This study examines counseling professionals’ knowledge concerning the Medicare program and related advocacy efforts. American Counseling Association members (N = 5,097) answered a series of true-false questions that were intended to measure proficiency in two areas: Medicare policy and the counseling profession’s advocacy for provider eligibility. Statistical analyses indicated that members have a wide range of Medicare knowledge. A significant difference in advocacy history knowledge was found when comparing counselor educators, practicing counselors, doctoral students, and master’s students. However, no differences in policy knowledge were present among these groups. Implications for the counseling profession and counselor training are discussed.
Suicide in later life is a pressing public health concern, which has likely been exacerbated by the COVID-19 pandemic. Many older adults who need mental health treatment do not have access to necessary services and training for mental health providers to support older adults experiencing suicidality is limited. One solution is developing interventions based in a public health approach to suicide prevention, whereby natural helpers who provide community services are mobilised to respond to older persons-at-risk. Home-delivered meal (HDM) services, for example, are one effective means to reach older adults who are isolated due to being homebound and may be instrumental in preventing suicide. This study examined the experiences of 20 HDM volunteers who received Applied Suicide Intervention Skills Training (ASIST), an evidence-based suicide intervention programme. Phenomenological analysis yielded findings centred on three areas demonstrating the impact of the ASIST training on HDM volunteers: putting asist skills into practice; response to ASIST skills; and role transformation. Implications for integrating suicide prevention efforts with HDM services and directions for future research are discussed.
Late-life suicide is a complex public health issue, and older adults have a higher risk threshold than the national average (Drapeau & McIntosh, 2020). Most late-life suicide research focuses on elevated risk of older white males, and less is known about risk factors among Black older adults (Joe et al., 2014). Although fewer Black older adults die by suicide than White older adults, forms of suicidality do not differ between Black and White older adults (Cohen et al., 2008). Suicide risk factors, such as psychological distress (Watkins & Johnson, 2018) and chronic pain (Bazargan et al., 2016), are prevalent among Black older adults. According to the Interpersonal Theory of Suicide (IPTS; Van Orden et al., 2016), thwarted belongingness and perceived burdensomeness inform the development of suicidal desire. These findings have been corroborated among older adult samples, though lacking racial diversity. To better understand how the IPTS functions for older adults, and probe whether suicide risk pathways operate differently depending on race, we used data from over 400 homebound older adults residing in a U.S. metropolitan area to clarify if this suicide risk pathway is similar for Black and White older adults. Race moderated the relationship between physical and psychological pain and thwarted belongingness and perceived burdensomeness, with pain among Black older adults having a greater impact on their sense of belonging and burdensomeness. Findings illuminate the need for culturally nuanced understandings of suicidality in older adulthood. The presenters will demonstrate these results and discuss implications for cross-cultural suicide prevention frameworks.
Older adults are reported to die by suicide at higher rates than the general population. Suicide desire among older adults is associated with pain, and pain experiences have been found to differ based on race. To investigate the relationship between pain and suicidal desire, 437 racially diverse older adults who receive home-based services (home-delivered meals) in the Southeastern region of the United States completed standardized measures of psychological pain, chronic physical pain, and suicidal desire. Results identified race moderated the relationship between pain and suicidal desire, indicating a stronger relationship between pain and suicidal desire among Black older adults than White older adults. Chronic physical pain (i.e., emotional burden) interacted with race to predict Perceived Burdensomeness ( p = .011) and Thwarted Belongingness ( p = .032). Greater attention to pain experiences among Black older adults is warranted, considering the impact of COVID-19 on racial/ethnic minorities’ mental health.
Although advocacy is a priority for counseling professionals, little is known about counseling advocates' participation in the legislative advocacy process. Recent legislation to address the opioid crisis allowed counseling advocates to provide public comments to advance counselor inclusion in the Medicare program. A thematic analysis of 548 public comments provided on behalf of the counseling profession yielded four categories: advocacy on behalf of (1) the proposed rule change; (2) broader Medicare inclusion; (3) the proposed rule change with an additional request for broader Medicare reimbursement; and (4) no clear advocacy. Subthemes included increasing access to care, qualifications necessary to provide care, and the urgency of the opioid epidemic, among others. Implications for the counseling profession and counselor advocacy are discussed.
A long-standing challenge in counseling practice is the application of multicultural and social justice competencies through traditional counseling paradigms, many of which uphold systems of oppression. Although contemporary standards for the profession emphasize the need for greater attention to systemic influences on clients’ lives, enacting frameworks such as the Multicultural and Social Justice Counseling Competencies (MSJCC) proposed by Ratts et al. without a complementary theoretical framework can be challenging for mental health counselors. Relational-cultural theory (RCT) offers such a framework to support counselors’ efforts to serve marginalized clients, as well as understand their own oppressed identities in the counseling room. Following an overview of RCT, the authors describe practical guidelines for enacting the MSJCC through RCT in clinical practice. A case study is provided to illustrate a workable application for mental health counselors.
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Sexual orientation is often invisible in counseling research despite increasing LGBQ+ identity in the United States. We used consensual qualitative research to explore considerations from LGBQ+ counseling researchers for collecting sexual orientation. Three domains emerged: risks, benefits, and methodological considerations. Our findings highlight inclusive research practice strategies for LGBQ+ research participants.
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