An Exploration of Clinical Mental Health Counselors’ Attitudes Toward Professional Identity and Interprofessionalism

Opportunities for clinical mental health counselors to practice in interprofessional settings are likely to increase as the larger health care system in the United States evolves. While aspects of interprofessionalism are embedded in the codes of ethics of the counseling profession, discussion of identity has primarily been focused on intraprofessional identity. To concurrently assess intraprofessional identity, interprofessionalism, and interprofessional identity, a study was conducted with clinical mental health counselors (CMHCs) using the Professional Identity Scale in Counseling–Short Form (PISC-S) and the University of West of England Interprofessional Questionnaire (UWE IPQ). Results indicated that CMHCs place importance on both intra- and interprofessional identity, although they have more confidence in their intraprofessional identity. A high degree of correlation was found between the PISC-S and UWE IPQ, indicating the interrelatedness of these aspects of identity. Results can be used to inform interprofessional education and identity development models for the CMHC profession.

Ethical Standards for a Post-COVID-19 World

The cataclysmic events of 2020 created an urgent need for mental health counseling to help individuals, families, and communities deal with grief, loss, and trauma. The sheer magnitude of the challenges has highlighted the necessity for collective interventions, as the need for help far surpasses what can be met through traditional individual or family counseling. Clinical mental health counselors must be prepared to respond to the new challenges in creative, culturally responsive, and ethical ways. The authors discuss the limitations of the prevailing codes of ethics, which are grounded in principle ethics, and propose that virtue ethics and relational ethics perspectives can be incorporated into ethical reasoning to make the process more responsive to collective interventions. A case scenario is presented and analyzed to illustrate this broader and more inclusive approach to ethical decision-making in a situation that calls for a collective intervention.

A Case of the Tail Wagging the Dog: The Medicare Mental Health Coverage Gap and Its Impact on Providers and Beneficiaries

Nearly one in four Medicare beneficiaries have been diagnosed with mental health or substance use disorders, and research indicates this population responds well to mental health treatment. However, Medicare policy omits licensed mental health counselors (LMHCs) and licensed marriage and family therapists (LMFTs) as approved providers, exacerbating an existing national provider shortage. Emerging research demonstrates that the provider omission, referred to as the Medicare mental health coverage gap (MMHCG), profoundly impacts excluded providers and the communities they serve. This paper represents a synthesis of the most current scholarship on Medicare research, policy, and advocacy. In particular, we explore three ways the MMHCG impacts providers and beneficiaries alike: limiting provider choices, thwarting continuity of care, and creating challenging decisions for beneficiaries and providers. Our aim is to help mental health counselors better understand and navigate the MMHCG and aid in advocacy efforts for legislation to include LMHCs and LMFTs as approved Medicare providers.

The Need to Consider Requiring Trauma Training in Entry-Level Academic Training Programs in Clinical Mental Health Counseling

The COVID-19 pandemic and heightened awareness of racial injustice and discrimination in the United States are likely to have a negative impact on mental health. This is concerning, given the already alarming prevalence rates of trauma exposure and adverse childhood experiences in the U.S. general population prior to the current pandemic, their immediate and long-lasting effects on human development across the life span, and their documented effects on adult chronic health conditions. For clinical mental health counselors (CMHCs) to respond effectively to the needs of the U.S. general population, entry-level counseling programs must provide comprehensive trauma training and education. The purpose of this article is to provide information about clinical competencies and relevant training requirements for CMHCs in trauma prevention and treatment to highlight the need to require comprehensive trauma training in entry-level academic training programs for CMHCs through relevant research and policy.

Public Policy Issues Affecting Integrated Health Care: Challenges, Opportunities, and Implications for Clinical Mental Health Counselors

The growing need for the treatment of the whole person creates an opportunity for establishing a holistic integrated health care (IHC) system in various clinical settings. Considering the issues with existing IHC models and related public policies, and the current barriers facing clinical mental health counselors (CMHCs) who hope to become an integral part of IHC teams, we propose a new holistic IHC model. We highlight several practical implications of our proposed model that could be beneficial for the development of professional identity of CMHCs and their inclusion in IHC teams. We also offer numerous propositions for improving IHC-related policies in favor of CMHCs and the counseling profession.

Avoiding Boundary Violations: Recommendations for Managing Attraction to and From Clients in Response to the Healthcare Providers Service Organization’s 2019 Report

The standards regarding sexual relationships with clients are among the most clearly stated in the codes of ethics for the American Counseling Association and the American Mental Health Counselors Association. However, the majority of liability claims filed against counselors are for boundary violations of a sexual/romantic nature. Aggregate insurance liability data are presented, followed by management strategies related to attraction.

Fatmisia and Clinical Counseling Decision-Making in Master’s-Level Counselor Trainees

The Centers for Disease Control and Prevention and the World Health Organization have documented an increase in fat people in recent decades, which is being met with a backlash of anti-fat biases, or fatmisia. Fatmisia is prevalent in most aspects of society, especially among fat people who have internalized fatmisia. Utilizing a diagnostic questionnaire in combination with the Fat Phobia Scale–Short Form and the Weight Bias Internalization Scale, this study explored the relationship between client body size, the presence of a major depressive disorder (MDD) diagnosis, and if applicable, the severity of MDD symptoms assigned by counselor trainees (N = 113). Results were analyzed using one-way analysis of variance and covariance. This sample (N = 113) significantly differed in diagnoses assigned to obese clients by assigning more severe MDD. Study limitations and implications are discussed.

Supporting Black, Indigenous, and People of Color Counselors: Considerations for Counselor Skills Training and Practice

Black, Indigenous, and people of color (BIPOC) counselors require training, practice, and consultation strategies to address client-initiated microaggressions and racism in counseling. Utilizing critical race theory in counselor education, the authors offer a counseling skills model, based on Sue et al.’s microintervention concept, to support BIPOC counselor training and supervision. The authors describe strategies all counselors may use to address microaggressions and racism in counseling sessions with relevant ethical considerations. Implications for mental health counselors, counselor educators, and clinical supervisors are provided.

The Mental Health of U.S. Parents During the COVID-19 Pandemic

Evidence suggests parents experience unique pandemic-related stressors related to isolation, food insecurity, school closures, and unemployment. This study examined 1,048 U.S. parents’ depression, anxiety, stress, and alcohol and substance use behaviors during March and April 2020 to better understand the impact of pandemic-related conditions on parents’ mental health. Mean scores indicated severe levels of depression and stress and extremely severe anxiety. Nearly two thirds (74.7%) indicated alcohol use in the past month, with 26.5% scoring in the range for problem alcohol use. Almost half of the sample reported using at least one substance in the previous 2 weeks. Men had significantly higher alcohol consumption and substance use than women. Depression, anxiety, and stress were higher for parents who consumed alcohol or substances and had a history of depression or anxiety. The long-term impact of COVID-19 is unknown, and mental health care is likely to be in high demand moving forward.