The Hidden Toll of DSM-5 on Psychotherapy

How Increasing Medication Sales Hurt the Therapy Profession

Rich Simon


Allen Frances—author of Saving Normal: Has Psychiatric Diagnosis Gotten Out of Control?—is one of DSM-5’s most outspoken critics, but his ultimate target is an even larger issue. “Putting aside all the problems with DSM-5,” he says in an interview in the March/April 2014 issue of the Networker, “the simple fact is that psychiatric diagnosis has become way too loose.”

“When the diagnostic system gets loosened,” Allen tells us in this video clip, “the major economic effect is a dramatic increase in the sales of medications. And with this increase comes a tightening on the psychotherapy benefit because so much money gets funneled into the drug companies.”

“The drug companies are spending $70 billion advertising their products,” he says. “In contrast, psychotherapists are mom-and-pop operations. It’s not a fair fight--there’s no psychotherapy advertising industry. Nevertheless, psychotherapy for mild to moderate conditions is just as effective as drug treatment with longer effects. If you step back and think about a lifetime of being on unnecessary medication, which could have been avoided if psychotherapy had been the initial treatment, the lifetime costs are much less to keep people away from medication.”

In the Networker Webcast series The Uproar Over DSM-5, Allen further details the problem with diagnostic inflation and drug-company marketing, and what this means for psychotherapy.

The Uproar Over DSM-5
How to Use the New Standards with Confidence

Click here for full course details

Topic: Business of Therapy

Tags: Allen Frances | big pharma | Diagnostic and Statistical Manual | diagnostic system | drug advertising | drug treatment | DSM | dsm-5 | psychotherapists | psychotherapy

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4 Comments

Monday, June 16, 2014 9:29:34 PM | posted by Kathe Skinner, M.A.,
Wanna get paid by insurance? Then you gotta play the game, and the name of the game is "Diagnose". Most of the clients I see are "V-code clients": partner relational problems being the prime presentation. But insurance won't pay to work with these clients; the choice? Make 'em sick! In my view, the reason diagnoses are "loose" is because they're tied to money. "Sickening", huh?

Sunday, June 15, 2014 11:54:55 AM | posted by Elena Taurke
I agree that it is obvious that we need a massive and creative PSA campaign. What is less obvious is how loose diagnosis leads to increased medication prescribing.

Thursday, June 12, 2014 3:30:55 PM | posted by christineh3
For heaven's sake, why ever isn't there advertising for psychotherapy? American Psychological Association, American Counseling Association, National Association of Social Workers, we're talking hundreds of thousands of professionals and mucho dinero. If we could just stop our petty turf wars over state licensure issues and insurance reimbursement and do a cooperative advertising campaign, we could deploy some pushback against pharma dominance. But no, somehow we're not smart enough to outwit the pharma and insurance industries divide and conquer strategy against therapists. Talk about being disempowered! Duh! How could we be so stupid as to not see through this and to not activate our empowerment, when we focus on this sort of issue all the time with our clients? Anybody smelling the coffee here? Or do we just keep taking the victim stance. Oh come on, let's get a clue and develop an ad campaign, including PSA's (Public Service Announcements) which are free to air, cost only for production.

Tuesday, June 10, 2014 8:08:14 PM | posted by dan mclean
its like the potential integration of economics and the environment; if we're interested in wellness, we will get a grip on the value of pharmacology as an adjunct to relational experience, not as a primary driver