TPC-Journal-V4-Issue3

The Professional Counselor \Volume 4, Issue 3 273 and wellness” was among the six critical themes identified at the Counselor Advocacy Leadership Conference (Kaplan & Gladding, 2011, p. 368). With the publication of the Diagnostic and Statistical Manual of Mental Disorders , fifth edition ( DSM-5; American Psychiatric Association [APA], 2013), issues related to counselor professional identity, diagnosis and the use of the DSM-5 within the counseling profession have reemerged. Concerns focus on the implications of the DSM-5 for counseling professionals who advocate prevention and wellness, and the impact of the diagnostic process on counseling ethical practice (Kress, Hoffman, Adamson, & Eriksen, 2013). Also, multicultural and contextual considerations may be ignored when adhering to a medical model implied by the DSM system. Despite these criticisms, few models exist for integrating diagnosis using the DSM-5 into a wellness and prevention orientation, which is central to professional counseling training and practice. Our goal is to explore the use of the DSM-5 in counseling training and practice, and to suggest ways that DSM-5 diagnosis might be integrated into a counselor training framework while maintaining a wellness orientation. DSM and Counseling Training Distinguishing counseling from other mental health professions by a focus on human development, prevention and wellness does not exclude counseling professionals and trainees from acquiring an understanding of behavior across the adaptive-maladaptive continuum. In promoting a counselor professional identity, and reinforcing the consensus definition of professional counseling as empowering individuals, families and groups, teaching diagnosis using the DSM-5 to counseling trainees requires a cultural and contextual understanding of individuals and their concerns. Providing counseling trainees with learning experiences designed to foster knowledge and skills extends beyond exposure to the DSM-5 classification systems for categorizing behavior identified as disordered. Successfully integrating knowledge, skills and practices of diagnosis and the DSM- 5 into counselor education involves a review of counselor common core curricular and professional practice (Council for Accreditation of Counseling and Related Educational Programs [CACREP], 2009). In the requirements for common core curricular experiences and demonstrated knowledge, CACREP (2009) requires that all counseling trainees learn about “the nature and needs of persons at all developmental levels and in multicultural contexts” (II.G.3, p. 10), including “theories for facilitating optimal development and wellness over the life span” (II.G.3.h, p. 10) and about “human behavior, including an understanding of developmental crises, disability, psychopathology, and situational and environmental factors that affect both normal and abnormal behavior” (II.G.3.f, p. 10). Furthermore, the standards for Addiction Counseling and Clinical Mental Health Counseling specifically require demonstrated “professional knowledge, skills, and practices” (CACREP, 2009, III, p. 17; p. 29), use of the current DSM and use of other diagnostic tools. Therefore, in addition to common core curricular experiences that develop knowledge and skills needed for “facilitating optimal development and wellness over the life span” (CACREP, 2009, II.G.3.h, p. 10), professional counselors must have diagnostic knowledge, skills and practices. This includes understanding “etiology, the diagnostic process and nomenclature, treatment, referral, and prevention of mental and emotional disorders” (CACREP, 2009, III.C.2, p. 30) and “the range of mental health service delivery” (III.C.5, p. 30). Specifically, CACREP (2009) standards require that counseling trainees must evidence knowledge, relevant skills and practices that include the following: knowledge of the use of the current edition of the DSM (i.e., DSM-5 ), an understanding of possible biases that might occur when using diagnostic tools with culturally diverse clients, knowledge of the correct use of diagnosis during a traumatic event, and the ability to differentiate “between diagnosis and developmentally appropriate reactions” to traumatic events (CACREP, 2009, III.L.3, p. 34). Moreover, in demonstrating knowledge, skills and practices of the diagnostic process, counseling trainees must understand the implications of diagnosis and treatment interventions. To this end, Kress et al. (2013) stressed the importance of weighing