The Diagnostic and Statistical Manual, the so-called 'Bible of Psychiatry,' is approaching its 70th year. It should be its last.
and has gained favor with clinicians, who find it easier to agree a patient has an internalizing tendency than whether they have depression, anxiety, or all of the above.
In drawing on child-focused mental health, HiTOP also offers a repackaging of older, gentler theories of inner life. Since the 1940s, many child psychologists and, later, child psychiatrists have deliberately avoided lumping children into diagnostic groups, instead evaluating children based on more general dimensions, like their ability to self-regulate their emotions, their response to risk, and their self-worth—often called theStill, HiTOP andalternatives face an uphill battle.
The PTMF works something like this: Therapists help clients identify the way power operates in their lives, and how it has created difficulties for them. Poverty, discrimination, and other inequalities, as well as traumatic experiences like abuse, are all incorporated into a personal narrative that reconceives of symptoms as threat responses.
Psychiatry has, at times, believed itself to be a liberator, aiding in the effort to destigmatize difference. But more often, it has ended up reinforcing the social, political, and moral systems that create the “normal” by cleaving it from that which is then declared “abnormal.” In moving outside of the medical model entirely, PTMF opens up possibilities for activism,
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