The Role of the School Counselor in Facilitating Sexual Development

Because there is a trend in the helping professions toward recognizing sexuality as an integral and important dimension of healthy personality development, school counselors and other school personnel have become committed to assisting students in understanding and dealing with their sociosexual needs and concerns. Yet school counselors need to be better prepared to meet these needs. This article suggests skills and attitudes that are necessary for accomplishing the goals of counseling on issues of human sexuality, and how counselors can acquire these skills and attitudes.     

Psychological aspects of genetic counseling. VIII. Suffering and countertransference

Two common forms of countertransferential problems seen in genetic counseling, associative and projective, are described and illustrated. Both forms have the potential of reducing the quality of empathy counselors provide counselees. When counselors experience the same problems as the counselees they counsel it is virtually impossible to avoid facing countertransferential reactions which may not always promote the counselees' interests and/or redound to their benefit. Genetic counselors, like other personal counselors and psychotherapists, have a professional responsibility to be aware of, monitor, contain, and learn from their countertransferential experiences.     

Ethical Guidelines for Counselors When Working With Clients With Terminal Illness Requesting Physician Aid in Dying

In 2005, the American Counseling Association (ACA) introduced a new ethical standard for counselors working with clients with terminal illness who are considering hastened death options. The authors’ purpose is to inform counselors of the Death With Dignity Act and explore relevant ethical guidelines in the ACA Code of Ethics ( ACA, 2005 ).     

Counselors' Evaluation of Rogers-Perls-Ellis's Relationship Skills

Twenty-two participants (12 employment counselors and 10 counselor supervisors) attended a three-week workshop on enhancing relationship skills, after which each participant evaluated the Rogers, Perls, and Ellis film, Three Approaches to Psychotherapy, on 15 skills. Results indicate that there was general agreement between the counselors and the supervisors when judging levels of therapist functioning by the relationship skills. However, they also show that within each group there is wide divergence of judgment. Neither counselors nor supervisors agree among themselves on their evaluation of the relationship skills of Rogers, Ellis, and Perls. Implications are drawn for the use of the film as a training/evaluation aid for employment counselors and supervisors.     

Why do people remain in abusive relationships?

Increasingly ministers and pastoral counselors are being consulted by people who are in abusive relationships. Consequently, it is important for all ministers and pastoral counselors to develop both an intellectual and an emotional appreciation for the complexities involved in remaining in, or leaving, abusive relationships. This article discusses six basic reasons why people choose to remain in abusive relationships, and concludes with three pastoral implications for ministers who counsel people in such relationships.     

Building Cultures of Peace: An Urgent Task for Counseling Professionals

The authors review articles in a 2001 special issue of Peace and Conflict: Journal of Peace Psychology (A. Brenes & M. Wessells, 2001b) devoted to building cultures of peace. Counselor educators are offered suggestions on how to prepare counselors to successfully create cultures of peace in a variety of communities. Recommendations for how counselors may construct and research cultures of peace are also discussed.     

Sexual Contact During and After Professional Relationships: Practices and Attitudes of Female Counselors

A national sample of female counselors (N = 377) was surveyed regarding sexual contact in professional relationships. Few respondents reported engaging in sexual contact either during or following professional relationships with clients, supervisees, or students. Individuals with doctoral degrees were more likely to have engaged in sexual contact with their own counselors, supervisors, or teachers. Counselors viewed sexual contact in current professional relationships as less ethical than contact in subsequent relationships, although relationships with former clients were seen as less ethical than relationships with former supervisees or students. Compared with male counselors from a previous study, female counselors were less likely to report sexual contact in their professional roles. Implications for research and training are discussed.     

Letter Writing: A Creative Tool for School Counselors Working with Adolescents

Letter writing is a therapeutic tool used in many helping professions with many populations. In school counseling, letter writing can be a useful way for school counselors to build relationships and assess student needs. Letter writing may appeal to students who are more introspective and prefer less direct forms of communication (France, Cadieax, & Allen, 1995). Evidence to support school counselors’ use of letter writing with students is underdeveloped. Citing conceptual, empirical, and theoretical support, the authors propose prompting students to write Letters About Themselves (LAT) at the beginning, middle, and end phases of the school year. Considerations for school counselors using letter writing with adolescents are explored.     

Ethical issues in genetic counseling: A comparison of M.S. counselor and medical geneticist perspectives

New technologies available in the field of medical genetics have increased the importance of responsible ethical decision-making among genetic counselors. A 1985 national survey of M.D. and Ph.D. genetic counselors assessed ethical attitudes using case scenarios designed to simulate dilemmas faced in genetic counseling (Wertz and Fletcher, 1988b). The current study focuses on attitudes of M.S. genetic counselors using similar scenarios, allowing for effective comparisons. M.S. counselors were more willing than M.D. and Ph.D. counselors to maintain patient confidentiality when screening for Huntington's Disease and occupational diseases, and a greater number would agree to counsel patients pursuing prenatal testing for sex selection. A majority of M.S. counselors would disclose an XY karyotype to a phenotypically female patient. M.S. counselors reasoned that respect for patient autonomy and patient confidentiality justified their decisions in many cases. The importance of these principles is discussed and questioned.     

Spiritual Dark Night and Psychological Depression: Some Comparisons and Considerations

The author contends that spiritual dark night and some forms of psychological depression share commonalties yet have distinctly different features that call for different responses from caregivers. The author presents comparisons between the 2 phenomena; highlights differences between them to offer counselors guidelines for making informed responses to their clients' issues; and compares professional preparation for spiritual directors, pastoral counselors, and traditional counselors. The article focuses on effective caregiver responses to dark night challenges that may be misperceived as manifestations of depression and stresses the importance of counselors and spiritual directors knowing their limits of expertise.     

Managed Mental Health Care: Intentional Misdiagnosis of Mental Disorders

Managed health care regulations affect the manner in which counselors provide and deliver services. Counselors are challenged by ethical and legal dilemmas when diagnostic codes in the Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 2000) are not honored for insurance reimbursement. In this article, the authors examine violations of codes of ethics and legal statutes and the consequences related to intentional misdiagnosis of mental disorders for reimbursement. They explore implications for counselors and offer suggestions for professional conduct.     

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.     

Counselors in South Korea: A Qualitative Study of Senior Professionals

The author describes a qualitative analysis of interviews with 12 senior counselors in South Korea. The participants were certified by the Korean Association of Counseling and Psychotherapy as professional counselors (sang‐dam sim‐li chun‐mun‐ga) and are among the first generation of counselors in South Korea. Eight semistructured questions were asked about the work of these counselors. Qualitative analysis identified practice, relationships, and emotional well‐being as 3 domains of professional experience, each consisting of 2 categories. The results provide (a) a view of counseling practices as experienced by senior members of the profession and (b) a starting point for further research on mental health workers in South Korea.     

Confidentiality of Adolescent Risk-Taking Behaviors: A Survey of Turkish School Counselors

The present study investigated school counselors’ ratings of the importance of factors in deciding to report adolescent risk-taking behaviors to parents. Turkish school counselors (N = 346) were surveyed. Differences based on gender, years of experience, level of education, attendance of a counseling ethics course, and geographic region were investigated. Mann-Whitney U and Kruskal Wallis tests were used in data analysis. Protecting the student was the highest rated factor. Women and those who took an ethics course rated protecting the student higher than others. Implications for counseling ethics training are discussed, and recommendations for future research are outlined.     

Disproportionate Diagnosis of Mental Disorders Among African American Versus European American Clients: Implications for Counseling Theory,Research, and Practice

Research generated by the professions of psychiatry and psychology reveals that African Americans are more often diagnosed with specific mental disorders (e.g., psychotic disorders) compared with European Americans. No research to date, however, has investigated whether professional counselors make differential diagnoses according to client race. This study (N = 1,648) found that counselors diagnosed African Americans with psychotic and childhood disorders at a disproportionately high rate. Implications for counseling theory and practice are discussed.     

The Unstructured Clinical Interview

In mental health, family, and community counseling settings, master's‐level counselors engage in unstructured clinical interviewing to develop diagnoses based on the Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; DSM‐IV‐TR; American Psychiatric Association, 2000). Although counselors receive education about diagnosis and the DSM classification system, the majority of them are not specifically trained in clinical interviewing. This article provides information about using the unstructured clinical interview to make a DSM‐IV‐TR diagnosis for adult clients with Axis I and Axis II disorders.     

Experiences of Altruism in the Therapeutic Relationship: Perspectives of Counselors‐in‐Training and Their Clients

The purpose of this phenomenological investigation was to explore experiences of altruism in the therapeutic relationship to better understand how counselors‐in‐training (CITs) and their clients mutually perceived the construct in sessions. Findings from interviews with clients (n = 14) included emotional–relational characteristics and cognitive–behavioral aspects of altruism by their counselors. Findings from interviews with CITs (n = 10) included explorations of the role of altruism in counseling, overall experiences of altruism in counseling sessions, and experiences of altruism with specific clients. Implications for practice and research are discussed.     

Perceived Impact of Professional Counselor Identity: An Exploratory Study

Counselor educators (N= 378) provided their viewpoints regarding the impact of counselor identity on professional advancement and recognition. Respondents indicated that counselors, the American Counseling Association, and other counseling organizations are responsible for advocacy of the counseling profession. Collaboration among counselors for the development of a single coherent message is necessary for advocacy efforts aimed at congressional Medicare leaders, managed care organizations, state licensing boards, and allied professions.     

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.     

Views on Abortion: A Comparison of Female Genetic Counselors and Women from the General Population

While literature characterizing individual genetic counselors’ abortion attitudes is sparse, the National Society of Genetic Counselors takes a clear stance for reproductive autonomy. To determine genetic counselors’ views, this study compared (1) genetic counselors’ abortion attitudes to those of women from the general population and (2) genetic counselors’ professional abortion attitudes to their personal abortion attitudes. Genetic counselors were invited to complete an online survey. Response rate was 44.3% (709/1,601). Compared to women from the general population, female genetic counselors were significantly more likely to agree abortion should be an option in all cases (p < .001). Controlling for other possible confounders, regression analyses revealed that being a genetic counselor, religious service attendance and age were significantly predictive of abortion attitudes. Although the vast majority of genetic counselors agree that abortion should be available, they are significantly less likely to personally consider abortion under all circumstances presented (p < .001), and the percentage of genetic counselors who would consider terminating in the case of a severe birth defect is similar to studies of other women.