Advocacy is key for the clinical mental health counseling profession. Clinical mental health counselor advocates (CMHCAs) rely on the advocacy competencies to guide their assistance to clients in removing barriers and to secure deserving resources, or to advocate on behalf of clients, groups, or communities. This chapter addresses the importance of advocacy and social justice advocacy, and the strategic positionality of the clinical mental health counselor as an advocate for addressing social and institutional barriers that reduce client access, equity, and success. It identifies the advocacy competencies and approaches to advocate for clients care, and emphasizes the ways that they foster resilience and growth. Specific cases illustrate clients' and professionals' understandings of and access to a variety of community-based resources. The chapter also addresses strategies to advocate for the profession and for clinical mental health counseling professionals.

This chapter sheds light on how the managed care system works as well as the counselor's role in managed care and the importance of advocacy and issues related to payment and reimbursement. It offers a starting point to understand the system, and counselors must continue to seek more resources, join organizations and build networks with other counselors and change makers to become active members of the professional community. Managed care is an integral part of the healthcare system, and it is imperative for counselors to be able to understand the system in order to navigate it better. Counselors can anticipate the issues that are related to cost and payments and can provide more efficient service to the clients, if they understand how managed care system operates. The chapter demystifies the issues of payment for counseling services, specifically third-party billing, managed care, medical assistance programs, and other issues therein.

The practice of professional counseling is governed at the national and state levels by a variety of governing boards and regulatory agencies. This chapter focuses on the legal and ethical issues that are salient to clinical mental health counselors. Specifically, it discusses the American Counseling Association (ACA) Code of Ethics, the American Mental Health Counselors Association (AMHCA) Code of Ethics, state licensure and national certification, confidentiality, mandated reporting, duty to warn, and scope of practice. The chapter also focuses on the responsibility of counselors to engage in ethically based practice. In addition, the chapter connects the ACA and AMCHA ethical codes and the Council for Accreditation of Counseling and Related Educational Programs standards to several topics in ethical practice, including values clarification, bias assessment, boundary awareness and maintenance, and self-reflection. The chapter concludes with a case scenario to illustrate chapter concepts and a section on resources to provide further information.

It is important for beginning Clinical Mental Health Counseling (CMHC) students to understand that their engagement in the CMHC specialty is one part of the larger professional counseling framework. This chapter provides a historical overview of the counseling profession and its developmental trajectory, emphasizing the origins of mental health treatment and the reemergence of counseling as a wellness-based approach. It offers discussion concerning the push toward a pathogenic model of conceptualizing mental illness and the subsequent, current resurgence of a strength-based notion of care. The chapter provides an overview of the major theories of counseling as a means for understanding the development of counseling as a unique and separate field from psychology, psychiatry, and social work. It identifies the specializations within the counseling field, the range of employment opportunities and the current labor market, and how counseling is integrated within a system-of-care approach.

Documentation and record keeping are not only legal and ethical mandates, they are also instrumental in providing competent, quality care to clients. This chapter discusses the importance of the record keeping and documentation processes for clinical mental health counselors. Specifically, it reviews record keeping practices and policies. Also included are legal and ethical issues related to appropriate documentation and record keeping, including the Health Insurance Portability and Accountability Act, subpoenas, and court orders. The chapter helps the reader to distinguish the content of clinical records and identify what is included in a client's clinical file. It helps to recognize the ethical obligation of professional counselors related to record keeping; and appreciate the legal elements of record keeping and how professional counselors can adhere to the laws regarding clinical documentation. The goal of counseling is to facilitate change for the client; quality record keeping is an instrumental element of that process.

This chapter provides an overview of how clinical mental health counselors work with crisis, disaster, and trauma issues. A focus is placed on the pragmatic, neurobiological, and existential natures of crisis, disaster, and trauma along with the ways that these dynamics are implicated in numerous counseling scenarios. The chapter presents the basic crisis intervention skills, discusses disaster response, and emphasizes the importance of understanding trauma. It anticipates that students will have an advanced course that covers these important topics more fully. The chapter provides an adaptation-resilience building framework for conceptualizing disaster response. It then discusses the issue of psychosocial trauma from a multidimensional perspective, and elaborates some of the key aspects of trauma. The chapter explores the most salient issues involving crisis, disaster, and trauma, with a focus on their implications for the clinical mental health counseling (CMHC) profession.

Our professional roles have evolved over time, and there is a great variety among the roles and functions of clinical mental health counseling (CMHCs) in each and every different system of work. However, there are also great commonalities that continue to define our identity as professionals. This chapter takes an in-depth look at the variety of functions, counseling and administrative roles, and tasks that may be required of counselors in clinical mental health settings. Pertinent issues include balancing consumer care with administrative duties, balancing employee well-being with productivity standards/financial concerns, ethical marketing and recruitment, and remaining current in the field while in nonclinical roles. The chapter helps the reader to discuss the clinical tensions experienced among CMHCs in relation to their job roles and synthesize an understanding of the complex role a CMHC serves in relation to best practices, professional ethics, and legislative regulations.

This chapter provides a brief overview of models of clinical supervision. It also offers a brief discussion of best practices, common struggles, and a salutogenic- or wellness-based approach to supervision, emphasizing how the latter complements parallel treatment interventions with consumers. Self-care is an important part of a counselor's efforts to maintain general and mental health. The chapter urges counselor trainees to develop continuing education and continued professional development as a part of their career-pathway planning. The discussion emphasizes the importance of remaining current, concerning clinical counseling issues as an ethical issue that is inherent in being a professional. The chapter focuses on the practice and importance of clinical supervision and continuing education for professional counselors. It reviews some of the most common theoretical approaches to supervision and how they may be used. The chapter concludes with a discussion of the ethical mandate and benefits of continuing education for counselors.

This chapter summarizes pertinent issues discussed throughout the text, especially reinforcing the multiple emphases on systems-of-care, ecological, salutogenic, social justice, and diversity approaches. In addition, the chapter identifies new frontiers for counseling practice, such as new opportunities for counselors within the Veterans Administration and TRICARE system, in hospital settings, in hospice programs and assisted living environments, in other community settings, in school-based programs, in college counseling centers, and in sports counseling. The chapter also addresses the influence of technology upon the counseling profession, discussing the Internet-based services, such as virtual counseling, and telecounseling. It provides a discussion of the ethical, legal, and practice concerns related to this developing branch of counseling. With our professional organizations and the advocacy efforts of our practitioners and educators, the future holds great promise for the further development of professional counseling as an important part of the field of mental health and wellness.