Counseling Clients with AIDS

The authors discuss issues and suggestions relative to counseling clients with AIDS. Several psychosocial issues are presented, and a psycho-educational model of treatment to meet the needs of AIDS clients is described.     

Pitfalls in Counseling Alcoholic Clients

Counseling alcoholic clients is a difficult problem for even the most seasoned counselor. Clients' abilities to use denial and manipulation demand a parallel counselor ability to identify dynamics properly, to deal with defenses, and to provide empathetic support while remaining emotionally noninvested. The unique dynamics of alcoholism demand that the counselor develop unique and innovative strategies within the counseling relation, literally to save the life of the client.     

Understanding and Counseling Narcissistic Clients

This article is intended to provide counselors with an overview of narcissism and its treatment. In the first section, dysfunctional narcissism is described, drawing on the diagnostic indicators presented in the DSM-III and the contemporary object relations theories of Heinz Kohut and Otto Kernberg. The second section focuses on counseling narcissistic clients.     

Counseling Adult Clients Experiencing Chronic Pain

Chronic pain affects 35% to 57% of the adult population in the United States and results in billions of dollars spent annually in direct health‐care costs and lost productivity. Extensive research confirms the considerable role psychological factors play in the experience and expression of chronic pain. The author discusses implications for counseling adult clients experiencing chronic pain, specifically interventions, interdisciplinary treatment approaches, treatment planning, diversity, and ethical/legal considerations.     

Perceptions of Clients and Counseling Professionals Regarding Spirituality in Counseling

Although current research indicates that psychotherapeutic change both affects and is affected by spiritual concerns, relatively little is known about the degree to which spirituality is used as an intervention in counseling and how it is perceived by clients and mental health professionals. The purpose of this study was to examine the perceptions of clients and professionals regarding the use of spirituality in counseling. The results suggest that more professionals may be using spirituality in counseling than has previously been reported.     

Mandated Clients in Career or Employment Counseling

The article describes some of the challenges facing employment counselors who are working with mandated clients. Suggestions are provided for use with mandated clients in individual and group employment counseling sessions.     

The Concerns about Counseling Racial Minority Clients scale

The purpose of this study was to develop and validate the Concerns about Counseling Racial Minority Clients (CCRMC) scale among counselor trainees. Sample 1 was used for an exploratory factor analysis and confirmatory factor analysis. Four factors were identified, Managing Cultural Differences (α = .82), Offending or Hurting Clients (α = .87), Biased Thoughts and Behaviors (α = .81), and Client Perceptions (α = .77). The coefficient alpha for the CCRMC was .90. The results support the validity of the scale. The scores on the CCRMC and its subscales have positive associations with fear of negative evaluation from others (r = .19 to .40) and negative associations with general counseling self-efficacy (r = -.30 to -.46) and multicultural intervention self-efficacy (r = -.30 to -.64). The CCRMC significantly predicted fear of negative evaluation, session management self-efficacy, and multicultural intervention self-efficacy over and above multicultural social desirability. The validity evidence was not different between White and minority graduate trainees. In Sample 2, the estimated 1-week test-retest reliabilities ranged from .75 to .96 for the CCRMC and its four subscales.     

Group Counseling and Group Psychotherapy with Rehabilitation Clients

An instrument designed to measure components of two distinct alcoholism aftercare treatments was developed and evaluated for reliability and validity. Trained judges reliably rated audiotaped samples of coping skills and interactional group therapy sessions. Coping skills groups engaged in significantly more education and skill training, problem solving, and role playing. Interactional groups showed more interpersonal learning, expression/exploration of feelings, and here-and-now focus. Groups that employed more education and skill training, less expression and exploration of feelings, and less her e-and-now focus were associated with fewer members reporting subsequent drinking-related problems. None of the ratings of group activities was related to abstinence.     

Characteristics of Clients Judged to Require Long-Term Counseling

This study examines one subgroup of clients seen at a university counseling center, namely, 72 clients who were expected by their counselor to remain in counseling for 10 or more interviews. Ratings were available on psychological characteristics for this sample and for the Counseling Center's total client population. In addition, the total university population could be compared with both of these groups on demographic characteristics. On the basis of pre- and post-counseling ratings of severity of problem, the sample being investigated was divided into Improved and Unimproved groups. Comparative data are examined with regard to class, college, sex, type of residence, type of problem, severity level at onset and termination, number of counseling interviews, motivation for counseling, defensiveness, and counselor's feelings toward client. Long-term counseling and improvement status are found to be a function of most of these variables.     

Advocating for Atheist Clients in the Counseling Profession

Atheism is a controversial topic, with individuals who identify as atheist reporting high rates of discrimination. Despite increasing literature discussing religious/spiritual views and beliefs, few scholarly discussions of atheism in the counseling field can be found. Counselors need to be made aware of the issues facing atheist clients and educated on the best interventions to use in collaborative work with clients. Counselors should also be prepared to advocate for atheist clients in multiple domains. This article aims to explore the relevant literature around atheism, identify implications for counselors, and provide a path to advocacy for counselors in their work with atheist clients.     

The Counseling Experiences of Transgender and Gender Nonconforming Clients

The counseling experiences of 13 transgender and gender nonconforming (TGNC) individuals were examined via semistructured, in‐depth interviews. Using multiple standards of trustworthiness (e.g., member checking, negative case analysis), the authors analyzed each interview from an interpretative phenomenological analytic framework. Four main themes were identified: mental health professional selection process, transaffirmative approach, transnegative approach, and support systems beyond counseling. Implications for implementing culturally responsive TGNC affirmative counseling, TGNC sensitive counselor training, and social justice–oriented research are discussed.     

Counseling Clients Who Self‐Injure: Ethical Considerations

This article provides an overview of ethical considerations related to counseling clients who engage in self‐injurious behaviors. Ethical issues concerning client welfare, counselor competence, countertransference, referral and consultation, informed consent, and duty to protect are discussed in relation to the American Counseling Association's (1995) Code of Ethics and Standards of Practice. Implications and recommendations for counselors who work with clients who self‐injure are provided.     

Individualistic and Collective Group Counseling: Effects With Korean Clients

In a study of 20 female and 21 male Korean clients with three group counseling approaches (individualistic, collective, and a balanced combination of both), no treatment effects were found for social commitment or perceptions of counselor effectiveness. Significant changes were seen in individualism-collectivism congruent with different treatments.     

Learning from Clients: Counseling the Frail and Dying Elderly

Each counseling experience with a frail or dying client is a learning opportunity. In these circumstances if is the counselor who is the student.