The utility of the DSM-5 Z-codes for clinical social work diagnosis

ABSTRACT

The Diagnostic and Statistical Manual of Mental Disorders (DSM) is the standard reference text used by social workers for diagnosing mental disorders. The social work profession has always had an uneasy relationship with the DSM, but for 33 years there was an opportunity to note a client’s psychosocial stressors on Axis IV. With the publication of the DSM-5, however, the multiaxial diagnostic system was abandoned, and many social workers are concerned that this change limits their ability to provide comprehensive diagnoses. The purpose of this article is to consider an expanded use of Z-codes as one way to continue including social work’s psychosocial perspective on human functioning in the diagnostic process.