Gulnora Hundley has a message for counselors: You might not have a medical degree, but you need to know something about the medications your clients are taking.
As the director of the outpatient Community Counseling Clinic at the University of Central Florida, Hundley says she’s seen cases of anxiety rise in the community, a substantial portion of that due to economic hardship. Hundley, a member of the American Counseling Association who also runs a private practice in Winter Park, says not only is it commonplace for clients to turn to self-medicating with alcohol and even illegal drugs, but there is also a tendency in the medical community to prescribe anti-anxiety medications more frequently than necessary.
At a minimum, counselors working with clients diagnosed with anxiety disorders need a basic knowledge of anti-anxiety medications, Hundley says, because those are the most prescribed medications in the mental health field. “Some clients are taking several medications simultaneously when therapeutic counseling and relaxation exercises might prove to be more beneficial and safer,” says Hundley, who was a psychiatrist in the former Soviet Union before earning master’s and Ph.D. degrees in counseling from UCF.
“Anxiety disorders are the most common psychiatric illness impacting both children and adults and frequently viewed as serious and debilitating,” Hundley says. “According to the National Institute of Mental Health, 37 million people in the United States suffer from some form of anxiety. These disorders are frequently treated by a number of techniques, often including a combination of psychotherapy and anti-anxiety medications. It is critical, therefore, that mental health counselors understand how these medications impact their clients’ lives in order to properly incorporate this knowledge into the treatment process.”
It’s the responsibility of the counselor to determine, as much as possible, what is best for the client, Hundley says. Clients bear responsibility as well, she adds, for educating themselves and asking questions instead of simply following a physician’s orders. “Individuals often view prescription medication as a quick solution to their anxiety and stress while counseling is often perceived as time-consuming and difficult,” says Hundley, who also teaches graduate counseling courses at UCF.
The origins of clients’ anxiety can vary, and many medications are administered almost through a trial and error methodology, Hundley says, where for every positive result, there is almost always a negative impact of some kind. “Therefore, it is critical that the counselor thoroughly assess each client to determine, to the greatest extent possible, the reasons for anxiety in his/her particular circumstance,” she says. “It is preferable that medication be used as a limited supplement to counseling and only when absolutely necessary.”
Although counselors aren’t the ones prescribing the medications, their role in the process is key, Hundley says. “Often it is the counselor who is in the best position to recognize subtle medication side effects and determine if the prescribed medication is or is not positively impacting the client’s anxiety,” she says. “By identifying and clarifying symptoms, the mental health counselor can play a crucial role in assisting the physician in the selection of appropriate and specific prescription medications. Whenever possible, the physician and counselor should work together to design and implement a treatment regimen with the primary objective being the well-being of the client.”
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To read the November cover story on stress and anxiety, click here.
Lynne Shallcross is a senior writer for Counseling Today. Contact her at lshallcross@counseling.org.
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