106 The Professional Counselor | Volume 12, Issue 2 For a variety of reasons, a substantial number of clients do not readily disclose the use of CAMs and OTCs to physicians or therapists (Agbabiaka et al., 2017; Ravven et al., 2011). This is concerning, as clients may be unaware of the pharmacological properties and side effects of these products. Considering these factors, counselors have a professional and ethical obligation to possess a working knowledge of psychopharmacology (American Counseling Association [ACA], 2014; Council for Accreditation of Counseling and Related Educational Programs [CACREP], 2016; Murray & Murray, 2007). We assert that this knowledge should include herbal remedies, OTCs, and dietary supplements. Despite the potential impact of psychoactive drugs on mental health, there is a paucity of research in the counseling literature that addresses psychopharmacology (Ingersoll, 2005; Sepulveda et al., 2016). There is even less counseling literature available that references herbal remedies, dietary supplements, and OTCs (Ingersoll, 2005; Kaut & Dickerson, 2007). A recent search of the ACA and ACA division journals returned very limited results on psychopharmacology, herbal remedies, OTCs, and dietary supplements. For example, the greatest number of articles pertaining to psychopharmacology was found in the Journal of Mental Health Counseling. The journal published five articles that ranged in year of publication from 2002 to 2011. The Journal of Counseling & Development published three articles that ranged in year of publication from 1985 to 2004. The only article related to herbaceuticals was published in the Journal of Counseling & Development in 2005. This article by Ingersoll (2005) discussed herbaceuticals in reference to the counseling profession. Although this review provided an overview of herbal remedies, it did not explore OTCs or dietary supplements. The counseling literature is in urgent need of expansion in this area because the scope of the counseling profession and mental health care are steadily evolving (Kaut, 2011; Sepulveda et al., 2016). Given the lack of literature, counseling professionals providing services to clients may lack practical information pertaining to herbal remedies, OTCs, and dietary supplements. The goal of this primer is to provide counselors with an introduction to CAMs and OTCs that clients may be taking. It provides an overview of the most frequently used non-prescription psychoactive products, and addresses the actions of these products (pharmacodynamics) and how the body responds (pharmacokinetics) to these substances. The most significant effects as well as side effects are also discussed. In addition, effective communication with clients about prescription and non-prescription drugs is examined. It reviews ethical and cultural considerations pertaining to counseling clients who use psychoactive herbal remedies, OTCs, and dietary supplements. The herbal remedies, OTCs, and dietary supplements selected for this article were those that, based on the literature, appeared to be most commonly used. Definition of Terms For the purpose of this article, several terms are defined. For example, pharmacodynamics is the study of how the body responds to a drug. As such, it addresses therapeutic effects as well as side effects (Stahl, 2021). Pharmacokinetics describes how the body absorbs, distributes, metabolizes, and excretes drugs and herbal remedies (He et al., 2011). Drugs and herbal remedies may affect organs, enzymes, and receptor sites. There are receptors located on neurons, which offer binding sites for neurotransmitters. These receptors are designed to respond to specific neurotransmitters. For example, dopamine will only bind to dopamine receptors and will not impact receptors designed for other neurotransmitters (Preston et al., 2021). There are several neurotransmitters that are considered important in terms of mental health. Neurotransmitters can be agonistic, which means they can activate specific receptors. Neurotransmitters
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