SOWK 6341 Social Work Research I
Discussion: Identifying Threats ­ Mental Health Treatment
A non­profit serving children who have witnessed family violence wants to know if their counselors should use
cognitive behavioral therapy (CBT) or trauma­informed cognitive behavioral therapy (TF­CBT).
They have two counselors trained in CBT who have been working at the agency for 15 years each. They also
have two new counselors straight from an MSW program who have been trained in TF­CBT. The CBT
counselors have a current caseload of 20 children each.
All new children will be assigned to the TF­CBT counselors. When a child is done with therapy, the counselors
will ask the parents if their child’s behaviors have gotten better. They will use that information to decide if they
should use TF­CBT or CBT.

Identifying Threats to Effective Mental Health Treatment
Mental health treatment aims to help individuals manage mental health conditions and improve overall well-being. However, several factors can threaten the effectiveness of these services if not properly addressed. This article will explore some common internal and external threats to mental health treatment and provide recommendations for mitigating their potential negative impacts.
Internal Threats
Lack of Buy-In from Clients
One internal threat is a lack of buy-in or engagement from clients in their own treatment. For therapy or counseling to be effective, clients need to be actively participating and putting in effort between sessions. However, some clients may be resistant to treatment or skeptical that it can help. Counselors can address this threat by building rapport, clearly explaining treatment goals and expectations, and involving clients in treatment planning (American Counseling Association, 2016). Motivational interviewing techniques may also help clients become more invested in the change process.
Non-Compliance with Treatment Plans

Another internal threat is when clients do not follow through with homework assignments, lifestyle changes, or medication regimens as prescribed in their treatment plans. Non-compliance can undermine treatment progress and outcomes. Counselors should discuss barriers to compliance openly with clients to problem-solve solutions. Simplifying treatment plans and breaking large changes into smaller, more manageable steps can also help improve compliance (National Alliance on Mental Illness, 2019).
External Threats
Lack of Access to Care
One major external threat is a lack of access to affordable, quality mental health services. Not having health insurance coverage or the financial means to pay out-of-pocket for treatment prevents many from receiving needed care. Community mental health centers and non-profit organizations aim to fill gaps, but demand often exceeds available resources. Improving health insurance parity laws and expanding public funding for mental health services could help address this threat (Substance Abuse and Mental Health Services Administration, 2016).
Stigma and Discrimination

Social stigma surrounding mental health conditions remains a significant barrier to effective treatment. The fear of discrimination from employers, insurers, or others may discourage some from seeking help or disclosing a diagnosis. Anti-stigma programs that educate the public and promote compassion are needed to counter this threat over time (National Institute of Mental Health, 2019). Counselors can also support clients in developing resilience and coping strategies to manage stigma’s impacts.
In conclusion, both internal and external factors can undermine mental health treatment if not properly mitigated. A collaborative, client-centered approach that addresses individual needs, social determinants of health, and systemic barriers will help maximize outcomes. Future research should continue exploring new ways to strengthen treatment and reduce threats to effective mental health management.
References
American Counseling Association (2016). Building client engagement. https://www.counseling.org/docs/default-source/vistas/building-client-engagement.pdf?sfvrsn=12
National Alliance on Mental Illness (2019). Treatment and services. https://www.nami.org/About-Mental-Illness/Treatments
National Institute of Mental Health (2019). Mental health information: Stigma and discrimination. https://www.nimh.nih.gov/health/topics/stigma
Substance Abuse and Mental Health Services Administration (2016). Mental health care access and affordability. https://www.samhsa.gov/sites/default/files/mental-health-care-access-and-affordability.pdf

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