Abstract
In the field of mental health, the DSM (Diagnostic and Statistical Manual of Mental Disorders) has a profound influence on the understanding and assessment of mental health disorders. In fact, it often serves as the primary model for understanding the presenting problems of clients. Although widely accepted, there are many critics of the DSM who believe that the model is too limiting. The DSM operates from a medical model, yet some believe family and developmental models are much more comprehensive. In an effort to increase awareness around the limitations of relying strictly on the DSM when assessing and treating clients, Karen Eriksen and Victoria E. Kress wrote Beyond the DSM Story: Ethical Quandaries, Challenges, and Best Practices. This book is unique to the field because it challenges the DSM's utility in making accurate diagnoses. The book highlights the model's tendency to neglectimportant individual components (i.e., racial background and gender) during the assessment process. This critical perspective is rarely considered in the field of mental health. As a result, it is a very timely piece that should, at the very least, be read by those working or planning to work in the mental health field. Although some readers may not agree with the perspectives of the authors, they are likely to benefit from increased awareness of criticisms of the DSM.
In the first chapter of the book, Eriksen and Kress provide an overview of the value of DSM diagnosis, although they focus primarily on the limitations. The authors believe that the benefits are well recognized by those practicing and training in the field, and as a result, this chapter focuses on their concerns. Subsequent chapters provide a detailed review of the major shortcomings outlined in the first chapter. These chapters help readers begin to challenge DSM diagnoses and to think about ways in which to resolve some of the limitations of this model. The authors examine the DSM strictly from an ethical standpoint, they center on multicultural challenges, and they discuss feminist challenges.
The second portion of the book is dedicated to helping readers consider some of the limitations of DSM diagnosis so as to engage in contextually sensitive diagnostic practices. The authors offer a variety of ways in which clinicians can resolve the quandaries of DSM diagnosis and then present clinical cases that incorporate the recommendations made throughout the book. Eriksen and Kress conclude the book by offering a contextual, developmental, and holistic diagnostic model that addresses the major limitations of the DSM.
The challenges of the DSM that Eriksen and Kress raise throughout the book are well thought out, clearly presented, and supported with ample evidence to support the authors' concerns. Contributing to the quality of the arguments made against the DSM diagnostic process are specific examples of DSM quandaries that clinicians may face. These examples help to illustrate the authors' points and solidify a strong understanding of their perspective. Additionally, Eriksen and Kress enhance the chapters by providing ways for readers to begin integrating the information presented in their book with information they have learned previously about the DSM diagnostic process and psychopathology in general.
Overall, the book encourages readers to question the current DSM diagnostic process and to consider the impact that this process has on the way clients are assessed and treated in mental health settings. The book also encourages readers to explore different, more encompassing models during the diagnostic and assessment process. Eriksen and Kress present their work in a scholarly manner that is accessible to all readers. It is important to note, however, that because Eriksen and Kress do not provide an extensive review of the utility and benefits of DSM diagnosis, readers will need to have some fundamental understanding of and exposure to the DSM prior to reading this book. Without being familiar with the DSM, the reader will not be able to fully comprehend, appreciate, or contemplate the issues discussed throughout the book. The book will also carry more meaning for readers who have utilized the DSM in clinical practice. DSM exposure and clinical experience do not need to be extensive, but will enable readers to think about the issues on a more practical level. Despite the fact that it does not review the positive functions of DSM diagnosis, this book will benefit novice clinicians such as graduate students, as well as experienced clinicians in the mental health field.