Diagnoses, Relational Processes and Resourceful Dialogs: Tensions for Families and Family Therapy

Area of Science:

• Psychiatry
• Family Therapy
• Mental Health

Background:

• The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) standardizes language for mental health but presents challenges for systemic family therapists.
• Its use medicalizes human concerns, impacting how clients, funders, and administrators respond.
• Family therapists, especially those with poststructuralist and strengths-based orientations, face tensions when DSM-5 use is expected.

Purpose of the Study:

• To explore how family therapists can recognize, navigate, and negotiate tensions arising from DSM-5 use.
• To provide strategies for managing expectations from clients, administrators, and funders regarding DSM-5 diagnoses.
• To address the systemic implications of standardized diagnostic language in family therapy practice.

Main Methods:

• Qualitative exploration of tensions in family therapy practice related to DSM-5.
• Analysis of systemic, poststructuralist, and strengths-based perspectives on diagnostic language.
• Discussion of negotiation strategies with clients, administrators, and funders.

Main Results:

• DSM-5 adoption creates significant challenges for systemic family therapists due to its individualistic and medicalizing approach.
• Tensions arise from the conflict between systemic, relational perspectives and the DSM-5's categorical diagnoses.
• Therapists must actively negotiate the use of DSM-5 language with various stakeholders to maintain therapeutic integrity.

Conclusions:

• Family therapists can effectively navigate DSM-5 related tensions by understanding their systemic impact.
• Negotiation and recognition of these tensions are crucial for maintaining client-centered and systemic practice.
• Adapting to the DSM-5's influence requires critical engagement and strategic communication within the mental health system.