A proposed diagnostic schema for religious/spiritual concerns

This article proposes the expansion of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) category on "Religious or Spiritual Problem" (V62.89), and the inclusion of an Axis 6 for the diagnosis of these issues. After defining and contrasting "religious" and "spiritual" as terms, and dealing with the potential difficulties of such a categorization for interfaith groups, the author proposes categories by which religious and/or spiritual issues presented by a client might be more pointedly and specifically assessed and understood. He also proposes criteria for each category, in keeping with the style of the DSM-IV-TR by which such assessments might be made. The author challenges his colleagues to both the beginning of a conversation regarding such a schema and research regarding the categories and/or criteria proposed. Several responses to the proposal are offered by colleagues in the pastoral arts and sciences.