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 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.

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.

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.

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.

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.

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.

As best friends in a small Midwestern town, Jon and Stephen, both extremely bright and inquisitive, often talked with each other about their dreams of jobs they would have as adults. Throughout childhood, made alive through imaginative play, their wide-ranging ideas about careers were inspired largely by television and movie characters. They were enthralled with the idea of “special powers” to save the universe, but soon realized that “superhero” wasn’t a career. A few years later, they considered becoming crime scene investigators, lawyers, emergency room doctors, and, briefly, even astronauts. Jon and Stephen were inseparable and were regarded by the elementary school’s Gifted and Talented (G/T) coordinator as the most academically advanced students in her memory. They loved to learn, had vivid imaginations, and inspired their classmates and each other to “dream big” about the future. They were big fish in a little pond (e.g., Marsh, 1987; Salchegger, 2016).

Then Jon’s family relocated to an affluent suburban neighborhood on the West Coast after his father took a position in Silicon Valley. Jon, in middle school, had to adjust to a new set of expectations and found the adjustment quite challenging—in fact, far more so than he had imagined. Surrounded by a large group of intense and extremely driven students, who all seemed to aspire to top-tier universities, and struck by the harsh realization that he was no longer one of the very best students, Jon now felt as if he were a fish out of water. He was plagued with self-doubt about his abilities and future educational and career prospects. Compared to the other students, who had long positioned themselves to earn coveted spots in the local STEM-oriented magnet high school, Jon felt inadequately prepared to compete and felt his excitement for learning fading quickly. Once a confident and enthusiastic student, Jon was immobilized by his fear of making mistakes, especially in the presence of his new peers, and he began to retreat from others both at school and at home. He had difficulty dealing with even minor setbacks and grew to resent the students who seemed ambitious and competitive. Adopting a defensive posture, Jon downplayed the importance of thinking about future goals; in his own words, it was “stupid” to worry too much about college and career. Although he generally maintained respectable grades (mainly to make his parents happy and to keep their anxieties at bay), he refused to take the most challenging courses at school and stopped taking academic risks. Since he was getting mostly As and Bs and an occasional C on his report card, Jon’s parents were not alarmed by the changes in his behavior and failed to notice that he had turned away from learning. His academic self-concept had taken a major hit.

In contrast to Jon, Stephen remained in the same small Midwestern school district for the remainder of his precollege years and continued to feel passionate—about everything! Stephen’s parents encouraged him to indulge his intellectual curiosity and explore every subject that captured his interest. But Stephen had difficulty narrowing his interests for the sake of establishing career direction. When he was first exposed to chemistry, for instance, he quickly memorized the periodic table and spent many nights at the dinner table teaching his younger brother everything he had learned about each element. Later, when introduced to physics, he could hardly contain his excitement about quantum field theory, cosmic inflation, fluid dynamics, and a host of other topics. Of course, he also loved math and was eager to learn computer languages. Adept not only in STEM subjects, Stephen also excelled in and enjoyed writing, history, and politics. However, because the school district was small and lacked resources, he often learned advanced content on his own by reading books and searching the Internet. The local public high school he attended offered few Advanced Placement (AP) courses, and school officials believed they could not justify offering additional AP courses just for him. Without his friend Jon, he had no intellectual peer with whom he could share ideas and interact meaningfully. As his precollege years progressed, Stephen did not gain sufficient clarity about educational and career direction to focus his efforts on developing any particular interest to a high level outside of the classroom.

Childhood bereavement support is provided by a variety of professionals including chaplains, social workers, mental health counselors, psychologists, child life specialists, nurses, school counselors, thanatologists, and educators. This chapter discusses the issue of professional accountability and ethical considerations when working with bereaved children and their families in order to offer a framework for standards for this important type of support. It is not enough to solely provide orientation training to volunteers, it is also important to offer continued training for both new and existing volunteers. Organizations that provide support to bereaved children should establish written, agreed upon standards of practice to which program staff and volunteers are held accountable. The parent or legal guardian of children attending individual support, peer support groups, or grief camps should be provided a clear description of services being provided. Services provided should fit within the mission, vision, and values of the organization.

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.

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.

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.

Because future practicum and internship placements depend on the willingness of the field placement site, it is important that one should always be mindful of how one should complete the final internship placement. Ideally, besides completing all internship requirements, one will express their gratitude to the field site supervisor and colleagues in the school, agency and so forth, in addition to saying goodbye to the clients. A job search involves many facets: planning, résumé writing, mock interviewing, applying, interviewing, following up, dealing with rejection, entertaining an offer, accepting a job, and negotiating salary, to name a few. This chapter is devoted to completing the practicum/internship sequence and preparing for the job search. It addresses termination of the field supervisor–intern relationship. It also covers preparing for the job search, including preparing a résumé or curriculum vitae, letters of reference, cover letters, interviewing, and issues of licensure and credentialing.

The practicum and internship experience is the backbone of any counseling program. Beginning a practicum/internship represents a major step in our development as a counselor. The goal of this book is to provide orientation and guidance to help us successfully navigate our field placements. This chapter first discusses various general issues regarding the counseling profession itself; then, it offers a brief overview of the practicum/internship process. It reviews some basics of the counseling profession. The chapter briefly describes some of the key organizations that one will likely encounter as a student or over the course of our professional career. It provides brief introduction to the counseling profession, professional counseling organizations, licensure and certification, theoretical approaches, and our practicum/internship experience. The counseling profession has experienced dramatic growth in the past two decades and the future suggests continued expansion, particularly for the areas of clinical mental health, addictions, and clinical rehabilitation counseling.

Multiculturalism is a critical issue in the counseling profession. Cultural humility is essential for sound, ethical, effective practice, particularly when working with diverse populations. Multicultural counselor education seeks to establish a foundation for cultural pluralism in counselor training, counseling practice, and in the manner counselors conceptualize multiculturalism. This chapter provides an overview of some of the issues related to becoming a culturally competent counselor. Because of the wide variation in global cultures, no one can reasonably claim to be an expert. Therefore, it is highly recommended for counselors to continue their education well beyond the classroom through workshops, networking, and reading texts on multicultural counseling.

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.

This chapter adresses how to maintain a healthier, more balanced life during the practicum and internship. It provides insights into recognizing stressors that accompany counseling a struggling population of clients. The chapter provides several exercises for the purposes of self-reflection. The ability to step back from an experience, however successful or disappointing, can be key skill for personal success as a counselor. The chapter explains how to develop and maintain a healthy and mindful lifestyle. It also includes assessments on quality of life, burnout, and mindfulness.

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.

Counselors serve an important role in the lives of youth. They provide safe spaces for children to express their emotions, fears, thoughts, and worries. Supporting children and adolescents of special populations and marginalized statuses requires that counselors (a) recognize how personal bias may impact the counseling process; (b) utilize culturally competent, theory-based techniques in counseling; (c) understand how socioeconomic status, poverty, race, gender, and sexual orientation impact children and adolescents; and (d) utilize practical, strength-based approaches to counseling. Counselors remain committed to the work of building strength-based, culturally competent, and inclusive practices. The counselor’s efforts to provide culturally responsive strategies and interventions will greatly influence the success of counseling diverse populations of children and adolescents. With this in mind, clinicians must remain critically reflective of their worldviews and biases and commit to the life-long process of cultural competence.

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.

The aging population is at a state of development that is not as focused on employment, and thus has difficulty finding its place in a society that defines people by their careers. Research is needed on the issues of aging workers, such as training needs, career transition issues, and retirement planning. Research is also needed on which accommodations, workplace modifications, and changes to policies and practices positively impact the retention and continued productivity of an aging workforce. Counselor practitioners are in a unique position to contribute to needed research design conceptualization, metrics, and analyses to test the multiplicity of interventions we will be exploring in the coming years to keep our aging workforce healthy and intellectually engaged in the employment environment. Counselors are experientially qualified to provide the needed services to keep this population productive and more fully engaged in their communities and continuing employment.

Everyone has needs and struggles. Awareness is a key step in assuring that the counselor’s needs and struggles do not negatively impact the children and adolescents with whom they work. A counselor should begin by knowing and acknowledging his or her own personal issues, strengths, and vulnerabilities and how these issues might be presenting in their work as a professional counselor. Self-awareness, support, supervision, boundaries, and self-care are the foundations of a sustainable counseling practice. It is not a sign of strength or quality of character to be able to individually suffer through or manage the stressors inherent in counseling work. In fact, independent or isolated management of stress is a liability. The counselors, who experience both effectiveness and well-being, acknowledge stress and the compassion fatigue that is inherent to this work. They show willingness to look at themselves and get the help they need.

Assistive technology (AT) has a profound impact on the everyday lives and employment opportunities of individuals with disabilities by providing them with greater independence and enabling them to perform activities not possible in the past. Self-esteem, self-efficacy, and motivation are described as central elements in increasing a consumer’s confidence and belief in self. Good outcomes and efficacy expectations, as well as strong motivation, help lead to successful adaptation to AT. This chapter presents the human component of technology, the relationship between consumers and technological devices/equipment, and the acceptance and use by consumers. It offers recommendations to assist rehabilitation professionals in helping consumers with accepting, utilizing, and benefiting from technology. There needs to be a close and appropriate fit between the technological device and consumer. Therefore, the need for the counselor to actively listen and engage the consumer in the process is essential to the effectiveness and outcome of AT success.

This chapter presents the elements of counseling that can influence self-awareness and growth among children and adolescents. It builds on the basics and offers guidance to enhance counseling effectiveness. Children and adolescents thrive within the context of responsive relationships and these relationships are central to emotional growth. A good counselor balances the child or adolescent’s need for support and the necessity of independence in self-reflection. The fields of motivational interviewing (MI), self-determination theory, and counseling with children and adolescents are filled with specific techniques to encourage growth and change. Accordingly, the chapter highlights key elements of counselor action. Of equal importance, there will be instances in which being present, in absence of action, will create space for the child or adolescent to experience and consequently increase awareness of his or her own self—a critical foundation for growth and change.

This chapter focuses on career counseling courses. In this course, students learn how career development theory can be applied to the practice of career counseling. There are three course objectives that are essential to this course: students will be able to identify career development theories and decision-making models; students will understand the roles, functions, and settings of contemporary career counselors; and students will practically demonstrate career and educational planning, placement, follow-up, and evaluation using mock clients or case study examples. The salient career counseling theories that should be touched on in this course are: Super’s life-space, life span theory; Roe’s personality theory of career choice; Gottfredson’s theory of circumscription, compromise, and self-creation; Holland’s theory of types and person–environment interactions; Krumboltz’s learning theory of career counseling; Lent, Brown, and Hackett’s social cognitive career theory; and Savickas’s career construction theory.

This chapter presents the American Psychological Association, the Council for Accreditation of Counseling and Related Educational Programs, and the Council on Social Work Education. It discusses professional identity within the context of accreditation of disciplinary programs. The chapter identifies the purpose of accreditation, generic steps of the process, and the value of accreditation. In addition, it examines key questions pertaining to: (a) factors that distinguish counseling psychologists, counselors, and social workers, (b) how these professional identities are defined using Emerson’s Counselor Professional Identity Measure (2010) by history, philosophy, roles and functions, professional pride, professional engagement, and ethics, and (c) changes in and challenges to professional identity. The chapter provides relevant discussion not only on the stability of human services disciplines, but also on their ability to change and interpret the impact of change on professional identity and eligibility for credentialing and licensure of practitioners.

This chapter offers (a) a description of the empathy fatigue construct as it relates to other professional fatigue syndromes, (b) a recently developed tool (Global Assessment of Empathy Fatigue [GAEF]) that may be useful for screening and identifying professionals who may be experiencing empathy fatigue, and (c) resources for self-care of empathy fatigue and building resiliency. The chapter’s author hypothesizes that empathy fatigue may be different from other types of counselor impairment and fatigue syndromes. The experience of empathy fatigue is both similar and different from other types of counselor impairment or professional fatigue syndromes. Thus, it is hypothesized that the cumulative effects of multiple client sessions throughout the week may lead to a deterioration of the counselor’s resiliency or coping abilities. Developing a clearer understanding of the risk factors associated with empathy fatigue is pivotal in developing self-care strategies for the professional counselor.

Diversity courses can go by many names: Cultural Diversity, Counseling Diverse Populations, Multicultural Counseling, or Cultural Diversity and Advocacy. Diversity courses are critical to a counselor’s development. These courses build on the skills developed in other courses and prepare students to work with clients, couples, and families and in school systems on topics such as culture conflict and personal identity, gender and racial issues, sex and sexuality, lifestyle concerns, coping versus personal empowerment, and effective intervention models when working with ethnic and linguistic minorities, including building effective parent involvement programs. This chapter focuses on helping counselor educators teach the aforementioned topics to their students. It provides more in-depth introduction to the course purposes and objectives. Topics that must be broached in this course should revolve around the following ideas: culture being at the center of the therapeutic relationship, worldview, language, leveraging differences, self-awareness, counseling relationship, advocacy, religion, and spirituality.

Amid all the excitement of beginning practicum and internship, where many counseling students encounter their first actual clients, one must of necessity consider the nature of the counseling relationship. Many students are idealistic and likely attracted to the profession due to the helping nature of the field. Thus, it would be no stretch to say counseling students and professional counselors are idealistic with regard to philosophical orientation. Many schools and agencies do a very good job of creating safety plans for students, clients, and staff, but some do not. This chapter covers some of the basics regarding safety on the practicum and internship. Still, the potential of assault is real and counseling programs must prepare students to deal with it. The chapter explores various ways one might identify, defuse, or deal with violence during the practicum/internship.

This chapter offers a brief overview of common clinical issues one may encounter at the practicum/internship site, along with suggestions and examples to assist us in counseling and assessment. Students beginning the initial placement may find the experience difficult at first, because they are actually encountering real people with real issues instead of theoretical scenarios in a textbook or on an educational recording. Compounding the issue is the amount of information and data that accompanies counseling. The chapter outlines some of the basic skills to be aware of: building the therapeutic alliance, handling intake and basic assessments, understanding counseling techniques, and other basics. The most critical factor in establishing the counseling relationship is creating an attachment with the client or clients. Beginning counselors should be aware that the counseling process might be new as well as intimidating to clients beginning therapy.

Ethical and legal issues tend to be perceived as significant concerns among graduate counseling students and for good reason. Functioning in the client’s best interests includes protecting confidentiality, practicing within our scope of competence, avoiding harm, avoiding conflicts of interest regarding your clients, and refraining from sexual and business relationships with clients, to mention a few. This chapter discusses these types of ethical issues and many others. Counselors practicing in various specialty areas must also be familiar with the ethics of their particular specialty (e.g., American School Counselor Association, American Rehabilitation Counseling Association, American Mental Health Counselors Association [AMHCA]). The chapter focuses primarily on the American Counseling Association (ACA) Code of Ethics as it represents the counseling profession’s flagship organization. Understanding the ACA Code of Ethics can provide guidance and spare the student anxiety.

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.

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.

Writing clear and descriptive clinical case notes is very different from most other types of writing. This chapter provides an overview on writing clear, concise, and effective case notes. Counselors have an explicitly stated legal and ethical duty to create and maintain client records on every client. Failure to maintain adequate records could form the basis of malpractice as it breaches the standard of care expected from a mental health professional. Counseling students should remember that like all other counseling training, developing good, clear, and concise clinical writing skills takes time and comes through experience. The practicum and internship placements are good beginning points for developing good clinical writing skills.

The practicum/internship experience involves not only the on-site clinical experience, but also structured supervision, individual and group, at the clinical placement and in the classroom setting. This chapter provides guidance to help us and our fellow students make the most of our supervision experience, both in the classroom setting and with our on-site supervisor. Remember, while counselors are specifically trained in supervision models (particularly at the doctoral level), not all on-site supervisors have received such training. Furthermore, on-site supervisors will vary in their supervision skill, just as clinicians vary in their counseling ability. Some excellent counselors may be mediocre supervisors, and there are mediocre counselors who are very good clinical supervisors. Clinical supervisors will vary in their skill and facility in providing helpful supervision to graduate interns as well as to professional staff.

Some counselor education programs have a Clinical Mental Health Counseling track and either a School Counseling or Marriage, Family, and Child Counseling (MFCC) track. Other programs may have all three and a nonclinical track from which students may choose. This chapter focuses on courses taught in the MFCC track. It summarizes some of the most helpful information to consider when prepping to teach a course in this track. These courses focus on helping students gain the necessary knowledge, skills, and attitudes to work with couples and families and introduce students to the theory, philosophy, and methods of systems work. The chapter focuses discussions and activities on topics such as systems theories, evidence-based interventions, contextualizing families, and cultural factors relevant to marriage. Courses in the MFCC track take a considerable amount of time to prepare. Like marriage, family, and child counseling, these courses are a spider web of processes.

Assessing and managing crisis situations are among the most challenging parts of the practicum and internship experience. No area of professional counseling practice creates as much stress and anxiety as crisis situations. Most practicum and internship settings, whether in schools, agencies, residential treatment centers, hospitals, and so forth, likely will try to screen potential crisis clients away from practicum and internship students due to the complexity and potentially litigious nature of a crisis. Because no screening system is perfect, however, counseling programs must prepare students for the possibility that they will encounter crisis clients on practicum. This chapter provides an overview of crisis situations and ways interns can begin addressing them. The most important information needed to address a crisis is to remain calm and to consult with the supervisor or a senior counselor if the supervisor is unavailable.

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 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.

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.

Rehabilitation counselors have long played a central role in helping persons with disabilities achieve their independent living and employment goals. Although the profession of rehabilitation counseling evolved from the state-federal vocational rehabilitation (VR) program, the professional practice of rehabilitation counseling is no longer restricted to state VR agencies. This chapter helps the reader understand rehabilitation and the impact of related legislation on rehabilitation counseling practices and the inclusion and participation of people with disabilities. The chapter explains the evolution of rehabilitation counseling and professional issues related to the profession, including certification and licensure. The chapter also provides the basic principles of ethics, ethical behavior, and risk management related to the professional practice of rehabilitation counseling.

The rehabilitation counseling process generally involves the integration of multiple client supports and community resources and the coordination of services provided by a variety of agencies, programs, facilities, and organizations. This chapter reviews the community supports and programs with which rehabilitation counselors and their clients most frequently collaborate. In this overview of the services available for a variety of rehabilitation populations, including persons with multiple disabilities, the chapter reviews the following topics: community resources and services for rehabilitation planning; programs and services for specific rehabilitation populations; Social Security Administration programs, benefits, and work incentives and disincentives; independent living services; financial literacy and benefits counseling; services available through client advocacy programs; and services available from one-stop career centers. The chapter also defines and distinguishes Social Security Administration disability benefits programs, including Social Security Disability Insurance and Supplemental Security Income, and describes the eligibility criteria.

People with disabilities are one of the most stigmatized and marginalized groups in the United States. Traditionally, rehabilitation counselors use a supply-side employment approach to provide employment services for people with disabilities, with a focus on medical, psychological, social, educational, and vocational services to improve functioning, stamina, and job skills of people with disabilities. Demand-side employment, on the other hand, has a focus on workplace culture and disability inclusion practices (and the interaction of employer demands and the environment [e.g., the job economy]) as predictors of high-quality employment outcomes for people with disabilities. This chapter reviews the literature related to demand-side employment approaches to create employment opportunities and improve the quality of employment for people with disabilities. It also discusses employers’ perceptions about hiring people with disabilities. The chapter concludes with a discussion of effective disability inclusion policies, procedures, and practices that increase employment opportunities and quality of employment for people with disabilities.

Poverty can be defined as economic deprivation. This chapter provides an explanation of the process through which a poor individual is at higher risk for acquiring a disability or chronic health problem. This chapter is divided into two parts. The first part focuses on the connection between poverty and disability: poverty as a risk factor for disability; the impact of poverty-related psychological factors on career development and health; and the impact of social role devaluation on individuals who are poor and have a disability. The second part discusses how poverty and disability affect career counseling and job placement and what counselors can do to assist persons who are poor and disabled to make effective career decisions and obtain employment. The chapter enables the reader to implement counseling strategies that can ameliorate the impact of disability and poverty on career counseling and job placement.