Pros and Cons of DSM for Practice and Research


Dr. Robert Abramoviz, JBFCS
Professor Janet Williams, New York State Psychiatric Institute


Professor Mark Mattiani, CUSSW

Workshop participants discussed a number of pressing questions, including: What should be expected of a diagnostic system, and what assumptions underlie such systems? What are the advantages and disadvantages of an atheoretical, descriptive system like DSM-III-R as compared with theoretically based system? Are the advantages and disadvantages related to the use of DSM substantive, and to what extent are they grounded in interdisciplinary issues? With its multisystemic ecological perspective, why has so cial work research not pursued development of a multi-axial system grounded in the realities of practice?

These questions posed genuine challenges to workshop participants. Highlights of the discussion included recognizing diagnosis as only a part of an overall clinical assessment, and issues related to the level of expertise that is reasonable to expert f rom students and practitioners. For example, systems going beyond the categorical may prove difficult to implement in practice settings, where the adequacy of training for use of the current system is sometimes not sufficient. Clear, specific relatively o bservable criteria are useful