Counseling Older Japanese American Clients: An Overview and Observations

Older Japanese American clients bring a unique set of historical and cultural characteristics to the counseling setting. Several important aspects of providing counseling to this group are discussed, including ethical issues based on cultural differences and nontraditional approaches to counseling.     

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.     

Working with Adopted Clients

When working with clients who have been adopted, therapists must be alert to the fact that lack of information about the birth mother and feelings of rejection can lead their patients to use defense mechanisms and create fantasies that will affect the transference and countertransference. Using examples from both agency and private practice, this article helps the clinician understand how adoption has affected their client's lives both in and out of the therapy room and suggests ways to modify treatment with a greater sensitivity to adoption issues.     

Rational-Emotive Assessment with Religious Clients

Rational Emotive Behavior Therapy (REBT), when practiced effectively and flexibly, can be an excellent treatment modality for religious clients. Most of the American population acknowledges some religious belief and/or practice and religious clients sometimes present with unique disturbances and concerns about psychotherapy. In this article we discuss the rapidly changing literature relative to religiousness and mental health and highlight the ethical-professional risks of failing to carefully assess and responsibly manage client religiousness when it is personally and clinically salient. We conclude by outlining a model for focused assessment of religiousness early in REBT and recommend that REBT practitioners consider different components of religiousness and the manner in which they may impact response to treatment.     

Helping Clients Manage Addictions with REBT

Most private practitioners of REBT and other cognitive-behavioral therapies avoid work with problems of addiction. Reasons to reconsider this choice are offered and specific methods for productive private work with addictive problems are provided.     

The Initial Psychotherapy Interview with Adolescent Clients

Initial psychotherapy sessions with adolescents can be very challenging due to the need to balance assessment, relationship building, caretaker/parent management, and case formulation with a client population that sometimes has little motivation for psychotherapy. This article combines empirical evidence, theoretical knowledge, and clinical experience to describe strategies for how psychotherapists can prepare themselves for initial psychotherapy sessions and manage tasks associated with five stages of the clinical interview: (a) the introduction, (b) the opening, (c) the body, (d) the closing, and (e) termination. Using case vignettes and short examples, there is an emphasis on how psychotherapists can develop and maintain a strong therapeutic alliance while simultaneously helping adolescent clients focus on psychotherapy tasks and goals. The overall goal of this article is to help psychotherapists smoothly navigate the potentially stormy stages of the initial clinical interview with adolescents.     

Strategies for Dealing with Clients We Dislike

Therapists frequently encounter clients they dislike. Surprisingly, however, there is little in the literature on this topic. The literature that does exist offers little guidance on how to deal with this problem when it arises. The purpose of this article is to explore possible reasons a therapist may dislike a client, as well as strategies that a therapist can use when the problem is encountered. Implications for clinical training are also briefly discussed.     

The Initial Interview with Asian American Clients

When grouped with Pacific Islanders, Asian Americans constitute the fastest growing ethnic group in the United States. In this article, the authors provide background information for understanding the diversity and commonalities within Asian American populations and discuss the challenges of initial assessment with clients who identify as Asian Americans. We conclude this article with guidelines for conducting an effective initial interview with Asian American clients.     

When Clients Die

Abstract

The contexts of loss are as numerous as they are varied. This article reflects upon loss within the context of the helping relationship and illustrates how storytelling, journaling, and correspondence can be used to process the experience of a counselor's loss. The richness of personal accounts, interwoven and connected, provides voice and place to the experience of the deceased and their loved ones. Through such a process, the counselor is assisted toward an integrative healing intervention that can be used to work through their shattered dreams following the death of their clients.     

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.     

The Non-Indian Therapist Working with American Indian Clients

Abstract

The lack of success non-Indian therapists have had in working with American Indian clients has perpetuated a repetitive cycle of poor mental health services with this population. Although we cannot change the historic distrust that exists, we can begin to understand cultural differences and how they can impact treatment to obtain positive results. Acknowledgment of these differences can promote trust, a core ingredient that must be established between the client and therapist. This paper offers guidelines to assist the non-Indian therapist in working with the American Indian client.     

When a Straight Psychologist Works with Lesbian Clients

No abstract available for this article.     

Reporting Colleagues Who Are Sexually Intimate with Clients

No abstract available for this article.     

Relational Psychoanalysis Potential Usefulness with Black South African Clients

The aim of this article is to suggest that relational psychoanalysis may be a useful approach for working with clients from indigenous African cultures. In particular, the article considers the utility of relational psychoanalysis to understanding and enacting the therapeutic relationship with clients from an indigenous African cultural background. The notion of “we” self from the perspective of African cultures is a case in point for possible compatibility between relational psychoanalysis and black clients who come from background that place a high value on communal or “we” selves. An integrative therapy that combines African worldviews and relational psychoanalysis is possible.     

A Narrative Approach to Supporting Clients Living with HIV

The number of individuals living with Human Immunodeficiency Virus (HIV) continues to grow, increasing the responsibility of mental health counselors to effectively intervene and better understand the unique struggles facing survivors of HIV. Narrative therapy, a postmodern approach to counseling, is presented for use with clients living with HIV. Basic tenets of narrative therapy (externalizing the problem, identifying socially constructed messages, focusing on strengths, and reauthoring client stories) and application with HIV-positive clients are discussed, highlighting the influence of narrative therapy on both physical and mental health issues. A case application is provided.     

Detecting Alcoholism in Clients

Alcoholism is a primary, progressive, fatal, and treatable disorder. It often goes undetected because of a lack of understanding of how to tell an alcoholic from someone who drinks heavily. This article presents a systematic approach using the most reliable and valid instruments available. The approach will allow a clinician to quickly and accurately diagnose or rule out the presence of alcoholism in a client. Accurate diagnosis will allow proper treatment of this disorder, which affects about 6.7% of all people.