Many believe that counselors should be advocates for their clients. However, if this is done, it must be done so in a way that does not impart a counselor's own beliefs, political views, and religious practices onto one or more clients. This can be a challenge as there are many hot-button social issues that have political ramifications in today's America, and many individuals have very strong, yet polarizing beliefs. A counselor who publicly shows support on either side of a political issue at the behest of advocating for a client runs the risk of alienating other clients whose views differ. Though this is the case, counselors must not sit on the sidelines while legislation is proposed and passed that will have an impact on their clients. This was the topic of my first publication, an essay on counselor advocacy.
The following was published in the May 2013 issue of Counseling Today as the grand prize winner of the American Counseling Association's Foundation’s Graduate Student Essay Competition supported by Gerald and Marianne Corey and Allen and Mary Bradford Ivey.
"Why must professional counselors accept an advocacy role in representing the interests of clients and becoming actively engaged in creating and supporting public policy initiatives that advance the role of counseling in addressing those interests?"
In the wake of the highly
publicized shootings in Connecticut and Colorado, it feels as though we have
entered into an era where acts of violence are commonplace. Following such
incidents, it is normal for people to search for answers and feel a sense of urgency
to act. In response, there have been actions taken by the government in order
to prevent future incidents; both firearms and mental health have been the
focus of recent legislation. However, focusing policies on a specific group of
people runs the risk of turning them into scapegoats. Sensationalized news stories can create
wildfires that paint the mentally ill as dangerous, ticking time bombs that
must be closely monitored. Since the perpetrators of many recent shootings have
been postulated to have suffered from mental health issues, this
characterization of mental illness may seem realistic to the layperson. This in
turn can lead to policies and laws being passed at the behest of the uninformed
public that alienate those who are mentally ill and those seeking mental health
services. In this respect, counselors must play an active role in advocating
for this population, ensuring that legislation regarding mental health or
illness does not infringe upon their right to privacy.
Perhaps
the biggest concern with recent policies is the ability of mental health
providers to assure client confidentiality. The turnkey of the Tarasoff case
ruling on duty to warn and protect was that of specific targets being
threatened. A bill recently passed in
New York expanded on this mandatory reporting, requiring mental health
professionals to report potentially dangerous clients. Additionally, following
recent shootings, it was determined that HIPAA allows medical doctors who
believe a patient is potentially dangerous are protected and encouraged in
disclosing client information, including mental health records, to law
enforcement officials. The goal in such legislation is to prevent violence from
occurring by screening potential perpetrators. However, what exactly
constitutes a potential threat is not clear, and the result of releasing a
person’s medical and mental health history are not mentioned. In effect,
medical professionals inexperienced in the area of mental health will be asked
to make a discretionary decision to release sensitive information to
individuals also untrained in the intricacies of mental illness. Furthermore,
the potential backlash of not reporting an individual who goes on to commit a
crime may encourage over-reporting and result in a prejudice against those with
a history of mental illness. While this is being done as a means of prevention,
it may discourage anyone with troubling thoughts to seek help. As counselors,
we encourage clients to share thoughts and feelings that individuals may not
feel safe sharing with anyone else. While
understanding that there are limits to confidentiality, it is not clear where
professionals draw the line in regard to the potential for future harm. As
professionals, we must advocate for the privacy and protection of our clients
and assure that legislation passed will not jeopardize the ability for people
with mental illness to receive services in confidence.
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