Abstract:Objectives: Around 26% of the British adult population are prescribed psychiatric drugs each year. Most therapists (counsellors, psychotherapists and psychologists) provide therapy to some clients taking prescribed psychiatric drugs. This study aimed to better understand the experience, knowledge, training and concerns of therapists working therapeutically with clients prescribed psychiatric drugs.
Design:This was a survey study, generating both quantitative and qualitative data.
Methods:The online survey w… Show more
“…One Canadian study, for example, has reported that 74.2% of respondents indicated they did not have adequate support to prevent and address the misuse of prescription drugs (Porath‐Waller et al, 2015). While counsellors have also acknowledged the need for evidence‐based information about substance use and support for client‐based empowerment (Blair et al, 2021), many do not feel adequately trained to work with clients who have substance use disorders (Martin et al, 2016). Counsellors are well placed to provide evidence‐based interventions to assist clients during withdrawal from overused psychoactive substances and are frequently asked about the impact of psychiatric drugs on therapy (Blair et al, 2021; Dorais et al, 2020).…”
Section: Introductionmentioning
confidence: 99%
“…While counsellors have also acknowledged the need for evidence‐based information about substance use and support for client‐based empowerment (Blair et al, 2021), many do not feel adequately trained to work with clients who have substance use disorders (Martin et al, 2016). Counsellors are well placed to provide evidence‐based interventions to assist clients during withdrawal from overused psychoactive substances and are frequently asked about the impact of psychiatric drugs on therapy (Blair et al, 2021; Dorais et al, 2020). Evidence‐based psychological support for BZD withdrawal includes cognitive behavioural therapy, motivational interviewing and supportive counselling (Darker et al, 2015; Dutra et al, 2008; Parr et al, 2009; Reeve et al, 2017).…”
Section: Introductionmentioning
confidence: 99%
“…evidence-based interventions to assist clients during withdrawal from overused psychoactive substances and are frequently asked about the impact of psychiatric drugs on therapy (Blair et al, 2021;Dorais et al, 2020). Evidence-based psychological support for BZD withdrawal includes cognitive behavioural therapy, motivational interviewing and supportive counselling (Darker et al, 2015;Dutra et al, 2008;Parr et al, 2009;Reeve et al, 2017).…”
Despite adverse health outcomes being associated with long‐term tranquilliser use, health professionals face numerous barriers in reducing reliance on benzodiazepines. This study investigated the effectiveness of focused counselling in facilitating benzodiazepine withdrawal. In phase one of a two‐phase mixed‐methods evaluation, preintervention and postintervention quantitative data for 24 participants were analysed. Measures included the Australian Treatment Outcome Profile, Kessler 10, and two client outcome ratings. In phase two, follow‐up individual interviews were conducted with six participants. Following counselling, 88% of participants reported either reduced use or withdrawal from benzodiazepines. Significant reductions in psychological distress were obtained in Kessler 10 scores, and the calculated effect size (d = 0.84) was large. Medically supervised tapering was well received when combined with focused counselling. We found strong support for the tapering process and for the appropriateness of counselling. Withdrawal was facilitated when services were well coordinated and the client's sense of control was maintained.
“…One Canadian study, for example, has reported that 74.2% of respondents indicated they did not have adequate support to prevent and address the misuse of prescription drugs (Porath‐Waller et al, 2015). While counsellors have also acknowledged the need for evidence‐based information about substance use and support for client‐based empowerment (Blair et al, 2021), many do not feel adequately trained to work with clients who have substance use disorders (Martin et al, 2016). Counsellors are well placed to provide evidence‐based interventions to assist clients during withdrawal from overused psychoactive substances and are frequently asked about the impact of psychiatric drugs on therapy (Blair et al, 2021; Dorais et al, 2020).…”
Section: Introductionmentioning
confidence: 99%
“…While counsellors have also acknowledged the need for evidence‐based information about substance use and support for client‐based empowerment (Blair et al, 2021), many do not feel adequately trained to work with clients who have substance use disorders (Martin et al, 2016). Counsellors are well placed to provide evidence‐based interventions to assist clients during withdrawal from overused psychoactive substances and are frequently asked about the impact of psychiatric drugs on therapy (Blair et al, 2021; Dorais et al, 2020). Evidence‐based psychological support for BZD withdrawal includes cognitive behavioural therapy, motivational interviewing and supportive counselling (Darker et al, 2015; Dutra et al, 2008; Parr et al, 2009; Reeve et al, 2017).…”
Section: Introductionmentioning
confidence: 99%
“…evidence-based interventions to assist clients during withdrawal from overused psychoactive substances and are frequently asked about the impact of psychiatric drugs on therapy (Blair et al, 2021;Dorais et al, 2020). Evidence-based psychological support for BZD withdrawal includes cognitive behavioural therapy, motivational interviewing and supportive counselling (Darker et al, 2015;Dutra et al, 2008;Parr et al, 2009;Reeve et al, 2017).…”
Despite adverse health outcomes being associated with long‐term tranquilliser use, health professionals face numerous barriers in reducing reliance on benzodiazepines. This study investigated the effectiveness of focused counselling in facilitating benzodiazepine withdrawal. In phase one of a two‐phase mixed‐methods evaluation, preintervention and postintervention quantitative data for 24 participants were analysed. Measures included the Australian Treatment Outcome Profile, Kessler 10, and two client outcome ratings. In phase two, follow‐up individual interviews were conducted with six participants. Following counselling, 88% of participants reported either reduced use or withdrawal from benzodiazepines. Significant reductions in psychological distress were obtained in Kessler 10 scores, and the calculated effect size (d = 0.84) was large. Medically supervised tapering was well received when combined with focused counselling. We found strong support for the tapering process and for the appropriateness of counselling. Withdrawal was facilitated when services were well coordinated and the client's sense of control was maintained.
Tobacco use is the leading preventable cause of death in America and is elevated among patients with non-tobacco substance use disorders. Substance use treatment centers (SUTCs) do not commonly address their patients’ tobacco use. Lack of knowledge on treating tobacco use with counseling and medication may be a barrier that underlies this inaction. A multi-component tobacco-free workplace program implemented in Texas SUTCs educated providers on treating tobacco use with evidence-based medication (or referral) and counseling. This study examined how center-level changes in knowledge from pre- to post-implementation (i.e., over time) affected center-level behavioral changes in providers’ provision of tobacco use treatment over time. Providers from 15 SUTCs completed pre- and post-implementation surveys (pre N = 259; post N = 194) assessing (1) perceived barriers to treating tobacco use, specifically, a lack of knowledge on treating tobacco use with counseling or medication; (2) receipt of past-year education on treating tobacco use with counseling or medication; and (3) their intervention practices, specifically, the self-reported regular use of (a) counseling or (b) medication intervention or referral with patients who use tobacco. Generalized linear mixed models explored associations between provider-reported knowledge barriers, education receipt, and intervention practices over time. Overall, recent counseling education receipt was endorsed by 32.00% versus 70.21% of providers from pre- to post-implementation; the regular use of counseling to treat tobacco use was endorsed by 19.31% versus 28.87% from pre- to post-implementation. Recent medication education receipt was endorsed by 20.46% versus 71.88% of providers from pre- to post-implementation; the regular use of medication to treat tobacco use was endorsed by 31.66% versus 55.15% from pre- to post-implementation. All changes were statistically significant (ps < 0.05). High versus low reductions in the provider-reported barrier of “lack of knowledge on pharmacotherapy treatment” over time were a significant moderator of effects, such that SUTCs with high reductions in this barrier were more likely to report greater increases in both medication education receipt and medication treatment/referral for patients who use tobacco over time. In conclusion, a tobacco-free workplace program implementation strategy that included SUTC provider education improved knowledge and resulted in increased delivery of evidence-based treatment of tobacco use at SUTCs; however, treatment provision rates—in particular, offering tobacco cessation counseling—remained less than desirable, suggesting that barriers beyond lack of knowledge may be important to address to improve tobacco use care in SUTCs. Moderation results suggest (1) differences in the mechanisms underlying uptake of counseling education versus medication education and (2) that the relative difficulty of providing counseling versus providing medication persists regardless of knowledge gains.
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