Clinical mental health counseling

Clinical mental health counseling is a distinct profession with national standards for education, training, and clinical practice. Clinical mental health counselors operate from a wellness perspective, which emphasizes moving toward optimal human functioning in mind, body, and spirit, and away from distress, dysfunction, and mental illness. Counselors also view wellness and pathology as developmental in nature, and take into consideration all levels of a client's environment when conducting assessment and treatment. Counselors also frequently take a team approach, collaborating with other mental health professionals to provide the most comprehensive care possible for the client. Clinical mental health counseling is a distinct profession with national standards for education, training, and clinical practice. Clinical mental health counselors operate from a wellness perspective, which emphasizes moving toward optimal human functioning in mind, body, and spirit, and away from distress, dysfunction, and mental illness. Counselors also view wellness and pathology as developmental in nature, and take into consideration all levels of a client's environment when conducting assessment and treatment. Counselors also frequently take a team approach, collaborating with other mental health professionals to provide the most comprehensive care possible for the client. Early Greek philosophy provides some of the earliest views of mental health and illness. Hippocrates, who is considered the father of medicine, related behavioral tendencies and a person's temperament to the relative balance of their body fluids. He believed that imbalances of these fluids led to aberrant behaviors. Other Greek philosophers such as Plato theorized that aberrant behaviors stemmed from societal issues that required a community response. Promoting happiness and wellness was also a major theme for the early Greeks and Romans. The founder of hedonism, Epicurus, advocated for the hedonistic lifestyle, but he also warned that there was a risk of pain if the pleasures were withdrawn. Epictetus, on the other hand, believed that people were not disturbed by things, but by the view they took of those things, so he advocated for peace of mind to treat these disturbances. There were both cruel and humane treatments developed in the Middle Ages for the mentally ill. Most behaviors that could not be explained were attributed to supernatural causes and that humans innately had a battle between good and evil happening inside of them all the time. People were tested to see if they were evil or with the devil using “water tests”. In Baghdad and Damascus, however, in the ninth and tenth centuries, humane treatments were being developed in which centers of care for the mentally ill were based in love and kindness. Humanity regressed again in the 16th century when hospitals known as asylums were developed to provide a place for people who were unable to care for themselves. These institutions were terrible and people were often kept in restraints and left there in their own waste. In the late 1700s, there were people who began to reform the system and developed something known as moral treatment at the time. Moral treatment included organized schedules of productive behavior, socializing, entertainment, education, exercise, and nutrition. In the early 1900s, counseling had not yet developed into treatment of mental health issues and was more focused in education. Frank Parsons, known as the father of guidance, developed a plan to educate counselors and began the Vocational Guidance Movement. He was concerned with the problems of youth as youth unemployment became a major concern for adolescents as urbanization occurred and sustainable work and family income generated on family farms was not as prevalent. At this time, counselors were considered vocational counselors and this initiated the approach that began to form the more contemporary counseling process. Around the same time, Clifford Beers, a former patient of mental health hospitals, wrote a book exposing the terrible conditions of mental health institutions and he advocated for reform. Beers later founded the National Committee for Mental Hygiene, which later became the National Mental Health Association. Jessie B. Davis was the first individual to make guidance a regular part of the school curriculum. He was a superintendent or administrator and advocated for what became school guidance and counseling. During the great depression, counseling methods and strategies for employment grew as it was greatly needed at the time. In 1932, Brewer wrote a book entitled “Education as Guidance”, which promoted the broadening of counseling beyond just occupation. He suggested that every teacher share the implementation of counseling and that guidance needed to be in every school curriculum. In the 1940s, Carl Rogers began the development of counseling and psychotherapy. He believed that the client knows best and that only they could explain what their needs are and what direction to go in counseling based on what problems were crucial and needed attention. Rogers clearly indicated that he was not doing psychology and the courses he taught were based in the department of education. World War II brought to the forefront the importance of testing and placement as there was a strong need for selection and training of specialists for the military and industry. Counselors and Psychologists had the necessary skills to fill this much needed role. At the same time, thousands of soldiers were in need as a result of their combat experiences. The veterans administration provided professional counseling services to soldiers after their discharge and in 1945, the VA granted stipends and internships for students in counseling and psychology, boosting the support and training available to counselors. This time marked the beginning of government spending on counselor preparation as we know it today. Clinical psychologists were trained to treat and diagnose individuals with chronic disorders, and counseling psychologists were trained to deal with issues presented by people with high levels of mental health. This led to a new division or category of psychologists and the Division of Counseling and Guidance of the American Psychological Association changed the title to the Division of Counseling Psychology. In the 1950s, flaws in the existing mental health system were being exposed and clinically effective pharmacological treatments were also being developed that could be provided in outpatient settings. This led to a need for community based clinics, but access to these services were very limited. The Community Mental Health Act of 1963 was very important in the development of the counseling profession. After the government analyzed the problems with mental illness and effective treatments, President John F. Kennedy believed that high quality treatment centers located in the patients community could lead to the phasing out of state mental hospitals and drastically improve the mental health system in the United States. The national network of community mental health centers created a demand for counselors and the profession began to expand and increase numbers of counselors. As the counseling helping profession grew, there became a need to regulate the quality of services being provided by professionals via state licensure. In 1974, a special committee was appointed by the American Personnel and Guidance Association that focused on counselor licensure. This began the steps towards the first counselor licensure law in Virginia in 1976. In the 1980s mental health counseling had clearly established itself as a profession with a distinct set of regulations and methods to providing services. According to Gerig & Gerig (2014), distinct professional are characterized by “role statements, codes of ethics, accreditation guidelines, competency standards, licensure, certification, and other standards of excellence”. The counseling profession as we know it today has established all of these facets of a distinct profession and is being recognized more and more as a valuable and much needed helping profession in our society. Counselor licensure is established by state law and is the most powerful type of credential. Receiving a license in counseling indicates that one has met the minimum standards to practice counseling in that state. State laws vary in the requirements that must be met to obtain a license. Candidates must have at least received a master's degree, have had post-master's supervised practice, and have passed a national exam. From state to state, the number of credit hours to be completed varies, as do the number of supervised hours that must be completed and the counselor titles used. Some counselors may find that if they are licensed in one state, and then move to another state, they may have to take additional courses in order to receive licensure in that state. Below, the standards for licensure in North Carolina are described. In order to explore licensure requirement for other states, please refer to the National Board of Certified Counselor’s state licensure board directory and locate the information for the licensure board in your particular state.