“ No man is an island. ” This is the quote that initially entered my mind, when i tried to refresh myself with the learnings i have gathered from our introductory discussions on Counseling. The need for guidance and support is indeed inherent in every creature – humans or even the lower forms. In our case, such need plays a significant role not just in the life of a child, who is totally dependent on his parents care for sustainance and survival, but on adults as well.
Each individual needs someone to cling on and confide with, when they are faced with draining situations especially in cases where one suffers emotional or psychological instability. Miraculously, provision of adequate support to people undergoing these emotional tremors, putting their mental health at risk to some extent, could hasten the recuperation process. What is really counseling? How is it able to heal the wounds that contribute to ones emotional & psychological state?
Counseling in the layman’s view can be described using a mental picture of an empathic man offering advice to a problematic or disturbed individual. From this perspective, we can see counseling as a one way process where the therapist is the one talking & the client is the the one listening & absorbing whatever it is that is said. But is this really the true essence of counseling? In our discussions, i have realized that effective counseling is supposedly done the other way around. It is giving the client more time to express himself for better understanding of the issues at hand.
A therapist should allocate more percentage to listen to what has been said especially during the initial sessions to get a good grasp of the problem at hand, instead of immediately offering an advice. However, asking probing questions is needed when necessary. Another learning that can be considered important is the knowledge on multicultural counseling. A therapist should have a clear grasp of the client’s cultural orientation or background before preparing the diagnosis report and treatment. It must be remembered that beliefs vary from culture to culture.
This means that what may be considered abnormal to one may not necessarily mean the same thing to the other. This is helpful not just in identifying culturally-determined conditions but in conceptualizing the type of treatment relationship. For clients with culturally diverse background, cultural formulation should be developed that would take into account the client’s degree of identification with the culture, the culture’s beliefs of psychological disorder, the ways in which certain events are interpreted within the culture, and the cultural supports available to the client (cited in “DSM IV”, 1999).
Knowing the individuals degree of involvement to the culture is as important as knowing the cultural explanations of the symptoms. In some cultures, psychological disorders may be expressed as “culture-bound syndromes”, which may be expressed as patterns of behavior that reflects predominant cultural themes that date back for centuries. An good example is “ghost sickness” which is referred to as a preoccupation with the death and the deceased. This form of sickness vary in meaning and interpretation when reported by a middle-class White person as compared to that of an American Indian (cited in “Classification & Treatment Plans”, n.
d. ). Apart from the role of cultural factors in the formulation, therapists must also take into account the significance of cultural factors in conceptualizing treatment. How he acts towards the client may have great effect on the rapport that is established in their relationship. For some cultures, using the individual’s first name to address the person may be considered rude and interpretation of the lack of eye contact on the client’s side may be erroneously interpreted as a form of disrespect by the clinician.. in other words, a therapist has to be sensitive to cultural differences in making the diagnosis and treatment plan.
In our study on mental health, i have learned that it is truly not easy on the part of the patient to accept the fact that he or she is suffering from any mental disorder. Emotionally and psychologically, the subject is constantly threatened by the horrible truth that her mental functioning and behavior are not the way they are supposed to be, just like any normal individual. Worst is being labeled inaccurately for a certain disorder, which they do not actually possess, because they failed to seek and receive accurate help.
In fact, in 1998, Canada’s Mental Health Plan recognized that people with severe or persistent mental illness (SPMI) are not always well served and this triggered the government’s renewal of its earlier commitment to make people with SPMI its priority for services (Berland, 2001). Mental health issues are truly not a joke and should be given serious attention from the initial stage of assessment until the the very last stage of treatment. Failure on the part of the therapist to properly carry out his or her role could shatter the hope of the patient’s full recovery.
The assessment stage, which is continuous and interactive in nature, plays a crucial role in the entire treatment process. The failure of the therapist to give an accurate diagnosis could mean losing a patient’s chance of living a normal life again. I have learned that as a therapist, one should be keener in detecting clues that are not directly provided or shared by the patients. Oftentimes, the key to a successful diagnosis is being able to grasp the meanings of the client’s nonverbal cues. An example of this is when a patient discreetly evades topics, which she considers traumatic.
If a therapist fails to note this down in the initial stage, she might miss the chance of knowing the root cause of the problem. What is even more dangerous is when the patient does this unconsciously as a result of constant repression. The dilemma could even be more complicated if the illness involved is either dual or multiple. In such cases, the therapist should be able to clearly identify the principal diagnosis, a condition established after study to be chiefly responsible for occasioning the admission of the individual.
This is very crucial because this is the main focus of attention or treatment. In cases of “dual diagnosis”, it is often difficult and somewhat arbitrary to determine which diagnosis is principal. For example, an individual hospitalized with both Schizophrenia and Amphetamine Intoxication might give the therapist a hard time to determine which diagnosis should be considered “principal”, because each condition may have contributed equally to the need for admission and treatment (DSM IV, 1999). Accurate diagnosis is therefore very necessary.
In our discussion on the five axes of diagnosis, i have learned the importance of having a clear understanding of each type of disorder. It is totally a “no-no’ to commit errors in developing the diagnostic hypothesis. It must be noted that several disorders have common symptoms and not having a clear understanding of the differences among these may mean worsening the client’s condition. The therapist must therefore capture the features of the individual’s functioning, prior to the development of the diagnostic hypothesis.
Each fact that the client presents is important and should b taken into account by the therapist when making diagnosis. He must not limit himself with the symptoms. In this way, we could assure that the final diagnosis accurate. Assuming that the therapist has accurately grasped all the necessary and significant information, verbal or nonverbal, that are essential in providing a good diagnosis and an accurate assessment of the disorder, the next important issue to be dealt with is deciding on the best counseling tools to employ as part of the treatment.
I t would also be best to formulate tools to be able to get the client’s 100 percent cooperation since the treatment would be most effective when both the therapist and client work together. Th provision of treatment should focus on outcomes. There should be continuity of care to avoid recurrence since this is always a possibility in clinical practice. A holistic or patient-centered approach is also important to ensure that proper care is provided – leading to fast recovery.
It would also be good to be able to include in the treatment all the significant people in the patient’s life in order to hasten the treatment process and make it more effective. This would include his family, friends, and other support groups. Commonly, the interventions are based on the therapist’s assessment of the patient, which includes the treatment of mental disorders, personality reconstruction, development of insight into a wide variety of historical and current life experiences, and resolution of unconscious conflicts.
Personally, I have realized that the primary goal of counseling should be to assist the individual psychologically in order for him or her to understand and develop coping strategies that he or she may be able to use in the future. For the therapist to achieve this and for him to understand the critical phase of the process, he has to learn to put himself into the shoes of his client. In doing this, the treatment plan will have long terms effects. It would not help the client address the most pressing needs at the moment through immediate management. It would help him change his behavior, thinking and emotions.
However, this should not be the focus as these do not involve major personality restructuring. The therapist should aim for the achievement of long terms goals which include more fundamental and deeply rooted alterations in the clients personality and relationships. Once this is achieved, the chance of recurrence the moment the treatment is stopped will be less. It must be noted that long-term goals are the ultimate aims of therapeutic change. Once the goals have been completely set, the treatment site would have to be chosen properly as well by the therapist.
Aside from being sensitive on the client’s financial capability, the therapist should also match the client’s needs with the services provided in the identified treatment setting. Based on the discussions, the treatment site should be able to provide the support needed by the client. Focus should also be on the assessment of strengths, adaptation of existing coping skills and development of new ones, instead of merely focusing on the diagnosis and treatment of the identified mental illness. Moreover, focus should be psycho-educational and not psycho-therapeutic.
It must be remembered that whatever technique the clinician would use, the quality of relationship between the client and therapist would still determine the success of the therapy. I have also realized that a good therapist or clinician must not only treat the client coldly and objectively. He has to show deep personal interest, concern and respect to establish a therapeutic relationship. Another important issue that has to be dealt with is confidentiality. In order for the client to fully recover, he has to fully trust his therapist.
This would only happen if the therapist is able to assure him that whatever it is that will be shared and discussed throughout the sessions will be treated with utmost confidentiality. Most of these people are afraid to be known by the public of having possessed certain disorders. Some even prefer to have their visits with the therapist done discreetly. These people are afraid to be labeled by the public as mentally-ill, thus it is the primary responsibility of the therapist to ensure that such is maintained and followed even until the treatment is completed.
In the previous discussions, i have learned that ethical responsibilities on the side of the therapist should always be remembered. The therapist should be able to maintain the client-therapist relationship all throughout. Romantic relationships could possibly be felt but it should always be disregarded as emotional attachments might only worsen the case. Mental health counseling is indeed very significant especially in today’s world. We are bombarded with different stressors and not being able to manage all of these could create an impact on our lives as individuals.
Moreover, it could affect our internal functioning which could consequently affect our relationships with the people around us. The role of mental health counseling in this sense is very crucial. The mere thought that a competent person is available to provide support in order to help one cope with the stressors in life is already something to be grateful of. This is not only for our own sake. It is a fact that chaos is everywhere in this world and how the people around us would behave is beyond our control.
Any member of our family’s mental health could be put at stake. This is a very crucial thing to deal with and should therefore be handled by someone trained to provide such help. Causes of these mental health issues may vary. They could be genetically or environmentally determined. Whatever the case may be, it doesn’t really matter much. The important thing is that there is hope for cure and recovery. As a possible therapist in the future, I have realized that there are indeed several challenges to be dealt with. In fact, too many to memorize.
However, I believe that the core value a good therapist should possess is empathy. Familiarizing oneself with all the mental health theories is useless if one is not able to get a good grasp of his clients problems. The therapist has to fully understand the underlying reasons of his client’s suffering before he could provide a good treatment.
References DSM IV. (1999). Diagnostic Criteria. United States: American Psychiatric Press, Inc. Mental Health: Community and Coping. (2006, July). Mental Health. Retrieved on February https://www.verywell.com/mental-health-4014688