critical issues brief version

Advocacy versus Social Justice in Counseling

Advocacy removes barriers to growth and development; Social Justice promotes access, equality, equal distribution of power and resources.

Mental Health Parity and Addiction Equity Act (2008)

Requires behavioral health to be covered by insurance in the same way that medical health is covered.

Five Ways of Knowing

Tenacity - Perseverance or holding fast to whatever you believe to be true because you know it to be true 

Experience - What one has learned across time in similar or different experiences  

Authority - To believe something just because someone in authority says it  

Research - The use of scientific method

Intuition - gut feeling

Evidence-Based Practice

Empirical research + Counselor expertise + Client values/preferences.

Motivational Interviewing (MI)

Four Elements PACE = Partnership, Acceptance, Compassion, Evocation.

Four Skills OARS = Open ended questions, Affirming, Reflecting, Summarizing.

Four Processes EFEP = Engaging, Focusing, Evoking, Planning.

Resolve ambivalence, designed for addiction

Psychotropic Medications for Anxiety

Benzos

Xanax, Klonopin, Valium, Ativan, Buspar (Buspar non habit forming)
Mimic actions of neurotransmitters

SSRIs used more than tricyclics now - mostly due to tricyclics side effects

Multicultural Counseling Competencies

Awareness of: counselor biases, client worldview, culturally appropriate interventions.

Privilege

Three dimensions: Unearned advantages, often unaware, linked to social dominance.

Oppression

Two modalities

• by force

• by deprivation

Individuals from oppressed groups are often misdiagnosed due to standards that do not apply to them

Client Advocacy

Empowers clients; levels: personal, community/organization, sociopolitical.

Professional Advocacy

Advances counseling profession and professional identity.

Wellness Approach

Holistic, person-oriented, promotes optimal wellness.

Client Empowerment

Supports autonomy and use of client strengths.

awareness of personal and social issues that affect one’s life

Core Conditions (Rogers)

Empathy, Genuineness, Unconditional Positive Regard.

Continuum of Care

Prevention, Outpatient, In-Home, PHP/IOP, Inpatient, Residential, Aftercare, Crisis.

SSRIs

Blocks reuptake of serotonin neurotransmitters (e.g., Zoloft, Paxil).

2nd gen, less side effects

Benzodiazepines

Mimic neurotransmitters; used for anxiety (e.g., Xanax, Ativan).

Stimulants

Increase dopamine/norepinephrine (e.g., Adderall, Ritalin).

Antipsychotics

Block neurotransmitter receptors (e.g., Haldol, Risperdal).

1st gen blocked dopamine, significant side effects (tardive dyskinesia, weight gain, tremors)

2nd gen blocks mostly serotonin, less side effects

HIPAA

Protects privacy of identifiable health information.

HITECH

Promoted Electronic Health Records (EHRs).

HIPPA for electronic records

Public Insurance

Medicaid, Medicare, TRICARE.

Scientist-Practitioner Model

Counselors utilizing research in their practice, counselors should know how to consume research and apply it to their treatments.

Ethical Principles

Autonomy, Nonmaleficence, Beneficence, Fidelity, Justice.

Legal vs Ethical

Legal = minimum standards; Ethical = best practices.

EFCT Emotionally focused couples therapy

3 stages: De-escalation, Changing Interaction, Consolidation.

Recognition that emotions serve to organize behaviors

Looks at attachment and expressing emotions

DBT Dialectical Behavior Therapy

Increase ability to be mindful of their experiences and make choices that reflect walking the middle path

Middle Path; Emotional Mind, Reasonable Mind, Wise Mind.

ACT Acceptance and Commitment Therapy

Challenges are inevitable and we can adapt to them

Acceptance: accept what is out of your control

Commitment = encouraging clients to commit to actions that will help them achieve goals

Six Processes:

Acceptance, Cognitive Defusion, Present, Self-as-Context, Values, Committed Action.

IPT Interpersonal Psychotherapy

Focuses on Grief, Disputes, Role Transitions, Deficits.

Foster change in relational patterns within one area of interpersonal difficulty

Bernard's Discrimination Model

it is a Developmental theory of supervision

Supervisor roles: Teacher, Counselor, Consultant.

Three main areas to cover in supervision

1. Performance - what counselor does during sessions

2. Cognitive - what client thinks about client

3. Personalization- how client feels about work, themselves, clients

Group Supervision Models

Wilbur and Associates

Borders and Associates

Three primary functions of group supervision

1. administrative

2. educational

3. supportive

Power

a privilege, but also inherent in the counseling relationship - awareness of privilege has been linked to increased multicultural counseling competence  

tricyclic antidepressant

1st gen, heavy weight gain and sedation