Volume 26, Number 3, July 2004
1. Anxiety Diagnoses and Their Relationship to the
Number of Prescribed Psychotropic Medications (Pages 189-198)
Randy A. Sansone; George A. Gaither; Dorota Rytwinski
We designed this study to explore the relationship between an anxiety disorder diagnosis and the number of prescribed psychotropic medications. We retrospectively reviewed the medical records of 337 psychiatry outpatients, who were being seen in a psychotherapy training clinic, with regard to psychiatric
diagnosis and the number of psychotropic medications.We grouped diagnoses into three categories:
(a) anxiety disorders, (b) mood disorders, and (c) other Axis I disorders.Approximately 16% of persons were prescribed no psychotropic medications, while 41.5%, 30.0%, 8.6%, 2.7%, and 0.9% were prescribed one, two, three, four, and five psychotropic medications, respectively. The proportion of individuals on more than one medication with anxiety disorders was significantly greater than the base rate in the overall sample (z = 3.21, p < .001) or the proportion diagnosed with mood (z = 2.53, p = .01) or other Axis I disorders (z = 3.90, p < .001). In addition, for persons who were diagnosed with different diagnostic groupings, when one was anxiety disorders, they were more likely to be prescribed multiple psychotropic medications. In an outpatient psychiatry clinic, an anxiety disorder diagnosis appears to heighten the likelihood of being prescribed a greater number of psychotropic medications.We discuss the possible implications of these findings in outpatient mental health settings.
2. Receiving Gifts from Clients: Ethical and Therapeutic Issues
Mark S. Gerig
The ethical and therapeutic implications of receiving gifts from clients are explored. The importance of the issue is noted, and relevant ethical considerations are discussed. Therapeutic meanings that underlie client gift-giving are explored. By integrating the ethical and therapeutic considerations, four general categories of gifts are identified. Specific therapeutic responses to each category are identified and briefly discussed.
3. Engaging Families in School-Based Mental Health Treatment
Linda M. Vanderbleek
Increasing populations of students are unprepared for learning due to emotional or behavioral problems. Yet, school-based mental health services are fragmented, marginalized, and underutilized. Despite the federal mandate to improve all student achievement and an increased ability to identify students needing mental health services, school-based mental health services are noticeably absent from school reform initiatives. The research clearly shows family involvement in school based mental health services is effective in improving student academic performance. By understanding barriers to school-based mental health counseling services and strategies for increasing family enrollment and retention, mental health counselors can help increase students’ academic readiness and the integration of mental health services into the structure of the nation’s schools.
4. Poor, Rural and Female: Under-Studied, Under-Counseled, More At-Risk (Pages 225-242)
Jane E. Myers; Carman S. Gill
The feminization of poverty has been well documented, and the relationship between the experiences of poverty and negative mental health outcomes has been identified. These consequences remain largely unexamined for women living in rural areas that comprise a population both at risk and underserved by mental health professionals. The dynamics of poverty for these women and the relationship between poverty lifestyles and physical and mental well-being is explored.A model for assessment and mental health interventions is presented. Implications for mental health counseling and for research are considered.
5. Unique Issues in Counseling the Bereaved (Page 243)
Heather L. Servaty-Seib, Guest Editor
This Special Section is consistent with the JMHC’s April 2004 Special Issue titled Perspectives on Counseling the Bereaved. The authors address two additional topics of interest.
Toray offers a unique clinical perspective, heavily influenced by her family studies background and her involvement in the development of and subsequent work (during the year 2001) as director for veterinary-based support institute, on death loss and the human-animal bond.As a grief support service, the primary mission of the institute has been to provide for the emotional needs of the clients of a veterinary school. Toray shares her insights regarding how mental health counselors can best assess, support, and counsel clients grieving the deaths of companion animals.
6. The Human-Animal Bond and Loss: Providing Support for Grieving Clients (Pages 244-259)
The purpose of this article is to increase mental health counselors’ awareness of the importance of pets in the lives of their clients and to provide a greater understanding of the grief process accompanying the death of a companion animal. A broad framework for assessing clients’ attachments to their pets and conceptualizing grief as it relates to pet loss will be presented.
7. Assessing Loss Reactions among Older Adults: Strategies to Evaluate the Impact of September 11, 2001 (Pages 260-281)
Carla J. Sofka
As a result of the events of September 11, 2001, older adults have experienced a multitude of death related and non-death losses. Mental health counselors who interact with older adults have a crucial
role in identifying individuals who may be at risk for experiencing a subsequent, temporary, upsurge of grief. Following a review of basic concepts and underlying philosophies that can be utilized to inform work with bereaved older adults, interviewing strategies and standardized measures available for use with older adults experiencing trauma and grief are described. Then using Corr’s (2003) task-based approach as a framework, strategies for identification of need and intervention are presented.