The mental health professional that I interviewed was Gary Parker he has been practicing for over 25 years. Gary came to Iowa from Indiana and stated that he was grand daddy into his licensure because of his early practice. Gary’s daily routine consists of seeing 8-10 clients per day within 3 different offices. He stated his hours are some nights till 8:00 p.m. while he felt other counselors that he knows they end their day at 5:00 p.m. and he felt that does not serve the clients. He has an office in three locations; Council Bluffs, Iowa, Glenwood, Iowa and Red Oak, Iowa; he has been in these communities for over 20 years. There are several days when his schedule varies from seeing clients in the office to going into client homes and completing assessments for Iowa Medicaid. ACA ethics A.1.a. ; That the primary focus of the counselor is to promote welfare and dignity of the client. Gary gave examples of his daily responsibilities and how he encourages the clients well being and change. Gary had a saying that “you need to show you care” on a plaque by his desk. Within his practice there are many procedures from his being on call, crisis management, confidentiality and how he maintains records.
His procedure for being on call he stated that he has his emergency number on his card and is available for his clients when needed. He stated that his answering system first tell the client that if it is an emergency to go to the nearest emergency room and they will assess the client and inform him of the clients circumstances. The same examples were given for crisis planning and the client. Gary stated that his records are kept locked and his file cabinet is labeled according to state code. Gary stated he has to keep record of the client’s progress, and he stated he prepares a treatment plan that is individualized for each client according to state code; this is also according to ACA A.1.b. and A. 1. C. I questioned Gary about his records he stated they contain notes and treatment plans and within the records he also has the consent to treat and the confidentiality (HIPPA) forms. These forms he stated are required by the state to have in each file signed by the client that he has gone over the forms with the client. Gary stated that within the consent form there is information about his counseling office and the counseling process, including expectation for the client as stated in the ACA guidelines A.2.a.. He stated the confidentiality took several forms from the written communications to the verbal and the inter office communication. Gary stated that his personnel are trained on confidentiality, and he is very careful with his faxes and his emails; that they are confidentially sealed before they are faxed. The state agencies he stated does however let him fax treatment plans and assessments to them, he stated he has seen this change throughout the years. With Gary professional experience and the acknowledgment of his professional identity has given me a guide line to see how a practice is operated and how to establish my personal identity as a mental health counse
According to Hendricks, that ethics plays a major role in our professional identity; as a counselor we gain the ability to work together and to give the best care to our clients. My professional identity as a Mental Health Counselor has taken place over the last 20 years I have been able to become aware of my personal values and goals. My values are altruistic and I believe in doing unto others as you would have them do unto you. My basics come back to my beliefs that we are all created by God and this gives me a love for all humanity. The differences I wish to make come from being able to be a support system for a family and helping with their child or adolescent who has behavioral concerns. My goals are to be able to help these families to be the best that they can be with guiding their children and maintaining their family balance.
My projected daily routine as a mental health professional should begin with spending time for me in exercise and a time to reflect on the day before reviewing my schedule and preparing my mind. Then as my morning progresses it will begin with office procedure and the supervision of what needs to be addressed in the office at the beginning of the morning. Then as appointments begin there are a few minutes to review the case and then to meet with the clients if they are new presenting the client the informed consent to treat as well as confidentiality and HIPPA forms to sign and place in the file. As a mental health professional I want to be warm and genuine with my clients to form an alliance of trust between this counselor and the client. Gary stated that he wanted to have a trusting relationship with his clients and I also believe that this is essential for me in my practice.
How many clients and how my schedule will vary every day depends on emergencies and appointments. This will need to be adjusted as the days begin probably 6-8 clients a day and my schedule will vary I’m sure with some evening appointments; from 5-7 Monday through Friday. Appointments will be maintained with a crisis appointment time setup in the schedule on a daily basis during lunch or even at the end of the day.
My administrative daily tasks will consist of keeping records updated, signing each page written within the file as required by Medicaid and other third party billing. There will be an assessment to complete and treatment plans to write, phone calls to team players if needed for clients. The practice of maintaining a crisis is that a point should be made to the client that they are important and they can get into the office the next day to be able to address the problem that is putting them into this crisis.
The ACA code of Ethics and daily routine will mesh together in many ways from my primary responsibilities to the confidentiality and the records that I keep. This responsibility is to promote dignity and the welfare of the client according to ACA 1.b.. Within this responsibility I find that the records need to contain the notes from the sessions and the progress accurately (ACA A.1.b.), and within them are the counseling plans or treatment plans these are all formulated by correlating the client’s needs.
My procedures that I will follow for being on call include the availability that I will maintain with my clients. The phone will be setup with a message that tells the client if there is an emergency they are to go to the nearest emergency room and they will contact this mental health counselor and be provided immediate care.
My practice for handling a crisis will be put into the treatment plan. I believe that a crisis plan is much like a weather warning within the area you live. It needs to be a written out process and practiced with the family so they know what to do in case of a crisis. The families that I have assisted in preparing this plan; which includes a separation plan, a calm down policy, and a family communication policy, that is practiced with the individuals and families.
My Procedures for confidentiality are strong with the files and the file cabinet that maintains the files are marked confidential and a locked file cabinet procedure. Training is given with the office personnel that they are to maintain confidentiality to ensure a clients trust. Then within the first session confidentiality is addressed within the consent to treat form and the HIPPA form that is signed and maintained. The process was done and is placed in records for each client. I also have in the confidentiality about harm to self or others and the steps that will be taken to protect the client and others.
My sessions will include an eclectic approach with an emphasis on solution focused therapy. Focusing on the solution moves the client toward the future and how they will see themselves. Capuzzi and Gross stated; that the main statement for solution focus therapy is the question; “how will you know when the problem is solved”. Oriented and Possibility Therapy is not only the solution focus to the problem; but they both added the internal experiences to their focus. There are several aspects of interest due the communities’ lack of psychiatric services, the Master in Mental Health counseling course work leading to licensure and private practice. The wellness model is my choice because it merges theological issues with psychological issues and presents a holistic model. This model integrates all of the ology’s including education and behavioral. I do believe that we should view a client as a whole person this would include mind-body-spirit. This would mean that we are able to integrate between theory and the use of the other ology’s if needed and finding out where the client is with their spirituality could be one of the ology’s. There are many things that we can learn from theology that supports what we do as Counselors. As a counselor we will be held accountable if we break the code of ethics. There are several different models like the deontology which is from Immanuel Kant; this is where you find the Golden Rule, Moral codes. I uphold the ACA Code of Ethics and I have been a member for almost a year. They have worked hard to bring Mental Health Counselor into the 21st century and to the social change of today.ACA goals and mission are the same as mine; they offer continuing education credits for mental health counselors and discounts for many services. They have been a great influence in being policy makers for Mental Health Counselors and other affiliations.
The challenges of private practice for a Mental Health Professional still continue today. Some of the challenges that I may face as developing an identity as a counselor are being part of a health care team, or gaining my own identity. These challenges seem to be based on the current market and the shifts to see Mental Health Counselors as practitioners overall. There have been challenges with the licensure and credentialing in the past; but those seem to be lessening because of the third party payees, educational benefits and associations working on the forefront for counseling recognition. The challenges and how I will manage them is to become diversified with being able to do groups, individual and provide in home services for the clients I will serve. Hendricks writes that counseling is not something that we simply do. Counseling is who we are. It is an identity an integral part of our personalities and counseling is something we live. Ethics is what we need to guide our practice and to be our best for our clients. According to Erikson and Kress the mental health counselor may be particularly be aware of the financial and occupational benefits of using the DSM because of third party reimbursement for services. Gary stated that becoming a licensed mental health counselor will make it possible to diagnosis and the ability to bill third party. This is my goal for my individual and family services I wish to facilitate.
Ethics are the regulation of counseling practice and the ACA and other organizations have helped with regulations and policy making for mental health counselors. Dr. Patricia Arredondo stated that all counseling is multi cultural; I agree we are all part of some multi cultural something, so looking at the whole individual their culture, and their history; as a counselor this will give competency and free us from prejudice.
How this day is different from other days of a Mental Health Professionals. Gary’s day was very similar to other mental health counselor’s days. He spoke highly of ACA and the Ethics that we follow. He seemed to be genuine and concerned for his clients. Erickson and Kress stated that an Ethical practice requires mental health counselors to become aware of their values, attributes, beliefs, and behaviors, and how these may influence their work so as to avoid imposing their values on clients from(ACA, 2005, Standard A.4.b.; AMHCA, 2000,1.D.2.). I am aware of my values, attributes, beliefs, and behaviors and that is why I know that they will not be imposed on my clients but these attributes make me a professional that will take many avenues when working with individuals, families, and being able to teach parenting skills.
Social change is stated from Lawson and Foster to include home based services; these home based services are defined as counseling and case management services provided for families that have a child at risk for removal from the home. The families I want to work with are those that have behavioral and parental concerns to be able to maintain these within the family.
Lawson and Foster stated that by providing counseling services in the home, the family would feel a greater investment with the counselor. This is an area of social change were as a mental health counselor I want to include into my practice. Erickson and Kress stated that counselors might intervene early with prevention programs that teach cognitive and coping skills in order to decrease the risks. As society changes according to Brooks and Gerstein the needs for individuals within the society will continue to change. As mental health counselors we will need to continue to change as well and the organizations ACA and AMHCA will help us to keep up with all the changes.