What do You Think of The Proposed DSM-5 Revisions?
Dayle Jones
What do counselors think of the proposed revisions in the DSM-5? I’d like to know. The proposed changes will have a profound impact on the way counselors assess, diagnose and treat clients. So, counselors – we need you to voice your opinions about the DSM-5. The purpose of this blog is to provide a place for counselors to share their thoughts about the DSM-5. There are no length requirements – we just want to hear what you think about the DSM-5. Please post your thoughts in the comment section or email your thoughts to me at daylejones@ucf.edu.
K. Dayle Jones is a counselor and associate professor at the University of Central Florida. She chairs ACA’s DSM Task Force, which was formed to provide feedback to the American Psychiatric Association on proposed revisions to the DSM-5. Contact her at daylejones@ucf.edu.
Dear Dayle,
I would like to express my concern regarding some of the proposed changes in the DSM-V. It appears that there is a pervasive lowering of the threshold for diagnostic criteria. One specific example that is close to home for me would be the withdrawal of bereavement as an adjustment disorder. I lost my dad unexpectedly three months ago and have been what would now be diagnosed as clinically depressed under the proposed APA changes. This seems like a natural part of the grieving process and not a diagnosable condition as the symptoms have been abating; it almost adds insult to injury to be told that my bereavement is “disordered”. Thank you for the work that you have done in this area and for illuminating the possible impact of the changes.
Best regards,
Shannon Ray, Ph.D., LMHC, NCC, CCMHC
Assistant Professor
Center for Psychological Studies
Nova Southeastern University
The DSM-5 is turning out to be a very ambitious document. The various work groups were encouraged to think “outside the box” and that “everything is on the table.” In short, the current task force is making many philosophical and practical changes to DSM classification system that will likewise require practitioners to adopt those changes to their work. Though the DSM system was meant to be atheoretical , some critics have quipped that any classification system reflects the theoretical and philosophical assumptions of its authors. I tend to agree with the critics. Though I see the value of having a common language between mental health professions to reduce confusion in diagnosis and treatment, it would be naïve of us to not acknowledge the clear association between the DSM and the medical model with all of its presuppositions and logical consequences. Presuppositions and consequences that have historical stood in stark contrast to those that have guided the counseling profession since its inception. From what I have read about the revisions in the DSM-5, it promises to make an expansion of diagnostic labeling so that more people will qualify for diagnosis who previously would have be considered “normal” or “healthy.” In other words, they are erring on the side of false positive diagnosis as opposed to the last edition that sought to err on the side of false negative diagnosis. What I have yet to see is if the risk of giving people a label they might not deserve is worth the insurance costs and social stigmatization.
Hello Ms. Jones,
I am a graduate student in the Marriage and family track through Capella University as well as a student member of ACA, APA, and AAMFT. I’ve been following the development of the DSM-5 with much curiosity and the hope that more systemic theory will be included. It is exciting to see the development of criteria which will be used by the counseling community as well as the medical community to treat individuals who have problems.
A major concern I have with the development of the DSM-5 thus far is the criteria for Personality Disorders. These disorders are difficult to identify and treat, even with the specific criteria available in the DSM-IV-TR. In looking over the criteria for Personality Disorders in the DSM-V the traits given are very vague and there are very little treatment options outlined. Anyone from a medical perspective with very little training in counseling theory will very rarely want to utilize the current criteria in the DSM-5 for these disorders. Even for those who have had psychotherapy training the criteria is confusing and will probably result in misdiagnosis for the individual who is exhibiting signs of a Personality Disorder. Granted I am only a student, but it would be extremely helpful to enlist the help of consultants who specialize in the treatment of Personality Disorders to define them in the DSM-5.
Thanks for giving counselors and students this opportunity to contribute to the DSM-5.
Sincerely,
Jennifer Dattilo Watts
Please see the two articles below to which I concur.
Lovefraud’s comment about sociopaths for the DSM-5
http://www.lovefraud.com/blog/2010/04/16/lovefrauds-comment-about-sociopaths-for-the-dsm-5/
Donna Andersen and Dr. Liane Leedom present research at psychopathy conference
(Also pdf brochure and poster links at the bottom of article)
http://www.lovefraud.com/blog/2011/05/27/donna-andersen-and-dr-liane-leedom-present-research-at-psychopathy-conference/
Thanks for the opportunity to respond.
Greetings.
I am grateful for the opportunity to work with people from a variety of backgrounds and settings. While I appreciate the work of those charged with developing the DSM V, I am reluctant to pass judgment on a work in progress (and it seems the DSM series has been so from the beginning). I find the additions, changes, and deletions helpful for a number of reasons and can remember when what was once thought to be orthodox became the next generations heresy.
As a professional who shares a common language and training in mental health with colleagues in Psychiatry and Psychology, I remain optimistic that the tool will continue to serve us well for the next 10-15 years as the earlier versions have done. The real test of the new version is how well it fits those we serve and whether its use will lead our clients and patients to a point of recovery the DSM V was intended to clarify, identify and treat.
Additionally, since the DSM V is not the only model of revelation available to the counseling profession as a source for understanding the human condition, I am open to exploring its descriptions of the phenomena I encounter on a regular basis and use it as the tool it was intended to be. And fortunately, there is always room for revision with the DSM V R!
Jay Tatum, MDiv, BCC
Hello,
I’ve been following threads regarding the controversies that are surfacing in regards to the DSM 5. I believe that the current membership of the American Psychiatric Association (according to their website,www.psych.org) is 38,000 strong. In contrast, Dayle mentioned 115,000 professional counselors. The American Psychiatric Association, I assume, is not considering the philosophical underpinnings of the counseling profession, but is perpetuating the medical model of helping: mainly,diagnose a problem and treat it (usually with medicine).
The problem as I see it is that counselors are railing against pigeon-holing people, but because the DSM has been the gold standard for years and years, no other viable alternative (with the exception of the ICD) exists.
Personally, I rely on the DSM-IV-TR daily in my work at a community mental health clinic. Reading through the threads and discussions regarding the proposed DSM 5 gives me pause as I think about the clients that come in requesting services. Will we continue to push drugs on them as a first-line of treatment? If so, then aren’t we perpetuating the values of the American Psychiatric Association rather than our own philosophy?
I do believe in the whole-person-in-context approach to understanding another person. While medications are certainly efficacious for many, I am saddened by the strong push to make psychotropic drugs common-place (for instance, the increase in advertising on television).
If thee new DSM 5 makes it “easier” to be diagnosed, and the drug companies are pushing their wares into our living rooms, then who will benefit the most? Our clients or big business?