week 3

Ch07_ECED6240.pptx

Clinical Mental Health Counseling in Community and Agency Settings

Fifth Edition

Chapter 7

Consultation, Advocacy, and Evaluation

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Learning Objectives

7.1 Understand characteristics of effective mental health consultation and the different roles consultants play

7.2 Describe the importance of advocacy on multiple levels

7.3 Recognize the need for client outcome evaluation and ways to evaluate client outcomes

7.4 Understand the need for systematic program evaluation and the importance of process evaluation and program evaluation

Mental Health Consultation

Mental Health Consultation: “A problem-solving, interpersonal relationship that develops through periodic face-to-face contacts between consultant and consultee” (Erchul, 2003, p. 105)

Gerald Caplan: Father of modern practice of mental health counseling (Erchul, 2009)

Consultant: Professional helper providing consultation

Consultee: Professional working directly with the client who request help from the consultant

Third party: Client or client system served directly by the consultee

Caplan’s Four types of Mental Health Consultation (1 of 2)

Client-Centered Case Consultation

Most commonly used form

Consultee presents a case about a particular client who is experiencing a problem for which the consultee needs treatment recommendations

Primary goal: to develop a plan to help a specific client

Consultee-Centered Case Consultation

Primary goal: to improve the consultee’s ability to work effectively with a particular case as well as with similar cases

Caplan’s Four types of Mental Health Consultation (2 of 2)

Program-Centered Administrative Consultation

Primary goal: to help an individual or group of consultees develop a new program or improve an existing one

Consultee-Centered Administrative Consultation

Primary goal: to help solve problems in organizational policy, enhance professional competency of staff, and increase overall functioning

Key Characteristics of Successful Consultants

Positive caring approach (nonjudgmental and sensitive)

Strong communication skills (listen, engage, and work collaboratively)

Responsible work ethic (follow through with commitments, flexible, time efficient, and not authoritarian)

Thorough diagnostic skills (objectively and carefully assess relevant variables and conduct well-planned evaluations)

Wealth of content knowledge (strong understanding of human development theory, specialized knowledge, and training in consultative methods)

System smarts (understand nature of systems)

Advocacy (1 of 2)

Advocacy Counseling

Expands the traditional role of individual counseling to a broader focus that addresses injustice, oppression, and environmental conditions that need to improve for the benefit of an individual or group (Kiselica & Robinson, 2001; Ratts et al., 2010)

Terms associated with advocacy:

Outreach

Empowerment

Social justice

Social action

Advocacy (2 of 2)

Actions taken by counseling professionals to help remove environmental barriers that hamper clients’ well-being (Toporek, 2000)

Serves two purposes: (a) to increase clients’ sense of personal power, and (b) to foster environmental changes tat reflect greater responsiveness to clients’ personal needs (Lewis et al., 2003)

Focuses on addressing systems of oppression that negatively affect clients (Lee, 2007)

Terms Associated with Advocacy (1 of 2)

Outreach

Initiating behaviors toward people in need for the purpose of making a helpful difference

Reaching out to vulnerable populations in their communities and helping them find new ways to cope with stressors.

Empowerment

Process through which clients gain the resources and skills needed to have more control over their environments and their lives (McWhirter, 1997)

Terms Associated with Advocacy (2 of 2)

Social Justice

“Involves promoting access and equity to ensure full participation in the life of a society” (Lee, 2013, p. 16)

Social Action

Behaviors designed to promote social justice

Empowerment

McWhirter’s (1994) 5 C’s Model of Empowerment for Counseling:

Collaboration (working together with clients to define the problem and plan for change)

Context (acknowledging role of factors such as poverty and racism)

Critical Consciousness (raising clients’ awareness of social, economic, and other power dynamics)

Competence (focusing on clients’ strengths, resources, and skills)

Community (Connecting with the community to facilitate empowerment)

Ways Counselors Can Serve as Advocates

Client empowerment (helps client develop self-advocacy skills)

Client advocacy (helps client gain access to needed services)

Community collaboration (works with community organization to bring about healthy change)

Systems advocacy (intervenes at the systemic level to facilitate change)

Public information (disseminates information to the public about disempowerment or disenfranchisement)

Social/political advocacy (takes action for populations they serve)

What Effective Advocates Do (1 of 2)

Provide vigorous representation for their clients

Use multiple methods to understand their clients’ needs, issues, and problems

Target specific policies or practices for change

Map the decision systems responsible for targeted policies and practices

Recast larger problems into solvable pieces

Propose concrete solutions to problems

What Effective Advocates Do (2 of 2)

Utilize several strategies and skills simultaneously and sequentially

Actively counter negative stereotypes and misbeliefs

Use the least confrontational tactics necessary to accomplish their objectives

Exhibit cultural awareness and respect as they relate to colleagues, clients, and decision makers

Place a high priority on influencing budgets

Closely monitor the implementation of changed policies and practices (Ezell, 2001, p. 193)

Advocacy for the Profession

Professional Advocacy

Contributing to the development of a strong professional identity

Lobbying for professional recognition

Demonstrating professional pride and accountability

Clinical mental health counselors should stay abreast of public policy and take steps to influence the passage of laws when conditions adversely affect either their clients or the counseling profession

A C A Office of Public Policy

Outcome Research Terminology (1 of 2)

Client outcome research

Designed to evaluate the effectiveness of specific interventions

Facilitates practitioners as they make decisions about how to work best with clients

Evidence-based treatment (E B T)

Identified based on the outcomes of randomized controlled trials

Conducted to determine whether the interventions outperform control or alternative interventions

Outcome Research Terminology (2 of 2)

Evidence-based practice (E B P)

“Broader term and refers to clinical practice that is informed by evidence about interventions, clinical expertise, and client needs, values, and preferences and their integration in decision making about individual care (Kazdin, 2008, p. 147)

Moderators

Characteristics that influence the intervention outcome (Karzdin, 2008)

Treatment integrity

The extent to which interventions are delivered in a comprehensive manner by a trained interventionist (Hager Moser et al., 2009)

Client Outcome Measures

Most measures address the following interrelated areas (Dharma lingam, Berg, & Hall, 2012):

Symptoms (manifestations of clients’ concerns)

Well-being (emotional stability, motivation, energy level, general life satisfaction)

Functioning (how clients are coping in their environment)

Examples of formal measures used by clinicians:

Clint Evaluation of Counseling Inventory (C E C)

Outcome Questionnaire-45.2 (O Q-45.2)

Clinical Outcomes in Routine Evaluation C O R E-O M

Beck Depression Inventory II (B D I II)

Program Evaluation

Steps in Evaluation:

Conducting a needs assessment

Identifying program goals and objectives using data gathered in needs assessment

Designing and implementing a program

Revising and improving the program

Assessing the program’s effectiveness in relation to the stated goals and objectives

Process Evaluation

Also called formative evaluation

Provides information about how well a program is being implemented (Daniels et al., 2017)

Evaluators determine whether the programs are operating in accordance with stated plans, objectives, and expectations

Involves ongoing monitoring of what serves are being provided, by whom, for whom, to how many, when, and at what cost (Lewis et al., 2001)

Program Outcome Evaluation

Provides information about whether, and to what degree, the goals and objectives of the program have been achieved (Daniels et al., 2017)

Also called summative or product evaluation

Allows counselors and agencies to demonstrate accountability for their services

Focus is on the components of the program being evaluated, not on the clients

Challenges of Program Evaluation

Logistics of data collection

Gathering and interpretation of evaluation data

Professional resistance to evaluation due to concerns about how the results would be used

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