Critical Evaluation of Counseling Service - Term Paper Example

Running head: CRITICAL EVALUATION OF COUNSELING SERVICE Critical Evaluation of Counseling Service Insert Insert Insert Name 25 December 2011 Critical Evaluation of Counseling Service Introduction Counseling services for individual, couple and family members remain the core activities at Community Counseling Center of Central Florida (Community Counseling Center of Central Florida, 2011). The community counseling forum functions largely based on the established mission which is to provide its clients services that are premium in terms of quality. The center specializes in providing community-based mental health and related services to both children and adults in the Central Florida community. The profession of Counseling has become critical to the diverse aspects in the society, and as this becomes real, there is growing emphasis on the need for professional accountability and credibility (Phillips and University of Wisconsin, 2007). Counselors’ in diverse areas of specialization are increasingly put under pressure to produce evidence of the effectiveness of the particular services they provide which has become the hallmark of professional approach (Donabedian, 2005). Stakeholder needs, decreasing resources and the need for efficiency have all combined to put pressure on practitioners to undertake thorough audit and elaborate evaluation of services they provide to different clients (American Heart Association, 2000). Feedback generated from such evaluation become critical in provide valuable information for decision-making, service improvement, and action planning (Phillips and University of Wisconsin, 2007). Quality therefore has gradually become the benchmark upon which success or failure of services and programs are rated (American Nurses Association, 2007). Evaluating quality therefore constitute core activities that professionals in the field take part in (Ovretveit and Gustafson, 2002). Donabedian, in his prominent scholarly works observes that quality of any given care can be evaluated from three perspectives (Heinemann et al., 1996). The three perspectives are: structures, process, and outcome (Heinemann et al., 1996). Structure incorporates all aspects and attributes related to setting, process on the other hand has to do with what and how things are performed in regard to the counseling service, while outcomes constitutes the output resulting into client satisfaction from the service (Heinemann et al., 1996).This has become the best known framework in which counseling services can be evaluated. Structure According to Donabedian, structure is defined as, “the relatively stable characteristics of the providers of care, of the tools and resources they have at their disposal and the physical and organizational settings in which they work” (cited in Phillips and University of Wisconsin, 2007, p.7). According to this definition, structure can mean physical, human and financial resources that are available to ensure the counseling service is carried out (Zinn and Mor, 1997). The available resources may include; location where the service facility is situated, parking facilities available, accessibility and support equipment, staff, and many more. Structure provides for evaluation of the service in terms of how well the performance of the counseling service can be carried out and be able to satisfy the clients’ needs (Zinn and Mor, 1997). In carrying out the interview, members of the group had to travel to the organization’s services central office located at Altamonte Springs office. The office is centrally located in a serene environment with roads leading to the office less congested. At the same time, the office location has ample and relatively enough parking space for clients who come in driving. The interview was conducted in the main counseling room which also serves as the main area where related counseling sessions are held. Looking around the room, it was observed that, it occupies a relatively large space with partitioned help desks but in one open room. On each help desk there is a representative who the client conduct first before a therapist can be invited. Enough chairs have been put in the room and the organization’s mission clearly in writing is placed on the walls in the room. On another section of the wall, there is an outline of different services the organization provides to its clients. Air in the room is fresh and on overall, cleanliness and maintenance of the room is of the highest quality. There are about twenty-one paid therapists and numerous others serving as volunteers, interns and trainee graduates. The paid therapists have advanced training in counseling in the various areas of their expertise and specialization. For instance, the highest level of manpower qualification is PHD qualification. Interns on the other hand are advanced students undertaking training in counseling and this is part of their course project work. Also, trainees are fresh graduates who the organization aims to equip with necessary skills and experience in counseling before they can be allowed to practice therapy on clients. Volunteers, trainees and interns operate under supervision of senior therapists in the organization under the leadership of director. Productive interaction and enriching cooperative experience is what is emphasized throughout as training interaction in the organization is concerned. Service provided by the organization largely aims to help those in distress, anxious, traumatized, and experiencing marital problems. The services are largely conducted based on one-to-one basis but in some cases, group sessions, institutions and home-based sessions are encouraged. Therapist operate and interact with clients on face-to-face, or by using telephone, and also through emails and this largely depends on the appropriateness of the means in providing client and therapist convenience. Process According to Donabedian, process includes, “the client’s activities in seeking care and carrying it out as well as the profession’s activities in making diagnosis and recommending or implementing treatment (Phillips and University of Wisconsin, 2007, p.7). Process of the services at Community Counseling Center of Central Florida (CCCCF) can be captured in the organization’s mission. The organization conducts its activities with broad aims of; providing quality services to the diverse clients of the organization. At the same time, the organization aims to provide adequate and appropriate community-based mental health and related services to adults and children largely in the Central Florida community. Moreover, given that the organization serves a large constituent of people, its aims centers on providing effective and long-lasting solutions to its clients as reflected in quality-effective services. In order to achieve these broad goals as envisioned in the organization’s mission, there are different customized counseling services the organization specializes in. The counseling services are tailor-made to address the needs of children, adolescents, young adults, family members, couples, and many more. Each case as it pertains to the particular client is received, assessed and subsequently dealt in accordance to the organization policy and the client’s needs. The therapists have specialized in their unique areas and this makes it possible to deal with the unique individualized cases. Given the relative weight of each case, therapists are assigned to attend to clients differently but in most cases it may involve; on weekly basis, once every two weeks, one in a month, or longer period if the case is sensitive and critical. Accordingly, the sessions therapists’ take on each client vary but in notable cases, time spent on each client has lasted 1 hour, 2 hours, 4 hours, and even more. Counseling sessions normally take place in the central office of the organization but in other arranged cases between the therapist and client, counseling sessions can be carried out through telephone, emails, at homes, in schools, visitation centers, place of employment, and many more. Also, at CCCCF, therapists are assigned duties or responsibilities based on clients’ appointments. To ensure justice is done, there is an effective appointment procedure system which is based on first-come, first-served but some level of flexibility is maintained. Records of clients’ visitation are effectively maintained and every detail is scribbled with appropriate reaction. Communication is highly encouraged between client and the therapist where effective and appropriate communication is fostered between the client and the therapist. To achieve this, the organization conducts frequent training of its staff on effective communication with clients. Moreover, therapists and related staff are required to select and agree on the most appropriate language to use for communication. Thereafter, therapists should foster effective intra- and interpersonal communication throughout the whole process of counseling. Feedback should be part of the communication process that should be emphasized and nurtured (Vacc, DeVaney and Brendel, 2003). Confidentiality of client information is highly emphasized and the therapists should always consult the client before undertaking any action or intervention. Moreover, ensuring time management and realizing targets as far as client counseling of the client should be the basis of professionalism in the organization. Outcome On the other hand, Donabedian defines outcome as, “a change in the client’s current and future health status that can be attributed to antecedent counseling service” (Phillips and University of Wisconsin, 2007, p.7). Outcomes of the Community Counseling Center of Central Florida’s services can be evidenced in the number of successful, or changes of output realized in the various programs. First, the success of the counseling services provided by the organization could be reflected in the number of increasing funding opportunities for the organization. For instance, the organization as per now boosts about nine different funding opportunities. At the same time, the success of the organization’s services can be evidenced from the fact that, the organization continue to hire more staff to attend to increasing number of clients in the organization. For instance, in 2007, the organization hired eight additional staff members in order to be able to serve more efficiently the core programs the organization has. Moreover, due to increase in the number of clients, the organization has been forced to increase and expand the size of the office space in order to accommodate the growth of clients (Community Counseling Center of Central Florida, 2007). More outcomes of the quality of services provided by the organization can be evidenced in the regional expansion of the organization’s services. For instance, the organization at the moment serves clients in regions such as Orange, Osceola and Seminole Counties, and further attempts have been made to serve clients in Volusia County. Success of outcomes can further be evidenced in the prudence resource allocation and revenue generated. At the moment, CCCCF remains fiscally strong and operate with minimal debts. This has ensured the organization continue to innovate, implement, and expand on new services. Also this ensures the organization hires the right staff to address the diverse client needs. Apart from financial strength, the organization has established diverse partnerships that aim to give the organization wide coverage in the areas it operates. Satisfaction among clients seems to be increasing and this can be evidenced from the numerous programs available in the organization and the expansion programs in place. Lastly, the quality of the services of the organization can be evidenced in the number of awards the organization continues to receive. For instance, in 2011, the organization for the second time was awarded the CARF Three-Year Accreditation for its numerous services (Community Counseling Center of Central Florida, 2011). Conclusion As a counseling therapist, the counseling environment I have to function in is dynamic and complex given the clients diverse cultural, social, political, and economic differences. This in turn may influence the counselor’s attitude, beliefs, and perception which subsequently lead to bias or stereotyping on the part of the counselor. But to operate successful in culturally diverse environment, I have been forced to increase my knowledge in matters of cultural awareness. For instance, I continuously participate in education programs that impact and inculturate specific knowledge and information concerning different groups of clients. The knowledge gained enables me to develop a clear awareness of clients’ life experiences, cultural heritage, and historical background in positive ways. At the same time, as a counselor working with diverse cultural population, I have constantly familiarized myself with relevant research work and latest findings in the field specifically that concerns mental health and how different ethnic groups are affected. In this way, I have been able to seek and increase my educational experiences which has enriching capacity and power in terms of; knowledge, understanding, cross-cultural skills, and effective counseling behavior. Moreover, as a counselor working in culturally diverse population, I have remained steadfast in innovating and implementing different methods of approach to providing help to the clients. This has been possible through undertaking thorough assessment of the client’s needs and problems, then developing different approaches to solving the identified problems. This requires the client to remain flexible with ability to change or modify the approach whenever possible in order to achieve desired goals. Assessment and change are two aspects that remain core in developing quality and appropriate counseling services. As a counselor, I have constantly discovered that, assessment instruments for the various services of counseling are likely to be biased, hence in undertaking any form of assessment; I regularly use procedures and interpret findings keeping in mind the cultural differences of the diverse clients. This in essence requires one to express maximum and non-bias respect to client’s ethnicity, religion, beliefs and values, and also norms. Therefore, succeeding in culturally diverse environment has emanated largely from remaining culturally sensitive to clients, increasing knowledge and education experiences concerning counseling services, and developing multiple approaches in addressing clients needs. References American Heart Association. (2000). Measuring and improving quality of care: Quality of care and outcomes research in CVD and Stroke working groups. AHA/ACC Conference Proceedings. Retrieved December 27, 2011, from http://circ.ahajournals.org/content/101/12/1483.full. American Nurses Association. (2007). The National Database of Nursing Quality Indicators (NDNQI). The Online Journal of Issues in Nursing, Vol. 12, No. 3. Retrieved December 27, 2011, from http://nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Volume122007/No3Sept07/NursingQualityIndicators.aspx. Community Counseling Center of Central Florida. (2007). 2007 Annual Report. Retrieved December 27, 2011, from http://www.ccccf.org/forms/oct08/2007-annual-report.pdf. Community Counseling Center of Central Florida. (2011). CCCCF Services. Retrieved December 27, 2011, from http://www.ccccf.org/. Donabedian, A. (2005). Evaluating the quality of medical care. The Milbank Quarterly, Vol. 83, No. 4, pp. 691-729. Retrieved December 27, 2011, from http://www.milbank.org/quarterly/830416donabedian.pdf. Heinemann, D., Lengacher, C. A., VanCott, M. L., Mabe, P., & Swymer, S. (1996). Partners in patient care: Measuring the effects on patient satisfaction and other quality indicators. Retrieved December 27, 2011, from http://findarticles.com/p/articles/mi_m0FSW/is_n5_v14/ai_n18607068/. Ovretveit, J., & Gustafson, D. (2002). Evaluation of quality improvement programmes. Qual Saf Health Care, Vol. 11, pp. 270-275. Retrieved December 27, 2011, from http://qualitysafety.bmj.com/content/11/3/270.full.pdf. Phillips and University of Wisconsin. (2007). Social influence in the physician-patient relationship: Physician credibility as a predictor of cancer patient treatment adherence. ProQuest. Retrieved December 27, 2011, from http://books.google.com/books?id=ViJPTrP9Vm4C&pg=PA105&dq=evaluating+the+quality+of+counselling+services+%28Donabedian+1988+model%29&hl=en&sa=X&ei=_9n5TsHFE8qJhQeQ0vDSAQ&ved=0CDAQ6AEwADgK#v=onepage&q=evaluating%20the%20quality%20of%20counselling%20services%20%28Donabedian%201988%20model%29&f=false. Vacc, N. A., DeVaney, S. B., & Brendel, J. M. (2003). Counseling multicultural and diverse populations: strategies for practitioners. USA: Psychology Press. Retrieved December 27, 2011, from http://books.google.com/books?id=Hz35SArmEQEC&pg=PA20&dq=communication+in+counseling+process&hl=en&sa=X&ei=J8P6TsbSOJCyhAftt9GTDA&ved=0CE4Q6AEwBA#v=onepage&q=communication%20in%20counseling%20process&f=false. Zinn, J. S., & Mor, V. (1997). Organizational structure and the delivery of primary care to older Americans. Health Services Research. Retrieved December 27, 2011, from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1070356/pdf/hsresearch00026-0075.pdf. Read More