Students: Chapter Summaries
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Therapeutic Alliance and the Helping Relationship
Rochelle Moss and Matthew Glowiak
You began this chapter viewing yourself as the client, feeling apprehensive about seeking counseling but motivated because of the critical problems in your life. Now imagine yourself as the counselor with each of the clients described in the introductory paragraph. You have learned the importance of establishing the counselor/client relationship and the conditions essential to a therapeutic alliance, including genuineness, empathy, and nonpossessive warmth.
You know that developing the alliance consists of three relatively distinct phases: building the relationship, challenging the client to find ways to change, and facilitating positive action. Also important are the characteristics most effective counselors possess, including high levels of self-awareness, empathy, genuineness, and respect for others, and an ability to use themselves as vehicles of change.
You have learned that effective counselors use attending skills (eye contact, body language, and vocal tone) and basic listening skills (client observation, encouraging, paraphrasing, summarizing, reflection of feeling, and open/closed questions) throughout the alliance. Also vital is the use of self-attending skills, which emphasize the importance of the person of the counselor in mediating the communications skills necessary in the therapeutic alliance.
You have been introduced to primary and advanced empathy skills as well as the challenging skills of confrontation, self-disclosure, and immediacy. These skills strengthen the alliance and move the client toward therapeutic change. Counselor action skills facilitate behavior change around the client’s stated goals for counseling. Finally, termination skills are needed to bring closure to, and end, the therapeutic alliance.
The Counseling Profession: Historical Perspectives and Current Issues and Trends
Harriet L. Glosoff and Jill E. Schwarz-Whittaker
The roots of counseling are deeply embedded in a variety of disciplines that have come together and created different emphases at various points in time. These emphases have led to the development of counseling specialties, counselors working in a wide variety of settings and offering a broad range of services, and the profession struggling with the formation of an identity.
Counselors in the United States, regardless of work setting or theoretical orientation, are linked by the common belief that a person has the capacity and right to choose directions and activities that are most personally satisfying. Choices must be made within the bounds of social and moral value systems that will not bring harm to self or to others. The counselors who were pioneers and the counselors who work now are dedicated to helping individuals find their way in an increasingly complex society.Counselors are active in dealing with a great number of social problems that affect the populations with which they work. Society is in turmoil, trying to deal with the use of illegal drugs, changing family structures; the effect of technology on education, occupations and employment; immigration issues; and complex pluralism; leading to the development of special populations at risk of being inundated by the majority. There is not space here to discuss each issue and the role of counselors in addressing these. Counselors must work to ensure that through their systematic, scientific, and professional efforts, individuals and groups will be served well.
Cross Cultural Counseling
Courtland C. Lee, GoEun Na, and Roxanna Pebdani
This chapter has presented an overview of the discipline of cross cultural counseling. Given the changing population demographics of the United States in the second decade of the 21st century, it is important that professional counselors develop the awareness, knowledge and skill to establish, maintain, and successfully conclude a counseling relationship with clients from diverse cultural backgrounds. At a fundamental level, any counselor who enters into a cross cultural counseling encounter must have self-awareness, an awareness of the world in which he or she lives, a foundational knowledge of traditional counseling theory, and aspire to high ethical standards. In addition, such a counselor must possess knowledge of culturally diverse perspectives of counseling and engage in cross cultural encounters as a way to enhance counseling skill development in a culturally competent manner. The sum total of this knowledge and experience should be cultural competency and the ability to effectively enter a cross cultural counseling encounter with culture in mind.
Ethical and Legal Considerations in Counseling
Mark Stauffer, Ann Ordway, and Laura Owen
Unethical treatment causes harm to clients and leaves the counselor open to malpractice suits and loss of credibility. This may leave the counselor and client in vulnerable positions which minimize or negate the benefits of counseling and damage the credibility of counselors and the counseling profession. A counselor’s best defense is to behave as ethically as possible while doing everything to promote the best interests of clients.
Most have entered this profession in order to help others while also earning a living and reaping the fruits of a rewarding career. For both to occur, counselors must keep the ethical codes in mind at all times; must strive to be as mentally, emotionally, spiritually, and physically healthy as possible; must obtain a thorough graduate education that emphasizes both knowledge and practice; and must seek continuing education, advanced training, and supervision when in the “real world.”
Self-Care and Self-Growth: A Professional Responsibility
Laura R. Simpson and Jeannie Falkner
Counselors are faced with many exciting challenges as they traverse this unique professional helper’s journey. Personal growth and development require the counselor to continually pursue a life of health and wellness in their personal and professional lives. Attunement to your cognitive, spiritual, physical, and emotional parts is vital to achieve your goal of helping clients and doing no harm.
There will be times when you find yourself on the spectrum of wellness toward wholeness and fulfillment in most areas of your life. Enjoy and be mindful of the simple things. Be good to yourself and to those you love. These are the times when you will have the energy and resources to give to your best to your clients, to your profession and to yourself. At other times, you will naturally find that the complexities of life have moved you toward the less desirable end of the wellness spectrum. You may have an unexpected illness, family concerns, changes in jobs, or any combination of these normal crises of life. You may find yourself in need of additional resources. Do not hesitate to seek the support you need! Personal counseling, supervision, and time spent in spiritual practices may be needed to restore the equilibrium of life and help you achieve balance. It is important to monitor the impact these trying times may have on our work. Feedback from trusted colleagues, supervisors and spiritual leaders can provide you with valuable insights and help you negotiate through the rough times. Remember, life has an ebb and flow and these times, as we often tell our clients, are not permanent.
If you should find yourself with symptoms of impairment, seek professional help. After all, we are human and may, at times, need to take a sabbatical from our work to refresh, renew, recover, or heal. As counselors, both authors have at one time or another felt burnt out, worn out, and used up. One author quit counseling children for five years in response to a trauma heavy caseload that became so heavy that she broke under the pressure. Realizing that her values for finding the good in people and giving the benefit of the doubt had been compromised, she made this drastic decision in an effort to salvage her ability to stay in a profession that she loved. Both of us have heard countless stories from professional colleagues that illuminate the need for self care. For example, one author’s very good friend found herself burnt out to the point of impairment. She described her experience like this: “One day I went in to the office and knew I simply could not sit through another counseling hour. ‘What is wrong with me?’ she asked. ‘I have a successful practice, a beautiful office, and a supportive supervision group’. Today none of this was enough. I was spent and I knew it. I had to take drastic action to save myself and protect my clients. I cancelled my appointments, made arrangements for emergency calls, and left town for three weeks. I could not really afford this time from work, but I could not afford not to take the break! When I returned, I realized three weeks was not enough. After six weeks of rest and recovery, I was able to return to work and begin again, humbled and appreciative of the care and concern expressed by my clients and colleagues.”You may never experience this level of impairment, but know that some of us will. Even in the worst of times, there is hope for rejuvenation and repair. We hope to have raised your awareness and offered knowledge and skills that can assist you in practicing good counselor self-care.
Research and Writing in Counseling
Teresa M. Christensen
This chapter addressed issues related to writing and research in counseling. Concepts and ideas were directed toward novice and experienced counseling students who are currently encountering assignments ranging from essays, term papers, and literature reviews to theses and dissertations. Specific attention was placed on the role of research in the profession of counseling. Concepts included the importance of research, the definition of research, how to use research and literature in counseling, how to construct a comprehensive essay or literature review, legal and ethical implications for writing and research, and how to utilize research in program evaluations.
Technology in Counseling
Melinda Haley, Jessica Gelgand, and Anne-Laure Bourgois
Counselors need to build their technological knowledge and skills in order to use these tools in their work. The Association for Counselor Education and Supervision (ACES) has composed twelve counselor education technological competencies that graduates should master upon leaving any program (Haley & Carrier, 2010). Technology is advancing so fast that by the time this chapter is in print parts of what is talked about here may already be obsolete. There may also be innovations that are not covered in this chapter.
Counselor education programs need to train future counselors to use the technology currently available. Otherwise these counselors will fall behind other mental health service workers who are using this technology. There is no choice today as to whether a counselor will use technological advances in his or her practice. It is more a matter of which technology the counselor chooses. A new world has opened to counselors within the last few decades, a world that at times can be simultaneously frightening and exciting. There are so many choices from which to consider, as technology can be utilized in some form or another to aid in nearly every aspect of a counselor’s work. Counselors need to think about the benefits, the drawbacks, and the ethical considerations when incorporating technology into their work.
Individual Counseling: Traditional and Brief Approaches
Matthew V. Glowiak
- Although Milton Erickson and Richard Bandler have been credited as the founding fathers of brief theory, it did not become a popular approach until 1973 when Jay Haley published the book Uncommon Therapy: The Psychiatric Techniques of Milton Erickson.
- Research supports the notion that many problems common to those seeking counseling may actually be resolved as well if not better using brief theory.
- By encouraging clients to focus on the present and create solutions to their own problems, they will likely undergo spontaneous and generative change.
- Solution-focused counseling has a focus that is on the future, specific goals, and the solutions toward achieving those goals.
- In the sense that behavior theory focuses on maladaptive behaviors, cognitive theory focuses on maladaptive thoughts. Therefore, central to the concept of Beck's cognitive theory is the belief that psychological dysfunction, or pathology, is a result of faulty logic in one's cognitions.
- The humanistic school of thought is phenomenological. It focuses on the here-and-now while believing that individuals possess the basic inclination to become fully functioning. In sum, humanistic counselors must be genuine, warm, and insightful.
- Existentialism concerns the dynamic transitions that people encounter when they "emerge, evolve, and become..." In what way am I an important part of everything else?
- The primary goal of brief psychoanalytic counseling is to either modify a maladaptive aspect of one's identity or integrate the learned and acquired skills missed during an earlier stage of emotional development.
David Capuzzi and Douglas R. Gross
The use of groups of all types is increasingly important to the role of the counselor in a variety of settings. As the decades have passed, emphasis has shifted from T-Groups to encounter groups to working with special populations. Self-help groups of all types are flourishing. The ASGW standards for the training of group counselors have received wide-spread acceptance.
ASGW’s definitions of the four group work specialty types (task/work, guidance/psychoeducational, counseling, psychotherapy groups), information about stages of group life, and research on the characteristics of group facilitators have also enhanced the ability of the group work specialist to function in the best interests of clients in groups. In addition, the more group work specialists know about their responsibilities and the interventions they need to master, myths connected with group work, and issues and ethics associated with groups, the more competent they will be as facilitators of group experiences. The importance of broad-based education and carefully supervised group practicum and other clinical experiences for group work specialists cannot be overemphasized.
Creative Approaches to Counseling
Although counseling has traditionally been characterized by a verbal orientation, practitioners are now encouraged to explore other methods to help people cope with psychological problems. In this chapter, a variety of creative approaches to counseling were described. These approaches have been found to be effective for a variety of problems presented by both children and adults.
As discussed in this chapter, creative approaches to counseling can be adapted to fit the client's learning style. Art, imagery, and writing were identified as appropriate strategies for clients of all ages. Specific ways to use music, bibliotherapy, and play were also described. Implementing approaches of this nature can enhance the counseling process because they combine theory and practice in flexible ways to focus on the unique aspects of the client and the problem.
Assessment Practices in Counseling
Linda H. Foster
Assessment is an integral and legitimate part of a counselor’s professional functioning. However, counselors have a choice about the attitudes they adopt toward assessment. They can view it as a “necessary evil” and employ minimal effort toward assessment functions, or they can do what they need to do to gain understanding of psychometric principles, tests, and assessment processes and, therefore, reap the benefits of effective assessment practices. Counselors who adopt this latter perspective will find that assessment is a valuable resource, and one that enhances their counseling practice.
Diagnosis and Treatment Planning
The processes of diagnosis and treatment planning are integral to the overall practice of mental health counseling and are important elements of other areas of counseling practice. While there is much debate within counseling as well as among other mental health disciplines regarding the validity of diagnostic systems, most famously of the DSMs, at this point the centrality of diagnosis in the accessibility, affordability, and therefore the delivery of counseling services cannot be denied. It is incumbent upon professional counselors to become proficient in the process of diagnosis, as well as to be cognizant of the counseling profession’s traditions and values of wellness orientation, an emphasis on strengths, and the awareness and integration of cultural and social justice issues into the counseling process.
Cynthia J. Osborn and Melanie M. Iarussi
Problematic substance use is not an isolated concern confined to certain groups of people. It is a public health issue that affects all Americans. This means that no counselor is immune to or can opt out of addressing the issue of addiction with clients and their families. It thus seems imperative that professional counselors obtain further and specialized training in theories of addiction beyond the disease model, screening and assessment methods, diagnosis of substance use disorders, and evidence-based prevention and treatment practices for persons with addictions and co-occurring disorders. Translating this training into routine counseling practice will advance the field, thereby improving access to services for the more than 20 million persons age 12 and older in the United States who needed treatment for a substance use problem in 2010 but did not receive it (SAMHSA, 2011b). That this number represents the overwhelming majority (89%) of persons with a substance use problem indicates that significant changes are still needed in addictions service provision. Implementing evidence-based practices in addictions counseling also will improve the quality of care once persons access services. Professional counselors are in a prime position to develop and implement a truly integrative approach to addictions counseling, one that is, according to W. R. Miller et al. (2011), comprehensive and evidence-based, multidisciplinary, holistic, and collaborative.
Abby Platt and Meredith Drew
The field of career counseling combines basic counseling skills, assessment, prevention, intervention, and diagnostic skills to work with the client. This chapter presented an overview of career counseling for beginning counselors. As new counselors embark on their professional journey, there remain many possibilities for both challenging and rewarding experiences. As a career counselor builds a strong foundation in the field of career development and intervention, it will enhance the counseling experience for both the client and counselor and allow for the exploration that is required. Resources that are available enhance the work that career counselors can do with their clients, providing for more positive outcomes. The area of career counseling is vital to the field of counseling.
Counseling in Clinical Mental Health and Private Practice Settings
J. Kelly Coker and Savitri Dixon-Saxon
The counseling profession is at a crossroads. Graduate training assures a solid preparation for entry into the field, increased credentialing options define for the public what they can expect from mental health counseling, and professional counselors have gained recognition and status as professionals in mental health care. With a bright future, it is important to not lose touch with the rich history of the profession. First and foremost, counselors care about those they serve, respecting the dignity of each human being.
In a new age, those roots will serve the profession well. The nature of advocacy is descriptive of the challenges faced by counselors in a new century. The pluralistic nature of America makes it imperative that the profession be mindful of its own biases, increase the knowledge and understanding of differing systems (especially families), and broaden counseling approaches to be more useful to more of the community. Along the same lines, the counseling profession itself would be well served to increase the diversity within its own ranks.
The concept of advocacy expands to include the responsibility of speaking on behalf of the clients we serve and those we don’t, seeking services and resources for those who may otherwise fall through the cracks. As economic diversity continues to create greater disparity between the “haves and the have-nots,” professionals must lend their clout to improving the conditions of their communities.
Maintaining clinical competence is a professional, ethical, and in the case of the private practice, essential responsibility in order to be successful. Conditions may sometimes conspire to make those previously listed responsibilities difficult to meet. Professional mental health counselors must take responsibility for self-care and must take measures to remedy such a situation in order to provide competent counseling for their clients.
Mental health counselors have a specific role in the larger profession of counseling. The role has evolved out of a rich history and is supported by specific academic and clinical training. Mental health counselors collaborate with other mental health care professionals and have opportunities to practice counseling in many diverse settings. Some of these settings include community agencies (public and private), hospitals and health care facilities, government sponsored programs and services, and private practice. Some counselors have private practices.
Professional counselors have available to them many different professional credentials, which helps to define for the public what counselors do and increases their professional recognition in the mental health care community. Fifty states offer some form of professional counseling license and all counselors who qualify can seek certification as a National Certified Counselor (NCC). Some professional counselors hold credentials in counseling specialties.
Mental health counselors have made many advances during the relatively brief history of the counseling profession. That history reflects ongoing efforts to make sure the definition of counseling accurately reflects the competencies of counseling practitioners, as well as the roles fulfilled in the mental health profession.
Marriage, Couple, and Family Counseling
This chapter has attempted to introduce the reader to the contextual thinking that is the essence of family therapy. I have tried to illustrate this perspective through descriptions of family therapy diagnosis, interviewing, and treatment. In family therapy, diagnosis focuses on interpersonal rather than intrapersonal dysfunction. Sound family therapy interviewing follows a distinct process beginning with pre-session planning. Family therapy treatment is rich with powerful techniques. These techniques include circular questioning and giving directives among others. It is my hope that this brief introduction to the concepts and techniques of family therapy will whet the reader's appetite for further exploration.
Professional School Counseling
Tamara E. Davis
The world of professional school counseling is one of great opportunity and challenge. Unlike other specialty areas in counseling, professional school counselors have, as an ultimate goal, the academic success of students. The role of professional school counselors is multifaceted and includes many activities related to providing services for students, parents, and other school personnel. The school counseling profession continues to respond to the needs of a diverse and ever-changing society. Issues related to diverse student populations, equitable access to education, technology, and role definition of the school counselor will continue to permeate the profession (Jones & Granello, 2002). Outcome-based program evaluation and finding time for counseling in an age of testing and accountability also challenge school counselors. However, the professional school counselor will confront these challenges head on and continue the positive course of recent events in school counseling that show the impact of school counseling programs and services on the academic success of students.
So, how would a professional school counselor work with Paul, the struggling student in Sidebar 17.1? First, the school counselor might consult with Paul’s teachers to try to understand what specific behaviors Paul has been demonstrating in class and what changes they have observed in his school performance. Second, the school counselor would conduct individual counseling with Paul to assess his perspective on what is going on in his life. Using effective counseling skills, the school counselor would try to get Paul to be open about his life situation and the effect his home life might be having on his school performance. The school counselor would encourage Paul to express his feelings about things and then ask what Paul would like to have happen. In this session, the school counselor is also going to address Paul’s decline in academic performance and help generate strategies to provide support for him at school. If necessary, the school counselor will help Paul identify resources that he can use to improve his academic performance. Finally, the school counselor would seek Paul’s consent to speak with his parents so that everyone can be informed about the impact of the family situation on his academic progress. If Paul gave consent, the school counselor would arrange a meeting with the parents (with Paul present if he wished) and perhaps include teachers as well so that everyone is collaborating about helping Paul experience success at school. A comprehensive school counseling plan, involving the roles of counseling, consultation, and coordination of services as well as monitoring and assessment of the effectiveness of interventions will highly increase Paul’s chances of school and personal success.
College Counseling and Student Affairs
Theodore P. Remley, Jr., and Brian M. Shaw
College counseling or college student affairs are career options for those who hold master’s degrees in counseling and college student development. Jobs in colleges and universities are varied and range from positions as counselors in traditional college counseling centers where clients are seen in individual sessions to positions in financial aid or admissions where little activity takes place that might be considered counseling. The setting of the college or university has a significant impact on the jobs master’s level counselors might find. Working in a small residential liberal arts college that has 1000 undergraduate students is much different from having a professional position in a multi-campus urban community college that has 100,000 freshman and sophomore students, or being a counselor in a large state university with 80,000 students who are both undergraduates and graduate students.
Graduate students who plan to be counselors or student affairs professionals in colleges or universities should join and be active members of the American Counseling Association (ACA) and its division, the American College Counseling Association (ACCA). They should also consider being members of the American College Personnel Association (ACPA). If they are oriented toward administration, they should also join the NASPA: Student Affairs Administrators in Higher Education. Once they become professionals, to ensure they have current information in the field, college counselors and student affairs professionals should maintain active memberships in appropriate professional associations.