current issues in clinical mental health counseling

For instance, ACA divisions such as the Association for Specialists in Group Work and the Association for Multicultural Counseling and Development have enacted a Day of Service to coincide with contemporary issues of multiculturalism and social justice and to meet in partnership with local communities surrounding conference venues. 2. Taking a contextual, integrative approach: Again, we have allowed ourselves to be limited by others definitions of evidence-based practices. In drawing on my business background and taking a best practice to investing, the profession needs to diversify, diversify, diversify. If my caseload is any indicator, therapy has become cool. Finding a good therapist is like finding a good pair of jeans, and clients are shopping. The harder we push into something outside of ourselves, the more we feel into our core. It is probably safe to say that the next 10 years in the counseling profession are certain to be both fraught with peril and bursting with possibility for new discovery and advancement in the field. Why Therapists Are Worried About America's Growing Mental Health Crisis Is it dark in the room? It is not enough to do the research. Being a therapist is difficult enough in good times. I add the quotation marks because our society is rightfully starting to reckon with the fact that people of color and other marginalized communities have not had a chance to share in those good times. So, we are challenged to take care of ourselves so that we can show up well for our clients, and continually try to expand our awareness of what those communities have faced for centuries. We are increasingly a nation of traumatic events, but perhaps our growing knowledge of neuroscience is creating one of the most exciting times in our field. Time will tell how they will be! Interdisciplinary cooperation is our best shot to address some of the macrosystemic challenges facing our human family. The counseling profession needs to learn how to use politicization as a tool rather than allowing it to become a distraction. Professionalism might include emails or message response time. Financial and insurance issues are among the biggest obstacles to patients finding care. This is also troubling when I attend international conferences because how we present ourselves as American counselors is confusing at best. Moreover, with requirements for social distancing, more people have been working from home. Instead of face-to-face meetings, individuals connected with friends and family more with texts, FaceTime or some form of web conferencing platform (e.g., Zoom). If we have a level of flexibility in meeting with clients that exceeds what we have done prior to 2020, then licensure portability is more important than ever before. During the 2019-2020 congressional cycle, over 150 lawmakers became co-sponsors of two bills that aim to address counselor exclusion from Medicare. Worldview - Addresses the appreciation of the perspectives of others and a personal development of a personal philosophy from which action and service arise. These efforts will facilitate accountability among stakeholders. About GAPP - American Counseling Association This awareness regarding the role of the brain in chronic pain has dramatically increased interest in mind-body counseling approaches and created significant opportunities for counselors to become leaders in the treatment of chronic pain. Workplace inequities across intersectional marginalizations run rampant in all levels of the workforce. Find more on your state requirements here. The year 2020 represented a set of crossroads to allow our profession to do better and be better for ourselves and the communities we serve. People in the United States still remember the coronavirus pandemic and its negative social and emotional impact. Its also virtually impossible to imagine any type of near future in which the events of the past year arent still reverberating and shaping our society. In the next decade, it is essential that counselors transcend these limitations as we assist clients with presenting issues beyond the transitory. Some counselors may perceive that advocating for the profession is self-serving; however, we cannot do what we were trained to do that is, help others if we cannot practice in the way we were trained to practice or be reimbursed for providing services. How can counseling ease the enduring health consequences of COVID-19? I think some of the most challenging things counselors have faced in our lifetime are related to the COVID-19 pandemic, and we will continue to navigate the difficulties of this time. Association for Assessment and Research in Counselings representative on the ACA Governing Council. Trauma-informed care Nearly 61% of adults have experienced at least one traumatic event in their lifetimes, according to the Adverse Childhood Experiences (ACES) study. Jude Austin is an assistant professor and clinical mental health counseling track coordinator at the University of Mary Hardin-Baylor, an American Counseling Association book author, and a private practitioner in Temple, Texas. From this perspective, professional advocacy is an ethically questionable activity. Literally everything around us is screaming for the awareness that harm to one is harm to all. As we know, complacency is harmful to the profession, ourselves, clients and society. Opportunity: This move to online or virtual services, of course, also provides a major opportunity. The emotional turmoil created by social inequities has highlighted the need for the counseling profession to continue to engage in social justice activities. My colleagues and I at the University of Scranton have helped to pioneer a Counselor Fit for the Profession statement and assessment process over the past 15 years, and it has served us well as mentors and gatekeepers for counselor preparation. I do not see computers overtaking the practice of real-time human counselors. The simple answer is for counselors to increase their business skills. Individual experiences of grief and loss carry an unfamiliar complexity as mourners have been unable to sit with a dying loved one in the hospital and then been unable to engage in traditional mourning rituals due to restrictions on public gatherings. They afford organizations opportunities to build a solid infrastructure that makes positive differences. Readers may think I am referring to a plunge, legislative advocacy or a cultural immersion project, but community engagement is so much deeper. Additionally, the sheer magnitude of these problems highlights the need for more collective interventions, and thus the counseling profession may have to refashion how it pursues its goal to empower people to attain mental health and wellness. I have never regretted my choice. Many have observed a secondary pandemic of anxiety and social isolation as a direct result of the response to the coronavirus, and counselors who have traditionally worked only in face-to-face modalities had to adjust to an online counseling world to continue to support their clients. Counselors will need to further differentiate from life coaches and other helpers who do not require the same level of education, experience or licensure as future clients seek the most expeditious, cost-effective services. In my own practice, clients have enthusiastically embraced online service delivery, both for individual and group sessions. I think we need to get our groove back. The clients of the future are going to be affected on multiple intersecting levels, which will require efficacious methods to address the complexity we are likely to see. Therapists are tired.. All the therapists I know have experienced a demand for therapy that is like nothing they have experienced before, said Tom Lachiusa, a licensed clinical social worker in Longmeadow, Mass. As such, counselors must continue to grow as advocates not just for clients, but also for our profession. Over the past 3,650 days, we have seen a dramatic increase in the explicitness of individual political and social stances. In the coming decade and beyond, lets bring justice to our clients and profession and extend our reach beyond state borders and into the world. The core of counseling hinges on relationship building. Additionally, counselors must advocate with technology developers for technologies that are tailored to meet the needs of diverse clients and promote equitable access to behavioral health services. Education at all levels has been affected; students will not get back the losses of the 2020-2021 academic year, including social skill development, organized sports and club activities, or academic programs that were canceled. 1. Introduction to Clinical Mental Health Counseling If we are not taking an intentional, proactive approach to normalize counseling, and by extension normalize the profession for underrepresented minorities, we will only continue to have the same candidates. So, when the first few news articles about the brutal killings of Black men at the hands of law enforcement officers were sweeping the media, I was not surprised. What about the importance of developing business skills that will help professional counselors become business wise ? Psychotherapy. We know the importance of a strong therapeutic relationship and increased self-awareness, but how, physiologically, do these lead to an abatement of symptoms? While I believe that we have made progress in enhancing research conducted in our field, I do not believe that our field has fully answered these calls. What changes can we foresee with technology? The month prior, Brain, Behavior, and Immunity published a study detailing the inflammatory predictors of anxiety and depression in COVID-19 survivors. On the other hand, we may see an increase in nonallied mental health professional telehealth counseling. Counselors need to take advantage of the upcoming need for standardized psychoeducational workshops in the community. These efforts will continue to require creative and reflective professionals to redefine and update credentials accordingly. Computer-augmented counseling is the next stage in counselor-client work. Nearly 75 percent of respondents said much of their time was spent helping clients with family and relationship issues. Based on my experience, when individuals gain a basic understanding that their emotional symptoms are directly related to their thoughts, and that their thoughts are essentially sentences that can be restructured to reduce distress, the result is an experience of validation and a greater sense of control over feeling better and doing better. As a counselor who works with athletes and exercisers, it is not only my responsibility to understand human growth and development through the stages of life, it is also my responsibility to understand interruptions to stages of development, including injuries, illness and unexpected interference to peoples physical and cognitive states. Our society will continue to present more and more opportunities to lead in the years to come. I predict that within the next 10 years, counselors will recognize all therapeutic work as bodywork an energetic dance that facilitates self-regulation. Sadly, these forces date back several centuries, and many are not entirely external to our profession. State Issues - American Counseling Association Inclusive counselors who understand their life station on the Multicultural and Social Justice Counseling Competencies framework. However, that couldnt be further from the truth. Also, some young people whose parents or guardians pushed them into getting professional help might be displaying rebelliousness. The final component is the consumer. Opportunity: As with all challenges, there are an equal number of opportunities for growth. Even if some clients dont recognize certain scientific aspects of the pandemic, theyre still feeling the isolation and separation, said Nathan Staley, a licensed professional counselor in Kansas City, Mo. Once we find ourselves, we have space for curiosity about others. We are, as a profession, enjoying a comfort we have not historically had, yet we have so much work left to do. Heather Trepal is the immediate past president of the American Counseling Association and a professor at the University of Texas at San Antonio. They dont know how to be in a room with 25 other kids. All industries are going through a transformation to make services accessible to a multicultural and global society. Gerard Lawson is a professor in the counselor education program at Virginia Tech, a past president of the American Counseling Association, an ACA fellow and a licensed professional counselor in Virginia. Our focus on self-efficacy will serve us well in helping our clients build resiliency and coping skills and bounce back from the pervasive impact of the extensive societal trauma of 2020. All Rights Reserved. Stigma is a barrier to help-seeking. This is not necessarily something to bemoan; some of the most priceless things on Earth are extremely delicate, and their value is in direct proportion to their fragility. Whatever means are undertaken to address these barriers must prioritize client safety, emergency procedures and the reality that not all counselors practice ethically and safely, unfortunately. Medicare advocacy in the counseling profession has a long history, but recent developments suggest that the near future is bright. This is an identity that undermines the relational factors that have the highest association with best practices and effectiveness. 1. Theyre fighting, their communication is negative, or it seems theyre just apathetic.. People are being more open about saying, Im feeling scared. The Multicultural and Social Justice Counseling Competencies that ACA has promoted for years guide us to challenge our biases and assumptions, to practice in a way that is culturally competent, and to support clients who have been marginalized and harmed by unjust systems. Missed family connections; lost life events such as weddings, graduations and proms; and disruption of daily routines of work and school need to be recognized as losses that impact our moods. Second, counseling overall is steeped in white middle-class norms. It seems unlikely that we will return to the way we used to practice, or that the nature of what clients bring to us will be the same, even after the pandemic has been brought under control. What kinds of people will they be? It is of great concern, for instance, that the occupant of the White House at the time I am writing this, enabled by high-ranking officials who supported him, refused to concede the election and instead spread dangerous conspiracy theories about it being rigged or stolen. My heart sank when I saw yard signs that read Stop the Steal and Voter fraud! After all, most of us would agree that 2020 felt like it lingered on for two full years, or at least well past its expiration date. I ask counselor educators and counselors, however, to intentionally build these partnerships and sustain them, so that they seek continuous input from community stakeholders and leaders rather than making them one-time events. S. Kent Butler is president-elect of the American Counseling Association and has been appointed interim chief equity, inclusion and diversity officer at the University of Central Florida. The unprecedented events of the past year were a sobering reminder that the inconceivable can happen, but they also illuminated a range of issues that have the potential to shape the future of the counseling profession in the next decade. Although the survey wasnt sent to psychiatrists, who often work with therapists to prescribe medication, we asked clinicians if they had seen an increase in patients use of or requests for antidepressants or anti-anxiety prescription drugs. Our field is one of the leaders in supervision and in promoting multicultural and social justice competencies yet we are just beginning to skim the surface on examining what is effective in both of these. If you have participated using only automated technology, we need you to make phone calls and write personal emails. Counseling is on the go. At minimum, mental health professionals will need to hold consistent awareness of what their public social presence beams to clients, along with the potential ascribed ethical, professional and ecological impact. How can we use our knowledge of the Multicultural and Social Justice Counseling Competencies to transform the lives of the students we teach and the colleagues with whom we work? Compiled by Jonathan Rollins January 5, 2021, [NOTE: To view this article as a PDF, log in with your ACA credentials here and select the January 2021 magazine.]. People suffering with chronic pain are also likely to experience a host of comorbid psychological conditions such as depression, anxiety and sleeplessness, as well as being at high risk for opioid addiction. What will counseling be over the next decade? I believe the biggest opportunity for clinicians in the next 10 years will be in advancing social justice causes. Some students are fair writers but shine when face to face, and vice versa. We need to disseminate it so that professionals and clients can access it. Id like to focus on two challenges in particular, the first being the ongoing response to the COVID-19 pandemic and the second being the broad public exposure of injustices in the U.S. And Oregon, California and Washington burned. We are entering a greater use of the semantic web (Web 3.0) where your device looks at your work, recognizes your preferences, and then provides you with choices for products and services that may interest you. Community partnerships become a way to signify that their lives and stories often stories that counter oppression ultimately do matter. In these pivotal times, we must join with professionals in other disciplines to promote a culture of compassion, healing and respect for human dignity. I dont think Ive had fewer than 20 people on my wait list, she said. Using the work of Sigmund Freud, Sarno theorized that many forms of chronic pain are actually created by the subconscious mind as a means to distract (or protect) us from experiencing painful emotions such as anger, rage and guilt, which we learned as children to be unacceptable and even dangerous emotions. In the next decade, we must explore not only what is occurring to clients, but also how it plays out within clients broader experience as perceptual, emotional, cognitive, social-relational, spiritual and culturally situated beings. Kestenberg and colleagues identify infant rhythms that alternate between ones they call indulging and ones they call fighting. The indulging rhythms tend to match with parents movements, while the fighting rhythms mismatch. Challenge: That change will challenge how counselors meaningfully meet clients in the next five to 10 years. No. Moreover, we need to incorporate mental and other holistic health indicators in all systematic program evaluations of counseling and counseling-relevant program and service delivery. It also helped to keep me fresh. The forces that could shape counseling's future Therefore, trying to predict how counseling will change in the future is close to impossible because of so many variables. Recognizing this, the business-wise professional counselor is poised to find increased and diverse opportunities to build their network in a domestic and global market and expand into what is being referred to as the gig economy. Because we are also researchers, we are well-positioned to collaborate with policymakers and federal entities that want to address social problems. This has restricted how we practice and how we train new counselors and conduct research. I recall what a controversy was stirred up many years ago when the NBCC rolled out its ethical guidelines for distance counseling. The therapeutic alliance is the best predictor of counseling outcomes; how does this relate to mental health bots? Michelle Fielder is a licensed professional counselor, an approved clinical supervisor in private practice, and a doctoral candidate in the counselor education and supervision program at Regent University. As the country seemingly sits on a divide, will this extend to political symbols? For me, I saw it as a triple pandemic in which I, as a Black female counselor educator, was faced with the existential threat caused by COVID-19, coupled with graphic evidence of police brutality, and topped with climate change. In addition, a surge in telehealth scholarship will better inform telehealth ethics and laws, best practices, and counselor and supervisor education. Challenges: The question posed in this essay is has the counseling profession held true to its mission of being an inclusive body, not just for our clients, but also for counselor educators and counselors in the field? Sylvia Nassar is a scholar, leader, advocate, mentor and counselor educator at North Carolina State University. The way that polyvagal theory aligns with longtime trauma expert Peter Levines understanding of trauma patterning has allowed counselors to better understand human behavior. They are used with populations from 8 to 80. It is necessary to critically reflect on the lack of counselors who represent diverse backgrounds across the intersections and how training programs perpetuate the lack of representation. Organizations unwilling to buy into this post-constructivist ideology will become obsolete. The pandemic has shown us that counselors are naturally resilient. Nevertheless, here are a couple thoughts regarding what might impact the counseling profession. Nearly one in five therapists surveyed reported having had to cut back hours because of home and life demands during the pandemic. During COVID-19, physical distancing interventions needed to protect older adult health have been isolating, and medical ethical guidelines that prioritize the care of younger patients signal the expendability of older adults. Others, such as professional athletes and celebrities, have become increasingly visible in their efforts to address stigma. Michelle Muratori, a senior counselor at the Johns Hopkins Center for Talented Youth and faculty associate in the masters counseling program at Johns Hopkins University, has co-authored several ACA publications, including the third edition of Clinical Supervision in the Helping Professions: A Practical Guide, Coping Skills for a Stressful World: A Workbook for Counselors and Clients, and Counselor Self-Care. This essay does not have the space to unpack all ethical concerns. For instance, counselor educators can design a major class assignment that addresses counseling and mental health literacy among community members. Therefore, they are continuing to talk about what constitutes good mental health. There can be benefits to technology supplementing human occupational roles, such as robots to inspect burning buildings for safety, but limitations include technological augmentation of jobs that are fundamentally rooted in human relationships. Unlike acute pain, which is short term and alerts people to an injury that needs treatment or rest, chronic pain is long term, often begins without an injury or, in the case of injuries, lasts beyond the normal time of healing. Danica G. Hays is interim dean and professor at the University of Nevada, Las Vegas. Organizations such as Dare2tri, Wounded Warrior Project, Special Olympics and Disabled Sports USA offer inclusive and supportive environments for adaptive athletes. Now we are seeing its role in all social interactions. Recognizing the role that infant fighting rhythms play in healthy individuation will help counselors better dance within the therapeutic relationship. Protests related to human rights, and specifically Black Lives Matter, highlight the importance of counselors being leaders in anti-racism action. Another client, who is a mom of two teens, is fearful and doesnt want them to leave the house. As a profession that is grounded in the wellness model, counselors must go beyond remedial action and engage in preventive measures that can help communities develop climate resilience and advocate for sustainable lifestyles.

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