History of Counseling Leading to Multidisciplinary Teams
Counseling is a relatively new profession which has transformed over time from treating mental illnesses to providing educational guidance to counseling with a variety of specializations. Pistole summarizes by stating that counselors, now, aim to, “contribute to the vitality and vigor and to the soundness in body, mind, spirit, and social connection that sustains well-being, and so is considered, by our society, to be health” (2001). However, this was not always the case. National events such as the industrial revolution, World War I & II, the Community Mental Health Centers Act of 1963, the formation of the American Mental Health Counselors Association (AMHCA) in 1978 and in field professionals have shaped the field of counseling (Smith, 1995 & Pistole, 2001). Frank Parsons, Jessie Davies, and Clifford Beers were early pioneers of the counseling profession and were part of establishing the counseling profession (Pistole, 2001).The counseling profession has undergone many changes within the previous three decades that have strengthened counseling’s focus on individual needs over the lifespan which encompass wellness, resilience and prevention as key philosophies.
Myers (1991) states that implementation of a wellness model of counseling incorporating prevention and developmental paradigms “requires an examination of self, family, group, society, and other systems, as well as the environment, as enablers or detractors of the pursuit of wellness” (2012). With focus on a wellness orientated approach that is achieved through prevention and development within individuals; Behavioral Counseling for young children is my preferred specialization specifically utilizing the approach of Applied Behavior Analysis. The National Center for Children in Poverty (NCCP) outlines the importance for early intervention with young children because a large number of children under the age of six have social-emotional and environmental difficulties that lead to disruptive behavior within schools. When these difficulties are not addressed within youth chances of adult mental health problems is heightened (NCCP, 2012). Impacting the lives of children must be approached from a team perspective to address all aspects of the child’s environment and relationships including caregivers, peers, teachers and school. Behavioral Counselors must collaborate with school counselors to understand the impact that school and teachers have on the child’s life. To appreciate School Counseling a review of the specialization’s history is important. School Counselors have evolved from vocational guidance and job-orientated counseling following World War I to educational guidance following World War II due to the passing of the GI bill as veterans were given right to education counseling (Minkoff, 1985). Today School Counselors support a wide variety of needs from a wide variety of student populations including but not limited to depression, college guidance, anxiety, oppositional disorder and developmentally delayed due to change in access to mental health care being more privatized (Lockhart & Keys, 1998). Lockhart states that because of the restructuring in access to care school counselors have been pushed to handle a wider variety of needs within mental health (1998).
A Behavioral Counselor can benefit a child struggling in school who has experienced an environmental change within their home such as a family member remarrying and combining new households by performing a functional behavioral assessment. To assume that a child is struggling due to the change in their environment without performing a functional behavioral assessment would have disadvantages if this was not the underlying reason for his or her behavior in the classroom. The behavioral counselor would coordinate to observe the child within their class to determine the function of the behaviors. Reasons for the child’s behavior may be escape due to a skill deficit and not be associated to the home environment. While a variety of functions are possible, the home environment likely plays a role and should be addressed. It is important to understand the underlying function of the child’s behavior prior to establishing a treatment plan to ensure the team is address to correct underlying problem/s.
The Behavioral Counselor would need to coordinate and collaborate with the School Counselor to ensure a unified and supportive team working together to assist the child. The School Counselor would be informed on school policy and resources available to the child while at school. Furthermore, the School Counselor would be able to coordinate the team’s treatment plan with the school district and teachers to ensure proper follow through producing change. Specific goals could be targeted using positive reinforcement opposed to focusing on the maladaptive behaviors elicited by the child. Perhaps the Behavioral Counselor and School Counselor could devise a token economy system aimed to increase the child’s appropriate behaviors to be implemented by the teacher. To ensure successful collaboration between the School Counselor and the Behavioral Counselor there would be benefit to the entire team to complete a POEM which stands for philosophy, ontology, epistemology and methods prior to collaborating (McAllister, Morrissey, McAuliffe, Davidson, McConnell, & Reddy, 2011). This would increase the team’s awareness, understanding and appreciation for the perspectives working together as those of the School Counselor and Behavioral Counselor likely vary. The completion of the POEM would proactively decrease dysfunctional collaboration by providing validation of perspectives and respect among for all professionals involved (McAllister et al., 2011). In summary, addressing the needs of individuals within the mental health field requires strong multidisciplinary team building skills. In order to create a unified, supportive and effective team it is important to understand the rich history of the counseling profession as a whole. By understanding the evolution of counseling as a whole one can understand the unique perspectives of specializations within the counseling field. This understanding leads to a level of respect that is imperative to cultivating an effective multidisciplinary team that when working together can create a greater impact and holistic approach to client care.
Lockhart, Estes J. & Keys, Susan G. (1998). The mental health counseling role of school counselors. Professional School Counseling, 1(4), Retrieved from PsychInfo. ‘ McAllister, Margaret, Morrissey, Shirley, McAuliffe, Donna, Davidson, Grahm, McConnell, Harry, & Reddy, Prasuna (2011). Teaching ideas for generating critical and constructive insights into well-functioning multidisciplinary mental health teams. Journal of Mental Health Training, Education and Practice, 6(2), 117-127. Minkoff, Hilda B., Terres, Cynthia K. (1985). ASCA perspective: Past, present, future. Journal of Counseling and Development, 63, 424-427. Myers, J .E. (1991). Wellness as the paradigm for counseling and development: The possible future. Counselor Education and Supervision, 30(3), 183-193.
National Center of Children in Poverty. ( 2012). Basic facts about low-income children: Children under age 6. Retrieved fromhttp://nccp.org/publications/pub_896.html Pistole, Carole M. (2001). Mental health counseling: Identity and distinctiveness. ERIC Digest. Retrieved from http://www.counseling.org/resources/library/ERIC%20Digests/2001-09.pdf. Smith, Howard B., & Robinson, Gail P. (1995). Mental health counseling: Past, present, and future. Journal of Counseling & Development, 74, 158-162.