TPC-Journal-V4-Issue3

202 The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders ( DSM-5 ; APA, 2013) continues its 60-year legacy as a standard reference for clinical practice in the mental health field. This practical, functional and flexible guide is intended for use by trained counselors in a wide diversity of contexts and facilitates a common language to communicate the necessary characteristics of mental disorders present in their clients (APA, 2013). As counselors use the DSM-5 , they will notice an expanded discussion of developmental and life span considerations, cultural issues, gender differences, integration of scientific findings from the latest research in genetics and neuroimaging, and enhanced use of course, descriptive and severity specifiers for diagnostic precision (APA, 2013). They will also notice a dimensional approach to diagnosis, consolidation and restructuring of most mental disorders; a new definition of a mental disorder; and emerging assessments and monitoring tools so as to promote enhanced clinical case formulation. The intent of this article is to assist all counseling specialists by presenting six clinical scenarios from the author’s counseling practice. The article begins by summarizing the clinical utility of the DSM-5 and provides recommendations for counselors on how to sequence their study of the new manual. Discussed next are use of the new emerging assessment measures, autism spectrum disorder, schizophrenia spectrum and other psychotic disorders, sleep-wake disorders, neurocognitive disorders, and comorbid conditions such as excoriation (skin- picking) disorder and post-traumatic stress disorder—with a focus on prominent changes between the DSM- IV-TR and the DSM-5 . Clinical formulation and its associated rationale using the DSM-5 are presented for each disorder classification. Counselors are encouraged to read the full manual and to especially read the Preface; Section I (i.e., Introduction, Use of the Manual, and Cautionary Statement for Forensic Use of DSM-5 ); Section III: Emerging Measures and Models (i.e., Assessment Measures); and Appendix (i.e., Highlights of Changes From DSM-IV to DSM-5 ) before they attempt applied clinical use of the manual. To appreciate the rationale for the DSM- 5 changes, counselors are encouraged to read the DSM-IV-TR discussion on limitations to the categorical approach (APA, 2000, pp. xxxi–xxxii) and on the nonaxial format (p. 37). This sequencing of study will help The Professional Counselor Volume 4, Issue 3, Pages 202–215 http://tpcjournal.nbcc.org © 2014 NBCC, Inc. and Affiliates doi:10.15241/jhk.4.3.202 Jason H. King is Student Development Coordinator in the School of Counseling at Walden University. Correspondence can be addressed to Jason H. King, 100 Washington Avenue South, Suite 900, Minneapolis, MN 55401-2511, jason.king6@waldenu.edu. The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders ( DSM-5 ; APA, 2013) continues its 60-year legacy as a standard reference for clinical practice in the mental health field. Six mental health disorders are reviewed with a focus on changes between the DSM-IV-TR and the DSM-5 that represent the new landscape for each of these disorders, respectively. Following the summary of changes, a clinical scenario is presented so that counselors can capture the vision of using the DSM-5 in their counseling practice. Clinical formulation (sample diagnosis) using the DSM-5 is also presented for each disorder classification. Keywords: DSM-5 , DSM-IV-TR , private practice, clinical formulation, mental disorders Jason H. King Clinical Application of the DSM-5 in Private Counseling Practice