Ethical considerations and training recommendations for philosophical counseling

Philosophical counseling is a diverse and burgeoning type of mental health service delivery. Despite competing approaches to theory and practice, the field has largely strayed from an ethical critique of its methodology and counselor training requirements. This article outlines several ethical considerations and training recommendations that are proposed to bolster the quality and effectiveness of philosophical practice. As philosophical counseling gains increasing recognition in North America, recently established national organizations in philosophical practice may profit from revisiting their interim codes for professional conduct. Proposed training suggestions for counselor preparation my further assist institutions and board-regulated agencies in establishing competent and acceptable standards of client care.     

Standards of Care: Potential Implications for the Counseling Profession

The potential implications for development of professionally defined “standards of care” treatment procedures for mental health counseling are presented. The role of xpert witnesses in malpractice cases is examined as one source from which the standards are currently derived. The influence of managed care on the current clinical practices is noted. Finally, the importance of using outcome research as the basis for developing a “best practices” concept of standards of care is discussed. The authors note difficulties and challenges involved in making a commitment to what could be the next major impetus to the mental health movement.     

Performance of Mental Health Counselors in Integrated Primary and Behavioral Health Care

Integrated primary and behavioral health care (IPBH) is becoming a preferred mode of service delivery in the United States. Integrated care includes the participation of medical and mental health professionals, such as mental health counselors. The clinical outcomes of these professionals need to be studied to determine their effectiveness in such settings. We examined the performance of 10 mental health counselors on the clinical outcome of 1,747 clients treated in an IPBH center. Analyses using growth curve modeling and pre‐post test design revealed that mental health counselors were effective overall, but they differed in client dropout rates and efficiency in reducing clients' initial symptoms. We used the analyses to rank order counselors based on their effectiveness. Counselors who were the most effective varied in their efficiency but demonstrated the lowest client dropout rates. Implications for future research and counseling practice were discussed.     

Adolescent males' view on the use of mental health counseling services

This study investigated adolescent males' view on mental health counseling. Additionally, participants were asked if they had ever used mental health counseling services, if they expected to use such services in the future, and what types of services/activities would constitute a successful counseling experience. The participants' responses indicated that they associated mental health counseling with mental illness and pathology. Eighty-eight percent of the participants reported having never used mental health counseling services. Surprisingly, 69% reported a willingness to use mental health counseling services for life's concerns. Finally, the participants identified a preference for action-oriented counseling strategies. Implications for mental health counseling practice are discussed.     

Therapists' judgments of mentally healthy beliefs for women and men

Clinical and counseling literature indicates that practicing psychologists often observe different mental health standards for women and men. Most of this research has examined mental health in terms of personality attributes, and as such there is a noticeable lack of research concerned with mentally healthybeliefs. The present research was concerned with the investigation of a possible gender bias in therapists' mental health standards, defined in terms of personal beliefs. For this purpose, the Irrational Beliefs Test (IBT; Jones, 1969) was completed three different times by a group of licensed psychologists in private practice, measuring their beliefs of how (1) a mentally healthy sex-unspecified adult, (2) a mentally healthy male adult, and (3) a mentally healthy female adult would respond to the IBT. The results indicated that both women and men therapists associated unique beliefs with women's and men's mental health.The late Dr. Frank B. Lambert studied the philosophical foundations of psychotherapy theory and was concerned about value issues in the practice of psychotherapy. He was pursuing his Ph.D. in counseling psychology at the time of his untimely death.Portions of these data were presented at the 1985 annual meeting of the American Psychological Association, Los Angeles, California. Graditude is extended to Lucia Gilbert and Mark R. Leary for their helpful comments on an earlier version of this article.     

Mental Health Counseling: Past,Present, and Future

This article examines the significant events in the history of mental. health care that have contributed to the development of a specialty within the counseling profession referred to as mental health counseling. The development of credentials for the specialty and the issues currently facing mental health counseling are discussed, and a perspective on directions for the future is offered.     

Integrating Career and Mental Health Counseling: Necessity and Strategies

Individuals seeking counseling might not recognize the interconnectedness of health, mental health, work, and life concerns. Counselors, however, need to be mindful that a person's wellness is interwoven with their work, life roles, and health. Research supports the interrelationship of career development and mental health as well as the effectiveness of an integrated approach to mental health and career counseling. An integrated approach from an ecological counseling perspective is proposed for conceptualizing client issues and intervention strategies.     

The Unmet Educational Agenda in Integrated Care

One of the reasons integrated care has not become a dominant service delivery model is the unmet training agenda. This article argues that the typical mental health professional is not trained to adequately address the challenges of integrated care. To insure competency both a macro and clinical training agenda are needed. At the macro-level, mental health professionals need to understand healthcare economics and basic business principles as any integrated care service delivery system is embedded and driven by economic forces. Integrated care practitioners also need some basic business skills to understand these forces and to create and manage a financially viable system, given the future flux of the system. Traditional mental health professionals also do not have the clinical skills to implement integrated care. Integrated care is not simply placing a traditionally trained mental health professional and letting them practice specialty mental health in a medical setting. Thus, the special skills needed in integrated care are enumerated and discussed. Finally, a new degree program is described as it is time given the huge need and advantages of integrated care to develop specialty training in integrated care.     

Multicultural Counseling and the Orthodox Jew

The cultural diversity literature largely ignores the effects of religion, and especially Judaism, on counseling and psychotherapy. The author reviews the meager and mostly anecdotal accounts relating to Orthodox Jews in the literature of several related disciplines, including counseling, social work, psychology, and psychiatry. The objective is to identify the barriers, institutional and personal, that must be overcome before the Orthodox Jew can receive adequate mental health care and to suggest recommendations for clinical practice.     

社区心理辅导实验模型的建构及其价值

建立实验模型,探索社区心理辅导的路径、具体实施的方法及其价值,为居民的心理健康和社区精神文明工作提供心理学理论和实践的依据;方法：采用症状自评量表(SCL-90)评估辅导前和辅导后社区居民的心理状况并进行自身比较;结果：l、辅导前居民的心理卫生存在问题较多;2、辅导后居民的心理卫生出现显著的变化;3、与辅导前比较,辅导后的居民心理卫生有明明显进步,特别在敌对的人际关系、偏执的认知方式和焦虑、抑郁的情绪等方面改变最为突出。结论：l、开展社区心理辅导是促进精神文明建设的全新理念和有效方法。2、建立、健全社区心理辅导网络对提高居民心理素质,减少心理疾病的发生、发展具有重要而又深远的作用。3、社区心理辅导实验模型的建立为广泛开展有关工作提供了理论和实践依据。     

Suicide prevention in the genetic counseling context

Utilizing a case report, this paper explores psychosocial aspects of suicidal intent in a woman seeking prenatal diagnosis. Using knowledge and practice of appropriate assessment, referral, and intervention procedures, the therapy team of genetic counselor and psychotherapist facilitated successful identification and management of this potentially suicidal client. The main counseling goals for the genetic counselor are to assess the situation adequately, decrease the immediate danger, and, with supervision and/or consultation, stabilize the seriously suicidal person until that individual can be triaged to mental health or medical professionals for treatment. The prevalence of suicide issues in genetic counseling contexts is unknown and reports mentioning suicidal ideation unusual in the genetic counseling literature. Is this reported case a rarity among genetic counseling referrals? Systematically collected information on the prevalence and resolution of suicidal issues in genetic counseling contexts would be helpful for those setting curricula for genetic counseling training programs, standards for professional certification exams, and policy and procedures manuals for clinical units.     

Succeeding in Rural Mental Health Practice: Being Sensitive to Culture by Fitting in and Collaborating

Sustainable solutions to the access to mental health care problems are complex and must address both the availability of mental health care resources and the acceptability of those resources to consumers. The purpose of this study was to determine how to address the acceptability problem by learning from medical and mental health care providers what mental health therapists need to know to be successful in providing care in rural communities. Using a qualitative design, focus groups were conducted in three rural communities (<2,500) with medical and mental health care providers practicing in these communities. Data were analyzed using inductive qualitative methods. Results indicate that in addition to sound clinical skill, mental health therapists should (A) be sensitive to the culture of the rural community in which they are working and (B) practice in a way that accommodates to the care culture of the community. The latter includes spending time with patients commensurate with what is expected by other providers, engaging in generalist practice, and collaborating with local providers in patient care. An important implication of these results is that mental health care must be acceptable to both the residents of the community and the gatekeepers to health care.     

CBT with Youth: Immodest Proposals for Training the Next Generation

January 2014 brings the inauguration of the Affordable Care Act (ACA) in the United States. The ACA introduces affordable healthcare to all citizens and proposes a system to hold all healthcare providers accountable for quality treatment. This article discusses differences in the new healthcare climate and highlights specific areas of focus for training child clinicians in CBT in the midst of this evolution. Child clinicians, more than ever, will need a sound foundation of CBT theory and training so that they may fluidly practice and apply core principles in any setting, with any intervention. Transformations to the health care arena brought about by the ACA will see doctoral level clinicians practicing in a wider variety of roles, in highly integrated settings, and with an increasingly diverse population. Ability to ground intervention in solid theoretical framework will enable clinicians to practice in these numerous conditions effectively and meet accountability standards set by the ACA. Arming child clinicians with these skills will create a generation of practitioners well-prepared to care for youth in the developing atmosphere of mental health care in the United States.     

Addiction‐Specific CACREP Standards in Clinical Mental Health Counseling Programs: How Are They Met?

In 2009, the Council for Accreditation of Counseling and Related Educational Programs (CACREP) included training standards specific to addiction for clinical mental health counseling programs. This study surveyed CACREP‐accredited program coordinators to determine how addiction‐specific standards were addressed.     

Health Focused Psychotherapy In Treating a Dual Diagnosed Patient

Health-focused psychotherapy offers a contemporary model used in assessment, treatment planning and evaluation in addressing patients with both medical and psychiatric diagnoses. Clinicians in the health and mental health disciplines must know and understand the importance of standards of care and models of intervention and evaluation in clinical practice for this type of patient. Examined is the use of a specific model providing a tailored orientation to patient education, along with the development and use of a clinical algorithm and care pathway for clinical practice. Provided is a case study for applying the development and use of a clinical algorithm and care pathway for a dual diagnosed patient receiving health-focused psychotherapy.     

Mental Health Literacy and Peer-to-Peer Counseling Referrals Among Community College Students

Mental health literacy (MHL) has utility for promoting peer-to-peer referrals to mental health support services among university students. However, there is a gap in the extant literature about the potential usefulness of MHL for supporting the mental health of community college students, a population facing a number of mental health conditions. The authors examined the construct validity and the utility of 3 dimensions of MHL as predictors of peer-to-peer referrals to the counseling center among community college students. Results of confirmatory factor analyses supported the dimensionality of the instrumentation and a hierarchical logistic regression analysis revealed that MHL was a significant positive predictor of peer-to-peer referrals to the counseling center. Implications for counseling practice and future research are discussed.     

Suicide and the Standard of Care: Optimal vs. Acceptable

ABSTRACT: The accepted standard of care in the treatment of suicidal patients is discussed from the perspectives of the law, malpractice insurance claims, the mental health professions, and the ideal. A review of decisions of professional liability in suits for wrongful death provides guidelines for what the court considers to be adequate care. Out of court settlements further connote accepted standards of reasonable care. Although attention to potential malpractice issues is necessary and appropriate, what appear to result are an acceptance of minimal standards and the practice of defensive care. It is argued that by demanding more optimal standards the consequent quality of care not only serves the patient best but provides the best legal protection as well.