ETHICS TUTORIALS

Ethics Tutorials

Ethics Tutorials

Introduction

In the past few years? professionals in mental health? mental retardation/developmental disabilities? and rehabilitation have increased their emphasis on the social-emotional adjustment of their clients with developmental problems this article reviews mental health issues concerning persons with mental retardation? particularly as these issues apply to mental health counseling. Included in this review is a discussion of the prevalence of psychopathology? types of problems presented? issues in clinical bias? access to community services assessment techniques? and specific mental health counseling issues.

Historically? human service professionals have focused on the adaptive and developmental aspects of their clients with mental retardation. In the past few years? professionals in mental health? mental retardation/developmental disabilities? and rehabilitation have increased their emphasis on the social-emotional adjustment of their clients with developmental problems. Some territorial issues have existed among different sectors in the human service delivery system. Personally? we have observed mental health professionals reluctant to deal with clients with mental retardation and professionals in the developmental disabilities sector uncomfortable dealing with their clients with psychopathology. Despite these issues? it is now recognized that clients with mental retardation can present with significant psychological adjustment problems

In this journal? Bihm and Leonard (1992) reported on a survey of mental health counselors' knowledge and skills in areas viewed as important in helping clients with mental retardation and psychiatric disturbance. Their results indicate that mental health counselors viewed a variety of skill and knowledge bases as important.

Interestingly? the five most important areas are a combination of general skills for dealing with persons with mental retardation and the specific knowledge bases. These areas are (1) establishing a therapeutic relationship? (2) assessment of mental retardation and mental illness? (3) psychology of mental retardation and mental illness? (4) treatment planning and counseling goals? and (5) helping skills (verbal). Bihm and Leonard also found that 87% of their sample had worked with a client with mental retardation? suggesting that mental health counselors do need to be better prepared to deal with persons with mental retardation.

This article reviews mental health issues concerning persons with mental retardation? particularly as these issues apply to mental health counseling. Included in this review is a discussion of the prevalence of psychopathology? types of problems presented? issues in clinical bias? access to community services? assessment techniques? and specific mental health counseling issues.

Prevalence of Psychopathology

Both clinical literature and empirical studies demonstrate that persons with mental retardation experience the same range of emotional disorders as the general population (Sevin & Matson? 1994). The variety of problems of maladjustment includes affective disorders? anxiety disorders? psychoses? personality disorders? psychosexual disorders? aggression and impulse control disorders? and somatoform disorders. It has not always been accepted that this range of psychopathology existed (Sovner & Hurley? 1983).

In fact? Sovner and Hurley (1983) entitle their article on depression in persons with mental retardation "Do the mentally retarded suffer from affective illness?" partially in reaction to the fact that some in the mental health community did not feel that persons with mental retardation often presented with ...