Why DSM-5 Is a Step Forward for Psychotherapy

As therapists, we’re well aware that our clients in psychological distress rarely—if ever—fit neatly into the strict confines of DSM disorders. Even Darrel Regier, vice chair of the DSM-5 Task Force and director of the APA’s research division, knows perfectly well that psychiatric diagnosis is often inherently ambiguous and that the science behind the classification system isn’t all it might be. Still, he argues that the DSM-5 is actually more equipped than previous versions to reflect the many dimensions of clients’ presenting problems. After all, its new severity scales make intuitive sense: most mental states, ordered or disordered, exist along a continuum and vary according to how long they last, how powerful or debilitating or animating or life-altering they are, and how much they bleed into other such states.

In this video clip, Regier talks about how the new definition of a major depressive disorder in DSM-5 better enables clinicians to diagnose clients who exhibit symptoms for both depression and anxiety. In the Networker Webcast series The Uproar Over DSM-5, Regier goes on to detail how a more dimensional approach to diagnosis can clarify the goals and challenges of treatment.

Ultimately, Regier regards DSM-5 not as The Law, certainly not any kind of bible of psychiatry, but as a work in progress, “a set of scientific hypotheses that are intended to be tested and disproved if the evidence isn’t found to support them.”

“We wanted to get therapists out of the mindset of having to find the exact diagnosis to fit a certain patient,” Regier states in a recent Networker interview. “DSM-5 looks at diagnostic categories as indicating a central tendency. In other words, it encourages therapists to think about the diagnosis that best characterizes an individual in terms of the range of symptoms they’re displaying.”

The Uproar Over DSM-5
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