Mental Health Program Development and Service Delivery for Individuals with Intellectual and Developmental Disabilities
A need exists in the Wilmington, North Carolina metropolitan area for licensed professional counselors willing to work with individuals of transition age (18-21) with intellectual and developmental disabilities (IDD) and their families. This paper deals with mental health program development and service delivery for this often-overlooked population. How client needs influence the design of a mental health program; models, methods and principles of program development and service delivery; and how the application of principles, models, and needs assessment results drive program modifications will be discussed. It is of note that there is little extant literature regarding mental health counseling with this population. How Client Needs Influence the Design of a Mental Health Program Successful mental health programs follow an evidence-based model of design which is based on the needs of a community or a target population within a community. Calley (2009) asserts that “counselors must be competent in comprehensive clinical program development from design through evaluation” (p. 9). Prior to the design process, a needs assessment must be completed and stakeholder groups identified to determine the direction of the new program (Erford, 2014). The Wilmington, North Carolina metropolitan area spans three counties with a population of 362,315 (U.S. Census Bureau, 2010). According to Morstad (2012), 1.5% to 2.5% of Americans are intellectually and developmentally disabled. Given these figures, between 5,435 and 9,058 people in this geographic region are IDD. Only one licensed professional counselor (LPC) and two licensed clinical social workers (LCSW) specialize in counseling persons with IDD and/or their families. These professionals work for the same agency, Cape Fear Case Management and Counseling Services. The agency website mentions counseling individuals with IDD, but appears focused on providing assessment and developing, implementing, and monitoring behavior plans (capefearcasemanagement.com, 2013). Special education teachers have communicated the dire need for licensed professionals willing to counsel transition-age adolescents from this population and their families. Parents have lamented that they need help dealing with the feelings surrounding their child’s transition to adulthood. A mental health LPC with a strong background working with individuals with IDD can provide this counseling and serve as an advocate for the person within the school systems as well as various service agencies and the managed care organization (MCO) who determine the eligibility for adult services. This perceptions-based needs assessment indicates the necessity for such a counselor. Models, Methods, and Principles of Program Development and Service Delivery According to Calley (2009), conducting a research review to provide a foundation for program design is essential before the actual development phase so that services and treatment are evidence-based. A small and slow-growing sector of literature exists related to persons with IDD, but very few focus on the use of counseling methodology within the population. Prout and Strohmer (1998) state, “…there is very little sound empirical analysis of the effectiveness of counseling and psychotherapy with persons with [IDD]. Few studies meet acceptable methodological standards, and the bulk of the literature is anecdotal and case-study based…it had been assumed that mental health counseling…was ineffective with persons with [IDD]” (p. 118). The authors go on to assert that mental health counseling is appropriate for those in the mild range of IDD (Prout & Strohmer, 1998). Most of the extant literature indicates modified counseling techniques are appropriate in the mild-moderate range of disability. Examples include eye movement...
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