Mental Health Counseling: Integrating Consultation and Social Advocacy

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Abstract
With the meshing of consultation and advocacy, mental health counselors can both assist in dealing with the issues that their clients face personally, but also help to make better the world around them. In order to respond to the thesis questions presented in this paper, we must first define consultation and social justice advocacy within the counseling context. Typically, consultation means a general meeting or conference between parties. In the counseling context however, we can say that it “usually involves three parties: a consultant, a consultee, and a client system. The consultant delivers direct service to the consultee, who delivers direct service to a client system" (Doherty, 1990). Consultation for professional counselors typically involves acting on behalf of an identified client (or student) through interaction with another professional consultee or other stakeholder in the client’s welfare (Brown, Pryzwansky, & Schulte, 2010; Kampwirth, 2006; Kurpius & Fuqua, 1993). The consultee may also be conceptualized as a system or organization that serves an identified client or student population (Brown et al., 2010; Moe & Perera-Diltz, 2009). With these definitions, a counseling consultant relationship could be thought of as a chain of assistance in dealing with client issues.

Advocacy, typically in regards to social justice, is a way in which a change is brought into society. In a historical context, the mental health reforms that Clifford Beers brought about in the late 1800s were an impactful form of social advocacy. Beers launched one of the earliest client-advocate health reform movements in the United States. A former patient who was institutionalized for three years, Beers led national and international efforts to improve institutional care, challenge the stigma of mental illness, and promote mental health. His efforts resulted in a major shift in attitudes toward mental illness, as well as the introduction of guidance counselors in US schools and the inclusion of evidence of a defendant's psychological state in law courts (Parry, 2010).

Consultation and social justice advocacy may not be exactly similar, but they can be used as cohesive tools that counselors use in order to help their clients. Though scholars continue to identify concerns regarding how the specific nature and scope of social justice advocacy for counselors will be defined (Nelson-Jones, 2002; Roysircar, 2009; Weinrach & Thomas, 2004), in 2003 the American Counseling Association (ACA) endorsed the creation and publication of the Advocacy Competencies (Lewis et al., 2003) for professional counselors. Along with the publication of this special issue, scholarship has focused on making the case for social justice (Prilletensky & Prilletensky, 2003; Vera & Speight, 2003), and on synthesizing the social justice counseling paradigm with other key counseling perspectives such as multicultural theory (Constantine et al., 2007; Crethar et al., 2008) and school counseling (Bemak & Chung, 2008; Dahir & Stone, 2009). The idea of meshing consultation with social advocacy is prudent because we as counselors should work not only to better the lives of our clients but of the world around them. There seems to be an obvious association with mental health and the groups to which social justice advocacy is most needed. Negative experiences of historically marginalized groups can lead to psychological dysfunction and an overall decline in mental health (Chang, Hays, & Milliken, 2009). The American Counseling Association’s Code of Ethics states that counselors should “recognize historical and social prejudices in the misdiagnosis and pathologizing of certain individuals and groups and the role of mental health professionals in perpetuating these prejudices through diagnosis and treatment.”

The need for counselors to integrate social justice advocacy with consultation stems from the fact that much of the clientele that is seeking...
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