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##  Mental Health Counseling: Identity and Distinctiveness. ERIC/CASS               Digest.                                                                      

INTRODUCTION
The human service provider field is comprised of a                complex and bewildering array of overlapping and related, but                   separate professions that include mental health counseling,                     psychology, social work, marriage and family counseling,                        professional counseling, and psychiatry. Because each provider                  profession has essentially the same goals and accomplishes these by             performing similar activities, human service delivery professions               may seem very alike from the outside, which means that it can be                very confusing to understand a profession's distinct identity. It is            not particularly surprising that the nuances that distinguish these             professions seem amorphous, unclear, and perhaps somewhat irrelevant            to the public. 
Graduate programs that train professionals for                 entry into a particular field spend 2 to 4 years purposefully                   socializing their students and providing them with a foundation in              the profession's history, its knowledge and techniques, and its                 relevant values, attitudes, and identity themes. Moreover, persons              seeking mental health services can usually be helped by virtually               any of the service providers, because of the interdisciplinary                  nature of the knowledge and theory of intervention related to                   personality organization. Nonetheless, it is worthwhile for the                 professions to articulate their distinctions. This clarification is             a vehicle to gain recognition and to vie for their legitimate                   position in the health care market place, and it also constitutes               responsible behavior that is consistent with being accountable to               the public's sanctioning of the professional work. 
In terms of                clarifying uniqueness, the borders of the human service delivery                fields can be distinguished based on "professional                              identification, ... practitioner's entry level graduate degree ...,             basic academic discipline, conceptualization of mental health                   problems, and approach to treatment" (Hersehenson & Power, 1987, p.             3). By weaving these elements into a discussion of the history of               the profession, the identity which organizes its stability, and the             distinctive characteristics which are included and excluded within              its identity, this paper seeks to convey to readers the uniqueness              of one of the youngest service provider professions, Mental Health              Counseling (MHC) (cf. Pistole & Roberts, in press). MENTAL HEALTH             COUNSELING - HISTORICAL TRADITIONMHC has a brief but bold past.             In the social-historical-economic context following World War II,               non-medical, behavioral and cognitive approaches to psychotherapy               flourished, with some of this growth being stimulated by the                    Community Mental Health Centers Act of 1963. This act,                          which "established funding for the development of community-based               mental health care programs with interdisciplinary teams" (Weikel &             Palmo, 1989, p. 8), contributed to increasing the number of                     master's-level practitioners. Many of these practitioners were                  trained in colleges of education and secured employment under a                 variety of professional and paraprofessional titles in community                settings (e.g., hospitals, private practice, community mental health            centers) (Beck, 1999; Weikel & Stickle, 1989). Although effective as            professionals, because they were not trained in the disciplines of              social work, psychology, or medicine (psychiatry), these                        practitioners were without a professional organizational home and               were unqualified for the traditional credentials or licensure; that             is, they were disenfranchised and rendered professionally invisible.            This new group of professionals, who had emerged within the health              care field, began a grass roots movement and in July, 1978 formed               the American Mental Health Counselors Association (AMHCA) to provide            themselves with a professional organization and identity. From its              inception, AMHCA's purpose was to pursue recognition, develop                   accountability standards, and acquire professional status for these             practice-oriented master's professionals who were already entrenched            in the marketplace (Beck, 1999). In turn, the pioneering founders of            the profession, drawn to this newly established identity of mental              health counselor because they "believed in the power of                         counseling" (Palmo, 1999, p. 217), began the political process of               differentiating their activities, roles, and identity from other                service provider professions so that the uniqueness of their                    profession was revealed to both themselves and others. MENTAL                 HEALTH COUNSELING - IDENTITYIn terms of a defining identity, MHC            can be understood as "an aggregate of the specific educational,                 scientific, and professional contributions of the disciplines of                education, psychology, and counseling" (Spruill & Fong, 1990, pp.               20-21). From early on, mental health counselors have defined their              work as "an interdisciplinary multifaceted, holistic process of (1)             the promotion of healthy life-styles, (2) identification of                     individual stressors and personal levels of functioning, and (3)                preservation or restoration of mental health" (Seiler & Messina,                1979, p. 6). 
When discussing identity themes, MHC has identified              itself as a profession in which the person is conceptualized both               developmentally and holistically with attention to contextual                   influences on persons' lives (Hershenson & Power, 1987). This                   approach involves both systemic and individual perspectives. On the             one hand, from the systems perspective, clients are embedded within             and influenced by their family, societal, historical, cultural, and             socioeconomic context, which means that community resources and                 interdisciplinary approaches can be useful in treatment.                        Simultaneously, the individual can be viewed as being the gestalt of            multiple domains - emotional, physical, social, vocational, and                 spiritual - that coalesce and culminate in a more or less healthy               life style. As part of the health care industry, mental health                  counselors focus on a wellness, holistic mental health philosophy,              regardless of whether the clients' issues are more reflective of                developmental struggles or more reflective of clinical pathology.               That is, the profession endorses a philosophy that is focused more              on strengths and wellness, as springing from the multiple                       synthesized domains of the person, and focused less on curing some              kind of mental illness. 
This way of thinking about clients is also            reflected in mental health counselors' collaboration with other                 professionals. Traditionally, the mental health counselor has worked            in a community setting (e.g., a community mental health center) and             participated as a contributing member of a health care team. In                 parallel to viewing clients as individuals within a complex system,             mental health counselors see themselves as a profession that                    functions and contributes within a complex system of health care                providers. Thus, mental health counselors extend the contextual,                holistic health model to the broad professional environment, and                also focus attention on understanding other professional frameworks             in order to improve their own effectiveness in interdisciplinary                teams. Similarly, consistent with a growth and developmental                    philosophy, mental health counseling, as a profession, has been                 responsive to market changes within the political and social                    zeitgeist of health care. This flexibility is a necessary aspect of             remaining vital and viable, that is, healthy, as a provider in the              health care industry. Thus, during its development, MHC has                     demonstrated flexibility within stability: It has retained its core             identity elements of development, strength, and mental health in a              holistic interdisciplinary perspective, while integrating new                   competencies that are consistent with today's managed care                      environment. For instance, remedial intervention as well as the                 diagnosis and treatment of psychopathology has been synthesized                 within the mental health counselor's underlying philosophy of                   strengthening or restoring development and mental health (versus                curing mental illness or helping clients adapt to the functional                impairments which accompany mental illness). MENTAL HEALTH                    COUNSELING - DISTINCTIVENESSAs a master's level, primarily                  practice-oriented profession, MHC has distinguishing characteristics            in terms of what it excludes and includes. Most obviously, MHC                  professional training builds on the theory and research of the                  behavioral sciences, but the education is not specific to the                   disciplines of social work, psychology, or medicine. On the other               hand, there are specified standards for MHC training, with                      accreditation available from the Council for Accreditation of                   Counseling and Related Educational Programs (CACREP), if programs               qualify by meeting the standards. Standards include 60 credit hours             with specified course work and supervised experience. However, these            standards, unlike doctoral education, do not include a requirement              for scholarly productivity, though some programs do provide                     students' the opportunity to do a master's research thesis. Although            a practice-oriented profession, because of its interdisciplinary                dimension and valuing of research productivity, MHC can comfortably             include people who stretch the practitioner boundary; that is, the              profession prizes the production and dissemination of scholarship,              as evidenced by the publication of research in the profession's                 Journal of Mental Health Counseling. Nonetheless, the employment                settings of most mental health counselors support efficacious                   practice rather than necessitate or reward scholarship. 
In                    relation to included characteristics, MHC shares a border with                  professional counseling in its conceptual and philosophical                     perspective that is more educational, developmental, and preventive             than clinical, remedial, and medical (Seiler & Messina, 1979). As               mental health counselors draw on the interdisciplinary knowledge                base of the behavioral sciences, they implement a                               scientist-practitioner approach to delivery of services. They are,              by training, effective consumers of the research and theoretical                literature and continue their learning throughout their careers,                because their foundation for practice is the research and theory                which is continually being developed and refined. Moreover, mental              health counselors' practice resembles the process of science in                 terms of practice being based in skeptical, cautious, and                       evidentially-based judgment. In fact, practice constitutes the                  implementation of science, that is, reflects local and idiosyncratic            research with each client. The research with each client is                     represented as an integrated way of critical thinking and a style of            working from the scientific attitude of inquiry, by using theory and            systematic observation to build hypotheses, collect data, interpret             data, seek alternative explanations for the data, and revise                    hypotheses. In terms of credentials, in most states, mental health              counselors obtain a license for practice. The title is often                    generic, termed "professional counselor," though some states use the            title "mental health counselor." In addition, these professionals               may hold a specialty credential as a Certified Clinical Mental                  Health Counselor. CONCLUSIONMental health counseling, one of              the youngest of the human service provider professions, was formed              by in-the-field professionals who were seeking visibility and                   recognition during the late 1970's. Based in the knowledge of the               behavior sciences and trained to focus on strengths, development,               and the holistic, multifaceted aspects of on-going mental health,               mental health counselors use scientific processes to strengthen or              restore clients' mental health. Their framework for                             conceptualization integrates (a) the person as a gestalt of various             domains with (b) the person's position in the family and                        socio-cultural matrix. This focus extends the resources for                     intervention to include the environment and extends the pressures               and inhibitions on development to include macro-systemic                        characteristics as well as family or personal dynamics. It is a                 misunderstanding to construe "mental health counseling" as                      meaning "to help those who suffer with mental illnesses to adapt to             life more effectively." Rather, mental health counselors are                    concerned with health and with the wide variety of circumstances,               socially and individually, that can impair or inhibit the                       functioning of a person's life. Mental health counseling is designed            to contribute to the vitality and vigor and to the soundness in                 body, mind, spirit, and social connection that sustains well-being,             and so is considered, by our society, to be                                     health. REFERENCESBeck, E. S. (1999). Mental health                       counseling: A stakeholder's manifesto. Journal of Mental Health                 Counseling, 21, 203-214. 
Hershenson, D. B., & Power, P. W. (1987).            Mental health counseling: Theory & practice. New York: Pergamon                 Press. 
Palmo, A. J. (1999). The MHC child reaches maturity: Does              the child seem short for its age? Journal of Mental Health                      Counseling, 21, 215-228. 
Pistole, M. C., & Roberts, A. (in press).            Mental health counseling: Toward resolving identity confusions.                 Journal of Mental Health Counseling. 
Seiler, G., & Messina, J.                J. (1979). Toward professional identity: The dimension of mental                health counseling in perspective. American Mental Health Counselors             Journal, 1, 3-8. 
Spruill, D. A., & Fong, M. L. (1990). Defining               the domain of mental health counseling: From identity confusion to              consensus. Journal of Mental Health Counseling, 12,                             12-23. 
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About the Author: M. Carole Pistole is Associate                 Professor of Educational Studies at Purdue University. 
ERIC                   Digests are in the public domain and may be freely reproduced and               disseminated. This publication was funded by the U.S. Department of             Education, Office of Educational Research and Improvement, Contract             No. ED-99-CO-0014. Opinions expressed in this report do not                     necessarily reflect the positions of the U.S. Department of                     Education, OERI, or ERIC/CASS.                                               **Title:** Mental Health Counseling: Identity and Distinctiveness. ERIC/CASS               Digest.                                                                      **Document Type:** Information Analyses---ERIC Information Analysis Products (IAPs) (071); Information Analyses---ERIC Digests (Selected) in Full Text (073); **Available From:** ERIC Counseling and Student Services Clearinghouse, University of               North Carolina at Greensboro, 201 Ferguson Building, P.O. Box 26171,            Greensboro, NC 27402-6171. Tel: 336-334-4114; Tel:                              800-414-9769 (Toll Free); Fax: 336-334-4116; e-mail:                            [email protected]; Web site: http://ericcass.uncg.edu.                       **Descriptors:**  Counseling, Counselor Role, Health Promotion,  History,  Mental                Health,  Mental Health Workers,  Professional Development, Theory               Practice Relationship, Wellness                                              **Identifiers:** ERIC Digests,  Professional Identity                                         
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