Sterling Interpretive Framework — Clinical Reasoning Domain SIF-CR v1.0
Sterling Interpretive Framework — Clinical Reasoning Domain
SIF-CR v1.0
A Domain-Specific Instrument for the Correct Reading of Clinical Situations
Instrument architecture: Dave Kelly. Theoretical foundations: the Stoic philosophical corpus of Grant C. Sterling, including Core Stoicism, the Sterling Logic Engine v4.0, the Sterling Decision Framework v3.3, the Sterling Interpretive Framework v1.0, and the CIA and SIF runs on William Glasser’s Choice Theory (same session). Primary clinical interlocutor: William Glasser, Reality Therapy (1965) and Choice Theory (1998). Stoic Hermeneutics theoretical foundation: Document 36, System Map v2.7. Prose rendering: Claude, 2026.
Instrument Scope and Governing Claim
The Sterling Interpretive Framework — Clinical Reasoning Domain (SIF-CR) is a domain-specific adaptation of the Sterling Interpretive Framework v1.0 for the correct reading of clinical situations. It governs what the practitioner, the patient, and any observer of clinical work are doing when they form propositions about a patient’s situation, its causes, and what it requires.
A clinical situation is a text in the SIF’s sense: it has determinate features that constrain correct reading, the clinician is prior to his therapeutic formation and capable of apprehending those features through correct use of his rational faculty, and the appropriate object of aim in any clinical reading is correspondence to what the patient’s situation actually contains — not to what the clinician’s therapeutic formation predicts it must contain, not to what the patient’s own self-presentation asserts it contains, and not to what the therapeutic community endorses as the correct formulation.
The SIF-CR governs two distinct clinical acts: the clinician’s reading of the patient’s situation, and the patient’s reading of his own situation. Both are interpretive acts in the SIF’s sense. Both are subject to Formation Capture. Both require the correct use of impressions through inner discourse. The instrument addresses both.
The Founding Demonstration
The SIF-CR is grounded in three completed runs on William Glasser’s Choice Theory framework:
The pre-instrument reading established the philosophical architecture of the clinical domain: the three formation traditions requiring stripping (therapeutic, humanistic, anti-psychiatry), the two loci of maximum philosophical productivity (the all-behavior-is-chosen claim and the five basic needs), and the level difference between Glasser’s behavioral intervention and the Stoic framework’s assent-level intervention.
The formal SIF run established the governing finding: Glasser’s framework and the Stoic framework are operating at different levels of the same structure. Glasser operates at the behavioral output level; the Stoic framework operates at the evaluative second assent that generates the behavioral event. The frameworks are consecutive rather than competing.
The CIA run established the presupposition pattern: two Divergent findings (C3 moral realism, C5 ethical intuitionism), four Partially Convergent findings, No Dissolution. The Divergent findings identify precisely what the Stoic framework adds: the capacity to ask whether the patient’s needs are correctly valued, grounded in the moral realism and ethical intuitionism Glasser’s framework lacks.
The second SIF run confirmed the most important finding for the rapprochement: Glasser’s texts are philosophically open on the metaphysics of the self. The divergence from substance dualism is produced by an absence of theorization rather than an explicit contrary claim. The Stoic account of the prohairesis can be introduced as a philosophical completion rather than a correction.
These four runs together constitute the founding demonstration of the SIF-CR. Each subsequent SIF-CR run cites them as the instrument’s operational precedent.
The Clinical Domain’s Specific Features
Three features distinguish the clinical domain from literary, legal, and historical interpretation and require domain-specific adaptation of the general SIF.
The text is the patient’s situation, not a written document. The clinical “text” is the presenting situation — what the patient reports, what the clinician observes, what the behavioral and emotional pattern reveals, and what the history discloses. This text is not fixed. It develops across sessions, it is partially constructed by the clinical relationship itself, and it is interpreted by both the clinician and the patient simultaneously. The SIF-CR must address both readings.
Two interpreters are always present. The clinician brings a therapeutic formation that may produce Formation Capture in his reading of the patient’s situation. The patient brings a self-narrative formation — the story he tells himself about what his situation is and what has caused it — that may produce Formation Capture in his reading of his own situation. The SIF-CR identifies both formations and strips both where they distort correspondence to the situation’s actual features.
The correspondence standard is double. The clinician’s reading must correspond to the patient’s actual situation. The patient’s reading must correspond to the moral reality about his situation — specifically, to the correct value status of the external conditions he is pursuing or avoiding. The first correspondence is empirical: what is actually producing the patient’s disturbance? The second correspondence is moral: is the patient holding the objects of his need-satisfaction as preferred indifferents or as genuine goods? The SIF-CR governs both correspondence tests distinctly.
The Clinical Domain’s Formation Traditions
The clinical domain has specific formation traditions that function as the sources of clinical Formation Capture. Each must be named before the instrument’s steps can operate effectively.
The Psychodynamic Formation imports the presupposition that the patient’s current disturbance is produced by unconscious conflicts originating in early developmental experience. It generates readings that trace every presenting problem to historical relational damage and that treat insight into those origins as the primary therapeutic instrument. Clinical Formation Capture from this formation: the clinician reads the patient’s current situation through the lens of assumed developmental causation rather than attending to the patient’s actual present situation and its actual features.
The CBT Formation imports the presupposition that disturbance is produced by maladaptive cognitive patterns — automatic negative thoughts, cognitive distortions — that can be identified and corrected through structured techniques. It generates readings that treat the patient’s thoughts as the primary object of clinical intervention. Clinical Formation Capture from this formation: the clinician applies cognitive restructuring techniques to the patient’s thoughts without examining whether the thoughts are false value judgments about externals or merely inaccurate factual beliefs. The Stoic framework and CBT share the insight that cognition generates emotion; they diverge on whether the governing correction is epistemological (are these thoughts accurate?) or evaluative (are these value judgments correct?).
The Choice Theory Formation — the founding demonstration’s primary subject — imports the presupposition that disturbance is produced by the gap between the patient’s Quality World and his perceived real world, and that the therapeutic work addresses how effectively the patient is pursuing his Quality World images. Clinical Formation Capture from this formation: the clinician helps the patient pursue his Quality World images more effectively without examining whether those images reflect correct value judgment. The five basic needs are taken as given; the question whether the needs are correctly held is not available within the formation.
The Medical Model Formation imports the presupposition that psychological disturbance is a disease requiring diagnosis and pharmacological treatment. Clinical Formation Capture from this formation: the clinician reads the patient’s behavioral and emotional pattern as symptom expression rather than as the patient’s best current attempt to satisfy needs through available behavioral repertoire.
The Patient’s Self-Narrative Formation is the most clinically significant formation for the SIF-CR’s second correspondence test. The patient arrives with a story about his situation: what happened, what it means, who is responsible, what is genuinely good or evil in his life. This self-narrative is typically organized around false value judgments — around the assignment of genuine-good status to preferred indifferents, and genuine-evil status to dispreferred indifferents. The patient’s self-narrative formation generates the impressions that prosochē is designed to examine. It is the primary object of the patient’s own SIF-CR run.
Named Failure Modes — Clinical Domain
The six general SIF failure modes apply throughout. The clinical domain generates six additional specific failure modes.
7. THERAPEUTIC FORMATION SUBSTITUTION: The clinician substitutes his therapeutic school’s formulation for correspondence to the patient’s actual situation. The psychodynamic clinician sees attachment wounds; the CBT clinician sees cognitive distortions; the Choice Theory clinician sees Quality World gaps — regardless of whether these formulations correspond to the specific features of this patient’s actual situation. This is Formation Capture at the clinical level: the formation governs the reading before the patient’s situation has been genuinely attended to.
8. SELF-NARRATIVE COLLUSION: The clinician accepts the patient’s self-narrative formation without examination, treating the patient’s account of his situation as the authoritative starting point rather than as a formation to be tested against the situation’s actual features. This is the clinical equivalent of Community Substitution: the patient’s self-described community of one is substituted for correspondence to what is actually there.
9. NEED-SATISFACTION SUBSTITUTION: The clinician treats effective need-satisfaction as the governing standard of therapeutic success rather than the correct relationship of the patient to his own needs. Helping the patient pursue his Quality World images more effectively is the appropriate first question; whether the images reflect correct value judgment is the necessary second question. Stopping at the first without proceeding to the second is this failure mode.
10. LEVEL CONFUSION: The clinician intervenes at the behavioral level (Discipline of Action) when the governing problem is at the evaluative level (Discipline of Desire). Redirecting Total Behavior while leaving the false value judgment that generates it intact is the clinical expression of addressing symptoms rather than sources. The corrective is always to ask: what evaluative second assent is generating this behavioral event?
11. VALUE QUESTION AVOIDANCE: The clinician recognizes that the patient is holding a preferred indifferent as a genuine good but avoids the question whether this is correctly valued — either because the therapeutic formation does not provide tools for asking it, or because the clinical relationship does not yet support it, or because the clinician himself holds the same false value judgment. This failure mode is often invisible precisely because it is produced by the clinician’s own formation rather than the patient’s.
12. DISSOLUTION OF AGENCY: The clinician’s formulation removes the patient’s genuine authorship of his behavioral responses — attributing his situation entirely to external conditions, developmental damage, neurochemical states, or social structures in ways that leave no space for the patient’s own governing act of evaluative assent. This failure mode produces the Full Dissolution finding in CIA terms: the patient adopts a self-description that closes the space in which the Stoic practical program operates.
The Five Governing Propositions — Clinical Domain
The five general SIF governing propositions (IP1–IP5) apply throughout. The clinical domain adds five domain-specific propositions.
CP1 — The Patient’s Situation Has Determinate Features That Constrain Correct Clinical Reading. The patient’s situation is not a blank surface on which therapeutic formations project meanings. It contains actual features: the specific external conditions present, the specific behavioral responses being generated, the specific value judgments embedded in the patient’s impressions of his situation, and the specific needs the symptomatic behavior is attempting to satisfy. These are facts. Clinical readings can correspond to them or fail to correspond to them. [Governs the clinician’s reading. Corpus: IP3, C3, C4.]
CP2 — The Patient Is Prior to His Self-Narrative Formation. The patient who arrives with a story about his situation — who is responsible, what is genuinely good or evil, what he needs — is not constituted by that story. He is a rational faculty that has formed that story through his history of evaluative assents, correct and incorrect. He can examine it. He can identify where it has introduced false value judgments. He can correct his relationship to his own situation. The self-narrative formation does not exhaust the patient. [Governs the patient’s own reading. Corpus: IP1, C1, C2.]
CP3 — The Appropriate Object of Aim in Clinical Reading Is the Evaluative Second Assent, Not the Behavioral Output. The governing clinical question is not what the patient is doing but what evaluative impression the patient has assented to that is generating what he is doing. The behavioral event is the output; the evaluative second assent is the source. Clinical work that addresses only the output without reaching the source is working at the wrong level. [Governs the level of intervention. Corpus: IP4, Props 23–26, Nine Excerpts Section 7.]
CP4 — The Patient’s Needs Are Preferred Indifferents, Not Genuine Goods. The five basic needs Glasser identifies — survival, love and belonging, power, freedom, and fun — are appropriate objects of rational pursuit. They are preferred indifferents: appropriate to aim at, rational to prefer, not appropriate to stake identity or equanimity on. The clinical question whether the patient is holding his needs as preferred indifferents or as genuine goods is the question that determines whether effective need-satisfaction produces genuine equanimity or merely more effective symptom management. [Governs the value question. Corpus: Props 16–22, Core Stoicism Theorems 10 and 12, Foundation Two.]
CP5 — The Reserve Clause Governs Both Clinical Readings. The clinician aims at the correct reading of the patient’s situation with full rational effort and holds the therapeutic outcome with reservation: whether the patient changes, improves, or achieves eudaimonia is not in the clinician’s control and cannot be the governing standard of the clinician’s own self-assessment. The patient aims at the correct relationship to his own situation with full rational effort and holds the external outcomes his needs require with reservation: they are preferred indifferents, appropriate to pursue, not appropriate to stake equanimity on. [Governs both readers. Corpus: Prop 62, Nine Excerpts Theorem 19, Foundation Three.]
The Six Steps — Clinical Domain Adaptations
Step 0 — Reader Check (Clinical)
Core question: What dominant clinical impressions does the clinician bring to this patient’s situation before genuinely attending to it?
Before engaging with the patient’s situation, the clinician identifies the dominant impressions his therapeutic formation generates about patients of this presenting type. These are the presuppositions — about what is likely causing the disturbance, what the patient probably needs, what the correct formulation probably is — that the formation produces before the specific patient’s specific situation has been genuinely attended to.
The patient simultaneously identifies the dominant impressions his self-narrative formation generates about his own situation — the story he has told himself about what is happening and what it means, held as hypothesis rather than as conclusion.
Formation-derived impressions to be identified by the clinician: Which therapeutic school’s categories are being pre-applied? What type of patient does this presentation resemble in the formation’s taxonomy? What formulation does the formation predict before the situation has been fully attended to?
Formation-derived impressions to be identified by the patient: Who or what does the self-narrative assign responsibility to for the disturbance? What externals has the narrative assigned genuine-good or genuine-evil status to? What is the self-narrative’s governing false value judgment?
Self-Audit at Step 0: Have both sets of formation-derived impressions been identified explicitly? Are all held as hypotheses rather than conclusions? Named failure mode 7 (THERAPEUTIC FORMATION SUBSTITUTION) check: is the therapeutic formation governing the reading before the patient’s situation has been attended to? Named failure mode 8 (SELF-NARRATIVE COLLUSION) check: is the patient’s self-narrative being accepted as authoritative before it has been tested? No failures detected / failure identified before proceeding.
Step 1 — Purview Check (Clinical)
Core question: What is actually the clinician’s to determine, and what is the patient’s? What is either’s to determine at all?
The Purview Check in the clinical domain establishes three boundaries simultaneously.
First boundary — clinician’s purview: the quality of the clinician’s attention to the patient’s actual situation, the honesty of his correspondence test, and the integrity of his clinical reasoning. Not in his purview: whether the patient changes, the therapeutic outcomes, and the patient’s reception of the clinical work.
Second boundary — patient’s purview: the patient’s own evaluative second assents — whether he holds his needs as preferred indifferents or as genuine goods, whether he examines his impressions before assenting to them, and whether he acts from correct evaluation of his situation. Not in his purview: other people’s behavior, the external conditions his needs require, the outcomes of his behavioral choices.
Third boundary — neither’s purview: external events, other people’s choices, bodily conditions beyond what voluntary action can address, and the social structures within which the patient’s situation is embedded. These are the dispreferred indifferents the clinical work must neither dramatize as genuine evils nor dismiss as irrelevant to rational response.
The evidence types relevant to the clinical correspondence test are: the patient’s behavioral pattern as directly observable; the patient’s self-report of his impressions, desires, and aversions; the history of situations in which disturbance has arisen; the specific external conditions the patient assigns genuine-good or genuine-evil status to; and the specific needs the symptomatic behavior is attempting to satisfy.
Self-Audit at Step 1: Have all three purview boundaries been established? Have relevant evidence types been identified? Have externals been distinguished from what is within the patient’s genuine purview? No failures detected / failure identified before proceeding.
Step 2 — Formation Strip (Clinical)
Core question: Which formation-derived impressions — the clinician’s therapeutic formation and the patient’s self-narrative formation — survive the correspondence test, and which must be stripped?
The Formation Strip in the clinical domain operates on two formations simultaneously.
Stripping the clinician’s therapeutic formation: For each formation-derived clinical impression identified in Step 0, apply the formation test: does this formulation correspond to a feature this patient’s actual situation actually has, or does it correspond to a feature the therapeutic formation predicts patients of this presenting type typically have? A psychodynamic formulation that traces the current disturbance to attachment damage must be tested against whether this patient’s actual history and behavioral pattern support that formulation, rather than whether patients of this type typically show such patterns. A Choice Theory formulation that identifies the Quality World gap must be tested against what this patient’s actual Quality World images are and what specific gap exists in this situation.
Stripping the patient’s self-narrative formation: For each self-narrative impression identified in Step 0, apply the formation test: does this impression correspond to a feature of the patient’s situation that is actually there, or does it correspond to a story the patient has told himself that assigns false value status to features of his situation? The patient’s self-narrative that his partner’s behavior is genuinely harmful to his good must be tested against whether the partner’s behavior is genuinely evil (in which case the impression may be factually correct but evaluatively false: the behavior is a dispreferred indifferent, not a genuine evil) or whether the impression has also distorted the factual first assent.
The Formation Strip in the clinical domain does not dismiss either the therapeutic formation or the patient’s self-narrative as simply wrong. Both contain genuine information. The therapeutic formation has accumulated clinical wisdom about patterns that are real. The patient’s self-narrative contains genuine information about what he has experienced and how he has interpreted it. What the Formation Strip strips is the presupposition that either formation’s account is authoritative rather than hypothesis. After stripping, both accounts remain available as evidence to be weighed rather than frameworks to govern the reading.
Self-Audit at Step 2: Have both formations been stripped? Has each formation-derived impression been restated as a hypothesis? Named failure mode 7 (THERAPEUTIC FORMATION SUBSTITUTION) check: clear. Named failure mode 8 (SELF-NARRATIVE COLLUSION) check: clear. Named failure mode 1 (FORMATION CAPTURE) check: no formation-derived impression governs the reading without examination. No failures detected / failure identified before proceeding.
Step 3 — Aim Identification (Clinical)
Core question: What is the appropriate object of aim in reading this patient’s situation, and what features are relevant to pursuing it?
The appropriate object of aim in the clinical domain is double, corresponding to the two correspondence tests the SIF-CR governs.
The clinician’s aim: correspondence to the patient’s actual situation — what is actually producing the disturbance, what need the symptomatic behavior is attempting to satisfy, what evaluative second assent is generating the behavioral event, and what the situation actually requires in terms of correct behavioral response. This aim is held as a preferred indifferent: the clinician pursues correct clinical reading with full effort and holds the therapeutic outcome with reservation.
The patient’s aim: correspondence to the correct value status of the externals he is pursuing or avoiding — specifically, whether the objects of his needs are held as preferred indifferents or as genuine goods. This aim is held as a preferred indifferent: the patient pursues the correct relationship to his own situation with full effort and holds the external outcomes his needs require with reservation. This is CP4 operationalized as the patient’s governing therapeutic aim.
The two aims are consecutive in the order of clinical work, corresponding to the ordering of the Discipline of Desire before the Discipline of Action. The clinician’s first aim — what is actually producing the disturbance — corresponds to identifying the false evaluative second assent at the source. The second aim — what the situation requires in terms of behavioral response — corresponds to the Discipline of Action proceeding from correct evaluation.
Self-Audit at Step 3: Both aims stated as correspondence claims. Named failure mode 9 (NEED-SATISFACTION SUBSTITUTION) check: the aim includes both the empirical question (what is producing the disturbance) and the value question (are the needs correctly held). Named failure mode 3 (CONCLUSION CAPTURE) check: the aim is correspondence, not confirmation of a preferred therapeutic formulation. No failures detected / failure identified before proceeding.
Step 4 — Correspondence Determination (Clinical)
Core question: What do the features of the patient’s actual situation actually support?
Factual Uncertainty Gate — Clinical
Check One — Features in hand: What features of the patient’s situation does the clinician have direct access to? The patient’s behavioral pattern as directly observable; the patient’s self-report of impressions, desires, and aversions; the history of situations producing disturbance; the specific externals assigned genuine-good or genuine-evil status. State only what is actually present. Do not import probable or assumed features as established.
Check Two — Dependence assessment: For each uncertain clinical question, assess whether the reading depends on features that are established, uncertain but non-essential, or uncertain and essential. If a clinical formulation depends on a feature of the patient’s situation whose presence is uncertain, that uncertainty must enter the reservation and must not be suppressed in the statement of the formulation.
Check Three — Domain boundary: Identify where the clinical reading requires domain knowledge that lies outside the Stoic corpus: psychological theory, clinical nosology, pharmacological knowledge, developmental research. This knowledge enters the reading from outside the corpus and must be attributed to those sources rather than to the corpus directly. Domain knowledge can be necessary and legitimate; it must be identified as such.
Move One — The Empirical Correspondence Test
Attend to the patient’s actual situation with the aim of identifying what is actually producing the disturbance. The governing clinical question, drawn from CP3, is: what evaluative second assent is generating this behavioral event? Apply Glasser’s diagnostic insight here: every symptom is the patient’s behavioral system’s best current attempt to satisfy a need. What need is this symptom attempting to satisfy? What external condition has the patient assigned genuine-good or genuine-evil status to that is generating the gap between his Quality World and his perceived reality?
This is the Level Check that the SIF-CR adds to clinical reasoning. The clinician identifies not only what the patient is doing (Glasser’s WDEP level) but what evaluative impression is generating what he is doing (the Stoic framework’s assent level). The two levels of identification are distinct and both are required for the complete empirical correspondence test.
Move Two — The Value Correspondence Test
Having identified the evaluative second assent generating the behavioral event, the value correspondence test asks: does this evaluative second assent correspond to how things morally are? Specifically: is the external the patient has assigned genuine-good or genuine-evil status to actually a genuine good or evil, or is it a preferred indifferent?
The answer is governed by Core Stoicism Theorem 12: externals are never genuinely good or evil. If the evaluative second assent assigns genuine-good or genuine-evil status to an external — a relationship, an achievement, a bodily condition, another person’s behavior — the assent is false, precisely and without qualification. The clinical formulation must state this: the patient has assented to a false evaluative impression. The impression is not merely unhelpful or maladaptive. It is false.
This is the question Choice Theory cannot ask from its own resources (the CIA’s Divergent findings on C3 and C5) and that the SIF-CR adds: not is the patient pursuing his needs effectively, but is he holding his needs correctly? The value correspondence test is the clinical expression of Foundation Two.
Move Three — The Verification Test
Apply the verification test to both the empirical formulation and the value formulation: would these readings be selected if the clinician had no therapeutic formation-derived preference for them, if the patient had no self-narrative-derived preference for them, and if neither had any investment in the outcome of the reading? If the readings survive this test, they have passed the verification check. If either would not survive — if either depends on formation-derived preferences to appear compelling — it must be revised.
Self-Audit at Step 4: Factual Uncertainty Gate run and Gate Declaration produced. Move One (empirical correspondence test) completed at both the behavioral level and the evaluative assent level. Move Two (value correspondence test) completed against Core Stoicism Theorem 12. Move Three (verification test) applied. Named failure modes check: 7 (THERAPEUTIC FORMATION SUBSTITUTION), 8 (SELF-NARRATIVE COLLUSION), 9 (NEED-SATISFACTION SUBSTITUTION), 10 (LEVEL CONFUSION), 11 (VALUE QUESTION AVOIDANCE), 12 (DISSOLUTION OF AGENCY). No failures detected / failure identified before proceeding.
Step 5 — Reservation and Release (Clinical)
Core question: Can the clinical reading be stated honestly, held with appropriate reservation, and released?
The clinical reading is stated with appropriate qualification: what the situation’s actual features support, what remains uncertain, where domain knowledge rather than direct corpus application is doing the work, and where genuine clinical complexity resists confident formulation.
The clinician holds the reading as a preferred indifferent. The reception of the reading — whether the patient accepts the formulation, whether the therapeutic work produces the hoped-for outcomes, whether the clinical relationship develops as intended — is external. It does not retroactively alter the quality of the clinical reading, which is closed at the moment it is made.
The patient, where the SIF-CR has been conducted with or for him, holds his own reading as a preferred indifferent. He has aimed at the correct relationship to his own situation with full effort. Whether external conditions change, whether the needs his Quality World images require are satisfied, whether the therapeutic work produces the outcomes he hopes for — all of these are preferred indifferents to be pursued rationally and held with reservation. His equanimity does not depend on them. This is Foundation Three stated as the clinical reserve clause: right assent, consistently practiced, guarantees eudaimonia regardless of the therapeutic outcomes.
Self-Audit at Step 5: Reading stated with appropriate qualification. Genuine uncertainties acknowledged. Reading held as a preferred indifferent. Named failure mode 6 (RESERVE CLAUSE ABANDONMENT) check: neither the clinician’s equanimity nor the patient’s equanimity is staked on the therapeutic outcomes. Instrument run complete.
The Level Architecture: Glasser and the SIF-CR
The SIF-CR preserves Glasser’s WDEP procedure as a valid and effective clinical instrument operating at the behavioral level. The instrument does not replace it. It supplements it by adding the prior level that Glasser’s framework cannot reach from its own resources.
The complete clinical architecture, from most fundamental to most behavioral:
Level One — The Evaluative Second Assent (SIF-CR Move Two): Is the patient holding the objects of his needs as preferred indifferents or as genuine goods? This is the foundational false value judgment that generates everything else. The inner discourse addresses it directly: “Does it concern something external? Yes. Then it is an indifferent. It is neither good nor evil. My contentment does not depend on it.”
Level Two — The Behavioral Generation (SIF-CR Move One, Glasser Level): What evaluative impression is generating the behavioral event? What need is the symptom attempting to satisfy? What Quality World gap exists between what the patient perceives and what his Quality World pictures? Glasser’s framework addresses this level with precision and the WDEP procedure is the effective clinical instrument at this level.
Level Three — The Behavioral Output (Glasser’s WDEP): What is the patient currently doing? Is what he is doing getting him what he wants? What will he do differently? This level is where the caring habits replace the deadly habits, where the solving circle addresses relationship problems, where the plan is formulated and committed to.
The SIF-CR adds Level One to what Glasser’s framework provides at Levels Two and Three. The three levels together constitute the complete clinical architecture the combined framework makes available. No level substitutes for another; each addresses what the others cannot.
Relationship to the General SIF and the Corpus
The SIF-CR is the first domain-specific instrument derived from the general Sterling Interpretive Framework v1.0 (Document 34, System Map v2.7). It shares the general instrument’s six-step structure, five governing propositions (IP1–IP5), six named failure modes, Factual Uncertainty Gate, Mandatory Self-Audit, and reserve clause governance. All additions are domain-specific adaptations, not departures from the general instrument’s architecture.
The SIF-CR is structurally parallel to the SDF v3.3 at the clinical level in the same way the general SIF is parallel to the SDF at the interpretive level. The SDF governs the agent’s practical decisions about what to do. The SIF governs the interpreter’s epistemic decisions about what a text means. The SIF-CR governs the clinician’s epistemic decisions about what a clinical situation means and the patient’s epistemic decisions about what his own situation means. In all three instruments the governing Stoic claim is identical: the quality of the act is determined at the moment of its making, by the quality of the rational faculty’s engagement with what is actually before it, not by external outcomes. In the SDF, the act is a practical decision. In the SIF, the act is a literary or textual reading. In the SIF-CR, the act is a clinical reading. In all three cases, the rational faculty is prior to its conditions, capable of correct correspondence to what is actually there, and genuinely responsible for the quality of the assent it gives.
Sterling Interpretive Framework — Clinical Reasoning Domain (SIF-CR) v1.0. Instrument architecture: Dave Kelly, 2026. Theoretical foundations: the Stoic philosophical corpus of Grant C. Sterling. Founding demonstration: SIF runs on William Glasser’s Choice Theory (same session). Prose rendering: Claude.
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