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CPD Credits
3.5
Event Type
Live Online Event
Location
Zoom & Recording for 365 days
Time
2:00 pm - 5:30 pm
Standard
£90.00
Trainee/NHS
£76.50
Friday, January 24, 2025
Diagnosis and Its Clinical Implications
With Nancy McWilliams, PhD & ABPP
Ever since the 1980 revision of the Diagnostic and Statistical Manual of the American Psychiatric Association, descriptive and categorical taxonomies such as the DSM and the ICD (International Classification of Diseases) have aimed at facilitating better research and providing a common language for categories of psychopathology. Every edition of the DSM since DSM-III has warned, however, that descriptive psychiatric diagnosis is insufficient to guide clinical treatment, and that for purposes of psychotherapy, clinicians must develop more nuanced case formulations.
Despite such caveats, it has become common for researchers to create manualized treatments for specific DSM-defined disorders, to test them on individuals who meet criteria for the chosen disorder without reported comorbidities, and to argue that such empirically tested treatments constitute the “gold standard” for clinical practice.
Dr. McWilliams notes that our current taxonomies reflect the influences of insurance companies particularly in the US, pharmaceutical corporations, governmental cost-cutters, and some academics more than the needs of patients and clinicians to mitigate psychological suffering in the most humane and effective ways. She will put the DSM and ICD taxonomies in historical context, mention several alternative approaches to diagnosis, and emphasize the value, with clinical examples, of a dimensional, inferential, contextual understanding of personality in guiding psychotherapy.
This workshop will include three sessions as well as time for discussion after each.
Programme
14.00 Introductions
14.05 Overview and Historical Context of Psychiatric Diagnosis
The language in which we talk about any phenomenon constrains how we can think about it. Ironically, as psychotherapy has evolved to be more essentially oriented toward the therapeutic relationship, and as vast evidence has accrued that the most powerful determinants of the success of psychotherapy are personality and relationship factors (e.g., the “therapeutic alliance,” “common factors,” “overall clinical skills”) rather than particular technical approaches, the mechanisms governing psychotherapy availability and evaluation have become increasingly objectifying, impersonal, and bureaucratic. Dr. McWilliams will describe the evolution of our contemporary classification systems, with emphasis on their impacts on treatment.
14.45 Q&A
15.00 Break
15.15 Personality Understood in Terms of Themes
Contemporary taxonomies of personality types and disorders, including the DSM’s alternative classification, tend to rely on research on traits, especially the “Big Five” traits of openness to experience, conscientiousness, extroversion, agreeableness, and neuroticism or emotional instability. But traits are shared across personality types, and seemingly opposite traits may characterize particular personality styles for example, an obsessive-compulsive individual may be fastidious in some areas and messy in others; a person with a histrionic psychology may be both exhibitionistic and inhibited sexually. This session will cover the themes that define types and disorders of personality and explore the implications of this conceptualization for treatment.
16.00 Q&A
16.15 Break
16.30 Alternative Approaches to Personality Diagnosis
Dr. McWilliams will review alternative approaches to diagnosis, including the Research Domain Criteria initiative (RDoC), the Hierarchical Taxonomy of Psychopathology (HiTOP), the Power Threat Meaning movement, the DSM Alternative Classification System for Personality Disorders, and the Psychodynamic Diagnostic Manual (PDM). Recognizing their respective strengths and limitations, she will give particular attention to the PDM, emphasizing the clinical utility of its P-Axis (personality styles and disorders), M-Axis (profile of mental functioning), and S-Axis (symptoms) as they apply to the maturational phases of infancy, childhood, adolescence, adulthood, and later life. Clinical vignettes will illustrate this usefulness of this manual for psychotherapy.
12.15 Q&A
12.30 End
Nancy McWilliams, PhD, ABPP
Nancy McWilliams is Visiting Professor Emerita at Rutgers University’s Graduate School of Applied & Professional Psychology and practices in Lambertville, New Jersey. She is author of Psychoanalytic Diagnosis (1994, rev. ed. 2011), Psychoanalytic Case Formulation (1999), Psychoanalytic Psychotherapy (2004), and Psychoanalytic Supervision (2021) and is associate editor of both editions of the Psychodynamic Diagnostic Manual (PDM) (2006, 2017). A former president of Division 39 (Psychoanalysis) of the American Psychological Association, she has been featured in three APA videos of master clinicians. She is on the Board of Trustees of the Austen Riggs Center in Stockbridge, MA. Her books are available in 20 languages, and she has taught in 30 countries.
- Psychotherapists
- Couple and Family Psychotherapists
- Psychoanalysts
- Psychologists
- Clinical Psychologists
- Psychiatrists
- GPs
- Counsellors
- Social workers
- Teachers/Educators
Session One:
Learning Objectives: This course is designed so that participants will be able to:
- Give two objectives underlying the development of a “neo-Kraeplinian” diagnostic model in 1980.
- Name the two most important factors overall associated with progress in psychotherapy, according to the empirical literature on therapy outcome.
- Name at least six qualities that have been empirically associated with effective therapists.
Session Two:
Learning Objectives: This course is designed so that participants will be able to:
- Describe four kinds of personality organization that have been written about in the scholarly literature as existing upon a dimension of severity.
- Describe the reasons behind the loss of the former “bereavement exclusion” in the DSM.
- Enumerate at least six empirical and theoretical concepts that are roughly equivalent to “internalized object relationships’ in accounting for themes that organize personality.
Session Three:
Learning Objectives: This course is designed so that participants will be able to:
- Name at least three systems of diagnosis that have been offered as alternatives to the DSM and ICD.
- Investigate via the Psychodynamic Diagnostic Manual the possible meanings of symptoms in terms of their cognitive, emotional, somatic, and interpersonal implications.
- Use the Psychodynamic Diagnostic Chart to identify both type and level of personality organization.
Standard: £90
Trainee/NHS: £76.50
Group Rates (for 4 or more): Contact makeritafaumui@trtogether.com for customised pricing.
Trainee discount: To qualify for this offer you need to be taking a course which provides core practitioner training in counselling or psychotherapy that is at least 1 year full time or two years part time and recognised by the BACP or UKCP. TR Together reserve the right to ask to see evidence of training being undertaken.
Alumni: If you are a TR Alumni (TRAPC member) please email anitabruz@tavistockrelationships.org for a discount code to add at checkout
Your CPD certificate will be available to download from your TR Together account 48 hours after the event.