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The development of diagnostic systems within psychiatry and their widespread use within the medical profession has led to their historical adoption within clinical psychology. For example a recent survey funded by the Higher Education Academy Psychology Network (Cromby et al., 2007) found that the vast majority ot undergraduate courses use textbooks following the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders. This leads to very outdated critiques of psychiatry and a failure to develop and teach a specifically psychological approach to peoples problems.

Mary Boyle has outlined a number of difficulties with of these diagnostic symptoms as they are used in clinical psychology

  • Diagnositic systems lack a scientific basis

  • Diagnosis distorts research

  • Diagnostic models restrict prevention

  • Diagnosis is ethically problematic

From a broad psychological perspective the development of these diagnostic systems may be viewed as a process of social construction of mental illness that serves a number of interests:

  • Psychiatrists maintain their position within the health professions by reference to the system that legitimizes their activities, and in the absence of adequate competing descriptions of either consumers problems or professionals activities, allows them to exercise an element of control over clinical language.
  • Drug companies gain commercial advantage if they can market their drug to treat a specific disorder (Moncrieff 2007)
  • Administrators benefit by being seen to have a convenient framework for record keeping, financial management and making decisions about access to services.
  • Families and carers can locate the illness in the patient and not have to consider their role in generating anxiety, depression, madness etc
  • Society at large can locate madness too in the patient and not consider the harmful psychological outcomes of social and political policies and structures.

With these forces clinical psychology can collude. It will take a considerable intellectual effort to develop an alternative system more attuned to our own work.

However we are starting a project towards working towards a new classification in clinical psychology in the hope we can make some preliminary progress

See also

References & Bibliography

Key texts


  • American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental Disorders (4th ed). Washington, DC: Author
  • Bracken. P & Thomas. P (2005) Postpychiatry Mental health in a post modern world. Oxford: Oxford University Press
  • Boyle,M. (2002) Schizophrenia:A Scientific Delusion. London Routledge
  • Kirk, S A & Kutchins,H.(l992).The selling of DSM: The rhetoric of science in psychiatry. New York Aldine de Gruyter
  • Kutchins. H & Kirk, S.A. (1997). Making us crazy: DSM - and the creation of mental disorders . New York The Free Press


  • Boyle,M. (2007) The problem of diagnosis. The Psychologist, 20,5, 290-292
  • Cromby, J., Harper, D. & Reavey, R (2007). Mental health teaching to UK psychology undergraduates Report of a survey. Journal of Community & Applied Social Psychology.
  • Cromby, J., Harper, D. & Reavey, R (2007).Moving beyond diagnosis. The Psychologist,20,5,289. Introduction to special issue
  • Harper, D., Cromby, J., Reavey, P., Cooke, A., and Anderson, J.(2007) Don't jump ship! New approaches in teaching mental health to undergraduates.The Psychologist,20,5,302-304
  • Moncrieff, Joanna (2007) Diagnosis and drug treatment. The Psychologist,20,5,296-298

Additional material


  • Scull,A (1979) Museums of madness: The social organisation of insanity in nineteenth ceniury England London: Allen Lane.


External links

Soteria Networks Beyond Diagnosis conference Critical Psychiatry Network