Careers in Counseling

Transcript

Hey guys. Welcome to this video over the different jobs within a counseling career.

Often times people have a very narrow view of counseling. When people think of counseling they often times think of this person you go lay on a couch and talk to while they take notes, then magically fix all your problems… or do nothing. However, there is so much more to counseling than listening and taking notes, there are also several different settings for counseling to take place.

There is a lot of versatility within a counseling career. Today we will talk about 14 different fields within counseling:

   Professional counselors

   Psychiatrist

   Clinical psychologists

   Social workers

   Psychiatric nurses

   Education settings

   Medical rehabilitation setting

   Hospice and grief counseling setting

   Elder care settings

   Community mental health positions

   Criminal justice system

   Business and industry

   Coaching positions

   Private practice

Professional Counselors
Professional counselors help their clients adjust and function in their everyday surroundings. Environments consist of work, school, home, and neighborhood communities. Professional counselors help individual clients gain better awareness of personal growth and self development. The progression of this awareness is directed in care that helps the client cope with crises and issues in everyday life situations. The client is directed to develop appropriate coping methods. The client may also be referred for other health care services when the client has more complex needs or stresses that are not handled within the professional counselor’s scope. The counselor educates the client in coping strategies for particular situations.

Professional Counselors provide similar services to those of the psychologist or social worker. However, the PC does provide a distinctive professional service in its own right. The professional nature of a PC is defined by six criteria:

Self-awareness helps a counselor to provide foundational therapeutic benefits. The counselor comes with his or her own experiences that provide a good backdrop for relating to others. The counselor allows the client to explore his or her own thought patterns, wishes, wants, and goals in a session. The counselor may discuss his or her own comparative experiences in the session while giving the client feedback about an incident. This approach can be seen in the work of Carl Rogers, who believed in promoting an atmosphere of therapy that provided a sense of self-respect and honor for others. Roger’s approach is contrary to the long-established, more analytical therapeutic method found in the works of Freud. Self-awareness is one attribute that put PCs in a distinctive class not commonly found in other counseling vocations.

Client Crises
The life of a client is bound to be impacted by a crisis at one time or another. Most people experience a number of crises in the course of their lifetimes. A crisis can originate from the death of a loved one, a divorce, debilitating illness or injury, or other personal problems. However, the professional counselor (PC) is more concerned with how the client copes with the situation resulting in the crisis, rather than in the prevention of the crisis. The client who exhibits an inability to function in a crisis situation is considered temporarily dysfunctional, but this dysfunction is not considered sickness. The PC believes that the person can grow from the experience and may only need some temporary counseling to get over the hurdles of life. This growth is part of the person’s normal self-development process.

Psychiatrist
Psychiatrists are medical doctors with four years of residency in psychiatry. Psychiatrists assess and prescribe treatment for more complex mental disorders, and provide expert consults for other mental health service providers. Psychiatrists are qualified to conduct psychotherapy and psychoanalysis, to order laboratory tests, to hospitalize patients, and prescribe all legal drugs. Psychologists conduct psychotherapy, cannot order lab tests, and most cannot prescribe drugs. Psychotherapy provides the client and family with a series of discussions involving treatment methods proven to be effective in resolving behavioral problems. Psychoanalysis includes psychotherapy and medications for an extended time. Prescription drugs help correct chemical imbalances at the root of emotional problems. In cases where medication is ineffective, the psychiatrist provides an alternative treatment, like electroconvulsive therapy.

Clinical psychologists
Clinical psychologists work in these settings to assist a wide range of people: Physical rehabilitation departments; family or marriage counseling centers; independent practices; group practices; and hospitals. Clinical psychologists may be needed after a surgical procedure or other life-altering event, such as divorce, separation, death of a loved one, stroke, brain injury, paralysis, spinal cord injury, or debilitating illnesses. Clinical psychologists can specialize as: Health psychologists; geropsychologists; or neuropsychologists. Health psychologists help people gain and retain good health practices. Neuropsychologists help people understand brain injury from stroke or trauma. Geropsychologists work with the elderly to ameliorate the effects of age-related diseases. Only the state of New Mexico has laws that give clinical psychologists permission to prescribe medications.

Social workers
Demand for social workers increased when their roles expanded to providing care in the community. They are classified as Clinical or Licensed Clinical Social Workers. Educational requirements are stringent. Most social workers obtain a Master’s degree in social work, with a specialization in psychiatry, as the minimum requirement for employment. Most social workers provide assistance to children and families in schools, homes, or within the community. Some social workers assist with support groups geared to teenage mothers, the elderly, at-risk students, and unemployed or untrained workers. Social workers can hold the titles of child welfare social worker, family service social worker, child protective social worker, occupational social worker, or gerontology social worker.

The Clinical or Licensed Clinical Social Worker can expect that a Master’s degree in social work with a specialization in psychiatry will be needed for employment. However, not all social work requires a master’s degree. Some positions have bachelor degree requirements. Social workers with a bachelor degree can expect to gain employment in agencies, institutions, hospitals, or certain positions within the community. The worker fulfills the duties required by the agency as well as assuming the role of a counselor. This additional responsibility can be linked to the expanding role of social workers within the community. There are even some social workers who have gone into private practice recently. For the most part, social workers provide support for clients by coordinating services that are available. The social worker also monitors the effectiveness of services that have been provided to the client.

Psychiatric nurses
Psychiatric nurses are the only mental health professionals besides psychiatrists who have experience in the medical field, along with mental health instruction and training. The psychiatric nurse works closely with individuals suffering from severe emotional problems. The psychiatrist holds the psychiatric nurse responsible for providing quality medical care and for the administration of prescribed medications. The psychiatrist may delegate some therapeutic counseling and intervention program responsibilities to the psychiatric nurse. A psychiatric nurse can provide a patient with outpatient care that is easily accessible. Insurance accepts claims for these services because of the licensure and training requirements associated with this position. Usually, psychiatric nurses do not open independent private practices within a community.

Education settings
Elementary and secondary school positions In the past, certified school counselors filled Guidance positions in both the elementary and secondary school systems. Over the past two decades, special programs were initiated to counter non-educational problems that students experience, such as drug and alcohol addictions and teenage pregnancy, which lead students to drop out. Individual counseling is usually conducted on a weekly basis to help students cope with problems they are having at home, school, or in their communities. Some students benefit from group therapy counseling sessions that present skills in socialization, behavior management, and problem-solving in the context of their family situations.

Counselors may consult with educators, principals, administrators, guidance counselors, and other school staff to help a child deal with life roles. Some students require specialized interventions to alleviate a crisis situation. Crisis services may help a student who has become a behavior problem at school, or who is on the verge of committing suicide, or who is inflicting self-injury. Crisis situations cause the student’s educational performance to deteriorate. Therefore, the school counselor has a responsibility to evaluate students’ academic successes and failures. The counselor seeks to identify the career interests and aptitudes of at-risk students. The counselor assists in college selection and in the general social development of the student. In New Jersey, Licensed Professional Counselors (LPC’s) are engaged for teen pregnancy preventions, employment, GED testing, individual and group counseling, support groups, and classroom education.

College setting positions Counselors may seek employment with college students in individual or group counseling, on a consultation basis or as a liaison between the faculty and students. Students self-refer to the counselor. However, if a student is in significant need of ongoing care, the counselor refers the student to an outside agency for mental health care services. Cost-cutting has reduced college staffing, yet the need still exists to provide qualified counselors to cope with emergency situations and make the needed referrals. Career center counselors may prepare resumes, interest and
aptitude assessments, job placement services, and career counseling services. Some counselors specialize in proactive drug and alcohol prevention programs.

Medical rehabilitation setting
Counselors may seek employment in a rehabilitation program. Rehabilitation counselors work to help a person gain skills to compensate for a disability. The effects of the disability may impair the person’s personal, occupational, or social life, and psychological well-being. The counselor must examine the strengths and weaknesses of the client to determine the course of treatment to be followed. The counselor works to collect personal information and data regarding training programs that will fit the individual’s needs. Long range planning goals are established. The title of these counselors is Certified Rehabilitation Counselor (CRC). Most CRC’s have a graduate degree in rehabilitation counseling. Rehabilitation work is a growth area for counselors because of the increasing age of the population.

Hospice and grief counseling setting
Hospice centers opened in the 1970s. The professional counselor seeking a hospice care position can expect to deal with families experiencing a crisis situation of catastrophic illness and the impending death of a loved one. The PC helps the family through the end-of-life experience and grieving. Ideally, the family comes to terms with the situation prior to the death, and the patient gains insights and coping skills regarding death and dying. The PC helps the patient deal with living wills, financial concerns, family of origin issues, and other associated problems that may need to be handled. The goal of the PC is to help the patient and his or her family to experience caring in the dying process and to retain their dignity.

Elder care settings
The skills that a professional counselor needs in positions which serve the elderly are numerous. The PC receives training in: Cognitive and emotional assessments specifically geared to the aged; grief and bereavement counseling procedures; how to establish a good rapport with the elderly; looking at the patient holistically and noting any medical problems or medications that impact a patient’s daily functioning; and laws that apply to treatment. The counselor listens to the concerns of family members involved in the patient’s care. The counselor is aware of the services and facilities that would benefit the patient, and acts as a referral resource regarding lawyers, medical doctors, financial advisors, insurance specialists, and community support services.

Community mental health positions
Community mental health counselors can expect to have a variety of age groups in their treatment programs. One specialized area where the young and the old alike need treatment is domestic abuse. Community mental health counselors also work to provide assessment and treatment for patients with drug and alcohol addictions. Some community mental health counselors help families during child adoption interviews and the assessment process. Some counselors work in geriatric treatment centers with the elderly. Still others may only work in AIDS treatment and support service centers. Some families require conflict resolution and psychoeducational services. Still other counselors find work as employment counselors, helping others to find work by assessing clients’ interests and aptitudes.

Criminal justice system
The number of professional counselors in the state-run criminal justice system has recently increased to alleviate some of the overpopulation found in prisons. The criminal justice counselor serves: Prison inmates; detainees; the accused on trial; recovering drug addicts and alcoholics. The job titles are: Probation officer; juvenile offender officer; and prison counselor. The entry requirement is a bachelor’s degree including criminology, counseling, psychology, social work, family relations or theology, and a one-year internship. The counseling segregation trend replaces models that previously incarcerated all prisoners together, regardless of the nature of their crimes. Addiction centers are specifically designed to treat criminals with drug addictions who commit crimes to support their habits. Career criminals and sexual predators are now separated from young offenders. Criminal justice counselors have high-stress but rewarding jobs.

Business and industry
Employers hire professional counselors to help improve job performance through Employee Assistance programs. Ongoing counseling helps to: Alleviate job discontent; enhance coping skills for dealing with family problems; provide drug and alcohol addiction treatment; resolve work problems; and ameliorate retirement issues. Some counselors provide contract training and educational workshops and seminars addressing job satisfaction, work productivity, family and personal problems. The counselor may work as a consultant to directly support supervisors, managers, and employees, and refers them to outside resources when necessary. Some counselors work on-call to provide crisis interventions on job sites, including: Catastrophic workplace accidents; deaths on the job; violence at work; sexual harassment; and layoffs or terminations of employees. Brief counseling is a cost-effective way to help employees cope with the transition process.

Coaching positions
Professional counselors may find employment as a personal coach. Coaching certification, insurance, and job restrictions vary from state to state. Generally, a coach provides a client with: Advice and coping strategies for specific issues; helps the client to focus on life goals; realizing potential; recognizing own value and self-worth. The coach can perform his or her duties in face-to-face interviews, online, or on the telephone, so the coach has more freedom than a licensed professional counselor. The coach may expect to find an increase in employment opportunities in the future.

Private practice
The private practitioner must be dedicated to the business at hand, whether it is run as a part-time or full-time operation, because the startup time and effort is significant in both cases. Use this standard calculation to determine the number of hours you need to bill for: Multiply the hours you spend directly with your client by two. The additional office hours not in the company of your client you spend doing paperwork and preparing for treatment. For example, if you have 15 clients, each of whom is booked weekly for an hour-long session, then you will spend 30 hours a week working. 30 clients mean 60 hours a week of work time. Make a realistic commitment for life-work balance.

Look at problems associated with charging fees for services in the mental health industry in perspective. If you are a counselor in private practice, find out which services are offered free in your community, and do not duplicate them. Survey the surrounding geographic areas to find out which mental health service models your colleagues use. Assess how you will deliver mental health services to the consumer based on your comparative survey. Private practice has a multitude of service options for you to explore. Make practical decisions about the delivery model that you will use, because the model you choose has financial implications for your business. You must thoroughly understand the advantages and disadvantages of setting up and running a private practice, and understand how insurance companies work in regard to reimbursement for services delivered. Balance financial concerns with your sound ethical background.

Requirements
Have a set schedule that includes face-to-face therapy time with your clients, research and preparation time, answering client phone calls and e-mails, coping with ethical issues, and handling everyday paperwork and operations. Plan ahead and budget for cancellations and payment problems that cause you financial losses. Do not overextend your resources, either in time or in financial considerations. Make referrals based on your confidence in your level of training and understanding of the client’s needs. Evaluate what types of mental health services are delivered in your community. There are four types of services, which include: Counseling; consultation; supervision; and community involvement. Provide a flexible model to make your services more attractive to the community.

Counseling services offered
Counseling is the main source of income for the private practitioner. Evaluate potential needs to be addressed in the community you serve. Good contacts for you to make within your community include: Pastors; social workers; school counselors; medical personnel; helping agencies; and employers. Other private practitioners in nearby geographic areas, with whom you do not compete for clients, may provide you with additional insights into the business. Some counselors are generalists. Others specialize in: Individual or group counseling sessions; marriage or family counseling; children, teens, or elders; rehabilitation counseling; drug and alcohol abuse counseling. You may choose a variety of different deliveries to ensure a more lucrative practice.

The private practitioner engages in two kinds of consultation services: Unpaid and paid. Unpaid consultation involves communication between two professionals about the private practitioners’ client. The counselor does not pay for or accept money for this exchange of information. Obtain a signed release of information consent form to protect your client’s right to privacy. Your consultation relationship with other professionals can lead to additional referrals for your services. Offer paid consultations to schools, agencies, industries, hospitals, vocational programs, nursing homes, or community organizations. Your services can benefit those who cannot afford full-time counseling services. You may receive payment based on renewable contractual agreements made for a specific period of time.

Supervisory roles
The private practitioner performs supervisory roles to obtain additional credentials, or education credits required for licensing. When you provide clinical advice and supervision to other professionals in the field, you need to keep your own skills up-to-date. The complexity of some patients’ cases requires the counselor to seek advice from peer supervision groups. These groups meet periodically to converse about cases and to review procedures. Insurance carriers and HMO’s often require private practitioners to have some supervision by a licensed psychologist or psychiatrist. The LPC, LCSW or LMFT receives payments based on the decisions of the overseeing psychologist or psychiatrist and the insurer. Not every private practitioner finds supervision acceptable, and many turn down work that necessitates this relationship with a supervisor.

Community involvement
Visibility within your community is good for your business. If you provide some free services to community groups, you create bonds and respectful relationships between yourself and the community members that could lead to paying referrals. Some organizations that may be in need of free services include: Parent Teacher Associations; diabetes and other illness support groups; and local church groups. Groups may require the services of a counselor to conduct seminars on bereavement, violence, or other social problems experienced in the community. All counselors should provide some community service as a demonstration of their ethics, but it can be especially difficult to fit volunteerism into a private practitioner’s role.

Work settings and networking
The three work settings of the private practitioner are: Incorporated office group’s; expense-sharing groups; and sole proprietorship. Incorporated office groups share the same workspace and the members are not personally liable for legal judgments against the corporation. Expense-sharing groups share resources and costs but not office space. Counselors can benefit from local, state, and national counseling group relationships. Group practice gives the counselor an outlet from the isolation and burnout associated with private practice. Sole proprietorship indicates a single person is in charge of the business, and is liable to pay business damages out of personal funds, if sued successfully. This business owner is not entirely alone, as he or she must continue to network with other mental health professionals. Make your work setting selection based on which type of work fits your life and occupational goals. Your choices will be influenced by the opportunities available in your geographic region, and limited by your type of training and licensing.

Incorporated office groups are mental health specialists who have signed on as legal partners with shares in a business. The specialists can include: Psychologists; psychiatrists; social workers; and professional counselors. Their salaries can be weekly, bi-weekly, or monthly payments, based on: Time spent on the job; the status of the specialist in the business; and the initial investment of the professional as a partner. The legal arrangements include an exit plan for leaving the practice, relocation of the practice, and expected changes in the practice. Consult an attorney to help you thoroughly scrutinize and understand all aspects of the legal contract before making the commitment to become a partner. Your understanding may prevent you from making costly and illegal decisions.

Expense sharing groups consist of mental health specialists who have not signed on as legal partners in a corporation. Their contractual agreements should define their financial and business relationships and costs incurred by each person in the group. A clear understanding prevents future misunderstandings and legal entanglements. The specialists can include: Psychologists; psychiatrists; social workers; and professional counselors. Their salaries are paid in the same way that a sole proprietor is paid. The group fees pay for office expenses and any consulting fees charged by other professionals. However, the private practitioner does not share his or her counseling payments received from patients or other agencies for services rendered. The legal options for the private practitioner include remaining in the group, incorporating the group, or leaving to start his or her own private practice.

I hope that, if you are pursuing a career in counseling, that seeing the broad range of opportunity within the field of counseling has been encouraging for you.

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