ABSTRACT
This chapter explores why and how the American Psychiatric Association (APA) responded to four challenges to defend their professional boundaries. Professional boundary issues were established early in the controversy, when the APA Committee on Women actively solicited and received support from mental health groups inside and outside the American Psychiatric Association. The boundary dispute resulted in letters from gynecologists to the APA, protesting inclusion of a purely physical disorder (PMS)-related diagnosis in Diagnostic and Statistical Manual of Mental Disorders (DSM)-III-R. The DSM-III-R is the property and official statement of the APA; as such, it is formally recognized as the means to code and reimburse mental health care. The majority of psychologists and social workers are required to use the DSM-III-R diagnoses for coding patients in organizational contexts and/or for the third-party reimbursement for psychotherapy. However, other mental health professionals were successful in one aspect as a result of their opposition to DSM-III-R revisions.
