The use of psychotropic medications (pharmacotherapy) in conjunction with psychotherapy is regarded as the standard of care for many mental health disorders. Counselors, therefore, need to be knowledgeable about psychopharmacology to monitor its impact on the therapeutic relationship and on client outcome. Discussed are potential ethical dilemmas with pharmacotherapy interventions, case studies demonstrating proper support of pharmacotherapy with diverse clientele, and critical elements of master's level training in psychopharmacology.
It is a pleasure to introduce this special DSM-5 edition of The Professional Counselor, which provides a solid primer regarding changes in the DSM-5 diagnosis process and how these changes will likely impact mental health professionals. Changes within the DSM-5 have prompted counselors to revisit the basics of diagnosis and consider the cessation of certain conventions (e.g., the multiaxial system) and what these changes mean to counselors as they perform their vital work for the benefit of clients. The unprecedented inclusion of various mental health professionals in the development of the DSM-5 is an inherent recognition of how this tool is being used across a wide range of professional disciplines that focus on psychopathology. I hope these articles not only inform, but encourage further research into the practical use of the DSM-5, "stimulate new clinical perspectives" in mental illness (American Psychiatric Association [APA], 2013, p. 10), and inspire continued professional dialogue around DSM nosology and the diagnostic processes.
Research from a variety of sources demonstrates that psychotropic medications have induced a number of unanticipated physiological and psychological client reactions. Although a great deal of literature is published concerning potential expected side effects from psychotropic medications, little is understood regarding other unexpected reactions that may cause significant client discomfort. These unanticipated psychotropic reactions may be considered as effects that may be rare and therefore not accounted for in randomized clinical drug trials. Like any medication, psychotropic medications do not produce the same effect in everyone. Some people may respond better to one medication than another. Mental health counselors are advised to be aware that some unexpected reactions can be important in determining client outcomes. In this article, we discuss the client's right to be informed about unanticipated side-effects of their medication regimen and the ethical question as to how much information to give clients.
There is a story about a Paris art shop during the occupation. In the window of the shop were displayed two enormous portraits, one of Petain and the other of Admiral Darlan. In the corner of each there was a tiny label indicating that the former was vendu and the latter a vendre. The Germans who walked past the shop apparently noticed nothing. On I November, 1940 there took place. in the Champs Elysees a demonstration of students, the first of its kind since the Germans occupied the city. Each of the students was carrying two long poles, or deux gaules.1Again, the allusion was lost on the enemy.Each of these incidents, which in themselves may appear trivial and merely quixotic, points to a fact of considerable significance: language is the last line of defence of a defeated country. Political institutions and military capacity can be destroyed, a language cannot. Language remains as an invulnerable guarantee of national identity and may be used, for example if its ambiguities are exploited, as an offensive weapon. As Aragon wrote during the occupation: 'll ne restait de ce pays que son langage'.2 It is with the various forms of what might be called 'linguistic resistance' that I shall be concerned .here.If someone shouts at you in a foreign language, the natural response is to return abuse in your own. If, however, a foreigner makes a great effort to use your language, to communicate with you, then one tends to reply politely. This was the temptation facing Frenchmen in the early stages of the occupation, when German policy was one of blandishments rather than threats. The only effective way to resist the temptation was to remain silent.
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