Many of the changes in DSM–5 were made to better characterize symptoms and behaviors of groups of people who are currently seeking clinical help but whose symptoms are not well defined by DSM–IV

Many of the changes in DSM–5 were made to better characterize symptoms and behaviors of groups of people who are currently seeking clinical help but whose symptoms are not well defined by DSM–IV (meaning they are less likely to have access to treatment). Primary goal is to more accurately defining disorders, diagnosis and clinical care will be improved and new research will be facilitated to further our understanding of mental disorders. The revised organizational structure recognizes symptoms that span multiple diagnostic categories, providing new clinical insight in diagnosis. Two primary controversies associated with the fifth manual are an unhealthy influence of the pharmaceutical industry on the revision process and an increasing tendency to medicalise patterns of behavior and mood that are not considered to be particularly extreme.
With the advent of the DSM-5 in 2013, the American Psychiatric Association eliminated the longstanding multiaxial system for mental disorders. The removal of the multiaxial system has implications for counselors’ diagnostic practices. Although paradigm shifts were not as comprehensive as some might have hoped, the most recent revision process resulted in the DSM-5 (APA, 2013) and the first major structural changes to diagnostic classifications and procedures since the DSM-III. In order to understand the implications of the elimination of the multiaxial system, professional counselors must possess a preliminary understanding of the complex relationship between professional counseling and the DSM. Over time, the more general DSM system has come under critical review, especially by counselors who question how the diagnostic process fits with our professional identity and ethical obligations.

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