Vistas Online 2012

VISTAS Online is an innovative publication produced for ACA by Dr. Garry R. Walz and Dr. Jeanne C. Bleuer of Counseling Outfitters, LLC. Its purpose is to provide a means of capturing the ideas, information and experiences generated by the annual ACA Conference and selected ACA Division Conferences. Papers on a program or practice that has been validated through research or experience may also be submitted. This digital collection of peer-reviewed articles is authored by counselors, for counselors. VISTAS Online contains the full text of over 900 proprietary counseling articles published from 2004 to 2017.


Alcohol Use Disorder: Clinical Case Evidence

Joanne Cohen Hamilton


The Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; DSM-IV-TR; American Psychiatric Association, 2000) has been criticized for using categorical diagnosis of psychiatric disorders despite considerable clinical evidence to the contrary (First, 2008). Although yes-no categories appear valid when diagnosing some conditions (e.g., Down Syndrome; Alzheimer’s disease), boundaries between mental health disorders (e.g., schizophrenia and bipolar disorder) and between disorders and normality (e.g., depression) more often exist on a continuum (Arnaout & Petrakis, 2008; First, 2008; Saha, Chou, & Grant, 2006). Client defiance of categorical diagnosis supports the idea that psychiatric diagnosis is a form of rhetoric (Kirk & Kutchens, 1992). DSM developers had hoped that empirically-based diagnostic categories would lead to discovering causes and treatments for disorders (cf. Regier, Narrow, Kuhl, & Kupfer, 2009), but research over the past 30 years has not provided the degree of categorical specificity originally hoped for.

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