University of Calgary

Long-awaited update to key psychology manual stirs debate among teachers, mental health professionals

UToday HomeMay 30, 2013

Tom Strong, professor of Counselling Psychology in the Faculty of Education, says future uses of the Diagnostic and Statistical Manual of Mental Disorders are in limbo because of disagreements among mental health professionals over changes in the text.Tom Strong, professor of Counselling Psychology in the Faculty of Education, says future uses of the Diagnostic and Statistical Manual of Mental Disorders are in doubt because of disagreements among mental health professionals over changes in the text.Along with every educational jurisdiction in North America, Alberta Education has a code for every special needs student. That code was developed using the Diagnostic and Statistical Manual of Mental Disorders, or DSM.

The manual, published by the American Psychiatric Association, was first developed in the 1950s and has been updated roughly every decade. The most recent version was the DSM-IV, last revised in 2000.

The manual could be considered the “bible” for mental health professionals, school psychologists, researchers, policymakers, and others to determine and classify psychological disorders across the board with universal acceptance and understanding of the diagnoses.

That is, until this week, when the DSM-5 was published.

The latest version of the manual has come under fire for some of the key changes from the previous version.

“The process leading to the development of the DSM-5 has been hugely controversial within psychiatry,” says Tom Strong, professor of Counselling Psychology in the Faculty of Education. “The American Psychiatric Association voted to approve its publication in December while the U.S. National Institute of Mental Health withdrew its support of any research to be funded by the DSM-5.

“This is a major move that pits two Goliaths in mental health against each other.”

Critics of the DSM-5 are many. Their list of complaints include the reliability of the diagnostic criteria; the removal of the criteria that took into account environmental factors in a diagnosis; the fact that the DSM uses observation of symptoms rather than the deeper causes of the disorders being diagnosed; and the influence of pharmaceutical companies on the authors, which raises the spectre of conflict of interest and what’s being referred to as the “medicalization” of counselling psychology.

It’s the last concern that has Strong, who is also the associate dean of research in the faculty, alarmed. Strong currently holds a Social Sciences and Humanities Research Council (SSHRC) grant to look into the topic of the medicalization of counsellor education which he says indirectly relates to the medicalization of the field of counselling.

Strong says that, fundamentally, DSM diagnoses are so woven into public thinking, mental health administration, and school special services administration that they have become almost unquestioned. But now, with the latest version causing so much controversy, future uses of the DSM are up in the air.

“The concerns clients present to counsellors often need more than the symptom identification and relief that the DSM-5will offer,” says Strong. “I think we’ll have to wait and see how this all plays out within the professional community.”

 

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