ABSTRACT
The issue of `diagnosis' and its potential location within a medical model has created signi®cant debate in the ®eld of psychotherapy in general, with strong arguments for and against the use of a classi®ed system. Our view is that familiarity with the major diagnostic systems is important, from both a clinical point of view as well as from the point of view of creating a language for discussion within psychiatric and medical contexts of interdisciplinary work. In our work as psychotherapists we have been drawn to using the DSM (currently DSM-IV-TR) rather than any other formal diagnostic system as a basis for diagnostic consideration. The DSM has the advantage of being organized into ®ve axes, each of which looks at a particular dimension of functioning; together these ®ve axes give a comprehensive overview of the client's presentation. Axis I refers to clinical disorders, the main mental illnesses or conditions, such as depression, anxiety disorders, schizophrenia, bipolar disorder and many more of the well-recognized conditions requiring treatment. Axis II refers to personality disorders whether mild or severe and also includes mental retardation. Axis III deals with general medical conditions, those physical conditions that may be impacting on the psychological presentation of the client. Axis IV refers to the area of current psychosocial and environmental problems that may be in¯uencing the client's diagnosis, treatment or prognosis. Finally, Axis V provides a global assessment of the client's functioning at the time of presentation. In this way, it is possible to get an overview of the many factors impacting on the client at a glance. Once you have an idea of the client's diagnostic presentation in DSM terms, then you can access some rich literature on the subject. For example, if you have a client who manifests with a schizoid process, you can draw on Guntrip (1992), Laing (1960), Smith Benjamin (2003), Johnson (1994), inter alia. In this sense the
of research studies.
