Counselors and medication advice

Started by cbrons
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cbrons

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I wasn't sure where to put this thread but I thought this forum was the best choice. I am in my final semester of graduate school and I am currently taking a course entitled, Substance Abuse Treatment and Diagnosis (90% of the students are working towards an MS in Clinical Psychology).

Anyway, in this course, the professor (an MS in clinical psychology currently working as a substance abuse counselor) teaches us the basic pharmacology of various common legal and illegal substances. She goes over common side effects, medical indications, withdrawal symptoms, etc.

Now there is this role-playing activity she has us do where one student acts as a client (typically someone addicted to one substance or another) and the other student acts as the counselor.

In some of these activities, the "client" asks the "counselor" about a medication his/her psychiatrist prescribed. The "counselor" is then instructed/encouraged to go over some potential dangers of taking the drug (i.e. addiction potential), explain how the drug works in "plain, understandable terms," and answer any questions the "client" might have about the drug.

Now when we first did this exercise and i heard the "client" ask a drug question, I raised my hand and asked the professor if the question was more appropriate for the pharmacist or the "client's" physician. I then went on to ask if it was even legal for counselors to give medication advice to psychiatric patients.

She said it was fine and something she does all the time ("some client don't feel comfortable with the psychiatrist"). Someone else asked: What if I don't know the answer? She said, "Look it up... I keep a book of common psych drugs right in my office in case a client asks a question I dont know."

My question for you: is it appropriate for a counselor (someone with a masters degree in clinical psychology or counseling or a related discipline) to give such guidance to patients under psychiatric care? If yes, what are the limits?
 
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I'm not a pharmacist, just a 2nd year student but what you are describing sounds like your psych professor is working outside her scope of practice and is asking for a lawsuit waiting to happen from one of her pts.

Be logical, ask yourself: what adequate training does she have to provide medical advice regarding the drugs, their side effects or counseling patients on the important points regarding to them (which is basically what she is doing) ?

Do you feel comfortable providing the advice outside of your training or scope of practice ? Will you have some sort of lincense to practice as a clinical psychologist that might get jeopardized by your actions ?

I sure as heck wouldn't feel comfortable performing surgeries if I didn't go to med school and completed surgical residency, how would this be any different ? 😉 🙄
 
I agree with chebs. What your psych professor is doing and encouraging is outside her scope of practice (and that of a master's level counselor). There are many other things to consider in drug therapy aside from side effects you can look up in a reference book.
 
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Be logical, ask yourself: what adequate training does she have to provide medical advice regarding the drugs, their side effects or counseling patients on the important points regarding to them (which is basically what she is doing) ?
I'm actually curious about this hypothetical with nursing. I spent 1 semester in nursing school before realizing that it wasn't my thing. We took a brief pharmacotherapy course (taught by pharmacists!), but it was quite limited and didn't provide enough background to counsel patients on medication issues, in my mind. Yet, that is exactly what the nursing program urged the nursing students to do -- counsel on drugs. Not full-on pharmacist-style counseling, but going over possible side effects to watch for and teaching how to use inhalers, etc.

I guess I wondered, after receiving the training, how it would be possible to teach this with the limited background provided by the nursing program...
 
It is less than appropriate but probably not illegal. If you could hear the things that some (non-pharmacist) CDEs say in diabetes education class... sheesh. And these are people who are credentialed. After all, it's not illegal for chiropractors to tell people to opt out of vaccines and d/c their BP meds and other quacky things. I can see some potential liability in all of these scenarios, but would be interested to know if there is any specific case law out there.
 
It is less than appropriate but probably not illegal. If you could hear the things that some (non-pharmacist) CDEs say in diabetes education class... sheesh. And these are people who are credentialed. After all, it's not illegal for chiropractors to tell people to opt out of vaccines and d/c their BP meds and other quacky things. I can see some potential liability in all of these scenarios, but would be interested to know if there is any specific case law out there.

Paging Dr. Law2Doc (though I doubt the man has time)

Interestingly, we had an exam question on our midterm id like to share when i get to my office today i might be inclined to post it