Mental Health Counseling and Research:

Mental Health Counseling and Research: A Critical Analysis

In the nineteenth century research was frequently done which would be considered highly unethical today. General paresis (syphilis) was the cause of much mental illness in the nineteenth and early twentieth century's. Franz Nissl in 1896 became able to diagnose general paresis on the basis of histopathological evidence. In 1897 Richard von Krafft-Ebing injected fluid from the sores of known syphilitics into general paralytic patients. Because these patients had no reaction to the injections, he concluded that they already had syphilis (American Pharmaceutical Association, 2003).

Even in the twentieth century endangering or ignoring the consent of the patient was not uncommon. Egas Moniz, in developing cerebral angiograms, endangered and damaged patients. In 1927 he began injecting a 70% solution of strontium bromide into the carotid artery and at times injected too much, leaving patients with neurological problems. Moniz and Pedro Almeida had their sixth patient die a few hours after the procedure. They then switched to a 25% solution of sodium iodide injected directly through the carotid artery through an incision in the neck. In pinching off the artery, they sometimes had negative results, including temporary paralysis of half the body, epileptic convulsions, and severe pain during the procedure. Moniz also used Thorostrast, a radioactive substance. At the time it was suspected of being unsafe; and within 10 years Thorostrast granulomas (nodules of inflamed tissue) were found in the brains of patients, and its use was discontinued (Visser, et al., 2009).

Freeman recommended electroconvulsive shock rather than conventional anesthetic during lobotomies in state hospitals because an anesthesiologist was often not available. He also recommended ECT for difficult to handle patients because they could be brought to unconsciousness quickly and they usually did not remember their earlier resistance (Grbich, 2007). In 1938 Cerletti and Bini first tried their electroconvulsion technique on a human (Holloway, 1995). A man who was wandering in a confused state at a train station and who was presumed to be a schizophrenic was sent to them by the police commissioner. After the first electric shock, the man did not lose consciousness. Hearing the doctors say they were going to repeat the procedure at a higher voltage, the patient said, "Not another one! it's deadly." Deciding that those were the only comprehensible words he had spoken, the doctors ignored him and did the second procedure. When the man awoke from it, he did not know what had happened (Lincoln & Guba, 2005). These are but a few of the examples of ignoring the safety, consent, and expressed wishes of patients.

The theme of the 1990 American Psychiatric Association's annual conference was "The Research Allliance." Clinical treatment depends on research for improved treatments. However, research may also interfere with clinical practice and may cross ethical lines. Pinheiro (1992) describes how even something as seemingly simple as filling out data collection forms may create a problem. When state hospital psychiatrists filled out forms, it took time away from the limited time that was already spent on clinical care. As agents of the research, they also lost some of their spontaneity and creativity. This limitation of scope comes about because research can only deal with a small number of variables. Pinheiro also points out that since research is usually funded by government or foundations, there may be biased priorities, and problems with research may revolve around what research subjects are chosen.

McIvor (1994) argued, "Although helpful, it is not essential that they (interpreters) have knowledge of mental health issues, but it is essential that they have a particular knowledge of the political and cultural background from which the survivor comes. It is often ignored that the interpreter should be socially, ethnically and politically acceptable to the survivor" (p. 268). A concluding point to be searched in selection is the vernacular of the language spoken by the probable interpreter (Glesne, 1999). A Well-educated person may have class and dialect differences from the child. Newcomers to the United States may speak unusual dialects that other speakers of the language may have difficulty comprehending. It is imperative to confirm the dialect match among the children in the school and the analyst.

The third task is to arrange the interpreter. If translators are unproven, it will be essential to teach the individuals in the methods of translating in crisis framework. Interpreters ought to learn ethical concepts, mainly the significance of keeping information confidential, how not to respond to responses or questions unsuitably, how to deal with physical motions and other kinesthetic information, and how to set up and ' maintain rapport. The psychologist will be using the interpreter as a substitute and should feel sure that good professional practice will be trailed. If there is time, interpreters must also be schooled in the rudiments of psychological first aide (Gilliland & Andress, 2006).

II. Methodology

Make Appropriate Referrals

As the first and perhaps only person on the scene, it is important to do what I can to be helpful. I plan to attend to physical needs, offer appropriate reassurance and anticipatory guidance, and help those in a crisis state to take positive action to facilitate coping. As soon as possible, however, I shall facilitate an appropriate referral to a culturally appropriate helper, and follow up to determine that a connection has been made. An emergency is a time when the usual world is fundamentally disrupted. But crises are not so atypical that humankind has not been competent to come up with ways of producing solutions for them. As crisis interveners, the least I can do is to be catalysts of processes that have been institutionalized in customs to help folks cope. We have to honor and respect the socially-based devices available to console and heal those exaggerated by shocking events (Woodward & Fergusson, 1999).

In the grounded hypothesis technique, the study and compilation of data goes on until "all of the main concepts and their co relationships have been hypothetically inundated and the investigator can find no extra data which adorn the theory" (Glesne, 1999). The data collection and study measures permitted for idleness in up-and-coming themes and prototypes connected to clinical supervisor insights of the management procedure with apprentices who advice clients with BPD uniqueness. I also plan to gaze in depth at the communications to see how the administrators defined and knowledgeable supervision concerning patrons with BPD (Colangelo, 2007).

Singular interviews shall be carried out with clinical supervisors convening the selection limits who will decide to participate in the study. Every one of the three interviews shall take place for about 60 minutes. All interviews will be recorded and transliterated by an expert transcriber, which will add to the use of low-inference semantics during analysis to gratify reliability criterion (Grbich, 2007). On the other hand, it is prudent that transcription might deteriorate dependability due to elimination of decisive data, such as participant silences, uncertainty, and dialectical overlaps. I will try to argue against this potential restraint by use of diaries, notes, and observations that will be taped during the interview procedure. Interviews will be planned about three weeks apart; this will allow enough time for study and research for ensuing interviews (Lincoln & Guba, 2005). Concurrent analysis of the recordings will also allow me to reformulate and fine tune the focal point of interview questions for the subsequent interview.

A great deal of the available literature depends on very special and prejudiced Samples, subjective case descriptions, or judgment based on individual experience. & #8230; There is a huge need for highly sensitive and well-grounded study using resonance, scientific techniques with use of consistent measurement and sufficient reins (Glickauf-Hughes, 2004). Of huge interest and worth would be supportive longitudinal studies of relations with an immobilized parent, using a methodical and uniform method of obtaining data; controlled empirical studies of effects of pa rental disability on children of different ages and stages; comparison of the responses and adjustment of children to an already disabled parent with the responses of children to a parent who later acquired a disability; study of children of families with one disabled parent compared with children in families where both parents are immobilizes, and contrast of the individuality of coping and non-coping families. (Glesne, 1999)

The professional literature now contains an increasing number of studies that point to certain outcomes for children based on a specific parental disability variable. Bornstein's (1995) four volume "handbook" represents a major contribution to the diversity of issues affecting parenting. His fourth volume includes extensive chapters on three conditions of parental disability: sensory and physical disability (Grbich, 2007), depression (Glickauf-Hughes, 2004) and substance abuse (Lincoln & Guba, 2005).

Previous research literature, which frequently employed case study methodology based on a small number of subjects, has portrayed outcomes for children of parents with a variety of disabilities (Millon, 1999). In addition, there is a growing body of literature on children of parents who abuse alcohol and other drugs. Much of the earlier literature on the topic was primarily descriptive and self-report with strong and predictable, primarily negative, child outcome effects. However, more empirical studies have been published in recent years which have both reported outcomes but also have acknowledged the complexity of the interaction of the number of variables involved in predicting outcome effects on children whose parents are substance abusers (Dworkin & Hirsch, 2004). This literature is particularly important because of the large number of children affected by substance abuse of various kinds and the social policy directed toward substance abuse offenders including parents.

Although the empirical research base is growing on the relationship of parental disability to child outcome effects (Emerick & Zirpoli, 2000) there continues to be a need for research that methodologically addresses specific critical parental disability factors.

Implementing Culturally Sensitive Crisis

In conclusion, when faced with an individual who is recognizably from a culture different from the crisis worker, some modification in approach will be considered. However, there is sufficient cultural diversity present in our population for me to view every child and family through a cultural lens (Moon, et al., 1997). It is reasonable to assume at the onset of my research encounter that the individual will come from a unique culture or subculture, even if it is the "culture" of the family of origin. Some assessment has to be made to establish how to work best with the client.

Examine Fit of Individual and Cultural Norms

A first step will be to learn the extent to which the client has become acculturated to the dominant culture. Informants can assist in this and careful interviewing can also detect an individual's worldview.

Consider What Culturally Relevant External Resources Are Available to the Person in Crisis

The second step is to examine resources and strengths. Prime resources in many cultures are the clergy, but others who can help are an influential neighborhood leader or politician. In non-Western (and Western) cultures the family is an important system of support during times of crisis and they must be mobilized, recognizing that definitions of "family" differ considerably.

Determine the Client's Capacity to Use the Resources

Not all individuals in crisis will be able to use either conventional resources or culturally provided resources. Attitudes toward seeing help and sources of help will be examined and taken into account (Moon, et al., 1997).

III. Participants Sample

Six participants will be chosen on the criteria of purposive sample in order to get together data from a diminutive, convenient sample of participants. In normative theory research, study participants notify the researchers about a fixed social phenomenon inside a given circumstance and with better depth (Colangelo & Assouline, 1993), and this kind of sampling is suitable for this approach (Dworkin & Hirsch, 2004). Emerick & Zirpoli, (2000) talked about how the logic and control of purposive sampling for qualitative research is in choosing information-rich cases. Particularly, focused sampling is the procedure of selecting 6-10 participants who will capitulate cases from which I can learn a lot about issues essential to the purpose of my study (Farrell, 2005). Among the criterion used in choosing clinical supervisors to take part in this research will be having (a) a curiosity in this subject, (b) three to five years of management experience, (c) a permit as a specialized counselor, (d) at least one skill with supervising apprentices who have counseled a customer with BPD personality, and (e) a readiness to meet for three interviews that could last 40-55 minutes each.

Ahead of the investigation we will be forced to make quite a few ethical suppositions, including the need of beneficence, high opinion, and fairness (Colangelo, 2007). Foremost, the Human Subjects Committee (Institutional Review Board) settled on approving (Colangelo & Assouline, 1993). Subsequently, for the intention of field notes, records, and investigative memos, participants will be assigned made up names to protect their identity and preserve confidentiality and ambiguity. The informed consent procedure states that contribution must be unpaid and subjects should have the right to opt out at any time (Glickauf-Hughes, 2004). All our study subjects will have to grant me permission for utilizing their information and knowledge in this and upcoming studies.

Subjects shall be enlisted from counseling and teaching centers, institutions of higher education, and nonprofit therapy agencies (Wadsworth, et al., 2000). An invitation to participate will be sent through the state Licensed Professional Counselor Board listing of accepted supervisors. There will ideally be five volunteers, four female and one male. Four participants shall be White and one will be Asian. Four will ideally have earned a Ph. D., and one will be an M. Ed. Subjects might also list several years as a certified professional, and that would be very good (2-13), time of supervising (3-9) years, and age ranges of (28-55).

This study will teach us the complexity of trying to find a "healthy, normal" volunteer group for research, and the difficulties of attracting a large enough pool of potential candidates to obtain the needed subjects after subjects' refusals based on informed consent and ruling out subjects who could invalidate the research (Zoccolillo, et al., 2002). The extent of the technological procedures which will be required to conduct the described research also points out why subjects who are given informed consent based on detailed protocols may decide to forgo participation. This may be a growing problem, as the biologically-based research of today calls for the use of technologies which may involve considerable time commitments and can include invasive procedures such as the injection of dyes with their potential risks.

IV. Proposed Method of Data Analysis

Subjects might quite possibly be caught up in deliberations about subjects and outlines that might materialize during each succession of interviews, thus permitting them to corroborate the answers of this research. Subjects and outlines improved and lessened the information from every round. Data will be evaluated by case and transversely during each session of interviews. Outlines and developing themes will be required both to more suitably appreciate supervisors' insight and to conceptualize a replica of the supervision procedure.

To confirm the genuineness of data and their understanding, in addition to group researcher prejudices, more than a few verification procedures will be employed. We shall make sure to keep a diary of academic notes, subject inspection comments (Stanger, et al. 2006), and investigative indications made for the duration of the interviews. The periodical will also note down issues of researcher reflexivity throughout the dialogue with subjects and to aid group any prejudices or postulations that cropped up. Precise attention will be set to how prejudice may have exaggerated the data compilation procedure (Selekman, 1997). Quite a few techniques will be engaged right through the process to guard against researcher prejudices, amongst them gapping the interviews, colleague discussion, "heavy" data, and discussion with specialists in counselor teaching.

The research shall use a cipher procedure. As Visser, et al. (2009) state, the procedure of study and cipher is "forceful and fluid" (p. I01). Data collected from the all the interviews and the researcher's diary will be implied by means of open, axial, and discriminating policy (Wagner, et al. 2003) and then obtainable in theoretically ordered exhibits. The motive for using so many levels of ciphers is "to enlarge, alter, and re-conceptualize information, opening up more varied logical possibilities" (Zoccolillo, et al. 2002). Initially we will commence content analysis (Wolcott, 2001) by making the most of open coding, the procedure of conveying tags or make to "portions" of information that might or may possibly not be linked to the research. We are capable enough to allocate data to groups of universal themes and outlines with the purpose of essential subjects and prototypes more purposely (Robinson & Curry, 2007).

Subsequently, information will be axial-coded, which will intend stating the categories that encircle specific ideas and producing properties to classify the notions (Colangelo, 2007). Strauss and Corbin (1998) describe axial coding as "the procedure of relating classes to their subcategories ... At the stage of properties and scopes" (p. 123). It will be utilized here to recognize exact themes and outlines as they might continue to appear and allocate meanings to classes and subclasses. The subsequent step will be discerning coding, with the intention of further specifying subjects, patterns, and notions and employ data to explain theoretical builds. The information that will be acquired through preceding data analysis shall be incorporated to recognize the scope, relationships, directionality, and notions of the subjects and patterns rising from the study (Visser, et al., 2009).