Assessment for and Challenges Related to Pervasive Mental Illness and Health Concerns In the 1950s, a radical shift in counseling occurred. Numerous key figures in the fields of family counseling and therapy proposed the view that pervasive mental health problems were not individual problems, as was previously thought, but originated with and were perpetuated by family dynamics. The shift from working with individuals with pervasive or severe mental illness or health concern via individual psychotherapy to working with the identified “patient” and their families in the 1950s provided the context for the birth and growth of family counseling/therapy. Since that time, mental health professionals working with families with a member experiencing pervasive mental illness or a health concern have moved away from the controversial stance above, to acknowledge that both genes and biology influence behavior and that relationships can maintain or exacerbate symptomology, as well as assist in alleviating it via various coping mechanisms. Tertiary intervention is the formal term for working with clients experiencing pervasive mental illness or health concerns, but it may also be referred to as remedial or rehabilitative counseling. When you encounter a couple or family for which tertiary intervention may be appropriate, your assessment focus should shift. First, you should be aware of any symptoms or cues that may substantiate your concerns, and assess whether couple and family therapy is indeed the best form of service to provide. It may be that one or more persons would benefit from individual services, whether simultaneously with or before any couple or family counseling. For this Discussion, you will examine couple/family sessions requiring assessment and intervention, as well as exploring the challenges couple/family sessions might include. A brief description of three symptoms/cues observed in a couple/family session that may require assessment and intervention beyond the scope of a couple/family session and explain why. Then, explain how you, as a helping professional, might take the next steps with the individual who requires additional assessment and intervention. Finally, explain any challenges of continuing working with the couple/family once an individual requires concurrent treatment.
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