This paper discusses the importance of collaboration within the different specializations of the counseling field. Two specializations, mental health counseling and addictions counseling are reviewed and are brought together to help a hypothetical 12 year old girl “Ashley” in her own education and problem-solving while in therapy. Counseling Specializations and Multidisciplinary Teams
The counseling profession and all of its specializations and the related fields that came before, all emerged due to the inabilities for some individuals cope with life stresses. These individuals were seen as non-resilient.
Newman (2012) explains the meaning of resilience as: individuals who exhibit positive outcomes in the face of serious threats to development. They may have experienced prolonged, severe poverty; they may have a parent with a serious mental illness; or they may have been exposed to ongoing abuse or violence. Faced with these and or other difficulties, resilient individuals show low levels of psychological symptoms and function effectively in the basic developmental tasks expected for their stage of life. (pg. 78).
Individuals who could not conform to “normal” societal expectations and were often locked up in the name of keeping society safe. It didn’t matter if these individuals were alcoholics, drug addicts, manic depressives, traumatized Vets, schizophrenics, or someone who merely suffered a temporary situational ordeal; they were locked up for the safety of others Smith & Robinson (1995) explain how Clifford W. Beers’s published autobiography in 1908 raised public awareness by detailing his own inhumane treatment while in a mental health institution. In 1793 the definition of mental health care was extended to include liberty, equality, and fraternity by Philippe Pinel who was the director of Bicetre, the largest mental hospital in Paris.
Pinel believed that punishment was ineffective upholding the idea that patients need some degrees of normalcy in their lives. Brooks and Weikel promoted the idea of “nonmedical approaches” to psychotherapy and state that this was an important step to the characterization and progression of mental health care. The client-centered theory emphasized by Carl Rogers and Fritz Perls, also helped to pave the way for current wellness models used today. Addictions counseling seems to follow a similar model and is often categorized under the same umbrella as professional counseling, however, “it is recognized that the addictions counselor needs to have specialized knowledge about what clients experience that have addictions problems” (Page, R.C., & Bailey 1995 pg. 170).
White (2004) asserts the advantages of mental health and addictions counselors who work together: As mental health professionals, we owe our clients who present with addictions no less in respect, support, or treatment than we would bestow upon any other client. The counseling relationship or therapeutic alliance is perceived to be central to achieving a positive outcome in all mental health counseling (Gelso & Fretz, 1992), and it is especially important that a positive relationship or therapeutic alliance be formed early in addictions counseling before the more difficult or challenging times (e.g., withdrawal symptoms, relapse) occur (pg.3)
As an example, consider a team that successfully joins forces in order to help a 12 year old girl named “Ashley”. Ashley asks her school counselor to help her set up an appointment with a therapist named “Ms. Henning.” Ashley tells the school counselor that she is unable to concentrate on her schoolwork because she is depressed. She further explains that her mother just recently re-married, her step-dad has 2 kids, and she is not adjusting well to the situation. Ashley asks the school counselor to speak to her mother on her behalf because she is afraid to ask. The school counselor makes the call. Fortunately, the family has health insurance and mom is onboard because she has been concerned about Ashley for awhile now and was considering this possibility as well.
The first meeting with Ms. Henning and Ashley goes well. Ashley explains that she misses her mom. Her mom is busy all the time. Her step-dad is nice but she misses her “real dad” and her new siblings are “okay” but she gets really jealous sometimes. Ashley is specific and articulate when explaining her depression but says that it gets worse sometimes the day after she does drugs with her friends. Ms. Henning explains to Ashley everything that she knows about drugs and the adolescent brain but suggests that Ashley get more information from an AODA counselor. Ms. Henning also encourages Ashley to inform her mother of the drug use. Ashley agrees reluctantly but states that she would be more comfortable addressing this issue with mom while in session. Ms. Henning agrees to make the arrangements. This therapist realizes that this is one of her easier cases.
The family has health care and seems supportive rather than angry and defensive. Ms. Henning continually reminds and comforts Ashley in the fact that this is her therapy and her choice and any suggestions that are made will be discussed first—there will be no surprises. One of Ms. Henning’s goals is to provide a “crisis plan” with the school counselor for Ashley in case Ashley needs additional support during the school day. Ms. Henning also wants Ashley to see an AODA counselor at least once a week (Mr. Marks), and will keep Mr. Marks up to date on what is happening in therapy while she implements his evaluations and suggestions. She has communicated this to him in a credulous manner. Ms. Henning also hopes to initiate family support for Ashley by teaching and encouraging family members to openly discuss the family changes, possible effects, and brain-storm potential solutions.
Ms. Henning would like to include “real” Dad and new siblings, at some point, if feasible and appropriate to Ashley and her family. Ashley’s ability to understand her sadness and develop coping skills will be greatly increased with a team of family members, the therapist, the AODA counselor, the school counselor, or possibly a psychiatrist if it is suspected that medication might be needed. Ms. Henning is dedicated to keeping all team members informed beyond progress reports by scheduling group meetings with everyone involved once a month. She is dedicated to receiving and offering feedback at every turn throughout the duration of Ashley’s therapy and reiterates this frequently to every member on this “team” emphasizing the value and importance of each team member. She knows that one field (or specialization) cannot effectively handle it all.
The significance of promoting team work and joining forces in the counseling field is also included in some college counseling curriculums. McAllister, M., Morrissey, S., McAuliffe, D., Davidson, G., McConnell, H., & Reddy, P. (2011), present the importance of the cooperation of professionals within the field and how some students are required to reach outside of their own specialization (or discipline) to connect with those students who have chosen other disciplines in order to build an understanding and respect between specialties.
These students are required to share their own POEM’s (philosophy, ontology, epistemology and methods) with students in specialties other than their own. Studies and research; on spirituality, the human body (especially the brain), pharmaceuticals, addictions, or how society, science, technology, or government and new laws can affect individuals, will continue to shatter preconceived ideas and current acceptable “norms” of life and society. Those who choose this field must keep up. Specializations and collaboration in counseling seems to be invaluable and necessary.
McAllister, M., Morrissey, S., McAuliffe, D., Davidson, G., McConnell, H., & Reddy, P. (2011).
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