Herb Kutchins

The Prognosis for Social Work Diagnosis

SOCIAL WORK DISTINGUISHES itself as a profession in part through its approach to the assessment of clients and their problems. Members of the profession, however, have been ambivalent about the development and use of formal classification systems because of their concern about the negative effects of labeling clients and the limited usefulness of classification systems for treatment planning. On the other hand, social work’s heavy involvement in the field of mental health has compelled workers to use the classification systems of the American Psychiatric Association, particularly its most recent version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III-R).1 Despite the widespread use of DSM by social workers, little attention has been given to its implications for social work. One difficulty social workers have in describing their work is their lack of an accepted, defined vocabulary for defining the problems of their clients.2 Because mental health has become the most common field of social work practice and because DSM is so widely used in mental health practice, the American Psychiatric Association’s system of naming and classifying mental disorders has unofficially and by default had significant effects on diagnosis in clinical social work. For example, a recent survey found that for the vast majority of clinical social workers, DSM has become the most frequently consulted reference book in the profession.3 Another survey found that information about DSM is incorporated into many courses in graduate schools of social work.4 The present article reviews the evolution of the profession’s distinctive conception of clinical social work diagnosis and suggests why, despite past efforts to formulate one, it lacks a comprehensive, well-formulated diagnostic system. It then considers some of the limitations of the DSM-111-R and how it affects social work assessment. Finally, recent developments in social work diagnosis are assessed.

Should DSM be the Basis for Teaching Social Work Practice in Mental Health? No!

It is ironic that we are having a debate about using DSM as the basis for teach ing social work practice in the field of mental health, because the approach taken in DSM contradicts many basic tenets of social work. Important social work per spectives—systems theory emphasizing the crucial role of families, small groups, and communities; a growth and develop ment model of human behavior; the indi vidualization of the client; a sensitivity and commitment to multicultural diver

Invited Essay Review : DSM-IV and the Hunt for Gold: A Review of the Treasure Map

A Review of Task Force on DSM-IV. (1991). DSM-IV Options Book: Work in progress. Washington, DC: American Psychiatric Association. (Pages unnumbered,

Does the Fiduciary Relationship Guarantee a Right to Effective Treatment

10.00 paperback, no ISBN).

Making Us Crazy: DSM: The Psychiatric Bible and the Creation of Mental Disorders

Although Corcoran concludes that the right to effective treatment does not exist, other legal remedies, particularly those based on fiduciary obligations, may ensure the opportunity for chents to choose the optimum intervention.