Research Paper on "Populations Span From the Egregiously Poor-Functioning Substance"

Research Paper 9 pages (2801 words) Sources: 15

[EXCERPT] . . . .

Populations span from the egregiously poor-functioning substance abuser to a graduate student who is merely struggling with stress and financial related problems. The need outruns the resources, and, oftentimes counselors may feel themselves inadequately equipped to address the need or situation. The literature on counseling and psychotherapy is vast. This essay introduces some of the pertinent, occasionally overlooked issues, provides several strategies to deal with some of these issues, introduces Biblical values and insights pertinent to the topic, and concludes with some personal reflections on the whole.

Brief History and Development of the Counseling Field

Modern psychotherapy traces its history back to Freud who, in 1896, publicized his theory that talking would enable the client to discover his 'hidden urges' that were restraining him and negatively impacting his life. The psychoanalyst, then, could via psychoanalysis, or, what become later interpreted as the 'taking cure', help the client transcend these psychological restraints and achieve a more effective style of living. Freud's disciples, prominently Jung, Fromm, Adler, Horney and others developed his teachings in various ways, some of them markedly different from Freud's. The new field of counseling was known as psychodynamics and was the popular established way of counseling in the first half of the 20th century.

Skinner in the 1950s rejected this emphasis on hidden sources of human behavior, structuring his model of behaviorism on the affirmation that behavior was caused by action and environment and could, therefore, modified by these variables.

The cognitive strand created in the 1960's (most famously popularized by Elliot and Beck) affirmed cognition to shape behavior. Thinking in a certain way, they argued, derives one's judgments hence one's behavior. Consequently, thought modification or working on one's thoughts, would engender efficacious living.

The 'third way', also called humanistic or client-centered counseling, pioneered by Carl Rogers specified that the client, being in control of his own destiny, could engender his own solutions provided that the client was helped to do so in an environment that was non-judgmental, accepting, emphatic, and presented other skills, such as active listening, that would enable the client to reach his goals. In Roger's schema that was distinct to previous counseling orientations, it was not the counselor who directed, but the client.

Numerous other methods of counseling (or psychotherapy) have emerged since then. Prominent approaches include Gestalt, Brief therapy, Existential therapy, and Body-oriented therapy. There are also hybrids such as Cognitive, cognitive-behavioral and rational emotive behavioral.

Counseling has also branched off into specializations geared to help people in the various aspects of their life. Examples include marriage counseling, family counseling, vocational counseling, and school counseling, aside from the fact that counseling may occur in group formats in which case it is known as group therapy.

The most recent offshoot, coaching, is tentatively related to the field.

Introduction of Topic and its Importance in Counseling

This essay is an examination of the national satisfaction with general mental and specialty health services, specifically, but not particularly, related to different cultural and sociodemographic features. Counseling, as this essay shows, engages a plethora of instances, more than is typically imagined. Populations span from the egregiously poor-functioning substance abuser to a graduate student who is merely struggling with stress and financial related problems. The need outruns the resources, and, oftentimes counselors may feel themselves inadequately equipped to address the need or situation. The literature on counseling and psychotherapy is vast. This essay introduces some of the pertinent, occasionally overlooked issues, provides several strategies to deal with some of these issues, introduces Biblical values and insights pertinent to the topic, and concludes with some personal reflections on the whole.

Major Themes Relevant to Topic

Individuals of other cultures may be reluctant to employ counseling services. Kim et al. (2007) found this to be the case in terms of Asian-American who were born outside the States. Existent data found that Asian-Americans were less satisfied with their medical care than their European counterparts, and therefore reluctant to use them. This is particularly so since they have different patterns of help seeking and, therefore, different expectation from these agencies.

In general, Asian-Americans seem reluctant to seek services in response to their emotional distress. Even among Asian-Americans who have a probable mental disorder & #8230; only a small proportion (17%), according to the U.S. Department of Health and Human Services, appear to seek services. (Kim et al., 2007, 92)

It is, therefore, of the utmost importance to discover differences between Asian immigrants and U.S. born immigrants in order to plan psychological interventions that will be more able to attract them and address their needs. Using data derived from the National Latino and Asian-American Study (2002 -- 2003), Kim et al. (2007) found that findings of earlier studies were on, the whole, reinforced, although English language proficiency was not associated with service use. They advocated intense outreach efforts to stimulate encouragement in employing mental heath facilities, and also showed that second-generation Asian-Americans are (contrary to what was previously thought) interested in using the same facilities as their parents.

Even when clients do decide to employ counseling, studies have found that attrition proceeds on the same scale as it did 50 years earlier (Barrett et al., 2008). Perplexity remains as to how to persuade clients to retain their counseling course until completion has been achieved. The problem is reinforced by the fact that these services are particularly important for minorities and the economically disadvantaged; and it is these individuals who are more prone to premature disengagement.

Another theme relevant to the topic is that, despite the largeness of the field, the needs and scope of the population may be so vast and overwhelming that they exceed the scope of existent medical services. A cosmic situation was that of Hurricane Katrina where the need to provide counseling exceeded the resources. On a micro scale this can exist on a daily existential level too, where, for instance, most school-attending adolescents do not receive the services that they need (Cummings, 2009), or the problem of substance abuse may be so vast that the mental health services needed to deal with the problems are sometimes non-existent (Brach et al., 2005). To deal with the latter sitution, the Linkage Programs assembled a group of specialized and non-specialized personnel to assist them with the needs of an ethnically diverse, multi-problem, substance-abusing population (Brach et al., 2005). However, such resources, as in the case of Katrina, may not always be available, or, if so, may not always be as expedient and as effective as desired (Goodman & West-Olatuni, 2008).

Another population that may be lacking the services of counseling and need for attention due to the vastness of its scope is the field of foster-care. Little attention is given to the growing populations of severely abused and/or neglected children that are routinely placed in foster care, this, despite the fact that child maltreatment is a significant risk factor for mental disorders and physical illness later on in life. To that end, Kessler at al (2008) strongly recommend public sector investment in higher-quality foster care services.

There are other counseling-related issues that, although vital, may be overlooked. Such an example, provided by Rhodes et al. (2009) is the association between intimate partner violence (particularly male) and co morbid health conditions. Just as child abuse may signal health problems later on in life, a clear correlation exists between violence to male partner and "a cumulative risk of depressive and PTSD symptoms, suicidal ideation, and substance abuse" (53)

Finally, something else to consider is that studies have consistently found that African-Americans are more often diagnosed with specific mental disorders as compared to European-Americans. Whether or not racial bias and stress appraisal may play a part in this is something that is as yet unclear. Either way, this issue is something that the counseling field is well advised to be aware of (Schwartz & Feisthamel, 2009).

Discussion of the Important Elements of Counselor Identity, Function, and Ethics Related to Topic

Characteristics that have been repeatedly correlated to Asians (and to immigrants in general) seeking counseling include the following: cultural barriers (e.g., stigma, and loss of face), culturally unresponsive services (e.g., lack of language match, lack of ethnic match, and poor cross-cultural understanding), and lack of awareness or understanding of services. The counselor can address all of these factors by recognizing the existence of and working on these cultural barriers, augmenting the response of her service and carefully explaining the aspects of her service to immigrant client.

To deal with attrition, the counselor may need to investigate the characteristics of her client and slant aspects of her service to appeal to the client in order to encourage retention. Recommendations include modifying the appearance of the office, presenting brief, ultra-brief or single-session treatments, incorporating a discussion of MI or pre-therapy role induction into the initial session in order to educate client about the treatment, and efforts to show the client the importance of treatment to his or her needs (Barrett et al., 2008). Friendliness always helps… READ MORE

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