DSM-5 ™ in Action: Chapter 1, Beginning the Process Introduction Application, Assessment, and...

DSM-5™ in Action:Chapter 1, Beginning the Process

IntroductionApplication, Assessment, and

Treatment Strategy

by Sophia F. Dziegielewski, PhD, LCSW

© 2014 S. Dziegielewski

After completion of this chapter, students will be able to:

Identify two major roles for social workers and other mental health professionals.

Describe the development of the DSM diagnostic system.

Report at least two pros and cons (strengths and weaknesses) of this diagnostic system.

List two major concerns in placing a diagnosis.


The Diagnostic AssessmentUse is embedded in the history and practice of the clinical mental health counseling strategy. Helps to provide efficient and effective communication among professionals.Facilitates the application of clinical research, and best practices.


DSM and ICD

The DSM-IV-TR (2000) replaced the DSM-IV with diagnostic criteria remaining the same since January 1995.

DSM-5™ was unveiled in May 2013.


Most practitioners are knowledgeable about both books.

DSM is often the focus and has gained the greatest popularity in the United States and Canada.

DSM is the resource tool most often used by psychiatrists, psychologists, psychiatric nurses, social workers, and other mental health professionals.


Generally it is for the trained professional.This is changing as patients want to be Informed.Patients today want to be informed. Read about illness on the Internet.Show up with printouts. In DBT…could hand patient the criteria and could say “Here, read this,” which do you have and which do not fit?


APA internal pressures ICD-11 coming out in 2015 ICD-10-CM in October 2014 Interest groups


Used to provide structure in the diagnostic assessment.

Some professionals question whether it is being utilized properly.

Regardless of the controversy, continued popularity of the DSM makes it the most frequently used publication in the field of mental health.


DSM-I and DSM-II not very popular. Paradigm shift occurred in DSM-III.


DSM-IDSM-IIDSM III (start of the categorical system)

DSM-III-RDSM-IVDSM-IV-TRDSM-5


Last meeting to finalize was December 2012Previously website listed the proposed

criteria: http://www.dsm5.org

Over 300 advisors13 work groupsTask force of 27 members overseeing the process


No more roman numerals!

Changes will be DSM-5.1, DSM-5.2, etc.


Section I: Introduction and Directions on How to Use the Updated Manual

Section II: Outline of the Categorical Diagnoses That Eliminate the Multiaxial System (20 Disorder Chapters and Two Additional Supporting Information Categories)

Section III: Conditions That Require Future Research, Cultural Formulations, and Other Information

Appendices


PRO: Leads to uniform and improved diagnosis.

CON: Does not describe intervention strategy.


PRO: Improves informed professional communication through uniformity.

CON: Can provide limited information on the relationship between environmental considerations and aspects of the mental health condition.


PRO: Provides the basis for a comprehensive diagnostic and educational tool.

CON: Does not describe intervention strategy.


Formulated in response to the need to identify client problems in a way that health professionals could easily understand.

A classification system for adults.

Work of Karls & Wandrei, 1996


Provides common language. Describes social phenomena that can

facilitate treatment or ameliorate problems. Provides a measuring tool to facilitate

evaluating effectiveness. Facilitates communication among social

work practitioners and between practitioners, administrators, and researchers.

Supports person-in-environment approach.


Need training in behavioral assessment.

Utilize the behaviorally based biopsychosocial approach.

Emphasis on client behaviors. Training needs to include behavioral observation on how to construct observable and reliable categories of behavior.


Completing the diagnostic assessment. Using this information to assist with the

treatment planning and practice strategy to follow.


Can you highlight the different versions of the DSM from DSM-I to DSM-5?

What major changes were made and why?


Label will stay with the client. Label may not fully explain the supportive

information relative to the client’s needs.


DSM-5 ™ in Action: Chapter 1, Beginning the Process Introduction Application, Assessment, and...

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