Sunday, April 8, 2012
The goal of mental health counseling and all psychological disciplines for that matter, are aimed toward the betterment of humankind, the creation of solutions for large-scale traumatization as well as personal crisis, and redirecting destructive human tendencies. The central theme of mental health services is change. If we can't facilitate some type of measurable change, then, the process is either ineffective, inefficient, or inappropriate.
In any service industry, especially in human services, the service rendered must have a definitive measurable effect where or on whom it is applied. Ultimately, the service is evaluated by the change the service facilitates. My concern, however, is the pressure to "perform" adequately, or to demonstrate a particular number of outcomes in a pre-determined time frame. Ultimately, though, it is important, and even essential to the discipline to use effective counseling programs. I think it is valuable that the primary evaluation takes place at the grass roots level - I will be the first to evaluate my own effectiveness. An important aspect of evaluation is that it seems to promote collaboration. If I am not seeing appropriate change in my efforts, I will be more likely to seek additional counsel, especially since I must ultimately evaluate my efforts.
I appreciated Astramovich and Coker's (2007) idea of the context evaluation cycle and it's four stages: feedback from stakeholders; strategic planning; needs assessment; and service objectives. This ongoing process seems like a natural one that can be easily integrated into the reflective aspect of mental health counseling. We evaluate how the counseling experience is working with a particular client, plan or re-plan accordingly, decide where the greatest need exists, and revising short and long-term goals. Rather than determining the most opportune time to evaluate a program, the evaluation is ongoing.
I think, perhaps one of the most difficult aspects of accountability is using appropriate assessment techniques that will efficiently or more importantly, realistically measure the construct wherein change is most needed. Measuring psychological constructs has always been difficult (Astramovich & Coker, 2007), and when all is said and done, the results of the measurement rely on human perspective. In that regard, it is always important to be aware of our own prejudice and bias in evaluating ourselves and our clients.
It's easy to think of evaluation as a judgment on our personal abilities as mental health counselors, as a reflection on our artistic competence to affect our clients. I do, however, think it's important to keep in mind that "counseling is, in most cases, effective (and) there is no 'best' approach" (Sexton, 1999, p. 3). The common factors attributed to positive outcomes are "the supportive value of a collaborative counseling relationship, the value of learning...and action (through behavior change, successful experiences, behavioral regulation, and mastery)" (Sexton, 1999, p. 3). Remembering this makes accountability a natural and valuable process of counseling, and "the purpose of evaluation is continuous quality improvement" (Erford, 2010, p. 388).
Astramovich, R. L., & Coker, K. J. (2007). Program Evaluation: The Accountability Bridge Model for Counselors. Journal of Counseling & Development, 85(2), 162-172.
Erford, B. T. (2010). Chapter fifteen: accountability in counseling. In Erford, B. (Ed.) Orientation to the Counseling Profession: Advocacy, Ethics, and Essential Professional Foundations (p. 361-389). Upper Saddle River, NJ. Pearson Education, Inc. Sexton, T. L. (1999). Evidence-Based Counseling:
Implications for Counseling Practice, Preparation, and Professionalism. ERIC Digest. (pp. 1-6, Rep.). Greensboro, NC: ERIC Clearinghouse on Counseling and Student Services. (ERIC Document Reproduction Service No. ED435948)