A normal day for a professional counselor too often entails focusing on remedial concerns. So many clients suffer from the aftermath of trauma and violence, while severe mental health concerns such as anxiety, co-occurring disorders and chemical dependency — among other mental health disorders — also necessitate in-depth therapeutic treatment. That reality raises a question. In today’s society, can professional counselors realistically do justice to promoting prevention while concurrently focusing on the priorities involved with clients’ pressing presenting concerns?

There is little debate that each day, professional counselors do their best to help thousands of individuals deal effectively with a myriad of life challenges. Counselors earn their character stripes in the trenches of a normal workday by deterring suicides, stabilizing and improving tenuous relationships, healing deep and traumatic emotional wounds and advocating for the respectful treatment of all individuals in an ever-changing and diverse world. Through the use of effective interventions, successes are regularly achieved, but rarely is it allowable to celebrate these successes with a drumroll. In the confidential confines of schools, mental health agencies and communities throughout our country and beyond, counseling efforts too often go unnoticed.

The counseling profession has come a long way since its beginnings. We are now a proud profession characterized by a code of ethics, accreditation guidelines, competency standards, licensure, certification and a commitment to excellence. Although the term counseling can be difficult to define, our mission, which is well articulated by the American Counseling Association, is generally accepted to be “The application of mental health, psychological or human development principles through cognitive, affective, behavioral or systemic intervention strategies that address wellness, personal growth or career development, as well as pathology.”(In March 2010 at the ACA Annual Conference in Pittsburgh, delegates to the 20/20: A Vision for the Future of Counseling initiative reached a consensus definition of counseling: “Counseling is a professional relationship that empowers diverse individuals, families and groups to accomplish mental health, wellness, education and career goals.” Twenty-nine major counseling organizations have since endorsed the definition.)

Nearly every counselor wants to ensure that this mission — retaining our unique identity as leaders in prevention, advocacy and empowerment — is not just rhetoric but reality. However, the challenge is that the National Institute of Mental Health reports that one in four adults — approximately 60 million Americans — experiences a mental health disorder in a given year. Crises in our homes, schools and communities, as well as global hardships, seemingly produce so much individual and collective suffering that counselors struggle to intervene effectively. Could the level of individual and collective suffering in our homes, schools and communities leave counselors struggling to retain our identity as leaders in prevention, advocacy, wellness and empowerment? Most of us are so overwhelmed that primary prevention and empowerment becomes de-emphasized as we focus on the most serious of mental health problems.

Prevention and the promotion of wellness have always presented enticing reasons for counselors to enter the profession. Even before positive psychology was in vogue, counselors advocated for increased efforts to promote physical, intellectual, social, psychological, emotional and environmental well-being. As each new edition of the Diagnostic and Statistical Manual of Mental Disorders grows thicker, vast numbers of individuals still need help ensuring healthy relationships, selecting meaningful careers and making healthy choices throughout the life span as they seek a sense of sustained joy and deep meaning in life.

The good news is that an emphasis on strengths-based interventions, self-efficacy, social support, self-help groups and incorporating community mental health models can minimize environmental pressures and promote the prevention of psychological difficulties.

Unfortunately, numerous funding sources appear to be in serious jeopardy due to economics, reimbursements and politics. Despite the impressive efforts of professional counselors during the past 30 years, there is clear evidence that overall mental health in our country is deteriorating.

How would our society be different if there were an emphasis on the following?

  • Social and emotional learning for our children, including character education
  • Diversity training that focuses on respect for individuals living in a culturally diverse society
  • Healthy relationship skills and effective sex education for our youth
  • Career development for those who lack awareness of their interests, values and aptitudes
  • Wellness promotion to combat unhealthy choices and the epidemic increase in obesity
  • The incorporation of drug and alcohol prevention efforts in all of our schools
  • Service projects for those who wish to advocate for individuals living in unhealthy environments
  • Premarital counseling for those seeking enriched, lifelong marriages
  • Parent education for those yearning to promote the healthy growth and development of their children

On a personal note, my (Mark’s) interest in prevention was cultivated early on by wonderful professors and supervisors, as well as through lessons learned from my clients. For instance, in the case of couples counseling, it soon became evident that most couples did not seek counseling until divorce was imminent. Generally, they would present a long list of grievances about their spouse, suggesting problem saturation. I would then begin the almost overwhelming task of helping them focus on learning from past mistakes, while simultaneously trying to foster some hope for the future of their marriage.

Although couples often felt quite defeated and desperate at the beginning of counseling, I found that I could often be helpful to them through sheer perseverance and by always focusing on their best interests. After one particularly challenging session, however, it occurred to me that I might be able to develop a more proactive method that would have the effect of creating a strong marital foundation in order to prevent the marital breakdown I was witnessing on a daily basis. I began envisioning a positive learning experience for couples that would give them information and tools to strengthen their marriage on an ongoing basis. That was 18 years ago, and in that time, 1,600 couples have participated in the Marital Preparation Program (pursuingthegoodlife.com).

Couples often seem hungry for information and skills to improve their relationships. Evaluations indicate that more than 90 percent of participants not only find the program to be meaningful, but that it also exceeds their expectations. The vast majority of couples participating in the Marital Preparation Program acknowledge actually enjoying the process. I believe this is an example of the strong, untapped demand for preventative efforts by individuals in our society and beyond.

Prevention and counseling should never be seen as mutually exclusive. That is, whenever a session includes a psychoeducational component with the objectives of helping a client improve coping strategies, change cognitive distortions, examine behavioral choices, explore career options or identify pathways to a more satisfying life, a component of prevention can be identified. Perhaps our ultimate goal is to continue reframing the counseling process as a wellness endeavor that can be utilized to some degree in each counselor-client interaction in hopes of providing a positive impact throughout the client’s life span.

This article serves as a respectful yet serious reminder to all professional counselors working in a variety of contexts to revisit with a renewed vigor our mission to focus on prevention. If we fail to do so, we are doomed to live with the consequences of remedial interventions that very often are too late to help relieve the significant emotional pain and suffering of many individuals.

The counseling profession has an opportunity to continue growing and to become a primary provider in the mental health arena. As a result, we will be successful in facilitating the health and well-being of individuals and creating more caring, respectful and altruistic communities that are responsive to reducing serious mental health problems through creative and effective efforts.

Mark J. Britzman is a tenured professor in the Department of Counseling and Human Resource Development at South Dakota State University. He is also a national trainer for the Josephson Institute of Ethics and the CHARACTER COUNTS! Initiative, a Glasser scholar, a clinical mental health counselor and a licensed psychologist. Contact him at Mark.Britzman@sdstate.edu.

Sela E. Nagelhout is a former registered nurse with several years of experience in critical care settings. She is a certified Within Our Reach instructor and is in private practice at Pursuing the Good Life Professional Counseling and Consultation Services.

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