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Shedding Light on DSM-5

Shedding Light on DSM-5

The View from the Trenches

By Martha Teater

March/April 2014

Since the release of DSM-5 in the spring of 2013, its critics have complained that the definitions in the new edition are now too broad, too inclusive (or not inclusive enough), too biological (or not biological enough), too vague, too quixotic, too unscientific, too much under the thumb of Big Pharma—the list goes on. However, since few people argue that mental health professionals can treat people or do research without some sort of diagnostic system, at this point—unless an unforeseen revolution upends the mental health field—we’ll have to make friends with DSM-5, particularly if we expect insurance companies to go on reimbursing us, or even if we simply want to maintain a decent sense of order in psychiatric diagnosis. Of course, DSM-5’s critics don’t like this, and their objections, like the National Institute of Mental Health’s disavowal of the new edition, have received widespread media coverage. But how are ordinary clinicians across the country adapting to the specifics of the new manual? As someone who’s given dozens of workshops on DSM-5 and trained thousands of therapists in its use, I’ve had a front-row seat on how psychotherapists have reacted to the changes it means for their practice.

Overall, most of the participants in my workshops seem to feel that the diagnostic system in the DSM-IV was handy and working just fine for them. As clinicians in mostly nonacademic settings, they’ve been unpersuaded that the…

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