Counseling a psychopharmacological approach, as well as

Counseling During the Initial Stages of a Psychopharmacological Intervention
Kelly Largent
Walden University

Counseling During the Initial Stages of a Psychopharmacological Intervention
The purpose of this assignment is to review a provided case study, evaluate the client’s depressive symptoms and provide potential medications that may be prescribed by a psychiatrist to treat these symptoms. Additionally, the role of the counselor during the initial stages of the psychopharmacological intervention will be discussed. Emphasis will be placed on the importance of educating the client regarding potential side effects that may occur while starting an anti-depressant medication. Lastly, possible challenges that are likely to arise during the implementation and initial stages of a psychopharmacological approach, as well as strategies for addressing these challenges will be defined. 
Summary of Case Study
For the purpose of this assignment, the author was asked to select a case study to review, from three provided options. The case study selected is the case of John. John is a biracial, middle aged man. He is now coming to counselling due to concerns regarding his decreasing mood. He is also concerned, as he has begun to have little interest in eating, and increased difficulty falling/staying asleep. John is also experiencing a lower drive to do things he once found enjoyable such a spending time with family. John is currently single, with no children. He has a tight-knit family that relies on him for assistance with childcare. John lives within a home that he owns and is able to maintain his needs through the finical gains of his employment as a handyman.
Symptoms Indicating Depression
When assessing a client for depression it is critical to look at the symptoms that are present during the client intake and initial assessment. Common symptoms of all depressive disorders are Moods of sadness, loss of enjoyment/pleasure, low self-esteem, social withdrawal, emotional sensitivity, pessimistic thinking, irritability, and suicidal ideas (Preston, O’Neal, & Talaga, 2013). Additionally, individuals with depression may also have physicals symptoms such as appetite changes, fatigue, restlessness, decreased sex drive and sleep disturbances (Preston, O’Neal, & Talaga, 2013). In regards to John’s case, He is presenting with a primary complaint of decreased mood. He also reports no longer enjoying spending time with family members as he once did. Additionally, John stated that food is not appealing to him as it no longer has a taste. Based on this information it can be assumed that John is also having weight loss. Finally, John, reports an inability to sleep due to racing thoughts regarding his life’s failures. However, he also mentioned a period of previous months where all he wanted to do was sleep. When considering the symptoms of the client, a Tricyclic Anti-depressant (TCA) may be a good option. TCAs are extremely effective in treating patients with symptoms of insomnia, weight loss, insidious onset, and insomnia, all of which John presents with (Perry, Alexander, Liskow, & DeVane, 2007).
Increasing Awareness of Medication-Related Effects.
If John were to be prescribed a TCA medication for the treatment of his depressive symptoms, there are many potential medication-related effects that it would be essential for the counselor to educate him on prior to being the psychopharmacological intervention. Some of the potential adverse reactions that may occur while taking a TCA medication include blurred vision, bowel changes, dry mouth, orthostatic hypotension, dermatologic, hematologic, and hepatic changes, weight gain, and acute delirium (Perry, Alexander, Liskow, & DeVane, 2007). Additionally, while listening to the client’s concerns of sexual performance issues, it is essential that the counselor addresses the minimal potential for individuals on TCAs to experience erectile dysfunction (Perry, Alexander, Liskow, & DeVane, 2007). Lastly, with this medication approach the client should be educated that while adverse effects may present rapidly that the beneficial qualities of the medication may take longer to be seen, so it is preferred to remain on the medication for a matter of weeks prior to changing the course of treatment (Perry, Alexander, Liskow, & DeVane, 2007).
Supporting Psychiatrist Recommendations
In addition to being responsible for educating the client regarding potential medication-related effects, the counselor must also aid in supporting the recommendations of the prescribing psychiatrist. In many cases the counselor will be the care provider who has the most contact with the client, and is able to monitor changes and symptoms to aid in proper mediation treatment (Preston, O’Neal, & Talaga, 2013). Additionally, there may be aspects of the clients depression that cannot be treated by the prescribed medication, such as the underlying causes and triggers of the depressive states, that can only be resolved through psychotherapy (Preston, O’Neal, & Talaga, 2013).
Challenges During Initial Stages of Intervention.
As with the beginning of all new treatment approaches both the counselor and client may experience challenges. When considering this case, the most difficult foreseeable challenge will be helping reassure John during the period of time when the potential side effects may be present. This is based on his stated concern regarding his ability to be able to deal with side-effects. An additional challenge may occur with non-compliance, as this is common with many individuals with depressive disorders. The best strategy for managing both of these potential challenges is patient education. It has been shown that when the patient is thoroughly educated on what to expect during the initial stages of the psychopharmacological treatment plan that they are more compliant and less hesitant with the course of treatment (Preston, O’Neal, & Talaga, 2013).
References
Perry, P. J., Alexander, B., Liskow, B. I., & DeVane, C. L. (2007). Psychotropic drug handbook (8th ed.). Baltimore, MD: Lippincott Williams & Wilkins.
Preston, J. D., O’Neal, J. H., & Talaga, M. C. (2013). Handbook of clinical psychopharmacology for therapists (7th ed.). Oakland, CA: New Harbinger Publications.

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