Counseling in Community Setting
Content
COUNSELING IN COMMUNITY SETTING
Background • The emergence of communities counseling came as a result of the final report of the Joint Commission on Mental Illness and Health in 1961 and Community Mental Health Centers Act of 1963. As a result of the mental health center legislation, helping professionals were encouraged to move toward more developmental and preventive interventions and away from remedial interventions. Major changes proposed by the legislation included the construction of 2,000 community mental health centers and the gradual reduction and elimination of the overcrowded state mental hospitals. • The Commission on Mental Health developed a formula that encompassed most mental health efforts: Organic factors + Stress Incidence = Coping skills + Self-esteem + Support groups • The incidence of mental disorders in an individual is equivalent to the presence of difficult life circumstances over available resources and strengths. Problems occur whenever the numerator is greater than the denominator. Effective efforts to alter factors in the numerator or denominator alter incidence at the other side of the equation. This is rooted in the public health tradition in which incidence of a physical disease is reduced either by increasing the resistance of the host (strengthening the factors in the denominator) or by reducing or eliminating the noxious agent (reducing factors in the numerator). Community Counseling • Community counseling is a multifaceted approach combining direct and indirect services to help community members live more effectively and to prevent the problems most frequently faced by those who use the services. • Their interventions are aimed primarily at populations who are most in need of mental health services and usually most excluded from receiving them, such as ethnic minorities and the poor and elderly. Community counselors' strategies reach out to the community and include: • Identifying and working with groups who are at risk for certain problems such as substance abuse; poor health; physical, emotional, and learning disabilities; poverty; and emotional and physical abuse in order to reduce their incidence. • They also attempt to empower and increase the amount of coping skills of their target populations through: • Education • Client advocacy • Political involvement such as influencing policy makers. Different Forms of community counseling The following are some of the ways counselors work to meet the mental health needs of the community: • Substance Abuse Counseling • Gerontological Counseling • Health Counseling • Rehabilitation Counseling • Crises/and Disaster Counseling • Client Advocacy Substance Abuse Counseling Substance abuse includes the abuse of all drugs, including alcohol. The definition even includes foods such as sugar when the foods are used to alter a person's mood or psychological state, usually for the purpose of avoiding dealing with difficult situations. Interventions: Detoxification and medical treatment • In many cases the problem may be so severe that detoxification is necessary, preferably under medical supervision. Medication may also need to be provided as part of a treatment plan. Group and family counseling approaches • In most cases of substance abuse, medical treatment alone is not sufficient; generally many types of counseling services are offered. These services include group and family counseling, both of which may be extremely important in helping a person decide to change an undesirable behavior pattern and then to maintain the new behavior. Groups like psychodrama and marathon sessions are quite popular. The group leader establishes rules, screens and prepares members for admission, educates clients about drugs, and tries to ensure that the group norms are followed. The support of the group allows for individual resolution to give up alcohol or other drugs.
Supplemented by support groups • For the best results, counseling is usually supplemented by support groups, such as Alcoholics Anonymous or Overeaters Anonymous, to help maintain the desired behavior for life. Exercise and relaxation programs are often prescribed to improve physical well-being and establish positive addictions • An area of specialization related to substance abuse counseling is working with the adult children of alcoholics (ACOAs). Alcohol abuse causes problems for the abusers and their immediate families and also for the adult children of the abusers regardless of whether they drink themselves. Having been part of a dysfunctional family has left the ACOAs with deficiencies in coping and in relationship skills that have a significant impact on their personal and emotional development. Counseling processes include working with grief and shame and helping clients learn to accept themselves, express their needs, and have fun without guilt. Methods • Interventions might include instructional lectures, discussions, deep analytic explorations, hypnosis, and confrontation. • Substance abuse counselors often participate in specialized programs and in some cases can receive special certification as drug and alcohol abuse counselors. Gerontological Counseling • Another area of growth in the counseling field is gerontological counseling, the counseling of older citizens. In a survey of counseling education in USA, Daniel and Weikel (1983) found that the primary trend identified was an increase in gerontological counseling as a specialty. • This movement toward working more with the older members of society was highlighted in 1988, when the Association for Adult Development and Aging (AADA) became a division of ACA. • In 1900, life expectancy was 49 years; today it is 76 in USA and in 60s in Pakistan. Schlosberg (1995) pointed out that the life expectancy is expected to continue to inch up slowly and in the next 20 to 30 years we will probably see more people between 100 and 110 years of age. This is more likely in the developed countries because of the developments rapidly taking place in the medical field. With the increasing number of people living longer, there has been a corresponding increase in interest in working with the aged in a variety of settings, such as community centers, retirement centers, nursing homes, and hospice programs. Health Counseling • Another major speciality area for trained counselors is health counseling. “Health counseling uses the skills of the counselor to help clients make the kind of lifestyle changes that enhance their physical health" (Lewis et al., 1993). • Rejecting the medical model that focuses on the diagnosis and treatment of disease, Thoreson and Eagleston (1985) prescribe an educational model that emphasizes training people to think, make decisions, and solve problems. These skills are considered necessary for the ongoing prevention of disease and the maintenance of wellness. Such an approach requires an educated, informed public. Skilled counselors may be employed in a variety to settings to work with health-related issues of men, women, and children of all racial and ethnic groups to ensure that these skills are learned. This area includes the concept of wholistic counseling, an approach that looks at the total person and works to integrate the physical, psychological, and spiritual dimensions of a person's life. Uses and Techniques? • Health professionals work with current cases and strive to prevent future occurrences through encouraging community education, starting AIDS support groups, establishing hotlines, and counseling AIDS’ victims and their families. Research into a number of areas has produced results indicating that some chronic diseases are not as inevitable as once feared. These diseases include lung cancer, heart disease, and adult-onset diabetes. Rehabilitation Counseling • Rehabilitation counselors are specialists who help clients with disabilities overcome deficits in their skills. Disabilities can manifest themselves in many different ways. Even though a major objective of a rehabilitation counselor is to help a client learn to cope with specific mental or physical disability, such as deafness, the full goal is wholistic in nature: to help the client become fully functioning in all areas in spite of any disability or limitation. Uses: • In addition to its applicability to clients with physical disabilities such as blindness or loss of a leg, rehabilitation counseling is necessary for prisoners after release from prison, for psychiatric patients after release from mental hospitals, and for people with developmental disabilities. Much substance abuse counseling might be considered rehabilitative. People who have lost their jobs after many years of employment also need to go through a rehabilitative process. Many companies and unions have established counseling programs for workers who have lost their jobs as a result of plant
closings or downsizing. • In USA, certification as a certified rehabilitation counselor (CRC) can be attained through the American Rehabilitation Counseling Association (ARCA), a division of ACA. Crises/and Disaster Counseling • Many counselors have responded to events that devastate communities, such as storms, floods, fires, earthquakes, and riots. • On a smaller scale, counselors regularly become involved in local crises, such as working with the victims of a school bus accident or of a shooting at a fast food restaurant. Crisis intervention research shows that if interventions are made quickly by helping professionals when these events occur, those affected will recover quickly. • One fast intervention of psychological first aid is critical incident stress management (CISM). It was originally developed in USA to treat public service workers exposed to extreme levels of trauma. Currently it has found widespread application in a variety of settings for treating anyone exposed to natural or manmade disasters. Client Advocacy • Often counselors engage in client advocacy for those who do not have the awareness or resources themselves or who are disenfranchised, such as rape and child abuse victims, oppressed minorities, neglected elderly populations, and homeless persons, such as rape and child abuse victims, oppressed minorities, neglected elderly populations, and homeless persons.
Background • The emergence of communities counseling came as a result of the final report of the Joint Commission on Mental Illness and Health in 1961 and Community Mental Health Centers Act of 1963. As a result of the mental health center legislation, helping professionals were encouraged to move toward more developmental and preventive interventions and away from remedial interventions. Major changes proposed by the legislation included the construction of 2,000 community mental health centers and the gradual reduction and elimination of the overcrowded state mental hospitals. • The Commission on Mental Health developed a formula that encompassed most mental health efforts: Organic factors + Stress Incidence = Coping skills + Self-esteem + Support groups • The incidence of mental disorders in an individual is equivalent to the presence of difficult life circumstances over available resources and strengths. Problems occur whenever the numerator is greater than the denominator. Effective efforts to alter factors in the numerator or denominator alter incidence at the other side of the equation. This is rooted in the public health tradition in which incidence of a physical disease is reduced either by increasing the resistance of the host (strengthening the factors in the denominator) or by reducing or eliminating the noxious agent (reducing factors in the numerator). Community Counseling • Community counseling is a multifaceted approach combining direct and indirect services to help community members live more effectively and to prevent the problems most frequently faced by those who use the services. • Their interventions are aimed primarily at populations who are most in need of mental health services and usually most excluded from receiving them, such as ethnic minorities and the poor and elderly. Community counselors' strategies reach out to the community and include: • Identifying and working with groups who are at risk for certain problems such as substance abuse; poor health; physical, emotional, and learning disabilities; poverty; and emotional and physical abuse in order to reduce their incidence. • They also attempt to empower and increase the amount of coping skills of their target populations through: • Education • Client advocacy • Political involvement such as influencing policy makers. Different Forms of community counseling The following are some of the ways counselors work to meet the mental health needs of the community: • Substance Abuse Counseling • Gerontological Counseling • Health Counseling • Rehabilitation Counseling • Crises/and Disaster Counseling • Client Advocacy Substance Abuse Counseling Substance abuse includes the abuse of all drugs, including alcohol. The definition even includes foods such as sugar when the foods are used to alter a person's mood or psychological state, usually for the purpose of avoiding dealing with difficult situations. Interventions: Detoxification and medical treatment • In many cases the problem may be so severe that detoxification is necessary, preferably under medical supervision. Medication may also need to be provided as part of a treatment plan. Group and family counseling approaches • In most cases of substance abuse, medical treatment alone is not sufficient; generally many types of counseling services are offered. These services include group and family counseling, both of which may be extremely important in helping a person decide to change an undesirable behavior pattern and then to maintain the new behavior. Groups like psychodrama and marathon sessions are quite popular. The group leader establishes rules, screens and prepares members for admission, educates clients about drugs, and tries to ensure that the group norms are followed. The support of the group allows for individual resolution to give up alcohol or other drugs.
Supplemented by support groups • For the best results, counseling is usually supplemented by support groups, such as Alcoholics Anonymous or Overeaters Anonymous, to help maintain the desired behavior for life. Exercise and relaxation programs are often prescribed to improve physical well-being and establish positive addictions • An area of specialization related to substance abuse counseling is working with the adult children of alcoholics (ACOAs). Alcohol abuse causes problems for the abusers and their immediate families and also for the adult children of the abusers regardless of whether they drink themselves. Having been part of a dysfunctional family has left the ACOAs with deficiencies in coping and in relationship skills that have a significant impact on their personal and emotional development. Counseling processes include working with grief and shame and helping clients learn to accept themselves, express their needs, and have fun without guilt. Methods • Interventions might include instructional lectures, discussions, deep analytic explorations, hypnosis, and confrontation. • Substance abuse counselors often participate in specialized programs and in some cases can receive special certification as drug and alcohol abuse counselors. Gerontological Counseling • Another area of growth in the counseling field is gerontological counseling, the counseling of older citizens. In a survey of counseling education in USA, Daniel and Weikel (1983) found that the primary trend identified was an increase in gerontological counseling as a specialty. • This movement toward working more with the older members of society was highlighted in 1988, when the Association for Adult Development and Aging (AADA) became a division of ACA. • In 1900, life expectancy was 49 years; today it is 76 in USA and in 60s in Pakistan. Schlosberg (1995) pointed out that the life expectancy is expected to continue to inch up slowly and in the next 20 to 30 years we will probably see more people between 100 and 110 years of age. This is more likely in the developed countries because of the developments rapidly taking place in the medical field. With the increasing number of people living longer, there has been a corresponding increase in interest in working with the aged in a variety of settings, such as community centers, retirement centers, nursing homes, and hospice programs. Health Counseling • Another major speciality area for trained counselors is health counseling. “Health counseling uses the skills of the counselor to help clients make the kind of lifestyle changes that enhance their physical health" (Lewis et al., 1993). • Rejecting the medical model that focuses on the diagnosis and treatment of disease, Thoreson and Eagleston (1985) prescribe an educational model that emphasizes training people to think, make decisions, and solve problems. These skills are considered necessary for the ongoing prevention of disease and the maintenance of wellness. Such an approach requires an educated, informed public. Skilled counselors may be employed in a variety to settings to work with health-related issues of men, women, and children of all racial and ethnic groups to ensure that these skills are learned. This area includes the concept of wholistic counseling, an approach that looks at the total person and works to integrate the physical, psychological, and spiritual dimensions of a person's life. Uses and Techniques? • Health professionals work with current cases and strive to prevent future occurrences through encouraging community education, starting AIDS support groups, establishing hotlines, and counseling AIDS’ victims and their families. Research into a number of areas has produced results indicating that some chronic diseases are not as inevitable as once feared. These diseases include lung cancer, heart disease, and adult-onset diabetes. Rehabilitation Counseling • Rehabilitation counselors are specialists who help clients with disabilities overcome deficits in their skills. Disabilities can manifest themselves in many different ways. Even though a major objective of a rehabilitation counselor is to help a client learn to cope with specific mental or physical disability, such as deafness, the full goal is wholistic in nature: to help the client become fully functioning in all areas in spite of any disability or limitation. Uses: • In addition to its applicability to clients with physical disabilities such as blindness or loss of a leg, rehabilitation counseling is necessary for prisoners after release from prison, for psychiatric patients after release from mental hospitals, and for people with developmental disabilities. Much substance abuse counseling might be considered rehabilitative. People who have lost their jobs after many years of employment also need to go through a rehabilitative process. Many companies and unions have established counseling programs for workers who have lost their jobs as a result of plant
closings or downsizing. • In USA, certification as a certified rehabilitation counselor (CRC) can be attained through the American Rehabilitation Counseling Association (ARCA), a division of ACA. Crises/and Disaster Counseling • Many counselors have responded to events that devastate communities, such as storms, floods, fires, earthquakes, and riots. • On a smaller scale, counselors regularly become involved in local crises, such as working with the victims of a school bus accident or of a shooting at a fast food restaurant. Crisis intervention research shows that if interventions are made quickly by helping professionals when these events occur, those affected will recover quickly. • One fast intervention of psychological first aid is critical incident stress management (CISM). It was originally developed in USA to treat public service workers exposed to extreme levels of trauma. Currently it has found widespread application in a variety of settings for treating anyone exposed to natural or manmade disasters. Client Advocacy • Often counselors engage in client advocacy for those who do not have the awareness or resources themselves or who are disenfranchised, such as rape and child abuse victims, oppressed minorities, neglected elderly populations, and homeless persons, such as rape and child abuse victims, oppressed minorities, neglected elderly populations, and homeless persons.
