Tuesday, September 13, 2011



If therapists let clients lead therapeutic conversations with questions, they invite answers that satisfy or lead to other pertinent questions regarding clients’ SSRI prescription. The type of questions and the way they are expressed can give therapists clues about how intricately or involved their answers to their clients need to be. 

Using such a strategy can help produce positive outcomes in therapy because therapists are facilitated in communicating adequate information about their clients’ prescription and in receiving information regarding clients’ perspectives.

On the other hand detailed explanations to some clients may be counterproductive. Knowing that the drugs work may be all the information clients want or need at a given time. More often than not, however, giving at least rudimentary explanations can enhance clients understanding of their therapeutic process and empower them to make positive changes. 

Rather than explaining re-regulation of neurotransmitters that block uptake and stimulate the site of nerve receptors, clinicians might chose a more general approach when explaining the process by which SSRIs work. A simple explanation that the SSRI helps bring the body’s chemicals back into balance may be appropriate for some clients, especially younger and lower functioning clients.

Clinicians also need to take into consideration that there may be times when their clients are too depressed to receive answers to their questions and address them at another time.

Crucial questions therapists need to answer include those involving possible side effects. If clients are aware of what to expect when taking their SSRIs, their discouragement and anxiety can be lessened in the therapeutic process.

In addition, because some cultures respond differently to SSRIs, making African American and Asian clients aware of the possibility of toxicity with SSRI use is paramount. Elderly clients may also be more sensitive to the side effects of SSRIs.

“Therapists must essentially understand that each culture has its conceptions of disorder and its therapeutic and healing system” (Reinecke & Davison, 2002, p. 70). Therefore, rather than imposing western or mainstream cultural understandings onto them, careful consideration of the way therapists respond to clients from a culturally diverse background is imperative when communicating diagnostic and drug information.

Clients may mistakenly attribute common side effects of SSRIs to their symptoms of depression. Some side effects are: insomnia, shakiness, decrease in appetite, dizziness, nervousness, and sexual dysfunction. Therefore, explaining these effects can help clients understand why they are feeling what they are feeling and decrease their anxiety about their condition and their use of the SSRIs. 

Teaching not only clients but also their families about the contraindications and side effects and methods for managing those side effects can be critical in helping achieve and maintain compliance with SSRI use and family support.

Therapists may need to communicate with clients’ doctors to help monitor and adjust the SSRI medication. If communication with clients’ doctors is indicated, therapists are advised to write down the most salient issues and have the chart available when discussing clients. 

Therapists must also be sure to obtain clients’ written consent when giving or getting feedback from clients’ doctors. If clients do not improve, referral to a psychiatrist may be indicated. When making a referral, therapists should write a letter outlining symptoms and reasons for the referral along with a copy of the client’s consent. However, therapists should never make recommendations for drugs, unless they are trained in pharmacy consulting. Clinicians can help reduce the possibility of ethics violations and malpractice by following the above steps.

In order to provide accurate and effective information on SSRIs, therapists may need to consult academic sources. A few of these sources may include “Physician’s Desk Reference,” “Quick Reference for Psycholopharmacology” by Elizabeth Rankin (2000), and “Psychotherapist’s Resource on Psychiatric Medications” by Buelow, Hebert, and Buelow (2000). Web sites authored by national societies involved in medical and therapeutic treatment of mental disorders is also appropriate and helpful.


When addressing prescriptions written by physicians, therapists need to gather all pertinent information. This process is done simply by asking and answering questions. 

If clinicians consider the age, culture, sexual activity, medical background, drug use, and history of clients, they are better equipped to decide what information to communicate and how to convey it. If therapists can elicit information through questions and answers regarding clients’ medical status and their interactions with their physician, they are better prepared to proceed with treatment.

If therapists emphasize the importance of therapy in conjunction with SSRI use, chances of effective therapy are increased. Especially during the initial phase of SSRI use, clients have an adjustment period and will need the most support. Therefore, clinicians can facilitate the most effective treatment by giving clear and effective communication when asking and answering questions.

(Feel free to ask for complete references.)


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