Harnessing the river of time: a theoretical framework of time use efficiency with suggestions for counselors

Some individuals have difficulty using their time efficiently and, subsequently, completing tasks in an allotted amount of time. This article offers an operational definition and a theoretical framework of time use efficiency. Suggestions are offered for counselors working with clients who have difficulties using their time efficiently.     

Intake Interviewing with Lesbian, Gay, Bisexual, and Transgender Clients: Starting from a Place of Affirmation

Initial interactions between lesbian, gay, bisexual, or transgender (LGBT) clients and psychotherapists can reveal existing biases from both parties. LGBT clients may have previous experiences with the mental health establishment and legitimate concerns about being pathologized. Psychotherapists may approach clients with openness and acceptance, but are likely to have little training in working with LGBT individuals. In this article, we discuss affirmative practices as a framework for clinicians beginning the intake process with LGBT clients. Through a brief history and overview of LGBT mental health, we provide mental health professionals with an appreciation of the multiple influences on LGBT individuals’ well-being. We then discuss the intake interview process in relation to each subgroup of the LGBT acronym, as each of these four populations face different (yet inter-related) challenges. While there is clearly no “formula” for working with LGBT individuals, in keeping with the principles of multicultural competency (Sue, The Counseling Psychologist, 29:790–821, 2001), our goal is to encourage therapists to reflect on their existing biases and to gain knowledge and skills for working with this diverse population. Overall, we hope this article demonstrates to therapists how to conduct an affirmative intake interview that minimizes heterosexual and dualistic gender assumptions that remain so pervasive in our society and in therapeutic practice.     

Psychosynthesis: A Foundational Bridge Between Psychology and Spirituality

Pastoral psychologists have long tried to establish a working model that encompasses the seemingly conflicting disciplines of science and religion. Psychosynthesis, a transpersonal psychology and therapeutic approach, offers such a model of the human personality, in which the psychological and spiritual perspectives can converge. This article explores psychosynthesis psychology and therapy as a theoretical framework for pastoral psychology. Although psychosynthesis psychotherapy relies on an array of techniques, it fundamentally works with the clients’ will while emphasizing, exploring, and cultivating their relationships on all levels—intrapersonal, interpersonal, and with the Higher Self. In addition to the subconscious, psychosynthesis includes a higher psychological plane, called the superconscious, from which our higher ethical, aesthetic, scientific, and spiritual values are derived. This article begins by introducing psychosynthesis concepts and techniques. It then provides qualitative findings showing that psychosynthesis counseling helped to awaken spirituality in three out of eleven clients who had formerly identified themselves as atheists. In addition, testimonies are included that show that psychosynthesis counseling also helped all eleven clients to attain personal growth. Finally, the counselor describes her experience of psychosynthesis as a Christian in the therapeutic setting. The framework of psychosynthesis psychology and its techniques are viable methodologies for anyone searching to incorporate spiritual growth into a psychological working model.     

What Every Therapist Should Know,Be and Do: Contributions from Humanistic Psychotherapies

Humanistic psychologists have made major contributions to the theory, practice and research in psychotherapy. Many of their contributions are applicable to a variety of therapeutic approaches. In this article I articulate what I believe to be some of the most useful things for all practitioners to consider incorporating into their therapeutic practice. Carl Rogers’ contributions are considered to be universal and foundational since his strong emphasis on the therapeutic relationship and the importance of empathic responding are considered to be core aspects of effective therapies. A variety of humanistic therapists have emphasized the importance of working with client emotion, effective use of the self, relational involvement and depth, working within the client’s frame of reference, focusing on the self-concept, being present and helping clients embrace choice and responsibility, all of which are addressed in this article.     

Is it Morally Wrong to Defend Unjust Causes as a Lawyer?

The question I address in this article is whether it is morally wrong for a lawyer to represent a client whose purpose is immoral or unjust. My answer to this question is that it is wrong, prima facie. This conclusion holds, even accepting certain traditional principles of lawyer's professional ethics, such as the right of defence and the so‐called principle of ‘adversarial’ litigation. Both the adversarial system and the right of defence are sufficient to support or justify the right of potential clients (and citizens in general) to defend their interests in the judicial system and to do so with the technical assistance of a lawyer. This right includes a right to pursue unjust or immoral purposes (within the law). However, having a right to do X does not mean that it is morally permissible to do X. We can have a right to do something morally wrong. This being so, the fundamental moral reason for a lawyer not to accept representation for a client with an immoral purpose is that it is, prima facie, morally wrong to help someone do something wrong.     

Suicide and the Law

SUMMARY

The purpose of this chapter is to delineate how mental health professionals can prevent their clients from acting in a suicidal manner while protecting themselves against potential liability when a client attempts or completes suicide. In our increasingly litigious society mental health professionals can apply their understanding about the elements of legal liability in cases involving client suicidal behaviors to structure their services in a manner to meet their responsibility in treating potentially suicidal clients.     

Ethical Guidelines for Counselors Working With Older Adults

Counselors working with older adults may encounter situations that are not directly addressed by the ethical standards of the American Counseling Association (1995). After an extensive review of the literature, the Standards Committee of the Association for Adult Development and Aging (1998) identified 3 areas of concern: older adults with cognitive impairments, older adults who are the victims of abuse, and older adults with a terminal illness. This article examines the unique needs of older adults with these concerns and proposes guidelines for counselors working with such clients.     

Collaborative Helping: A Practice Framework for Family-Centered Services

This article offers a framework for collaborative family-centered practice that can reinvigorate our work with families who have not responded to more traditional approaches. Collaborative Helping is grounded in family-centered principles that include: striving for cultural curiosity, believing in resourcefulness, working in partnership, and making our work more accountable to the clients we serve. The article introduces collaborative inquiry as an organizing metaphor for clinical practice and offers a five-step practice framework with clinical illustrations and sample questions. The framework draws from appreciative inquiry, motivational interviewing, the signs of safety approach to child protection work, and solution-focused and narrative therapies.     

Addiction,the addict,and career: Considerations for the employment counselor

Employment counselors have been resistant to working with persons in recovery from addiction except under the strictest of criteria. This article examines the relationship between this resistance and the concepts of addiction and addict. Following this is an examination of substance abuse recovery and practical suggestions on incorporating recovery knowledge into career counseling. The goals of the article are twofold: (a) to present a framework that highlights the necessity of employment counseling for the recovery process from substance misuse and (b) to affirm that many employment counselors have the skills needed to assist clients who have been labeled as addicts.     

Collaboration and a Self-Help Orientation in Therapy with Suicidal Clients

Working with suicidal clients historically has placed a heavy burden of responsibility on the therapist for a successful outcome. This orientation generally has left clinicians feeling stressed and in need of controlling their clients' behavior; clients, in turn, often have developed unrealistic expectations of therapy or resistance of the therapist's interventions. In this context, the chance for a potentially valuable collaboration between client and therapist is often lost. This paper builds on previous work that has introduced the notion of a collaborative working relationship with suicidal clients. It is argued that the therapeutic process ideally should not only utilize the therapist's knowledge and skills in treating suicidal clients, but also cultivate self-efficacy by encouraging the client to adopt a self-help orientation to therapy. Several general principles of a collaborative/self-help orientation to working with suicidal clients are discussed and a variety of specific therapeutic strategies consistent with this orientation are described.     

When REBT Goes Difficult: Applying ABC-DEF to Personality Disorders

ABC-DEF framework is at the core of rational emotive behavior therapy. It is a highly flexible framework and has proven to be applicable to many emotional disorders. We cannot take for granted, however, that this framework can be used successfully with all clients, particularly with those suffering from severe disorders or personality disorders. In fact, the difficulties of these clients in recognizing, naming and reflecting upon states of mind, their dysregulated emotions and self-defeating behavior, and their difficulty in establishing a strong working alliance with a therapist may hamper the correct implementation of the ABC-DEF framework and the disputing of their irrational beliefs. This paper aims to describe in detail the challenges that clients with personality disorders may pose during treatment and offer possible technical suggestions, derived from either REBT or non-REBT literature, that can help REBT and CBT practitioners adapting their interventions to resistant clients.     

Understanding Clients' Perceptions of Stress

The association of individual behavioral and personality characteristics with the stress response provides a natural role for stress management and the development of coping responses within the counseling process. The incorporation of stress management within the counseling process requires a theoretical framework for examining clients' perceptions of their coping capabilities as they experience difficulty with stressful life events. In this article the author presents a framework based on learned helplessness, called systematic rationalization. Empirical support and applications of the framework for working with clients experiencing difficulties coping with stressful life events are discussed.     

Aging and Family Therapy: Exploring The Training and Knowledge of Family Therapists

The present study examined therapists' training in aging issues, and their knowledge and attitudes about aging. One hundred and ninety-one clinicians completed a web-based questionnaire. The majority of respondents reported to have some training in aging issues, although they did not believe it prepared them well to work with older clients. Clinicians reported feeling comfortable working with older adults, yet they also agreed that special training could benefit their work. Knowledge scores were significantly correlated with interest in aging issues, perceived importance of training, perceived competence, and perceived effectiveness in treating older adults. Research and clinical implications are discussed.     

Positive CBT: From Reducing Distress to Building Success

Recent decades have witnessed the development of competency-based, collaborative approaches to working with clients. This article reveals how cognitive behavioral therapy (CBT) becomes Positive CBT, with a shift in the focus of therapy from what is wrong with clients to what is right with them, and from what is not working to what is. The concept of Positive CBT, aimed at improving the well-being of clients and their therapists, draws on research and applications from Positive Psychology and Solution-Focused Brief Therapy. A FBA of exceptions to the problem and the ‘upward arrow’ instead of the ‘downward arrow’ technique are two of the many practical applications of Positive CBT, described in this article. Further research is necessary due to its recent development.     

Chaos Theory as a Model for Life Transitions Counseling: Nonlinear Dynamics and Life's Changes

Chaos theory is presented for counselors working with clients experiencing life transitions. It is proposed as a model that considers disorder, unpredictability, and lack of control as normal parts of transition processes. Nonlinear constructs from physics are adapted for use in counseling. The model provides a method clients can use to reconstruct their own alternative life narratives, a framework in which life stories are understood, and a means to facilitate cocreation of adaptive interventions.     

When Words are not Enough: Psychotherapy with Clients Who are Living Below the Poverty Level

The present article describes six strategies found useful when working with depressed clients who are struggling with severe financial limitations. First, it is important to help clients maintain an attitude of hope for a better future, so they remain as positive yet realistic about their current options and future goals. Second, empathy is considered to be a central component in all psychotherapy sessions, helping therapists to understand their clients’ life experiences and ongoing struggles. Third, clients can learn to develop more adaptive perspectives about life, family, and friends, trying to focus on the positive events they have experienced and the supportive bonds they have developed. Fourth, clients can develop new specific coping skills that may help them to manage the problems they encounter. Fifth, many clients can better utilize the social support that is often available, starting to ask family members and friends for assistance and support when help is needed. Sixth, an interdisciplinary treatment team is often optimal when the treatment plan integrates the potential benefits derived from psychotherapy, medications, and social service agencies. An effective psychotherapist respects the limits of psychology while consulting with colleagues from other health care professions. These six strategies can help guide therapists when working with clients who are struggling with persistent depression in the face of adversity.     

Using Visual Journaling in Individual Counseling: A Case Example

The purpose of this article is to describe and illustrate through a hypothetical case example how visual journaling, a form of expressive arts counseling, can be adapted for use in individual counseling. Counselors may consider using visual journaling as a counseling intervention when working with clients who may not have words for what they are feeling or experiencing, and for clients who tend to be very analytical. Visual journaling can be a way to bypass the intellect and give clients another way to access their experience.     

Creating Structure in a Time of Intense Stress: Treating Intimate Partner Violence

Violence is an increasingly visible problem in the United States, with the news and other forms of media bringing this into the forefront of the public’s awareness. Violence comes in many different forms, including intimate partner violence (IPV), which occurs for about 36% of women and about 29% of men across the United States. Given the high incidence in the United States, it is imperative to consider the best ways for mental health professionals to treat violence in relationships. Some professionals in the field have developed and utilized conjoint treatment models for working with couples who have a history of violence. This article presents the application of attachment theory to a conjoint treatment model for couples that have experienced violence. A case study is included to demonstrate the implementation of an emotionally focused therapy framework and provide a sample outcome of this treatment approach. The framework of this article provides clinicians with insight into how to approach working with violent couples in a safe and productive way. Mental health professionals are at the front lines of implementing evidence-based interventions and creating lasting change for the clients whom they work with.     

Working with the intelligent career model

The changing contemporary work environment has brought new career realities that suggest an altered role for the career counselor. This article reaffirms the benefits of working with the subjective aspects of career. The focus is on the intelligent career, a model that provides a framework to integrate career data into a coherent picture. The Intelligent Career Card Sort, specifically developed to elicit and work with subjective career data, is offered as a way for counselors to accommodate personal and dynamic needs of their clients beyond a job focus.     

Ethics and Counseling Decisions

Although some behavioral scientists and practitioners contend that man has no genuine moral choices to make, common sense and philosophical reflection ineluctably affirm the moral nature of man. When young people are faced with moral decisions, they often seek the assistance of a counselor. Although such counselors are routinely expected to aid clients in making decisions about their education and their careers, there is considerably less agreement about their responsibility for helping students to make moral choices. The central thesis of this article is that a knowledge of ethical theories, the practical principles which flow from them, and the method of decision-making which they indicate will enable the counselor to assist his clients with their moral problems.