Counseling in Mental Health and Private Practice Settings

1. Counseling in Mental Health and Private Practice Settings History • Prior to the 1960’s: 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”

2. Counseling in Mental Health and Private Practice Settings History (continued) • 1960’s-1970’s: 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. “Copyright © Allyn & Bacon 2004”

3. Counseling in Mental Health and Private Practice Settings History (continued) • Political and social events and the counseling profession’s 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.) “Copyright © Allyn & Bacon 2004”

4. Counseling in Mental Health and Private Practice Settings 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. “Copyright © Allyn & Bacon 2004”

5. Counseling in Mental Health and Private Practice Settings 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. “Copyright © Allyn & Bacon 2004”

6. Counseling in Mental Health and Private Practice Settings 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. “Copyright © Allyn & Bacon 2004”

7. Counseling in Mental Health and Private Practice Settings Mental Health Counseling In Community Settings(continued) • For-Profit Mental Health Care: The counselor is paid from the client directly or through the client’s 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). “Copyright © Allyn & Bacon 2004”

8. Counseling in Mental Health and Private Practice Settings Mental Health Counseling In Community Settings(continued) • 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. “Copyright © Allyn & Bacon 2004”

9. Counseling in Mental Health and Private Practice Settings Mental Health Counseling In Community Settings(continued) • Managed Health Care (HMOs): A large, privately run comprehensive health care system that includes mental health care. • Both the Master’s and Doctoral level counselors can work in HMO’s. • There are many ethical considerations when working in an HMO. • Client care is limited in duration and treatment modality. “Copyright © Allyn & Bacon 2004”

10. Counseling in Mental Health and Private Practice Settings 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. “Copyright © Allyn & Bacon 2004”

11. Counseling in Mental Health and Private Practice Settings 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. “Copyright © Allyn & Bacon 2004”

12. Counseling in Mental Health and Private Practice Settings 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. “Copyright © Allyn & Bacon 2004”

13. Counseling in Mental Health and Private Practice Settings 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. “Copyright © Allyn & Bacon 2004”

14. Counseling in Mental Health and Private Practice Settings 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. “Copyright © Allyn & Bacon 2004”