Professional counselors in educational and mental health settings all must deal with so‐called psychopathology. At issue is how can they work with “disorder” from a positive, developmental perspective? Developmental counseling and therapy (DCT) offers an approach to the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (American Psychiatric Association, 1994) classification systems that enables the reframing of severe client distress as a logical response to developmental history. Included are specific suggestions for positive case management and practice. Special attention is given to the interface of multicultural issues, etiology, and treatment. The authors maintain that if professional counselors take a developmental approach to a so‐called disorder, the positive theoretical and psychoeducational integrity of the American Counseling Association can be maintained while working with the most difficult issues.

Enhanced primary care services reduce the number of transfers to ED from RACF.

The Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; American Psychiatric Association, 2000) represents a medical model that can be reframed for more effective use in counseling. To achieve this goal, the authors describe how they can shift from client diagnosis to case formulation. In describing this shift, the authors offer an example of a theory-based etiology and relate case formulation to specific counseling interventions.

Counselors of all types need an understanding of and an ability to work with issues described by the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM‐IV; American Psychiatric Association, 1994). The traditional approach to the DSM‐IV tends to locate the problem in the client, whereas a developmental approach focuses on the client in social and historical context. Specific recommendations for organizing a comprehensive treatment plan are presented. The authors endorse an educational and developmental role for counselors.

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