Back to Basics: Using the DSM-5 to Benefit Clients

Field: Health Professions (Health Sciences)

It is a pleasure to introduce this special DSM-5 edition of The Professional Counselor, which provides a solid primer regarding changes in DSM-5 diagnosis process and how these changes will likely impact mental health professionals. Changes within DSM-5 have prompted counselors to revisit basics of diagnosis and consider cessation of certain conventions (e.g., multiaxial system) and what these changes mean to counselors as they perform their vital work for benefit of clients. The unprecedented inclusion of various mental health professionals in development of DSM-5 is an inherent recognition of how this tool is being used across a wide range of professional disciplines that focus on psychopathology. I hope these articles not only inform, but encourage further research into practical use of DSM-5, stimulate new clinical perspectives in mental illness (American Psychiatric Association [APA], 2013, p. 10), and inspire continued professional dialogue around DSM nosology and diagnostic processes.Keywords: DSM-5, diagnosis, psychopathology, mental illness, multiaxial systemThe fifth edition of Diagnostic and Statistical Manual for Mental Disorders (DSM-5) is an update of a major diagnostic tool (APA, 2013). The manual was originally designed to help mental health professionals within a wide variety of disciplines assess and conceptualize cases in which people were suffering from mental distress. This conceptualization is important in that it facilitates an understanding in a common language toward development of treatment planning to address complex and entrenched symptomology. The DSM has undergone numerous iterations and represents current knowledge of mental health professionals about mental illness (APA, 2013). One of primary aims of DSM-5 workgroups was to align manual with current version of International Classification of Diseases (ICD-9). In addition, political, social, legal and cultural dynamics influenced development of DSM-5-and not without controversy (Greenberg, 2013; Locke, 2011; Linde, 2010; Pomeroy & Anderson, 2013). As with any tool, concerns have emerged about potential of misuse. It is professional responsibility of skilled and ethical mental health counselors and other professionals to prevent misapplication of manual (American Counseling Association [ACA], 2014, E.l.b, E.5.a-d). Walsh (2007) succinctly noted that the primary goal of DSM is to enhance care of individuals with psychiatric disorders (p. S3).The introduction of DSM-IV-TR states that DSM has been used by numerous mental health practitioners (APA, 2000), with no mention of their investment as legitimate stakeholders in process of DSM development. Well before final revision of DSM-5, various mental health professionals, organizations and other relevant collaborators helped formulate manual in unprecedented capacities. In introduction to DSM-5 (APA, 2013) authors intentionally state that numerous stakeholders were involved in DSM5 5 including counselors and patients, families, lawyers, consumer organizations, and advocacy groups (p. 6). Of particular note was inclusion of national organizations such as ACA in form of a DSM-5 task force, which submitted position statements and recommendations to APA. Various mental health professionals participated directly in formulation of DSM-5, primarily in field trials which supplied valuable information about how proposed revisions performed in everyday clinical settings (p. 8). Much of data supports use of more than 60 cross-cutting and severity symptom measures (see http ://www.psvchiatrv. org/practice/dsm/dsm5/online-assessment-measuresVClinical UtilityFirst (2010) reported that utilizing broad and diverse populations of mental health professionals provides rigor for clinical utility. Achieving clinical utility within DSM diagnostic processes meets following four objectives:1. …