School Counselors and Psychotropic Medication: Assessing Training, Experience, and School Policy Issues.

This article reports the results of a national survey of school counselors that gathered information about the extent of school children's psychiatric diagnoses and usage of psychotropic medication, school policy issues arising from these practices, and counselors' perceived need for further training. Results support the assertion that psychotropic medication is widely prescribed to school-aged children creating school policy concerns and that school counselors desire further training regarding children and psychotropic medication. Note: A copy of the survey instrument is available upon request from the authors. ********** The discussion surrounding the proper role and duties of the school counselor began when the role was first implemented and continues today. School counseling textbooks written in the 1960s (Boy & Pine, 1968), 80s (Cole, 1988), and 90s (Schmidt, 1999) as well as recent articles (Baker, 2001; Gysbers, 2001; Whiston, 2002) all grapple with a definitive description of proper duties of the school counselor. A problem associated with the ambiguity of the role occurs when counselors are assigned quasi-administrative functions that compete for time with more proper counseling activities. Paisley and McMahon (2001) suggested that it was possible to look at the fluidity of the role as a strength rather than a detriment. Simply put, as the world changes, the needs of students change, and school counselors respond to those changing needs. As the divorce rate went up in our society, school counselors responded by leading divorce support groups. With the current emphasis in the school community on testing and academic accountability, school counselors focus more on academic intervention and support. The schools that were sites of mass violence such as Columbine High School or the Westside Middle School in Jonesboro, Arkansas, have required support to heal from the attendant trauma. In any case, it is the fluidity of the school counselor's role that makes it possible for school counselors to respond to the needs of the environment in which they are placed. Given that, it makes sense to suppose that a change in the way society as a whole and the medical profession in particular treat children will affect the parameters of the service offered by school counselors. This article focuses on how the increased prescription of psychotropic medications to school-aged children is affecting schools and school counselors. The latest large-scale study confirming this increase is Zito et al. (2003). These researchers found that despite a lack of evidence of efficacy, prescriptions for psychotropic medication for school-aged children continue to increase annually. The history of this trend began with the pediatric use of stimulants. The use of stimulants to treat what was initially labeled as Minimal Brain Dysfunction (MBD), now referred to as Attention-Deficit/Hyperactivity Disorder (ADHD), began in the 1960s. Since then, there has been a steady increase in the number of children taking stimulant medication (Werry, 1999). In a summary of several studies from 1971 to 1997, Gadow (1999) concluded that drug treatment for ADHD had doubled every 4 to 7 years. During that period of time, in the process of fulfilling their role as consultant, school counselors had to deal with a variety of scenarios resulting from the increased number of children diagnosed with ADHD. Physicians, teachers, parents, and students vary in the degree to which they support the diagnosis of ADHD and subsequent treatment with psychotropic medication, and school counselors are sometimes called upon to mediate when parties disagree. School counselors have supported the educational process of those students diagnosed with ADHD by consulting with teachers and parents and offering individual and group counseling services tailored to these students (Thompson & Rudolph, 2000). In order to offer these supportive services, school counselors have sought out information about the treatment of ADHD in texts, professional journals, and in-services or workshops (Schwiebert, Sealander, & Tollerud, 1995). …