Diagnostic and Statistics Manual 5th Ed. (DSM 5) Talking Points


    The DSM is built on the premise that we should help clients change their behaviors / thinking / feeling related to a particular situation. However, culturally competent counselors know that many times it's not the client but the situation that is sick and in need of changing - think of reactions to system oppression, family violence, etc.

    The primary use of the DSM as a tool for treatment planning is NOT a reason to have the DSM. Treatment planning should be based on an individual client's needs - and each one is unique.

    Using labels to describe clients' experiences and narratives is not useful, not accurate, and serves to depersonalize that client. Certainly the use of the DSM is not in service to the client.

    Use of the DSM for the sole purpose of securing reimbursement for clinical services is not ethical, helpful, or appropriate.

    The DSM is pathology focused rather than strengths or holistically based.

    The DSM is Eurocentric in that it requires labeling i.e. you either have "it" or you don't.

    The definition of "mental disorder" continues to be revised. In 1952, there were 106 disorders; in 1968, there were 182 disorders; in 1980, there were 265 disorders; and, in 1994, there were over 300 disorders listed in the DSM.

    The proposed DSM-5, collapses diagnostic categories and broadens them to include even more people as "mentally ill" than ever before.

    The proposed DSM medicalizes more diagnoses than ever before - and this results in even more individuals seeking / receiving pharmaceutical "solutions."

    Little or no references to the benefits of counseling, psychotherapy, traditional "talk therapy," or "developing" therapies is noted in the proposed DSM.

    There is no strength-based focus.

    The DSM does not take the absence of client resources into account.

    This text is 100% based on medical model - not a wellness or health- or strength-based model.

    The use of the DSM requires a one up / one down i.e. expert model rather than a collaborative or client-as-expert model of care.