Wednesday, February 15, 2012

Psychopharmacology and the Mental Health Counselor

Kaut and Dickinson (2007) claim "a growing challenge for mental health counselors is to understand the potential benefits and limitations of many different types of drugs" (p. 204-205). Regarding pharmacology and human behavior, understanding the relationship between the two has become an essential education. Effective, collaborative professional relationships provide the client with comprehensive treatment planning that may include pharmacological intervention for which referral must be made to prescribing professionals (King & Anderson, 2004).

Boundaries for Recommending and Prescribing Medication

In the contemporary milieu of pharmacology's role in mental healthcare, it is essential for mental health counselors to understand their role as well as the boundaries within which they must ethically and legally function. Having an awareness of pharmacological interventions benefits the client, the counselor, and the prescribing professional (King & Anderson, 2004). Advancing knowledge of the neural mediation of behavior through pharmacological treatment does not antiquate psychotherapy and its beneficial methods (Kaut & Dickinson, 2007). On the contrary, both aspects of supporting mental health are elemental.

Mental health counselors practicing at the master's degree level do not usually have essential knowledge and training to recommend medications. Certainly, they have no legal right to prescribe them. Prescribing medications must be left to a trained professional with drug- prescribing licensure, although with training, the counselor may assist the prescriber by making recommendations. Because of the counselor's comprehensive understanding of the client's circumstances, the prescribing professional may benefit from the counselor's assistance (King & Anderson, 2004). Referring the client to the appropriate medical professional is in the client's best interest, especially when the counselor suspects a biological basis for presenting behavior. Specifically, the trained counselor may well recognize the client's need for prescription medication but making recommendations to the client for such treatment is the exclusive responsibility of the prescribing professional.

Mental Health Counselors' Role in Client Medication Education

As suggested by Kaut and Dickinson (2007), without specialized training in pharmacology, the mental health counselor must self-educate, sometimes on a case-by-case basis. Considering the significant role of pharmacology in contemporary mental health care, maintaining a balance of understanding its significance as well as using caution in its application is essential (King & Anderson, 2004). Ingersoll and Brennan (2001, as cited by Kaut & Dickinson, 2007) emphasize the counselor's role as the one who "understand(s) prescription medication (or other psychoactive drugs/substances) in order to capably address client concerns or therapeutic issues" (p. 216). The mental health counselor provides the client with necessary information as well as maintaining an open discussion about the drugs specific to the client's treatment as well as monitoring side effects and drug interactions. In many cases, the prescribing medical professional may fall short in explanations to the client, leaving the client's medication education to the counselor (Kaut & Dickinson, 2007). For example, if a client is experiencing troubling side effects, likely he or she will contact the counselor with questions and concerns.

Referring Clients for Prescription Medication

Identifying Medical Health Professionals for Client Referral

Depending on the particular client need, the appropriate referral for prescription medication may be directed to a psychiatrist, a psychologist with prescribing rights, the client's primary care physician, or other medical professional. It is not unusual to include specialists, depending on the health concerns. For example, a neurologist might be the appropriate referral when the client has seizures or frequent migraines. Determining the most appropriate collaborative partner depends on the client's significant issues (Ruddy, Borresen, & Gunn, 2008).

Providing Client Information to Prescribing Professional

To support collaboration with other medical professionals adequately, the mental health counselor needs to provide an overall case conceptualization, assessments, and "past history or contextual circumstances" (Kaut & Dickinson, 2007, p. 218). Additionally, the counselor may convey any ethically allowable and reasonable information necessary to create a comprehensive perspective of the client's need for pharmacological intervention. The primary responsibility for such therapy ends with the prescribing physician and in the client's best interest, any appropriate information pertinent to this decision should be shared.

The Relationship between the Mental Health Counselor and Prescribing Professional

According to Ruddy, Borresen, and Gunn (2008), "health care professionals must receive training in how to work together productively" and "must work toward developing interdisciplinary relationships" (p. 123). The mental health counselor plays a bidirectional role, communicating information between the client and the prescribing professional, a role that "maximizes client outcomes where integrative therapies are involved" (Kaut & Dickinson, 2007, p. 218). The counselor is in regular contact with the client, and in collaboration with medical professionals, functions as the foremost representative for the client as well as the eyes and ears of the prescribing professional. Throughout pharmacological intervention, the mental health counselor must continually re-assess the effects and success of the overall treatment. Always the client advocate, the mental health counselor collaborates with other healthcare professionals, consistently in the client's best interest (King & Anderson, 2004).


Ruddy, N. B., Borresen, D. A., & Gunn, W. B. (2008). Colocating with medical professionals: A new model of integrated care. In The collaborative psychotherapist: Creating reciprocal relationships with medical professionals (pp. 115-133). Washington, DC: American Psychological Association. doi: 10.1037/11754-006

King, J. H., & Anderson, S. M. (2004). Therapeutic implications of pharmacotherapy: Current trends and ethical issues. Journal of Counseling & Development, 82(3), 329-336.

Kaut, K. P., & Dickinson, J. A. (2007). The mental health practitioner and psychopharmacology. Journal of Mental Health Counseling, 29(3), 204-225.

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