Volume 4 – Issue 3

Let us start with two important disclaimers. First, I will be identifying the many ways that the Diagnostic
and statistical manual of mental disorders (DSM) system has been detrimental to psychotherapy and how the
fifth edition (DSM-5; American Psychiatric Association [APA], 2013) will make the current situation even worse.
However, this does not mean that I consider DSM diagnosis irrelevant to psychotherapy and counseling, nor do
I believe that psychotherapists and counselors should neglect learning about diagnosis. I do not trust therapists
who focus their contact with the client exclusively around the DSM diagnosis. Hippocrates believed that it is
more important to know the person who has the disease than the disease the person has. Nevertheless, I also do
not trust therapists who are completely free-form, impressionistic and idiosyncratic in their approach to clients.
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.