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52 TPC D igest a major focus of clinical attention and the starting point of all treatment guidelines. Its provision of clearly defined criteria allowed for reasonably reliable diagnosis and for targeting specific symptoms that became the focus of treatment. The prevailing mental health approach before DSM-III was the well-rounded biopsychosocial model. At that time, clinicians conceptualized symptoms as arising from the complex interplay of brain functioning, psychological factors, and familial and social contexts. Perhaps without intention, the DSM- III downgraded the psychological and social factors and promoted undue emphasis on the biological factors. Clinicians often adopted a symptom checklist approach to evaluation and forgot that a complete evaluation must account for psychological factors, social supports and stressors. In addition to its considerable impact on the mental health profession, DSM-III also significantly affected the pharmaceutical industry. Drug companies benefited greatly from the DSM-III approach, particularly since 1987, when Prozac established the template for promoting blockbuster psychiatric drugs. Their marketing campaign offers the misleading idea that mental disorders are underdiagnosed, easy to diagnose due to chemical imbalances in the brain and best treated with a pill. Use of medication has skyrocketed as a result of these billion-dollar marketing budgets, turning us into a pill-popping society. More than $40 billion a year are spent on psychiatric drugs. For mild to moderate psychiatric problems, psychotherapy and counseling are just as effective as medication, and their effects are much more enduring. Insurance companies consistently favor medication management over psychotherapy and counseling based on the mistaken assumption that it will be cheaper. In fact, brief treatments are often much more cost-effective because their effects are lasting, whereas medication may be necessary for years or a lifetime. In preparing the DSM-IV , we attempted to hold the line against diagnostic inflation and the medicalization of normality; however, we failed. During the past 20 years, the U.S. has experienced fad epidemics of ADHD, autism and bipolar disorder. Inaccurate diagnoses are easy to give, but they are hard to remove, often haunting clients for life with stigma, unnecessary treatments and reduced expectations. The DSM-5 will considerably increase medicalization and may turn our current diagnostic inflation into hyperinflation. The DSM is only one guide to diagnosis—it is not a bible or an official manual of diagnosis. The DSM codes that clinicians routinely use for reimbursement are in fact all ICD-CM codes that are available for free on the Internet. Receiving a psychiatric diagnosis can be a turning point in a client’s life. Therefore, watchful waiting or brief counseling is usually best. Full article and references: Frances, A. (2014). DSM , psychotherapy, counseling and the medicalization of mental illness: A commentary from Allen Frances. The Professional Counselor , 4 , 282–284. doi:10.15241/afm.4.3.282 The Professional Counselor DIGEST Volume 4, Issue 3 http://tpcjournal.nbcc.org © 2014 NBCC, Inc. and Affiliates