Case study: Research with brain-dead children

The esophageal obturator airway (EOA) is a device used throughout the United States to facilitate artificial respiration of critically ill patients who are not hospitalized. Its use is restricted to persons who are over 15 years old because obturators for children are not available. A protocol submitted to an institutional review board (IRB) intended to develop EOAs suitable for use in children. The investigators proposed to perform preliminary testing of these devices on children who had sustained irreversible loss of brain function (“brain death”). In its review of this protocol, the IRB had to confront several vexing questions.     

Counselling the (self?) diagnosed client: generative and reflective conversations

In this paper, we address the phenomenon of clients who present their concerns in the medicalised discourse of the Diagnostic and Statistical Manual of Mental Disorders – Fifth Edition (DSM-5). We contextualise this phenomenon, highlighting how a ‘diagnose-and-treat’ logic increasingly pervades everyday understandings and informs people's efforts to make sense of their concerns. We relate these cultural ways of sense-making to discursive counselling practice, noting possibilities for circumventing ‘discursive capture’ through reflective and generative dialogues. We then turn to two common ways in which clients present their concerns in counselling: (1) arriving self-diagnosed or diagnosed by another professional and (2) as a family in which parents present a child as having a mental disorder. We suggest ways of moving beyond medicalised discourse via resourceful and critically reflective conversations with clients.     

Dialogic Considerations of Confrontation as a Counseling Activity: An Examination of Allen Ivey's Use of Confronting as a Microskill

The authors examine confrontation as a communication skill practiced and described by counselor educator Allen Ivey. Seeing confrontation as a dialogic activity completed interactionally, they use conversation analysis to examine 2 passages where Ivey used confrontation in his teaching tapes. Their microanalyses highlight some important and largely unnoticed aspects of communication used in counseling skills such as confrontation. They conclude by discussing pedagogical implications they see following from their perspective and analyses.