Clinical Mental Health Counseling © 2007 Thomson Brooks/Cole, a division of Thomson Learning How CACREP defines Clinical Mental Health Counseling Content knowledge in areas common to all CACREP programs (e.g., school, clinical mental health, college counseling, etc.) Additional coursework in such things as psychopahtology, psychopharmacology, treatment planning, addictions, marriage and family, and more 2009 CACREP standards did away with the 48 hour community counseling program Today, CACREP requires 54 credits for Clinical Mental Health Counseling After July 2013, CACREP will require 60 credits for Clinical Mental Health Counseling © 2007 Thomson Brooks/Cole, a division of Thomson Learning In most states, if you don’t go through a CACREPaccredited program you can still get licensed Most states require that you have 60 credits in Clinical Mental Health Counseling (or related counseling specialty —e.g., agency counseling) to be eligible to become a Licensed Professional Counselor There still isn’t easy transferability from one state to another as states often have similar, yet different requirements to be an LPC See Box 17.1, p 581: What a Long Strange Road Its Been © 2007 Thomson Brooks/Cole, a division of Thomson Learning Turn of 20th century Emotional problems seen as psychological in nature Freud—1st comprehensive theory Sanitariums became more humane Vocational guidance and counseling 1930s Federal money for mental health treatment and research Increasing humane mindset toward mental illness 1940s New approach to counseling that encapsulated psychoanalysis, counseling, existentialism, and American take-charge philosophy © 2007 Thomson Brooks/Cole, a division of Thomson Learning 1940s (Cont’d) New approach was optimistic and short-term compared to psychoanalysis Around WWII, assessment techniques increasingly used Recovery rates of emotional illness from the war were high NIMH created 1950s Mental Health Study Act of 1955 Expansion and acceptance of mental health services Widespread use of psychotropics © 2007 Thomson Brooks/Cole, a division of Thomson Learning 1960s Upheaval in American Society More social programs: Johnson’s “Great Society” 1963: Community Mental Health Centers Act 1960s and 1970s Expansion of mental health centers and funded substance abuse treatment 1975: Donaldson vs O’Connor Rehabilitation Act of 1973 President Carter (and Rosalind): Focused on mental health Establishment of AMHCA © 2007 Thomson Brooks/Cole, a division of Thomson Learning 1980s to 1990s Reagan’s Block Grants limited some services Expansion and diversification of field More diversification of settings Most Recently 36% of counseling graduates are in clinical mental health Today we find graduates in wide a large variety of settings Gradual acceptance of diagnosis and psychopharmacology (see Table 17.1, p 584) © 2007 Thomson Brooks/Cole, a division of Thomson Learning Most Recently (cont’d) More credentials (e.g., 50 states have licensing) Licensing is most important step toward counselors obtaining third-party reimbursement Increased inclusion of counselors receiving third-party reimbursement Patient Protection and Affordable Care Act (2010) expands mental health benefits of state insurance exchanges More acceptance of use of diagnosis and psychotropic drugs © 2007 Thomson Brooks/Cole, a division of Thomson Learning MOST COMMON ROLES Case manager Appraiser of client needs Counselor Consultant Crisis responder Supervisor/supervisee Supervisor/supervisee Accountability evaluator Other? © 2007 Thomson Brooks/Cole, a division of Thomson Learning OTHER LESS COMMON ROLES Outreach worker Broker/Networker Advocate Evaluator Teacher/educator Community planner Administrator Clinical assistant Other, Less Common Roles Outreach worker Broker/Networker Advocate Evaluator Teacher/educator © 2007 Thomson Brooks/Cole, a division of Thomson Learning Other Less Common Roles Community planner Administrator Clinical assistant 10 Another classification of roles and function: Primary, Secondary, and Tertiary Prevention ▪ ▪ ▪ ▪ Primary: Prevention and wellness Secondary: Control of nonsevere emotional problems Tertiary: Control of serious mental health problems See Figure 17.1, p 587 © 2007 Thomson Brooks/Cole, a division of Thomson Learning 11 Due to the number of different types of settings, it is difficult to talk about a theoretical focus However, Hershenson et al., (2003) offer principles that govern the ways counselors deliver services at all agencies: Respect the client Provide a facilitative environment that fosters client progress Help clients actively define goals in order to promote growth and development Empower clients and help them understand that counseling is an educational process involving client learning Focus on client strengths, not weaknesses Focus on both the person and the context (environment) Use techniques shown to be valid through prior research © 2007 Thomson Brooks/Cole, a division of Thomson Learning 12 Career and Employment Agencies Associations: AMHCA; NCDA; NECA Community Mental Health Centers Association AMHCA Correctional Facilities Associations: AMHCA; IAAOC Family Service Agencies Associations: AMHCA; IAMFC; AAMFT Gerontological Settings Associations: AMHCA; AADA See Box 17.2, p 591 © 2007 Thomson Brooks/Cole, a division of Thomson Learning 13 HMOs, PPOs, and EAPs Association: AMHCA Military and Government Association: AMHCA; ACEG See Box 17.3, p 592 Pastoral, Religious, and Spiritual Agencies Association: AMHCA, ASERVIC, AAPC See Box 17.4, p 592 Private Practice Agencies Association: AMHCA See Box 17.5, p 595 © 2007 Thomson Brooks/Cole, a division of Thomson Learning 14 Rehabilitation Agencies Associations: ARCA; NRCA Residential Treatment Centers Associations: AMHCA; ARCA, NRCA See Box 17.6, p 597 Substance Abuse Settings Associations: AMHCA, IAAOC Youth Service Agencies Associations: AMHCA; ASCA Other Settings? © 2007 Thomson Brooks/Cole, a division of Thomson Learning 15 Clinical mental health counselors need to be aware of following: Clients from nondominant groups are underrepresented at mental health centers 2.Clients from nondominant groups are frequently misunderstood, misdiagnosed, find therapy not helpful, attend therapy at lower rates, and are more likely to terminate therapy Clients from cultural backgrounds different from their counselor’s may experience counseling more negatively than others 4.Most counseling theories are Western-based and might be dissonant with some minority cultures’ values and attitudes 5.Some clinical mental health counselors may not have the sensitivity or training necessary to work with minority clients 6.Some mental health counselors have an ethnocentric worldview © 2007 Thomson Brooks/Cole, a division of Thomson Learning 16 Assessment of Clients at Agencies Be careful about bias in tests Remember, that to some degree, diagnoses are culturally predisposed Consider “culture-bound” diagnoses Limited Number of Counselors from Diverse Cultures Agencies need to actively hire more minority counselors Counselor Ed programs need to actively recruit more students of color © 2007 Thomson Brooks/Cole, a division of Thomson Learning 17 Ethical Issues Ethical Complaints and Ethical Concerns Ethical complaints made against LPCs (Neukrug, et al (2001): • • • • • • • 24%: inappropriate dual relationship 17%: incompetence in the facilitation of a counseling relationship 8%: practicing without a license or other misrepresentation 7%: having a sexual relationship with a client 5%: breach of confidentiality 4%: inappropriate fee assessment 1%: failure to inform clients about goals, techniques, rules, and limitations of the counseling relationship • 1%: failure to report abuse • 33%: Other © 2007 Thomson Brooks/Cole, a division of Thomson Learning 18 Ethical Issues Perceptions of what is and is not ethical (see Table 3.1, p 68) Counselors have little agreement about some situations Professional Issues AMHCA ▪ Addresses needs of wide spectrum of agency/mental counselors ▪ Purpose: To enhance the profession of mental health counseling through licensing, advocacy, education and professional development ▪ Provides a wide range of member benefits ▪ Quasi independent from ACA © 2007 Thomson Brooks/Cole, a division of Thomson Learning 19 Professional Issues Credentialing ▪ ▪ ▪ ▪ Clinical Mental Health Counselor Certification (CMHCC) Masters Addictions Counselor (MAC) Nationally Certified Counselor (NCC) Licensed Professional Counselor (LPC) Outlook and Salary ▪ Outlook: Strong ▪ Salary: $25,000 to $40,000 entry level ▪ Salary: $50,000 or more with advancement ▪ Salary: $100,000 or more in private practice and networked © 2007 Thomson Brooks/Cole, a division of Thomson Learning 20 Legal Issues HIPAA ▪ Provide information to patients about their privacy rights and how that information can be used ▪ Adopt clear privacy procedures for their practices ▪ Train employees so that they understand the privacy procedures ▪ Designate an individual to be responsible for seeing that privacy procedures are adopted and followed ▪ Secure patient records © 2007 Thomson Brooks/Cole, a division of Thomson Learning 21 Legal Issues Confidentiality of Records Assured by: ▪ ▪ ▪ ▪ HIPAA FERPA (Buckley Amendment) Freedom of Information Act Client’s to their records ▪ They have rights to view their records (except process notes) ▪ Parents usually have rights to view their children’s records © 2007 Thomson Brooks/Cole, a division of Thomson Learning 22 Legal Issues Confidentiality and Privileged Communication ▪ Licensed practitioners have privileged communication ▪ The privilege is held by the client Confinement Against One’s Will ▪ As result of Donaldson v O’Connor, one can no longer be held against his or her will unless he or she is at danger of harming self or other ▪ Individuals can generally be held for short amount of time, pending court hearing © 2007 Thomson Brooks/Cole, a division of Thomson Learning 23 Growing, Changing, Accepting The ever-increasing acceptance of diagnostic tools such as DSM-IV-TR The dramatic shifts in the health care delivery system The increase in the kinds of counseling services offered The ever-increasing knowledge of multicultural issues and their effects on client treatment The development of new ways of treating individuals with various emotional problems © 2007 Thomson Brooks/Cole, a division of Thomson Learning 24 [...]... Brooks/Cole, a division of Thomson Learning 18 Ethical Issues Perceptions of what is and is not ethical (see Table 3.1, p 68) Counselors have little agreement about some situations Professional Issues AMHCA ▪ Addresses needs of wide spectrum of agency/mental counselors ▪ Purpose: To enhance the profession of mental health counseling through licensing, advocacy, education and professional development... for short amount of time, pending court hearing © 2007 Thomson Brooks/Cole, a division of Thomson Learning 23 Growing, Changing, Accepting The ever-increasing acceptance of diagnostic tools such as DSM-IV-TR The dramatic shifts in the health care delivery system The increase in the kinds of counseling services offered The ever-increasing knowledge of multicultural issues and their effects on... Another classification of roles and function: Primary, Secondary, and Tertiary Prevention ▪ ▪ ▪ ▪ Primary: Prevention and wellness Secondary: Control of nonsevere emotional problems Tertiary: Control of serious mental health problems See Figure 17. 1, p 587 © 2007 Thomson Brooks/Cole, a division of Thomson Learning 11 Due to the number of different types of settings, it is difficult to talk... negatively than others 4.Most counseling theories are Western-based and might be dissonant with some minority cultures’ values and attitudes 5.Some clinical mental health counselors may not have the sensitivity or training necessary to work with minority clients 6.Some mental health counselors have an ethnocentric worldview © 2007 Thomson Brooks/Cole, a division of Thomson Learning 16 Assessment of Clients... mental health counselors need to be aware of following: 1 Clients from nondominant groups are underrepresented at mental health centers 2.Clients from nondominant groups are frequently misunderstood, misdiagnosed, find therapy not helpful, attend therapy at lower rates, and are more likely to terminate therapy 3 Clients from cultural backgrounds different from their counselor s may experience counseling. .. Provides a wide range of member benefits ▪ Quasi independent from ACA © 2007 Thomson Brooks/Cole, a division of Thomson Learning 19 Professional Issues Credentialing ▪ ▪ ▪ ▪ Clinical Mental Health Counselor Certification (CMHCC) Masters Addictions Counselor (MAC) Nationally Certified Counselor (NCC) Licensed Professional Counselor (LPC) Outlook and Salary ▪ Outlook: Strong ▪ Salary: $25,000 to $40,000... advancement ▪ Salary: $100,000 or more in private practice and networked © 2007 Thomson Brooks/Cole, a division of Thomson Learning 20 Legal Issues HIPAA ▪ Provide information to patients about their privacy rights and how that information can be used ▪ Adopt clear privacy procedures for their practices ▪ Train employees so that they understand the privacy procedures ▪ Designate an individual to. .. relationship 17% : incompetence in the facilitation of a counseling relationship 8%: practicing without a license or other misrepresentation 7%: having a sexual relationship with a client 5%: breach of confidentiality 4%: inappropriate fee assessment 1%: failure to inform clients about goals, techniques, rules, and limitations of the counseling relationship • 1%: failure to report abuse • 33%: Other © 2007... to talk about a theoretical focus However, Hershenson et al., (2003) offer 7 principles that govern the ways counselors deliver services at all agencies: 1 Respect the client 2 Provide a facilitative environment that fosters client progress 3 Help clients actively define goals in order to promote growth and development 4 Empower clients and help them understand that counseling is an educational process... privacy procedures are adopted and followed ▪ Secure patient records © 2007 Thomson Brooks/Cole, a division of Thomson Learning 21 Legal Issues Confidentiality of Records Assured by: ▪ ▪ ▪ ▪ HIPAA FERPA (Buckley Amendment) Freedom of Information Act Client’s to their records ▪ They have rights to view their records (except process notes) ▪ Parents usually have rights to view their children’s records ... become a Licensed Professional Counselor There still isn’t easy transferability from one state to another as states often have similar, yet different requirements to be an LPC See Box 17. 1, p 581:... Advocate Evaluator Teacher/educator Community planner Administrator Clinical assistant Other, Less Common Roles Outreach worker Broker/Networker Advocate Evaluator Teacher/educator © 2007... Thomson Learning Other Less Common Roles Community planner Administrator Clinical assistant 10 Another classification of roles and function: Primary, Secondary, and Tertiary Prevention