As a professional counselor in training, I have heard and seen some disconcerting assumptions asserted about the Diagnostic and Statistical Manual of Mental Disorders (5th Edition). I have encountered Christian professionals, both counselors and pastors, who argue with some contempt, that the DSM-5 does not offer “Christian” solutions to mental health issues. I use the term “mental health” lightly here, because I know that many pastors and Biblical Counselors reject the idea that there are “actual” mental health problems, preferring to use words like soul problems, human problems, sin problems, martial conflict, and so forth. In any case, this post is dedicated to the making of the DSM-5 and what the DSM-5 is designed to do.
Before I address the history, it is first necessary to recognize what the DSM-5 is designed to do. If a psychologist in Sweden, a licensed counselor in Germany, a medical doctor in Montana, and a psychiatrist in Canada were to sit in a room and discuss particular clients that all share the same symptoms they would use the DSM-5 as a point-of-reference, since the DSM-5 is internationally recognized as a reference and diagnostic tool. For example, a person diagnosed with Post-Traumatic-Stress Disorder from the DSM-5 will have either the same or very similar symptomatology of any other person (regardless of where they are in the world) as long as that other person has also been diagnosed with the DSM-5. They key point that I am trying to get at here, is that the DSM-5 is a diagnostic tool, listing certain sets of criteria that have to be met before someone can receive a particular diagnosis.
History of the DSM-5
The history of the DSM-5 began in 1999, which was initiated by the American Psychological Association (APA). The APA wanted a significant amount of collaboration on this project, so they recruited professionals from many different fields: internationally recognized clinicians, scientific researchers, and professional organizations. “Through this wide scale collaboration, the DSM-5 development process has involved not only psychiatrists, but also experts with backgrounds in psychology, social work, psychiatric nursing, pediatrics, and neurology” (APA, 2013).
A task force was created that included over 160 mental health and medical professionals who were leaders in their fields. From these 160 professionals, 13 work groups were created which comprised over 90 academic and mental institutions around the world. More specifically, within the 160 professionals collaborating on this project: “Nearly 100 are psychiatrists, 47 are psychologists, two are pediatric neurologists and three are statisticians/epidemiologists. In addition, also included are a pediatrician, speech and hearing specialist, social worker, psychiatric nurse and consumer and family representative” (APA, 2013).
In addition to the 160 mental health and professionals who were collaborating on this project, an additional 300 advisors came along side the project to help inform specific areas requiring additional expertise.
The American Psychological Association partnered with the World Health Organization as well as the World Psychiatric Association to help with the organization of the DSM-5. “From 2004-2008, APA, WHO and the National Institutes of Health supported 13 additional conferences involving nearly 400 participants from 39 countries, including 16 developing nations. The work resulted in 10 monographs, hundreds of published articles regarding the current state of knowledge and recommendations for additional research in many fields” (APA, 2013).
Committees also helped in the process, such as the APA Board of Trustees, which overviewed the content for the DSM-5 along with A Scientific Review Committee and A Clinical and Public Health Committee.
Additionally, public feedback was also requested, which brought in about 11,000 comments which impacted changes. Lastly, thousands of additional clinicians and professionals volunteered their time to over up their expertise, contributing to the making of the DSM-5.
It is important to understand that the DSM-5 is not a “Christian” document. It’s purpose is to function as a diagnostic tool. It is it true that the DSM-5 does not offer Christian advice for how to address mental health issues, however the DSM-5 does not offer any advice on how to treat or medicate mental health issues. It is not designed to do that.
American Psychological Association (2013). The People Behind the DSM-5. PP 1-2. Click here for page location.