Continuous Improvement Options
If there is an inherent tension between family therapists and the current DSM-IV requirements, how can the tension be resolved? One option is to work within the DSM system to incorporate family assessment using the GARF and the CORD, as well as enhancement of Axis IV psychosocial stressor definitions. A unified effort will be required to achieve this goal in DSM-V. Another option is to develop a separate, parallel classification system. Several options are discussed in Florence Kaslow's (1996) Handbook of Relational Diagnosis and Dysfunctional Family Patterns. Perhaps a third option is for family therapists to abandon the use of diagnosing and participation in the current insurance and court testimony requirements (Becvar and Becvar 2000). Professionals could make a greater effort to educate insurance companies and courts about the efficiency of family therapy without diagnosis; some Employee Assistance Programs (EAP) accept this premise. If education were unsuccessful, moving away from payment by insurance and/or courts and accepting the financial risk of serving only self-paying clients would be a dramatic way for family therapists to make a statement consistent with systemic beliefs.
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LYNELLE C. YINGLING
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