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• W153145871 abstract "Electroconvulsive therapy is treatment of choice for severe depressive episodes. Although little definitive research exists to explain its effectiveness, since its development in 1938 it has proven effective for treatment of depression with psychotic features and suicidal ideation. The procedure is explained and implications for mental health counselor are discussed. Changes in professional understanding of mental illness have led to increasing use of somatic, or biological, therapy as part of successful treatment of some of more common disorders. Somatic therapies are physical in nature, and most commonly used of these are medication and electroconvulsive therapy (ECT). Many psychiatrists returned to biological model in 1980s and use both medication and ECT to treat more severe or serious illnesses: (a) depression, (b) mania, (c) schizophrenia, (d) severe anxiety disorders, and (e) dementia. These disorders are common, handicapping, and often resistant to treatments other than ECT (Rey & Walter, 1997). In addition, they are most likely disorders to have biological causes, and somatic therapies are seen as correcting an underlying biological imbalance. Electroconvulsive therapy is widely used today, but continues to attract controversy (Baldwin & Jones, 1998; Johnstone, 1999). Even by 1970s many psychiatric texts did not address ECT with children or adolescents, while others included brief references to possible clinical indications for administration. A paucity of training courses regarding ECT exists for health professionals as well as nonmedical mental health workers, who often hold responsible clinical or administrative positions (Kramer, 1999). Education and experience in use of ECT result in a more positive attitude toward ECT as a viable treatment option for clients with refractory mood disorders and psychotic disorders (Baldwin & Jones, 1998; Finch, Sobin, Carmody, DeWitt, & Shiwach, 1999; Gass, 1998; Hermann, Ettner, Dowart, Hoover, & Yeung, 1998). The belief held by many outside mental health professions that ECT is dangerous, unnecessary, and misused is erroneous. Dr. Daniel Dye was a psychiatric resident with diagnosis of bipolar disorder. He took lithium regularly after an initial course of ECT for severe depression. He is quoted by Restak (1988) in a case study as saying that ECT is the gold standard (p. 188). He felt that ECT broke through his depression and stopped it. Research supports efficacy, safety, and economic savings of use of ECT; however, use of ECT varies widely and depends on geographic location (Irvin, 1997; Olfson, Marcus, Sackeim, Thompson, & Pincus, 1998; Salzman, 1998; Sherman, 2000; Wheeldon, Robertson, Eagles, & Reid, 1999). Rey & Walter (1997) suggest that more research and education of professionals and public are needed, since information is necessary in order to accept or reject opinions and criticisms of those who wish to limit use of ECT. The purpose of this article is to provide basic information on ECT to mental health counselors for use in developing and providing more effective services to clients considering, receiving, or completing a course of ECT. APPLICATIONS When ECT was developed it was often given without adequate sedation beforehand and without use of muscle relaxants to prevent violent seizures. ECT was a frightening and risky procedure. As a result of this, ECT was frequently portrayed inappropriately in films as a form of punishment with which to control unruly patients (Salzman, 1998). Background Convulsive therapy as a treatment for schizophrenia was introduced by von Meduna and reported in 1934. His reasoning for such an approach was based on two observations long noted by mental hospital physicians. The first was that patients would suddenly lose their symptoms when they had a convulsion. …" @default.
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• W153145871 date "2001-01-01" @default.
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• W153145871 title "Electroconvulsive Therapy: A Primer for Mental Health Counselors" @default.
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