What is a DSM?

If you have ever been in counseling, you may have heard your counselor refer to the “DSM” during a session. Or, even better, perhaps they have pulled out the DSM during session and have gone through specific material with you. DSM is the acronym for The Diagnostic and Statistical Manual of Mental Disorders. It is likely your counselor uses the most recent editions, which is the fifth edition or a revision of the fifth edition, the DSM 5-TR. These recent versions are bright purple and teal in color. They are akin to a counseling bible. In fact, just like bibles, there are little pocket versions that are available as well!

There are strengths and limitations when it comes to the use of the DSM. The DSM’s strengths include providing a dominant way that mental health professionals can communicate about client problems and struggles. The use of the DSM has created a system in which mental health professionals can receive reimbursement through coding which is submitted to insurance companies. The text serves as a manageable form to share complex client related information. It also acts as a broad lens for which mental health professionals can better understand their clients. The use of the DSM provides a means for counselors to better select evidence-based treatments corresponding with their clients’ disorders, can help the counselor to predict the course of treatment for the client, and can assist the counselor in determining if client problems are beyond the counselor’s scope of practice.

Unfortunately, there are limitations to the use of the DSM, which is why every so often, as advancements are made in the field, a new version of the DSM is released. Some limitations to the use of the DSM model include marginalizing, stigmatizing, and harming those that vary from the mainstream. If fact, in the first version of the DSM, which was published in 1952, homosexuality was listed as a sociopathic personality disturbance. While this categorization was discussed and argued against by those in the field of psychology at the time, it remained in the DSM until 1973. The use of the DSM can unintentionally exclude contextual and cross-cultural factors that contribute to the client’s experience. It also fails to recognize how client strengths and resources can impact their diagnosis. The DSM is not able to specifically predict outcomes for clients and it cannot specifically identify what caused the client to develop their diagnosis.

What is most important for you as a client to know, is the what is written in the DSM is not a self-fulfilling prophecy. Even if you meet some of the criteria for a diagnosis, if you do not meet all the criteria for a specific diagnosis, you cannot be given that diagnosis. If you do meet all the criteria for a diagnosis, once you no longer meet the criteria, you move into remission. Remission in the counseling world meets you have returned to a healthy level of functioning. After an extended period of being in remission, I hope you find yourself in recovery, which means you no longer have that diagnosis.

If you would like to speak to a professional counselor or psychologist about this and are in the Chicago area, please feel free to contact Olive Branch Counseling Associates, Inc. at 708-633-8000. We are located at 6819 West 167^th Street in Tinley Park, Illinois 60477.

Hillary R.,

Masters Level Intern, 2023

Sources –

Metcalf, M. (2019, June 1). Research guides: LGBTQIA+ studies: A resource guide: Introduction. Introduction – LGBTQIA+ Studies: A Resource Guide – Research Guides at Library of Congress. https://guides.loc.gov/lgbtq-studies/introduction