COUN6965_Unit4a1_GraceBelt

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1 Program Evaluation Plan Part 1: The Clinical Program Grace C. Belt COUN6965 - Applied Research and Program Evaluation in Mental Health Counseling February 4th, 2024 Capella University
2 Program Evaluation Plan Part 1: The Clinical Program A program evaluation is used as a roadmap to assess, monitor and show intention of services. The program evaluation outlines the purpose of the program, its outcomes and overall effectiveness (Royse, et al., 2010). The program being evaluated is called the Holistic Being Program, which focuses on the mental health care of individuals who identify as LGBTQIA+, specifically people who experience symptoms of anxiety &/or depression. According to multiple journals and various articles, there are interventions appropriate and effective to utilize when treatment planning for this demographic. Most of these studies mention and consider substance abuse, social support, suicidality and individual empowerment. The program being evaluated aims to provide holistic, inclusive and effective services for individuals who identify as LGBTQIA+ that also experience symptoms of anxiety &/or depression. Holistic Being Program Holistic Being Program is designed to implement a safe and inclusive space for individuals and groups that identify as LGBTQIA+ and are experiencing symptoms of various mental health disorders. The Holistic Being Program strives to provide access to effective mental health care focusing on this specific demographic's experiences and struggles. The purpose of this program is to evaluate individuals who identify as LGBTQIA+ and determine the most effective resources appropriate for this individual’s care. The type of evaluation conducted will be the utilization-focused evaluation. The stakeholders of the program are the client, the counselor conducting evaluation, front-desk staff at the clinic, if the client is a minor - the parents will be involved, various community resources for appropriate referrals, and the health insurance companies (if applicable).
3 The interventions offered by this program include treatments that focus on developing self esteem, increasing feelings of empowerment, fostering healthy relationships, and decreasing internalized discrimination such as homophobia or misogyny. Cognitive behavior therapy (CBT) aims to address factors that maintain low self esteem, such as self critical thinking and avoidance, and underlying core beliefs and unhelpful attitudes (Bullock, 2018). Feminist and Existential theories focus on the knowledge of social norms and expectations of individuals based on race, gender, etc., as well as the overall meaning of life and an individual’s inherent power within. These theories may help clients develop empowerment within their mind, body and soul (Oh, et al., 2019). Adlerian therapy may help foster healthy relationships for clients who undergo this intervention during treatment. Adlerian therapy emphasizes the importance of relationships and being connected to others (Pachankis, et al., 2021). People are generally viewed as trying to belong and be accepted into the social circle. “The outside world shapes their consciousness, as does the world of the family” (Pachankis, 2021). Multicultural counseling is also an effective intervention that can be utilized during this program. This type of intervention can be added to any of the above-mentioned interventions, as it is imperative to gain understanding and practice multicultural interventions in all aspects of mental health care (Parker-Barnes, et al., 2022). The program’s long term goals are to address the clinical concern of rising anxiety and depression symptoms in the LGBTQIA+ population, as well as gaining individual retention in the counseling program. The short term goals are lessening triggers in regard to substance use, providing a safe space for individuals who are seeking mental health counseling by promoting an inclusive environment, as well as establishing health coping mechanisms for adversity situations, and promoting more healthy lifestyle choices.
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4 Literature Review There are various programs that are designed to serve the vastly diverse LGBTQIA+ community. I have chosen to include two articles that display knowledge in helping the LGBTQIA+ community. There is a specific model used to help counselors work efficiently with BIPOC who identify as LGBTQIA+. The Socially Just and Culturally Responsive Counseling Leadership Model (SJCRCLM) provides a framework by which counselor leadership may move from performative to authentic allyship to prevent and buffer against racial trauma. The authors of this article describe “how the SJCRCLM leadership causal conditions promote actionable advocacy within the counseling academic community” (Parker-Barnes, et al., 2022). This model recognizes historically underserved communities that identify LGBTQIA+ and helps counselors who may not have this experience, personally or professionally, to understand and advocate for these individuals seeking care in a mental health setting. Another program that exists around the country, depending on the school system, is called the Gay-Sraight Alliance. This is usually in the secondary school setting, so middle or high school age. This idea was formed to help students form a social bonding group with like-minded people sharing similar values. The article I found that references this group specifically mentions students who are experiencing anxiety and depression symptoms, possibly correlated with cyber-bullying and homophobia. The Gay-Straight Alliance is determined to be an effective social support group to help students experiencing homophobia, cyber-bullying, transphobia, and overall discrimination (Wright, et al., 2022). The findings revealed that perceived social support was related negatively to homophobic cyberbullying involvement and depressive and anxiety symptoms (Wright, et al., 2022).
5 The interventions are various assessments conducted within the participating LGBTQIA+ community, as well as group counseling to promote positive community engagement. It is determined that group counseling interventions may help individuals in underserved communities gain positive relationships and insight surrounding their respective experiences (Smith, et al., 2022). Ensuring connectedness for the LGBTQIA+ community will help individuals feel a sense of belonging and understanding within their environment (Bullock, 2018). These interventions may help the program flourish and remain successful in client treatment planning. Program Evaluation Model Selected The population that the program focuses on is LGBTQIA+ younger adults. Race and ethnicity are randomized, but diversity is respected and recognized. This program was started because individuals in the focused demographic are proven underserved and often misunderstood or antagonized. The clinical concern being addressed is any mental health disorder the LGBTQIA+ community mentions in this program. The primary mental health disorders addressed in this community are eating disorders, suicidality, depression and anxiety (Ventriglio, et al., 2022). I have chosen to use Michael Patton’s “Utilization-Focused Evaluation” model. I have decided to base my program on the LGBTQIA+ population, variable with age, gender and sexuality. Since my program is designed to work with a vastly diverse population, I thought choosing the utilization-focused evaluation would be beneficial. “By establishing a working relationship with intended users, evaluators help them determine what kind of evaluation they need and select the most appropriate content, model, theory, and methods for their evaluation, rather than advocating any particular evaluation approach” (Giancola, 2020).
6 Needs Assessment An assessment that will be used during this program is The Socially Just and Culturally Responsive Counseling Leadership Model (SJCRCLM). This assessment, as mentioned above, is a framework that helps counselors move from performative allyship to authentic allyship. Performative allyship is considered to be individuals' thoughts and beliefs being wholly based on social acceptance, rather than genuine advocacy for positive change within mental health care and the LGBTQIA+ community. An example of this is claiming you are supportive of trans and nonbinary individuals, but not utilizing the correct pronouns during treatment. Authentic allyship is when a counselor considers their own personal bias and actively practices advocacy efforts during the counseling process, and the outside world. An example of this is utilizing the correct pronouns of a trans or nonbinary client, even if they are a minor and their parents scoff at these pronouns being used. The program may not reach every identity of the LGBTQIA+ community. Specifically, trans and asexual individuals. Although there are aspects of the program designed for clinicians to be educated and promote inclusion, if clinicians are not able to practice their skills on clients who have these identities, their knowledge may be difficult to utilize. It is known that these individuals live in a variety of places. The program may reach them by hiring competent and experienced clinicians in various states, as well as offering telehealth options for services. According to the ACA Code of Ethics § F.11.c, “Counselors understand that the profession of counseling may no longer be limited to in-person, face-to-face interactions. Counselors actively attempt to understand the evolving nature of the profession with regard to distance counseling,
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7 technology, and social media and how such resources may be used to better serve their clients'' (2014). The ever changing dynamics of technology has made counseling more accessible to clients. This program will reach underserved clients by utilizing ethical technological services. Once in service, clients are encouraged to continue services to implement positive change and coping mechanisms. Clients who drop out are given a questionnaire, which surveys their overall experience and specific experiences throughout the program. The questionnaire will also ask why they have decided to discontinue services within the program, and if they are seeking services elsewhere. All of the questions are anonymous and optional. This questionnaire will populate data that could be helpful when evaluating the program’s effectiveness and overall client satisfaction. Ethical and Evaluation Standards The intended services are identified as mental health counseling for LGBTQIA+ individuals and groups. Specifically, clients who are exhibiting symptoms or diagnosis of depression and anxiety disorders. Clients seeking these services may be from a diverse range of demographics, as the counselors are trained in multicultural counseling and ethical guidelines. According to the ACA Code of Ethics § F.11.c, “Counselor educators actively infuse multicultural/diversity competency in their training and supervision practices. They actively train students to gain awareness, knowledge, and skills in the competencies of multicultural practice” (2014). The program is designed to promote a safe and inclusive space for clients to seek mental health care. Another ethical and evaluation standard that will be considered is advocacy efforts by the program’s counselors. According to the ACA Code of Ethics § A.7.a, “When appropriate, counselors advocate at individual, group, institutional, and societal levels to address potential
8 barriers and obstacles that inhibit access and/or the growth and development of clients” (2014). The program’s counselors are encouraged to promote inclusivity of the LGBTQIA+ community throughout their personal and professional lives. When appropriate, the program encourages counselors to advocate on the local, state and federal level regarding anti-LGBTQIA+ legislation across the board. Anti-LGBTQIA+ legislation is proven to affect individuals in this specific demographic in a negative way (Wright, et al., 2022). Within the advocacy efforts and remaining ethical in practice, the American Evaluation Association clarifies that a professional’s “interpersonal skills include cultural competence, communication, facilitation, and conflict resolution (2004). These considerations are imperative when promoting an inclusive and safe program for the LGBTQIA+ community who exhibit symptoms of depression &/or anxiety.
9 References American Counseling Association. (2014). 2014 ACA code of ethics . http://www.counseling.org/resources/aca-code-of-ethics.pdf American Evaluation Association. (2004). American Evaluation Association guiding principles for evaluators . http://www.eval.org/p/cm/ld/fid=51 Bullock, K. (2018). Enhancing school connectedness for lesbian, gay, bisexual, transgender, queer, intersex, asexual (LGBTQIA) students Giancola, S. P. (2020). Program Evaluation . SAGE Publications, Inc. (US). https://capella.vitalsource.com/books/9781506357454 Oh, S., Kim, N., Bennett, C. M., & Taylor, D. D. (2019). Multiculturally competent intake interview with LGBTQI + clients. Journal of Gay & Lesbian Mental Health, 23 (2), 186-204. https://doi.org/10.1080/19359705.2019.1568943 Pachankis, J., Clark, K., Jackson, S., Pereira, K., & Levine, D. (2021, April 21). Current Capacity and Future Implementation of Mental Health Services in U.S. LGBTQ Community Centers . Psychiatry online. https://doi.org/10.1176/appi.ps.202000575 Parker-Barnes, L., McKillip, N., & Powell, C. (2022). Systemic Advocacy for BIPOC LGBTQIA + Clients and Their Families. The Family Journal., 30(3), 479–486. https://doi.org/10.1177/10664807221090947
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10 Paul, S. (2021). Overcoming the challenges and mitigating the disparities in our LGBTQI+ patients. The American Journal of Gastroenterology, 116 (9), 1815-1818. https://doi.org/10.14309/ajg.0000000000001359 Royse, D., Thyer, B. A., & Padgett, D. K. (2010). Program evaluation: An introduction (5th ed.). Wadsworth/Cengage Learning. Smith, N. L., & Lértora, I. (2022). Group work with LGBTQIA youth using relational cultural theory: A case example. The Journal for Specialists in Group Work, 47 (3-4), 224-236. https://doi.org/10.1080/01933922.2022.2126050 Ventriglio, A., Mirandola, M., Galeazzi, G. M., Amaddeo, F., Pinna, F., Converti, M., Fiorillo, A., & Italian Working-Group on LGBTQI Mental Health. (2022). Mental health for LGBTQI people: A policies' review. International Review of Psychiatry (Abingdon, England), 34 (3-4), 200-214. https://doi.org/10.1080/09540261.2022.2052266 Wright, M. F., Wachs, S., & Gámez-Guadix, M. (2022). The Role of Perceived Gay-Straight Alliance Social Support in the Longitudinal Association Between Homophobic Cyberbullying and LGBTQIA Adolescents’ Depressive and Anxiety Symptoms. Journal of Youth and Adolescence, 51 (7), 1388-1396. https://doi.org/10.1007/s10964-022-01585-6