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.     

The application of solution‐focused work in employment counseling

The author explores the applicability of a solution‐focused therapy (SFT) model as a comprehensive approach to employment counseling. SFT focuses the client on developing a vision of a preferred future and assumes that the client has the talents and resources that can be accessed in the employment counseling process. The solution‐focused counselor enters the therapeutic relationship from a point of “not knowing” and works with the client in job transition to develop possibilities that evolve from the client's strengths and knowledge. Examples are given of how solution‐focused employment counseling could be practiced.     

Career‐Community Development: A Framework For Career Counseling and Capacity Building in Rural Communities

The authors propose a framework for career counseling in rural communities that addresses the psychosocial and economic challenges of natural disasters and other catastrophic transitions. The career‐community development framework expands the notion of “client” to include a community‐as‐client approach within a capacity building orientation to supporting workers in the wake of large‐scale disruptions. Drawing on a case study of 2 communities recovering from a devastating forest fire, the authors outline an intervention approach that integrates elements from psychological‐trauma theory, career‐community capacity building models, and libratory educational practices. Implications of this framework for counselor training and practice are discussed.     

New Directions in Counseling Women

A revolution in counseling women is one logical outcome of recent changes in the social, political, and economic movements that have predisposed individuals to modify their life-styles and value systems. This article discusses four facets of that revolution and concludes that new counselor training programs are required to meet the needs of emerging client populations. The conclusions are supported by research that indicates (a) new sources of knowledge about the development and functioning of women clients; (b) new groups of client populations whose needs are not being met by traditional counseling strategies; (c) innovative procedures specifically tailored to the unique characteristics of these client groups; and (d) revised standards of ethical practice to ensure competent and appropriate services for all client populations. Training programs are outlined that provide guidelines for sex-fair education for all counselors and more intensively focused training for counselors who select the counseling of women clients as a career specialty.     

Genetic counseling for the next 25 years: Models for the future

Currently, two trends pose particular challenges for genetic counseling: (1) spin offs from the Human Genome Project leading to new diagnostic genetic tests far in advance of any cures; and (2) an increasing and diversified client population. These trends will lead to changes in both genetic service delivery systems and the development of alternative models of the genetic counseling process itself. Two models that could be adapted for genetic counseling are: the mutual participation model and the life history narrative model. Technological advances present ethical dilemmas and raise many questions. Already, improved detection of genes for predisposing conditions has entered clinical medicine requiring renewed ethical appraisals of genetic testing. Integration of genetic counseling (and required pre-screening education) into primary care settings involves time constraints and the involvement of health care personnel with less training in genetics. Alternative approaches are beginning to be discussed. Innovative genetic counselors with expanded visions of counseling goals and practices will play an increasingly important role in the future of genetic counseling.     

Person‐Centered Counseling: The Culture Within

The variables most related to success in counseling outcome research are the client‐counselor relationship and the personal and situational resources of the client (extratherapeutic variables). When these variables are compromised, a “specificity myth” is endorsed purporting that there are specific treatments for particular groups of people. This myth is a direct result of a shift in focus from the client to the counselor as the expert who focuses on “doing” counseling rather than “being” a counselor. Person‐centered counseling cuts to the core of therapeutic success: the relationship of the counselor‐client and the utilization of the client's resources.     

An Integral Approach to Counseling Ethics

The authors offer an integral approach to counseling ethics using K. Wilber's (2000a, 2000b) integral metatheory. The article examines traditional counseling ethics through the lens of K. Wilber's (2000a, 2000b) “all‐quadrants, all‐levels” model, consisting of quadrants, levels, lines, states, and types. The authors begin with the 4 quadrants and how they can inform understanding of traditional counseling ethics. Vertical development in relation to counseling ethics is addressed, followed by a case study of an ethical dilemma in counseling. The authors offer an integrally informed process of ethical decision making that can be seen to complement less comprehensive ethical decision‐making models.     

我国心理咨询业的伦理学探讨

目前我国心理咨询需求日趋增加,心理咨询师培训异常火爆,但是从业者的素质良莠不齐,心理咨询工作者的伦理道德和行业规范不健全,导致了来访者和咨询师之间的伦理学困惑和问题,本文系统地分析我国心理咨询工作中的伦理学现状,结合欧美国家心理咨询伦理规范的发展历程,提出了自己的几点思考。     

Career counseling meets motivational interviewing: A sequential analysis of dynamic counselor–client interactions

Motivational Interviewing (MI) is a client-centered communication style with the aim to resolve client ambivalence within a change-related counseling. Its potential benefit for career counseling has been discussed by several scholars but no empirical research has investigated MI in this context so far. The current study used process measures from MI to investigate dynamic interactions within a career counseling intervention. Overall, we analyzed two videotaped sessions of 14 unique counselor–client dyads. Verbal behavior of counselors and clients were coded with two observational coding schemes from MI (one for counselors and one for clients, respectively). Behavior profiles of counselors were compared with benchmarks of good MI. Furthermore, client verbal ambivalence was compared between sessions. Finally, we conducted lag sequential analyses to analyze temporal dynamics between counselor behavior and immediate client verbal responses across N = 6883 behavioral events. Our results showed, first, behavior profiles of career counselors did significantly differ from recommended counseling benchmarks of good MI practice. Second, as assumed on the basis of past studies, client ambivalence decreased across sessions. Third, MI consistent counselor behaviors showed a positive sequential association with client positive career talk, whereas MI inconsistent counselor behaviors showed the reverse pattern. Our results suggest that counseling behaviors recommended from MI are facilitating career interventions. We discuss how trainings in MI could amend career counseling interventions and provide ethical implications when integrating MI into career counseling programs.     

Photovoice: Fulfilling the Call for Advocacy in the Counseling Field

Counselors are bound by ethical code to advocate at individual, group, institutional, and societal levels to examine potential barriers and obstacles that inhibit the growth and development of clients. Photovoice is a participatory action research method that utilizes a specific photographic technique to capture an issue from the lens of those affected. The authors of this article propose that photovoice can be adapted to individual counseling with clients to fulfill our ethical call to advocate at the individual level to address barriers and promote growth. A case example is given to demonstrate how photovoice can be used in a counseling session to advocate for clients.     

Ethics in Case Conceptualization and Diagnosis: Incorporating a Medical Model Into the Developmental Counseling Tradition

In this literature review, the author focuses on several ethical considerations in case conceptualization and diagnosis, including diagnostic training and competence. Meeting the American Counseling Association's (1995) ethical standard for diagnostic training has several ethical implications for counselors, counselor educators, and supervisors. For counselors who might struggle with how to meet their ethical responsibilities in diagnosis but who want to remain true to their developmental counseling emphases, the author discusses some of their concerns, the implications of and possible approaches to this aspect of their work. Conclusion Yalom (2002) asked a poignant question of counselors in his book, The Gift of Therapy: “If you were in personal psychotherapy or are considering it, what DSM‐IV diagnosis do you think your therapist could justifiably use to describe someone as complicated as you?” (p. 5). This question and continued dialogue about the ethics and implications of diagnosis are essential aspects of diagnostic training. Yalom's poignant and deeply personal question seems especially appropriate for increasing a counselor's empathy toward the client's sensitivity and vulnerability during the diagnostic process. Counselor educators might ask how one remains true to a developmental model of counseling while adhering to the ethical and accreditation standards of teaching the DSM's medical model of diagnosis. Counselors may also question how to use diagnosis ethically and empathically. Seligman (1999) recommended that clinicians view the DSM as one of many important sources of information about a person. Furthermore, counselors should seek to incorporate diagnostic information into a holistic context, recognizing that a diagnosis does not reflect the totality of the client. Some counselor educators have advised students to integrate the DSM model into their work with clients rather than abandoning their developmental roots (Waldo et al., 1993). Some counselors may not actually put their diagnoses in writing; Seligman believed, however, that thinking diagnostically may assist counselors in determining the best approaches to help clients and to help clients help themselves. This clinical and ethical debate about how, and in fact, whether, to integrate the medical model of the DSM and the developmental origins and distinctiveness of counseling continues. However, the CACREP (2001) standards, managed care systems, and other forces have pushed counseling professionals toward a medical model by mandating counselor knowledge and use of the DSM. Whatever a counselor's stance and behavior on client assessment and diagnosis may be, the literature presented in this review and discussion seems to suggest a need for heightened sensitivity to, preparation for, and accuracy in all facets of client assessment, especially diagnosis.     

Client as Expert: Incorporating Spirituality Using the Tree Ring Technique

Addressing spirituality with clients from diverse spiritual backgrounds is a facet of culturally competent and ethical practice, yet various obstacles contribute to spirituality being overlooked. This article features a counseling technique used with clients who are experiencing difficulty with issues of a spiritual nature. Based on constructivist principles, the tree ring technique provides a context and process for examining clients’ spiritual conflicts, whereby the client is the expert and the counselor adopts a not‐knowing stance.     

Predictors of Early Termination in a University Counseling Training Clinic

Despite the existence of counseling dropout research, there are limited predictive data for counseling in training clinics. Potential predictor variables were investigated in this archival study of 380 client files in a university counseling training clinic. Multinomial logistic regression, predictive discriminant analysis, and classification and regression trees converged on the use of a 4‐predictor model (client age, income, perceived difficulty, and functional impairment) for classifying counseling dropouts. Implications for research and practice are discussed.     

Are ethics different in different settings?

Practicing counselors may interpret ethical obligations differently according to their work settings. These differences are related to: (a) the relative strength of the professional identification of counselors in various settings, and (b) differences in the support for or pressures against ethical practice in different settings. This article focuses on one of the problems related to the nature of the client population and the counseling setting: What rights of confidentiality do minors have against disclosure to their parents?     

Client Adherence to Asian Cultural Values,Common Factors in Counseling,and Session Outcome With Asian American Clients at a University Counseling Center

Based on data from 61 Asian American clients at a university counseling center, the study found that client‐perceived match on client‐counselor belief about problem etiology was related to counselor credibility, empathy, and cross‐cultural competence; the client‐counselor working alliance; session depth; and the likelihood of the client recommending the counselor to another client. An interaction effect showed that both strong match on belief about problem etiology and high client expectation for counseling success were associated with strong client‐counselor working alliance.     

Enhancing Social Justice by Promoting Prosocial Values in Career Development Interventions

In career counseling, social justice is typically integrated by helping oppressed groups navigate their way around obstacles of injustice while also working to dislodge the oppressive conditions from society. The authors affirm both of these courses of action while also advocating a third strategy: inviting clients to serve as agents of change by introducing and incorporating prosocial values into career development interventions. This article makes the case that this strategy may enhance client well‐being while simultaneously promoting harmony among organizations and society. Support for this strategy comes from theory, research, and the ethical approaches for working with values in counseling.     

The Ethics of Prayer in Counseling

Spirituality has become increasingly important in counseling, with prayer being the spiritual intervention of choice for Christian counselors. The controversial nature of including prayer in counseling requires careful consideration of ethical issues. This article addresses the intersection of spiritual interventions, particularly prayer, with client welfare, multicultural sensitivity, values, and countertransference. The authors consider the ethical mandates, articulate concerns, and make recommendations.     

Ethical considerations and training recommendations for philosophical counseling

Philosophical counseling is a diverse and burgeoning type of mental health service delivery. Despite competing approaches to theory and practice, the field has largely strayed from an ethical critique of its methodology and counselor training requirements. This article outlines several ethical considerations and training recommendations that are proposed to bolster the quality and effectiveness of philosophical practice. As philosophical counseling gains increasing recognition in North America, recently established national organizations in philosophical practice may profit from revisiting their interim codes for professional conduct. Proposed training suggestions for counselor preparation my further assist institutions and board-regulated agencies in establishing competent and acceptable standards of client care.     

The Use of Touch in Counseling: An Ethical Decision‐Making Model

Although some counselors have advocated for the limited use of touch in counseling, others have argued that touch has no place within the counseling relationship. Despite the controversy, the use of touch has been shown to have a number of therapeutic benefits; however, there are few ethical decision‐making models that are appropriate for considering the use of touch in counseling. The authors discuss the controversy surrounding the use of touch and the benefits/contraindications of touch. The 5 ethical principles of counseling are also examined; a new ordering of the principles is presented as a useful ethical decision‐making model when considering the use of touch in counseling.     

Suicide: Dynamics and Implications for Counseling

‘The authors discuss the dynamics of suicide, how to work with a potentially suicidal client in the counseling relationship, and legal and ethical implications for the counselor.