Counseling Adolescents and the Challenges for Genetic Counselors

Genetic counselors may have an important role in helping the adolescent make an informed decision with regard to genetic testing and in helping them to adjust to genetic risk information. However, counseling techniques that are used with adults may not be always be suited to the adolescent population. Adolescence is a time of development during which separation from the family and formation of identity is achieved. The process of this development may impact the genetic counseling relationship. Family relationships may have a strong influence on the client's decision to have genetic testing. Additionally, it may be difficult to engage the client as adolescents may not have the ability to think abstractly and consider the short and long term consequences of genetic testing. It is helpful therefore to discuss the counseling process and techniques that may be useful when counseling these clients. This paper presents two case studies that illustrate some of the difficulties that may occur when counseling adolescents for genetic testing. The authors' have reflected on their clinical experience with these clients and this is presented here to add to the growing literature on this subject.     

Client as counselor: self-regulation strategies

Recent research in counseling suggests the efficacy of teaching the clients to be their own counselors through the use of self-regulation procedures. This article explores three primary steps involved in helping clients to control their own behavior change: self-observation, self-monitoring, and self-regulation strategies. Self-regulation provides an affirmative answer to the question: “Is the client a counselor?” by promoting client responsibility and independence in the counseling process.     

Spa in Counseling

A place may be made in nearly every counseling session for spa: uplifting, positive experiences in which the focus is placed directly on helping clients feel good about themselves. With many clients, a few minutes at the end of each interview may be saved for these positive experiences; with some clients the entire effort of an individual session may be that of spa. The simplest of the several examples of spa in counseling offered in this article is the activity “Things I Can Do,” in which the counselor helps the client focus on and savor some of the most often-repeated actions of which he or she is capable: breathe, walk, talk, eat, sleep, think, and so on. All counseling clients can benefit from the emerging sense of wellness that can come from spa in counseling.     

The Effect of Job Search Method,Sex, Activity Level,and Emotional Acceptance on New Job Characteristics: Implications for Counseling Unemployed Professionals

This study investigated intrinsic and extrinsic new job characteristics for a sample of involuntarily dismissed white-collar workers. Results suggest employment counselors can ease the transition into satisfying new jobs by helping clients deal with the negative emotional trauma of job loss, encouraging active coping strategies, fostering realistic job expectations, and tailoring counseling to meet individual needs.     

Alcott's Little Women: A Study in Death and Dying

This article examines one approach to helping counselor trainees and clients gain insight into the death and dying process and its stages, and supports the use of literature as a counseling tool for helping clients confronted with the death or dying experience.     

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.     

Applying Person‐Centered Counseling to Sexual Minority Adolescents

Drawing attention to the very unique and complex needs of stigmatized sexual minority youth, the authors explore the therapeutic potential of person‐centered counseling in helping lesbian, gay, bisexual, transgender/sexual (LGBT) adolescents who are working toward the acceptance and disclosure of their sexual identity. They suggest that person‐centered counseling embodies 6 aspects that are particularly helpful to LGBT adolescent clients and propose 3 additional methods that compensate for the limitations of the person‐centered approach in this particular helping context.     

Genetic Counseling for Personal Genomic Testing: Optimizing Client Uptake of Post-Test Telephonic Counseling Services

The field of genetic counseling faces a broad challenge: many potential clients may not be aware of the value and benefit of genetic counseling services, and therefore may not utilize those services. Navigenics is a personal genomic testing company that provides telephonic genetic counseling services for multifactorial diseases and pharmacogenetics. When first offered in 2008, utilization of the Navigenics genetic counseling service was less than expected. To explore the basis for under-utilization and potential mechanisms for increasing uptake, Navigenics initiated a quality improvement study, in which three different methods of engaging clients in the uptake of genetic counseling services were assessed over the course of 1 year. Outcomes showed significant differences in uptake rates between methodologies (7.5%, 24.6%, and 60.1%), yielding an 8-fold increase in service utilization when post-test telephonic outreach to all clients was performed. Further, utilization spanned all risk levels based on client results, evidence that not only clients with high-risk results were motivated to engage in the genetic counseling service. This research indicates that implementing strategies to educate clients about genetic counseling can positively impact client engagement and utilization of available services.     

A Process and Outcome Study Examining Career Indecision and Indecisiveness

Despite the abundance of research on undecided and indecisive students, there is a lack of literature on the actual change process of counseling these individuals. No published studies have applied advances in single-subject methodology to career research. This study uses both process and outcome measures to investigate the counseling process with an undecided and indecisive college student to examine (a) what specific events were the most significant in each session, (b) counselor intentions in the “best” versus “worst” sessions, (c) role of the working alliance with career clients, and (d) differential counseling outcomes. Participants were two female counselors, one male undecided student, and one male indecisive student. Results (a) support previous speculation about the differential utility of interventions for undecided and indecisive clients, (b) suggest that the relationship may be important to clients in career counseling, and (c) raise questions about previously assumed intervention strategies for career clients.     

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.     

Counseling Persons With Disabilities: Are the Feelings,Thoughts, and Behaviors of Helping Professionals Helpful?

Seven counseling “syndromes,” with illustrative vignettes, focus on some of the feelings, thoughts, and consequent verbal and nonverbal behaviors of counselors working with physically disabled clients. Nathanson urges counselors and other helping professionals to become aware of their feelings and thoughts, and to monitor their interactions with disabled clients so that existing beliefs and biases will not interfere with positive client growth.     

Qualitative Assessment: An Approach for Counselors

Qualitative assessment offers the counselor methods of helping clients to know and understand themselves better—methods that are flexible, open-ended, holistic, and nonstatistical. The methods are diverse and include card sorts, simulations, exercises and games, worksamples, and others. Many of the methods may be considered projective in nature and thereby tap values, interests, and needs in ways that standardized tests do not. Because these activities involve the client actively, they can flow directly out of and back into the counseling relationship rather than being a discrete element.     

Virtues,Values, and the Good Life: Alasdair MacIntyre's Virtue Ethics and Its Implications for Counseling

The philosopher Alasdair MacIntyre's critique of modern ethics and his virtue‐centered alternative suggest that counseling can be considered a form of applied virtue ethics, helping clients cultivate the qualities necessary to live the good life. Although similar to developmental theory and positive psychology, this perspective also questions whether counseling is value neutral and suggests that counseling should account for the (often hidden) traditions, virtues, and practices of the good life it promotes. Comparison with spiritual direction suggests ways counseling can apply the insights of this model ethically within a pluralistic setting.     

Cognitive career counseling: A rationalemotive approach to career development

The application of cognitive techniques to the career counseling process has been minimal. Since the career and personal development of individuals is interwoven, practitioners from a variety of disciplines are faced with a wide range of complex presenting problems regardless of their specialty. Providing occupational information and assessing job skills are partial components of the career counseling process. This paper addresses the cognitive barriers which interfere with successful career development. Cognitive career counseling (CCC) is described as a methodology for helping clients modify their vocational irrational beliefs (VIBes) so that they may achieve their career and personal goals during realistically unstable changes in economic conditions.Diana R. Richman, Ph.D., Senior Supervisor, Staff Psychologist, and Graduate Fellow, Institute for Rational-Emotive Therapy, New York City, maintains a private practice in Queens and Manhattan. She is Director of Clinical Supervision at APPLE Continuing Treatment Program, and serves as an organizational consultant.     

The helping alliance and premature termination

The study was conducted to determine the relationship between strength of the helping alliance and type of client termination (premature or with mutual knowledge of client and counselor). Participants were 102 client-counselors dyads at a university counseling center. After an average of 8 sessions, clients and couneselors completed Alexander & Luborsky's (1986) Helping Alliance Questionnaires. Clients terminated after an average of 19 sessions. Clients who later terminated with mutual knowledge of their counselors gave significantly higher strength of helping alliance ratings than did clients who later terminated unilaterally and prematurely. Counselors' ratings of strength of helping alliance were only modestly related to clients' ratings and unrelated to type of client termination.     

THE INVOLUNTARY CLIENT

The involuntary client is a frequently encountered problem in employment counseling and other social agency counseling. Possible reasons for his recalcitrance are examined and their implications for the counseling relationship are discussed. Four necessary conditions for working with involuntary clients are proposed and strategies are suggested for meeting these conditions.     

Psychological Aspects of Genetic Counseling. X. Advanced Counseling Techniques

Four procedures commonly used by experienced counselors are described: simple interview formulations, helping clients think through their problems, reframing, and role playing. Each procedure is illustrated by examples. Among other things, the goal of these procedures is to promote the autonomy and self-directedness of clients and thus are particularly valuable in circumstances requiring a nondirective stance. The need is underscored for a more active counseling stance appropriate to the psychological and problem-solving needs of genetic counselees.     

Conflicts Between Ethics and Law in Counseling and Psychotherapy

Codes of ethics are designed to guide and govern the behavior of the professional for whom they are written. In such fields as counseling, psychology, and social work, ethical standards are necessary to protect clients, guide professionals, safeguard the autonomy of professional workers, and enhance the status of the profession. Sometimes, however, the professional worker finds that the ethical standards of the profession seem to be in conflict with the law. These conflicts may arise in such areas as advertising, confidentiality, and clients' rights of access to their own files. The authors discuss the nature, ramifications, and implications of ethical-legal conflicts in the helping professions.     

Toward Explaining Success and Failure in Interpersonal Learning Experiences

The findings from programs of guidance, counseling, and psychotherapy suggest an answer to Eysenck's challenge to the efficacy of the “helping” professions. While no average differences are found in the outcomes of treatment and control groups, there is a pronounced trend toward significantly greater variability in the post-counseling change indices of the treatment groups when compared to the control groups. The direct suggestion is that students, clients, and patients may be hurt as well as helped in the interpersonal encounter. Some attempts toward explicating the facilitating and the retarding interpersonal processes are elaborated in counselor-counselee, teacher-student, and parent-child relationships.     

Ethical considerations in the supervision of applied sport psychology graduate students

Abstract

Some of the most important relationships that a sport psychologist experiences in his or her career are between the supervisor and supervisee in applied practica and internships. These relationships may become models for future professional and ethical behavior with colleagues, students, and clients, and thus deserve careful examination. Ethics form a foundation for practice, and while classroom discussions of ethical issues help educate graduate students, the supervisor-supervisee relationship may provide a hands-on experience of ethical dilemmas and ethical problem solving. Ethics in supervisor-supervisee relationships cover at least two broad areas. First, there is the supervisor's monitoring and mentoring of ethical considerations in the supervisee's relationship with the athlete-client. Second, ethical questions arise in the relationship between the supervisor and the supervisee. The present paper includes discussion of general supervisory issues (e.g., modeling ethical behavior, helping develop counseling skills) and explores the specific ethical problems of referring for counseling, intimacy, and exploitation. Also, three case examples illustrate ethical concerns that may appear in the process of applied sport psychology supervision. Broadening education in ethical issues in supervision for both psychology and exercise science graduate programs may help future practitioners better serve their clients.