Electroconvulsive therapy from a social work perspective

The purpose of this paper is to fill a gap in the social work literature which has not, to date, included a thorough discussion of electroconvulsive therapy (ECT) from a social work perspective. It discusses the rationale for ECT in current practice; enumerates improvements made in stimulus delivery since convulsive therapy was introduced in 1934; and summarizes the myths, realities, advantages and limitations of the treatment in modern psychiatry. It advocates a team approach, which includes social work support and education of the patient and family regarding treatment related matters and discharge planning. Several clinical vignettes are included to illustrate the types of illness for which ECT is used as well as the social work role with the team and patient/family during hospitalization and discharge planning. The Ontario College of Certified Social Workers Guidelines are used to explain social work interventions. The paper is also relevant to social workers in non-psychiatric settings in understanding and planning with patients and families where a member has experienced ECT.