One of the difficulties with the list of disorders is that there isn't a unified vision in the mental health care system. There are several different kinds of therapist, each with its own set of guidelines for care. There's the insurance industry, who have a vastly different set of priorities as to who needs what. And then there's the laws around government services, which exist more often to restrict access than to grant it.
The DSM categories exist, mainly, as a patchwork language for bringing all these diverse (and sometimes contradictory) forces together. It's far from perfect, and in some places it out-and-out sucks.
In my training, we discussed all the subtleties you bring up, and were encouraged to be flexible with the definitions in the best interests of the client. Our instructors were vocal in their opinion that "official diagnoses" were mainly only useful for insurance, and we should bear that in mind when trying to get/give our clients the help they need.
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Date: 2009-11-04 08:03 pm (UTC)One of the difficulties with the list of disorders is that there isn't a unified vision in the mental health care system. There are several different kinds of therapist, each with its own set of guidelines for care. There's the insurance industry, who have a vastly different set of priorities as to who needs what. And then there's the laws around government services, which exist more often to restrict access than to grant it.
The DSM categories exist, mainly, as a patchwork language for bringing all these diverse (and sometimes contradictory) forces together. It's far from perfect, and in some places it out-and-out sucks.
In my training, we discussed all the subtleties you bring up, and were encouraged to be flexible with the definitions in the best interests of the client. Our instructors were vocal in their opinion that "official diagnoses" were mainly only useful for insurance, and we should bear that in mind when trying to get/give our clients the help they need.