The Role and Life of a Mental Health Counselor

The Role and Life of a Mental Health Counselor: Final Project

Mental health counselors provide treatment to help others achieve healthy development and improve their quality of life (Erford, 2010). According to Hershenson, Power, and Waldo (as cited by Erford, 2010), counselors assist individuals achieve healthy development by preventing problems from impeding with healthy development, by helping the individual redirect problem behaviors, or teaching the individual to cope using individual strengths and techniques. This paper explores the role of a mental health counselor through a summation of an interview with a professional mental health counselor, and by incorporating the information from this interview with information gained through coursework at Walden University. This paper also discusses the beginning of my personal journey towards becoming a professional mental health counselor.

The Interview

Daniel Doe is a professional mental health counselor working for a nonprofit organization that serves the needs of adults with severe and persistent mental illness. Daniel currently works in a secure residential facility, where the majority of clients suffer from an Axis I diagnosis of schizophrenia and have been court committed to the facility for their own safety and the safety of others. Daniel provides individual and group counseling that focuses primarily on identifying triggers and learning coping skills. Many of the counseling sessions take place in the community as he works with clients with the ultimate goal of societal reintegration. In this work setting, as with the counseling field in general, confidentiality laws are extremely important. Daniel mentions that in order to maintain confidentiality when out in the community, he cannot disclose the fact that the group he is with is from a residential treatment facility or discuss treatment in a manner that allows community members to overhear.

Daniel stresses that work as a professional mental health counselor in a residential setting is much different than working in a private practice or outpatient setting; his workplace is the clients's home. As such, he does not have typical hour sessions scheduled in advance. Rather, he comes to work and observes and participates in the clients's activities of daily living. These include activities such as eating meals, cleaning, and personal hygiene habits. Each of these activities provides opportunities for counseling as he helps clients identify areas they need to improve on and teaches them skills necessary for successful reintegration into society.

Another aspect of counseling through daily living is Daniel's involvement in crisis intervention. Erford (2010) states that a crisis is an intense emotional difficulty that the individual is unable to cope with, and that lasts a short amount of time. In the facility where Daniel works, it is not uncommon for at least one client crisis to occur each day. These crises range from severe and debilitating anxiety issues to extreme anger or suicidal ideation, and often trigger violent outbursts or intimidating behavior. Recently a client left the facility on a family pass and refused to come into the building when his family member brought him back to the facility. When he finally did come inside, the client threatened suicide. Daniel provided crisis intervention by helping the client process his feelings and exploring the client's thought process. Through this counseling session Daniel discovered that the client felt unsafe in the facility and believed that peers were entering his room trying to hurt him while he slept. When suicide is a concern Erford (2010) states that client safety is the counselor's primary concern. Daniel confirmed this statement as he explained that his top priority was ensuring that the client felt safe, which would hopefully result in decreased thoughts of suicide. To help the client feel safe, Daniel put him on close observation, where staff check on him every fifteen minutes, and offered him the ability to sleep in the quiet room, which is a room near the office and away from peers that has constant camera monitoring. The client felt safer with staff being able to continuously monitor him and ensure that peers were not entering his sleeping area.

In addition to counseling through participation in the daily life of clients, Daniel runs group sessions that sometimes simply include talking about symptoms and coping techniques, and that sometimes involve group outings that focus on appropriate behavior in the community. Oftentimes, clients will respond badly or are uncomfortable with group outings and require more intensive, one-on-one outings that Daniel is happy to provide. When counseling clients, Daniel uses a behavioral approach. The clients have a level system, and good behavior and adherence to treatment plans earn higher levels and, thus, more privileges. Daniel also explains that the facility uses a token economy, where clients receive "Faulkner Bucks" for completing activities of daily living and assigned chores. These "Faulkner Bucks" can be used to buy items at the resident store.

In addition to therapeutic, direct contact with clients, Daniel also participates in treatment planning and case conferences. He states that treatment planning occurs in partnership with the facility's psychiatrist and administration, and that they work together to develop a plan of success for each individual client in the facility. These treatment plans must also meet certain requirements so services can coincide with the treatment plan in a manner that allows insurance reimbursement.

Daniel states that multicultural awareness is essential in his career, both when it comes to therapeutic contact with clients and during treatment planning. He stresses that mental illness impacts the lives of people without concern for race, gender, or sexual orientation. As such, the clients he works with all come from different backgrounds with different challenges and influencing events. The relationship between client and counselor varies depending on this background, as do goals and treatment techniques that will be effective. As an example Daniel tells of an African-American client who had difficulty trusting David and who would often shout profanities at him regarding his Caucasian status. Before Daniel could work effectively with this client, he had to acknowledge the anger the client had towards Caucasians as a result of the discrimination he faced and the oppression of the African-American race.

In addition to multicultural awareness, Daniel states that psychological and intake assessments are also imperative for his work. These assessments help him understand the challenges facing clients and allow him to develop accurate and effective treatment plans.