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Apr 8, 2013

Mental Health Counselors and the Long Term Care System

Over the course of my internship and now working as a professional counselor within a long term care and skilled nursing setting, I have been learning many strategies for navigating within a larger system. Furthermore, I have found there to be a great deal of need for mental health services; a need that requires mental health counselors within such a system to act as an advocate for our profession.

After the education and training of my graduate program, the necessity and belief in the power of mental health services has become ingrained into my operating core. However, after more experience within an interdisciplinary setting, it is my observation that the benefits of mental health services are not fully realized within the other professions for which I work with daily. This is where I have come to understand another role as a mental health counselor, that of a systems consultant. The priority placed on medical needs and physical rehabilitation, from my observations, can often create a narrowly focused treatment plan in which the patient’s mental health can take the back burner, and sometimes not even be considered. However, recently I believe there has been a shift to more emphasis placed on the inclusion of mental health services into treatment plans in order to provide more comprehensive care. Mental health counselors play a crucial role in introducing an understanding of what mental health counselors have to offer and how our services can further benefit the patient’s care.

More specifically, my experience working in assisted living and skilled nursing settings has demonstrated a growing need for mental health services as the older adult population continues to increase rapidly. As a mental health counselor within such settings, I have developed my role as not only providing one on one counseling to the residents of the facilities, but also as an advocate for my own skills and resources I have to offer. I have found that beginning with simple introductions to all staff that interacts with the residents is an easy, yet often overlooked point. In introducing myself, my background, education, and training, the staff can gain a better sense of mental health counseling as a profession. In talking to staff, such as nurses, LPN’s, nursing aides, I have been able to also realize the benefits of milieu therapy. Milieu therapy is built on the idea that the entire unit within the skilled nursing facility and assisted living facility functions as a whole community. Therefore, each resident and staff member makes up the greater community. I have grown to learn that one of the most crucial aspects to this milieu approach is learning the operating language of each discipline you are working with. For example, in one of my first opportunities to work with staff on developing a behavioral treatment plan for a resident, I realized the framework, along with numerous terms, that I used for a certain point were different than what other staff members used. Since each discipline has had tailored training, it becomes so important that as we communicate with other professions, we must often define what we mean as we go discuss assessment, diagnosis, and treatment. Alternatively, as we communicate we must also ask questions to gain a thorough understanding of where our colleagues of other disciplines are coming from and the points they are trying to make pertaining to our clients. These ideas of being detailed in our communication and asking questions seems so simple in theory, but I have truly found them to be incredibly important in my work as a member of an interdisciplinary team. It leads to the general idea that making assumptions of what other professions do and what they are trying to communicate can lead to more work for professionals in the end, and also hinders the comprehensive approach that affects quality of care for each client. Thank you for your time in reading! If you have any experiences or ideas regarding these thoughts, please feel free to email me at ________________________________________________________________________
Lee Kehoe is a counselor working with the older adult population. It is her passion to serve the older adult population through counseling, research, and advocacy efforts, with the hope of raising awareness to the growing needs of older adults and their families.

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