Couple and Family Counseling and the DSM-5

This is a social work class : Social Work Practice With Couples and Family Systems

Though the philosophy and values surrounding couple and family counseling emphasize prevention and wellness, awareness of diagnosis is important when interacting with other mental health professionals who may view mental health issues through the medical model. The DSM-5, the primary diagnostic system/manual used in the United States by such professionals, identifies and describes individual mental health disorders, not relational issues or disorders.
Those mental health professionals who adopt a systems or relational view of mental health have been able to implement small changes within the DSM in its subsequent editions, and these changes acknowledge the systemic influence on certain individual disorders. Nevertheless, there is not yet an adopted diagnostic structure for relational problems. Therefore, you may sometimes need to negotiate your relational perspective with other professionals and communicate client matters with insurance reimbursement boards (who see mental health problems as individual in nature) in their language.
For this Discussion, you will examine the DSM-5 and how it informs your professional practice. You also explore the advantages and disadvantages of being familiar with the DSM-5.

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By Day 4
Post an example of a specific instance in which you may need to consult with another mental health professional who utilizes the DSM-5. Then, explain how your familiarity with the DSM-5 may influence this consultation. Next, explain one advantage and one disadvantage of a couple and family practitioner being familiar with the DSM-5. Be specific.
Be sure to support your postings and responses with specific references to the resources.
Read a selection of your colleagues’ postings.


By Day 6

Respond to two of your colleagues’ postings in one or more of the following ways:
Ask a probing question.
Share an insight from having read your colleague’s posting.
Offer and support an opinion.
Make a suggestion.
Expand on your colleague’s posting.


Post an example of a specific instance in which you may need to consult with another mental health professional who utilizes the DSM-5.
Treating a couple where one partner or both people has a mental illness may require me to consult with another health care professional or a team of professionals who shares a common interest and who also utilizes the DSM-5 catalog. For example, major depressive disorder or borderline personality disorder impacts not only the individual, but the couple/family group (Gurman, Lebow, & Snyder, 2015, p. 622). When working with this family, I may find the therapeutic process challenging in meeting the needs of each family member. Oftentimes an individual, couple/family who is suffering from a mental illness may bring along other issues (i.e. marital problems, addiction) that require intense and ongoing treatment. Therefore, I will need to consult with another therapist or a multidisciplinary team for advice on how to better assist the client(s) and to avoid becoming overwhelmed. Additional, with some interventions such as dialectical behavioral therapy (DBT), an intervention that focuses on regulating one’s emotions, mindfulness, distress tolerance, and improvement in interpersonal relationships requires a team of professionals to assist each other with critical thinking skills and emotional support; especially (Psychology Today, 2020). Consultation can also help decreases the chances of burnout (Gurman, Lebow, & Snyder, 2015, p. 622).

Then, explain how your familiarity with the DSM-5 may influence this consultation.
Being familiar with the DSM-5 can help me effectively communicate with other therapists/clinicians who are a part of my team or those who utilize the DSM-5 catalog in general. As a therapist, I must be knowledgeable of the language associated with mental illness and the DSM-5 as to not confuse myself and my colleagues regarding diagnoses, symptoms, and treatment planning. My familiarity can help other clinicians form diagnosis and implement successful treatments. Also, I can share empirical/evidence-based information and learned skills that can assist other clinicians with similar issues.

Next, explain one advantage and one disadvantage of a couple and family practitioner being familiar with the DSM-5. Be specific.
Advantage… Utilizing the DSM-5 can increase the chances of a clinician accurately diagnosing a client and decrease the chances of misdiagnosing a client who is suffering from a mental illness. The catalog specifies the required symptoms under the diagnostic criteria that help to provide a diagnosis (American Psychiatric Association, 2013, p. 21). It helps to rule out possible diagnoses that share similar symptoms but may miss some of the required symptoms for a full diagnosis. For example, with a diagnosis of anorexia nervosa the diagnostic criterion may state the client must be experiencing all the following: A.) daily purging B.) withdrawal/isolation C.) decrease appetite and, 4.) unintentional and extreme weight loss. If the client is only experiencing two/three of the four symptoms, Anorexia Nervosa is ruled out.
Disadvantage…Some scholars believe that the DSM-5 catalog consists of deceitful or misleading information and does little to nothing to acknowledge and simplify human behavior and problems (LeBow, 2013, p. 155). It has received major criticism for confusing normal with abnormal behavioral (LeBow, 2013, p. 155). When working with clients who are displaying behaviors such as moodiness and stress, practitioners may immediately assume the client is showing cues of mental illness as these behaviors are identified throughout the DSM-5 catalog and considered abnormal human behaviors. Without critically assessing the client situation, the clinician may base her knowledge of the DSM-5 (abnormal behavior) to unintentionally misdiagnose a client with a mental illness who may be otherwise suffering from a stressful situation. Moodiness and stress can be normal behavior depending on the situation. Lebow, 2013, stated a con to the DSM-5 is an oversimplification of all human problems and behaviors as those that cause for medical needs or concerns.



Post an example of a specific instance in which you may need to consult with another mental health professional who utilizes the DSM-5.

According to Larner, Strong & Busch (2013), “…family therapists working in the mental health field will not be able to avoid engaging with it, whether in communicating with colleagues or managing their mental health care responsibilities in the public or private sector.” Therapists and professionals working with couples and families will inherently encounter the DSM-5 or variations of mental health and diagnosis. One instance which might require the consultation of another mental health professional is when the couple or family therapist identifies red flags to underlying mental health symptoms that are inadvertently impeding in the participation in sessions.

Therapists should be on the lookout for indicators of psychopathology – “high levels of emotional distress, sensitivity, reactivity, and impulsivity, including suicidality and self-harming behaviors; interpersonal difficulties; fears of abandonment; and occasional transient paranoia and difficulties with experiencing “emptiness” or maintaining a consistent and independent sense of self” (Gurman, Lebow, & Snyder, 2015).

Then, explain how your familiarity with the DSM-5 may influence this consultation.

My familiarity with the DSM-5 will allow me to be able to better serve and support the clients I see. I will be able to notice, acknowledge, and address the red flags to psychopathology that would indicate that clients would need further assessment in order to fully participate in couple and family sessions. Clients would then be able to receive the necessary services they need.

Next, explain one advantage and one disadvantage of a couple and family practitioner being familiar with the DSM-5. Be specific.

There are various advantages and disadvantages to having familiarity with the DSM-5.

One Advantage: When the practitioner has familiarity with the DSM-5, the practitioner has the ability to notice additional red flags and warning signs to symptoms consistent with mental health diagnoses. This will also offer the practitioner the ability to accurately diagnose an individual as well as effectively communicate with other mental health professionals.

One Disadvantage: There is controversy to whether the information contained in the DSM-5 is misleading and contains inaccuracies with regard to human behavior (LeBow, 2013, p. 155). This can lead to misdiagnosis, preconceived notions about the individual’s symptoms and mental health or lack thereof.

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