Learning to live together: Constructivist therapies and the 'Diagnostic and Statistical Manual of Mental Disorders'.

摘要

There are considerable epistemological differences between constructivist psychotherapies and objectivist uses of the Diagnostic and Statistical Manual of Mental Disorders (DSM). My purpose in this dissertation was to discover the ways in which practicing constructivist therapists overcome those differences. This was a qualitative study that used a phenomenological methodology to explore the ideas and clinical practices of constructivist therapists who have worked within diagnostic frameworks. The participants interviewed are six nationally recognized doctoral-level psychotherapists who identify their theoretical orientation as constructivist: Douglas Flemons, Steve Madigan, Neil Ravella, Jaqueline Sparks, Tom Strong, and Michael Yapko. More than six hours of interview data was recorded and transcribed. Eight categories and three themes emerged when the transcripts were analyzed using an editing data analysis approach supported by the Nvivo 2(c) software package. The results of this study confirm prior research and published critiques and advance new understandings of the articulation of constructivist therapies within diagnostic contexts and the relationships between constructivist therapists, their clients, and the Diagnostic and Statistical Manual of Mental Disorders. Importantly, this research yields a number of new pieces of information that offer insight into the field at large, provide imitable ways to moderate the potential lack of correspondence between objectivist diagnostic practices and constructivist models of therapy, and represent positions of disenfranchisement with the DSM and diagnosis.