Mental Health Profession 101

Soooo...this next post was supposed to be about the intersection of social justice, pop culture, and the mental health profession. And then, I remembered that I hadn't yet posted my mental health profession 101 article. Whoops! My bad. Thus, here's a (not so) brief overview of some of the basic concepts of the mental health profession.*

For starters, what do we mean when we say "mental health?" 
Psychological wellness, or mental health: 

• Can be understood as a state of well-being wherein the individual can 
• realize her/his own abilities
• cope with the typical stresses of everyday life, 
• work productively and fruitfully, and 
• make a contribution to her/his community (World Health Organization, 2013)

 What then, is mental illness? 

Psychological distress, or mental illness: 

• Can be understood as a medical condition or state of illness that 
• may have genetic and/or contextual causes, and 
• disrupts a person's thinking
• feeling
• mood
• ability to relate to others and 
• daily functioning (National Alliance for Mental Illness, 2013).

If someone is in, or goes to therapy, what does that mean? 

Psychotherapy/therapy: 

• Which most often occurs in 
• individual
• group
• couple's 
• or family format, 
• is a varyingly designed practice that seeks to: 
• provide symptom relief  
• promote adaptive changes in behavior, affect, and cognition
• reduce future symptomatic episodes
• enhance quality of life
• promote adaptive functioning in work/school and relationships
• increase the likelihood of making healthy life choices and 
• offer other benefits that may bring someone to therapy
• Via collaboration between the client and the therapist. (American Psychological Association. 2013. Recognition of psychotherapy effectiveness. Psychotherapy, 50, 102-109.)

Various representations of therapy, including individual, group, couples, family, and child. 

So, if someone were to go to therapy, what would happen first?
More likely than not, (s)he would begin with some initial paperwork and an
Intake interview:

• Which is the client and clinician’s first meeting with one another, intended to:
• provide the client with a chance to 
• get to know the clinician before the two start working together,
• explore the framework for clinical services, including 
• duration of sessions and/or episode of care
• fee structure
• privacy and confidentiality, etc., as well as to
• provide the clinician with a chance to:
• build rapport with the client
• direct the client to resources for immediate symptom relief, if appropriate
• gather necessary data to determine if the clinician and/or clinician’s practice can adequately serve the client’s needs
• collaborate with the client to assess what is bringing the client in for services, and what (s)he would like to occur as a result of clinical services

Sometimes therapists mention or write about their theoretical orientation. What does that mean?

(A psychological) Theoretical orientation

• Refers to a mental health professional's basic philosophy about what causes someone's distress, what will likely relieve it, and how the professional approaches working with people. 
• Common psychological theoretical orientations include:
• Cognitive-behavioral theory
• Family/systems theory
• Feminist theory
• Humanistic/existential theory
• Multicultural theory
• Psychodynamic theory
• Trauma theory
• And more, including which
• Common factors theory which suggests that all varied theoretical orientations share underlying common factors that contribute quite significantly to therapeutic progress and gains.

Sometimes when someone isn't doing well in school, or is doing really well, they mention being tested. What's that about?
In instances like the ones above, as well as in some court cases, before being hired for certain jobs, and for other reasons, an individual may have a psychological assessment performed. A
Psychological assessment

• Is a process of information-gathering and analysis that uses a combination of techniques (often a clinical interview, record review, and the administration and interpretation of formal assessment measures) to help arrive at grounded hypotheses about a person and their behavior, personality, and/or capabilities.
• Psychological assessments are almost always performed by a licensed psychologist, or by someone who works under the supervision of a licensed psychologist (such as a psychology trainee or psychology intern). 
• Common types of psychological assessments are
• Psychoeducational assessments
• Personality assessments
• Forensic assessments and
• Neuropsychological assessments.
• Further details of these types of assessments are provided below.

 Psychoeducational assessment

• Is a process of information-gathering and analysis that most often uses:
• A clinical interview
• Educational history
• Previous records, and 
• Data gathered from tests of 
• Cognitive ability or cognitive “horsepower” 
• Educational achievement
• Attention
• Executive functioning
• Behavioral/emotional functioning, and 
• Other relative areas of functioning. 
• These sources of information are used to help a psychologist or psychology trainee arrive at grounded hypotheses about a person’s cognitive and academic functioning, and to recommend reasonable accommodations, should a disability or learning difference be found.

Child participating in psychoeducational testing

Personality assessment:

• Is a process of information-gathering and analysis that generally uses 
• A clinical interview
• Administration and interpretation of formal personality and/or behavioral assessment measures
• Record review 
• to help arrive at grounded hypotheses about a person's behavior, personality, and/or psychological functioning. 

Forensic assessment: 

• Is a process of information-gathering and analysis that generally uses 
• A clinical interview
• Review of data across multiple sources and
• Administration and interpretation of formal assessment measures, such as
• personality
• behavioral
• adaptive functioning
• and/or malingering tests
• to help arrive at grounded hypotheses about a person's behavior, personality, and/or capabilities, such as competency to stand trial, risk of re-offense, validity of illness or claim, and more. 

And finally,

Neuropsychological assessment

• Is an assessment of how someone's brain functions, which indirectly provides information about the 
• Structure
• Functioning of, and 
• Presence or absence of injury to the brain. 
• Neuropsychological assessment usually entails 
• A clinical interview and 
• Administration and interpretation of neurological and neuropsychological tests.

Moving along from assessment, another branch of the mental health profession is
Psychopharmacology

• Which is the scientific study of the effects of natural and synthetic substances on
• Mood
• Sensation
• Cognition and 
• Behavior

The discipline of psychopharmacology studies, identifies, and/or produces
Psychotropic medication

• Or medications that treat sleep disturbances and the symptoms of psychological disorders such as schizophrenia, depression, bipolar, anxiety disorders, and attention deficit-hyperactivity disorder (ADHD). (National Institute for Mental Health, 2013)

There are lots of different kinds of
Mental health professionals

• Or varied health care providers who offer services to help people's
• realization of their own abilities
• coping with typical and atypical stresses of life
• ability to work productively and fruitfully, and
• ability to contribute to her/his community
• Many different types of mental health professionals exist, including:

Counselors 

• Or people who have received specialized training in providing guidance with
• personal
• relational or 
• professional difficulties.
• Counselor is a non-specific term that is sometimes used to describe 
• psychologists
• psychiatrists
• social workers, as well as other
• mental health professionals
• who provide therapy.

Psychologists:

• Are individuals who 
• Have doctoral degrees (such as PhDs, PsyDs, or EdDs) in psychology from
• A school of professional psychology or an accredited university. 
• Psychologists generally

• Study and assess a wide variety of human behavior and psychological processes, and may also
• Diagnose and treat the behavior and psychological processes of individuals who are experiencing distress.
• Psychologists 
• Often facilitate psychotherapy
• Can perform psychological assessments
• May conduct research
• May provide consultation and/or outreach, and/or
• May teach psychology.

• Unless they have additional training and licensing, psychologists generally do not prescribe medication.

Psychiatrists:

• Are individuals who
• Have medical degrees (such as M.D.s or D.O.s), and have completed
• Post-doctoral training in the assessment and treatment of psychological distress
• Psychiatrists also evaluate individuals to determine if their symptoms are 
• Physiological
• Psychological 
• Or some combination of the two.
• Most psychiatrists 
• Prescribe medicine, and 
• May also provide psychotherapy. 

Psychiatric nurse practitioners

• Are registered nurses who 
• Have received specialized training in mental health and can 
• Diagnose psychological distress, 
• Prescribe medication, and 
• Provide therapy to clients.

Social workers

• Are mental health professionals who follow one of two main paths
• The first is that of direct-service, wherein social workers help people solve and cope with problems in their everyday lives.
• The second path is that of clinical work, wherein social workers diagnose and treat mental, behavioral, and emotional issues. 
• Clinical social workers perform many of the same functions as psychologists; however, they cannot administer or interpret assessment measures.

School counselors

• Are certified and/or licensed mental health professionals who 
• Have a master’s degree or higher in school counseling, or a substantial equivalent. 
• School counselors most often support students in 
• Academic achievement, 
• Personal and social development, and 
• Career planning.

School psychologists

• Are psychologists who help children and adolescents succeed academically, socially, behaviorally, and emotionally.
• Specifically, school psychologists
• Support students' social, emotional, and behavioral health through
• Counseling, instruction, and mentoring
• Increase students' academic achievement by 
• Assessing barriers to learning, which may include formal psychoeducational assessment, and
• Determining the best instructional strategies to improve learning
• Collaborate with multidisciplinary teams to evaluate students' eligibility for special education services (National Association of School Psychologists, 2013). 

Neuropsychologists

• Are psychologists who  
• Study the structure and function of the human brain as it relates to 
• psychological functioning and
• behavior. 
• Neuropsychologists may work in 
• Clinical and/or
• Research/experimental settings.

Forensic psychologists 

• Are psychologists who 
  
• Work with the intersection of the law and 
• Human cognition, affect, and behavior.
• Forensic psychologists 
• May provide expert testimony in court cases
• May consult with law enforcement
• May perform forensic psychological assessments, and
• May provide clinical services to individuals in correctional facilities

Industrial/Organizational psychologists

• Are psychologists who 
  
• Study various aspects of the human work environment, such as 
• Communication among employees
• Socialization or enculturation of workers
• Leadership
• Job satisfaction
• Stress and burnout, and 
• Overall quality of life. (Gerrig, R.J.,. & Zimbardo, P.G. 2002. Psychology And Life, 16th edition. Boston, MA: Allyn and Bacon).

All of the above mental health professionals, as well as professionals in some other disciplines must abide by a
Professional ethics code

• Or principles designed to address moral issues that may arise within a particular profession
• Based upon the specifics of the particular mental health profession, the specifics of its ethics code will vary.

In the case of psychology in the United States, psychologists and psychology trainees abide by the
American Psychological Association's (APA) Ethics Code

• Which is characterized by 5 main principles:
• Beneficence and nonmaleficence
• e.g., benefiting and not doing harm to those you work with
• Fidelity and responsibility
• Integrity
• Justice
• Respect for people's rights and dignity.
• Numerous specific ethical standards are guided by these principles, including standards about
• Resolving ethical dilemmas
• Professional competence
• Relationships
• Privacy and confidentiality
• Advertising
• Record keeping and fees
• Education and training
• Research and publication
• Psychological assessment
• Psychotherapy
• If interested in learning more, you can find the whole code here.

Finally, some schools of psychology have their own ethics code that supplements a code such as APA's. For example, the
Feminist ethics code

• Is informed by
• Cultural diversity and oppression
• Power differentials within psychological work
• Overlapping relationships
• Therapist accountability
• Social change
• Specific ethical standards arise from these issues and concerns. 
• If interested in learning more, you can find the whole code here. 

And now, pop culture! For real, this time--I promise. :)

*Dr. Alison's note: I had a REALLY hard time finding images representing the mental health profession that were not exclusively white, able-bodied, heterosexist, and psychoanalytically biased. I think this definitely speaks to how we culturally conceptualize mental health, as well as who has held power in this profession in both historical and recent times.