Date of Award

5-2014

Level of Access

Campus-Only Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Education

Advisor

Sandra Caron

Second Committee Member

Dorothy Breen

Third Committee Member

Janet Fairman

Abstract

Home-based counseling first gained wide recognition in the 1970s and today is one of the fastest growing segments of mental health services. However, the preponderance of counseling research explores topics relevant to the office-based counseling setting. There has been limited research into the experiences facing home- based counselors and particularly those within the rural setting. In order to better prepare counselors for the expanding home-based modality a greater understanding of the issues these counselors face in their professional experience is required.

This qualitative research study sought to understand the experiences of home- based counselors working in the rural setting of the State of Maine. In-depth interviews were conducted with Licensed Clinical Professional Counselors who have worked between six months and six years with families in the home setting. Twelve participants (six women, six men) were asked to describe their experiences in the areas of preparedness, professional development, and challenges. Several important themes emerged from the analysis of their interviews.

Many described feeling unprepared for all the paperwork, having a preference to work in teams, and the need for more training in therapeutic interventions designed for implementation within the home-based setting. They also noted previous professional experience and a positive attitude as being essential factors in feeling prepared to provide services in the home-based setting. While many home-based counselors reported satisfaction with individual supervisors, the majority described frustration with group supervision experiences that involved more time devoted to non-clinical issues such as completing paperwork. All participants reported that they had not attended a professional meeting in over two years.

Some of the greatest challenges participants discussed included the unpredictable nature of the work setting and incidents that caused confusion as to whether or not a mandated report should be made. Participants also described the difficulty of maintaining confidentiality for clients and their families when others would enter the home during counseling sessions. Other challenges included documentation timelines, excessive solitary travel, and engaging the caretakers of identified clients in the therapeutic process.

Several themes emerged that were gender specific, including male participants who felt that with so many more females employed within the home-based modality, it is a disadvantage because they perceive it to reduce the likelihood that they will have colleagues who share very similar stylistic service delivery preferences. Most females described boundary challenges with female clients/caregivers that they believed to be unique to their gender. In addition, most of the female participants believed that providing home-based services with family members that have a history of domestic violence puts them at a disadvantage due to the inclination of domestic abusers to devalue, debase, and intimidate females at large.

An examination of the themes which emerged from the interviews on preparedness, professional development, and challenges revealed three common elements for those working as home-based counselors: shared isolation, ethical ambiguity, and high intensity. These common elements are discussed and recommendations have been developed for home-based counselors, home-based counseling agencies, counselor education programs, and professional counseling associations. Directions for future research are discussed.

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