Human history suggests that humans have coped with hearing loss and Deafness for centuries, because it was addressed in some of the world’s most ancient texts, including the writings of Plato and Aristotle, the Torah, and the Talmud. A person who is Deaf or hard of hearing from birth or in the first days of life has a congenital hearing loss. Mixed hearing loss results from a combination of both conductive and sensorineural causes. The distinction between medical hearing loss and membership in the cultural group is made by capitalizing the term Deaf when referencing individuals in the Deaf cultural community. Cultural transmission is primarily a function of residential schools for the Deaf, and for this reason, the Deaf community strongly resists public school mainstreaming or inclusion. Treatment and management of hearing loss are very important and usually involve provision of assistive listening devices.
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- Go to chapter: A Synopsis of the Health Insurance Portability and Accountability Act and the Affordable Care Act
The passage of the 1996 Health Insurance Portability and Accountability Act (HIPAA) was originally an effort by Congress to ensure portability of health insurance between jobs for American workers. This chapter provides a brief overview of HIPAA regarding mental health services, compliance issues for providers, filing and investigating complaints, violation penalties, a list of terminology, and resource links for more detailed information. Patients must be informed of their rights and are required to sign the appropriate forms authorizing the health care provider to obtain and/or provide information to other health care providers as relevant. All psychotherapy notes recorded on any medium by a mental health professional such as a licensed counselor or psychologist must be kept by the author and filed separately from the rest of the patient’s medical records to maintain a higher standard of protection.
This chapter reviews dimensions of effective intake interviewing, including preparation, skills, cultural competency, informed consent, and format. Preparation is important for the effectiveness of an intake interview. This includes attention to space in which the interview will be conducted, a review of available client information, and consideration of the purpose of the interview. An intake interview relying primarily on questions may leave clients feeling disconnected from the counselor and discouraged about the potential benefits of the counseling process. The structure and the breadth of the intake interview is determined by many factors, including where the counseling is taking place, accreditation and insurance requirements, and the intensity of clients’ distress or level of functional impairment. An effective interview allows the counselor to accurately understand clients’ presenting concerns, collaboratively consider outcome goals, develop a supportive relationship, and promote hope about the benefits of the counseling process.
This chapter offers a practical approach for facilitating disaster mental health and stress debriefing groups using a combination of crisis response models; specific guidelines for structuring such interventions and responding to individuals and groups; and resources to assist in personal and professional growth in the specialty area of disaster mental health response. Additionally, three case scenarios are provided at the end of the chapter for the purpose of practicing the skills of disaster mental health and stress debriefing interventions. Initially, the preintervention and planning stage is critical in assessing, coordinating, and communicating with others on the disaster team concerning the trauma survivors’ psychological, spiritual, and medical/physical level of functioning. The ethical and competent disaster mental health practitioner knows that he or she should never force emotions or shame individuals for not disclosing, especially early on in the grieving and healing process.
Perceived prejudice events are recognized as stressors that are linked to lowered mental health for those who experience such events. Frequently misrepresented and even vilified in the press, Middle Eastern Americans are routinely negatively portrayed in the media and entertainment and are often the victims of stereotypes. Religion plays an integral role in the lives of many Middle Eastern Americans and may be a central component of their identity. The family is the central structure of Middle Eastern culture and plays a critical role in Middle Eastern social origination and in collective identity. Middle Eastern Americans may have a general skepticism of the authority of mental health professionals, in part due to the negative connotations of mental illness. The concept of mental disturbance may be difficult for them to accept as a diagnosis.
This chapter provides a general overview of the cognitive behavioral history, model, and techniques and their application to counseling practice. Cognitive behavior therapy (CBT) originally evolved out of two traditions, the behavior therapy tradition and the psychodynamic tradition. Behavior therapy was one of the first major departures from the more traditional, psychodynamically oriented approaches to therapy. Through the use of Socratic questioning, CBT involves an ongoing assessment of the person and the problems throughout the therapy experience and is very sensitive to the idiosyncratic nature of an individual’s problems. Once cognitive, behavioral, and emotive patterns are identified for change, the CBT therapist begins to introduce a variety of focused techniques to facilitate this process. Behavioral interventions can be especially helpful in promoting change in individuals who have a harder time making elegant core belief changes through cognitive methods.
The uniqueness of Native American Indian (NAI) people in the United States is founded on rich and diverse cultures that have enabled this population to survive severe political, economic, and environmental hardship. Counselors, psychologists, psychiatrists, and other mental health providers and therapists have an obligation to bear in mind the cultural differences of all clients in their vulnerable states. Respect for cultural beliefs and ways of living and thinking, regardless of how alien they may seem to the caregiver, will encourage the Native client to develop trust and more fully participate in his or her own healing process. It is important that therapists learn as much as they can about the NAI client because of the importance their identity and beliefs have for them as people with proud histories. In contrast, majority or White culture emphasizes saving, domination, competition, individualism, a future time orientation, and the nuclear family.
The history of counseling is a fascinating evolutionary process, particularly how the profession developed, and how quickly it has evolved through the professionalization process during the past half century. This chapter reviews and highlights the major events that led to the development of professional counseling, including the numerous professional specialty groups that make up the family of professional disciplines in counseling that provide services to clients in diverse practice settings. One of the critical issues that continues to challenge the counseling profession and related specialty areas are professional identity and professional unification. The unique divisions within the American Counseling Association (ACA) represent areas of specialized practice and special-interest areas that relate to a broad constituency of counselors regardless of their specialty areas of practice. Examination and certification standards for the certified rehabilitation counselor (CRC) credential have been established through empirical research throughout the Commission on Rehabilitation Counselor Certification’s (CRCC) history.
This chapter presents an overview of a guiding model for clinical practice for the use of homework with a broad spectrum of clients and presenting problems. As with many aspects of clinical practice, these guidelines will be most effective if tailored to meet the individual client’s goals for therapy. The chapter provides suggestions for increasing counselors’ skills in incorporating homework assignments into the therapy process. This material is primarily based on the work of Aaron T. Beck’s cognitive theory and system of psychotherapy. Certainly, behaviors and cognitions are commonly addressed by homework, but better accessing of emotions, or addressing interpersonal relationships, are examples of other directions that homework can take. A theoretical framework to explain the mechanisms behind how clients engage in homework assignments, and how such successful engagement can augment psychotherapy outcomes.
This chapter clarifies differences between two aspects of supervision and reviews the need to evaluate training interventions to improve clinical supervision competence. It examines evidence-based practice as it relates to qualities and competencies needed to work as an effective clinical supervisor. The chapter addresses the benefits of using group supervision and its potential for developing multicultural competence; examines possibilities through distance supervision; and concludes with a brief discussion of the importance of ethical standards in clinical supervision. It provides foundational material that is expounded elsewhere in this desk reference as applied to rehabilitation counselor supervision practice. Using the available information from various clinical and research sources to inform the professional field is commonly referred to as evidence-based practice. In general, supervisors who are knowledgeable about counseling theory and practice and help supervisees to develop a deeper understanding of clinical issues through constructive feedback, demonstrate respect and concern for their supervisees.
A national expert on managed care was invited to help explain what counselors were up against as they tried to be recognized as providers on insurance plans. Managed health care plans negotiate lower prices with therapists so that employers can give their employees discounted services. There are three types of managed health care plans: health maintenance organization (HMO), preferred provider organization (PPO) and point of service plan (POS). All licensed counselors who work with insurance and managed care plans must use the national provider identifier (NPI) number when filing an insurance claim. The specter of managed care has caused anxiety and frustration for counselors, but many times the issues can be tackled with an old-fashioned problem-solving approach. A medical billing software system allows the counselor to keep patient information on the computer and send claims directly to a clearinghouse that will format and send the claim to the insurance carriers.
Rational emotive behavior therapy (REBT) is a founding cognitive behavioral approach to treating psychological problems and is the basis for most of the cognitive behavioral approaches as studied and practiced today. REBT is a modern interpretation and outgrowth of the Stoic and rationalist schools of philosophy. The REBTer distinguishes between appropriate negative emotions and inappropriate negative emotions. REBT demonstrates the applicability and practical usage of its psychotherapeutic message. The main demands in REBT that constitute a wide variety of disturbances can be categorized as Three Main Musts, and their corollaries. All of these beliefs interact and affect each other in nuanced ways, and the experienced practitioner would explore how that occurs. Most of these salient beliefs contain demands, in the form of Musts: musts on self, musts on others and musts on the world, and conditions.
Community-based rehabilitation (CBR) originated in 1978 as a strategy for improving rehabilitation services and outcomes for people with disabilities living in low-and middle-income countries who were not well served by traditional medical-model rehabilitation. CBR enlists and empowers the person’s social network from family to community to provide and sustain a network of care and support, create opportunities for participation, and remove physical and attitudinal barriers to inclusion. Guidelines for CBR practice are ensconced in the five key components of the CBR matrix: health, education, livelihood, social, and empowerment. Poverty and its consequences are a particularly central concern to CBR planning as a prerequisite to robust community health and health care. Empowerment is the starting point for CBR planning, acting as an organizing feature of the plan, and the source of its motivation for success.
The terms sexual abuse and sexual assault are frequently used interchangeably in the literature to indicate sexual acts with a person who does not give consent. When these acts are also accompanied by physical force, death threats, incapacitating substances, or kidnapping, the term aggravated sexual abuse is applied. Sexual abuse is commonplace, but the actual prevalence of sexual abuse is difficult to determine because there is no central agency responsible for the gathering and assimilation of these data. Abuse can be reported to a number of agencies that do not share information, such as government and legal entities, medical facilities, mental health services. Unresolved sexual abuse may result in somatic reactions, negative thoughts and beliefs about the self, negative emotions, destructive behaviors, and interpersonal problems. A number of additional issues may require therapeutic interventions if the sexual abuse was intrafamilial, including addressing the mother-victim relationship and the perpetrator-victim relationship.
- Go to chapter: Enhancing Client Return After the First Session, and Alternatively Dealing With Early Termination
This chapter explores two separate occurrences in the counseling process: clients who do not return after the first session, and effectively dealing with early termination of counseling. Most practitioners are all too familiar with one or both of these phenomena in counseling and are often left wondering what happened during the process for it to end prematurely or to never begin. The chapter addresses probable reasons why clients do not return following the first session and offers practical strategies regarding how to minimize this occurrence. Professional disclosure provides clients with answers to many questions they might otherwise have about the process, policies, and procedures. Treatment goals and length of treatment will vary depending on counselor theoretical orientation. Cognitive behavior therapy, is usually short term, focusing primarily on symptom reduction through the development of client coping skills and self-efficacy, and less emphasis on the client-counselor relationship.
This chapter explores some of the possible underpinnings behind Sue and Sue’s citation that in counseling situations with minorities, more than 50% of clients do not return for a second visit with a counselor. This potential elephant in the room may lie deep within the past history of cultural distrust that many persons have toward the White race in America through stories that are passed down by their parents and grandparents. The chapter discusses a brief history behind some of the transgressions by White Americans toward racial and ethnic minorities to provide counselors with some perspective on the possible reasoning behind each minority group’s lack of trust. It explores those characteristics of culture that transcend time, acts of legislation, and cursory attempts at equality. Ethnic and racial minorities in the United States are still connected to yet vivid histories of segregation, oppression, marginalization, and discrimination.
This chapter provides readers with an overview of the roles, functions, and knowledge base of counselors and addresses the professional issues that influence the identity and practice of counselors today. The primary role of a counselor is to assist clients in reaching their optimal level of psychosocial functioning through resolving negative patterns, prevention, rehabilitation, and improving quality of life. Rehabilitation counselors work with clients with disabilities and/or chronic illnesses, including those with psychiatric conditions, in settings such as state vocational rehabilitation agencies, hospitals, and so on. Addiction counseling, a recently acknowledged master’s-level counseling specialty, involves working in the substance abuse/addictions field and provides addiction prevention, treatment, recovery support, and education. The shared practice and knowledge domains of counselors and other helping professions coupled with the diversity within the counseling profession has, on the one hand, produced a rich, comprehensive, and inclusive field.
This chapter provides a primer of knowledge with the aim of increasing skills for professional counselors working with LGBTQ individuals, couples, and families. People today can see television shows with lesbian, gay, bisexual, transgender, or questioning (LGBTQ) characters, same-sex couples, married same-sex couples raising children, as well as art depictions of diverse, modern families. Despite the numerous civil rights advancements made by the LGBTQ community, many state legislators and attorney generals have argued that allowing gay men and lesbians to marry will harm the institution of heterosexual marriage. In addition, traditional family organizations have worked to impede or overturn the civil rights progress made by the LGBTQ community. Same-sex individuals and couples form families tantamount to heterosexual individuals and couples. Heterosexual marriage remains one of the most common ways that LGBTQ parents acquire children.
This chapter provides a review of key evidence-based practice (EBP) concepts and discusses how this approach can be effectively implemented to improve the professional practice of rehabilitation counseling. EBP is particularly relevant to the rehabilitation counseling profession in this era of accountability, best practices, and quality outcomes. Rehabilitation counselors have been incorporating empirically supported interventions used by counseling professionals and vocational rehabilitation (VR) professionals that are validated by disability and rehabilitation researchers. However, there are still not enough rehabilitation counseling interventions that are developed and validated specifically for people with disabilities. Dunn and Elliott argued for the supremacy of theory and its place in rehabilitation research. With greater efforts to conduct meaningful theory-driven and intervention research, it will enable rehabilitation counselors to truly engage in EBP to improve employment and quality of life outcomes for people with disabilities.
This chapter briefly highlights existing literature and research concerning identity development formation and the coming-out process for lesbian, gay, and bisexual (LGB) individuals. It then focuses more specifically on cultural issues that exist within the LGB community and more closely focuses on counseling considerations that will assist mental health professionals to work more effectively with LGB clients of color. Sexual identity development models were constructed to better understand the coming-out process for LGB individuals. Specifically, LGB identity models provided a conceptual framework to describe the psychological and sociocultural identification as a LGB group member. Social supports relative to racial or ethnic identity may not be the same social supports relative to the LGB community. Counseling professionals may find that LGB people of color often struggle to reconcile their feelings of homonegative beliefs and their desire to practice their form of religion or spirituality.
A brief description of the practice of Gestalt therapy is offered and presented here under its four primary theoretical constructs, but a more in-depth description following this same development can be found in The Handbook for Theory, Research, and Practice in Gestalt Therapy. The unity of Gestalt therapy theory does not refer to one grand design originated by one comprehensive theorist. To practice Gestalt therapy requires experiential training and supervision. Finally, the Gestalt theory is unified in Gestalt’s holistic approach. The therapeutic relationship is perhaps one of the best-attested factors with regard to outcomes in psychotherapy. The entire therapeutic relationship could be considered experimental, because at one level it is the provision of corrective, relational experience for many clients. Thus, there is a corollary between nondirective play therapy in working with children and the experimental approach of Gestalt therapists working with adults.
Experts in the fields of special education and rehabilitation recognize that the transition process must include the provision of quality services for all youth with disabilities as they prepare to leave school. Transition for any student with a disability involves several key components, including an appropriate school program; formalized plans involving parents and the entire array of community agencies; and multiple, quality options for gainful employment and meaningful postschool education and community living. Facilitating a student’s transition from a school program to the workplace requires movement through school instruction, planning for the transition process, and placement into meaningful community-integrated employment. Traditionally, rehabilitation counselors working with a public agency have spent most of their time in case management rather than counseling responsibilities. As a member of a transition planning team, the counselor may also assume a role of ensuring dissemination of accurate information to parents and educators.
Of the eight core areas that the Council for Accreditation of Counseling and Related Educational Programs requires in all counselor education programs, two are concerned with development: human growth and development, and career development. One may ask why career development merits its own distinct category and is not just subsumed under human development. The roots of our concern with human development extend back to the Enlightenment of the 18th century, with its emphases on rational thinking, scientific method, and the rights of the individual. Although trying to stay within the new paradigm by casting his theory as a personality theory because it describes different types of persons, Holland was primarily concerned with the match between these types and occupations that call for people of that type. In the 1970s, a heightened interest in cognitive processing and in strategic decision making emerged across a range of academic disciplines.
This chapter addresses work in the context of disability and provides a choose-get-keep framework for examining vocational development and work issues in counseling. It also discusses implications for counseling. Many helping professionals focus on the medical condition or diagnosis as defining disability. The presence of a health condition or symptoms is not the sole cause of disability but may contribute to limitations in functioning, and not all health conditions lead to disability. The legislative environment also affects work and disability. Counselors must be prepared to discuss the functional limitations that the individual experiences that may be attributed to a physical or mental impairment related to the first part of the definition of disability. Vocational development may be affected by disability in a number of ways. Disability that occurs from birth, or in childhood or adolescence, may delay development of vocational identity.
The relatively high rates of marriage and low rates of divorce, along with a greater tendency to live in extended family households, indicate a strong orientation toward family among Asian Americans, for whom it serves as an important source of strength and resiliency. Asian Americans’ self-worth and self-identity are strongly tied to their collective identity as members of a family. Characterized as faithfulness to parents, this value is very significant and is exemplified by children offering respect, honor, loyalty, dutifulness, and sacrifice to their parents. Asian Americans may be accommodating, appeasing, and amenable, refraining from openly confronting others in order to maintain interpersonal harmony. The valuing of interpersonal harmony can result in the client striving to build a strong working alliance with the counselor. Asian Americans are distinguished by the extremely low levels at which outside treatment is sought for mental health problems.
Feminist therapy was born during the Feminist Movement of the 1960s and 1970s in protest over the oppression of women receiving treatment in counseling and psychotherapy. These practices start when children are born and they continue throughout their lifetime as gender-role socialization. To fully understand Feminist therapy, counselors need to first appreciate the issues involved in gender socialization and oppression. The oppression of women is evident when one considers that, regardless of occupation, there is a wage gap between men and women doing the same job; the glass ceiling that is reflected in the absence of women at the highest levels of business, industry, and education; sexual harassment of women; domestic violence in which women are most often the victim. Feminist counselors work to help clients understand the family history, internalized messages, and the effects of the socialization process on their presenting issue.
Clients have the freedom to choose whether to enter into or remain in a counseling relationship and need adequate information about the counseling process and the counselor. Professional disclosure statements disclose to clients the nature and boundaries of the counseling relationship they are about to enter. All states’ counselor licensure boards have their own requirements for topics to include in professional disclosure statements, and these may vary slightly from the standards in the ACA Code of Ethics. A major challenge in developing a written disclosure statement is balancing the need to include enough information to clearly communicate the nature and parameters of the counseling experience and the need to avoid providing so much information as to overwhelm and intimidate the client. For example, counselors employed in organized work settings, such as mental health, rehabilitation, or addiction programs, will provide different information in some areas, such as fees for services.
This chapter covers two kinds of situations where the leader has to deal with involuntary members: all members not wanting to be in the group, and one or more members not wanting to be there. In groups where the entire group does not want to be there, the leader must recognize that he or she has two purposes: to try to cover the subject, such as anger, drinking, and driving, and to try to get the members to become voluntary. Many counselors find themselves leading involuntary groups groups with members who do not want to be there. These kinds of groups may include driving under the influence (DUI) groups, short-term inpatient groups where members have had psychotic breaks or tried to commit suicide, long-term inpatient groups such as drug and alcohol treatment centers or adolescent treatment centers, and school groups where students are in trouble for their behavior, truancy, or failing.
Many Hispanics/Latinos have a high need for mental health services. Their emotional needs include issues around ethnic identity, immigration, acculturation, and discrimination. It has been suggested that H/Ls’ risk of mental illnesses is closely associated with the duration of stay in the United States, suggesting an inverse relationship to acculturation. Research suggests that compared to Anglo Americans, Hispanics have less access to and availability of mental health services, are less likely to receive needed mental health services, often receive a poorer quality of mental health care, and are under-represented in mental health research. The treatment of H/L men by psychotherapy remains one of the most challenging of all endeavors for the psychologist or therapist. Counselors must be culturally sensitive when treating H/Ls, keeping in mind traditional family patterns and gender norms, as well as other stresses that influence or can present as a mental health concern.
This chapter provides a contextual discussion in which to understand sexual minority people of color. The term sexual minority people of color represents a diverse group of people; in many ways, it is an imprecise construct to describe the many unique specific characteristics and concerns of individuals generally included under this umbrella term. This term is used in the chapter in an effort to reflect the diverse racial identity and sexual identity expressions among individuals often labeled as “people of color” and “LGBTQ” (lesbian, gay, bisexual, transgender, and questioning). It discusses some of the psychological, sociopolitical, and sociocultural concerns of the group. The chapter also discusses some of the unique experiences of this group broadly to provide an overview of the issues that many people of color may experience that mental health practitioners need to know when working with members of this group.
Counseling techniques that focus on communication training and family therapy may have developed as remedies for such problematic interpersonal coping strategies. The implication for counseling is that models for interpersonal negotiation and gender role flexibility may be lacking in some southern European American homes. Many treatments for European Americans are already part of the traditional counseling practice. Sometimes issues that arise in counseling a White American client may be related to a lack of understanding of the impact of privilege on the client and ignorance related to race. Some scholars have noted the lack of emphasis on encouraging White people to explore what it means to be White or have called for White people to explore their own cultural identities. When counseling White Americans, the ethnic variety within one specific religion or denomi-reference nation creates further diversity in religious and spiritual expression.
Within rehabilitation counseling practice, clinical supervision is a process fundamental to one’s professional training and ostensibly to one’s ongoing professional development. This chapter addresses additional information relevant to current practice as it pertains to effective, ineffective, and harmful supervision as well as strategies to address the lack of training in clinical supervision, which seems to exist in the rehabilitation counseling field. This process involves individual, triadic, and group supervision formats through direct and indirect observation methods where supervisors function within acceptable ethical practices to promote counselor awareness, knowledge, and skills that result in successful rehabilitation outcomes. Although clinical supervision is an activity that, to varying degrees, each rehabilitation counselor participates in and may benefit from, we have limited understanding as to what constitutes evidence-based practice to inform the field. A long-term strategy would be to teach clinical supervision content as a separate course of clinical fieldwork for rehabilitation counselors-in-training.
Counselors seek to understand their clients; based on that understanding, they establish a therapeutic alliance and, in cooperation with the client, develop treatment goals. Greater numbers of persons with physical, cognitive, emotional, and psychiatric disabilities seek counseling services due to the following factors: the growing number of people with all types of disabilities; more complete integration of people with disabilities (PWDs) into the broader culture; growing awareness that anyone can acquire a disability; and a rising Disability Rights movement, which is advocating for civil rights and a higher standard of living for PWDs. Counselors may avoid dealing with disability issues, or they have restrictive ideas about the roles of PWDs, and counselors may not expand the range of roles and behaviors available to their clients with disabilities. Individual counselors and the counseling profession are faced with the task of questioning our assumptions about disability and the individuals who experience them.
This chapter discusses the challenges counselors typically encounter when working in rural communities as well as suggestions for maximizing the opportunities that rural practice provides. Because of stressors characteristic of rural areas, such as poverty, single parenting, less formal education, unemployment, lack of health insurance, stigma surrounding mental illness, and inaccessible or inconsistent community resources, few opportunities may exist for receiving mental health care. In terms of mental health service delivery, Human and Wasem suggest that availability, accessibility, and acceptability are important aspects to consider in rural communities. The use of communications technology in the educational, clinical, training, administrative, and technological aspects of health care is known as telehealth. Telehealth can vary from e-mail communication to videoconferencing to more advanced computerized therapy programs. One of the most salient ethical issues in providing therapy in rural areas is that of dual relationships.
To develop an appreciation for the electronic health record (EHR) it is important to understand the barriers to its adoption among mental health professionals. This includes the belief that it is easier and more convenient to document care using paper and pen. The chapter mentions a scenario, where even if the emergency room personnel were able to gain access to the patient’s paper medical record, they would have had a hard time understanding the record’s content. Another common problem with the paper record is the lack of organization especially under circumstances in which the patient has multiple mental health issues. After addressing a major concern with EHRs among mental health professionals and the inherent problems with paper records, the chapter focuses on the functionality that makes the EHR an appealing proposition. When health care data are stored electronically, the capability to share data among health care providers is heightened.
This chapter presents an overview of the principles and skills of the counseling style. Motivational interviewing (MI) is a clinical style, a form of psychotherapy, which is “a person-centered goal-oriented approach for facilitating change through exploring and resolving ambivalence". Applications of MI in health and mental health are increasing. Mental health studies have encompassed dual disorder management; mental health treatment; problem gambling counseling; sexual behavior change. The microskills can be used in any counseling context. Ambivalence is central to the philosophy and practice of MI. It is a discrepancy between a counsel-ee’s behaviors and how he or she wants to be that is elicited and reinforced in the direction of change. MI has good evidence for effectiveness, and training in the style can potentially improve outcomes in a range of treatment contexts.
This chapter focuses primarily on one of the core qualities of the professional counselor: a commitment to wellness. Interrelated with development, personal growth, and prevention, wellness informs the way counselor assess client needs, develop and implement wellness plans, and evaluate client outcomes. The wellness paradigm, in contrast to the medical, “illness-oriented” model of client care, shifts the focus to facilitating optimal growth and development in clients. Remediation of many disorders may be reconceptualized as helping clients overcome developmental challenges through positive lifestyle choices; growth itself can become the target of counseling. While discussing wellness components, self-assessment is needed to personalize the meaning of each factor for clients. Using a psychoeducational model to teach wellness components allows clients to see how change in one area contributes to changes in others, and helps them review the components of holistic wellness.
The definition of career encompasses one’s vocational behavior across the life span. Although the field of career counseling is developmental in both nature and definition, there are few theories that have specifically focused on this aspect of career counseling. This chapter focuses on highlighting a few of those career development interventions that have been shown to be effective and how they can be appropriately utilized across a person’s life span. It discusses aspects of diversity that offer their own unique challenges across the life span and are currently a priority topic in career development. Career guidance techniques in the elementary school setting might include curriculum infusion such as reading reference books and storytelling, group activities such as role-playing, and, finally, community involvement activities such as field trips and inviting local businesses to the school. Career counselors need to be cognizant of sexual identity models, regardless of a person’s developmental aspect.
The professional counselor often takes on the role of resource broker. A resource broker is a professional who helps the client to identify, access, and successfully use any vendor who can provide a service or material good necessary to operationalize the client’s service plan, that is, meet the client’s developmental needs or therapeutic goals. Success as a resource broker depends on the professional counselor having in-depth knowledge about community and professional resources. A resource broker is a professional who helps the client to identify, access, and use any vendor who can provide resources necessary to operationalize the client’s service plan. Resource brokers act in a liaison role among the client, the organization serving the client, and outside organizations from whom it is necessary to secure resources. The professional counselor, with whom the client is in a developmental or therapeutic relationship, is the ideal person to serve as resource broker.
This chapter discusses career development theories in four different categories: personenvironment fit, developmental, social learning, and postmodern career development theories. The leading developmental career theory is Donald Super’s life span, life space theory. Super’s theory drew on a variety of disciplines, such as psychology and sociology, and developed what he called a “differential-developmental-social-phenomenological career theory". Postmodern career development theories emphasize a person’s subjective career development experience or his or her understanding of his or her career development journey as it takes place. The contextual theory views career development as dynamic, allowing for individuals to achieve meaning through their own actions within their social environment. Integrating theoretical orientations related to individual difference and individual development provides the fullest explanation for those seeking to understand the career development process. Such integration also links career development to human development, which represents an important next step in the evolution of career development theories.
The individual psychology of Alfred Adler is based on a holistic and phenomenological understanding of human behavior. Adlerians believe that all behavior has a purpose and occurs in a social context, noting that one’s cognitive orientation and lifestyle is created in the first few years of life and molded within the initial social setting, the family constellation. The Adlerian theory purports that humans are all social beings and therefore all behavior is socially embedded and has social meaning. Adlerian psychotherapy is a psychoeducational, present/future-oriented, and time-limited approach. The Adlerian approach is a contemporary therapy as it is cognitive behavioral, culture-sensitive/ multicultural, and integrative. The four stages of Adlerian therapy are as follows: relationship, assessment, insight and interpretation and reorientation. This is believed to be a good strategy because the Adlerian theory gives counselors an overall framework from which to use a host of other methods that might appeal to them.
- Go to chapter: Integrative Approaches in Counseling and Psychotherapy: Foundations of Mind, Body, and Spirit
This chapter offers guidelines and resources that will assist therapists to integrate traditional talk therapies with indigenous health and healing practices. Additionally, it offers foundational principles, thoughts, beliefs, ancient wisdom, and philosophies on mind, body, and spiritual wellness. The comprehensive foundational resources at the end of the chapter explore the literature in counseling, psychology, theology, spirituality, and complementary and integrated medicine. Each of these resources honors the tradition of various culturally relevant indigenous practices that integrate the mind, body, and spirit. In many ways, person-centered counseling and psychotherapy are ritualistic in their form, structure, and practice. Likewise, indigenous healing practices also maintain a form, structure, and ritualistic system for health and healing. The author makes an attempt to objectively state 30 specific foundational cultural beliefs through an extensive literature base in psychology; theology; spirituality; and complementary, alternative, and integrated medicine.
This chapter defines job satisfaction, examines the literature linking occupational choice to job satisfaction and describes the relationship between work satisfaction and well-being. The relationships among occupational choice, job satisfaction, and life satisfaction are important issues for counselors to consider no matter what specialty or setting they are in, as the problems or stress clients experience in one of these domains may affect the other and may overall decrease their sense of well-being. Job satisfaction has been studied from different perspectives, including organizational or sociological perspectives and psychological or career perspectives. Career theories and theorists have often approached the issue of job satisfaction and the meaning of work from a person-environment interaction framework. Research indicates that satisfaction in work potentially spills over into satisfaction in life; therefore, counselors’ awareness of the way the occupational choice contributes to the meaning and importance of work is a critical component of counseling interventions.
The purpose of this chapter is to acquaint therapists with the major concepts of disability-affirmative therapy (D-AT), focusing on five key concepts: special knowledge areas; using the models of disability clinically; making treatment accessible; case formulation; and being culturally affirmative. A basic tenet of D-AT is that incorporating information about disability will inform the case formulation such that it neither overinflates nor underestimates the role of disability. These are the effects of disability on developmental history, understanding models of disability, disability community and culture, and psychosocial issues. Adolescents with disabilities, particularly developmental or intellectual disabilities, may not be taught about sexuality. In the Medical model, disability has been stripped of the moral symbolism, and now is seen as representing abnormality contained within a person’s corporeal self. Such abnormality is the province of medicine, and intervention focuses on amelioration of the abnormality to the greatest extent possible.
Feminism is a social and political movement that focuses on improving the status of women and establishing equity among men and women. This chapter introduces the utility of multiracial feminism within clinical practice, particularly with women of color. It provides brief overviews regarding feminist theory, critiques of feminist theory, and feminist therapy. Lastly, although the term women of color is used within the chapter to reference ethnic minority women, it is used to recognize other social locations beyond race and gender, to include lesbian, poor, disabled, older, and non-American women. While gender inequality is a cornerstone of feminist theories, feminist theories of the past half-century can be grouped into three broad categories: gender reform feminisms, gender resistance feminisms, and gender rebellion feminisms. Various counseling and personality theories can also be integrated within feminist approaches. In addition, contemporary feminist therapy includes men, both as clients and therapists.
This chapter addresses what counselors need to know about professional credentialing, including trends and considerations that counselors may need to monitor. It concludes with basic tips for counselors interested in licensure and certification. Professional credentialing is critical to defining and regulating the practice of counseling. Licensure, certification, and accreditation are distinct forms of professional credentialing. Although each serves the common purpose of protecting public safety by establishing the minimum standards of knowledge and skill for professional counselors. Credentialing is likely to evolve rapidly as the U.S. health care system becomes more politicized. With such progress in professional credentialing, professional counselors need to look ahead for opportunities and challenges in licensure laws and national certification standards. The variety of counselor licensure laws nationally presents a serious problem for professional counselors in their ability to move from state to state without disruption and the ability to practice counseling.
The priorities of community mental health services exerted further pressures toward brief interventions that could reach more clients. Many health care systems in the United States have been developing practices such as managed care to reduce the number of psychotherapy sessions. This chapter defines brief psychotherapy, provides an overview of the types of brief psychotherapy, and outlines some of the major theoretical concepts and techniques associated with each of these therapeutic approaches. Brief therapy is dependent on the type of mental health condition, onset of the disorder, degree of client motivation, and the therapist’s ability to establish an effective therapeutic alliance and assist clients in attaining therapeutic goals. The values of brief therapists tend to be different from those of traditional, long-term therapists. Brief therapists also take the client’s presenting problem seriously and believe that understanding why a problem has arisen is often secondary or irrelevant to producing client change.
African Americans constitute approximately 14% of the American population. They have been an integral part of this society since its conception, yet they face a myriad of issues. These issues include health issues, employment issues, health insurance issues, racism, and discrimination. In the area of employment, the unemployment rate for Blacks is more than twice as high as the White population, and the poverty rate is approximately three times as high. Racism and poverty are manifested in African American incarceration rates. The term African American as a descriptor includes many segments of the American population, including populations brought to America from West Africa during the slave trade. Many African American children have self-respect and positive self-esteem despite the specter of racism and discrimination. Religion and spirituality are an important part of American culture and this is no less so for the African American community.
We are in the midst of a paradigm shift in the helping professions as a result of new extraordinary stressful and traumatic events that have accelerated globally. While medical professionals, police, and other first responders prepare for the medical-physical rescue in a host of disaster scenarios, professional counselors are also called on to provide the mental health rescue. The disaster scenarios that take place on the global media stage add another dimension of reality that negatively fuels our experience of empathy fatigue. Overall, the epidemiological significance of global disaster rehabilitation means that we must be in a constant state of “mission readiness” for service to assist others that may be affected locally, regionally, or nationally. Counselor empathy and insight in acknowledging that oppressed minorities’ daily lives may include food insufficiency and the need to deal with these basic survival necessities must take precedence before any mental health counseling can occur.
The 2014 edition of the ACA Code of Ethics raises the bar for the ethical practice of professional counselors and is the first edition of the code that delineates the core values of the counseling profession. This chapter provides an overview of new concepts and professional responsibilities in such areas as professional values, ethical decision making, avoidance of the imposition of counselors’ personal values, counselor education, social media, and distance counseling. It concludes with a list of resources for learning more about the ethics code for the counseling profession. The Ethics Revision Task Force (ERTF) spent time researching and discussing counseling codes of ethics from around the world. The counselor-in-training cited personal religious beliefs as the basis for their decision. In order to protect a client’s privacy when conducting distance counseling, the revised ethics code requires counselors to verify a client’s identity at the beginning of each electronic session.