Reframing the DSM‐IV‐TR From a Multicultural/Social Justice Perspective

The Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; American Psychiatric Association, 2000) represents a medical model that can be reframed for more effective use in counseling. To achieve this goal, the authors describe how they can shift from client diagnosis to case formulation. In describing this shift, the authors offer an example of a theory‐based etiology and relate case formulation to specific counseling interventions.     

Adjusting to Retirement: Considerations for Counselors

The purpose of this article is to examine retirement while focusing on issues older adults face in adjusting to retirement and to suggest implications for counseling people who are making this transition.     

Managed Care: Ethical Considerations for Counselors

Key factors and trends in health care will have an impact on the ethical practice of counselors. Ethical challenges to clinical practice presented by trends in managed care are discussed in relation to the American Counseling Association (1995) Code of Ethics and Standards of Practice. Recommendations for practice are also included.     

Child Maltreatment in DSM‐5 and ICD‐11

Child maltreatment is widespread and has a tremendous impact on child victims and their families. Over the past decade, definitions of child maltreatment have been developed that are operationalized, face valid, and can be reliably applied in clinical settings. These definitions have informed the revised Diagnostic and Statistical Manual (American Psychiatric Association, 2013) and are being considered for the International Classification of Disease–11 (World Health Organization). Now that these definitions are available in major diagnostic systems, primary healthcare providers and clinicians who see children and families are poised to help screen for, identify, prevent, and treat child maltreatment. This article reviews the definitions of maltreatment in these diagnostic systems, along with assessment and screening tools, and empirically supported prevention and intervention approaches.     

Description of Relational Processes: Recent Changes in DSM‐5 and Proposals for ICD‐11

Epidemiologic, prospective, and retrospective research confirms that family relational variables are significant risk factors for the development of mental and physical health problems in children as well as adults. In addition, relationships also play a moderating role in the maintenance, exacerbation, or amelioration of chronic health problems. Although acknowledgment of the importance of these variables in the pathophysiology of a number of health conditions is reaching more prominence, the integration of assessments of family factors as part of standard health care has made little progress. With the arrival of the Affordable Care Act in the United States, there is a desire for earlier identification of these risk factors, and the ability to implement prevention programs that reduce risk, and enhance protective factors. On a global level, there is increased awareness of the health impact of relational problems, for example, many countries have attempted to implement programs to decrease domestic violence. More reliable and standardized assessments of key relational processes will enhance both of these missions, and allow comparison of a variety of prevention and intervention programs. This article discusses progress over the last decade in constructing more reliable definitions of relationship processes, how these have been integrated into the Diagnostic and Statistical Manual 5th edition (DSM‐5), and progress toward implementation into the World Health Organization's International Classification of Diseases (ICD‐11).     

School‐Based Health Centers: Implications for Counselors

School‐based health centers (SBHCs) have been established to provide comprehensive physical and mental health care and preventive services for students. Growing evidence of outcome effectiveness has spurred the rapid development of these centers. SBHCs have received little coverage in the counseling literature. This article provides a review of the issues and opportunities that SBHCs offer for the counseling profession.     

End‐of‐Life Care: An Overview for Professional Counselors

Although “End‐of‐Life Care for Terminally Ill Clients” is a section of the ACA Code of Ethics (American Counseling Association, 2005), neither the Code nor the counseling literature provides much direction for counselors who work with clients who are dying and with the clients' loved ones. The authors provide counselors with an overview of the issues that may be relevant when working with such clients.     

Dimensional and Cross‐Cutting Assessment in the DSM‐5

A significant proposed change to the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM‐5) that will significantly affect the way counselors diagnose mental disorders is the addition of dimensional assessments to the categorical diagnoses. The author reviews the current DSM's (4th ed., text rev.; American Psychiatric Association, 2000 ) categorical classification system, describes the proposed dimensional and cross‐cutting assessments, and provides implications about clinical utility and user acceptability of a dimensional diagnostic approach.     

VISION: A Model of Culture for Counselors

Current and popular views of multiculturalism emphasize between-group differences attributable to race and ethnicity with little appreciation of within-group differences, the individuality of each person's phenomenal field, or an individual's capacity to participate in different groups. VISION is a model of culture that accounts for within-group and between-group differences, the disappearance of groups, and the emergence of new ones. VISION has program applications pertinent to counselor education in the areas of mental health counseling and in modeling the multicultural training of counselors. A paradigmatic shift from a group level of abstraction to the individual is commonly contemplated among cultural anthropologists, but the need for this shift is illustrated in a counseling context.     

The Concept of Culture and Its Significance for School Counselors

Understanding the role of culture, as it affects attitudes and behavior, can be extremely useful in the social service fields for enabling more effective communication across social barriers. However, in connection with the “culture of poverty,” or “cultural disadvantage,” the culture concept has often been distorted, and transformed into a stereotype behind which the individual is not revealed, but hidden. Specific examples of productive and unproductive uses of the concept in school guidance work are discussed. Another aspect of the cultural dimension, understanding of which is useful to the school counselor, is the nature of the counselor's role in relation to the institutional structure of the school.     

Ethical Dimensions of Diagnosing: Considerations for Clinical Mental Health Counselors

There are numerous ethical considerations inherent within the process of assigning a Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; DSM‐IV‐TR; American Psychiatric Association, 2000) diagnosis. In this article, general ethics considerations such as informed consent and confidentiality, accuracy of diagnosis, and multiple relationships are examined as they relate to clinical mental health counselors' use of the DSM‐IV‐TR. The article concludes with the authors' suggestions for ethically sensitive diagnostic practices.     

Beyond the DSM‐IV: Assumptions,Alternatives, and Alterations

Current diagnostic processes reflect the limitations and utility of the framework of the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM‐IV; American Psychiatric Association, 1994). Clinical information in the DSM‐IV's 5‐axis system almost exclusively focuses on weaknesses and pathology and is summarized in a flawed categorical system. Hence, the authors describe 3 adjunctive, or alternative, means of conceptualizing behavior; several means of altering the current DSM‐IV system; and 2 future directions in the diagnosis of strengths.     

Sexual Abuse Prevention for Individuals with Mental Retardation: Considerations for Genetic Counselors

It is now widely recognized that children, adolescents, and adults with mental retardation are especially vulnerable to sexual abuse. Because at least 10% of genetic conditions are reported to include mental retardation as a feature, the provision of services to individuals with mental retardation represents a substantial portion of the case load for many genetic counselors. Our objective is to educate genetic counselors and other health professionals about this vulnerable population in order to enhance the frequency and efficacy of inquiry into sexual education and sexual abuse prevention training for patients with mental retardation. The following review article is intended to assist genetic counselors by increasing their knowledge of factors that lead to sexual abuse and provides recommendations for integrating this information into the counseling interaction.     

Navigating Bereavement With Spirituality‐Based Interventions: Implications for Non‐Faith‐Based Counselors

The relationship between spirituality and bereavement has been studied in a multitude of disciplines, yet there is a significant gap in the counseling literature on this topic. The authors explore how spirituality is often avoided in secular counseling settings, discuss adverse effects of unresolved grief on clients' functioning, and propose the concept that spirituality can be used to help clients through the bereavement process. Finally, the authors offer research and clinically based interventions that counselors, particularly those who do not identify as faith‐based, can use to incorporate spirituality into their work with bereaved clients.     

Towards the DSM‐5 Criteria for Autism: Clinical,Cultural, and Research Implications

The new edition of the DSM is proposing significant changes to current diagnostic definitions of autism and related conditions. In this article, we will discuss the clinical, research, and cultural implications of these changes. We conclude that the new criteria appear to better reflect current understanding of the autism spectrum disorder than the current DSM‐IV criteria. As expected with any major change in classification systems, there are also significant risks, which will have to be carefully monitored and addressed by both policy makers and the scientific community to ensure that best clinical practice and research are facilitated and advanced.     

The psychometric properties of the Portuguese version of the Personality Inventory for DSM‐5

The DSM‐5 Section III proposes a hybrid dimensional‐categorical model of conceptualizing personality and its disorders that includes assessment of impairments in personality functioning (criterion A) and maladaptive personality traits (criterion B). The Personality Inventory for the DSM‐5 is a new dimensional tool, composed of 220 items organized into 25 facets that delineate five higher order domains of clinically relevant personality differences, and was developed to operationalize the DSM‐5 model of pathological personality traits. The current studies address the internal consistency (study 1), the test‐retest reliability (study 2) and the criterion validity (studies 3 and 4) of the Portuguese version of the PID‐5 in samples of native speaking psychology students. Results indicated good internal consistency reliabilities and good temporal stability reliabilities for the majority of the PID‐5 traits. The correlational pattern of the PID‐5 traits with two measures of personality was in accordance with theoretical expectations and showed its concurrent validity.