Working as Part of a Multidisciplinary Team

One of the major tasks of the mental health profession stated in the American Counseling Association (ACA) Code of Ethics (2005) is to “encourage client growth and development in ways that foster the interest and welfare of clients”. Professional researchers in the field of counseling strive to illuminate the meaning of this competency for mental health professionals aspiring to practice effective standards of care. Three of the best practice strategies that help counseling professionals meet these standards are consultation, advocacy, and collaboration.

Consultation for professional counselors involves “acting on behalf of an identified client through interaction with another professional consultee or other stakeholder in the client’s welfare” (Brown, Pryzwansky, & Schulte, 2010). Advocacy is a values-driven effort that strives to promote systemic change at the macro level in an effort to promote social justice where barriers to equity and access appear, and restrict full and active participation at the socio-cultural level (Crethar, Torres, Rivera, & Nash, 2008). Collaboration in counseling means working together with professionals of related disciplines, to meet the standards recommended by the ACA (Moe, Perera-Diltz & Sepulveda, 2010). Collaboration occurs at the individual level, and includes service provision by medical physicians, psychiatrists, social workers, addictions counselors, marriage and family counselors, career counselors, school counselors, and mental health counselors, to name several. Effective collaboration also occurs at the systemic level, as identified by Bryan (2009) who proposes that counselors engage strategic family-community partnerships “to enhance direct counseling services to clients”.

Mental health services are delivered proficiently and integrally when consultation and advocacy spring from collaborative efforts between professionals. The professionals, charged with exercising collaborative roles maximize the impact on the client’s well-being while engaging strategies from both internal and external sources. Internal impacts are those that affect the client directly through practical application of knowledge (theories) and skills, such as services provided by mental health counselors and addictions counselors. External impacts are maximized when staff exercises specific roles that advocate for systemic change, such as services provided by social workers (Mellin, Hunt & Nichols, 2011). When these roles collaborate to work on behalf of the client’s interest, their personal growth and development is fostered, their welfare is advanced, and the standards of ethical care are met.

An example of strategic collaboration enhancing the client’s welfare may be recognized in the following case example:

Paul, a 32-year old man, seeks counseling at a community mental health center. He has recently returned from his third deployment to a combat zone. He reports drinking frequently and feeling anxious. For the past three weeks, Paul has been extremely worried that his neighbors are spying on him. Paul's wife has tried to reassure him that he is imagining things, but he cannot get these concerns out of his mind. Paul feels reluctant to leave the house and has missed over a week of work.

The collaborative team engaging this client in this hypothetic facility includes those who exercise roles as mental health counselor, addictions counselor, and social worker. According to Brown et al (2010), these would qualify as professionally appropriate consultees by virtue of their education, training, and credentials. The social worker would help Paul connect to resources related to his status as a veteran. Such resources may include group work for those struggling with PTSD, so collaboration at this level might appear as an external link to resources at the local VA hospital. If a group does not exist, the social worker could develop a strategy for initiating one. The addictions counselor would assist Paul in recognizing his maladaptive dependence on alcohol and apply theories to assist him in coming to terms with his recovery process. The mental health counselor could possibly use appropriate mental health diagnostic tools such as the bio-psycho-social assessment and the DSM-IV-TR Statistical Manual to evaluate Axis-specific level of function, and determine appropriate referrals. The referrals (a psychiatrist/physician) may indicate psychopharmacological treatments or other higher order therapeutic interventions relevant to the symptomology displayed. In this case Paul would require in-depth assessment for agoraphobic behavior, anxiety, and paranoia (which may be related to the impact of drenching his brain with toxic alcohol, or a result of lingering effects of unrecognized/untreated PTSD, or a combination of many complex factors).

The role of each professional included on this particular multi-disciplinary team would be distinct, but their collaboration would be cohesive, and it would be comprehensive. Their strategic plan ideally would be developed according to the desires of the client, yet without compromising diagnostic altruism. Hopefully, their intentionality would culminate in integrated delivery of services, thus fulfilling the expected professional standards of care designed to meet this unique client’s service plan goals.

American Counseling Association. (2005). ACA Code of Ethics. Retrieved March 5, 2013 from http://www.counseling.org/Resources/aca-code-of-ethics.pdf

Brown, D., Pryzwansky, W., & Schulte, A. (2010). Psychological consultation and collaboration: Introduction to theory and practice. The Merill Counseling Series. (7th ed.) Prentiss Hall.

Bryan, Julia.(2009) Engaging clients, families, and communities as partners in mental health. Journal of Counseling and Development. volume 87, issue 4. pg. 507

Crethar, H., Torres-Rivera, E., & Nash, S. (2008). In search of common threads: Linking multicultural, feminist, and social justice counseling paradigms. Journal of Counseling & Development, volume 86, pages 269-278

Mellin, Elizabeth A., Hunt, Brandon, & Nichols, Lindsey M. (2011) Counselor professional identity: Findings and implications for counseling and interprofessional collaboration. Journal of Counseling and Development, volume 89, issue 2, pages 140–147.

Moe, Jeffrey L., Perera-Diltz, Dilani, & Sepulveda, Victoria. (2010). Are consultation and social justice advocacy similar? Exploring the perceptions of professional counselors and counseling students. Journal for Social Action in Counseling and Psychology, volume 2, issue 2, pages 106–123