The use of medication to treat various psychological disorders has expanded greatly over the last decade. Therefore, counselors need more sophisticated knowledge about psychopharmacology to work effectively in school and community settings. This article describes the curriculum, structure, resources, and teaching methods for effective instruction in psychopharmacology for counselors.
During the last 40 years, the way mental and emotional disorders are conceptualized has changed drastically. In the recent past, the theoretical base for the etiology and treatment of mental and emotional disorders was strongly psychodynamic (Gabbard, 1994). Despite trends in brief and cognitive therapies, this base has become increasingly medical (Cohen, 1993). The medical model emphasizes the biological bases of behavior and pharmacological manipulation of these biological bases to achieve behavior change (Gabbard, 1994; Schatzberg, Cole, & DeBattista, 1997). At the time of this writing, the core treatment for most major mental and emotional disorders listed in the American Psychiatric Association's (1994) Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) is pharmacological (Victor, 1996), and there are more pharmacological treatments available for these disorders than ever before (Littrell & Ashford, 1995).
Furthermore, it is estimated that 7.5 million children in the United States experience significant mental health problems (Kratochwill, 1994) and are increasingly being prescribed psychotropic medication as part of their treatment (Gadow, 1991; Pelham, 1993). According to the Associate Director of the Office of Research of the American Psychiatric Association, it is difficult to get exact estimates on psychotropic prescriptions in the United States (T. Tanielian, personal communication, February 8, 1999), but evidence suggests that such prescriptions are increasing. Psychotropic medications accounted for approximately 90% of the total prescription drug market in 1994, and that number is rising (Pincus et al., 1998). The number of visits to primary care physicians and psychiatrists for psychotropic medication has increased (Pincus et al., 1998), and much of the increase is attributable to newer antidepressants and the increased use of stimulants to treat children and adolescents with attention-deficit/hyperactivity disorder (ADHD).
A general working knowledge of psychopharmacology is important for several reasons. First, all mental health professionals should be able to help their clients understand treatment options that they are likely to encounter (Meyer & Deitsch, 1996), and psychotropic medications are increasingly considered as treatment options in agency counseling settings (Faiver, Eisengart, & Colonna, 2000). A problem develops when many clients of master's-level counselors, social workers, or school psychologists are taking some form of psychotropic medication, and research studies have noted that these professionals lack training in psychopharmacology (Bentley, Farmer, & Phillips, 1991; Kratochwill, 1994; West, Hosie, & Mackey, 1988). Second, counselors need to understand how taking medications or noncompliance with medication prescriptions can affect a client's progress in counseling. Understanding these issues can help counselors decide when referral back to the professional prescribing the client's medication is necessary. Third, state counselor licensure laws, modeled after the American Counseling Association's (ACA) model licensure law (Bloom et al., 1990), are beginning to recommend training in "knowing the effect on client behavior and the interaction of psychotropic medications and mood altering chemicals in the treatment of mental and emotional disorders" (State of Ohio Counselor and Social Worker Board, 1996, p. 38).
These developments support offering an introductory psychopharmacology course for counseling students. The purpose of this article is to describe the structure and goals of such a course offered in the counselor education program at a midsize state university.
COURSE STRUCTURE: GOALS, CONTENT, AND RESOURCES
The course began as an elective course for post-master's students and is now a required course for agency counseling students because of changes in the counselor licensure law in the state where the course is taught. The course is taken at the end of the program of study and has a prerequisite of a psychopathology course in which students study DSM-IV nosology. The primary text used is Julien (1998), although Grilly (1998), Stahl (2000), or Buelow, Hebert, and Buelow (2000) are also appropriate comprehensive texts.
The first issue in designing a course is to identify the knowledge bases to be covered and resources for those knowledge bases. The American Psychological Association (APA) has published curriculum guidelines for three levels of training in psychopharmacology (APA, 1995). The APA Level-1 guidelines were …