DSM-5 ™ in Action: Chapter 1, Beginning the Process Introduction Application, 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. © 2014 S. Dziegielewski

The Diagnostic Assessment  Use 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. © 2014 S. Dziegielewski

 DSM and ICD  The DSM-IV-TR (2000) replaced the DSM-IV with diagnostic criteria remaining the same since January  DSM-5™ was unveiled in May © 2014 S. Dziegielewski

 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. © 2014 S. Dziegielewski

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? © 2014 S. Dziegielewski

 APA internal pressures  ICD-11 coming out in 2015  ICD-10-CM in October 2014  Interest groups © 2014 S. Dziegielewski

 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. © 2014 S. Dziegielewski

 DSM-I and DSM-II not very popular.  Paradigm shift occurred in DSM-III. © 2014 S. Dziegielewski

 DSM-I  DSM-II  DSM III (start of the categorical system)  DSM-III-R  DSM-IV  DSM-IV-TR  DSM-5 © 2014 S. Dziegielewski

Last meeting to finalize was December 2012 Previously website listed the proposed criteria: Over 300 advisors 13 work groups Task force of 27 members overseeing the process © 2014 S. Dziegielewski

 No more roman numerals!  Changes will be DSM-5.1, DSM-5.2, etc. © 2014 S. Dziegielewski

 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 © 2014 S. Dziegielewski

 PRO: Leads to uniform and improved diagnosis.  CON: Does not describe intervention strategy. © 2014 S. Dziegielewski

 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. © 2014 S. Dziegielewski

 PRO: Provides the basis for a comprehensive diagnostic and educational tool.  CON: Does not describe intervention strategy. © 2014 S. Dziegielewski

 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 © 2014 S. Dziegielewski

 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. © 2014 S. Dziegielewski

 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. © 2014 S. Dziegielewski

© 2013 S. Dziegielewski

 Completing the diagnostic assessment.  Using this information to assist with the treatment planning and practice strategy to follow. © 2014 S. Dziegielewski

 Can you highlight the different versions of the DSM from DSM-I to DSM-5?  What major changes were made and why? © 2014 S. Dziegielewski

 Label will stay with the client.  Label may not fully explain the supportive information relative to the client’s needs. © 2014 S. Dziegielewski