DSM-5 and the Family Therapist: First-order Change in a New Millennium

• Published in: Australian and New Zealand journal of family therapy 2013-06, Vol.34 (2), p.147-155
• Main Authors: Denton, Wayne H, Bell, Chance
• Format: Article
• Language: English
• Subjects: classification systems; DSM; Mental disorders; psychodiagnostic typologies; psychopathology; social neuroscience
• ISSN: 0814-723X; 1467-8438
• DOI: 10.1002/anzf.1010

Family therapists have struggled to find a place in the Diagnostic and Statistical Manual of Mental Disorders, and the fifth edition of the manual will provide no relief. Small first‐order changes in DSM‐5 continue the same paradigm in place since DSM‐III wherein mental disorders are defined as occurring only in an individual. This was not always the case, however, as DSM‐I viewed mental disorders as a reaction between the environment and biology while DSM‐III through DSM‐IV‐TR utilised a multiaxial system of evaluation (eliminated in DSM‐5). Many proposals were made for both DSM‐IV and DSM‐5 to allow for an inclusion of relational processes in diagnosis but were met with limited success. The DSM approach now, however, is being attacked from a new direction. Neuroscientists have exposed limitations in the validity of the DSM categories and have proposed an entirely new system called the Research Domain Criteria (RDoC) project, which offers new hope for systemically oriented practitioners and researchers.