Making Meaning out of Medication: Interview with Kia J. Bentley, Ph.D.

[Episode 42] Today’s podcast is the third of three interviews with Kia J. Bentley on psychopharmacotherapy. Kia J. Bentley is Professor of social work at Virginia Commonwealth University in Richmond Virginia and has published extensively in the area of psychopharmacotherapy (see references below). Psychopharmacotherapy refers to the treatment of psychiatric disorders with the use of medication. But, as Kia pointed out in our interview, psychopharmacotherapy is not just about giving people medication and calling it a day. It is an approach to treatment that acknowledges the strengths and limitations of medications.

In today’s podcast, Kia talked about a recent, and as of this date unpublished, study she did on the meaning that residents of an in-patient psychiatric facility made out of medication. Kia’s study was qualitative, meaning that she analyzed the text of interviews and drawings from the residents. One of the purposes of qualitative research is to develop a deeper understanding of the meanings that people make out of their lives and experiences. Our conversation turned out to be not only a fascinating view into the meanings that the residents made of medication, but it was also a wonderful sketch of Kia’s process of making meaning out of the interviews and drawings. In qualitative research, the researcher is the analytical tool, and Kia’s struggles with making sense of these meanings is central to qualitative inquiry.

Download MP3 [19:54]

Based on an analysis of the residents’ narratives, Kia identified 7 dimensions of meaning, the intersection of which suggested that medication incites meaning, influences identity, and impacts life. The seven dimensions are:

1. As a positive force across dimensions of functioning
2. As a tolerated fact of life
3. As primarily internal and individual experience
4. As prominent part of the story and evolution of one’s mental illness
5. As basis of gratitude and source of victory
6. As prevention of relapse and protection of humanness
7. As a symbol of differentness and dependency

Click on the image below to see a visual representation of these seven domains:


Kia had each resident draw a picture of what medication meant to them. Click on the image below to see the full-sized version of a resident's drawing entitled, "Night of the Butterfly":


UPDATE APRIL, 2009: Kia's article will be published in 2010 by Qualitative Health Research. You can see all 21 images at her blog:
http://blog.vcu.edu/kbentley/2008/07/a_typology_of_the_meaning_of_p.html

In the first interview, Kia and I talked about key concepts and the role that social workers can play in psychopharmacotherapy. In the second interview, Kia talked about best practices for referring clients for psychiatric medications, resources for social workers interested in learning more about psychopharmacotherapy and how social workers can think critically about psychopharmacotherapy for both adults and children.

Today's interview was recorded using Skype. This is because Kia was in Richmond, VA and I was in Pittsburgh, PA. There are some pops and hisses, but not enough to detract from the quality of the interview. If you have questions or comments for Kia or me, please leave your comments below and we'll get back to you.

About Kia J. Bentley, Ph.D.

Dr. Bentley is a tenured Professor and Director of the Ph.D. Program at the Social Work at Virginia Commonwealth University where she has taught since 1989. She publishes, presents and teaches social work practice in mental health, especially serving people with severe mental illness and is involved in several community-based research projects. One research project concerns the meaning of and impact of taking psychiatric medication, in partnership with Gateway Homes, a residential treatment facility for adults with serious mental illness. You can hear more about that project in our third interview. Another in collaboration with colleague Sarah Kye Price, is a study of decision-making about psychiatric medication among pregnant and postpartum women.

She is the former chair of Central State Hospital’s Human Rights Committee, a state psychiatric facility in Petersburg, Virginia, the former Chair of the Virginia Mental Health Planning Council, and served six years on the Board of Virginia’s chapter of the advocacy organization the National Alliance on Mental Illness (NAMI). She has been active with the Council on Social Work Education for many years, currently serving as consulting editor of the Journal of Social Work Education and was one of last year’s winners of the “Reviewer of the Year Award.” She is an active and enthusiastic site visit chair and accreditation consultant. In the past she has served on their Commission on the Role & Status of Women for 6 years and their Commission on Accreditation for three.

References and Resources

• Bentley, K.J. & Collins, K.S. (2006). Psychopharmacological treatment for child and adolescent mental disorders. In C. Franklin, M. B. Harris, & P.A. Meares (Eds.) The school services sourcebook: A guide for school-based professionals (pp. 15-30). NY: Oxford University Press.
• Bentley, K. J. & Walsh, J. (2006). The social worker & psychotropic medication: Toward Effective collaboration with mental health clients, families and providers (3rd Ed.). Belmont: CA: Wadsworth.
• Bentley, K.J., Walsh, J. & Farmer, R. (2005a). Roles and activities of clinical social workers in psychopharmacotherapy: Results of a national survey. Social Work, 50(4), 295-303.
• Bentley, K.J., Walsh, J. & Farmer, R. (2005b). Referring clients for psychiatric medication: Best practices for social workers. Best Practices in Mental Health, 1(1), 59-71.
• Bradley, S. (2003). The psychology of the psychopharmacology triangle: The client, the clinicians and the medication. Social Work in Mental Health, 1(4), 29-50.
• Buelow, G., Hebert, S. & Buelow, S. (1999). Psychotherapist's resource on psychiatric medications: Issues of treatment and referral. Belmont, CA: Brooks/Cole.
• Floersch, J., Townsend, L., Munson, M., Winbush, V., Kranke, D., Faber, R., Thomas, J., Findling, R. & Jenkins, J. (2007, January 13) Adolescent experience of psychotropic treatment. Paper presentation at the Society for Social Work and Research, San Francisco, CA.
• Ingersoll, R.E. & Rak, C. F. (2006). Psychopharmacology for the helping professions: An integral exploration. Belmont, CA: Thomson.
• Jenkins, J., Strauss, M.E., Carpenter, E.A., Miller, D., Floersch, J. & Sajatovic, M. (2005). Subjective experience of recovery from schizophrenia-related disorders and atypical antipsychotics. International Journal of Social Psychiatry, 51(3), 211-227.
• Karp, D. A. (2006). Is it me or my meds?: Living with antidepressants. Cambridge, Massachusetts: Harvard University Press.
  
• Stahl, S.M. (2000). Essential psychopharmacology: Neuroscientific basis and practical applications. (2nd Ed). Cambridge: Cambridge University Press. (advanced knowledge)
• Walsh, J., Farmer, R., Taylor, M.F., & Bentley, K.J. (2003). Ethical dilemmas of practicing social workers around psychiatric medication: Results of a national study. Social Work in Mental Health, 1(4), 91-105.
• Psychiatric Medications (n.d.). Wikipedia. Retrieved May 22, 208 from http://en.wikipedia.org/wiki/Psychiatric_medication
  
• Wilens, T.E. (2004). Straight talk about psychiatric medications for kids, Revised edition. NY: The Guilford Press.

During the podcast, Kia mentioned that she receives a weekly email about psychopharmacotherapy from Medscape. To learn more about Medscape: Psychiatry and Mental Health, visit http://www.medscape.com/psychiatry. To register for free access to articles and newletters on Medscape, visit https://profreg.medscape.com/px/registration.do?cid=med

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APA (6th ed) citation for this podcast:

Singer, J. B. (Producer). (2008, June 30). Making meaning out of medication: Interview with Kia J. Bentley, Ph.D. [Episode 42]. Social Work Podcast [Audio podcast]. Retrieved from http://socialworkpodcast.com/2008/06/making-meaning-out-of-medication.html