This chapter reviews the theories of child psychotherapy and the associated treatment interventions as the next step of integrating theories of developmental psychology into clinical practice. It provides an overview of specific psychotherapies that are significant to the treatment of children; psychodynamic, cognitive behavioral, experiential, family systems, and integrative approaches. The chapter also reviews some of the diagnosis-specific treatment protocols. Trauma-focused cognitive behavioral therapy (TF-CBT) combines cognitive therapy, behavioral therapy, and family therapy in a specific treatment protocol focused on psychotherapy with children who have experienced trauma primarily from abuse. The chapter suggests that case conceptualization in eye movement desensitization and reprocessing (EMDR) with children can include both directive and nondirective roles from the therapist depending on the phase of the EMDR protocol and the individual needs of the child. EMDR is based on adaptive information processing (AIP) theory.

In our success-oriented culture, optimal development of giftedness often is construed as fulfilling one’s potential for greatness. In humanistic psychology, optimal development has been conceptualized differently. Self-realization can be understood in terms of Maslow’s self-actualization, Dabrowski’s secondary integration, Jung’s individuation, or other theoretical perspectives of human development. The goals of inner development involve deepening the personality, overcoming conflicts, and actualizing one’s potential for becoming one’s best self. Many parents of the gifted complain that their children are the ones exerting the pressure. Their speed of learning and quest for knowledge often exceed their parents’ comfort level. The purpose of parent guidance is to foster “optimal development” through early intervention and prevention of social and emotional problems. Assessment can act as a prelude to family therapy. Family therapy usually involves a commitment to several successive sessions to deal with family interactions.

It is critical to distinguish between how to approach medical crises and how to approach emotional crises. By contrast, emotional crises during drug withdrawal are best handled with supportive psychotherapy or family therapy, without resorting to medication, so that the individual’s opportunity for medication-free mastery and growth are maximized. A medical crisis often stirs up an emotional crisis. In addition, many physical illnesses can cause cognitive and emotional dysfunction by directly impairing brain function or by producing physical exhaustion. An evaluation is likely to disclose stressors or conflicts that have caused or contributed to the acute emotional distress. The Non-Emergency Principle or nonviolent communication requires the clinician to be self-confident and self-controlled, and react in an empathic manner, despite provocations or emotional turmoil emanating from the other person. During acute withdrawal, psychotherapeutic interventions should usually be limited to reassurance and guidance.

Wrapping up a solution-building session is about trusting the clients and trusting the process. Reflection teams play an important role in solution-focused therapy at the Brief Family Therapy Center in Milwaukee, but by taking a break to develop well thought-out compliments and suggestions for a couple, individual therapists can act as their own reflection teams. Using the couple’s own words is the most important step in formulating helpful feedback. It requires that the therapist pay close attention to the language used throughout the conversation and to stick with it. Feedback should be related to the couple’s strengths and the traits that have the potential to lead them away from their problem toward the preferred future. In early family therapy literature as well as early solution-focused literature, making suggestions and invitations was referred to as assigning tasks.

This chapter includes the guiding tenets of solution-focused therapy (SFT). Solution-focused (SF) practice differs from other therapeutic approaches in its use of solution building rather than problem solving. The solution-building process is about creating what is most desired by the couple, and not about problem solving. For a couple to be seeking therapy together, there has to have been a time in the past when the relationship was working better for both the parties. By focusing on the relationship and the skills that each partner uses to contribute to the relationship, the therapist conveys a level of hope to the couple. Solution-building conversations must be co-constructed with input from all participants. Motivation should never be in doubt, even if one member of the couple claims that he or she is only there because the other partner “made” them come to therapy.

This chapter presents a framework from which to assess how individuals approach relationships based on power, gender, and the social context. It addresses how to conceptualize individuals in terms of their orientations to relationship. Four relational orientations are described: position directed, rule directed, individuality directed, and relationship directed. Relational orientations are internal ways of experiencing oneself in relation to others. Relational Assessment demonstrates how relational orientations are context-specific and also shows that it can be valuable to help clients distinguish between their preferred orientations and what may actually be happening. The Contextual framework can also help family therapists keep relationships central and bridge the gap between individual and systems/relational assessments. The framework raises issues regarding our ethical responsibility when gender and power push relationships out of balance. Another set of ethical concerns involves who does the assessment and who sets the clinical goals.

One of the most trying aspects of training professionals to work with couples using solution-focused therapy is expecting professionals to go slowly and to develop a connection with their couples before moving on. In fact, the therapist is working to uncover the positive aspects of the couple’s life, and how they were living before their problem. Lipchik calls this process listening with a constructive ear probing for evidence of strengths, resources, and past success, learning what life was like before or without the problem, what the clients want, or anything at all that can be reinforced as a positive aspect of the client’s lives going forward. Every couple comes from a past when the relationship was working much better. The therapist listens for clues about how the relationship was built to understand what worked in the past and continues to work today.

Rational emotive behavior family therapy follows the principles and practice of rational emotive behavior therapy (REBT). REBT and cognitive-behavior therapy (CBT) have a good record as far as their basic personality hypotheses and claims for clinical effectiveness are concerned. The author began to do conjoint marital counseling and family therapy but found the techniques to be much more efficient and less time-consuming as he replaced analytical with REBT. Hassles and frustrations of living are the inevitable human condition. Parent or child one has to go along with many domestic restrictions, including room arrangements, money expenditures, meal scheduling, and a hundred other limitations. Family systems therapy tends to require an active-directive therapist who makes clear-cut interventions and who engages in a great deal of problem solving. Clients are held to be responsible for their attendance at family therapy sessions and for doing their homework assignments.

This chapter examines both the history and benefits of teaching specific models in Marriage and Family Therapy (MFT) supervision and then focuses on an integrative, moderate common-factors approach. MFT as a profession originated in the late 1950s and 1960s with a series of rebellious pioneers who rejected the dominant individual-based behavior and psychoanalytic models of the time in favor of something new. Supervisors who intend to integrate common factors into the supervisory experience and education have several tasks, possibly the most important of which is to provide education to supervisees about the factors that truly are common to all psychotherapy modalities. The chapter describes the seven common factors: client factors, therapist factors, the therapeutic alliance, hope and expectancy, allegiance of the therapist, feedback, and interventions, such as behavioral, cognitive, affective that cut across all models.

Murray Bowen Family Systems Theory attempts to explain life and the human phenomenon, rather than specific families. As with many early family therapists, the development of Bowen’s theory grew out of the decision to include family members in the treatment of patients diagnosed with schizophrenia. Bowen Family Systems Theory is based on the need for intrapersonal and interpersonal balance, with chronic anxiety and differentiation serving as the foundational constructs for the theory. These constructs are opposing: the former causing symptoms and the latter acting as the antidote. Bowen believed that family systems theory was describing life, not merely families, arguing that the constructs of his theory were universal to all genders and cultures. The implication of this belief is that culture-including race, ethnicity, gender, and the specific beliefs, values, and traditions that vary between people-does not matter and does not affect the ability for change to occur in therapy.

This chapter presents an overview of Marriage and Family Therapy (MFT) supervision was presented in a non-contextual format. The MFT profession has long recognized the pivotal role of supervision in preparing and socializing future generations of MFT professionals and in fostering the ongoing personal and professional development of both novice and seasoned MFT practitioners. The normative, socialization, educative, and evaluative functions are interrelated and intersect over the course of supervision. The functions represent a translation of the MFT profession’s ecosystemic perspective into a contextualized framework for supervision. Supervisors and supervisees bring their personal, family, community, cultural, and professional backgrounds to the supervisory encounter. The chapter explores the required tasks and structures to be developed, with a focus on multiculturally appropriate service at both the supervisory and therapeutic levels. It emphasizes the significance of an evolving contract and clear evaluation plan based upon self-assessment and reflectivity.

Feminist family therapy is a meta-philosophy: a group of feminist perspectives that can focus and expand psychotherapy models. This chapter reviews several feminist perspectives and how each can inform a feminist family therapy lens. It discusses the role of feminist clinicians, the process of change, specific feminist-informed conceptual and executive techniques, and the role of feminists as supervisors and trainers. Radical feminists paid most of their attention to gender but also acknowledged that racism, classism, and heterosexism also affected people in couples and families differently, and argued that overt attention to the origins and outcomes of power dynamics should be incorporated into the therapist’s work. Cultural feminism arose concurrently with the radical feminist critique and quickly brought into discussion the construction of social power as it intersected with class, ethnic identity, gender, age, physical ability, and soon thereafter sexual orientation.

The Emotionally Focused Therapy (EFT) supervision model is the first known empirically derived model of supervision in the field of couple and family therapy. This chapter presents the basics of the EFT supervision model, along with additional insights that have been gained by the authors since 2011. EFT is a humanistic, systemic, experiential model which posits that people and relationships can grow and change. The EFT therapist takes a collaborative stance and assumes that client emotions, experiences, and behaviors make sense in their context. An important part of EFT involves accessing, expanding, and reprocessing emotional experience. The EFT supervisor-supervisee relationship is one of collaboration and respect. Attuning to supervisees, like attuning to clients, demands flexibility and self-awareness. Recognizing the many levels of intervention-alliance, conceptual, experiential, and self-of-the-therapist (ACES)-provides a broad framework for the supervisor to meet the supervisee’s varying needs.

Structural Supervision, adapted from the Structural Family Therapy model developed by Salvador Minuchin, is an effective supervision model used in Marriage and Family Therapy (MFT) training. This chapter discusses the components of using Structural Theory in supervision; the philosophical foundation of the theory; the use of techniques and modalities in supervision; the role of the therapist and supervisor; the process of change; and culture, gender, and diversity issues related to the use of this theory in supervision. It also includes a case example. Providing a theoretical foundation for supervisees is essential for the growth and development of Marriage and Family Therapists as well as for setting a standard for the profession. The primary goal in the Structural model of supervision is correcting the hierarchy. Creating healthy boundaries and an effective hierarchy are also an important process of change in Structural Theory.

The systems/dialectical model of supervision is based in emotional restructuring and isomorphic and developmental components. It consists of three simultaneously occurring stages or processes in which emotional, cognitive, and behavioral components interact to produce change: building relationships, breaking impasses, and orchestrating change. The systems/dialectical model of Marriage and Family Therapy (MFT) supervision was developed in a master’s-level program in order to apply a generic systems approach to supervision that would be compatible with various systemic approaches. Two guiding principles undergird the systems/dialectical model: the process of supervision is isomorphic with the therapy process, and developmental change occurs in both the supervisee and the couple or family. A systems/dialectical model proposes that the role of the therapist is to bring about change in the client using both implicit and explicit processes. A systems/dialectical perspective of cultural, racial, and gender factors in cross-cultural therapy is dialectical in nature.

The field of Marriage and Family Therapy (MFT) is on the fast track to becoming a prominent and competitive mental health profession, based on an expected growth in MFT jobs, as well as a growing body of clinical research. The Commission on Accreditation of Marriage and Family Therapy Education (COAMFTE) develops accreditation standards for graduate and postgraduate Marriage and Family Therapy training programs to ensure that students are getting a strong educational foundation in MFT. The COAMFTE focuses on the various aspects of MFT training, including the educational and practice regulatory requirements. Supervision for MFT students and postgraduates working toward licensure is generally provided by American Association for Marriage and Family Therapy (AAMFT) Approved Supervisors. Today’s fast-growing technology is affecting both Marriage and Family Therapy and supervision. Multiculturalism in a globalized society is important for marriage and family therapy students and supervisees as well as AAMFT Approved Supervisors.

Few guides exist that outline the use of contextual therapy theory as a supervision model for training systemic therapists. This chapter presents an overview of contextual therapy theory and its application to supervision, the role of the supervisor and supervisee, and the application of this supervision model to the given case example. The contextual therapy approach assumes an integrative, intergenerational stance, positing that both individual and relational realities constitute human existence. In order to examine both individual and relational realities in the supervision relationship, the contextual supervisor should incorporate the four basic tenets of the contextual therapy model into the supervision approach: existential facts/biology, individual psychology, transactional relational patterns, and relational ethics. The supervision relationship should also incorporate specific components related to ethics, such as fairness, trust, loyalty, and entitlement. The goals for training a contextual therapist mirror the goals put forth for the therapeutic relationship.

This chapter sheds light on how the managed care system works as well as the counselor's role in managed care and the importance of advocacy and issues related to payment and reimbursement. It offers a starting point to understand the system, and counselors must continue to seek more resources, join organizations and build networks with other counselors and change makers to become active members of the professional community. Managed care is an integral part of the healthcare system, and it is imperative for counselors to be able to understand the system in order to navigate it better. Counselors can anticipate the issues that are related to cost and payments and can provide more efficient service to the clients, if they understand how managed care system operates. The chapter demystifies the issues of payment for counseling services, specifically third-party billing, managed care, medical assistance programs, and other issues therein.

Angela was extremely excited to begin school as a kindergarten student and was matched with a supportive teacher for her first year in the rural community in which her family lived. She was lively and talkative around adults, and her parents worked hard to find opportunities for Angela to connect with kids her own age. However, in their small community there were limited possibilities for connection, and Angela often retreated physically behind her parents in public.

During the first parent–teacher conference for Angela, her parents were surprised at the teacher’s observations that Angela was reading well beyond the level of her peers. Not knowing many other children with whom to compare Angela’s abilities, they had assumed she was on par with most other kids her age. While there were no services available in their school system until the third grade, the kindergarten teacher remarked that the Lees might want to look into additional enrichment opportunities for Angela elsewhere. However, the teacher was eager to provide additional reading opportunities. Because reading was one of Angela’s favorite activities, this arrangement seemed to be a good fit.

It was during Angela’s third-grade year that challenges began for her at school. She often came home upset that she was reprimanded at school, and she rarely talked about positive interactions with her peers. She shared with her parents that she did not have much in common with many of the girls in her class, and that they often teased her about her friendship with a boy in the class they all thought was “weird.” This social tension was exacerbated when she was reprimanded for not showing her work in math class. She expressed her frustration with “Why do I need to write out all the steps for something when I just know the answer!” A friend of Angela’s parents worked in the school Angela attended and shared with them that contacting the school counselor might be the best next step.

This chapter provides a brief overview of models of clinical supervision. It also offers a brief discussion of best practices, common struggles, and a salutogenic- or wellness-based approach to supervision, emphasizing how the latter complements parallel treatment interventions with consumers. Self-care is an important part of a counselor's efforts to maintain general and mental health. The chapter urges counselor trainees to develop continuing education and continued professional development as a part of their career-pathway planning. The discussion emphasizes the importance of remaining current, concerning clinical counseling issues as an ethical issue that is inherent in being a professional. The chapter focuses on the practice and importance of clinical supervision and continuing education for professional counselors. It reviews some of the most common theoretical approaches to supervision and how they may be used. The chapter concludes with a discussion of the ethical mandate and benefits of continuing education for counselors.

School Counselors are uniquely positioned to work as individuals in educational settings to support children and their families, teachers, administrators, and other invested educators. This chapter reviews the school setting which presents distinctive legal and ethical challenges related to counseling minors. It discussed the various roles of school counselors’ within the school setting, as well as ethical challenges and considerations for practice. The chapter compares the ethical codes applicable to the practice of school counseling. It identifies strategies to maintain ethical school counseling practice. School counselors make significant contributions to the educational and personal development of students. When the law and ethics conflict or they cannot be clearly applied in the specific circumstances, school counselors seek consultation, consider ethical implications, apply an ethical decision-making model, and stay apprised of societal changes to make decisions ethically.

Counseling adults in transition is an exciting and challenging job that gives us an opportunity to function at many different levels. Advocacy, consulting, and program development are three ways that one can assist the clients with their transitions–through changing the situation, enhancing their sense of self, developing more supports, and increasing the strategies available to them. Some counselors now work in the corporate world, and others are community organizers; some counselors design programs in colleges and universities, whereas others develop workshops for senior centers; some walk the halls of legislatures as lobbyists, whereas still others talk about mental health on talk shows, on their own or others’ blogs, on twitter, or other internet sites and social media. This chapter talks about a variety of ways counselors can do these things, including consulting, developing programs, and advocacy.

The use of counseling technology and electronic communication between clients and counselors has received increasing attention. While there is great potential in using the internet to deliver counseling services, it is critical that counselors are aware of the ethical implications whenever they use technology to interact with clients. The chapter focuses on the ethical use of counseling technology and provision of distance counseling services. It identifies common ethical tensions underlying the decision to use technology when providing counseling services. The chapter promotes the critical-evaluative thinking underlying e-professionalism and technology ethics as necessary habits in the digital age. A focus on accessibility is critical because we are all dependent on digital technology as a necessary form of assistive technology to function in a digital society. Social media has become the way people communicate, and thus counselors need to inform clients about the inherent threats to privacy and confidentiality.

This chapter explores how pastoral counselors might work with queer-identified persons. It reviews theories of sexual orientation and literature establishing gay/lesbian-affirming approaches to pastoral counseling. The chapter considers emerging theories regarding “queer” identities and how such identities are related to prevailing constructs of gender and sexuality in psychotherapeutic discourses. Pastoral counselors working with queer-identified persons especially in couples and family therapy are challenged to critically reflect on and intentionally deconstruct the ways in which dominant discourses of gender and sexuality have become embedded in operative psychotherapeutic approaches. It is critically important for queer-affirming pastoral counselors to clearly identify the theological, scientific, psychological, anthropological, and sociological conclusions about human sexuality because each of these assumptions shapes the clinical practice. Pastoral counselors are encouraged to seek continuing education and specialized training before working with persons who are transgender, especially those who are actively seeking gender transition.

This chapter provided an overview of the possible effects that the work of counseling may have upon counselors themselves. It has long been recognized that exposure to the distressing experiences and feelings of others can cause similar distress in those who listen and provide intervention. We also recognize that counselors can derive benefit and grow from the work that they do with their clients. Finding approaches to the work of counseling that enhance the potential for growth while minimizing distress is significant part of maintaining successful counseling practice. The chapter addresses issues related to counselor self-care and maintaining a healthy ability to continue with the work of counseling. The issues that are addressed include vicarious responses to trauma (both positive and negative), a biopsychosocial systemic approach to counselor wellness, strategies for engaging in wellness-focused self-evaluation, techniques and tools for stress management, and approaches for maintaining a healthy work/life balance.

This chapter explores the issue of parental involvement in the internet addiction of their adolescent children. It describes familial and parental factors of adolescent internet addiction. The chapter then explores the relationship between parental mental health and their children’s Internet addiction taking into consideration parental Internet addiction, the mental health of the children, as well as the genders of parent and child using a structural equation modeling approach. There are many suitable instruments for assessing parent-and-child mental health problems and internet addiction, as well as their ways of coping such as Depression, Anxiety, Stress Scale (DASS), Internet Addiction Test (IAT), and Ways of Coping Revised (WOC- R) Questionnaire. The family therapy approach should be considered as a front line treatment option in handling adolescent internet addiction. Particular attention should be paid to the identification and treatment of any mental health issues within the family including parents and children.

Counselors and clients are immersed in a social and cultural context and embedded in multiple systems and subsystems, such as family, workplace, community, and society. This chapter addresses system views, integrated care, barriers to treatment, multicultural issues, and the use of multicultural and social justice skills in the provision of clinical mental health counseling. Specific topics include a discussion of systems, holistic care, barriers to healthcare, and culturally competent counselors. The chapter further explores the connections between culturally competent care and the potential role for clinical mental health counselors in ascertaining the systemic need for new agency- and integrated healthcare-based programs. The student is introduced to basic tenets of system worldviews, developing integrated new programs aimed at meeting the clinical mental health needs of diverse and varied clients, and the application of multicultural and social justice skills in clinical mental health counseling.

Our professional roles have evolved over time, and there is a great variety among the roles and functions of clinical mental health counseling (CMHCs) in each and every different system of work. However, there are also great commonalities that continue to define our identity as professionals. This chapter takes an in-depth look at the variety of functions, counseling and administrative roles, and tasks that may be required of counselors in clinical mental health settings. Pertinent issues include balancing consumer care with administrative duties, balancing employee well-being with productivity standards/financial concerns, ethical marketing and recruitment, and remaining current in the field while in nonclinical roles. The chapter helps the reader to discuss the clinical tensions experienced among CMHCs in relation to their job roles and synthesize an understanding of the complex role a CMHC serves in relation to best practices, professional ethics, and legislative regulations.

Aside from the study of theories of counseling and psychotherapy, there is probably no other area of study that is more related to the everyday practice of counseling that than the area of professional ethics. This chapter defines terms related to the ethical practice of counseling and psychotherapy such as an “ethics”, “morality”, and an “ethical dilemma”. It differentiates professional versus philosophical ethics. The chapter outlines mandatory versus inspirational standards of practice. It also addresses professional credentialing issues, along with the need for ethical sensitivity in decision making. The chapter explains the system of ethics governance in counseling and defines skills necessary to become a professional decision maker. Decision making is a cornerstone of professionalism. Counselors must be viewed, and must view themselves, as intellectuals. They must also invest in their profession and be actively engaged in professional activities that better the profession and those served by the profession.

Children who have suffered attachment trauma due to maltreatment, neglect, separations, losses, and caregiver changes have difficulty trusting adults, accepting comfort, recognizing and managing their feelings, and managing their behaviors. The family therapist strengthens attachment security by helping the parents understand the traumatic roots of the children’s behaviors and respond to their children’s emotions with greater sensitivity. The Eye Movement Desensitization and Reprocessing (EMDR) therapist implements EMDR Therapy resource development exercises to strengthen attachment security and self-regulation and addresses memories, triggers, and future templates, depending on the insights discovered and communicated by the family therapist. This chapter provides case studies that have shown EMDR Therapy to improve symptomology and attachment in adults with complex trauma. Attachment resource development (ARD) and Self-Regulation Development and Installation (S-RDI) with parent involvement during the preparation stage increase the child’s sense of security and capacity for self-regulation.

Documentation and record keeping are not only legal and ethical mandates, they are also instrumental in providing competent, quality care to clients. This chapter discusses the importance of the record keeping and documentation processes for clinical mental health counselors. Specifically, it reviews record keeping practices and policies. Also included are legal and ethical issues related to appropriate documentation and record keeping, including the Health Insurance Portability and Accountability Act, subpoenas, and court orders. The chapter helps the reader to distinguish the content of clinical records and identify what is included in a client's clinical file. It helps to recognize the ethical obligation of professional counselors related to record keeping; and appreciate the legal elements of record keeping and how professional counselors can adhere to the laws regarding clinical documentation. The goal of counseling is to facilitate change for the client; quality record keeping is an instrumental element of that process.

Counselors hear stories about what might have been, about what should have been, and about what did not happen. Yet much research and counseling advice has been focused only on marker events such as marriage, childbirth, changing jobs, divorce, or being fired. Most of these events are observable; many have rituals and celebrations attached to them. Counselors have enormous power to help clients exchange heartbreaks for heartmends. Counselors need to help clients deal with nonevents. Thus, this chapter focuses on specific suggestions and strategies for counselors to use with their clients. It suggests a three-step program for counselors to use as they help clients work through their nonevents. The three steps are counselors need to use are: understand the concept of nonevents as a way to listen with a third ear; develop specific strategies for clients to use as they cope with nonevents; and teach lessons for life literacy.

It is important for beginning Clinical Mental Health Counseling (CMHC) students to understand that their engagement in the CMHC specialty is one part of the larger professional counseling framework. This chapter provides a historical overview of the counseling profession and its developmental trajectory, emphasizing the origins of mental health treatment and the reemergence of counseling as a wellness-based approach. It offers discussion concerning the push toward a pathogenic model of conceptualizing mental illness and the subsequent, current resurgence of a strength-based notion of care. The chapter provides an overview of the major theories of counseling as a means for understanding the development of counseling as a unique and separate field from psychology, psychiatry, and social work. It identifies the specializations within the counseling field, the range of employment opportunities and the current labor market, and how counseling is integrated within a system-of-care approach.

School absenteeism refers to physical absence from school, but school refusal behavior refers more broadly to child-motivated refusal to attend school. This chapter focuses on child-motivated school refusal behavior. Youth with school refusal behavior evince substantial heterogeneity in behavioral characteristics or symptoms. This population is notably high in internalizing behavioral problems, such as general and social anxiety, fear, worry, depression, self-consciousness, fatigue, and somatic complaints. Interventions for school refusal behavior can be arranged along a multitiered system similar to a Response to Intervention (RtI) model. RtI involves problem-solving-based interventions that focus on prevention, early intervention for emerging cases, and intense intervention for severe cases. The chapter contains a step-by-step process for several evidence-based interventions that address school refusal behavior in youth, including child-based therapy that focuses on anxiety management, parent- and family-based therapy that focuses on contingency management, and a broader approach that incorporates school personnel and other professionals.

Working with families can be helpful for promoting long lasting change in individuals, as it provides the therapist with a glance at the system in which the problematic behavior emerged. This chapter focuses on working with families as an efficient method of creating long lasting change in individuals and in the systemic interactions of a family. It reviews the cases that are seen in private practice and in many agencies today, therapists are incorporating family therapy into treatment plans. The contribution of Shannon Semersky, a Licensed Marriage and Family Therapist, demonstrates the applicability of Virginia Satir’s family sculpting within a solution focused framework. The chapter shows how using the SFNT approach helps couples reconnect with the times when they met and felt attractive to each other, thus, introducing a lens through which even the most distressed couples are able to view who they were and who they could be.

This chapter provides an overview of how clinical mental health counselors work with crisis, disaster, and trauma issues. A focus is placed on the pragmatic, neurobiological, and existential natures of crisis, disaster, and trauma along with the ways that these dynamics are implicated in numerous counseling scenarios. The chapter presents the basic crisis intervention skills, discusses disaster response, and emphasizes the importance of understanding trauma. It anticipates that students will have an advanced course that covers these important topics more fully. The chapter provides an adaptation-resilience building framework for conceptualizing disaster response. It then discusses the issue of psychosocial trauma from a multidimensional perspective, and elaborates some of the key aspects of trauma. The chapter explores the most salient issues involving crisis, disaster, and trauma, with a focus on their implications for the clinical mental health counseling (CMHC) profession.

The field of family therapy has been moving ever onward toward attempting to address the complex, multidimensional, diverse, and multicultural needs of the profession. This chapter presents a summary of Systemic Cognitive-Developmental Supervision (SCDS) and integrates a case study to illustrate basic concepts and use of the SCDS supervision model. Systemic Cognitive-Developmental Supervision is a supervision model that was developed upon the same theoretical foundations as Systemic Cognitive-Developmental Therapy (SCDT). SCDS is a supervision model that is built upon the theory of SCDT and is grounded in integrative, developmental, co-constructive, holistic, and systemic assumptions. The intersecting domains of class, gender, race, ethnicity, ability, sexual orientation, spirituality, and so forth also provide important context to supervision and therapy. Although the general SCDS model provides an important framework as a beginning, value is added by a knowledge of the developing literature on culturally sensitive therapy and supervision.

This chapter discusses the differences among children, preteens, and adolescents and the implications for treatment planning and treatment goals for these groups. It also discusses the inclusion of family and individual therapy, the inclusion of the school as part of the milieu, and some unique problems that may need to be addressed. The patient in the child cohort is cognitively concrete, and the clinician interventions may be as much family based as they are individual. Although there may be some depression and suicidality present, impul-sivity and aggression tend to be more common problems. The successful group therapy approach is group play for socialization and art therapy for expression. Family therapy is important for addressing behavioral issues in the home and for monitoring progress. The child and adolescent cohort is the only partial hospitalization program (PHP)/intensive outpatient program (IOP) cohort for which both family and individual therapy are program expectations.

This chapter presents cognitive behavioral therapy (CBT)-based techniques specifically for practicum and internship students and other trainee clinicians. Problem solving is another staple of CBT. The methodology for problem solving is a little bit different if it is done with an individual kid or in a family session. In research looking at what mediates benefits in family therapy, communications training and problem solving come out on top. This is a monstrously helpful technique. And it saves individuals and families all kinds of time and distress. The author appreciates that a mental health professional (MHP) gets extra data and can also try to be helpful with a wider range of problems that could be affecting the identified child client. The factors to be considered to introduce communications training and problem solving in a family or an individual session are: age, maturity level, and psychological mindedness of the child.

Clinical supervision is a crucial and necessary element in the helping professions. Supervision is the primary resource that trains therapists/counselors and helps them gain practical skills as well as knowledge that will assist them in becoming ethical and effective helping professionals. One of the hallmarks of Marriage and Family Therapy (MFT) training is supervision, specifically “live” or “raw” supervision. This chapter outlines four modalities of supervision, including case consultation, online supervision, videotaped supervision, and live supervision. Case consultation is a broad methodology used to better understand the process of therapy. One of the major attractions of cybersupervision is the ability to meet with supervisors regardless of their geographical locations. Online supervision challenges that assumption as the implications of autonomy, nonmaleficence, and fidelity may be debatable. Videotaped supervision allows the supervisor the time to review and conceptualize the case without the time constraints of live supervision.

The practice of professional counseling is governed at the national and state levels by a variety of governing boards and regulatory agencies. This chapter focuses on the legal and ethical issues that are salient to clinical mental health counselors. Specifically, it discusses the American Counseling Association (ACA) Code of Ethics, the American Mental Health Counselors Association (AMHCA) Code of Ethics, state licensure and national certification, confidentiality, mandated reporting, duty to warn, and scope of practice. The chapter also focuses on the responsibility of counselors to engage in ethically based practice. In addition, the chapter connects the ACA and AMCHA ethical codes and the Council for Accreditation of Counseling and Related Educational Programs standards to several topics in ethical practice, including values clarification, bias assessment, boundary awareness and maintenance, and self-reflection. The chapter concludes with a case scenario to illustrate chapter concepts and a section on resources to provide further information.

Groups have been around since the beginning of humankind and across all cultures. People have historically gathered into groups to create, achieve, and resolve matters that would be otherwise impossible. Besides the potential to accomplish tasks, groups are sources of meaning and belonging, meeting needs for personal contact and interaction. This chapter focuses on group counseling as a useful modality for facilitating transition work with clients. Groups are complex, requiring counselors to combine individual counseling and group-leadership skills. It begins with some general information about the unique value of groups and discusses factors that are relevant to group work, including therapeutic factors, cultural diversity, and multicultural competencies. It also illustrates the different types of groups designed for adults who are experiencing various types of transitions. The chapter turns to an examination of the value of groups in helping people assess their assets and liabilities in each of 4 S areas.

Most families exist in some type of homeostatic balance, and the loss of a significant person in the family group can unbalance this homeostasis and cause the family to feel pain and to seek help. Specific factors that affect the mourning process and influence the degree of family disruption have been identified. These include stages in the family life cycle; roles played by the deceased; power, affection, and communication patterns; and sociocultural factors. This chapter discusses how family dynamics can hinder adequate grieving. The concept of family therapy is based on the belief that the family is an interactional unit in which all members influence each other. The characteristics of individual family members help determine the character of the family system, but this family system is more than the sum of its individuals’ characteristics.

This chapter provides a theoretical background for Medical Family Therapy (MedFT) as the systemic approach to integrated care as well as unique considerations for supervision in the integrated care settings where MedFTs typically practice. It consists case example to offers a frame and illustration for the application of this important approach. MedFTs master the elements of a traditional mental health intake to assess any psychopathology, history of past treatments, use of medications, family and social history, and relational dynamics that influence the exacerbation or maintenance of individual, relational, and/or health problems. In integrated care settings, a course of treatment typically unfolds episodically because the patients and their family members will have onsite access to return to psychotherapy when the need arises again. For most MedFTs, clinical care and supervision occur in an integrated health care setting.

This chapter describes the Family, Integrated Treatment, Social Connection–Internet Addiction (FITSC-IA^TM) approach as an intensive, community-based, integrated approach to the treatment of adolescent Internet addiction. FITSC-IA assesses and treats adolescents in the context of their functioning within their families and social systems in order to implement real-time intervention and treatment approaches to stabilize the addictive behaviors and common co-occurring diagnoses, such as social anxiety and depression. The chapter discusses clinical assessment, parenting style and integrated treatment approach. It describes key components of the family agreement, including setting expectations, negotiation meeting, and agreement active period. Harm reduction and abstinence approach are also applicable in the treatment of Internet addiction. The chapter also describes social recovery and effective treatment approaches such as cognitive behavioral therapy, exposure therapy, community-based support groups, motivational interviewing, transition, and technology reintroduction plan in the treatment of adolescent Internet addiction.

This chapter explores the provision of group therapy and psychoeducation. It examines family therapy, case management, discharge planning, and the unique problems found with the population of adults from age 18 to 65. The clinician will likely prepare an initial treatment plan at admission and a concurrent treatment either at the designated interval or in conjunction with the next insurance or managed care review. The clinician is typically the responsible party to make aftercare appointments for the patient as ordered by the psychiatrist or as suggested by the managed care organization (MCO). Adult population is best served with an organized rotation of psychoeducational subjects that relate to illness management, practical coping skills, and relationship issues. Family therapy is not common with the partial hospitalization program (PHP)/intensive outpatient program (IOP) adult cohort. The need for a family therapy session will be identified in the course of treatment planning, group therapy.

Concerns over the increasing prevalence and severity of children’s mental health issues have led to calls for interventions that focus on the family. In a report of the Surgeon General’s Conference on Children’s Mental Health, the United States’ national action agenda included the development of cost-effective, empirically validated prevention and intervention strategies that engage families. Similarly, during a Surgeon General’s workshop on the prevention of child abuse, speakers declared a need for age-appropriate, family-centered, and culturally competent services and reached a consensus that educating parents early is essential in the prevention of child maltreatment. A form of filial therapy, child parent relationship training (CPRT) teaches parents to use child-centered play therapy (CCPT) skills with their children. Based on attachment theory, CPRT espouses that a secure bond between parent and child is mandatory for children’s healthy development.

Conduct disorder in childhood and adolescence is considered to be a significant mental health concern because of its connection to numerous other social, emotional, and academic outcomes, both in terms of concurrent and future functioning. This chapter focuses on the examination and explanation of the treatment strategies for the conduct disorder. There are four main groupings of behavior for conduct disorder: aggressive conduct, nonaggressive conduct, deceitfulness or theft, and serious rule violations. The chapter examines the role of genetic, neurological, and environmental factors implicated in the development of conduct disorder. Psychosocial treatment programs such as multisystemic therapy (MST), functional family therapy (FFT), and multidimensional treatment foster care that combine parental management training (PMT), structural family therapies, and skill-building appear to have a moderate to large-effect size in reducing aggression and symptoms of conduct disorder.

Advocacy is key for the clinical mental health counseling profession. Clinical mental health counselor advocates (CMHCAs) rely on the advocacy competencies to guide their assistance to clients in removing barriers and to secure deserving resources, or to advocate on behalf of clients, groups, or communities. This chapter addresses the importance of advocacy and social justice advocacy, and the strategic positionality of the clinical mental health counselor as an advocate for addressing social and institutional barriers that reduce client access, equity, and success. It identifies the advocacy competencies and approaches to advocate for clients care, and emphasizes the ways that they foster resilience and growth. Specific cases illustrate clients' and professionals' understandings of and access to a variety of community-based resources. The chapter also addresses strategies to advocate for the profession and for clinical mental health counseling professionals.

This chapter summarizes pertinent issues discussed throughout the text, especially reinforcing the multiple emphases on systems-of-care, ecological, salutogenic, social justice, and diversity approaches. In addition, the chapter identifies new frontiers for counseling practice, such as new opportunities for counselors within the Veterans Administration and TRICARE system, in hospital settings, in hospice programs and assisted living environments, in other community settings, in school-based programs, in college counseling centers, and in sports counseling. The chapter also addresses the influence of technology upon the counseling profession, discussing the Internet-based services, such as virtual counseling, and telecounseling. It provides a discussion of the ethical, legal, and practice concerns related to this developing branch of counseling. With our professional organizations and the advocacy efforts of our practitioners and educators, the future holds great promise for the further development of professional counseling as an important part of the field of mental health and wellness.

This chapter reviews the evolution of internet gaming addiction and how it has impacted adolescents and children. It outlines how online gaming provides a medium for youth to indulge in gaming as a form of mental escape. The chapter also describes signs of internet gaming addiction, reasons that gaming is especially addictive, and how to apply brief strategic family therapy (BSFT) to treat adolescents and children addicted to games. This chapter reviews diagnostic and treatment considerations associated with Internet gaming addiction among children and adolescents. BSFT is a short-term, problem-focused therapeutic intervention, targeting children and adolescents 6 to 17 years old, which improves youth behavior by eliminating or reducing maladaptive internet use and its associated behavior problems and changes the family members behaviors that are linked to both risk and protective factors related to online use. This model can also be applied to internet gaming addiction among adolescents and children.

Work environments are cultures that create particular ethical climates that influence the quality of service provided to clients. This chapter addresses how organizations influence ethical practice. It defines “Organizational culture”, “organizational climate”, and “ethical climate”; each term represents factors unique to the work environment that affect ethical behavior. The chapter also addresses several work-place issues, such as dealing with impaired colleagues, mobbing, “burn-out”, whistle blowing, boundary issues at the work-place (e.g., sexual harassment) and substance abuse affecting worker performance. It defines “impaired professional” and describes the effects of impairment on professional practice. Counselors are profoundly influenced by the environments and work cultures in which they practice. Work environments are cultures that create a particular ethical climate that influences the quality of services provided to clients. Ethical and unethical colleagues influence their coworkers to behave ethically and unethically.

Anxiety disorders are the most common mental health conditions to impact school-aged children. A particular diagnostic subtype termed “separation anxiety disorder” accounts for the majority of referrals seen within child and adolescent psychological service delivery systems including schools. The developmental connection between childhood separation anxiety disorder and adolescent/ adult panic disorder has also been well documented in the literature. Associated features of separation anxiety include parent-child dysfunction, school attendance difficulties, and challenges to social functioning. Biological and environmental factors play a role in the development of separation anxiety disorder. Evidence-based interventions for children and adolescents with separation anxiety disorder include cognitive behavioral therapy (CBT), family therapy, pharmacological treatments, or a combination of these biopsychosocial therapies. Parental behaviors and parenting style are associated with increased risk for childhood anxiety, including separation anxiety disorder.

Counselors must exercise their ethical and professional judgment responsibly. This chapter reviews decision making models applied in mental health contexts. It classifies past models based on theory and/or practice. The chapter describes in detail the Tarvydas Integrative Decision Making Model of Ethical Behavior and how it is applied to mental health practice. It is a model that brings together the best of ethical theory to date in one comprehensive model. The chapter presents the Cottone Social Constructivism Model of Ethical Decision Making as a theory driven approach. The model is built on radical social constructivism, a unique philosophy that purports that decisions are not made psychologically by a person; rather decisions are an outcome of the relational matrix within which a decision maker finds him or herself. Three intellectual movements are defined: principle ethics, virtue ethics, and relational ethics.

One of the most widely known, researched, and disseminated therapeutic interventions for traumatized children and adolescents is trauma-focused cognitive behavioral therapy (TF-CBT). The TF-CBT model being implemented today began when several clinical researchers combined their similar trauma-focused interventions into a single model with the most efficacious components. The new model combined well-established cognitive behavioral, learning, and family therapy theory and techniques with emerging research on childhood posttraumatic stress disorder (PTSD), neuroscience, and child development. The result was a relatively short-term, manualized intervention that included both the child and the nonoffending caregiver in the treatment process and could be implemented in a wide variety of settings. TF-CBT contains specific goals for the child and the nonoffending caregiver. TF-CBT caregiver goals include helping nonoffending caregivers cope effectively with their own emotional distress while supporting their child’s recovery.

Trauma occurs on various levels, such as child abuse, spouse/partner abuse, street violence, school and job violence, large-scale transportation accidents, human-generated disasters, and natural disasters. Each level and occurrence has implications for training trauma-informed family therapists. The field of traumatology is growing rapidly, and research such as the Adverse Childhood Experiences (ACE) study is showing the long-term effects of childhood trauma, both psychological and physiological. This chapter provides a theoretical background for Trauma-Informed Marriage and Family Therapy (T-IMFT), as well as unique considerations regarding training and experience, self-of-therapist, vicarious traumatization, and organizational factors, and the Ecosystemic Developmental Trauma Model for supervision where T-IMFT is practiced. It provides a case example to offer a framework for and illustration of the application of this approach. Supervising a novice T-IMFT working with a survivor and his or her family highlights the significance of context in culturally informed survivor- and family-centered trauma care.

This chapter makes a distinction between grief counseling and grief therapy. Counseling involves helping people facilitate uncomplicated, or normal, grief toward a healthy adaptation to the tasks of mourning within a reasonable time frame. The chapter reserves the term grief therapy for those specialized techniques that are used to help people with abnormal or complicated grief reactions. The overall goal of grief counseling is to help the survivor adapt to the loss of a loved one and be able to adjust to a new reality without him or her. Whatever one’s philosophy of grief counseling and whatever the setting, there are certain principles and procedures that help make grief counseling effective. The chapter provides guidelines for the counselor so that he or she can help the client work through an acute grief situation and come to a good adaptation.

The focus of career counseling has been on helping individuals successfully enter the world of work. This chapter provides a description of the career counseling specialty, defining the roles and functions, employment settings, and clients of career counselors. It provides a brief history of the professional specialty, with information on historic and current credentialing. The chapter outlines professional credentialing and licensure matters for career counselors. It describes ethical and legal issues specific to the practice of career counseling and explains diversity issues and ethical decision making. It differentiates the roles and functions of practitioners of career counseling from those of practitioners of other counseling specialties. The chapter reviews the assessment issues of career counseling. Career counselors practice in a variety of settings and render services to diverse individuals, corporations, and organizations. They must have sufficient knowledge and training to assess clients and administer tests.

Children and adolescents depend on many systems to foster their social, emotional, personal, and developmental needs. School leaders, school counselors, communities, families, mental health counselors, and representatives from all systems in a child’s life need to collaborate and integrate care to produce the best outcomes for every child. This chapter identifies the many systems that impact child and adolescent development. It describes ecological systems theory and recognizes the many different types of families. The chapter explains how counselors in schools and mental health settings can adopt a systemic view of child and adolescents. It illustrates the impact of culture in the systems in which children and adolescents are embedded. The chapter explains how counselors can assist in collaborating with and connecting systems for best treatment outcomes. It outlines best practices for counselors working with children and adolescents.

One of the most promising implementations of eye movement desensitization and reprocessing (EMDR) therapy is within primary addiction treatment settings as a primary psychotherapy. Mindfulness and EMDR Treatment Template for Agencies (MET(T)A) Protocol accomplishes this by training all the clinicians in EMDR therapy and mindfulness and all other staff in the principles and application of mindfulness-based trauma-focused care. MET(T)A Protocol centers use the eight-phase protocol and the Adaptive Information Processing Model as the template for all that occurs at a treatment center, from individual, group, and family therapy to operations management, to admissions and intake, all the way to discharge planning and long-term recovery assistance. MET(T)A Protocol is just one of the ways that EMDR therapy is being brought further into the mainstream and in some instances to the very center of addiction care.

Michael is a 12-year-old Black male in the seventh grade in a remote rural farm community. He recently relocated to this community from a large metropolitan area, where he was a sixth-grader in a culturally diverse elementary school. He is the oldest of three children with parents who have become pillars in the community despite being new there. Identified as gifted in his previous elementary school, Michael took science and math classes in higher grade levels by single-subject acceleration. He had to work much harder in his language arts classes, but he loved his school and was liked by his peers and teachers.

While Michael’s new school is culturally diverse, the school and community norms for students are different. The emphasis is on community fellowship, service, and helping one’s family. Little is said about college; instead, jobs in agriculture and manufacturing are emphasized. Michael has been invited several times to participate in the 4H club. Upon arriving at his new school, despite providing his previous years’ school records, he is placed in the traditional seventh-grade classes. He complains to his parents that his math and sciences courses are a repeat of information from his previous school. Michael is also encountering difficulties in his language arts classes, which require more traditional essay-writing than his last school did.

In a six-week progress report, Michael’s teachers noted that he seems unengaged and withdrawn in class. His parents believe he has become apathetic about school, and they are worried he might lose his love of math and science. In addition, Michael’s language arts homework frequently leads to anger and frustration at home.

Michael’s parents have requested meetings with his teachers, with the school counselor, Brenda, also attending. Prior to the meeting, she evaluates Michael’s cumulative file. Based on his grades, standardized test scores, and teacher comments, she determines that he is extremely bright and very talented in math and science, but has challenges in language arts and social sciences. His teachers’ comments include “Handwriting continues to be a challenge, but he is working very hard,” “Michael is a very hard worker, but writing paragraphs or persuasive essays requires much more effort,” “He is quick at multiple-choice questions and short-answer questions are okay,” “His reading comprehension is fantastic, but writing brings out frustrations,” and “I realized Michael was much more at ease with oral book reports than written. His love of learning really shines through when he gets to talk about what he knows, in all subjects. He even manages to get his peers interested.”

Brenda makes a phone call to the school counselor at Michael’s former middle school and the elementary school he attended. She hears wonderful things about Michael, as well as about his challenges with written work. Many of his former language-arts teachers allowed Michael to demonstrate his mastery of content and skills orally or via multiple choice or computerized testing. The middle school counselor reported that he and Michael’s parents had discussed talking to their school psychologist about more testing for Michael because they were concerned about the increased requirements for writing in middle school. But that conversation did not lead to changes before the end of the school year, when Michael’s family moved.

Counselors must consider how to approach the struggles, fears, and vulnerabilities young clients face in schools and communities, and how to help them make sense of their world. Counselors must understand their own level of self-awareness, cultural knowledge, theory of orientation, and commitment to counseling this population. Children and adolescents must gain a sense of control through counseling and feel respected and valued. Counselors identify the use of counseling theories listed in this chapter along with creative strategies and expressive approaches (e.g., drawings, music, toys, and books) as best practices for working with young clients. This chapter describes the different theoretical frameworks commonly used in child and adolescent counseling. It helps the reader to identify specific reasons why these theories effectively work with children and adolescents. The chapter applies interventions appropriate to the guiding theoretical framework.

Stewart and Tray are the seventh- and eighth-grade school counselors in a new middle school in a large urban district with a diverse student population. Wintercrest Middle School has been a magnet school for science, technology, engineering, and mathematics (STEM) for only 3 years. Currently students can take Algebra I, Geometry, Honors Biology, and semester classes in Advanced Computing, Introduction to Physics, Robotics, and Trigonometry. Logistically, the magnet school functions as a school within a school, with students attending classes in one wing of the school building. Teachers and students who are not involved in the magnet school are located in two other wings on the opposite side of the school. During the past school year, Tray and Stewart have sensed tensions in the school in various relationships, including within, between, and among teams of teachers, between parents and teachers, among students, and between administrators and teachers. Mr. Wallace, their building principal, has seen the explosive outcomes of some of these tensions and has encouraged the counselors to investigate the current school climate.

Mental health professionals who work with students must be well-versed in the protective factors that maximize youth academic, social and personal success. One can and must cultivate healthy communities and teach youngsters to advocate for themselves as one advocate for them. Significant research points to strategic ways one can strengthen schools, families and communities. All too often, violence, substance abuse, bullying, sexual assault, suicidal ideation and more threaten student well-being. The profession calls upon professional school and mental health counselors to be ethical, skilled, culturally attuned and ready to engage in prevention and intervention as they work with students and families. This chapter expresses familiarity with social challenges to healthy child development. It helps to recognize the crucial role of professional school and clinical mental health counselors in the cultivation of positive school and community contexts. The chapter hypothesizes counseling from a strengths-based, curious, and creative stance.

This chapter uses the case study and relevant literature to understand using the transition model with work transitions. In looking at issues relating to self, one sees that it is important to consider salience, balance, resilience, self-efficacy, and meaning making. The dimensions of salience, balance, resilience, self-efficacy, meaning making, and sense of purpose are all critical aspects of a client’s work transitions. Listening for and asking about these dimensions will help counselors gain a more complete picture of a particular client’s experience and aspirations. The chapter looks at characteristics of the situation, support and strategies. It presents a multiplicity of issues related to the kinds of experiences, thoughts, and feelings that have an impact on adults engaged in work transitions. The chapter discusses what counselors might hear from the perspective of the 4 S transition model and proposition that all transitions involve moving in, through, out, and back in again.

Ben, the middle school counselor from Chapter 5, continues to work with the district’s task force. There, he also meets Julie the district’s coordinator of gifted and talented services. Based on the superintendent’s concerns, Julie wants to re-imagine the district’s identification and programming for gifted youth. Ben’s experiences have given Julie new insights into potential roles of school counselors when working with high-ability learners and their parents. Julie was particularly drawn to Ben’s discussions of talking with parents about why their students were not identified. Ben’s frustrations with the gifted services have also included the pervasive mythology that the program is a “cookie” program used as a reward for “good” students with “good” behavior and even better grades—a myth that disenfranchises diverse populations in the school district, including underachieving students, and doesn’t accurately identity those students who may need services. Historically, because the district has implemented identification procedures in third grade, Julie has contacted several of the elementary school counselors in her district to get their perspectives. She is surprised by the range of their knowledge about identification and the degree of the school counselors’ involvement in this process. While Ben has informed her that all practicing school counselors have training in testing and assessment, not all have connected this with identification practices for gifted learners—until they meet with their first parent.

A speech/theater teacher at a large urban high school refers Andrew (pseudonym for a composite profile), 16, to the school counselor because “he’s out of control and living dangerously.” The counselor, who routinely examines the student’s school file before such a meeting, finds standardized test percentiles in the high 90s, a good attendance record, and regular participation in the arts, but also a high incidence of lateness to class and an academic record that has deteriorated in high school. Family information shows an older brother attending a distant university, parental divorce when Andrew was 5, and, at age 12, Andrew relocating with his brother and mother when she remarried.

Andrew presents as personable, verbal, socially smooth—and somewhat arrogant. He claims he can raise his current low grades before the semester ends. Missed assignments are the key. He says he adds provocative comments to class discussion, and teachers like him.

His best friend lives 2000 miles away, where Andrew lived prior to his move at age 12. Andrew has gravitated toward dramatic females locally, and his current girlfriend is in high conflict at home. His grades deteriorated after becoming involved with her. He has run away several times and now has thoughts of running away with her. He mentions a special relationship with a male friend. When he drinks, he drinks too much, and his friends worry about him.

Andrew believes the psychologists he saw in the past did not understand him. He was diagnosed with attention deficit hyperactivity disorder (ADHD) and depression, but was noncompliant with medication. He recognizes that he makes poor choices. He claims not to be suicidal currently, but has been in the past. He has self-harmed. He says his father has almost no contact with him, but his father does have a close relationship with his brother. Andrew says his own problems resemble his highly intelligent father’s. Andrew has been exploring anarchic and white supremacist groups online.

The counselor plans to meet with him in a week, but will informally check on him daily and then meet with him and his mother together, a meeting Andrew quickly agrees to. Regardless of whether a referral will be made eventually, the counselor hopes to build a therapeutic relationship with Andrew to be able to provide ongoing support at school as needed.

A few days after the school counselor’s meeting with Andrew, his mother contacts the counselor because of the girlfriend. She says Andrew struggles with impulse control, is easily distracted and affected emotionally, has difficulty managing emotions, and escalates conflict quickly when sad or angry. He resists authority at home, and his arguments with her leave her worn out and sad. She says her husband, Andrew’s stepfather, ignores Andrew and does not understand giftedness.

In a rural school district, Abby is responsible for creating and delivering gifted-education programming across all school levels. She wants to develop a comprehensive K–12 affective curriculum for it. Though the majority of students are from middle-class families, others come from families that are struggling economically due to unemployment, military deployment, parental incarceration, single parenting, and addictions. Teachers and administrators are concerned about student well-being. Bullying has been a school concern, and the community has been shocked by three student suicides among the “best and brightest” over the past 2 years. Abby believes that attention to the social and emotional development of gifted students during all school years might make a difference. She wants to collaborate with Jack, the one K–12 school counselor, in possibly cofacilitating two proactive small discussion groups of gifted students. She wants to observe his listening and responding skills and share information with him about giftedness. In the past, Jack has not thought of organizing small groups for gifted students, but agrees to the collaboration. He says they should conduct a needs assessment among students identified as gifted and organize a group of high achievers around a common concern, such as bullying or bereavement—an approach he used in the past with the general population. Abby has something different in mind, but is hesitant to advocate for her view, since group work is in Jack’s “territory.” After she learns some skills from Jack, she wants all identified students to have a small-group experience at some point. She also understands that programming should address needs of more than just high achievers, including highly intelligent academic underachievers, who currently are not viewed as eligible for it. Abby needs to have a clear rationale for both the group format and mixing achievers and underachievers in the groups before she talks with the counselor again.

The practice of couple, marital, and family counseling is unique among the counseling specialties. It is developing and growing as a counseling specialty. This chapter describes ethical issues related to the practice of couple therapy or family therapy. It addresses issues of privacy, confidentiality, privileged communication, informed consent, roles and relationships with clients, responsibility, professional competency, and values. The chapter addresses professional issues related to couple, marital and family therapy as a specialty of counseling versus a separate profession of “marital and family therapy”. It also addresses the ethics codes of respective professional associations and diversity issues. The chapter discusses the major issues in couple, marital, and family counseling, including professional identification, licensure, and certification. Couple, marital, and family counseling is founded on theory that has evolved to be culturally relevant and acknowledges cultural differences.

Developmental considerations provide great implications for counselors. Development follows a path that is continuously impacted by systemic, relational, and multicultural influences. These influences impact how children make sense out of and act in response to critical life circumstances. Incorporating a developmental perspective when counseling children and adolescents and aiding them in successfully mastering tasks at various developmental milestones continues to be a core and essential component of counseling. Children’s level of development effects how they respond to creative and time-efficient counseling strategies, interventions, and modalities. This chapter identifies the relationship between social, emotional, and mental health maturation with child and adolescent development. It demonstrates a comprehensive understanding of how developmental theory frameworks inform crafting and integrating client-centered counseling interventions, strategies, and best practice methods. The chapter develops an awareness of counseling implications when working with children with diverse developmental histories.

Tosha and Erik are the two school counselors in a large suburban elementary school. For 5 years, they have worked to create a school counseling program aligned with their state’s framework, which was developed with the ASCA National Model in mind. This year, they are hosting a school counseling intern, Tony, from a program in the school of education at a local university. Although the school counselors are grateful to have an intern with fresh eyes and new ideas, they wonder whether the supervision will require too much time and divert their attention from the report they must write prior to a visit by the state department of education later in the year. At the initial interview, Tosha and Erik learn that because Tony had already had several education classes, his program advisor suggested that he take some electives in areas of interest. During his student-teaching experience, he had been intrigued by creative and artistic students and therefore opted to take a few courses in gifted education. He is excited to be working with Tosha and Eric and wants to know if he might work with gifted students and find out how the gifted-education program is currently serving them.

The counseling session remains the focus of what most counselors-in-training (CIT) think of when they reflect on the type of work that they will be undertaking. It appears, perhaps, to be the culmination of all the training and education that CITs go through. Questions asked to new counselors, such as “What happens in the counseling session?” usually evoke a likely response, “Well, we talk. We establish rapport and discuss the client’s issue”. However, when pressed for additional details about what occurs in the counseling session, new counselors may struggle to describe more specific responses. Consequently, this type of ambivalence inspires the focus of this chapter, the stages of a counseling session. Counselors work in a variety of settings. This chapter describes the purpose of the counseling session and identifies necessary skills used to conduct a counseling session. It provides a basic outline for a counseling session.

This chapter focuses on understanding issues of loss and grief as well as their intersections with trauma experiences. It examines the classical theories associated with loss and grief, describing the transition to a postmodern perspective of how grief is experienced. The chapter describes interventions that can be used with clients experiencing loss and grief, along with the counseling implications. Practice-based resources are available online.

Trauma work with children and adolescents remains challenging on all levels and becomes increasingly complex when violence permeates various domains of life. Counselors must also consider the reciprocal relationships between trauma and neurological, psychological, social, cultural, and systemic factors that alleviate or exacerbate the experience of trauma. Early identification, assessment, and intervention remain critical components of trauma recovery. The inclusion of trauma-informed interventions such as emotional awareness and regulation, as well as mindfulness skills can help children and adolescents diminish symptoms that overwhelm internal coping mechanisms. This chapter helps readers to distinguish the complexity and range of trauma experienced by children, identify the neurobiological, social, psychological, and academic impact of trauma causing events on children, and recognize various trauma-informed and creative interventions when working with children and adolescent clients, as well as important considerations for school counselors.

The study of ethics is like a journey. This chapter provides a synopsis of responses to allegations of unethical or illegal practice. It defines prevention measures and ways to avoid breaches of ethics. The chapter describes ethical practice in counseling and psychotherapy. It outlines the consequences for victims of unethical conduct. The chapter defines the ethical professional counselor and describes the counselor’s response to an ethical challenge in the context of potential legal and professional scrutiny. It discusses what a counselor should do when confronted with an allegation of ethical misconduct. No professional is immune to ethical dilemmas—no matter how ethically sensitive counselors may be circumstances will always arise that place them in a quandary. It is important, however, that counselors recognize when they are facing a serious ethical challenge. With such recognition, wise counselors protect themselves from a naive decision and a possible breach of ethical standards.

For professional school counselors and clinical mental health counselors to serve students with disabilities and adequately advocate within the comprehensive school and community contexts, they must first understand the legislation that exists. Congress set these legislations in place to protect the rights of students with disabilities and assure them access, inclusion, and a free and appropriate public education. This chapter helps to identify the disability categories under the Individuals with Disabilities Education Act and the common characteristics of giftedness. It recognizes legislative mandates that apply to education of children and adolescents with disabilities and giftedness in grades Pre-K through 12. The chapter describes postsecondary transition issues for adolescents with disabilities entering postsecondary institutions. It expresses the connection between identity and disability. The chapter explains the role of the professional school counselor and clinical mental health counselors when working with students with disabilities and those classified as gifted.

This chapter offers guidelines to assist counselors in obtaining legal advice. Ethical decision making, by contrast, is the responsibility of the counselors themselves. It helps readers to identify ethical and legal issues with unique applications to counseling minors and distinguish between parents’ rights and the rights of minor clients. The chapter describes best practices in securing informed consent, defining confidentiality, determining competence, managing crisis, and dealing with boundaries and value conflicts when counseling children and adolescents. It explains how to best address situations when a minor client appears to be at risk of suicide, non-suicidal self-injury, or other dangerous behavior. Child and adolescent counselors are called upon to exercise their professional judgment when minor clients engage in risky behaviors such as non-suicidal self injury, sexual experimentation, or unsafe use of social media. The chapter concludes with discussion of consultation with adults who are important in the lives of minor clients.

An experienced, progressive superintendent is new to a large school district, and at her first meeting with all teachers, she describes ambitious goals, one of which is to reconceptualize and reorganize the program for gifted students. She wisely does not speak negatively of the present program; instead, she explains that an administrative transition is simply an opportunity to look at existing programs. Regarding gifted education, she wants to examine current thought in the field about giftedness, what residents in the district think about those perspectives, whether criteria used for identification of eligible students in the district match the programming offered, which programming models are available, which kinds of goals might be appropriate for local programming, which community resources might supplement and enhance programming, and whether the “whole” gifted child is adequately attended to.

The district she left had experienced individual and family tragedies and disturbing student behavior in recent years involving gifted scholars, gifted athletes, gifted musicians, gifted visual artists, gifted leaders, and gifted underachievers. She says she has already begun her own personal exploration of pertinent literature, and she wants the district to be proactive and strategic regarding preventing poor outcomes for gifted and talented students—at all school levels, beginning at the elementary level. She promises to organize a task force of representative classroom teachers, school counselors, gifted-education personnel, parents, and possibly students to study pertinent literature, explore various models, and make recommendations. She encourages individuals interested in being on the task force to contact her.

Ben, a middle school counselor, immediately expresses interest. He has been frustrated with not being able to connect adequately with some gifted students who have concerns—both high and low achievers. He was always a high achiever himself, but he has realized that gifted students are highly idiosyncratic, with many not fitting common stereotypes. He wants to understand them better and help them understand themselves better as well. He is glad the superintendent seems interested in their well-being, not just their academic performance.

Ben suspects there are many counseling needs in this population, but he has never heard a local or state counseling peer refer to these needs at professional meetings. He also has wondered about the identification process and the fit of his most complicated gifted counselees with the current programming. In fact, he has met with brilliant thinkers who have not been deemed eligible and assumes that learning disabilities affect the test scores used for screening. Last, since he has worked with a number of referred gifted underachievers, he has wondered which kind of program would engage them in school and academics—and even whether academic achievement should be the sole goal.

Ben believes that being on the task force, if he is selected, will be informative and helpful as he considers how to be more effective with this special population. In fact, he is selected. The superintendent is wise to include a counselor on the task force.

School counselors collaborate, consult, and coordinate resources. They partner with community agencies, empower parents and families, advocate for students, and are probably part of the leadership team in their schools. Every day school counselors probably make lists of tasks that must be accomplished and then prioritize those according to level of urgency. When prioritizing student needs, the needs of gifted students may not rise to the top in the mind of the school counselor. Most educators equate "gifted" with high-achieving, perfectionistic, perhaps slightly eccentric students who have helicopter parents. School counselors work with gifted students regularly. These students come with a variety of different concerns ranging from typical developmental needs to mental health concerns that warrant immediate attention and service. While gifted students are no more or less likely to experience concerns tied to mental health, they do experience the world differently by nature of being gifted.

This chapter presents a case study of a 9-year-old Caucasian child who lived with his paternal grandparents in a small rural community. The patient attended a local private school where he received individualized education accommodations based on school-level evaluations, asserting that his learning is being impacted by behavioral deficits. Media outlets also played a large role in his life as he reportedly spent a large amount of his formative years locked inside of his bedroom with a television and video games. According to Erikson’s theory of psychosocial development, at 9 years of age the patient was in the industry versus inferiority stage of development. Based on his developmental level and age, the author used a child-centered play therapy modality to facilitate the therapeutic process. Based on his grandmother’s report of the patient’s behavior, he developed some of the skills needed for treatment to be considered successful.

Group counseling raises some interesting ethical dilemmas because treatment involves more than one client. Because of the presence of individuals other than a counselor and one client, group counseling poses some interesting ethical dilemmas. This chapter discusses the origins, standards and specializations that characterize the area of group counseling, and issues related to its status as a formal specialty of counseling. It provides an overview of ethical and legal issues related to the practice of group counseling. The issues of confidentiality and privileged communication, informed consent, roles and responsibilities with clients and responsibilities of the group leader are addressed. The role and importance of group counselor values and competence are discussed, particularly in the context of issues of multicultural diversity. Counselors must be culturally sensitive and provide culturally competent services. They should develop comfort applying decision-making principles to dilemmas as they arise.

Membership in a profession offers an individual status and responsibility. Law and medicine, both considered models of professionalism, are founded on a body of knowledge, technique, and practice. This chapter describes the mental health professions and outlines types of degrees, degree requirements, licensure requirements, board certifications associated with a profession, and the scope of practice of the professions. The chapter helps the reader distinguish counseling from psychology and the other mental health professions. Psychiatrists are licensed physicians who hold either the MD or DO degree. Psychologists treat individuals with psychotherapy and counseling, and assess individuals with IQ, aptitude, personality, and interest tests. Psychiatric nurses are master’s-degree–trained nurses with specialized coursework in psychotherapeutic approaches. Marriage and family therapists focus on relationship concerns experienced by couples or families. Social workers generally specialize in public policy or clinical social work.

Samantha has been the middle school counselor in a small rural district in the Midwest for the past 3 years. She has spent most of her time in program development and building relationships with students, parents, staff, and community partners. Currently, she is working with community and district administrators to increase access to Internet and other technology in her building for more program options; unfortunately, the district’s increasingly tight budget precludes upgrades to current systems. As the academic year comes to a close, she talks with Rachel, a veteran teacher with considerable experience in differentiation. Rachel is concerned about some of her math students. By year’s end, due to her differentiated curriculum, at least seven will have completed Algebra 1, the most advanced math class at the school. Rachel wonders what can be planned for them for next year. A few parents have expressed concerns about future classes as these students progress. She asks to meet with Samantha about this situation.

Rehabilitation counseling as a specialty area of counseling has been at the forefront of advocating for disability rights and the employment, inclusion, and integration of individuals with disabilities. The ethical and professional practice of rehabilitation counseling is similar to other counselors, yet with additional ethical responsibilities and considerations related to disability rights. The ethics of rehabilitation counseling have a more explicit emphasis on client autonomy, advocacy, and accessibility. The chapter describes the specialty of rehabilitation counseling, the historic trends in its evolution, and the sociopolitical issues of importance to the field. It helps the readers differentiate the roles and functions of rehabilitation counselors from those of other counseling specialties. The chapter discusses multiculturalism and diversity in rehabilitation counseling. Rehabilitation counseling has had a complex evolution. With such a diverse scope of practice, it is imperative that rehabilitation counselors only practice within their individual training, education, and supervised experience.

This chapter examines what counselors hear about individual transitions. It shows how individuals experience their transitions in a unique manner, depending on their particular situation, the aspects of self that come into play, the support they have available, and the strategies they are currently using. The chapter discusses the triggers to internal transitions, some of which may come from internal awarenesses and some of which may be stimulated by external events. It turns the attention to the timing of these transitions. The chapter talks about the duration of the transition, and, addresses the source of control—or perceived control. It focuses on the self issues related to internal transitions, looks at issues of identity, autonomy, meaning-making, and self-efficacy. The chapter describes what counselors may hear as clients describe their “people” supports. The goal of the strategies helps to identify what one may hear from clients about strategies they currently use.

This concluding chapter presents brief summaries of the chapters of the book. The chapters in the book have covered a wide range of theories, concerns, and perspectives. Chapter content has implications for policy and practice. School professionals can incorporate the information and recommendations in them into their current services to ensure that gifted students receive needed support. School counselors respond every day to students who feel different, perhaps painfully different, from those around them—at home, at school, or in the community. Those counselors are distinguished in the school context by rare skills and perspectives that can be used to help gifted students make sense of themselves, value their differentness, and embrace their complex feelings and sometimes perplexing behaviors. Change can happen in either direction because of life events or circumstances. Moving out of impasse and accomplishing developmental tasks can contribute to increased motivation for underachievers.