Comprehensive Program Development in Mental Health Counseling: Design, Implementation, and Evaluation

Article excerpt

With increasing emphasis on the use of evidence-based practices and efficient clinical operations, mental health counselors must be competent in comprehensive clinical program development that covers program design, implementation, and sustainability. To address this need, a practice model here presented integrates scientific knowledge and business principles by emphasizing research-based program design and due diligence in program development. The model consists of 12 sequential, interrelated phases to guide the professional in creating comprehensive mental health counseling programs.

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The discipline of professional counseling has witnessed dramatic change over the past two decades. The role of the mental health counselor has become increasingly more expansive and the practice of counseling more scientific. Counselors are employed as clinicians, program managers, and administrators in a variety of settings (e.g., outpatient mental health clinics, juvenile justice facilities) and must demonstrate both evidence-based practices and efficient operations. Moreover, as society evolves, counselors find themselves treating an increasing number of specialized clinical issues (e.g., gambling addiction and self-mutilation). As a result of these striking changes, counselors now must possess both scientific and business knowledge in order to design efficient and effective specialized treatment programs that are both viable and sustainable. Essentially, counselors must be competent in comprehensive clinical program development from design through evaluation. Unfortunately, the literature has yet to address how to formulate comprehensive mental health counseling programs. Scholarly attention has been limited to discussions of best practices for specific clinical issues; research has not addressed the practical aspects of program implementation and sustainability that make possible the use of best practice research.

EVIDENCE-BASED AND BEST PRACTICES

In the past 20 years, in developing mental health counseling programs there has been increasing emphasis on scientific methods and rigor, driven largely by the managed care movement in mental health treatment and the more recent concern with evidence-based practices (EBPs). The far-reaching adoption of EBPs has had a considerable effect on the practice of counseling. In fact, Sexton, Gilman, and Johnson (as cited in Marotta and Watts, 2007) asserted that

   the impact of EBPs is dramatic in that they are fundamentally
   changing the way practitioners work, the criteria from which
   communities choose programs to help families and youth, the methods
   of clinical training, the accountability of program developers and
   interventions, and the outcomes that can be expected from such
   programs (p. 492).

Also referred to as empirically based practices, EBPs are predicated on the use of scientific methods to evaluate clinical interventions. As a result, there is greater pressure on mental health professionals to utilize clinical interventions that have established efficacy and to rigorously evaluate previously unevaluated new practices.

Addressing this movement toward greater intentionality and accountability in the counseling profession, A. Scott McGowan (2003), editor of the Journal of Counseling and Development, announced a "Best Practices" section to highlight evidence-based practices. Since then, a growing body of best practice literature has emerged that addresses assessment of the risk of violence (Haggard-Grann, 2007); treatment of obsessive-compulsive disorder (Hill & Beamish, 2007); treatment of depression (Puterbaugh, 2006); and clinical interventions for specialized populations of juvenile sex offenders (Calley, 2007) and adult male survivors of trauma (Mejia, 2005).

Within the broader counseling and mental health literature can be found proposals for specific types of research-based clinical interventions, such as wilderness therapy (Hill, 2007); rape survivor treatment (Hensley, 2002); and outreach strategies for female immigrants and refugees (Khamphakdy-Brown, Jones, & Nilsson, 2006). …