This discussion is designed to help you consider some of the issues you may want to address with a parent or guardian of a child or adolescent who is prescribed a psychotropic medication. To develop your response, review the readings and any other resources you have identified.

• What are some of the main things you would want to include in a conversation with the parents or guardians of a child or adolescent who is prescribed a psychotropic medication?
• What is important for you to know about the medication itself?
• When might it be necessary to consult with the prescribing doctor? How would you reach out to the doctor?

  Client, counselor prescriber Counselors can serve as an important link between clients and the medical professionals who prescribe them antidepressants

  R oughly one in 10 Americans over the age of 11 takes .antidepressant medication,

  according to data released this past fall by the Centers for Disease Control and Prevention. Antidepressants are the third most common prescription taken by Americans of all ages and the most common among Americans ages 18-44. The rise in popularity of antidepressants has been meteoric in recent decades. Since 1988, the rate of antidepressant use nationwide among all ages increased almost 400 percent.

  These data, collected as part of the National Health and Nutrition Examination Surveys between 2005 and 2008, don’t surprise Dixie Meyer. In fact, they further support the message she tries to share with counselors: You need to know about the antidepressants your clients are taking.

  Antidepressants, which are prescribed not just for depression but also for anxiety disorders, pain disorders, learning disabilities and more, are the medication most requested by patients, says Meyer, an assistant professor in the Department of Counseling and Family Therapy at St. Louis University and a member of the American Counseling Association. She notes that primary care physicians prescribe the majority of antidepressants. “This suggests that a large portion of our clients on antidepressants sought out the medication without knowledge of why individuals need medications, and in most cases, an expert on psychotropic medications did not prescribe the medications,” says Meyer, who teaches psychopharmacology and has been researching the topic since 2007. “While counselors are not experts on antidepressants either, counselors need

  By Lynne Shailcross

  to understand when their clients may need to have the medication reassessed or when the counselor may need to meet with the medication prescriber.”

  Elisabeth Bennett, chair of the Department of Counselor Education at Gonzaga University, says even though counselors are not prescribing the medications, they are in a prime position to assist clients who are taking antidepressants. “Medical professionals see their psychiatric patients an average of about eight minutes each … three to four meetings per year. This is not enough time to do all the tasks they must do, let alone to build a relationship [with the patient, which] is likely the most critical element contributing to successful compliance and treatment,” says Bennett, an ACA member who also works as a counselor in private practice and has researched, taught and presented on neuropsychology and psychopharmacology.

  Counselors, on the other hand, see their clients two to four times per month for an average of 50 minutes per session, Bennett says. When counselors understand what an antidepressant is meant to do and what side effects it may cause, they can better prepare their clients to follow the regimen prescribed by the medical professional, she says. Counselors can also help prepare clients to note negative side effects that might need immediate attention, note when the medication is effective or when there are breakthrough symptoms, and to otherwise gain the most benefit while experiencing the least harm.

  A second set of eyes Meyer echoes Bennett, noting that

  the regular interaction counselors have with their clients positions them to help

  38 I Counseling Today | July 2012

   

   

  with management of antidepressant medications and, in some cases, to act as the liaison between clients and the prescribing doctor. To play that role effectively, however, Meyer emphasizes that counselors must educate themselves about antidepressants. “It is important for counselors to be knowledgeable about potential side effects of antidepressants, the empirical support for antidepressants and how antidepressants work, including how they alter neurochemistry,” she says. “Counselors also need to understand the neurochemical differences of depressive symptoms and how to monitor symptom improvement when clients are taking antidepressants. This is especially important when clients think their antidepressant is not working.”

  Bennett points out that the liability and authority for all elements of a medical regimen remain with the prescribing physician but says counselors can be of great value to clients by educating them about the medications and the regimens that doctors prescribe. “Oft:en, the time limitations of the doctor make such educational sessions rushed, and the counselor can supplement at a time when the client is better able to understand, thus increasing compliance,” she says. Among the topics Bennett suggests that counselors consider discussing with these clients:

  • How antidepressant medications work

  • Why complying with the regimen is critical

  • How long it takes to reach therapeutic windows (when enough medication is in the bloodstream to be effective)

  • Potential side effects that might arise

  • Which side effects to be concerned about and which to endure

  • How to talk with the prescribing doctor about symptoms

  Meyer encourages counselors to stay alert to the side effects their clients are experiencing. If the side effects appear to be getting out of hand, Meyer suggests talking with the client and perhaps encouraging him or her to ask the prescribing physician to reassess the medication or dosage. Sometimes, too many side effects mean the dosage of the antidepressant is too high, Meyer says. “Other side effects may lead a physician to prescribe an additional medication to alleviate the unwanted effect,” she says. “For example, for individuals experiencing sexual side effects [such as] lack of desire, a physician may prescribe Wellbutrin, which has been shown to help with unwanted sexual side effects.”

  The counselor’s role in medication monitoring is to check in weekly with the client, Meyer says. “It is important

  for counselors to ask their chents if they are noticing anything unusual physically or mentally,” she says. “Counselors then need to be knowledgeable about what may be expected during the course of treatment. For example, some individuals report increased anxiety when they begin taking an antidepressant, but the anxiety subsides after a few weeks of treatment. It is important for counselors to know if certain side effects are transient.”

  Sattaria Dilks, a licensed professional counselor who teaches at McNeese State University, says some antidepressants can have serious or even life-threatening side effects that counselors should be aware of and educate clients about. For instance, certain foods can have life-threatening interactions with monoamine oxidase inhibitors (MAOIs), a class of antidepressants, Dilks says. Other medications potentially can produce a life-threatening rash. Being knowledgeable of such side effects will alert counselors that a client needs to see a medical professional immediately, says Dilks, an ACA member who works in private practice as a psychiatric nurse practitioner in Lake Charles, La.

  All medications have side effects, but there are two major concerns when it comes to antidepressants, Meyer says. One is increased risk for suicide among

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This final assignment provides you an opportunity to transform your vision into reality by translating your exploration and brainstorming activities into a plan to actualize your vision and achieve your goals. By now, you are a practitioner-scholar with a lot of knowledge and insight about your interests in psychology and your career trajectory.

Preparation

Throughout this course, you had opportunities to clarify your passions and interests in psychology practice and scholarship, to create goals to help you achieve your vision, and to explore the competencies and requirements for pursuing a career in your specialized field of psychology. To begin this assignment:

• Take some time to reflect on all you have learned about the field and ways you can contribute to psychology, especially within your specialization.
• Review work you have done in previous weeks that you could revise and incorporate into this final assignment.
• Review the Your Career in Psychology Template [DOC]. You will need to use this template when writing your paper.
• Use the Your Career in Psychology Worksheet [DOC] to organize your ideas.
• Read the Your Career in Psychology Assignment Exemplar [PDF] for an example of a completed assignment.

Instructions

Complete the following in the Your Career in Psychology Template:

1. APPLICATION AND RESEARCH VISION

• Describe your vision for your career as a practitioner-scholar.
• Discuss how you would apply the findings from your literature review to your future professional practice in psychology.
  • What aspects of your research affected your vision or goals?
  • Given this, what topics do you think you would be interested in researching in the future?
• Analyze how your work this quarter will help you accomplish the functions, responsibilities, and ethics required of a professional in your specialization. Remember to critically evaluate all information you use.
• Describe how your vision was affected by the information in your readings from your Career Paths in Psychology text and in your exploration of the Career Center and other resources.

2. PROFESSIONAL COMPETENCIES AND REQUIREMENTS

Understanding the competencies and responsibilities involved in your future career in psychology is essential for growing as a practitioner-scholar in your field. It is also necessary to understand any requirements needed for your specialized practice and scholarship.

For this step in the assignment, describe the competencies, responsibilities, ethical considerations, and other requirements needed for achieving your vision and goals as a professional in psychology. These include:

• Capella program and specialization requirements.
• Credentialing, certification, licensure, and accreditation practices and standards.
• Analyze the role of the practitioner-scholar model in guiding professional development.
  • Skills, abilities, and attitudes critical to success in the field of psychology, such as those related to critical thinking, decision making, problem solving, evidence-based practices, ethical integrity, cultural competence, and conflict resolution.
    • Make note of skills, abilities, and attitudes related to the practitioner-scholar model and the experience you had in researching scholarly sources in your literature review.
  • Ethical codes, principles, laws, and policies applicable to your chosen career path.

3. ACTION PLAN

With all this knowledge of your vision and goals, and the competencies and requirements for the field in hand, you are ready to plot your course to making these aspirations a reality. The final step in this assignment is to create an action plan to achieve your goals. This means translating the requirements for your profession and the development areas you identified into specific, measurable, achievable, realistic, and timed (SMART) steps to achieve your vision.

Include these elements in your action plan:

• Plan for completing your Capella program.
• Possible opportunities for additional training or volunteer work to address gaps in your knowledge or skills.
• Possible opportunities in your current position to develop additional skills.
• Capella community groups and professional organizations that you could join for networking with others and completing additional informational interviews.
• How you will stay current with the research, literature, and ethics in the field.
• Steps you can take to become more inclusive in your professional life.
• How you can apply what you have learned in this course about researching psychological literature and evaluating it in terms of reliability, credibility, ethics, and value.
• How you will apply critical thinking and effective decision making in your specialization.
• How you will use Capella’s support resources to develop the skills required to improve your writing and other competencies essential to the profession and to your role as a graduate learner.

Review the SMART Goals presentation, Career Center resources, and search the Capella University Library for additional reflective exercises and inspiring ideas about transforming your vision into an action plan.

Before You Submit

To maximize your scoring potential, be sure that you fully address all assignment requirements and meet the criteria in the scoring guide that will be used to assess your assignment. It is helpful to self-score your paper using the scoring guide before submitting, to be sure that you are meeting criteria for the grade you want to earn.

SMARTHINKING

It is recommended that you have your assignment reviewed by Smarthinking. Plan 24–48 hours to get results from this service, and additional time to make revisions before you submit the assignment to your instructor for a grade.

SAFEASSIGN

Submit a draft of your assignment to SafeAssign for review of proper citations and references. It is very important that you always submit your work as a draft so you can make revisions before submitting your assignment for grading. Refer to the courseroom SafeAssign resources for guidance in accessing your feedback from SafeAssign, interpreting your report, and improving your writing and citations for your assignment.

Additional Requirements

• Written communication: Should be free of errors that detract from the overall message.
• Writing style: APA expectations for scholarly writing include the use of third-person narrative, unless it is awkward to do so. However, because you are talking about yourself in this paper, you may write in the first person.
• APA formatting: References and citations should be formatted according to current APA style and format. Include a title page, abstract, and references list.
• Resources: Minimum of five resources with at least three of them from course readings. Your references may include both scholarly literature and practitioner sources. All references need to be cited in-text, according to current APA standards. Remember that citations are to support your thoughts, not take the place of them!
• Length: 5–7 double-spaced pages, not including the title page or references page.
• Font and font size: Times New Roman, 12-point.
• Template: Use the Your Career in Psychology Template [DOC] to format your assignment. Also see the Week 9 Assignment Exemplar for an example of a completed assignment.
• Submission: Once you are satisfied with your paper and have made all necessary revisions, submit your assignment no later than Sunday at 11:59 p.m. Central time.

SCORING GUIDE

Your work will be evaluated using this criteria.

VIEW SCORING GUIDE

Competencies Measured

By successfully completing this assignment, you will demonstrate your proficiency in the following course competencies and scoring guide criteria:

• Competency 1: Analyze the role of the practitioner-scholar model in guiding professional development.
  • Describe a vision for your career, including three specific goals.
  • Explain how your literature review and research on career information affected your vision.
• Competency 2: Evaluate psychological literature in terms of reliability, credibility, ethics, and value.
  • Discuss how to evaluate psychological literature in terms of reliability, credibility, ethics, and value.
• Competency 3: Analyze the functions, responsibilities, and ethics required of a psychology professional.
  • Analyze the functions, responsibilities, and ethics required of a psychology professional.
  • Create an action plan to achieve your goals that includes most of the required elements.
• Competency 4: Apply critical thinking and effective decision making.
  • Discuss how to apply critical thinking and effective decision making as a psychologist.
• Competency 5: Communicate in a manner that is scholarly, professional, and consistent with expectations for professionals in the field of psychology.
  • Convey purpose, in an appropriate tone and style, incorporating supporting evidence and adhering to organizational, professional, and scholarly writing standards.