Update Follow Up Interview with Dr. Allen Frances
Professor emeritus at Duke University, Dr. Allen Frances, penned an article in Psychology Today entitled Why Social Workers Should Oppose the DSM-5. Dr. Frances was chair of the DSM-IV task force and of the department of Psychiatry at the Duke University School of Medicine. In the article, Dr. Frances acknowledges that Social Workers have not been previously included in the DSM development process despite being the largest providers of mental health services, and he also states that social workers may be the only ones who can prevent the DSM-5 publication in this 11th hour.
The article makes a strong case that the DSM-5 changes may open a gateway for exploitation by drug companies to push unnecessary medications on clients. Dr. Frances in his article quotes several professionals consisting of social workers and doctors. The new DSM 5 publication is schedule to published in the upcoming week, but its publication has suffered several set backs due to continued opposition. The National Institute of Mental Health dealt another blow when it withdrew its support for the new edition.
Here is an excerpt from his article:
Dr. Carney writes:
“Where are the social workers? Where are the NASW and its local and state-wide chapters? Over 12,000 individuals mental health professionals have publicly declared their concern at the planned 2013 publication of the DSM-5. They’ve signed the petition launched six months ago by the Society for Humanistic Psychology requesting that the DSM-5 Task Force delay publication of the new DSM and subject it to an independent scientific review. Fifty-one professional organizations have also endorsed the petition. It is extremely puzzling that the National Association of Social Workers and its local affiliates are not to be found among them.”
“So what’s going on with social workers? It’s almost like asking ‘What’s the matter with Kansas … ?’ It seems like they and their professional organizations are voting against their own self-interest… Ultimately, however, most social workers, like most Kansas voters, are not motivated by self-interest but by core values and beliefs. Their acquiescence to theDSM-5 as currently composed signifies for me an abandonment of core principles—service to others; pursuit of social justice; respect for the worth of the persons being served; the importance of human relationships; and the salience of integrity and competence in social work practice (Code of Ethics @ www.socialworker.org)—and seriously undermines their fundamental mission of helping those who need it.”
“The Open Letter which the Society for Humanistic Psychology states that ‘the proposal to lower diagnostic thresholds is scientifically premature and holds numerous risks … (that) increasing the number of people who qualify for a diagnosis may lead to excessive medicalization’ and the increased prescription of neuroleptic medications, with all their attendant risks.”
“The DSM-5 Task Force will soon announce its last public commentary period—check its website @ www.dsm5.org—after which it will begin to finalize the new edition. Accordingly, if you’re a social worker dismayed with a public mental health system in disarray, alarmed at the distortions resulting from the system’s sole reliance on the biomedical model, determined to re-commit to core social work values and promote change in a system that no longer works, here’s what you need to do:
1. Read the Open Letter and sign the petition …https://www.ipetitions.com/petition/dsm5/
2. E-mail the Board of Directors of NASW and ask them to endorse the petition … President@naswdc.org;
3. Spread the word to your social work brothers and sisters. There’s still time to put a stop to the DSM. Don’t mourn, organize!!”(excerpted from “1984 & DSM5 Revisited: Where Are the Social Workers?” … posted 3/27/12 on www.madinamerica.com) (excerpted from “1984 & DSM5 Revisited: Where Are the Social Workers?” … posted 3/27/12 on www.madinamerica.com)
The petition calls for 50,000 signatures. As of today, only 14, 000 have been collected. Since Social Workers represent 60 percent of those providing mental health services in the US, this publication can’t be stopped without social work support. Last week, I wrote an article asking “Will Clinical Social Workers Embrace the New DSM V“. I got a lot of responses to the question. However, social worker responses reflected a variety of feeling towards the DSM-5 changes, and I would like to share a few.
Interesting (and of course timely) post. Thanks! — Not at all sure that SW must use the DSM-5. Other professions are turning to the ICD, for example. Yes, we need an appropriate manual for diagnosis…esp. for insurance… The DSM-5 isn’t it!! It’s just toooo wrong in too many places. E.g., tell me how we get over the loss of a loved one in 2 weeks. Two weeks? Nonsense! But the DSM-5 (BTW, it is DSM-5, not DSM V) says that if the bereaved doesn’t “get over it” in 2 weeks, he is automatically labeled w/ major depression. — So, I’m not at all happy with this revised manual! ~ Rea G.
I have one question. If clinical social workers DON’T embrace DSM-5, then doesn’t that blur the line between them and those who are not clinically trained? The only certainty is that even DSM-10 will have limitations. My understanding is that client-centered therapists will always be cognizant, and therefore use good judgement on a case-by-case basis. But without a universally accepted standard, the entire field opens itself up to quacks and dubious practices.~ Rodney D.
In answer to your request Rodney (addressing Camille’s point), when DSM-5 comes out this Saturday, DSM-IV-TR will no longer be applicable for diagnostic criteria. Mental health professionals do not have the luxury to pick and choose which manual they prefer. However, as many psychiatrists are pointing out, diagnosis is (and has always been) in the eyes of the evaluating professional and the self reporting of the individual with the concern. Bottom line, we should be up on DSM-5, understand it, apply it appropriately and help our clients to the best of our ability.~Julie R.
Peter has summed up the DSM issue in a nutshell for me. I cringe when Social Workers, Psychologists, LPC’s, PsychNP’s, Psychiatrists, and other mental health practitioners refer to DSM “diagnosis:. I do not care how many axsis or qualifiers one puts with diagnosis, when it comes to mental illness we do not need a medical model as yet. We need evidence and outcome based criteria for treatments. I do appreciate psychopharmaceutical interventions, as do I appreciate all other interventions that can work: behavioral, mindful, interpersonal, etc. However, nobody is saying taking away the science. We need the science and the research. We do, however, need to educate the mental health profession about the unreliability and sham the DSM is about. Of course, the way the system is setup, we do need the DSM for insurance and I do embrace it for that.~Sherry L.
The article by Dr. Frances sheds new light on the DSM-5 and what the social worker response should be, but what do think about his article? Do you think psychiatry will begin including social workers in the DSM development process in the future?
