“The Role and Life of a Mental Health Counselor”
“My Friend My Counselor”
Component I: Narrative Summation of Interview
(Charleston, SC) This interview is taking place on Friday, October 11th, 2013 at City Lights Coffee, our favorite coffee shop on Market Street in Downtown Charleston, directly off of King Street. Today I am interviewing Mrs. Mary Bolden who has a Masters degree in Social work along with other degrees and certificates, from Winthrop College and the University of South Carolina. She is the program director for Pinelands Psychosocial Residential Treatment Facility in Summerville, South Carolina. In conjunction with being the program director at Pinelands PRTF, she is an emergency intervention specialist with adolescents’ for Charleston County school system. She is one of only 25 substance abuse professionals in the state of South Carolina and she was the program initiator and director for South Carolina SAP which stands for Substance Abuse Program. I am excited to interview her as I have stated she is my mentor and friend and very seldom does one have the pleasure to work with and for someone they respect and admire so highly.
“Mrs. Mary”, as I call her; “how is being a mental health counselor different than being a social worker or psychologist?” “Well”, she says; “it is different in that a social worker focuses on the use of a systems and family-oriented approach to helping their clients cope on a practical level and a psychologist has the responsibility of being similar to a mental health counselor. I, however; have the pleasure of interacting between agency, (Pinelands) and private practice. My private practice allows me to relate on a more personal level with my clients which as you know are adolescents. I see my clients on a day to day basis and not just once a week as a psychologist or once a month as a social worker would.” So, I asked her; “what does your normal day consist of?” She said, “My normal day would start, usually with a staff meeting with the CEO, various health service providers or HSP’s, and the Director of Nursing, We meet to discuss any treatment team issues and discuss any new admissions or discharges and other concerns for that day. I would then start my day by returning phone calls to various social workers or probation officers with the state and from there I would review any scheduled family therapy sessions or emergency interventions that were needed. Then my next step is to have my sessions with my clients, which usually takes about an hour each client.”
“What ethical and legal issues do you have to keep in mind each day?” Mrs. Mary replied. “Of course, the first thing that comes to mind for me when you say ethics and legal is being professional and holding myself accountable for my actions. And one thing I would like to tell you, Pearl is to always hold yourself to a higher standard because what you do not only reflects your professionalism but respect of your colleagues in the profession. (Young, 2014, P. 66) She said; “The mental health counseling profession has a “Code of Ethics”, which you should study and learn. (Young, 2014, p.67)
I know that you have your own style of counseling, which I love, but do you have a certain theory that you tend to use more often? Mrs. Mary replied; “no, I do not and you will not be able to remember nor use all those theories you learn in that text book. You must first learn all there is to know about your client and choose the best method, or “theory”, that fits for that particular clients issue. You will learn in that book of yours, that your client should set goals and you should not be the problem solver. Your client should solve his or her own problem and you should just be the facilitator of a means to help them along with their problem. Because if you solve your clients’ problems, you are not “guiding” them or giving them the means to solve their own problems and you are doing more harm than good. Take for instance an alcoholic, which as you know is where my most experience comes from. Only the alcoholic can stop using, you cannot stop them from using unless you put them in a padded room and lock the door. You and I know that cannot happen, so you are left with guiding them to a means to an end. Be your clients’ sounding board, if that makes any sense.”
My next question; “Mrs. Mary; does having knowledge of human growth and development really play that much of a part in your practice?” Mrs. Mary replied strongly; “without a doubt!, If you do not understand what milestones in life are normal and expected from an individual, you cannot attempt to put into place a counseling goal for them in a correct manner.” Would you explain that to me Mrs. Mary? I asked. She said, “Well say for instance that you are trying to communicate a cognitive behavioral theory process to a 30 year old man who only has a 6 year old mentality, it ain’t gonna happen. Without knowing what milestones in life are appropriate for whatever age, you cannot establish a case plan or goal for that person and the only way to understand that process is to take a growth and development class.”
How does understanding multiculturalism help in your counseling profession? “There is someone in all races and social status in need of counseling and you have to understand your client’s heritage and culture to be able to treat them. Some cultures don’t believe in treatment, others use alcohol or drugs as a means of relieving stressors.” (Young, 2014, p. 241)
I know that you use assessments because you are giving them to me to file all the time, so why do you use them to help you with client case conceptualization? Mrs. Mary’s’ answer was; “an assessment is one of your tools that you will be using to help diagnose your clients.” “What kind of experiences have you had when you refer a client to someone for medication? I asked.” “I have had both negative and positive experiences,” she said, “when referring clients for meds, but it all depends on the person or professional that you are referring your client to. Some will medicate and some don’t believe in it, but it is a courtesy from one professional to another to make an evaluation and act in the best interest of the client.” (Young, 2014, p. 388)
You and I have seen many client crisis together and I know the procedure which is we refer our clients to the MUSC Institute of Psychiatry but have you ever responded to a large scale crisis? “I only respond to anything that happens within the public school system,” she said, “and so far in my career here in Charleston, nothing has happened.”
Our interview was cut short because she had to return to her job and we both lost track of time. I did have a chance to ask her one last question from my remaining list and that was about advocacy for the adolescents she counsels. She replied, “I stand up for my clients no matter the situation, just like I would stand up for you as my friend. Some children don’t have a voice especially those who are abused or neglected and I have to be their voice. Now do they get on my last nerve sometimes, yes but I never let that show and I will go to bat for these kids anytime day or night.” References for this section:
Young, M. A., & Basham, A. (2014). B. T. Erford (Ed.), Orientation to the counseling profession: Advocacy, ethics, and essential professional foundations (2nd ed., pp.66, 67, 241, 388). Loyola University, MD: Pearson Inc.
Component II: "A Day in the Life of a Mental Health Counselor" What I learned from my interview with Mrs. Mary Bolden was that there can be two separate types of mental health counselors and each day spent with them would be different. A day would depend on whether or not the counselor was in private practice or working for an agency. In either situation the counselor is assisting individuals in finding answers. The Counselor must use their competency and perception when a client is expressing their feelings so the counselor can develop a strategy to help set goals for treatment A commitment to the profession is made and followed daily and the counselor understands the importance of their role in the counseling process. The counselor must be aware that they should pay attention to their self-maintenance and physical fitness. The Counselor has a day to day level of anxiety and demonstrates the awareness of uncertainty with their future clients. There has to be a passion for the profession and also a commitment to really “be there” for their clients which takes a lot of sacrifice. The counselor must be able to recognize and accept these anxieties as opposed to denying them and it takes a lot of courage to do so. The counselor has the opportunity to discuss the anxieties with their supervisors and peers. They gain the support from their fellow interns with the same concerns, fears and anxieties.
Of course the counselor has a structured set of ethics and possibly even a day to day schedule that they may have to follow and anyone can write about that particular schedule for their workday. What I have discussed is the behind the scenes concerns that every counselor faces in their day to day activities.
Component III: Reflection
Thinking back on this class and my interview with Mrs. Mary Bolden, I realize that I have taken on an important and multi-faceted endeavor. There is a lot to learn and there will always be more to learn. This makes becoming a mental health counselor even more fascinating to me. I will reflect on some of the areas that stand out most in my memory but there is no way I can touch on everything available to me from my textbook. I know I will keep in handy and use it again and again, which is more than I can say about any other textbook I have ever used. I am excited about becoming a counselor and here are just a few of the points I would like to make. Beginning counselors commonly make two mistakes when they consider private practice. The first assumption is that maintaining a private practice is easier than working in other mental health settings, and the second assumption is that novice private practitioners can immediately specialize in their favorite treatment area. (Young, 2014, pp.343, 4) If you are associated with an agency your day is dictated by the guidelines set forth for that agency and in private practice you are less restricted but you still have to follow ethical standards and laws as set forth by the American Counseling Association. Ethical standards are based on generally accepted norms, beliefs, customs, and values. The code of ethics published by the American Counseling Association (ACA) (2005) is based on five principles of autonomy, justice, beneficence, non-maleficence and fidelity (Linde, 2011)
Of course in a counseling field there is going to be talking and listening. A client comes to a counselor to resolve some type of conflict whether it is internal or external. The counselor is expected to help improve their client’s emotional and mental well being. There is always a research component and a lot of reports that need to be written. Risk communication and management are essential to the ethical conduct of research, yet addressing risks may be time consuming for investigators and institutional review boards may reject study designs that seem too risky. This can discourage needed research, particularly in higher-risk protocols or those enrolling potentially vulnerable individuals, such as those with some level of suicidality. Improved mechanisms for addressing research risks may facilitate much needed psychiatric research. (JAMA Psychiatry, 2013) A mental health counselor’s day to day activity involves either working with an individual or family in a group. A counselor should be prepared to treat a wide variety of issues from alcoholism to depression, emotional disorders, suicidal ideations, loss of loved ones and low self esteem. Even now with an increase in this country’s recent military interventions a counselor may treat a significant amount of post traumatic stress disorder. All of the previous issues need an assessment which the counselor should be doing throughout those clients’ sessions. Assessment is the process of gathering information in a systematic way to evaluate concerns or questions that a client brings to counseling. It is a broad umbrella term that includes intake interviews, tests and inventories, behavioral observations, and relevant information gathered from other sources. (Barlow & Durand, 2009; Nystul, 2011) The assessment process informs case conceptualization, diagnostic foundation, and these resulting counseling plans, and helps to identify resources that could allow the client to cope better with the presenting concern. (Erford, 2013,pp.388,2)
The counselor should always follow the ethics set forth by the profession and of course the American Counselors Association, but there are larger components. That same counselor should be aware of their accountability and know how to address it. Accountability is a central responsibility of all professional counselors. However, accountability is not just tallying the number of clients seen or how much time has been spent providing various types of services. At its core, accountability demonstrates the effect that a professional counselor has in producing changes in clients and program stakeholders. (Erford, 2013, pp,452, 1) Supervision is an important component of the counseling profession along with being an advocate for the profession. Supervision can take many forms and by supervising you are becoming an advocate. Supervision is a process that involves a supervisor overseeing the professional work of a trainee with four major goals: (1) to promote supervisee growth and development, (2) to protect the welfare of the client, (3) to monitor supervisee performance and to serve as a gatekeeper for the profession, and (4) to empower the supervisee to self-supervise and carry out these goals as an independent professional. (Erford, 2013, pp.425, 2) The most significant personal development issues that a counselor faces are motivation, personal support and dealing with their own personal issues. “It is important for the counselor to also take care of the single most significant instrument in any counseling relationship and that is, the counselor themselves.” The counselor should maintain self-care and wellness. What I have learned from my interview is that growth in my own life will be crucial and I will need to be aware of the causes of burnout. It is important to know how to recognize and remedy burnout and how to prevent it. I learned from the interview that I won’t possibly be able to remember every theory, every citation, every method of gathering research from the textbook but I will do my best to try. I understand better the importance of following the strictest of ethical and profession protocols and to present myself in a professional way at all times.
The most important thing that came to life from the interview was to have fun and enjoy the day to day environment that I hope to have the opportunity to become a part of. I can only see myself growing and becoming an empathetic and important member of the mental health society. REFERENCES:
American Counseling Association. (2005) American Counseling Association code of ethics (3rd ed.). Alexandria, Va.
Barlow, D.H. , and Durand, V.M. (2009). Abnormal psychology; an integrative approach (5th ed.). Belmont, Ca. Wadsworth Cengage Learning.
Erford, T. B., (2013). Orientation to the Counseling Profession, Advocacy, Ethics, and Essential Professional Foundations, (pages; 388, 425, 2 425, 452, ) Loyola University Maryland.
JAMA Psychiatry, (2013). http://archpsyc.jamanetwork.com/journal.aspx
Linde, L.E. (2011), Ethical, legal and professional issues in school counseling. In B.T. Erford (Ed.), Transforming the school counseling profession (3rd.ed.) Columbus, Oh: Pearson Merrill.
Nystul, M.S. (2011). Introduction to counseling: an art and science perspective (4th ed.). Boston Ma. Allyn & Bacon
Young, M.E. (2013). Learning the art of helping: Building blocks and techniques (5th ed.) Upper Saddle River, NJ: Pearson Education.