ABSTRACT
Some time within the past 20 years, the part of the practice of psychotherapy that is a business has changed radically. Today, we must do more than simply respond to whatever distress or trauma our clients bring to us. In order for them to receive reimbursement for their treatment we must also provide a diagnosis to the powers that be (insurance companies and Health Maintenance Organizations (HMOs)), whether or not this knowledge is relevant to our immediate relationship to the person we are seeing. The diagnosis must be one formally listed in the most current version of the Diagnostic and Statistical Manual of Mental Disorders (DSM) published periodically by the American Psychiatric Association since 1952. Currently there is DSM-IV (published in 1994 and re-issued, with minimal text revisions and no changes in diagnostic nomenclature, as DSM-IV-TR in 2000), and we are looking ahead to DSM-V (scheduled for release by 2010).
