Various clinicians collaborate with mental health counselors to help patients swiftly access the help they need and ensure they achieve optimal outcomes. Many counselors work within the US healthcare system, so their services can be integrated with that of primary providers. Having an office in the same building means referrals are simpler to make, and patients don’t have to navigate a separate facility to meet their counselor. In addition to supporting physicians in diagnosing complex mental health disorders, the work of mental health counselors includes identifying the best medical treatment plans and offering talking therapies to support each patient’s recovery.
According to the Centers for Disease Control and Prevention, 20% of all adults in the US are living with some form of mental health problem. In addition, around one in every 25 will experience a more serious mental illness, such as bipolar disorder or clinical depression. This highlights the vital role of mental health counselors within the healthcare industry.
In response, the White House has announced a series of actions designed to ensure more people, from children to older adults, can access quality mental healthcare.
More mental health counselors are needed
As part of the government’s program, there will be a drive to substantially increase the number of practitioners who make up the mental healthcare workforce. This means more training places are required. In addition, to attract the best people, these opportunities need to be accessible to those who are already working but may be considering a new career. Educational institutions have responded by designing flexible, online courses with affordable fees.
Earning a Master’s in Mental Health Counseling online at a reputable institution such as St. Bonaventure prepares students for the licensed professional counselor exam, which they need to pass to practice independently. With two internships and a community-based practicum, this program is ideal for bachelor’s degree graduates who are new to the field, as well as those with previous experience in counseling.
How is a mental health condition diagnosed?
When patients first approach their physician or nurse practitioner with a concern about their mental health, the practitioner will carry out a general medical examination to ensure that the root cause is not physical. They will delve into the patient’s symptoms, make sure they are getting enough sleep, and possibly order lab tests to rule out hormonal issues caused by thyroid problems. If they cannot determine a physical cause for the symptoms a person is experiencing, a physician will refer their patient to a mental health counselor to ensure they receive an accurate diagnosis.
The various forms of mental illness, as well as the treatments for each, are detailed in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders. This will be used by a mental health professional to make a diagnosis and consider the best treatment to offer. Although medications cannot cure a mental illness outright, used in combination with the kind of talking therapies provided by mental health counselors, they have a positive impact on a patient’s symptoms. As the treatment program progresses, the physician and mental health counselor can work with other healthcare professionals, including nurse practitioners, social workers and pharmacists, as well as family members. They will monitor the patient’s overall recovery and consider how well they are physically responding to any medication.
For many years, collaboration between primary care workers, such as physicians and mental health professionals, has been commonplace. These teams help to improve the patient experience by supporting better communication within the care system, establishing good working relationships between professionals and making help more accessible for patients.
What conditions can a mental health counselor help to diagnose?
Everyone is different, and patients often experience the symptoms of the same mental health condition uniquely. As a result, mental health counselors use a range of techniques to understand what’s wrong, establish a diagnosis and identify the best form of treatment.
Patients will be asked to describe their feelings in detail and explain how long they have been having these thoughts or experiences. They will also be asked about the impact their feelings are having on their life in terms of their ability to work, enjoy relationships and take care of themselves. Often, a practitioner will use questionnaires to shed more light on the problem. Some mental health problems will not fit any specific condition and, therefore, will lack a diagnosis; however, help can still be offered for the symptoms. Here’s a look at some of the conditions that may be diagnosed, as well as what the symptoms are and how the issue can be treated:
Making an anxiety diagnosis
Often, people who eventually receive an anxiety diagnosis first visit their physician with physical problems. However, if no underlying cause can be found, they may be referred to a mental health professional. The mental health professional will spend time with the patient discussing their thoughts, behaviors and feelings, as well as enquiring about any complications that may be related to the issue. Often, anxiety arises and becomes worse when another mental health problem is present. This could include anything from an addiction to a disorder like depression or PTSD.
Once the counselor is satisfied that the patient is indeed suffering from anxiety or an anxiety disorder, they may decide that medication is the best route or talking therapy. Most often, they will use a combination of the two, as they tend to optimize the effects of each other. When it comes to talking therapies, cognitive behavioral therapy (CBT) is considered the most beneficial for alleviating the symptoms of anxiety. Although this type of treatment tends to be a short-term solution, patients are asked to attend sessions regularly.
These appointments will focus on providing the skills a person needs to manage the symptoms of their anxiety more successfully. During a CBT session, patients are often treated using exposure therapy. This involves the therapist gradually exposing a patient to the things that make them feel anxious. Over time, the patient builds up their confidence, becomes less reactive and can manage their symptoms more successfully. As a result, they should be able to get back to the way they were living and the activities they enjoyed doing before their anxiety worsened.
Many different types of antidepressants are prescribed to people who are trying to manage an anxiety disorder, but some medications are specifically used to deliver anti-anxiety benefits, such as buspirone. When a patient is feeling overwhelmed by their anxiety, the counselor and the physician may decide to offer a sedative, such as a beta blocker, for the short term. These are not a permanent solution, but they are an effective way of relieving some of the worst symptoms.
Working with patients to diagnose and treat bipolar disorder
Bipolar disorder causes extreme mood changes, from manic highs to severe lows, also referred to as depressive episodes. A mental health counselor will ask the patient how often their symptoms occur, as some people can suffer from occasional mood swings while others can experience these changes in feelings regularly. They will also inquire in more depth about these unpredictable moods, whether there is any form of psychosis in which the patient feels detached from reality, and which type of episode, depressive or manic, is the most common.
When looking for evidence of mania, counselors expect there to be an increase in activity, feelings of extreme confidence, less need for sleep and talkativeness. The patient may also be distracted very easily during a bipolar high and exhibit rash behavior, such as overspending or taking risks with their health. A depressive episode might include feelings of hopelessness, sadness and disinterest. The patient may have trouble sleeping, feel tired all the time or have difficulty concentrating. Occasionally, they may experience suicidal thoughts.
In a recent study, researchers found that around 60% of people who had been diagnosed with bipolar disorder had a coexisting addiction. As a result, counselors will look into whether a person has problems with alcohol or drug abuse and discuss their treatment options for that problem, as well as their bipolar diagnosis. Many diagnoses are made in young people in their teens or early 20s. Identifying bipolar disorder in older adults can be more of a challenge because they may not see their symptoms as a problem. Indeed, some may like the high they feel during a manic episode, and as a result, they may be more productive.
Bipolar disorder lasts a lifetime, but the symptoms can be managed with a good treatment plan. This will usually include counseling and medication, as well as lifestyle advice. Again, talking therapies are provided by mental health counselors to help people manage their moods, recognize the signs of an episode beginning and keep their relationships on track. Mood-stabilizing drugs may also be offered to prevent manic episodes from taking hold, but antipsychotic medicines can be useful for people who suffer from more severe symptoms.
Diagnosing depression and providing treatment
After ensuring that there is no hormonal or physical cause for a person’s low mood, a physician will usually send a patient for a psychiatric evaluation with a mental health professional. To reach a diagnosis, the counselor will ask the patient about their symptoms and often provide a questionnaire for them to complete. This stage can take time because depression can present differently between patients, and it can have certain features that are more prominent. These include anxious depression, which causes people to feel deep concern about events that have not yet happened, and melancholic depression, which makes it difficult for people to find joy in activities and situations.
Some people may exhibit a mixed range of mild depressive features, while others have psychotic features, which might include hallucinations or delusions. A counselor will also try to establish the onset of the symptoms because some can occur at specific times. For example, seasonal depression is related to sunlight and the changing seasons, while postpartum onset depression can begin after a person has given birth. In addition, a mental health counselor will need to consider the presence of an additional disorder, such as bipolar disorder, premenstrual dysphoric disorder or cyclothymic disorder, which includes depression as a key symptom.
Once a diagnosis has been reached, a patient can be prescribed a variety of different mood-stabilizing medications or antidepressants to alleviate their symptoms, especially feelings of lethargy, sadness and disinterest. Alongside this, counselors will often recommend a course of therapy. For depression, interpersonal therapy, in which patients are encouraged to identify the people and relationships that may be causing them problems, can be useful. It works best for people with mild to moderate depression and is based on the idea that poor relationships can have a significant impact on people’s mental health and tendency to depression.
Supporting people who are living with post-traumatic stress disorder
Physical examinations are usually the first way for a doctor to begin a diagnosis of PTSD, but if no apparent cause is found, they will refer the patient to a mental health professional for a psychological evaluation. Counselors start by discussing the patient’s symptoms and which event or series of events led to these emerging. The person may have difficulty focusing, feel jumpy or tense, have trouble sleeping and be aggressive or irritable regularly.
For a PTSD diagnosis, the patient must have been exposed to a situation in which they were threatened with various traumatic experiences. This could be through the patient experiencing one of those things as an individual, watching them happen to someone else or finding out about them happening to someone they care about. Anyone in these situations can be affected for up to a month after the events, but when the problem continues beyond this period and affects other areas of their life, PTSD may be diagnosed.
For most patients, the initial course of treatment that a mental health counselor would recommend is likely to be talking therapy. However, the treatment plan can also include medication if it will have a more profound impact on a person’s symptoms. Using cognitive behavioral techniques, a counselor will teach the patient how to manage their symptoms, healthy coping mechanisms and change how they currently perceive the world.
By recognizing negative cognitive patterns and working through them, patients with PTSD can be empowered to regain control of their lives and emotions. Mental health counselors may also encourage patients to attend group therapy sessions in which they have the opportunity to connect with other people who have gone through a similarly traumatic experience. Medication for PTSD is often in the form of antidepressants, as these can balance a patient’s mood, help them sleep and enhance their concentration.
Establishing a diagnosis for and treating schizophrenia
Along with a physical examination, practitioners will determine whether a patient has a substance abuse problem or any other form of mental health disorder before diagnosing schizophrenia. This is an especially severe mental illness that manifests in delusions, hallucinations, disorganized thought processes and speech patterns. A counselor will spend time observing the patient’s overall demeanor and changing moods and delve into the way they experience false beliefs, hear voices or experience problems communicating. For many, the symptoms can come and go in terms of how severe they are. Some symptoms may occasionally vanish altogether, while others are always present.
Often, a mental health counselor with training in diagnosing schizophrenia will make a final diagnosis and work with other health professionals to establish a treatment plan. This group can include a social worker and a psychiatric nurse, as well as a counselor and a case manager, to ensure the patient’s care is properly coordinated. This is a lifelong condition that will require the patient to continue taking medication, even when their symptoms are waning. The medications provided are often antipsychotic. They are started at a low dose and can make it easier for a patient to manage their symptoms.
In terms of talking therapies, a counselor is likely to offer psychosocial therapy as an initial intervention. Psychosocial therapy is aimed at teaching patients to understand social behavior, in addition to supporting their intellectual and emotional skills. This can improve their confidence, enable them to interact with others more positively and to feel comfortable while doing so.
Conclusion
Although people are often referred by another professional in a primary care setting, it is the mental health counselor who develops a deeper relationship with the patient. They will delve into the patient’s past, learn more about how they have coped so far and try to understand why their condition has emerged. Over time, a counselor works to build a relationship of trust, to put the patient’s condition into context and to treat the person, not just their symptoms.
