Counseling Regulations Regarding Sexual Misconduct: A Comparison Across States

Sexual relationships with clients, former clients, and supervisees are some of the most powerful and difficult clinical issues for counselors. These issues force counselors to examine the heart of the therapeutic process: the counseling relationship. The purpose of this study was to gather and analyze different approaches used by state counseling boards to deal with sexual relationships in counseling and supervision. This information affords counselors and state licensure board members a broader view of options and issues involved in this difficult area of ethical decision making.     

Supervision for Counselors Working With Eating Disorders Groups: Countertransference Issues Related to Body Image,Food, and Weight

Because of similarities in age, education, and background, group counselors and members of eating disorders groups may easily identify and connect with each other. Although it can be positive, such overidentification may also create countertransference issues and demand attention in supervision. A model of supervision based on parallel process is presented to address these issues. The article describes (a) societal values related to eating disorders and countertransference; (b) specific themes in eating disorder groups and their impact on group process; (c) examples of countertransference related to body image, food, and weight; and (d) guidelines for supervision of female counselors working with eating disorders groups.     

A Relational Approach to Genetic Counseling for Hereditary Breast and Ovarian Cancer

Ethical issues arise for genetic counselors when a client fails to disclose a genetic diagnosis of hereditary disease to family: they must consider the rights of the individual client to privacy and confidentiality as well as the rights of the family to know their genetic risk. Although considerable work has addressed issues of non-disclosure from the client’s perspective, there is a lack of qualitative research into how genetic counselors address this issue in practice. In this study, a qualitative approach was taken to investigate whether genetic counselors in Australia use a relational approach to encourage the disclosure of genetic information from hereditary breast and ovarian cancer (HBOC) clients among family members; and if so, how they use it. Semi-structured qualitative interviews were conducted with 16 genetic counselors from selected states across Australia. Data collection and analysis were guided by a basic iterative approach incorporating a hybrid methodology to thematic analysis. The findings provide indicative evidence of genetic counselors employing a relational approach in three escalating stages––covert, overt and authoritative––to encourage the disclosure of genetic information. The findings lend credence to the notion that genetic counselors envision a form of relational autonomy for their clients in the context of sharing genetic information, and they depart from individualistic conceptions of care/solely client-centered counseling when addressing the needs of other family members to know their genetic status.     

Career and Career-Related Educational Concerns of College Students With Disabilities

This article providas career counselors with an overview of career-related issues relevant to students with disabilities in postsecondary educational settings. Topics addressed include the impact of disability on career development, the impact of disability on postsecondary educational participation, and access and accommodation issues. The authors argue for an expanded role for career counselors who work with college students with disabilities. It is concluded that career counselors can play an important role in facilitating college students with disabilities in their adaptation to the college environment, their acquisition of appropriate accommodations, and their transition to employment.     

Practice variability in prenatal genetic counseling

This study demonstrated that the content of prenatal genetic counseling sessions varied from counselor to counselor and from center to center. The study was designed to examine which specific issues were included by genetic counselors in prenatal genetic counseling sessions, and to determine which factors led genetic counselors to include or exclude this information from such sessions. Data were collected by randomly surveying 200 full, master degree members of the National Society of Genetic Counselors (NSGC). Respondents provided information by deciding which of 45 specific issues they would include in a standard prenatal genetic counseling session, and which one factor from a bank of 11 factors most accurately described the reason for this decision. The results indicated that the issues included/excluded from sessions varied widely among genetic counselors. The results also indicated that Patient Education/Informed Decision Making (34.5%) played the largest role in decision making overall, with Standard at Center/Departmental Policy (17.6%), Personal Experience/Preference (12.4%), and Applicability (10.9%) serving as the next three most important reasons for including or excluding issues from prenatal genetic counseling sessions.     

The Need for an Awareness of Specialized Issues in Counseling Alcoholic Women

Because of the increase in the number of women seeking treatment for alcoholism in recent years, it is essential that counselors give careful consideration to how this client population can most effectively be helped. Three counselors from the Alcohol Institute of the Eastern Maine Medical Center, Bangor, were interviewed for this article. Their perceptions and experiences as alcoholism counselors are integrated with some of the current research on alcoholic women to provide a framework for professionals in a variety of settings to develop an awareness of the specific issues affecting alcoholic women and to begin to address these issues with their clients.     

Ethical Issues in Counseling Adult Survivors of Incest

Most counselors working with an adult clientele are faced with negotiating the many ethical dilemmas that occur when counseling adult survivors of child sexual abuse. In this article, the primary ethical concerns encountered in the treatment of adult survivors are addressed. Meta-ethical principles are identified for guiding ethical decision making in dealing with issues that arise in the survivor's relationships with the counselor, the abuser, and other family members.     

understanding and counseling transgender clients

Because transgender individuals experience widespread employment discrimination, counselors need to understand and be able to work with members of the gay, lesbian, bisexual, and transgender communities. The aim of this article is to help counselors become more transgender literate by (a) defining gender dysphoric disorder and related terms; (b) discussing the causes, diagnosis, and treatment of gender dysphoria; (c) highlighting career realities faced by transgender employees; (d) touching upon legal issues pertaining to transgender workers; and (e) offering a few suggestions to counselors working with transgender clients.     

Clinical Behaviors for Addressing Religious/Spiritual Issues: Do We Practice What We Preach?

To determine if counselors integrate clinical behaviors for addressing religious/spiritual issues in counseling consistent with their ratings of the importance of such behaviors, the authors conducted a national survey of American Counseling Association (ACA) members. Seventy‐eight ACA members rated the importance of and frequency with which they engaged in a set of 30 clinical behaviors that were identified in the existing literature as addressing religious/spiritual issues within counseling. Results indicated possible disparities between importance and frequency ratings. Potential barriers to counselors' utilization of religious and spiritually directed clinical behaviors were identified.     

“It’s Challenging on a Personal Level”—Exploring the ‘Lived Experience’ of Australian and Canadian Prenatal Genetic Counselors

Prenatal genetic counselors work with clients who are at risk of having a child with a fetal anomaly, or who have been diagnosed with a fetal anomaly. This can raise challenging ethical, moral and legal issues for both clients and counselors. Few studies have explored whether this type of work impacts on genetic counselors themselves. Interviews were conducted with 15 prenatal genetic counselors, five from Toronto, Canada and ten from Melbourne, Australia. A qualitative approach was used to allow for an in-depth exploration of the experiences of genetic counselors working in the prenatal setting. While participants reported that working in a prenatal setting affected them in several ways, this paper focuses on one particular unanticipated finding—that of the impact experienced by counselors from both countries while working when pregnant.     

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.     

Direct-to-Consumer Genetic Testing: What Are We Talking About?

The term Direct-to-Consumer (DTC) genetic testing refers to many different categories of testing. This editorial addresses the issues related to DTC testing for large effect and small effect variants associated with disease. In particular, there are issues of clinical validity and utility, informativeness and residual risk. Genetic counselors are poised to address these issues because of their training in probability and statistical models. The authors suggest that genetic counselors can impact the general public’s understanding of DTC test results by: including evaluation of DTC concepts in graduate program curricula, holding AEC plenary sessions about emerging DTC concepts, and helping other professionals understand DTC concepts. Importantly, genetic counselors are advised to continue doing and promoting rigorous research on how people access and use DTC genetic testing and results, as well as gathering empirical data so that discussions of harms and benefits can go beyond theory. It is our hope that genetic counselors in practice will continue to critically evaluate claims made about emerging new tests, including those marketed DTC, in order to provide the best possible services to our patients.     

A teaching framework for cross-cultural genetic counseling

The increasing diversity of American society has brought growing recognition of the need to bridge cultures in the delivery of genetic counseling services. New immigrants and members of diverse ethnic groups face multiple barriers to genetic counseling services. The need to train genetic counselors to deal with cultural diversity is especially crucial in the new genetic era, given the rapid expansion of available technology, with the resulting social and ethical ramifications. A framework for teaching cross-cultural issues in genetic counseling training programs is presented that can be implemented in step-wise fashion, consistent with available resources. Cross-cultural issues can be incorporated into existing teaching and training modalities by expanding the orientation from monocultural to multicultural. Relevant clinical experience, exploration of students' preconceptions and biases, reading materials, and lectures by invited speakers can all enhance students' knowledge and sensitivity. It is critically important that training programs furnish students with the basic tools necessary for the ongoing process of learning about cultural diversity.     

Shame in Sexual Minorities: Stigma,Internal Cognitions,and Counseling Considerations

Theorists, clinicians, and researchers have suggested that shame is a central concern in the lives of sexual minority individuals. Cognitive theorists believe that shame occurs when a person fails to achieve his or her standards, which are often based on social, cultural, and spiritual values. Although it is asserted that stigma causes shame among members of a sexual minority, the empirical evidence suggests that negative internal cognitions are partly responsible. By targeting negative beliefs, counselors can help sexual minorities reduce their sense of shame, particularly around issues related to sexual identity. The authors offer counseling strategies for reducing shame in sexual minority clients.     

Once-Married Lesbians: Facilitating Changing Life Patterns

Many women have undergone a significant life transition from a heterosexual marriage to a lesbian life pattern. As facilitators of life transitions, counselors can play an important role in minimizing the pain and maximizing the growth involved in such a change. This article provides counselors with information about the diversity of this life transition and then discusses three areas in which counselors may facilitate this process by helping clients to (a) develop a positive identity as a lesbian, (b) adapt to their relationships with women partners, and (c) deal with work-related issues arising from the changed life pattern.     

Religious Counseling: To Be Used,Not Feared

Our society is placing more emphasis on religion and religious issues. Persons seeking counseling often request Christian counseling. Students in academic settings often express an interest in becoming Christian counselors. Often the religious aspect is left out or avoided in courses for training counselors. This article gives some specific ways in which religious issues can be used in a counseling setting using the three ps: place, personhood and philosophy.     

From Campers to Counselors: a Resource for Prospective Genetic Counseling Students

When thinking about the future of the genetic counseling field, one place to start is with prospective genetic counseling graduate school applicants. Although resources and mentorship opportunities exist for genetic counselors entering the field, the process of deciding on a career, applying to graduate programs, and being admitted can be daunting. As members of the profession, we should take responsibility for ensuring that individuals have the information and resources necessary to make an educated decision about whether genetic counseling is the correct path for them and to take the initial steps along this path. In this article, we present our Genetic Counseling Boot Camp as a model for other genetic counselors to use in developing their own local programs. This type of program can benefit prospective genetic counselors as they begin their professional journeys and can also provide value for the organizers and presenters who are already seasoned in the field.     

高校心理咨询师多重关系情境与决策类型的研究

为探索高校咨询师面临的多重关系伦理情境、决策过程,对访谈17名高校心理咨询师的资料进行分析。结果：常见情境主要包括接送礼物承载的新关系、来访者和咨询师除咨询关系外的师生关系、咨询师与和来访者有关的第三人有关系、咨询师在咨询室之外的场所偶遇来访者、来访者有咨询师的联系方式、来访者和咨询师有身体接触等。决策表现为两种：经验主导型,决策时未意识到处于伦理情境只凭经验决策;伦理主导型,决策时意识到处在伦理情境。结论：高校心理咨询存在一些特殊多重关系,心理咨询师需增加具有伦理意识的决策。     

Counselors,confidences, and the civil liberties of clients

Counselors can and do injure counselees by prying improperly into private matters, by passing information along without the counselees' informed consent, and by using privileged information as a basis for recommendations to others. The danger is especially great where counselors work within organizations, and even greater when their clients are fellow members. Safeguards against this danger would appear to take an uncounselorlike form. Although counselors are not usually sympathetic to a legalistic approach, it is from our constitutional traditions that we can best deduce the kinds of protection that we need.