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TPC D igest 51 Allen Frances, MD, is Professor Emeritus at Duke University. He served as the Chair of both the Department of Psychiatry at Duke University and of the DSM-IV Task Force. Correspondence can be addressed to Allen Frances, allenfrancesmd@gmail.com . L et us start with two important disclaimers. First, I will be identifying the many ways that the DSM system has been detrimental to psychotherapy and how the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders ( DSM-5 ) will make the current situation even worse. However, DSM diagnosis is relevant to psychotherapy and counseling, and psychotherapists and counselors should learn about diagnosis. Hippocrates believed that it is more important to know the person who has the disease than the disease the person has. DSM diagnosis is only a small part of what goes into therapy, but it is often a crucial part. We need to know what makes each person different and unique; on the other hand, we also need to group clients with similar problems as a way of choosing interventions and predicting the treatment course. Second, the next disclaimer relates to the proper roles of medication, psychotherapy and counseling. The DSM has promoted a reductionistic medicalization of mental illness that, in combination with misleading drug company marketing strategies, has created a strong bias toward treatment with medication and against treatment with psychotherapy and counseling. Psychotherapists and counselors are important gatekeepers who should recognize when medication is needed and when it is not. It is crucial that medication not be used carelessly, but also essential to realize that it is sometimes absolutely necessary. Before the publication of DSM-III in 1980, psychiatric diagnosis was a subject of little interest or importance, because it was unreliable and not particularly useful for treatment planning. DSM-III marked a sudden and dramatic change—it made diagnosis DSM , Psychotherapy, Counseling and the Medicalization of Mental Illness: A Commentary from Allen Frances – DIGEST Allen Frances