Women and AIDS: Implications for Counseling

Women's concerns regarding AIDS have been ignored or minimized by most writers and AIDS educators. Although women may share many similarities with men in their reactions to AIDS, they have unique concerns that must be recognized. Understanding these concerns is essential for counselors in order to give quality care to women at risk for infection. This article describes women at risk and offers suggestions for counselors in working with such women.     

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.     

Counseling Gay Men with AIDS: Human Dimensions

As the incidence of acquired immunodeficiency syndrome (AIDS) becomes more widespread, individuals with AIDS will present themselves for counseling in both public and private settings, and counselors will need to become familiar with the psychological manifestations of the AIDS virus. This article provides case material that demonstrates the emotional responses of gay men to AIDS. Specifically, denial, anger, rage, guilt, and shame are discussed with an emphasis on the human dimensions of AIDS.     

Counseling in the Era of AIDS

The AIDS (Acquired Immune Deficiency Syndrome) crisis is affecting greater numbers of people, and counselors are being called upon to work with this population. Counseling roles have expanded, and counselors have been thrust into the medical, social service, and political spheres. In this article the authors describe the role of the counselor in the era of AIDS; psychological reactions to a chronic, stigmatized, and ultimately fatal illness; and the special needs of specific populations (gay men, families and friends of gay men, gay youth, significant others, people of color, heterosexual women and lesbians, college students, substance abusers, and the “worried well”). The authors also examine the effects of HIV (human immunodeficiency virus) illness and AIDS on the care giver. Counseling interventions are described throughout the article.     

Counseling the Irresponsible AIDS Client: Guidelines for Decision Making

Counselors treating a socially irresponsible AIDS client face the dilemma of preserving the client's right to confidentiality while protecting unsuspecting sexual partners from infection. Specific guidelines for decision making are suggested.     

Counseling Persons with a Fear of AIDS

The increasing incidence of AIDS has created a societal fear of AIDS that, in turn, has raised the level of fear and anxiety in individuals prone to fear responses. Fears accentuated by AIDS are discussed and guidelines for counseling offered.     

Hispanic Culture,Gay Male Culture,and AIDS: Counseling Implications

The AIDS epidemic is affecting Hispanics in disproportionately high numbers. High-risk sexual behavior conducive to HIV infection seems to continue taking place among Hispanic gay men. This article presents some necessary considerations when counseling this population.     

Reflections on transference and countertransference reactions in the treatment of AIDS patients

Proceeding from experiences she made in the treatment of AIDS and pre-AIDS patients the author describes the psychodynamics of their situation and subsequently discusses the specific problems of transference and countertransference reactions. She also suggests the possible coincidence of social and personal fear of contact in the course of treatment.     

Counseling to End an Epidemic: Revisiting the Ethics of HIV/AIDS

In the decades since HIV/AIDS was first identified, medical discoveries have advanced prevention and treatment, and shifting demographics have changed the face of the illness. Despite these changes, the counseling literature on HIV/AIDS and its ethical implications for counselors have remained limited and stagnant. Whereas past discussions have focused primarily on issues of confidentiality, this article addresses multiple ethical implications of HIV/AIDS to reflect current knowledge about the illness and its effects on clients.     

Spiritual Wellness for Clients With HIV/AIDS: Review of Counseling Issues

The epidemic of HIV/AIDS has resulted in an increasing population of individuals in need of counseling services: persons living with AIDS, as well as family, friends, and caregivers. The relationship between HIV/AIDS clients' counseling and spiritual issues is demonstrated by a review of salient literature. Three broad themes are used: terminal illness issues such as post-death existence and existential meaning of life, religious disenfranchisement from society or families of origin, and multicultural spiritual and religious issues. Practical recommendations for counselors and research implications are included.     

Graduate training and the treatment of suicidal clients: the students' perspective

Existing literature suggests that graduate programs may not provide adequate training in working with suicidal clients. Therefore, we surveyed 238 predoctoral psychology interns and assessed the prevalence of clients engaging in suicidal behaviors and the amount of formal training in managing suicidal clients received. Results showed approximately 5% of participants indicated a client suicide and 99% indicated they had treated at least one suicidal client during their graduate training. In contrast, results demonstrated only 50% of the participants reported attending programs where formal training was offered. These findings suggest a continued need for increased formal training in managing suicidal clients in graduate psychology programs.     

Group therapists and AIDS groups: An exploration of traumatic stress reactions

As the AIDS epidemic continues unabated, there is growing clinical evidence that the catastrophic nature of this disease is creating a second category of trauma casualties. They are the health care practitioners who witness the narratives of those who are living with and dying from AIDS. This article examines how multiple AIDS-related deaths of group members exert a traumatizing effect on group therapists, creating vicarious traumatization. Vignettes are presented that illustrate reactions associated with traumatic stress, including death images, survivors' guilt, psychic numbing, suspicion of counterfeit nurturance, and struggle for meaning. Possible therapeutic interventions for group therapists coping with multiple deaths are also explored.The author wishes to acknowledge the endeavors of the volunteer group therapists and the Clinical Group Services staff of the Gay Men's Health Crisis of New York City, who provide group therapy to over 900 clients a week. This article is written in admiration of their extraordinary effort and dedication.