TPC Journal V8, Issue 3- FULL ISSUE

The Professional Counselor | Volume 8, Issue 3 237 in mapping out a sustainable, long-term plan. Such a plan will normalize the influence of both individual- and systems-level variables, emphasizing the importance of multiple sources of support, maintenance of his sobriety, and the inevitability of confronting both developmental and historical challenges. Just as a person with progressive multiple sclerosis needs to anticipate their future medical and assistive technology needs, so does Jason need to identify and plan for his future health, wellness, and economic needs within our rapidly changing society. An ecologically sensitive counselor understands both Jason’s personal development and larger historical trends, and is thus able to advocate for Jason’s preparation to survive and thrive over time. Advocacy as an Inherent Element of Ecologically Informed Treatment Over the past few decades, the counseling profession has increasingly recognized that advocacy is a vital component of the counselor’s role (Chang, Barrio Minton, Dixon, Myers, & Sweeney, 2012; Ratts, Toporek, & Lewis, 2010). Counselors are ethically required to understand their clients in a deeply contextualized manner and have a responsibility to try and reduce social and ecological barriers that may be blocking their clients’ growth, development, and flourishing, and exacerbating their clients’ mental and physical health challenges. Understanding the pivotal role ecological factors play in clients’ health, relationships, and careers has long been central to the field of rehabilitation counseling (Parker & Patterson, 2012). Issues such as accessibility and universal design were recognized as central to the success of people with disabilities, just like evidence-based treatments. For example, if a client who uses a wheelchair is seeking to participate in a program or obtain a job requiring access to a particular building, and that building lacks accessible parking or public transportation, curb cuts, and an accessible entrance and bathroom, the client is likely going to be blocked from reaching goals. Such systemic, advocacy-oriented thinking can be applied to the current opioid crisis. As described in the previous sections, using Bronfenbrenner’s ecological model and creating an eco-map as a tool in the client conceptualization process led to the identification of a wide range of variables related to Jason’s treatment and recovery. Counselors need both awareness of and knowledge about factors affecting their clients at multiple systemic levels. Advocacy as understood within this model includes understanding labor market trends and participating in public policy discussions concerning support for workers displaced by globalization and automation. It means working to obtain more medical resources and treatment centers for clients struggling with addiction, striving to change laws to emphasize treatment over incarceration, and providing more access to life- saving medications such as naloxone. In short, the pursuit of social justice and counselors’ roles as advocates are intrinsic in this model of conceptualization and intervention, highlighting the clinical and societal relevance of a broad range of systemic variables and public policy debates. One area in which counselors can advocate for the improved access to services for those struggling with opioid use is through supporting programs, such as the Mental Health Facilitator program (Hinkle, 2014), aimed at training laypersons with the basic skills to identify, briefly intervene with, and refer people in their communities who are experiencing a mental health crisis. The increased presence of persons with such skills in the microsystem—in schools, hospitals, faith communities, businesses, and neighborhoods—creates opportunities for detection, referrals to treatment, and life- saving emergency interventions, particularly among underserved populations. Mental Health First Aid is an international, evidence-based, 8-hour training course that teaches community members steps they can take if they encounter a person who is having an emergency, such as having suicidal ideation, a panic attack, or an overdose. Mental Health First Aid has recently added opioid-specific overdose training and naloxone administration to their curriculum (Pellitt, 2018).