DSM-5: Do Counselors Really Want an Alternative?

Abstract

The results of a survey exploring counselor attitudes toward the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) are presented. The survey revealed that counselors have mixed attitudes toward the DSM. They view DSM positively and see it as both beneficial to their profession and important in determining treatment. They also believe that DSM-5 revisions reflect the best science available. Counselors worry that the DSM prioritizes diagnosis over treatment, have concerns about proposed DSM-5 revisions, and support developing alternatives to the DSM.

What Might an Alternative to the DSM Suitable for Psychotherapists Look Like?

“…If we are to develop an alternative system for these professionals, what might it look like? The results of my studies (Gayle & Raskin, 2017; Raskin & Gayle, 2016) on psychologist and counselor attitudes toward the DSM-5 lead me to believe that now is a good time to raise this question. After all, psychologists and counselors both indicated support for alternatives.…”

“…I recently coauthored a pair of studies on the latest version of the Diagnostic and Statistical Manual of Mental Disorders ( DSM-5 ; American Psychiatric Association, 2013). One study looked at psychologist ( N = 104) attitudes toward the DSM (Raskin & Gayle, 2016); the other looked at counselor ( N = 121) attitudes (Gayle & Raskin, 2017). Though there were some interesting differences between psychologists and counselors—the most striking one being that counselors were generally optimistic about the DSM-5 (Gayle & Raskin, 2017) while psychologists were pessimistic (Raskin & Gayle, 2016)—there were also some noteworthy similarities.…”

“…One study looked at psychologist ( N = 104) attitudes toward the DSM (Raskin & Gayle, 2016); the other looked at counselor ( N = 121) attitudes (Gayle & Raskin, 2017). Though there were some interesting differences between psychologists and counselors—the most striking one being that counselors were generally optimistic about the DSM-5 (Gayle & Raskin, 2017) while psychologists were pessimistic (Raskin & Gayle, 2016)—there were also some noteworthy similarities. Both psychologists and counselors had concerns about the DSM-5 despite more than 90% of them saying they plan to use it, which is not surprising given its centrality in helping professionals get paid.…”

“…Both psychologists and counselors had concerns about the DSM-5 despite more than 90% of them saying they plan to use it, which is not surprising given its centrality in helping professionals get paid. Nonetheless, when asked, psychologists and counselors expressed support for the development of alternatives to the DSM (Gayle & Raskin, 2017; Raskin & Gayle, 2016). We asked them about five possible alternatives— social-interpersonal diagnosis, mapping developmental and personal meanings, behavioral analysis, assessment of faulty beliefs/cognitions , and even nondiagnosis .…”

“…Our findings were telling. Psychologists expressed support for every alternative other than nondiagnosis (Raskin & Gayle, 2016), and counselors expressed support for every alternative including nondiagnosis (Gayle & Raskin, 2017). These studies provide evidence implying that many psychologists and counselors are interested in diagnostic alternatives suitable for psychotherapy.…”