As a graduate student trying to familiarize myself with the latest standards in evidence based practice, I am beginning to realize that there are a lot of seemingly conflicting ideas in the counseling field. In regards to managed care and evidence based practices, it seems that there is quite a lot of pressure to structure sessions with behavioral techniques and procedures. On the other hand, some of my professors teach that the humanistic model of client-centered counseling should be focused on the therapeutic relationship and using techniques should occur only when appropriate in session. And now, I am left scratching my head in confusion! How should I plan sessions to help my clients and satisfy my obligations?
I think Nancy McWilliams, (2011) really gets to the heart of my concern: "Psychotherapy used to be generally understood as a healing relationship.... Recently, it seems to have been re-conceived as a set of techniques that can be applied to specifiable discrete types of suffering.... We are increasingly pressured to see ourselves as technicians in the service of the narrowest possible definitions of symptomatic improvement." As a counseling intern, I am struggling to wrap my mind around all these conflicting messages and figure out what exactly is a counselor's job? How can I best help my clients with evidence based practices while keeping my priority on the therapeutic relationship?
I think that I will find my answers in developing knowledge of psychological theory. As my understanding of theory deepens, I am beginning to see that I resonate with the wellness perspective, which aims to help people live a more balanced and meaningful lifestyle. I think that no matter what the client's diagnosis, each client at some level wants to live a happy, healthy, meaningful life. Each client wants to be able to learn to cope with pain and minimize their suffering. Furthermore, I believe that clients want to learn to balance each aspect of their lives and move in a valued direction. Hettler (1984) described six dimensions of wellness that are important to maintaining a healthy, happy, and meaningful life. These dimensions include: intellectual, emotional, physical, social, occupational, and spiritual wellness (Myers, 1991).
Dr. McWilliams explains that most people experience the need to find balance between meaningful work, love, and play. I really like the simplicity of this model. No matter what mental illness a client faces, we can help them find something important to work towards. Life is stressful, and we all get out of balance sometimes. However, when people are able to work towards something that they value, it seems that it makes the struggle to cope with the really difficult things worth it.
In my next six posts, I want to share my thoughts on each of the six dimensions in the wellness model. I am interested to know what other counselors find interesting about the wellness perspective. Also, what do other counselors make of the pressures of the managed care system?
Hettler, B. (1984). Wellness: Encouraging a lifetime pursuit of excellence. Health Values, 8(4), 13-17.
Myers, J .E. (1991). Wellness as the paradigm for counseling and development: The possible future. Counselor Education and Supervision, 30(3), 183-193.
Hanna Rodriguez is a counselor in training at McNeese State University, and is completing her internship at the McNeese Kay Dore Gambling Treatment Program in Lake Charles, Louisiana. She is interested in viewing mental health from a wellness perspective. Read more about Hanna at: