Counselinginmental

Counseling in Mental Health and Private Practice Settings
History
Prior to the 1960s: Counselors usually worked in traditional educational settings.
National Defense Education Act of 1958: Federal funding provided for the proliferation of school counselors in elementary, middle and high schools.
The Community Mental Health Centers Act of 1963: Counselors employed to treat the mental health of clients instead of just those clients who were essentially healthy.
Copyright Allyn & Bacon 2004

History (continued)
1960s-1970s: Counselors employed in colleges, universities and junior colleges.
Vietnam War: The amount of federal dollars used to fund school counseling began to dry up and counseling positions within school settings decreased.
Proliferation of the community mental health centers offered counselors new opportunities.

History (continued)
Political and social events and the counseling professions focus on human growth and development all raised public awareness for the need for mental health counselors. 1978: The American Mental Health Counselors Association (AMHCA) (a division of the American Counseling Association) was founded. The AMHCA actively advocated equality for mental health counselors among the ranks of other mental health specialists (e.g. psychiatrists, psychologists and social workers.)

The Need For Community-Based Mental Health Counseling
22% of the adult population might be affected by mental disorders in any given year.
15 million Americans will suffer from depression within their lifetime.

Unipolar depression is considered the leading cause of disability in the world.

The Need For Community-Based Mental Health Counseling (continued)
52 million Americans have some type of drug, alcohol or mental disorder each year. School counselors cannot provide all the mental health services needed by students due to extremely large caseloads. As the population ages, gerontological counseling will be greatly needed.

Mental Health Counseling In Community Settings
Public Nonprofit Agencies: Usually sponsored by the state, county, or city. These agencies usually offer multifaceted services and are available to the general public. Private Nonprofit Agencies: These are usually funded by private organizations (e.g. The United Way, Good Samaritan, or a religious organization). These usually include what the community mental health centers offer but also might have some services not available through the nonprofit centers.

Mental Health Counseling In Community Settings (continued)
For-Profit Mental Health Care: The counselor is paid from the client directly or through the clients insurance provider. There is a greater selection of treatment options in these centers. Private Agencies: Usually provides a range of services (e.g. individual, group, or marital therapy) or specializes in certain disorders (e.g. substance abuse, eating disorders or sexual abuse).

Private Practice: Usually this is provided by one counselor who has spent a lot of time and has gained a lot of experience working for another agency. However, many cannot be reimbursed by third-party payments so clientele is likely to be middle to upper class. Hospital and Health Care Facilities: May be profit or nonprofit, private or public. Counselors in this setting often focus on crisis work, prevention, remediation or supportive counseling with patients.

Managed Health Care (HMOs): A large, privately run comprehensive health care system that includes mental health care. Both the Masters and Doctoral level counselors can work in HMOs.
There are many ethical considerations when working in an HMO.

Client care is limited in duration and treatment modality.

Intervention Strategies in Mental Health
Counseling: Individual, group, marriage and family, and substance abuse.
Crisis Intervention: An intense, short-term intervention to help the client who is in crisis.
Advocacy: To plead the cause of a client or group and follow it up with action in support of that cause.

Intervention Strategies in Mental Health (continued)
Prevention: Primary: Strengthening resistance to head off harmful influences. Secondary: Identification of individuals who are at risk and providing remedial interventions to keep an event from happening. Tertiary: Tries to avert further consequences when a problem has already occurred.

Intervention Strategies in Mental Health (continued)
Consulting: Providing specialized knowledge designed to help the consultee work through a problem. Mediation: The facilitation of an agreement between two or more individuals.

Categories of Mental Health Services
Problems of Living: Problems that develop as one moves through the life-span (e.g. relationship difficulties, work problems, self-esteem problems, stress or psychosomatic illness.) Mental Disorders: A dysfunctional pattern of behavior or psychological pattern that causes distress or disability for a prescribed amount of time. Substance Abuse or Dependence: An impairment of social or occupational functioning and/or signs of tolerance or physiological withdrawal due to use of a substance.

Diversity Issues
Mental health counseling embraces all aspects of diversity. Training programs have a multicultural component and train mental health counselor to be culturally sensitive. Culture must be considered in all phases of counseling.

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Counseling in Mental Health and Private Practice Settings

Copyright Allyn & Bacon 2004