Consultation and Advocacy
A collaboration of works was examined to answer the following questions. How do you see yourself related to advocacy or consultation as you become a professional within your area of specialization? Within your own definition, do you see consultation and advocacy similar or different? How does advocacy benefit the care provided for children, adolescents, adults, couples, and families related to the specific specialty area that you plan to practice? Within the context of the examined works institutional and social barriers were also addressed.
In an effort to further relate advocacy to the area of focus a hypothetical situation was created that tied in advocacy, consultation and collaboration. It is important to understand the role we have as advocates of social change and how that affects the individuals we serve. Counselors are encouraged to consider the role that their profession plays within the dominant culture to reconcile the role of healer with that of social change agent and to advocate for systematic change on behalf of clients (Moe, Perera-Diltz, & Sepulveda, 2010).
Consultation and Advocacy Essay Example
Advocacy for both clients and for the profession is essential for the future of counseling (Myers, Sweeny, & White, 2002). A national plan for advocacy is needed; the effectiveness of this plan depends on professional identity, promoting a positive self image, and effective interprofessional collaboration (Myers et al. , 2002). The need for professional advocacy can be traced in the history of mental health counseling, dating back to the 1700’s when the advocacy for persons’ with mental illness emerged as a moral issue (Myers et al.
, 2002). Mental illness expands across the board and includes various levels of intensity and includes dual diagnosed individuals. Prout and Strohmer (1998) note that persons with mental retardation often have been served in the mental retardation, developmental disability, and rehabilitation service delivery systems. However, when their problems extend into the mental health area, there appear to be some difficulties accessing the full range of services (p.
115). It has been a common occurrence that when a dual diagnosed patient is brought to the hospital in crisis they are often diverted or sent home without being properly assessed by the on call psychiatrist due to the simple fact that the psychiatrist is unable to distinguish if the presenting issues are related to the patients’ cognitive disability or their mental health disorder. This is where advocacy comes into play for our dually diagnosed clients.
When mental health agencies are made aware of clients that are in crisis and can benefits from a respite from their residential setting, the mental health agency can advocate and collaborate with the treating hospital to provide crisis intervention. Myers et al. (2002) indicates that within any given setting the needs of clients can best be met through collaboration efforts of all professionals. Merriam-Webster defines advocacy as supporting a cause or proposal.
Advocacy and consultation plays two diverse roles in the counseling field and serves two distinct purposes for clients and can be utilized simultaneously to achieve one desired goal. In other words, advocacy and consultation should be used together to optimize the successful outcome for any vulnerable client. According to Moe, Perera-Diltz, and Sepulveda (2010) scholars have identified that consultation and advocacy share conceptual grounding in modes of practice that encourage counselors to act outside of the counselor/client interaction.
Practice such as collaboration with multiple groups may promote marginalization of vulnerable community members are used by advocates to achieve desired goals (Moe et al. , 2010). According to Knight and Oliver (2007) recent policy has emphasized the need for advocacy services for children and young people, developments that have gone hand-in hand with greater levels of participation of young people in decision making. Advocacy for young people is especially important, as they are a particular vulnerable group and have, traditionally, been even more excluded from decision making about matters affecting their lives.
In today’s culture we readily accept the role of nurturer and protector of all vulnerable individuals and we may not understand how that might in fact be harming the individuals even at a young age. Society traditionally sees disabled children as being passive, vulnerable and in need of protection and that makes advocating for disabled children particularly challenging (Knight and Oliver, 2007). Many disabled children and young people are not used to
being asked for their views and may not think that what they have to say is important (p. 423) Advocates must be cognizant that most children and adolescents have guardians and/or parents and have been taught at a young age that their opinion does not matter. Further more most if not all children and adolescents have been raised in a society where their parents and guardians have the ultimate say and the clients as minor have no rights. Looking at the lives of individuals down the line as they reach adult hood a common theme emerges.
Stanley and Vahe (2012) established that advocacy in the mental health system promotes that advocacy strives to return decision-making authority to consumers and thus to empower them to play a more central role in their own care, treatment, rehabilitation, and life choices. Although not intended as treatment, advocacy may have therapeutic effects. It may reduce the barriers to fulfillment of consumers’ own goals for recovery and enable solutions to problems of everyday life. Advocacy also may reduce stigma that impairs consumers’ ability to improve their own life circumstances (p. 115).
Moe, Perera-Diltz, and Sepulveda (2010) suggest that a practice mandated by the Individuals with Disabilities Education Act was established to facilitate the equitable and effective services to individuals with disabilities by way of behavioral consultation and the use of functional behavioral analysis and assessments to promote empowerment of clients. Consider the case of a developmentally disabled adult whose behaviors have become increasingly problematic in his residential and day program setting. Michael is a 68 year old Caucasian male born with Down syndrome who resides in a group home setting and attends a day time activities program.
Michael’s state appointed support coordinator reached out to the mental health agency, which is treating Michael for Bi Polar disorder. The state support coordinator requested the mental health agency complete a Functional Behavioral Assessment (FBA) since Michael’s behaviors have increasingly worsened and medication changes have been unsuccessful. Michael’s support coordinator advises that Michael has been increasingly obsessive, aggressive towards group home staff, and been arrested twice for his aggressive nature and threats in the community.
In this case, the mental health counselor along with Michael’s assigned case worker collaborated to complete a case review which will be utilized for the mental health agency to review the case and provide feed back and possible new interventions aside from medications. Following the case review, the mental health counselor will conduct interviews with the client’s guardian, group home provider, and day program provider to obtain a clear idea of the target behaviors, antecedents, and desired replacement behaviors in order to complete the FBA.
Once all interviews are completed and the FBA is finalized it will be reviewed with Michael’s team consisting of state support coordinator, guardian, group home staff and day program staff. Interventions will be addressed and the team will be advised and trained on how to implement the interventions recommended in the FBA. In this scenario, it is evident that the mental health counselor requires a strong sense of professional identity to be an effective advocate for the client. The client is in need of strong supports that are capable of collaborating and consulting on his behalf in order for his treatment to be successful.
The main goal for Michael’s team is to ensure his safety and keep him out of jail. Walsh and Bricout (1997) point out that family members and professionals can advocate for change in treatment of people with mental illness in jail. For some younger adults, jails have served as sites for containing deviant behaviors that in many cases are more reflective of mental illness than of criminality. Jails are not well-suited to the care of people with mental illness because they were not designed to serve that function.
Problems associated with serious mental illness in jails include increased suicide risk, the need for extra staff attention, the disruption of normal jail activities, the potential for violence, and abuse by other inmates. Without proper care such people may experience a resurgence of symptoms and become less able to function in the community after release (P. 420-421). As Advocates it is fundamentally important to note as Walsh and Bricout (1997) suggested that mental health professionals must ensure that families and people with mental illness receive appropriate services during and after incarceration.