noodle

For the purpose of this discussion, I'd like to just simply answer these questions as someone who has been in the mental health field professionally for 12 years and who is currently working on a PhD in clinical psych.

The DSM has its use. Just like any other field of science, there has to be a set of guidelines. People get frustrated when guidelines and sets of scientific law are placed on people, functioning and behavior. It also has its limitations. Which is why it is constantly under review. I, personally, have learned to underdiagnose rather than put something in someone's medical record for life. Example: using "Anxiety Disorder, Not Otherwise Specified" rather than something that someone could meet criiteria for but maybe not totally, e. g. a panic disorder. I'm comfortable with the training I have and I'm receiving now to be able to responsibly use the DSM. Many psychologists won't take insurance so that the DSM codes will not be placed in a medical record and labeled.

Normal is relative. You look at a person in their environment, assess their global functioning in all areas. No one is "normal." There is "common" or "like others" but I avoid "normal" in practice as do the responsible psychological professionals. When you're unable to function or function is significantly impaired that you or someone else is concerned, then it's time to evaluate. Yes, there is a set of guidelines and criteria. All of it is up for some level of interpretation.

It all depends on the diagnosis. And the GAF score. That's the standardized method of determining functioning. Secret: We're ALL diagnosible. Every. Single. One. Of. Us. You can find yourself in the DSM... don't believe me? Try it. Difference is when a person educated specifically in how to use it appropriately and responsibly diagnoses you. You're all histrionic. lol.

Damn skippy. I've got hella more education than an RN, already. More than some D.O.s. Comparable to a physician when I finish. I have to go through rigorous training, practica, APA certified internship and ONLY if I pass through a jury of my peers, do I have permission to call myself Doctor Noodle. Then, I have to get licensed in the state in which I choose to practice, follow up with continuing education to maintain that license, get malpractice insurance, fight with insurance companies, and argue for the best course of treatment for my patients. But, there are different levels of education and experience for both professions. I couldn't do what an RN does nor could I expect them to do what I do. We're currently fighting the APA for continued accreditation, even though my school is meeting EVERY mandate (which is more stringent than some med schools). In every profession, though, you're going to run into the International School of _______ that hands out degrees to cats and dogs. It's up to patients and clients to do research and make sure that whomever they are seeing didn't get their degree from a school that only exists on paper. And believe me, there are internal checks and balances in the DSM, the APA, and every single licensure board that we come into contact with.

A medical doctor may offer treatment that fails to "save" someone from their physical disease... but are they looked upon the same as a psychologist that tried a treatment that didn't work and their client committed suicide?


Just a side note:
Baraka, milove... you might be offered meds, but you'd never "be medicated." I respectfully disagree here. Some psychiatrists jump to medication because that tends to be their jobs. Psychologists can't prescribe meds in the U.S., I don't know about Canada offhand because I'm tired, but that's a "safer" option for those who want to be evaluated and have treatment suggestions without being shoved towards medication. Many diagnoses are not typically treated with meds, and some are treated with short term meds to provide a crises intervention type treatment. I hate that people avoid talking things out with a professional because they are concerned about meds. I have people that have approached me outright stating "my child will not be on meds." My response? "Okay, let's see what we can do." If there absolutely need to be medications involved, it's typically because there is a medical issue involved (e.g. extreme ADHD stemming from neuro insult) or because that person has become a danger to his or herself. But no one can force you to take medications. Or make that their only recommendation... if they ever want to earn your trust or see you again.

I'm taking a stand. The newer generations of psychologists are arguing the DSM and the coding practices that the health care system is requiring for billing purposes. We're using extensive standardized testing to look at every dimension of cognitive functioning and areas of concern. And challenging the ones that are outdated and inconsistent. Just because you don't see it, don't discount that it may be happening. You don't hear about drugs or medical therapies that don't make it through testing unless they're already on the market very often either.

Oh hell....
/soapbox.

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