Clinical Mental Health Counseling

J. Scott Young, Ph.D., NCC, LPC is Professor and Chair of the Department of Counseling and Educational Development at the University of North Carolina at Greensboro. His leadership in the field has included service as past-president of the Association for Spiritual Ethical and Religious Values in Counseling, as a member of the Governing Council and Executive Committee for the American Counseling Association. He has served as an editorial board member for numerous journals including the Journal of Counseling and Development, Counseling and Values and Counselor Education and Supervision. He is co-editor of the book Integrating Spirituality into Counseling: A Guide to Competent Practice and the text Counseling Research: Quantitative, Qualitative, and Single Subject Design. He has published numerous articles on the interface of clinical practice with spirituality and religion. Awards Dr. Young as received awards including ACA Fellow, the Meritorious Service Award from the Association for Spiritual, Ethical, & Religious Values, the Alumni Excellence Awarded from the Department of Counseling and Educational Development and UNCG and the Administrator of the Year from the North Carolina Counseling Association. Craig S. Cashwell, Ph.D., LPC, NCC, ACS, CSAT-S is Professor in the Department of Counseling and Educational Development at the University of North Carolina at Greensboro (UNCG). He has served as President of Chi Sigma Iota International, ASERVIC President, CACREP Board Chair, and ACES representative to the ACA Governing Council. Craig has received numerous awards, including the CSI International Thomas J. Sweeney Professional Leadership Award, the American Counseling Association David K. Brooks Distinguished Mentor Award, and the Association for Spiritual, Ethical, and Religious Values in Counseling (ASERVIC) Lifetime Service Award. In 2011, Craig received designation as an ACA Fellow. He has over 125 publications and has received multiple research awards, including an ACA Best Practices Award, and twice being the recipient of the Association for Counselor Education and Supervision Outstanding Counselor Education and Supervision Article Award. Craig values mentoring relationships and has been recognized with mentoring awards from the UNCG Graduate School, the North Carolina Counseling Association, and the Conference of Southern Graduate Schools. Additionally, he has been recognized with a UNCG School of Education Teaching Excellence Award.

Preface About the Editors and Contributors SECTION I FRAMEWORK OF CLINICAL MENTAL HEALTH COUNSELING 1 History and Evolution of Clinical Mental Health Counseling - Kerrie K. Fuenfhausen, Scott Young, Craig Cashwell, and Muthoni Musangali Foundational Principles of Counseling Wellness Model of Mental Health Developmental Perspective Prevention and Early Intervention Empowerment Multicultural Worldview History of CMH Counseling Historical Influences Professional Practice in CMH Counseling Professional Identity Qualifications Models of Change Roles and Functions of CMH Counselors CMH Counselor Functions CMH Counselor Roles Populations Served Case Study References 2 Legal and Ethical Issues 31 - Jamie Crockett What Is Professional Conduct? Consult, Consult, Consult! Moral Principles Professional Standards for Ethical Practice Legal Considerations Legal and Ethical Challenges Ethical Decision Making Multicultural and Social Justice Considerations Case Studies Select Resources for Ethical and Legal CMH Counseling Practice References 3 Advocacy and Social Justice - Catherine Y. Chang, Simone Lambert, and Emily Goodman-Scott The Case of Yolanda Ecological View Case Study Discussion Understanding Advocacy and Social Justice Case Study Multicultural Competence and Culturally Responsive CMH Counseling Case Study Discussion Social Injustice and Mental Health Privilege and Oppression Privilege Oppression Racism and Sexism Racism Case Study Discussion Sexism Case Study Discussion Advocacy and Social Justice Counseling Client Advocacy Case Study Discussion Professional Advocacy Case Study Discussion Global Perspectives on Counseling Conclusion References 4 Continuum of Care - Amy Banner Continuum of Care: One Size Does Not Fit All Modalities of the CMH Counseling Continuum of Care Individual Counseling Group Counseling Couple and Family Counseling History of the CMH Counseling Continuum of Care Ethical and Developmental Aspects of the CMH Counseling Continuum of Care Services, Settings, and Roles Across the CMH Counseling Continuum of Care Prevention and Education Services Outpatient Services In-Home Services Partial Hospitalization Programs (PHPs) and Intensive Outpatient (IOP) Services Inpatient Services Residential Services Aftercare Crisis and Emergency Services Professional Issues Affecting the CMH Counseling Continuum of Care Case Study References SECTION II PROCESSES AND PROCEDURES OF CLINICAL MENTAL HEALTH COUNSELING 5 Assessing Client Concerns - Casey Barrio-Minton Assessment Foundations Purposes and Methods of Assessment Clinical, Intake, and Diagnostic Interviewing Types of Interviews Initial or Intake Interview Unstandardized Questionnaires and Checklists Mental Status Examinations Mini-Mental State Exam Using Standardized Tests and Inventories to Inform Counseling Broad-Symptom Inventories Specific-Symptom Inventories Structured Personality Inventories Projective Techniques Qualitative Assessment Collateral Sources Screening for High-Risk Situations General Medical Conditions Suicide Risk Violence Risk Intimate Partner Violence and Abuse Substance Concerns Cultural Bias in Assessment Using Assessment to Inform Counseling Case Study References Appendix: Current Concerns Questionnaire and Checklist (Adult) 6 Diagnosis - Gary Gintner Psychopathology and Etiology Mental Health and Mental Illness Dimensions of Psychopathology Etiological Factors and the Biopsychosocial Model Diagnostic Issues With the DSM DSM: A Look Backward DSM-5 Diagnostic Process: Four Guiding Principles Principle 1: Check the Adequacy of Your Information Principle 2: Use Diagnostic Hierarchies for Differential Diagnosis Principle 3: Resolve Diagnostic Uncertainty by Examining the Usual Suspects Principle 4: Your Diagnosis Is a Hypothesis That May Need Correcting Case Study References 7 Treatment Planning - Daniel M. Paredes and Maria A. Brunelli Paredes Determining Client Needs and Appropriate Services Case of Tara From Conceptualization to Treatment Planning Personal Style Counselor Theoretical Framework Expectations of the Counselor's Work Setting Developing and Implementing Treatment Plans Treatment Goals Case of Joseph and Sophia Treatment Objectives Treatment Interventions Additional Treatment Plan Components Referral, Keeping a Resource List, and Application Keeping a Resource List Application Case of Emily Termination Versus Maintenance Treatment Planning and Special Populations Treatment Planning With Children and Adolescents Treatment Planning With Mandated Clients Case Study References 8 Psychiatry and Psychopharmacology - Todd Lewis and John Culbreth Brain Physiology, Neurotransmitters, and Medication: A Basic Overview Mechanisms of Action Why Use Medication in the Treatment of Mental Disorders? Controversy in Using Medication in the Treatment of Mental Disorders The Mental Health Counselor's Dilemma Classes of Psychotropic Medications, Their Effects, and Side Effects Antidepressant Medications Antianxiety Medications Antipsychotic Medications Bipolar Medications Working Effectively With Psychiatrists Making Medication Referrals Medication Compliance Assessing and Managing Side Effects Working Effectively With Clients and Medication Talking to Clients About Medication Medication Advocacy Legal and Ethical Issues With Psychopharmacology Case Study References 9 Managed Care, Billing, and Documentation - Laura Welfare, Paige Greason, and Keith Mobley Managed Care Managed Care Laws and Legislation Health Insurance Portability and Accountability Act (HIPAA) HIPAA Privacy Rule HIPAA Security Rule HIPAA Enforcement Mental Health Parity and Addiction Equity Act Affordable Care Act Managed Care: Becoming an Approved Provider Insurance: Private and Public Payers Private Insurance Government-Sponsored Insurance Self-Pay and Other Means Maintaining Records Importance of Paperwork Administrative and Clinical Documentation Practices Clinical Documentation Practices Intake Assessment Forms Screening and Outcome Measures Clinical Case Notes Conclusion Case Study 1: Navigating Insurance Coverage Case Study 2: Writing Eff ective Case Notes References Appendix: Personal History and Intake Form 10 Crisis Management and Disaster Relief - Amber L. Pope and Allison Marsh Pow Differentiating Crisis Management and Disaster Relief Crisis Management What Is a Crisis? Crisis Counseling Range of Individual Crises Principles of Crisis Management Crisis Management Planning Emergency and Disaster Relief Impact of Crises and Disasters Factors Influencing Mental Health After an Emergency or Disaster Groups at Risk Emergency and Disaster Response Immediate Interventions Intermediate and Long-Term Interventions Disaster Mental Health Training Impact of Crisis Counseling and Disaster Relief Work on CMH Counselors Case Study 1: Crisis Management Case Study 2: Disaster Mental Health References SECTION III MAXIMIZING YOUR EFFECTIVENESS AS A CLINICAL MENTAL HEALTH COUNSELOR 11 The Importance of Clinical Supervision to Effective Practice - DiAnne Borders Models of Clinical Supervision Developmental Models Discrimination Model Peer Models Group Supervision Models Triadic Supervision Maximizing Your Supervision Experience Practice Self-Assessment and Create Learning Goals Prepare for Supervision Take Risks Practice Self-Reflection Consider Power and Authority; Evaluation and Feedback Practice Peer Feedback in Triadic and Group Supervision Bring Difficult Topics to Supervision Poor Supervision Conclusion Case Study References 12 Wellness, Self-Care, and Burnout Prevention - Gerard Lawson and Jennifer M. Cook CMH Counseling Risks and Challenges High-Touch Hazards Burnout What Burnout Looks Like Burnout Prevention Vicarious Traumatization Symptoms and Signs of Vicarious Trauma Addressing Vicarious Trauma Compassion Fatigue Compassion Fatigue Described Contributing Factors to Compassion Fatigue Identifying Compassion Fatigue Counselor Wellness Mindfulness Mindfulness Defined Balance Career-Sustaining Behaviors Healthy Habits Case Study References 13 Using Research to Improve Clinical Practice - Kelly L. Wester and Tamarine Foreman Research Defined and Described Ways of Knowing Evidence-Based Practice Scientist-Practitioner Model Case Study Step 1: Assess the Client Step 2: Create a Well-Formulated Question Step 3: Conduct a Search for Evidence Step 4: Select and Access Articles to Read Step 5: Evaluate and Appraise the Quality of Research Step 6: Synthesize Information Step 7: Clinical Application Step 8: Evaluation Conclusion References SECTION IV CURRENT AND FUTURE TRENDS IN CLINICAL MENTAL HEALTH PRACTICE 14 The Applications of Neuroscience to Clinical Mental Health Counseling - Jane E. Myers and Laura Jones Neuroscience in Counseling Neural Anatomy Neuroscience and the Therapeutic Relationship Therapeutic Process and Neuroplasticity Neurofeedback: One Application of Neuroscience in Practice What Is Neurofeedback and How Does It Work? Case Study Conclusion References 15 Emerging Approaches to Clinical Mental Health Counseling - Amanda L. Giordano, Philip B. Clarke, Cheryl L. Fulton, and Tammy H. Cashwell Motivational Interviewing The Basics of MI Support for MI MI in Practice Case Study Emotionally Focused Couple Therapy The Basics of EFT Stage 1: Deescalation of Negative Cycles of Interaction Stage 2: Changing Interactional Positions Stage 3: Consolidation and Integration Support for EFT EFT in Practice Case Study Dialectical Behavior Therapy The Basics of DBT Support for DBT DBT in Practice Case Study Interpersonal Psychotherapy The Basics of IPT Support for IPT IPT in Practice Case Study Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) The Basics of TF-CBT Support for TF-CBT TF-CBT in Practice Case Study Mindfulness The Basics of Mindfulness Support for Mindfulness Mindfulness in Practice Case Study Acceptance and Commitment Therapy The Basics of ACT Support for ACT ACT in Practice Case Study Spirituality in Counseling The Basics of Spirituality in Counseling Support for Spirituality in Counseling Spirituality in Counseling in Practice Case Study Conclusion References Index

"Having gathered a plethora of established experts in the field of mental health counseling, the editors packed this book with content that will meet or exceed the curricular needs of any graduate counseling course; 'comprehensive' is an understatement!" -- W. Bryce Hagedorn "An instant classic. Young and Cashwell have assembled a stellar group of counselor education authors and produced an outstanding, comprehensive, and easy-to-read text that clearly articulates and elevates the discipline of clinical mental health counseling. This book covers everything a CMHC needs to hit the ground running in clinical practice!" -- Bradley T. Erford "A 'must-have' resource for anyone looking for a comprehensive and reader-friendly clinical mental health counseling text! The introductory chapter provides a solid context for the ensuing chapters that focus on specific topics (such as legal/ethical issues, diagnosis, supervision), all authored by leading experts. It's all here-everything that learners need to know as they embark on their professional journeys to becoming CMHCs." -- Barbara Herlihy "Clinical Mental Health Counseling: Elements of Effective Practice is a great text for introducing students to the roles and functions of clinical mental health counseling. The authors have organized the material in a clear and engaging level which makes it appropriate for students. I particularly appreciate the documentation and evidence-based sections." -- Alfonzo Haralson "The authors have succeeded in building a very comprehensive book, focused on the CACREP standards, that is up to date and gives new and also practical information regarding the profession. There are some chapters that are very unique for an introductory textbook (e.g., chapters devoted to billing, documentation, psychopharmacology, neuroscience, a full chapter on research). There is also some cutting-edge information included on evidence based practices. Usually, there isn't an entire chapter devoted to advocacy. Thus, instructors have to supplement the information in textbooks with the ACA Advocacy Competencies and various articles and examples. The chapter on advocacy is a treasure because it is comprehensive and really introduces the students to the counselor advocacy role up front!" -- Heather Trepal "The authors were able to invite contributors that are known experts in their field. They write from a strong theoretical base and are practitioners in their areas of expertise." -- Judith G. Miranti "This book provides the most comprehensive knowledge, skills, and applications about mental health practice in community settings." -- Kananur V. Chandras "By offering a text that can provide a thorough foundation for counselor trainees, Young & Cashwell have offered Counselor Educators a much-needed tool for bridging a significant gap in counselor training." -- Kathleen Woods "Clinical Mental Health Counseling: Elements of Effective Practice is current, thorough, and student friendly." -- Lakitta Johnson "Clinical Mental Health Counseling: Elements of Effective Practice is a comprehensive overview of a complex topic." -- Robert C. Schwartz