[Counselor_Educ] FW: ACES Graduate Student Newsletter

Mon Oct 24 18:43:16 EDT 2011

Tracy Leinbaugh, PhD, NCC, PCC-S
Associate Professor and Chair, Department of Counseling and Higher Education
Ohio University
The Gladys W. and David H. Patton College of Education and Human Services
205 McCracken Hall
Athens, OH 45701

Phone: 740-593-0846
E-mail: leinbaug at ohio.edu<mailto:leinbaug at ohio.edu>

Show, by your actions, that you choose peace over war, freedom over oppression, voice over silence, service over self-interest, respect over advantage, cooperation over competition, action over passivity, diversity over uniformity, and justice over all.

From: CESNET-L is a unmoderated listserv concerning counselor ed. & supervision [mailto:CESNET-L at LISTSERV.KENT.EDU] On Behalf Of Sejal Mehta
Sent: Monday, October 24, 2011 4:01 PM
To: CESNET-L at LISTSERV.KENT.EDU
Subject: ACES Graduate Student Newsletter

Hello! We are pleased to share the first annual ACES Graduate Student Newsletter with you and your students. This newsletter is in line with this year's conference theme, "Helping the Helpers, Leading the Leaders and Shaping the Future" offering several short pieces on leadership development as well as highlights for graduate students at the upcoming conference. We would greatly appreciate your assistance in disseminating this newsletter to graduate students in your department. We hope to see you in Nashville in a few days!

The newsletter can be downloaded at:
http://www.sendspace.com/file/zvugeu

Thank you!
Sejal Mehta, ACES Graduate Student Faculty Liaison and Jennifer Cook, ACES Graduate Student Representative- Designee

Sejal Mehta, PhD, NCC, LPC, ACS
Assistant Professor
Counselor Education
University of Central Florida
College of Education, ED 322H
Orlando, FL 32816-1250
Email: Sejal.Mehta at ucf.edu<mailto:Sejal.Mehta at ucf.edu>

From: CESNET-L is a unmoderated listserv concerning counselor ed. & supervision [mailto:CESNET-L at LISTSERV.KENT.EDU] On Behalf Of Hipple, John
Sent: Monday, October 24, 2011 9:13 AM
To: CESNET-L at LISTSERV.KENT.EDU
Subject: Re: Use of Antidepressants on the Rise in the U.S.

And again,  I agree with the comments of Cynthia.   She presents a very positive case for approaching all clients, but especially those with depression in a balanced manner.

I, too, like to ask clients who have been on medication in the past or are currently taking meds how they evaluate their experience.   I also like to ask about their level of understanding as to 'why' a particular medication was prescribed.   A family history of depression is also a strong indicator for the positive potential of medication.  I think we have to acknowledge the fact that there often has to be a period of 'experimentation' as a client and his/her physician work to find the 'right' medication and the 'right' dosage level.

A CPT approach to depression is certainly supported by the literature.

And since I am only a Ph.D., not an M.D. I try to walk the fine line of providing only basic medication information and coach the client as to what questions they might want to consider asking the prescribing physician.

John Hipple

From: CESNET-L is a unmoderated listserv concerning counselor ed. & supervision [mailto:CESNET-L at LISTSERV.KENT.EDU]<mailto:[mailto:CESNET-L at LISTSERV.KENT.EDU]> On Behalf Of Cynthia Miller
Sent: Friday, October 21, 2011 6:25 PM
To: CESNET-L at LISTSERV.KENT.EDU<mailto:CESNET-L at LISTSERV.KENT.EDU>
Subject: Re: Use of Antidepressants on the Rise in the U.S.

I have so many thoughts about this thread that I could write a dissertation.  But it's a Friday night and I would hope I have better things to do, so I'll try to be succinct.

The 400% increase in antidepressant use could be due to any number of factors - increasing recognition of depression, decreasing stigma about receiving treatment, direct to consumer advertising, the use of antidepressants as adjunctive treatment for other conditions (fibromyalgia, perimenopause, people recovering from strokes & heart attack,) etc.

There may not be any evidence to support a chemical imbalance theory but there is plenty of evidence indicating that the brain of a depressed person functions differently than the brain of someone who isn't depressed.  There is a clear biological component to depression, anxiety, and other conditions.  Because counselors aren't trained as neuroscientists I think we sometimes under-appreciate the role the brain, as a biological organ, plays in various emotional conditions.

At the same time, I think physicians often fail to appreciate the role the environment and stress play in both emotional and physical conditions.  The mind-body connection is real - the body will express the mind's struggles.  The ACE study demonstrates how much adverse life experiences contribute to chronic medical conditions but physicians are often unaware of it.  Psychiatrists have a better understanding of this, yet GPs are often forced into being psychiatrists because psychiatry appointments are increasingly difficult to come by in many areas.  Unfortunately, the only get about 6 weeks of psychiatry training in the course of medical school so they're not always very good at it.  So then we end up seeing clients whose GP prescribed them benzos as a first line treatment for anxiety, or who diagnosed them as bipolar because they complained of mood swings and put them on a mood stabilizer and antipsychotic after a 15-minute assessment.  I'm a huge fan of the movement towards integrated care where counselors work beside primary care physicians in a holistic approach to health problems.  Imagine the impact we could make!

My impression of the research on antidepressants is that it is fraught with methodological issues that make the results questionable.  One of the biggest problems is with the participants who sign up for the studies - some of them are professional subjects and many don't have the level of depression that would necessarily merit drug treatment.  The clients who are more severely depressed often don't qualify for the study for ethical reasons - they need immediate treatment, not an experimental study in which they might receive a placebo or a medication that doesn't work.  So the studies may be flawed, but that doesn't mean the medication is ineffective.  The suicide risk is small but real, though it's also real if depression goes untreated.  That's why close monitoring and a therapeutic relationship is important.

Which brings me back to the balance.  When a client comes in and has a history of taking psychiatric medications I always ask whether they have helped and, if so, what exactly they helped with.  That gives me a clue about how much biology may be at work in their symptoms.  I always encourage my clients to see a psychiatrist, not a GP, for their meds.  I find it helpful to tell them that getting their psych meds from a GP is like getting heart surgery from their GP - probably not advisable.  Then I tell them what role I can play in helping them address the life stressors and coping deficits that may be contributing to their struggles.

Whew!  I think I still have time for some Friday night fun...

Cindy
On Fri, Oct 21, 2011 at 4:45 PM, Heather Trepal <Heather.Trepal at utsa.edu<mailto:Heather.Trepal at utsa.edu>> wrote:
I agree with both Cynthia and John about the need for presenting a balanced perspective. I also see a need for education and advocacy between the mental health and medical professions. What I have found to be really interesting over the past year in observing the number of clients in our clinic who don't take their medications as prescribed (for many reasons...financial, time, side-effects...the list goes on) is that many don't seem really aware of the side effects of stopping (or stop-starting) psychotropic medications. Some folks seem to take the whole issue pretty casually and never discuss it with their physician/psychiatrist or counselor.

Great discussion!

Heather

Heather Trepal, Ph.D., LPC-S

Associate Professor

University of Texas at San Antonio

College of Education and Human Development

Department of Counseling

501 W. César E. Chávez Boulevard

San Antonio, Texas 78207-4415

(210) 458-2928<tel:%28210%29%20458-2928>; 458-2605 (fax)

heather.trepal at utsa.edu<mailto:heather.trepal at utsa.edu> <mailto:heather.trepal at utsa.edu<mailto:heather.trepal at utsa.edu>>

________________________________

From: CESNET-L is a unmoderated listserv concerning counselor ed. & supervision on behalf of Sommers-Flanagan, John
Sent: Fri 10/21/2011 3:35 PM
To: CESNET-L at LISTSERV.KENT.EDU<mailto:CESNET-L at LISTSERV.KENT.EDU>
Subject: Re: Use of Antidepressants on the Rise in the U.S.

The research on antidepressants is, in a word, "depressing."

I totally agree about staying balanced. Individual clients often respond positively to antidepressants (much more in adults than youth), but the general data are quite negative. There is substantial money spent marketing the antidepressants to all of us. Even the name is a misnomer. And there's no good evidence of a chemical imbalance. And the research studies are strongly biased in favor of finding positive antidepressant outcomes. And there's clear evidence that SSRIs increase suicidality - especially in youth who are not suicidal. Of course, all these general facts do not tell us much about whether the client in our office might or might not benefit. It does suggest that more than just meds are needed in most cases. However, the research on combination treatment being more effective than counseling alone is equivocal in adults and non-existent in youth. Having published a recent review on this I was surprised to find that the data contradicts the usual idea that most of us have come to believe about combination treatment being more effective.

Again, I agree with Cynthia about being balanced, but sometimes, in this area in particular, it's important to counter what's spread around as common knowledge - sometimes by the pharmaceuticals - with some of the research facts that don't really support antidepressant medication efficacy for treating depression.  I'm not suggesting we tell our clients meds don't work or that they shouldn't seek medication treatment. . . but that we should help them work on making positive changes in their lives along with or not along with medications. In the end, hardly anything beats behavioral activation, good cognitive-behavioral therapy, and counseling that helps individuals, couples, families, and groups problem-solve, cope with stress, and improve their relationships.

John SF

John Sommers-Flanagan, Ph.D., Professor
Department of Counselor Education

College of Education and Human Sciences

32 Campus Drive

The University of Montana

Missoula, MT  59812

406-243-5820<tel:406-243-5820> (office)

406-721-6367<tel:406-721-6367> (cell)

From: CESNET-L is a unmoderated listserv concerning counselor ed. & supervision [mailto:CESNET-L at LISTSERV.KENT.EDU<mailto:CESNET-L at LISTSERV.KENT.EDU>] On Behalf Of Hipple, John
Sent: Friday, October 21, 2011 12:40 PM
To: CESNET-L at LISTSERV.KENT.EDU<mailto:CESNET-L at LISTSERV.KENT.EDU>
Subject: Re: Use of Antidepressants on the Rise in the U.S.

I appreciate how Cynthia has stated the practical case for medication and counseling.   While I am currently working in a college counseling  center I have also worked in rural and urban mental health centers as well as a day treatment facility.   In all of these situations I have seen the benefits of medication.   One important task for counselors is to work with  clients to find what combination best fits their needs and wants.   Not every client will want to have both and some want one type of intervention and not the other.  Educating clients about their options for intervention is critical.

John Hipple, Ph.D.

Counseling Center

Univ. N. TX

From: CESNET-L is a unmoderated listserv concerning counselor ed. & supervision [mailto:CESNET-L at LISTSERV.KENT.EDU<mailto:CESNET-L at LISTSERV.KENT.EDU>] On Behalf Of Cynthia Miller
Sent: Friday, October 21, 2011 1:31 PM
To: CESNET-L at LISTSERV.KENT.EDU<mailto:CESNET-L at LISTSERV.KENT.EDU>
Subject: Re: Use of Antidepressants on the Rise in the U.S.

I think we need to be really careful about how we think about psychiatric medications and what we tell our clients.  As a practitioner on the front lines I can tell you that I have seen clients who have been helped tremendously by antidepressants and other psychiatric medications.  Are they overprescribed?  Probably.  But I don't think they're a placebo, either.  We don't necessarily understand how and why they work, but for many people the antidepressants are the difference between maintaing a stable, functional life and a revolving door of hospitalizations and instability.

Recruitment for drug studies is rife with problems.  Questions abound regarding how representative study patients are compared to true clinical populations.  I read the studies and I see the arguments going back and forth.  And then I see my clients in my practice and I see the difference antidepressants and other medications can make.

As a society, we do seem to be increasingly prone to pathologizing bad behavior or situational stressors and turning them into psychiatric conditions.  At the same time, there continues to be significant stigma associated with taking medications for psychiatric reasons.  I think our role, as counselors, is to provide the balance.  Research has consistently shown that the combination of medication and therapy is best for moderate to severe cases of depression, anxiety, and other mental illnesses.  The problem is that a lot of people don't get referred for therapy or don't follow through with referrals.  We can educate the public on the benfits of therapy and promote it as a potential alternative to medications in cases of mild to moderate depression.  But I don't think we should dismiss or diminish the usefulness of medications.

On Thu, Oct 20, 2011 at 10:57 PM, Jered Kolbert <jeredkolbert at gmail.com<mailto:jeredkolbert at gmail.com>> wrote:

The last time I looked at the literature regarding anti-depressants they appeared to be only slightly more effective than a placebo.

On Thu, Oct 20, 2011 at 11:10 AM, John Yasenchak <YasenchakJ at husson.edu<mailto:YasenchakJ at husson.edu>> wrote:

In light of this topic, any thoughts on Robert Whitaker's book "Anatomy of an Epidemic" and his review of research on psychotropic medications? Anyone using his book in a course? His website has some interesting postings. He is also author of "Mad in America"

John Yasenchak, Ed.D., LCPC,LADC,CCS

Assistant Professor

Graduate Programs in Counseling and Human Relations

Husson University

Bangor, Maine 04402

207 973 1014<tel:207%20973%201014>

From: CESNET-L is a unmoderated listserv concerning counselor ed. & supervision [mailto:CESNET-L at LISTSERV.KENT.EDU<mailto:CESNET-L at LISTSERV.KENT.EDU>] On Behalf Of Hipple, John
Sent: Thursday, October 20, 2011 9:11 AM
To: CESNET-L at LISTSERV.KENT.EDU<mailto:CESNET-L at LISTSERV.KENT.EDU>
Subject: Re: Use of Antidepressants on the Rise in the U.S.

I don't agree that 'All GP's " don't believe in counseling.   Many of our local physicians regularly refer to counselors, social workers, and psychologists.   I think it is critical for counselors in practice to be active in introducing themselves to the medical professionals in their area.

The fact that many individuals taking medication aren't seeking counseling is not necessarily the 'fault' of inadequate physician referral.   Talk therapy takes a lot of time and money and for many medication is more convenient.

I think all of us who engage in providing talk therapy must continue our efforts in showing potential consumers that what we have to offer has value.

John Hipple, Ph.D

Counseling Center

Univ. N. Tx

From: CESNET-L is a unmoderated listserv concerning counselor ed. & supervision [mailto:CESNET-L at LISTSERV.KENT.EDU<mailto:CESNET-L at LISTSERV.KENT.EDU>] On Behalf Of Jeff Edwards
Sent: Wednesday, October 19, 2011 7:35 PM
To: CESNET-L at LISTSERV.KENT.EDU<mailto:CESNET-L at LISTSERV.KENT.EDU>
Subject: Re: Use of Antidepressants on the Rise in the U.S.

that is because the majority of prescribing physicians are GP;s and not psychiatrists, and GP;s do not believe in counseling, and the pay come from insurance companies who know it is cheaper to have a clinician prescribe meds than to script them off to a counselor.  It's all about the money.

Dr. Jeffrey K. Edwards, Professor Emeritus
CACREP Accredited Family Counseling Program,
Department of Counselor Education
Northeastern Illinois University
Chicago, IL 60625
773-442-5541<tel:773-442-5541> http://www.neiu.edu/~jkedward<http://www.neiu.edu/%7Ejkedward>
Cell 630-890-7440<tel:630-890-7440>

Contributing Faculty Member of Walden University
College of Social and Behavioral Sciences/School of
Counseling and Social Service/Mental Health Counseling
Marriage, Couple and Family Counseling Program

President-elect, Illinois Counselor Educators and Supervisors
Buy our book A Consumers Guide to Mental Health Services: Unveiling the Mysteries of Psychotherapy at: Click here: Amazon.com: A Consumer's Guide to Mental Health Services: Unveiling the Mysteries and Secrets of Psychotherapy (Ha <http://www.amazon.com/Consumers-Guide-Mental-Health-Services/dp/078903266X/ref=sr_1_1?ie=UTF8&s=books&qid=1205697471&sr=1-1>
and look for my new book, Strengths-Based Supervision in Clinical Practice, Sage Press, due out Aprl, 2012

Be environmentally responsible; if you don't need to print this out, don't!

In a message dated 10/19/2011 7:17:08 P.M. Central Daylight Time, daylejones at UCF.EDU<mailto:daylejones at UCF.EDU> writes:

       CDC reports that antidepressant use has increased nearly 400% since 1988.

       What's concerning for counselors is this: Less than a 1/3 of people taking one antidepressant drug have visited a mental health professional in the past year.

       Here's the link to this article: http://www.cdc.gov/nchs/data/databriefs/db76.htm

       K. Dayle Jones, Ph.D., LMHC
       Associate Professor, Coordinator
       Mental Health Counseling Program
       University of Central Florida
       Orlando, FL 332816-1250
       Phone: (407) 823-6477<tel:%28407%29%20823-6477>
       Email: daylejones at ucf.edu<mailto:daylejones at ucf.edu>
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--

Jered Kolbert, Ph.D., LPC, NCC

Director of the Doctoral Program in Counselor Education & Supervision
Associate Professor
Department of Counseling, Psychology, and Special Education (DCPSE)
Duquesne University
600 Forbes Avenue
110D Canevin Hall
Pittsburgh, PA 15282
(412) 396-4471<tel:%28412%29%20396-4471>

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Cynthia M. Miller, Ph.D., LPC
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See www.CESNET-L.net<http://www.CESNET-L.net> for information on how to sign-off, sign-up, and use the CESNET-L listserv.

--
Cynthia M. Miller, Ph.D., LPC
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******************** See www.CESNET-L.net<http://www.CESNET-L.net> for information on how to sign-off, sign-up, and use the CESNET-L listserv.
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