However, confidentiality is difficult to guarantee or provide in home-based settings, where the structure and consistency of the office-based setting are not in place. One of the primary ethical duties of counselors is to maintain their clients’ confidentiality. Confidentiality, boundary issues and access to supervision are among the ethical concerns that counselors are likely to encounter when providing home-based counseling services. Additionally, the possibility of experiencing counselor burnout is a factor to consider when evaluating this type of format for sessions.Ĭounselors are required to act ethically when providing counseling services to their clients. A home-based counselor could work with such an individual in their home to help them identify their feeling of paranoia and learn to use reality-testing techniques to decrease the paranoia.Īlthough home-based counseling offers many benefits, ethical and safety concerns can dissuade professional counselors from providing this service. Home-based counseling provides the opportunity to meet clients where they are and with what they can contribute to the relationship.įor instance, clients diagnosed with a psychotic disorder may experience symptoms such as paranoia that prevent them from coming to the office and seeking treatment or engaging in other activities such as grocery shopping. Examples include the recent loss of transportation or employment, parental leave for a new baby, medical or health issues that warrant bed rest, severe and limiting psychiatric symptoms and so on. For example, a client who cannot pay her rent, has little food available for her family, and has broken floorboards in the kitchen may not have the same focus or motivation as a client in a more stable living situation.įinally, clients may “no-show” or cancel office-based counseling sessions for a variety of reasons. In combination with behavioral indicators, the physical environment and the home’s level of cleanliness can provide the counselor with important information relative to the client’s situation. Conducting counseling in the home allows the counselor to directly observe these behaviors and use immediacy to point them out, then work collaboratively to identify more appropriate behaviors. For example, family members may be on their “best behavior” while in the counselor’s office, or an individual family member may deny their part in a problem. Issues specific to the family or environment can be assessed through examples and observation in the here and now, which often leads to a more immediate feedback process. Home-based counseling offers the counselor a more enriched perspective of the client and the context of the presenting issues. In the home, the counselor can prompt the individual to recognize the triggers before anxiety begins and encourage the use of coping skills. ![]() Another example is that of adults diagnosed with anxiety who struggle to use effective coping skills in triggering situations. Additionally, the counselor can observe the parent or caregiver prompting the child to use the skill and work with them to increase consistent implementation. Learning and practicing the skill in the home environment with the counselor present to assist and support the child increases the likelihood of success. For example, a child with intellectual disabilities and behavior problems may be able to successfully implement a calming technique in the counselor’s office but unable to do the same thing in the home. Transferability of skills is one main benefit of home-based counseling, meaning that it can be helpful to those who struggle to transfer skills from one environment to another environment. Finally, home-based counseling can be particularly helpful for individuals who cannot or will not come to a counselor’s office for services. It is often helpful to have a counselor in the home environment to witness maladaptive behaviors, relational issues and other contextual considerations. Mood disorders, anxiety disorders, psychotic disorders, behavior problems and family disturbances are typical presenting problems that may benefit from home-based counseling. Home-based counseling, which is sometimes referred to as community-based counseling, can be effective and beneficial with multiple client populations, including families, older adults, children, and individuals with developmental disabilities. Russell Crane, Harvey Hillin and Scott Jakubowski, home-based counseling has proved to be cost-effective and to reduce hospitalizations, so there is evidence for its usefulness. Traveling to the client may seem foreign, particularly if the counselor’s internship experiences were all office-based. Many newly minted counselors begin entry-level positions as home-based counselors, traveling to see their clients in homes, schools, community centers and elsewhere.
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