Counseling for Wellness and Prevention

Helping People Become Empowered in Systems and Settings

Robert K. Conyne

• Publisher: Routledge
• Year: 2015
• Print ISBN: 9780415743143
• eBook ISBN: 9781317802723
• Topic: Psychology
• Subtopic: Mental Health in Psychology
• Index: Psychology

Counseling for Wellness and Prevention brings Preventative Counseling, one of prevention's founding texts, firmly into the twenty-first century. Counseling for Wellness and Prevention thoroughly updates and significantly expands on discussions of practical applications and emerging best practices. Counselors and counseling psychologists will find evidence-based, contemporary guidance to help them engage in needed efforts to help clients and the general population to enhance their overall wellness and ward off future dysfunction. Author Robert Conyne demonstrates the ways in which the traditional model of one-to-one therapy can be expanded to embrace wellness and prevention as well as strategies for putting into practice a broad range of environmental and system change strategies, such as advocacy and community organization. The book is well-suited for adoption in counselor-education courses and includes explicit connections to CACREP accreditation standards. It's also an excellent choice for programs in psychology, where the APA-approved prevention guidelines for psychologists are now available, and in social work, where prevention and community change have long been hallmarks.

Section II Wellness and Prevention Applications

You read in section I about the foundations of wellness and prevention in counseling. Theory, methods, strategies, and models all were considered, as well as building wellness and prevention into daily living. Now we move to wellness and prevention applications that counselors and other professional helpers can apply in their work with clients and client systems.

Wellness and Prevention Approaches, Programs, and Initiatives

These approaches, programs, and initiatives are framed by the ecological perspective that we discussed in earlier chapters. Chapters 5–8 describe applications connected to each ecological level, as follows:

Individual and Group: Approaches to be taken (chapter 5)

Relational I: Settings of Families and Schools: Programs (chapter 6)

Relational II: Settings of Communities and Workplaces: Programs (chapter 7)

Collective: Systems: Societal initiatives, such as political, legislative, and health care (chapter 8)

To assist readers in comparing programs contained in chapters 6 (families and schools) and 7 (communities and the workplace), a common descriptive framework is applied to each program. We answer, What is it? How is it done? What works? Why does it work?, and provide implications for counselors and other helpers.

Note to Faculty Instructors: When assigning readings, you may find it useful to split chapters 6 (families, schools) and 7 (communities, the workplace).

It is helpful conceptually to set wellness and prevention programs and initiatives within ecological levels. However, it’s also important to realize the important maxim that in practice effective wellness and prevention interventions typically are not constrained within any one ecological level. Rather, wellness and prevention approaches, programs, and initiatives that work cut across levels, combining and coordinating multiple strategies. A good example can be found with the FAST (Families and Schools Together) program described in chapter 7, which I identified as a community program. Well, it is. But it also could just as well be classified as a school program or as a family program. It cuts across these levels, which is one of the reasons that it can produce positive results in children and adolescents.

Note that wellness and prevention applications at the individual and group counseling levels typically do not involve structured programs. Rather, wellness and prevention approaches are embedded within ongoing work and take advantage of emerging dynamics. A counselor may assist her client to carefully implement a new exercise routine or to strengthen her social connection by volunteering at the Girls Club. Or, a group leader may help members plan how they will apply constructive feedback skills learned in the group to situations they could very well face in the future.

Program Selection Criteria Used in This Book

Programs are salient for settings, including families, schools, communities, and workplaces. Remarkable progress has been realized over the last 20 years in the number of effective programs that are now available (Romano, 2015). The difficulty in identifying examples for inclusion in this section was not due to a shortage of such interventions; the challenge was to cull just 12 of them from all the other worthy contenders. Establishing program selection criteria helped with this task. These criteria are presented next, which are similar to those contained in the National Registry of Effective Programs and Practices (NREPP, n.d.) document “Questions to Ask as You Explore the Possible Use of an Intervention.” Keep in mind that these criteria also could serve as a checklist for others to use themselves when they need to identify good wellness and prevention programs.

Program Selection Criteria Checklist Use in This Book

• Clear prevention wellness and prevention goals and orientations
• Easy to find
• Actively in use
• Evidence base demonstrating effectiveness
• Acceptable study designs used
• Intervention well described
  • –What settings? What populations?
  • –What are its core dimensions?
• Intervention materials available
• Staffing requirements
• Training and support available
• Widespread implementation
• Dissemination results available
• Program costs reported
• Positive external evaluations, drawn online accessible registries
• Were included in previous book edition and kept and updated if met most criteria, above, were met

Systems initiatives also can strongly influence wellness and prevention. This is especially the case in the area of public policy and legislation (Pirog & Good, 2013). Counselors and other professional helpers and researchers have contributed to the development of important initiatives in the areas of health care and education. In turn, policies and legislation in these areas, such as the National Prevention Strategy and the Healthy People directives, can serve as touchstone resources for guiding practitioner actions.

Online Resource Directories Containing Effective Wellness and Prevention Programs

Certainly, counselor researchers, practitioners, faculty members, and students all can benefit by being informed about effective wellness and prevention programs that already exist. A number of searchable online resource directories have emerged over the last few years that identify effective wellness and prevention programs. Programs and initiatives contained in these directories have been designated as excellent, promising, and/or as model programs. I will discuss two examples of directories, involving the Substance Abuse and Mental Health Administration’s (SAMHSA) NREPP and the Center for the Study and Prevention of Violence Blueprints for Healthy Youth Development.

The SAMHSA produces a list of prevention programs, with brief descriptions and follow-up information. SAMHSA uses the NREPP to identify programs that first rest upon a science base, meaning that they are deemed to be conceptually sound and internally consistent, with program activities that are related to program conceptualization and that are reasonably well implemented and evaluated. Upon that platform, then, prevention programs are judged as being “promising” programs if they produce some positive outcomes, as being “excellent” programs if they consistently produce positive outcomes and are strongly implemented and evaluated, and as being “model” programs if they also are available for dissemination and if technical assistance is available from the program developers.

The Center for the Study and Prevention of Violence Blueprints for Healthy Youth Development Web site at the University of Colorado (2012–2014) also contains extensive information related to the evaluation of prevention programs. Evaluation criteria used in the Blueprints project include (a) evidence of deterrent effect within a strong research design; (b) evidence of sustained effects that endure beyond the length of the prevention program of at least 1 year; (c) multiple site replication, demonstrating that the prevention program can be replicated effectively; and (d) evidence of attention to important mediating effects (e.g., risk and protective factors) and if the program is cost effective in relation to benefits. These are stringent criteria.

A set of useful online search registries that can point the way to effective wellness and prevention programs and initiatives is contained in the next box.

Some Useful Online Search Registries

• NREPP-SAMHSA’s National Registry of Evidence-based Programs and Practices (http://www.nrepp.samhsa.gov/)
• Blueprints for Healthy Youth Development (http://www.blueprintsprograms.com/about.php)
• What Works Clearinghouse (http://www.ies.ed.gov/ncee/wwc/)
• Child Trends (http://childtrends.org/)
• Social Programs That Work (sponsored by the Coalition for Evidence-Based Policy) (http://evidencebasedprograms.org/about-this-site)
• Promising Practices Network (http://www.promisingpractices.net/)
• National Institute of Justice, Crime Solutions (http://www.crimesolutions.gov/about.aspx)
• EpisCenter (through Penn State; http://www.episcenter.psu.edu/ebp)

Fit of Online Registries Within Planning of Wellness and Prevention Projects

Uncovering excellent wellness and prevention program examples can be very helpful in the planning stage of the wellness and prevention program development process, which also includes stages of implementation and evaluation (Conyne, 2010, 2013; Raczynski, Waldo, Schwartz, & Horne, 2013). While space does not allow for discussion of program development and evaluation, the planning steps excerpted in the following indicate where using the online search directories can fit. Please refer to the references cited for more detail on the entire program development and evaluation process.

Plan the Program (from Conyne, 2013)

1. Lay the groundwork for community, collaboration, and cultural relevance
2. Analyze local context and conduct professional literature review
3. Create problem statement
4. Develop preventive goals, objectives, strategies, and evaluation
5. Obtain inputs and resources (Note: Online registries fit here)

Now, let’s move on to the chapters of section II, beginning with wellness and prevention within both individual counseling and group work.

References

Conyne, R. (2010). Prevention program development and evaluation: An incidence reduction, culturally-relevant approach. Thousand Oaks, CA: Sage.

Conyne, R. (2013). Program development and evaluation in prevention. Thousand Oaks, CA: Sage.

National Registry of Effective Programs and Practices. (n.d.). Questions to ask as you explore the possible use of an intervention. Retrieved from http://www.nrepp.samsha.gov/pdfs/questions_to_ask_developers.pdf

Pirog, M., & Good, E. (2013). Public policy and mental health: Avenues for prevention. Thousand Oaks, CA: Sage.

Raczynski, K., Waldo, M., Schwartz, J., & Horne, A. (2013). Evidence-based prevention. Thousand Oaks, CA: Sage.

Romano, J. (2015). Prevention psychology: Enhancing personal and social well-being. Washington, DC: American Psychological Association.

University of Colorado. (2012–2014). Blueprints for healthy youth development. Retrieved from http://www.blueprintsprograms.com/

5 Personal Wellness

Individual Counseling and Group Work

You must be the change you want to see in the world.

—Mahatma Gandhi, Indian political and spiritual leader (1869–1948)

Introduction

This chapter begins the second book section that examines wellness and prevention applications. It is framed around the pragmatic question: How is counseling for wellness and prevention done?

We will start with individual counseling and group work because most wellness and prevention work conducted by counselors and other mental health professionals revolves around these methods. These approaches reside within the personal wellness level of the counseling for wellness and prevention model discussed at the end of the preceding chapter.

Individual counseling and group work are the essential, “bread-and-butter” methods of the helping professions, although involvement with settings and systems certainly is waxing. Gandhi’s quotation, above, is salient. Wellness and prevention counseling efforts, as any others oriented toward change or progress, can be delivered best by “change agents” who are whole and healthy themselves. Helping others starts first with helping ourselves.

Wellness and Prevention Through Individual Counseling

How can individual counseling and group work be structured to support wellness and prevention? We will consider this question in this chapter segment (see Figure 5.1).

Figure 5.1. Individual counseling session. Counseling for wellness and prevention occurs within individual counseling.

Source: iStock photo

Prevention in mental health has followed the public health tradition. It emphasizes a before-the-fact community and system change approach, while also embracing competency enhancement. Wellness in mental health emphasizes a personal responsibility approach, where individuals are encouraged within the supports and constraints of their life context to seek optimal health through establishing and maintaining positive health practices. Most attention in prevention has been given to communities and systems, while wellness has focused most on individual persons. Wellness and Prevention together, the focus of this book, combine the strengths of each approach to seek optimal health in people, and in settings, and in systems through personal and environmental changes. The aim is to enhance both personal and environmental competence (Conyne & Rogers, 1977; Steele, 1973).

Wellness and prevention counseling with individual clients and with group members, therefore, utilizes personal and environmental strengths to help clients resolve existing problems that they bring to sessions and learn how to apply learning that is gained to prevent future flare-ups. The fulcrum for change pivots explicitly around helping clients move toward optimal health to enhance current functioning and to avert impending onslaughts, not only with the reparation of problems and dysfunction (Conyne, 2014a).

During counseling and group work clients can learn to identify and develop assets that work for them, such as possessing a sense of fairness or an interest in others. They also can learn how to take positive advantage of aspects of their environment that support their healthy functioning, or to alter what constrains or reduces it.

Outside of counseling, individuals can and should take actions to protect and promote their own bio-psycho-social health. You will recall that the focus of chapter 2 was devoted to this matter, showing how evidence-based everyday wellness and prevention practices—exercising or eating nutritiously, for example—can be adopted by people to move themselves forward. Individuals also can learn how to mobilize their focus, when appropriate, to seek change in their environment to benefit themselves and others. As an example, they can learn stress management techniques, such as relaxation, to combat a corrosive stressor, such as an over-demanding work situation. However, they might also learn how to take actions to change stressors in the work situation itself, such as negotiating with one’s supervisor and colleagues a way to re-distribute some work assignments. Importantly, these same approaches can be used by counselors with clients inside the counseling relationship, too.

A General Process for Wellness and Prevention Approaches in Individual Counseling

Individual counseling with a wellness and prevention focus follows the...

Table of contents

• Cover
• Title
• Copyright
• Dedication
• Contents
• List of figures and tables
• Preface
• Acknowledgements
• Section I Foundations of Wellness and Prevention
• Section II Wellness and Prevention Applications
• Index