Key Considerations for Using No‐Harm Contracts With Clients Who Self‐Injure

One of the more controversial issues in working with people who self‐injure is whether counselors should use no‐harm contracts. Important therapeutic considerations include the efficacy of such contracts or agreements in preventing self‐injury, the emotional and behavioral responses of clients, and the perceived protection these contracts or agreements may offer counselors. The authors weigh potential benefits and pitfalls and make recommendations for working collaboratively with clients to meet their individual needs.     

Working With Clients Who Self‐Injure: A Grounded Theory Approach

This article presents the findings of a qualitative study examining the experiences of counselors in their work with clients who self‐injure. Using grounded theory methodology, the authors established 6 categories to explain the counselors’ conceptualization of self‐injury and their process of working with these clients: (a) external factors to self‐injury, (b) defining self‐injury, (c) potential for harm, (d) conditions for treatment, (e) counselors’ reactions to working with clients who self‐injure, and (f) clients’ response to treatment.     

Writing About Clients: Ethical Considerations and Options

Today, the decision to prepare clinical case material for publication is a decision that cannot be taken lightly. The decision involves reviewing ethical considerations and choosing among various options to safeguard client privacy. Such options include seeking the client's permission, disguising case material, and developing composite case material. These considerations are discussed and options are described along with guidelines and a case example illustrating these points.     

Using Art in Counseling: Ethical Considerations

Various mental health professionals use, on occasion, drawings and other types of art in therapy, but relatively little has been written on the ethics surrounding this technique. The authors take the position that artwork should be viewed as equivalent to verbal communication. Such equivalency gives rise to a variety of ethical issues that encompass confidentiality, documentation, ownership, research, publication, and display of artwork.     

The Use of Relational‐Cultural Theory in Counseling Clients Who Have Traumatic Stress Disorders

Counseling scholarship has increasingly demonstrated the utility of relational‐cultural theory (RCT) in promoting the relationship‐building and growth‐fostering connections many clients require to manage problems in living. The authors applied RCT to counseling clients with traumatic stress disorders rooted in traumas of an interpersonal nature (e.g., child abuse, interpersonal partner violence, sexual assault). An overview of traumatic stress disorders and RCT, as well as the ways in which RCT can inform trauma conceptualization and treatment approaches with victims, is provided.     

Treatment of Deaf Clients: Ethical Considerations for Professionals in Psychology

Providing therapy to deaf clients raises important ethical considerations for psychologists related to competence; multiple relationships and boundary issues; confidentiality; assessment, diagnosis, and evaluation; and communication and using interpreters. In evaluating and addressing these, psychologists must consider the American Psychological Association’s Ethics Code and other relevant issues (e.g., Americans with Disabilities Act) necessary to provide ethical treatment. The current article provides background, ethical considerations, principles and standards relevant to the treatment of deaf clients, and recommendations to support psychologists, training programs, and the field. Psychologists have the responsibility to guarantee that the benefits of mental health treatment are fairly and justly provided to this traditionally underserved population.     

Applying Social Empowerment Strategies as Tools for Self‐Advocacy in Counseling Lesbian and Gay Male Clients

Social empowerment is designed to prepare individuals to reconstruct their political, economic, psychological, and social environments. Addressing empowerment for lesbian and gay male populations is critical because of the numerous stereotypical situations that result in their powerlessness. The application of social empowerment strategies as tools for self‐advocacy with lesbian and gay male populations is presented as a consideration for counseling.     

Ethical Considerations for Therapists Working With Demographically Similar Clients

The increasing emphasis on multicultural competence within psychotherapy continues to highlight the need for being sensitive to key differences between therapist and client. However, this attunement to the psychotherapeutic impact of therapist–client differences may obscure the equally critical need to evaluate ethical problems associated with therapist–client similarities. It will be argued that therapists treating clients who are demographically similar to themselves encounter a unique set of ethical challenges that warrant careful consideration and caution precisely because of therapist–client matching. The extant research on matching therapists and clients based on demographic similarities is discussed, with a particular emphasis on psychotherapeutic outcomes and client preferences. Attention then turns to the nonrational heuristics and biases that can often cloud therapists’ ethical decision making regarding the appropriate uses versus contraindications for demographically matching therapists and clients. Within the discussion of nonrational heuristics and biases, suggestions are offered for managing related challenges for ethical decision making.     

Counseling and Guided Self‐Help Outcomes for Clients With Bulimia Nervosa: A Meta‐Analysis of Clinical Trials From 1980 to 2010

This meta‐analysis included 111 clinical trials exploring the effectiveness of counseling/psychotherapy and guided self‐help approaches in the treatment of bulimia nervosa. In general, single‐group studies supported higher efficacy of counseling/psychotherapy, whereas wait‐list, treatment‐as‐usual, and placebo studies indicated both approaches were equally effective at termination (posttest) and follow‐up in altering binging, purging, laxative use, and self‐reported bulimia or body dissatisfaction perceptions in nearly all comparisons.     

Language Anxiety and Counseling Self‐Efficacy

A total of 120 master's‐level counseling students were given the Foreign Language Classroom Anxiety Scale and the Counselor Self‐Estimate Inventory. Significance was found for all 3 hypotheses: (a) nonnative English‐speaking students have significantly more language anxiety than native English‐speaking students, (b) nonnative English‐speaking students’ language anxiety was negatively correlated with counseling self‐efficacy, and (c) native English‐ and nonnative English‐speaking students significantly differed in their perceptions of counseling self‐efficacy. Se administraron la Escala de Ansiedad en Clase de Lengua Extranjera y el Inventario de Autoestimación de Consejeros a un total de 120 estudiantes de máster en consejería. Se encontró significación para las 3 hipótesis siguientes: (a) los estudiantes cuya lengua nativa no es el inglés sufren un nivel considerablemente más alto de ansiedad a causa del idioma que los hablantes nativos de inglés, (b) la ansiedad a causa del idioma de los estudiantes cuya lengua nativa no es el inglés mostró una correlación negativa con la autoeficacia en consejería y (c) los grupos de estudiantes nativos y no nativos en inglés mostraron diferencias significativas en sus percepciones de autoeficacia en consejería.     

The Self‐System in Integral Counseling

The authors introduce the integral model of the self‐system and, using that model, describe the dynamics of healthy growth and the development of psychogenic pathology. Self‐identification is described as “sliding” in nature, and stage theories for self‐related lines are outlined to help clinicians understand the characteristics of each stage the self may slide into. The authors outline K. Wilber's (2000a) metaphor of ladder, climber, and view to describe both healthy development and the development of pathology. Constructs of translation and transformation are described in the context of ladder, climber, view, and the authors conclude by summarizing clinical approaches to problems in translation.     

Cultural Considerations in Counseling Couples Who Experience Infertility

Infertility creates challenges affecting various aspects of couples' intimate lives. Practices regarding reproduction are often shaped by cultural messages. Culturally sensitive treatment methods help counselors provide effective therapy to couples with fertility problems. This article describes cultural influences, challenges, and counseling interventions for couples struggling with infertility. La infertilidad crea una serie de desafíos que afectan a varios aspectos de la vida íntima de las parejas. Las prácticas relacionadas con la reproducción son determinadas frecuentemente por mensajes culturales. Unos métodos de tratamiento culturalmente sensibles ayudan a los consejeros a proporcionar una terapia eficaz para las parejas con problemas de fertilidad. Este artículo describe las influencias culturales, los desafíos y las intervenciones de consejería para parejas que sufren a causa de su infertilidad.     

Counseling Transgendered,Transsexual, and Gender‐Variant Clients

The emergent consciousness and political activism within the transgender community has important implications for the field of counseling. In the current paradigm, the focus has shifted from using surgical and hormonal interventions and thereby enabling transgendered persons to “pass” within the traditional gender binary of society to affirming the unique identities of transgendered persons. To prepare counselors, counselor educators, and counseling supervisors for this important challenge, the authors describe the evolving nature of the transgender community, discuss mental health issues and counseling interventions for use with transgendered clients, and present a case study detailing the progression of counseling with 1 transgendered client.     

Counseling Considerations for the Twice‐Exceptional Client

Counselors can be pivotal in helping families to understand the identification of twice‐exceptionality and related implications, including developing successful interventions for the school years and beyond. There are many potential counseling concerns, including bullying and peer interactions, social and emotional development, career guidance, college transition planning, and functioning in adulthood. Learning how to work with twice‐exceptional clients regarding these concerns needs to begin during training and progress throughout one's career. Recommendations for best practice are provided.     

Solution‐Focused Counseling for Clients With Religious and Spiritual Concerns

Solution‐focused counseling is presented as a framework for clients with religious and spiritual concerns. The theory of solution‐focused counseling is described. Implications for using this model with religious and spiritual clients are considered. A case example is provided to illustrate the application of solution‐focused counseling for a client dealing with religious and spiritual issues.     

Commentary: Critical Reflections on the Ethical and Professional Considerations in Writing About Clients

From the standpoint of a journal editor and researcher, this commentary critically reflects on some of the primary notions addressed in the 4 featured articles of the special section, discussing areas of agreement and divergence. As a way of further exploring these ethical and professional concerns, the contentious issue of using school children as case studies in publications and in graduate counseling courses is briefly examined.     

Distinguishing Between Subgroups of Adolescents Who Self‐Harm

The differences in factors associated with subgroups of adolescents in the continuum of deliberate self‐harm (DSH) phenomena were investigated. In an anonymous self‐report survey of 6,020 adolescents aged 15 and 16 years, 3.2% of adolescents (5.3% females, 1.3% males) reported DSH with intent to die, 2.8% (4.3% females; 1.5% males) reported DSH without intent to die, and 15% (22.4% females; 8.5% males) reported thoughts of DSH without acts. Regression analysis indicated considerable overlap in vulnerability factors along the spectrum of DSH thoughts and acts. A uniquely distinct relationship was found between DSH of a friend and DSH without intent to die on one hand and DSH of a family member with DSH with intent to die on the other. Results indicate that familial and nonfamilial social influences on DSH behavior may be important in designing prevention programs and that educational programs for the promotion of psychological well‐being may be helpful for adolescents at any point along the spectrum of DSH that was examined.     

Self‐Monitoring and Counseling Skills: Skills‐Based Versus Interpersonal Process Recall Training

The purpose of this study was to investigate the role of personality traits of counselors‐in‐training with regard to counseling performance. There were no differences in pretest or posttest scores on the Skilled Counseling Scale (SCS) of high and low self‐monitoring counselors‐in‐training. Skill attainment may have more effect on personality traits than traits have on skill attainment. Both Interpersonal Process Recall (IPR) and Skilled Counselor Training Model (SCTM) groups improved their scores on the SCS, but the SCTM group improved significantly more than the IPR group.     

Guidelines and Strategies for Cross‐Cultural Counseling With Korean American Clients

The 3 major topics discussed begin with a recommendation of family counseling as the primary therapeutic modality for Korean Americans. Second, the article recommends various culturally congruent joining strategies, presented in 5 general groups. The 3rd major section of the article offers the cross‐cultural counselor strategies for therapeutic changes, discussed under 7 categories. Los 3 temas mayores discutidos empiezan con una recomendación de aconsejos de familia que aconseja como la modalidad terapéutica primaria para Americanos Coreanos. Segundo, el artículo recomienda varias estrategias culturalmente congruentes de la unión, presentado en 5 grupos generales. La sección mayor tercera del artículo ofrece las estrategias transculturales de consejero para cambios terapéuticos discutidos bajo 7 categorías.     

Promoting Self‐Advocacy Among Minority Students in School Counseling

This article presents self‐advocacy competencies developed to promote the academic, career, and personal/social success of minority students. The authors discuss challenges faced by minority students in today's educational environment and review principles of self‐advocacy. Competencies for developing self‐advocacy awareness, knowledge, and skills are discussed along with school counseling strategies for promoting self‐advocacy among minority students.