We get asked the question all the time, “What kinds of issues do you treat?” This is typically after we say, “We work with youth and families struggling with mental health or behavioral health problems.” Time after time, I realize that people really do not understand the definition of a mental health disorder. According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) a mental health disorder defined as:
A syndrome characterized by clinically significant disturbance in an individual’s cognition, emotion regulation, or behavior that reflects a dysfunction in the psychological, biological or developmental processes underlying mental functioning. Mental disorders are usually associated with significant distress or disability in social, occupational, or other important activities. An expectable or culturally approved response to a common stessor or loss, such as the death of a loved one, is not a mental disorder. Socially deviant behavior (e.g., political, religious, or sexual) and conflicts that are primarily between the individual and society are not mental disorders unless the deviance or conflict results from a dysfunction in the individual, as described above.
This is the clinical definition, and it helps guide clinicians when they are deciding if someone meets the requirements of a diagnoses or not. It then helps guide us as to how we go about treating that person clinically in an attempt to improve their mental health.
One of the other things we keep in mind that is stated in the definition, is that a mental disorder is typically causing the individual and/or their loved ones significant stress and is disturbing their ability to function in some aspects of their life. When we provide therapy, including equine-assisted psychotherapy, we are trying to improve that functioning for that individual and their loved ones in a very targeted way. We develop a treatment plan with specific measurable goals for that individual or family and we work towards them. When those goals are met, the individual or family will no longer meet the requirements for needing our services for that particular struggle.
An example would be a child having very high anxiety that was disturbing her behavior and functioning at home and out in the community. After an intake assessment interview, the therapist has determined that the anxiety is exacerbated, if not caused, by the relationship with her parents, who have been going through a several year custody battle. The clinician would make the diagnoses of anxiety, but would also add a descriptor about the parent-child relationship to explain why the anxiety is so high. The child is probably a higher anxiety person than others, but would likely not meet the definition of an anxiety disorder if it weren’t for the custody battle. Therefore in the treatment, we would focus on coping skills related to managing her anxiety in her current living situation.
We hope this helps explain what a mental health disorder is and just how targeted our services are. We welcome questions at any time.