ELECTROCONVULSIVE THERAPY AS A
TREATMENT FOR MENTAL ILLNESS:
DEVELOPMENT OF AN EDUCATIONAL
PROGRAM FOR SOCIAL WORKERS:
A GRANT PROPOSAL
CALIFORNIA STATE UNIVERSITY, LONG BEACH
Carrie Levinson
May, 2012
What is Electroconvulsive Therapy?
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Also known as ECT, it is the therapeutic application of electricity to the brain to
induce a grand mal seizure. (Abrams, 2002)
Stigma surrounding the procedure is often based on the assumptions that the
procedure is dangerous or painful- both untrue facts (Ottosson & Fink, 2004).
Many consider this treatment controversial; however, it is a widely accepted
treatment option within the medical field for individuals with severe forms of major
depressive disorder, bipolar disorder, and some forms of schizophrenia (Fink, 2009).
ECT is most commonly utilized with individuals diagnosed with depression; 80% of
patients who receive this treatment are diagnosed with Major Depressive Disorder
(Payne, 2009).
ECT has a higher effectiveness rate than most anti-depressant medications, with an
86% remission rate for those diagnosed with depression (Kellner et al., 2006).
There is a stigma and misunderstanding of ECT, which leads to underutilization; this
is harmful to patients (Fink, 2009).
Social Work Relevance
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The presence of social workers in the medical and
mental health fields is growing rapidly. According to
the Bureau of Labor Statistics (2008), social workers in
the health care industry made up 32.19% of all social
work positions in 2008, and this number is projected to
increase by approximately 19% by the year 2018.
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As the majority of ECT treatments are performed in
hospitals, this increases the likelihood that social workers will
be exposed to clients who could be offered ECT as a
treatment option (Keltner & Boschini, 2009).
Cross-Cultural Relevance
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In California, there are approximately 1,175,000 adults living with a severe mental
illness (National Alliance on Mental Illness, 2010).
Mental illness is not limited to a particular age, gender, culture, ethnicity, or type of
person. Department of Mental Health (DMH, 2007) statistics demonstrate the
breakdown among ethnic groups in their utilization of mental health services:
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White (4.21%),
African American (5.98%)
Asian (1.74%)
Pacific Islander (2.37%)
Hispanic (5.11%)
Multi-Ethnic (5.96%).
Because electroconvulsive therapy can be used as a form of treatment for those with
depression or bipolar disorder, and some types of schizophrenia, there is potential
for social workers to provide education and support to clients from many different
cultural, religious, or ethnic backgrounds about this form of treatment.
Methods
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Target Population: The target population for this grant is social
workers in Southern California. The grant will be used to develop
an educational program that will inform social workers of the current
use of electroconvulsive therapy and will help lessen the myths and
stigma associated with the treatment.
Objectives of the program include:
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Objective 1: To create an effective educational program that will address
the current use of electroconvulsive therapy within the mental health arena.
Objective 2: To present social workers with factual information regarding
electroconvulsive therapy, thereby encouraging competence within the
profession.
Objective 3: Create an educational program focusing on ECT that can be
utilized by social workers in multiple settings and repeated as needed.
Methods
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The National Institutes of Health was identified as a
potential funding source.
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organization commonly funds programs which
emphasize the propagation of knowledge gained
about health behavior change interventions and
evidence-based prevention, as well as projects that
focus on mental health.
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The proposed budget for the project is $3,600.00,
including In-Kind donations.
Grant Proposal
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The goal of this project is to develop an educational program about
ECT to be presented to social workers.
The proposed program will be comprised of a single day workshop
lasting approximately 3 hours with multiple components, including:
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An LCSW guest lecturer, who will discuss the education process for
patients and families, possible side effects, and how to assist patients
and families in coping with side effects or stigma of using this treatment
option.
A psychiatrist guest lecturer, who will address the consent process for the
state of California, discuss what type of patient qualifies as a candidate
for ECT, the mechanism of action, and will describe the procedure itself.
A video presentation of ECT being performed will be created through
the grant, and presented at the workshop.
The grant will provide for the creation of an educational resource
pamphlet that will be given to social workers who participate in the
program; this resource can be utilized with patients and families.
Grant Proposal Evaluation
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A pre and post survey will be administered before and after participation
in the program, which will include measures of knowledge of ECT and
attitudes towards ECT. These surveys will be analyzed to determine the
effectiveness of the program in improving the knowledge and attitudes
towards ECT amongst participating social workers.
In addition to this instrument, follow-up with social workers will be
performed for 6 months after their participation in the program.
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Social workers will be given 25 educational resource pamphlets after
participating in the educational program. Each month, social workers will be
contacted and asked how many educational resource pamphlets they have given
to patients or family members, for the purpose of educating those consumers
about the ECT treatment option.
The number of pamphlets given away by social workers will be recorded; if
more social workers are utilizing the educational resource in their interactions
with patients and families, this may indicate an improvement in attitudes towards
ECT, and an increase of knowledge in the efficacy of the procedure.
Conclusions
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As professionals, it is imperative that we be educated regarding this
treatment option, particularly due to the negative opinions so often
associated with ECT within the general public. The goal is not to
convince a client to undergo this procedure; the goal is to provide
adequate education so that the client can make an informed decision
based on evidence-based practice.
The skill of grant writing is highly desired in the field of social work,
regardless of the topic being funded. The economic downturn in
recent years has created an environment in which services are at an
even higher demand, and funding to support these services is at a
low. It is an unfortunate reality that many social service programs
and agencies will continue to face cut-backs in programming for
clients as our economy recovers. It is imperative that social workers
be educated in the process of applying for grants and understand
the intricacies of discovering alternative sources of funding.
References
Abrams, R. (2002). Electroconvulsive Therapy. New York, NY: Oxford University Press.
Bureau of Labor Statistics. (2008). National employment matrix. [Matrix of Social Work fields]. Retrieved from
http://www.bls.gov/oco/ocos060.htm.
Department of Mental Health. (2007) Statistics and data analysis. [CPES estimates of need for mental health
services for California]. Retrieved from http://www.dmh. ca.gov/
Statistics_and_Data_Analysis/docs/Population_by_County/California.pdf
Fink, M. (2009) Electroconvulsive therapy: A guide for professionals & their patients. New York, NY: Oxford
University Press.
Kellner, C., Knapp, R., Petrides, G., Rummans, T., Husain, M., Rasmussen, K., … Mueller, M., (2006). Continuation
electroconvulsive therapy vs. pharmacotherapy for relapse prevention in major depression: A multisite study
from CORE. Archives of General Psychiatry, 63, 1337-1344.
Keltner, N.L., & Boschini, D.J. (2009). Electroconvulsive therapy. Perspectives in Psychiatric Care, 45(1), 66-70.
National Alliance on Mental Illness. (2010) State advocacy 2010 (State Statistics: California). Retrieved from
http://www.nami.org/ContentManagement/ ContentDisplay. cfm?ContentFileID=93482
Ottosson, J. O. & Fink, M. (2004). Ethics in electroconvulsive therapy. New York, NY: Brunner-Routledge.
Payne, N. (2009b). Electroconvulsive therapy: Part II. A Biopsychosocial perspective. Journal of Psychiatric
Practice, 15(5), 369-390