The Counselor’s Companion:

What Every Beginning Counselor

Needs to Know
Authors’ Purpose

In our interactions with counselor trainees, we often hear them express uncertainty
about how to proceed after graduation. While they are in the midst of their counsel-
ing programs, students are surrounded by support systems comprised of profes-
sors, supervisors, and peers; yet, once in the field, novice clinicians often experi-
ence a sense of loss and can even become overwhelmed with questions that arise in
their clinical interactions. Although we sincerely hope beginning counselors will
create a support system with other professionals, we also recognize the harsh real-
ity that not every counselor works in an environment with other trained mental
health professionals and that there are few written resources that provide compre-
hensive and practical information for counselors who are just getting started. The
goal of this project is to provide novice counselors with a reference tool or “friend”
of sorts where they can turn when questions related to areas such as professional-
ism, ethics, research, and day-to-day clinical work arise in their practices. The jour-
ney to becoming a successful professional counselor is one that should not be
walked alone. We hope that this book will become a faithful companion for stu-
dents who have left their supervisors and teachers behind after graduation and
that being able to reference the knowledge base of counselor educators and sea-
soned practitioners will ensure a journey to professionalism that is a little less
bumpy!

Jocelyn Gregoire and Christin M. Jungers

Duquesne University
The Counselor’s Companion: What Every Beginning
Counselor Needs to Know
by Jocelyn Gregoire and Christin M. Jungers
Duquesne University

Ideal for use in practicum or graduate capstone courses, this book includes …
Cutting-Edge Topics: In addition to a focus on the traditional CACREP curriculum areas,
readers will also find chapters on important and cutting-edge trends in the counseling field.
Some of these areas include the use of neuroscience in counseling practice (chapter 28),
bioecological approaches to practice (chapter 27), crisis counseling, pastoral counseling, and
addictions counseling.
NCE Preparation Tool: Key chapters reflect specific content areas that students preparing
for the NCE will need to know. Also included is a 200-question sample exam to test knowl-
edge, application, and analysis of key concepts and information in the counseling field.
Case Examples: Throughout the book, readers will find example boxes that highlight impor-
tant points or provide case examples to clarify counseling theory and bring counseling mod-
els into day-to-day practice.
Web References: Each chapter includes Web references that readers can use to find more in-
formation, download articles, and retrieve full documents, such as the ACA Code of Ethics,
about relevant counseling-related topics.
Concise, Heart-of-the-Matter Format: The format is intentionally concise and presented in
an outline form so that counselors can easily grasp and retain main points of each topic area
without getting lost or distracted by peripheral details.

SPECIAL OFFERS!
Online Counseling Case Management Software: Athena Software, producer of Penelope, a
Web-based case management software package designed especially for counseling and hu-
man services practitioners, is offering a special package for anyone who purchases this book.
For only $7.95, you can subscribe for 120 days to the Penelope program. It is a great way for
students in their practicum and internships to become familiar with the reality of the elec-
tronic revolution in counseling practice (e.g., the program supports online record keeping,
note summary, appointment calendars, and evaluations). Visit www.athenasoftware.net/
index.html for more information.
Titles of Related Interest From Lawrence Erlbaum Associates, Inc.

䊏 Advancing Social Justice Through Clinical Practice

Etiony Aldarondo
䊏 Countertransference and the Therapist’s Inner Experience: Perils and Possibilities
Charles J. Gelso & Jeffrey A. Hayes
䊏 Handbook of Posttraumatic Growth: Research & Practice
Lawrence G. Calhoun & Richard G. Tedeschi
䊏 Empathy in Counseling and Psychotherapy: Perspectives and Practices
Arthur J. Clark
䊏 Handbook of Culture, Therapy, and Healing
Uwe P. Gielen, Jefferson M. Fish, & Juris G. Draguns
䊏 Half in Love With Death: Managing the Chronically Suicidal Patient
Joel Paris
䊏 Group Counseling and Psychotherapy With Children and Adolescents: Theory, Research,
and Practice
Zipora Shechtman
䊏 An ADHD Primer, Second Edition
Lisa L. Weyandt
䊏 Neuropsychotherapy: How the Neurosciences Inform Effective Psychotherapy
Klaus Grawe
䊏 The Professional Counselor as Administrator: Perspectives on Leadership and Management
of Counseling Services Across Settings
Edwin L. Herr, Dennis E. Heitzmann, & Jack R. Rayman
䊏 The Mind in Therapy: Cognitive Science for Practice
Katherine D. Arbuthnott & Dennis W. Arbuthnott
䊏 Emotionally Intelligent School Counseling
John Pellitteri, Robin Stern, Claudia Shelton, & Barbara Muller-Ackerman
䊏 The New Handbook of Counseling Supervision
L. DiAnne Borders & Lori L. Brown
䊏 Working With Troubled Men
Morley D. Glicken
䊏 Counseling and Therapy With Clients Who Abuse Alcohol or Other Drugs: An Integrative
Approach
Cynthia E. Glidden-Tracey
䊏 Multicultural Assessment: Principles, Applications, and Examples
Richard H. Dana
䊏 The Great Psychotherapy Debate: Models, Methods, and Findings
Bruce Wampold
The Counselor’s Companion:
What Every Beginning Counselor
Needs to Know

Jocelyn Gregoire
Christin M. Jungers
Duquesne University

L Lawrence Erlbaum Associates, Publishers

2007 Mahwah London
Copyright © 2007 by Lawrence Erlbaum Associates, Inc.
All rights reserved. No part of this book may be reproduced in any form, by
photostat, microform, retrieval system, or any other means, without prior
written permission of the publisher.

Lawrence Erlbaum Associates, Inc., Publishers

10 Industrial Avenue
Mahwah, New Jersey 07430
www.erlbaum.com

Cover design by Tomai Maridou

Interior design by Wendy MacRobbie

Library of Congress Cataloging-in-Publication Data

The counselor’s companion : what every beginning counselor needs to know /

edited by Jocelyn Gregoire, Christin Jungers.
p. cm.
Includes bibliographical references and index.
ISBN 978-0-8058-5683-5 — 0-8058-5683-8 (cloth)
ISBN 978-0-8058-5684-2 — 0-8058-5684-6 (pbk.)
ISBN 1-4106-1674-6 (e book)
1. Counseling psychology. 2. Counseling psychology—Practice. I. Gregoire,
Jocelyn. II. Jungers, Christin.
BF636.6.C68 2007
158’.3—dc22 2006030183
CIP

Books published by Lawrence Erlbaum Associates are printed on acid-free paper,

and their bindings are chosen for strength and durability

Printed in the United States of America

10 9 8 7 6 5 4 3 2 1
 Brief Contents

Preface xxxv
Acknowledgments xxxix
Meet the Contributors xli

part one
What Are the Primary Roles and Responsibilities
of the Professional Counselor? 1

chapter On Being a Professional Counselor 2

1
chapter The Demands and Obligations of Ethical Counseling 18
2
chapter The Legal Intrigues of Counseling Practice 32
3
chapter Multicultural Intricacies in Professional Counseling 52
4
chapter Supervision: An Essential for Professional Development 72
5
chapter Collaborative Supervision for the Novice Supervisor 86
6

vii
viii Brief Contents

part two
What Are the Essential Elements of Counseling With
Which All Counselors Must Be Familiar? 111

chapter Understanding Human Growth and Development 112

7
chapter Counseling Across the Lifespan 136
8
chapter Major Forces Behind Counseling Approaches 154
9
chapter Individual and Social Aspects of the Helping Relationship 194
10
chapter The Cultural Kaleidoscope: Eyeing Diverse Populations 218
11
chapter Approaches to Group Work 246
12
chapter Fundamentals of Group Work 274
13
chapter Multicultural Components of Group Work 298
14
chapter Counseling in the World of Work 314
15
chapter Multicultural Issues in Career and Lifestyle Counseling 340
16
chapter Fundamentals of Professional School Counseling 360
17
chapter Approaches to Family Counseling 376
18
chapter Understanding and Assessing Psychopathology 404
19
 Brief Contents ix

part three
What Are the Fundamental Components of Appraisal
and Research that New Counselors Should Use
in Their Practice? 433

chapter Foundations of Measurement and Psychometrics 434

20
chapter Testing and Assessment in Counseling Practice 458
21
chapter Quantitative Research Designs 486
22
chapter Fundamentals of Qualitative Research 512
23

part four
What Are the Special Topics and Important Trends
That Counselors Might Encounter? 527

chapter A Look at Consultation 528

24
chapter Crisis Intervention in Counseling 550
25
chapter Addictions Counseling 568
26
chapter Ecological-Transactional and Motivational Perspectives in
27 Counseling 586

chapter Neuroscience in Psychotherapeutic Practices 606

28
chapter Developmental Counseling and Therapy 624
29
x Brief Contents

chapter Counseling for Wellness 642

30
chapter Spirituality and Pastoral Counseling Practices 658
31
appendix Preparing for the National Counselor Exam:
A What You Need to Know 675

appendix Your Online Companion in Electronic Case Management:

B An Introduction to Penelope Software 721

appendix Hints, Helps, and FAQs About Working in a Managed Care

C Environment 731

References 741
Index 785
 Contents

Preface xxxv
Acknowledgments xxxix
Meet the Contributors xli

part one
What Are the Primary Roles and Responsibilities
of the Professional Counselor? 1

chapter On Being a Professional Counselor 2

1
A Brief History of the Counseling Profession 3
䊏 Theoretical Shifts; Specialization; Professionalization

The Counselor’s Identity 4

䊏 The Diversity of Counselor Identities; How Counseling Differs From

Psychology and Social Work; Characteristics of an Effective Counselor

Professionalism 8
䊏 Training for Professional Counselors; Licensure; Certification; Professional

Associations; Advocacy; Ethical Principles in Professional Counseling

Personal Health and Wellness 15

䊏 Countertransference; Burnout; Networking

chapter The Demands and Obligations of Ethical Counseling 18

2
The Basics of Ethics in Counseling 19
䊏 Definition of Ethics; Ethical Codes; Ethical Codes and Cultural Diversity;

Development of Ethical Codes; ACA Code of Ethics; Mandatory

and Aspirational Ethics

xi
xii Contents

Ethical Theory 22
䊏 Epicureanism; Utilitarianism; Kantianism; Situationalism

Ethical Principles and Decision Making 24

䊏 Nonmaleficence; Beneficence; Autonomy; Fidelity; Justice; An Ethical

Decision-Making Model

Common Ethical Concerns for Professional Counselors 28

䊏 Confidentiality; Dual Relationships and Potentially Beneficial Interactions;

Sexual Misconduct; Transference; Countertransference

Summary 31

chapter The Legal Intrigues of Counseling Practice 32

3
Basics of Professional, Ethical, and Legal Practice for Counselors 33
䊏 A Look at Professions, Professionalism, and Professional Identity; Legal

Issues Related to Counselors’ Professional Identity; Ethical Codes and

Standards of Practice; What Is Law?; Contracts in Counseling: Informed
Consent; Torts and Counselor Negligence

Professionalism for School Counselors 38

䊏 Building Collaborative Relationships; Facing the Political Barriers of the

School System; Community Standards in School Counselor Practice;

Protecting Students’ Best Interests

Legal and Ethical Aspects of Competence 40

䊏 Consultation; Continuing Education; Malpractice

Record Keeping 42
䊏 School Records: Family Education Rights and Privacy Act (FERPA); ASCA

Ethical Guidelines on Educational Records; Agency Records: Health

Insurance Portability and Accountability Act (HIPAA)

Dual Relationships in School and Community Settings 45

䊏 Ethical and Legal Considerations of Dual Relationships; Complexity of

Dual Relationships in Schools; Safeguarding Clients’ Emotional Health

Confidentiality, Privacy, and Privileged Communication 46

䊏 Ethical Standard of Confidentiality; Confidentiality for School Counselors;

Privacy; Legal Facets of Privileged Communication; Duty to Warn: Limit to

Privileged Communication; Duty to Protect
 Contents xiii

chapter Multicultural Intricacies in Professional Counseling 52

4
Cultural Influences in Counseling 53
䊏 Influence of Eurocentric Perspectives on Counseling; Rationale for a

Multicultural Approach in Counseling; Multicultural Competencies for

Professional Counselors

Essential Factors in Culture-Sensitive Counseling 54

䊏 Culture Defined; Cultural Convergence; Etic and Emic Cultural Viewpoints;

Cultural Encapsulation; Ethnocentrism; Acculturation and Assimilation;

Alloplastic and Autoplastic Viewpoints

Cultural Constructs: A Closer Look 60

䊏 Sex and Gender; Sexuality and Affectional Orientation; Race; Age; Ability;

Religion and Spirituality

Bias, Prejudice, Discrimination, and Oppression 64

䊏 Bias; Prejudice; Discrimination; Oppression; Privilege

Cultural Identity Development 67

䊏 Racial and Cultural Identity Development Model; White Racial Identity

Development

Multicultural Theories in Counseling 69

䊏 Multicultural Counseling and Therapy; Benefits of Multicultural Counseling

and Therapy

chapter Supervision: An Essential for Professional Development 72

5
Basics of Clinical Supervision 73
䊏 Supervision: A Key to Professionalism; Benefits of Supervision; Supervision

Defined

Models of Supervision 75
䊏 Developmental Models of Supervision; Theory-Specific Supervision

Models; Social Role Models of Supervision: Discrimination Model;

Integrated Model of Supervision; A Supervision Videotaping Method:
Interpersonal Process Recall

chapter Collaborative Supervision for the Novice Supervisor 86

6
A Look at Supervision 87
䊏 Purposes of Supervision; Importance of Supervision to the Counseling

Profession; Supervision, Professional Development, and Credentialing

xiv Contents

Becoming a Supervisor: Some Starting Points 89

䊏 Training Through Doctoral Programs; Self-Developed Supervision Skills:

Modeling as a First Step; Self-Developed Supervision Skills: Gathering

Other Resources
A Collaborative Model of Supervision: An Overview 91
䊏 Constructivist Roots of the Collaborative Model; Meeting Competencies

Through the Collaborative Model; Advantages of the Collaborative Model

Professional Development of Novice Supervisors: Knowledge Competency 92
䊏 Theoretical Foundations; Ethical and Legal Considerations; Multicultural

Impact
Professional Development of Novice Supervisors: Disposition 97
䊏 Collaborative, Learner-Focused Stance; Supportive and Critical

Dispositions: Coexisting Roles

Professional Development of Novice Supervisors: Strategies 99
䊏 The Inquiry Learning Cycle; Building the Therapeutic Alliance; Using the

FERA Inquiry Model in the Therapeutic Alliance; Promoting the

Construction of Meaning; Using the FERA Inquiry Model in the
Construction of Meaning; Evaluating the Work of the Counselor; Using the
FERA Inquiry Model for Evaluating the Work of the Supervisee
Summary 109

part two
What Are the Essential Elements of Counseling With
Which All Counselors Must Be Familiar? 111

chapter Understanding Human Growth and Development 112

7
Prenatal Development 113
䊏 Influences on Prenatal Development; Genetic Makeup; Prenatal

Developmental Periods; Risks During Prenatal Development

Infancy: The First 2 Years of Life 114
䊏 Physical Development in Infancy; Cognitive Development in Infancy;

Social-Emotional Development in Infancy

Early Childhood: The Preschool Period 119
䊏 Physical Development in Early Childhood; Cognitive Development in Early

Childhood; Social-Emotional Development in Early Childhood

 Contents xv

Middle Childhood: Elementary School Years 123

䊏 Physical Development in Middle Childhood; Cognitive Development in

Middle Childhood; Social-Emotional Development in Middle Childhood

Adolescence: Transition From Childhood to Adulthood 127

䊏 Physical Development in Adolescence; Cognitive Development in

Adolescence; Social-Emotional Development in Adolescence

Adulthood 130
䊏 Physical Development in Adulthood; Cognitive Development in Adulthood;

Social-Emotional Development in Adulthood

Death, Dying, and Bereavement 133

䊏 Death and the Young; Theory of Dying Process; Grief and Bereavement

chapter Counseling Across the Life Span 136

8
Perspectives in Human Growth and Development 137
䊏 Nature and Nurture; Continuity and Discontinuity; Developmental

Domains

Psychodynamic Theories of Human Development 139

䊏 The Psychoanalytic Approach; The Psychosocial Approach

Behavioral and Learning Theories of Human Development 143

䊏 Classical Conditioning; Stimulus–Response Model; Law of Effect; Skinnerian

Approach; Social Learning Theory

Cognitive Theories of Human Development 146

䊏 Piagetian Theory of Cognitive Development; Theory of Moral

Development; Sociocultural Theory of Development

Ethological and Maturational Theories of Human Development 150

䊏 Konrad Lorenz; Attachment Theory; Theory of Genetic Determination

Humanistic Theories of Human Development 152

䊏 Maslow’s Hierarchy of Needs

chapter Major Forces Behind Counseling Approaches 154

9
Psychodynamic Approaches: Psychoanalysis 156
䊏 View of Human Nature; Theory of Personality; Key Theoretical Concepts;

Goals of Therapy; Therapeutic Techniques; Role of Therapist; Strengths

and Limitations
xvi Contents

Psychodynamic Approaches: Analytic Psychology 159

䊏 View of Human Nature; Theory of Personality; Key Theoretical Concepts;

Goals of Therapy; Therapeutic Techniques; Role of Therapist; Strengths

and Limitations
Psychodynamic Approaches: Individual Psychology 161
䊏 View of Human Nature; Theory of Personality; Key Theoretical Concepts;

Goals of Therapy; Therapeutic Techniques; Role of Therapist; Strengths

and Limitations
Psychodynamic Approaches: Transactional Analysis 164
䊏 View of Human Nature; Theory of Personality; Key Theoretical Concepts;

Goals of Therapy; Therapeutic Techniques; Role of Therapist; Strengths

and Limitations
Cognitive-Behavioral Approaches: Behaviorism 167
䊏 View of Human Nature; Theory of Personality; Key Theoretical Concepts;

Goals of Therapy; Therapeutic Techniques; Role of Therapist; Strengths

and Limitations

Cognitive-Behavioral Approaches: Neo-Behaviorism 169

䊏 View of Human Nature; Theory of Personality; Key Theoretical Concepts;

Goals of Therapy; Therapeutic Techniques; Role of Therapist; Strengths

and Limitations

Cognitive-Behavioral Approaches: Cognitive Therapy 172

䊏 View of Human Nature; Theory of Personality; Key Theoretical Concepts;

Goals of Therapy; Therapeutic Techniques; Role of Therapist; Strengths

and Limitations
Cognitive-Behavioral Approaches: Rational-Emotive Therapy 176
䊏 View of Human Nature; Theory of Personality; Key Theoretical Concepts;

Goals of Therapy; Therapeutic Techniques; Role of Therapist; Strengths

and Limitations
Cognitive-Behavioral Approaches: Reality Therapy 179
䊏 View of Human Nature; Theory of Personality; Key Theoretical Concepts;

Goals of Therapy; Therapeutic Techniques; Role of Therapist; Strengths

and Limitations

Cognitive-Behavioral Approaches: Multimodal Therapy 182

䊏 View of Human Nature; Theory of Personality; Key Theoretical Concepts;

Goals of Therapy; Therapeutic Techniques; Role of Therapist; Strengths

and Limitations
Existential-Humanistic Approaches: Person-Centered 185
䊏 View of Human Nature; Theory of Personality; Key Theoretical Concepts;

Goals of Therapy; Therapeutic Techniques; Role of Therapist; Strengths

and Limitations
 Contents xvii

Existential-Humanistic Approaches: Gestalt 187

䊏 View of Human Nature; Theory of Personality; Key Theoretical Concepts;

Goals of Therapy; Therapeutic Techniques; Role of Therapist; Strengths

and Limitations
Existential-Humanistic Approaches: Logotherapy 190
䊏 View of Human Nature; Theory of Personality; Key Theoretical Concepts;

Goals of Therapy; Therapeutic Techniques; Role of Therapist; Strengths

and Limitations

chapter Individual and Social Aspects of the Helping Relationship 194

10 The Helping Relationship 195
䊏 Why Bother With Theories?; Theory Defined; Theories With Which

Helpers Need to Be Familiar; A Word About Eclecticism; Helping Defined;

The Helping Process; Frameworks Within Which the Helping Process
Occurs; Helping Helpees Meet Their Needs
What Constitutes Effective Helping? 199
䊏 Professional Helpers as Growth Facilitators; Personal Characteristics of

Effective Helpers; Helpers’ Skills; Helpers and Diversity Issues

Training Models for Coping Skills Development 203
䊏 People-in-System Model; Life Skills Education Model; Structured Learning

Therapy Model; Social Skills

Training Models for Interpersonal Skills Development 207
䊏 Skilled Helping: Problem Management Model; Relationship Enhancement

Therapy Model; Microskills Counseling Model; Interpersonal Process

Recall; Human Resources Development Model; The Politics of Giving
Therapy Away: Listening and Focusing
Social-Psychological Approaches to Helping 211
䊏 Symbolic Interaction; Role Theory; Social Exchange; Cognitive Consistency;

Dissonance Theory; Heider’s Balance Theory; Congruity Theory;

Newcomb’s A-B-X Model of Interpersonal Attraction; Attributions

chapter The Cultural Kaleidoscope: Eyeing Diverse Populations 218

11 Opening up to Multicultural Realities in Counseling 220
䊏 Implications of a Multicultural Worldview to Counselors’ Training;

Implications of a Multicultural Emphasis for Counselor Educators;

Implications of Multicultural Counseling for Program Development;
Cross-Cultural Differences in Counselor–Client Relationships; What Is
Cultural Context?; A Model for Understanding Differences; Avoiding
“Preferred” Clients Only; The Notion of White Privilege
xviii Contents

Challenges for Children of Specific Populations 224

䊏 Examining the Influence of Ethnicity on Children; Additional Concerns

When Working With Children of Different Ethnic Groups

Native American Population 225

䊏 Historical and Demographic Factors; Family Characteristics; Value

Orientations; Stereotypes; Communication Styles; Mental Health Issues

African American Population 228

䊏 Historical and Demographic Factors; Value Orientations; Family

Characteristics; Communication Styles; Mental Health Issues;

Considerations When Counseling

Asian American Population 231

䊏 Historical and Demographic Factors; Family Values; Common Stereotypes;

Mental Health Issues; Communication Styles; Effective Counseling

Approaches

Latin American Population 234

䊏 Historical and Demographic Factors; Family Characteristics;

Communication Styles; Value Orientations; Mental Health Issues

Arab American Population 236

䊏 Historical and Demographic Factors; Family Characteristics; Value

Orientations; Stereotypes; Counseling Issues

Elderly Population 239

䊏 Demographic Factors; Stereotypes; Mental Health Issues; Approaches to

Counseling

Ableism and Disability 241

䊏 Demographics; Stereotypes; Rehabilitation Counseling; Counseling Issues

Gay, Lesbian, Bisexual, and Transgendered Population 243

䊏 The Process of “Coming Out”; Counseling Issues

Conclusion 244

chapter Approaches to Group Work 246

12
Psychoanalytic Approach to Group Work 247
䊏 Key Theoretical Concepts; Goals and Stages; Therapeutic Techniques; Role

of Group Leader; Strengths and Limitations

Adlerian Approach to Group Work 249

䊏 Key Theoretical Concepts; Goals and Stages; Therapeutic Techniques; Role

of Group Leader; Strengths and Limitations

 Contents xix

Transactional Analytic Approach to Group Work 251

䊏 Key Theoretical Concepts; Goals and Stages; Therapeutic Techniques; Role

of Group Leader; Strengths and Limitations

Psychodramatic Approach to Group Work 254

䊏 Key Theoretical Concepts; Goals and Stages; Therapeutic Techniques; Role

of Group Leader; Strengths and Limitations

Behavioral Approach to Group Work 257

䊏 Key Theoretical Concepts; Goals and Stages; Therapeutic Techniques; Role

of Group Leader; Strengths and Limitations

Rational-Emotive Behavior Therapy Approach to Group Work 260

䊏 Key Theoretical Concepts; Goals and Stages; Therapeutic Techniques; Role

of Group Leader; Strengths and Limitations

Reality Therapy Approach to Group Work 262

䊏 Key Theoretical Concepts; Goals and Stages; Therapeutic Techniques; Role

of Group Leader; Strengths and Limitations

Person-Centered Approach to Group Work 264

䊏 Key Theoretical Concepts; Goals and Stages; Therapeutic Techniques; Role

of Group Leader; Strengths and Limitations

Gestalt Approach to Group Work 267

䊏 Key Theoretical Concepts; Goals and Stages; Therapeutic Techniques; Role

of Group Leader; Strengths and Limitations

Existential Approach to Group Work 270

䊏 Key Theoretical Concepts; Goals and Stages; Therapeutic Techniques; Role

of Group Leader; Strengths and Limitations

chapter Fundamentals of Group Work 274

13
History of Group Counseling 275
䊏 Theoretical Influences; Uses of Groups; Ethical and Legal Considerations

Fundamentals of Group Work 276

䊏 Definition of Group Work; Types of Group Work; Group Member

Activities; Leader Interventions

Group Dynamics 278

䊏 Group Processing; Group Conflict; Group Cohesiveness; Therapeutic

Factors in Groups; Group Typology

Group Leadership 281

䊏 Leadership Styles; Group Leader Attributes; A Framework for

Intervention; Concerns of Beginning Group Leaders; Coleadership

xx Contents

Cultural Considerations for Group Leaders 284

䊏 Influences on Diversity; Non-Western Values in Group Work;

Characteristics of Culturally Competent Leaders; Benefits of Multicultural

Awareness

Pregroup Planning 287

䊏 Logistics; Site Considerations; Defining the Group’s Purpose; Selection of

Members

Beginning Phase 288

䊏 Structure; Group Norms; Role of the Leader in the Beginning Phase; Goal

Setting Feedback in the Beginning Phase

Middle Phase 292

䊏 Conflict in the Middle Phase; Group Interactions; Role of the Leader in the

Middle Phase; Feedback in the Middle Phase

Final Phase 295

䊏 Final Phase Resistance; Generalization of Learning; Role of the Leader in

the Final Phase

chapter Multicultural Components of Group Work 298

14
History of Multicultural Group Work 299
䊏 Goals of Group Work; Culture and Group Work; Multicultural Group

Work Defined; Multicultural Group Work and Ethical Practice

Core Competencies of Multicultural Group Work 301

䊏 Individual Competencies of Multicultural Group Workers; Principles for

Diversity-Competent Group Workers

Theory and Multicultural Group Work 303

䊏 Diversity and Multicultural Framework; Failure to Recognize Diversity

Issues in Theory; Flexibility to Operate Within Multicultural Worldviews

Assessment and Group Ideologies 305

䊏 Assessment in Multicultural Group Work; Process of Assessment; Delivery

of Assessment Decisions; Communication Styles; Thematic

Communication in Assessment; Individual and Cultural Values in
Assessment

A Diversity-Competent Model of Multicultural Group Work 311

䊏 How to Choose a Model of Multicultural Group Work; Images of Me: An

Afrocentric Approach to Group Work

 Contents xxi

chapter Counseling in the World of Work 314

15
Career Counseling Overview 315
䊏 Historical Development of Career Counseling; Nature of Career

Counseling; Important Terminology in Career Counseling

Career Development Theory 317

䊏 Frank Parsons: Trait and Factor Theory; John Holland: Theory of

Vocational Choice and Adjustment; Eli Ginzberg: Developmental Career

Theory; Donald Super: Life-Span Theory; Anne Roe: Needs Theory; E.
Bordin: Psychoanalytic Career Theory; Tiedeman and O’Hara: Choice and
Adjustment Theory Gottfredson: Theory of Circumscription and
Compromise; John Krumboltz: Social Learning Career Theory;
Socioeconomic Career Theories; Career Theories for Women

Process of Career Counseling 325

䊏 Stage 1: Dealing With Change; Stage 2: Developing Career Focus; Stage 3:

Exploring Career Options; Stage 4: Preparing for Job Search; Stage 5:

Obtaining Employment

Use of Assessment Tools in Career Counseling 328

䊏 History of Assessment: Trait and Factor Model; Interest Inventories;

Personality Inventories; Values/Lifestyle Inventories; Qualitative Tools

Special Issues in Career Counseling 332

䊏 Job Loss; Dual-Career Considerations; Displaced Homemakers; Individuals

With Disabilities; Midlife Career Changes

Technological Competencies for Career Counselors 336

䊏 ACES Technology Competencies; Need for Technological Skills

chapter Multicultural Issues in Career and Lifestyle Counseling 340

16
Understanding Cultural Issues in Career Counseling 341
䊏 Historical Approaches to Multicultural Career Counseling; Important

Terminology: Cross-Cultural and Multicultural

Multicultural Career Development: Traditional Theoretical Approaches 342

䊏 Holland’s Person–Environment Fit Theory; Roe’s Theory of Occupational

Classifications; Super’s Life Span-Life Space Theory; Gottfredson’s Theory

of Circumscription and Compromise; Social Cognitive Career Theory;
Theories Summary

Culture-Specific Variables 349

䊏 Acculturation; Racial and Cultural Identity Development; Racial Salience;

Loss of Face
xxii Contents

Culturally Appropriate Career Counseling Models 351

䊏 Integrative Sequential Model of Career Counseling Services; Culturally

Appropriate Career Counseling Model; Developmental Approach Career

Development Assessment and Counseling; Integrative Multidimensional
Model

Future Research and Theory Development 356

䊏 Key Concepts in Career Counseling Research; Recommendations for

Future Research

chapter Fundamentals of Professional School Counseling 360

17
Foundations of Professional School Counseling 361
䊏 What Is School Counseling?; Brief Historical Background; Professionalism

for School Counselors

ASCA National Standards 364

䊏 Domain 1: Academic Development; Domain 2: Career Development;

Domain 3: Personal and Social Development

ASCA National Model 367

䊏 The Foundation; The Delivery System; The Management System; The

Accountability System; Programmatic Approach: A New Paradigm for

School Counseling; Collaboration and Systemic Support

The Transforming School Counseling Initiative 371

䊏 Implications for School Counselor Practice; The Counseling Process;

Consultation; Coordination of Services; Leadership; Advocacy;

Collaboration and Teaming; Managing Resources; Use of Data

School Counseling in the 21st Century 374

䊏 Functions and Responsibilities of the School Counselor; The Transformed

School Counselor

chapter Approaches to Family Counseling 376

18
Behavioral and Cognitive-Behavioral Family Therapy 378
䊏 Key Concepts in Behavioral and Cognitive-Behavioral Therapy; Role of

Therapist in Behavioral and Cognitive-Behavioral Therapy; Goals of

Treatment in Behavioral and Cognitive-Behavioral Therapy; Therapeutic
Techniques in Behavioral and Cognitive-Behavioral Therapy; Strengths and
Limitations of Behavioral and Cognitive-Behavioral Therapy
 Contents xxiii

Bowenian Family Therapy 380

䊏 Key Concepts in Bowenian Therapy; Role of Therapist in Bowenian

Therapy; Goals of Treatment in Bowenian Therapy; Therapeutic

Techniques in Bowenian Therapy; Strengths and Limitations of Bowenian
Therapy

Constructivist Family Therapy 383

䊏 Key Concepts in Constructivist Therapy; Role of Therapist in

Constructivist Therapy; Goals of Treatment in Constructivist Therapy;

Therapeutic Techniques in Constructivist Therapy; Strengths and
Limitations of Constructivist Therapy

Experiential Family Therapy 385

䊏 Key Concepts in Experiential Therapy; Role of Therapist in Experiential

Therapy; Goals of Treatment in Experiential Therapy; Therapeutic

Techniques in Experiential Therapy; Strengths and Limitations of
Experiential Therapy

Feminist Family Therapy 387

䊏 Key Concepts in Feminist Therapy; Role of Therapist in Feminist Therapy;

Goals of Treatment in Feminist Therapy; Therapeutic Techniques in

Feminist Therapy; Strengths and Limitations of Feminist Therapy

Psychodynamic Family Therapy 389

䊏 Key Concepts in Psychodynamic Therapy; Role of Therapist in

Psychodynamic Therapy; Goals of Treatment in Psychodynamic Therapy;

Therapeutic Techniques in Psychodynamic Therapy; Strengths and
Limitations of Psychodynamic Therapy

The Satir Growth Model of Family Therapy 391

䊏 Key Concepts in the Satir Growth Model; Role of Therapist in the Satir

Growth Model; Goals of Treatment in the Satir Growth Model;

Therapeutic Techniques in the Satir Growth Model; Strengths and
Limitations of the Satir Growth Model

Solution-Focused Brief Family Therapy 394

䊏 Key Concepts in Solution-Focused Brief Therapy; Role of Therapist in

Solution-Focused Brief Therapy; Goals of Treatment in Solution-Focused

Brief Therapy; Therapeutic Techniques in Solution-Focused Brief Therapy;
Strengths and Limitations of Solution-Focused Brief Therapy

Strategic Family Therapy 396

䊏 Key Concepts in Strategic Therapy; Role of Therapist in Strategic Therapy;

Goals of Treatment in Strategic Therapy; Therapeutic Techniques in

Strategic Therapy; Strengths and Limitations of Strategic Therapy
xxiv Contents

Structural Family Therapy 398

䊏 Key Concepts in Structural Therapy; Role of Therapist in Structural

Therapy; Goals of Treatment in Structural Therapy; Therapeutic

Techniques in Structural Therapy; Strengths and Limitations of Structural
Therapy
Systemic Family Therapy 400
䊏 Key Concepts in Systemic Therapy; Role of Therapist in Systemic Therapy;

Goals of Treatment in Systemic Therapy; Therapeutic Techniques in

Systemic Therapy; Strengths and Limitations of Systemic Therapy

chapter Understanding and Assessing Psychopathology 404

19
Understanding Psychological Disorders 406
䊏 What Is Abnormality?; Models of Abnormality

Assessment of Psychopathology 407

䊏 Diagnostic Classification Systems; The Assessment Process; Gathering

Information: Written, Verbal, and Observational Methods; Assessment

Results
The Diagnostic System: Some Considerations 411
䊏 Uses and Advantages of the DSM Classification System; Limitations of the

DSM System; Dimensional Diagnoses: A New Approach to Diagnosing

Disturbances Related to Anxiety 412
䊏 Approaches to Understanding Anxiety; Generalized Anxiety Disorder;

Phobias; Panic Disorder; Obsessive-Compulsive Disorder; Stress Disorders

Disturbances With Mood 415
䊏 Approaches to Understanding Depression; Unipolar Depression; Bipolar

Disorder; Suicide
Disturbances Related to Eating and Weight Loss 418
䊏 Approaches to Understanding Eating Disorders; Anorexia Nervosa;

Bulimia Nervosa (Binge–Purge Syndrome)

Disturbances in Substance Use 419
䊏 Distinctions Between Abuse and Dependence; Approaches to

Understanding Substance Abuse; Some Drugs of Choice

Disturbances With Sexuality and Gender Identity 421
䊏 Approaches to Sexual Dysfunction; Sexual Dysfunction; Paraphilias; Gender

Identity Disorder; Sex Therapy

Disturbances of Psychosis, Memory, and Other Cognitive Functions 424
䊏 Approaches to Understanding Schizophrenia; Symptoms of Schizophrenia;

Dissociative Disorders
 Contents xxv

Disturbances in Personality 426

䊏 Approaches to Understanding Problems With Personality; Odd Personality

Disorders; Dramatic Personality Disorders; Anxious Personality Disorders

Disturbances in Childhood 428

䊏 Approaches to Understanding Childhood Disturbances; Mental Health

Problems in Childhood; Elimination Disorders; Chronic Disorders

Beginning in Childhood

Disturbances Related to Aging and Cognition 431

䊏 Problems With Cognition and Neurology in Older Adults; Mood

Disorders in Older Adulthood

part three
What Are the Fundamental Components
of Appraisal and Research That New Counselors
Should Use in Their Practice? 433

chapter Foundations of Measurement and Psychometrics 434

20
Statistics: A Brief Introduction 435
䊏 Ethics in Statistical Research; Differentiation Between Descriptive and

Inferential Statistics: Some Basics

Descriptive Statistics 436

䊏 Scales of Measurement; Measures of Central Tendency: Mean, Median, and

Mode; Measures of Dispersion: Range, Variance, and Standard Deviation;

Distribution; Percentile

Inferential Statistics 441

䊏 Probability; Standard Scores; Tests of Significance

Reliability 445
䊏 Classical Test Theory; Importance of Reliability; Measurement of Reliability;

Methods of Estimating Reliability; Standard Error of Measurement; The

Confidence Interval

Validity 449
䊏 Content Validity; Face Validity; Construct Validity; Criterion-Related

Validity
xxvi Contents

Test Construction 453

䊏 Methods of Test Development; Writing the Items; Item Try-Out;

Normative Sample; Writing the Manual

chapter Testing and Assessment in Counseling Practice 458

21
Overview of Assessment 460
䊏 Uses of Assessments; Professional Organizations Supporting Assessment

Assessment Process 461

䊏 Review Referral Information; Decide Whether to Take the Case; Obtain

Background Information; Consider Systematic Influences; Observe the

Client in Several Settings; Select and Administer an Appropriate Test
Battery; Interpret Results; Develop Intervention Strategies; Document the
Assessment; Meet With Concerned Individuals; Follow Up on
Recommendations

Cognitive Assessment 463

䊏 Nature of Intelligence; Stanford–Binet Intelligence Test; Wechsler Scales;

Woodcock–Johnson Scales

Educational Assessment 468

䊏 Achievement Tests; Aptitude Tests; Psychoeducational Test Batteries

Personality Assessment 472

䊏 Rorschach Psychodiagnostic Test; Thematic Apperception Test; Minnesota

Multiphasic Personality Inventory; MMPI-A; NEO Personality

Inventory–Revised

Behavioral Assessment 475

䊏 Self-Report; Direct Observation; Behavior Rating Scales

Neuropsychological Assessment 478

䊏 The Mini Mental State Examination; The Wechsler Memory Scale–Third

Edition; The Halstead–Reitan Neuropsychological Battery

NEPSY 480

Interest in Employment 480

䊏 Strong Interest Inventory; Armed Services Vocational Aptitude Battery;

General Aptitude Test Battery; Myers–Briggs Type Indicator

Assessment of Organizational Culture 483

䊏 Discussion of Organizational Culture; Job Descriptive Index; Minnesota

Satisfaction Questionnaire; Organizational Commitment Questionnaire

 Contents xxvii

chapter Quantitative Research Designs 486

22 Foundations of Research Design 487
䊏 The Hypothesis; Types of Research Hypotheses; The Null Hypothesis;

Decision to Reject or Accept the Null; Alpha or Significance Level; Point

Estimates and Confidence Intervals; Hypothesis Testing
Experimental Research 491
䊏 Manipulation; Random Assignment; Controlling for Confounds; Treatment

Integrity; Manipulation Check; Settings for Conducting Experiments

Experimental Validity 495
䊏 Internal Validity; External Validity

Basic Experimental Design 497

䊏 One Group Posttest Only Design; Treatment–Control Posttest Only; One

Group Pretest–Posttest Design; Pretest–Posttest Control Group Design;

Posttest Only Design; Treatments and Concomitant Variables; Factorial
Designs; Solomon Four-Group Design
Quasi-Experimental Designs 502
䊏 The Nonequivalent Control Group Design; Interrupted Time-Series

Design; Counterbalanced Designs; Single Case Experimental Designs;

Multiple-Baseline Designs; Alternating Treatments Design and Changing
Criterion Design
Nonexperimental Research Designs 507
䊏 Classifications of Independent Variable; Purposes of Nonexperimental

Research Design; Types of Nonexperimental Designs; Combining

Experimental and Nonexperimental Designs; Interpretation of
Nonexperimental Research; Longitudinal Research

chapter Fundamentals of Qualitative Research 512

23 Roots of Qualitative Research 513
䊏 Cultural Anthropology; Sociology; Education

Meaning in Qualitative Research 514

䊏 The World Is Meaningful; Some Things Are Only Meaningful; Knowledge

Depends on Understanding
How to Recognize Qualitative Research 516
䊏 Natural Setting; Holistic Approach; Researcher Involvement

Basic Techniques of Qualitative Research 517

䊏 Observation; Interviews; Participation; Interpretation

Basic Products of Qualitative Research 520

䊏 Ethnography; Case Study; Grounded Theory; Material Analysis
xxviii Contents

The Role and Future of Qualitative Research in Counseling 524

䊏 Qualitative Research Tackles Complex Questions and Issues; Counselors

and Qualitative Researchers Share Similarities; Qualitative Research

Provides Possibility and Freedom

part four
What Are the Special Topics and Important Trends That
Counselors Might Encounter? 527

chapter A Look at Consultation 528

24 Historical Evolution of Consultation 529
䊏 Clinical or Expert Approach; Organizational Consultation; Client-Centered

Consultation; Total Quality Management Approach; Social Work

Perspective; Definition of Consultation; The Counselor as Consultant;
Stages in Consultation
Theories of Consultation 533
䊏 Person-Centered Theory of Consultation; Learning Theory of

Consultation; Gestalt Theory of Consultation; Psychoanalytic Theory of

Consultation; Chaos Theory of Consultation
The Consultation Relationship 535
䊏 Consultant-Centered Orientation; System-Centered Orientation

Mental Health Consultation 536

䊏 Definition of Mental Health Consultations; Basic Characteristics of Mental

Health Consultation; Psychodynamic Orientation of Mental Health

Counseling; Types of Mental Health Consultation
Behavioral Consultation 539
䊏 Definition of Behavioral Consultation; Characteristics of Behavioral

Consultation; Bergan and Kratochwill’s Model of Behavioral Consultation

Organizational Consultation 542
䊏 Definition of Organizational Consultation; Use of Systems Theory;

Diagnosing Organizational Problems; Content and Process Consultation;

Organizational Paradigm; Paradigm Shift
School-Based Consultation 545
䊏 Collaboration; Types of School Consultation; Theoretical Approach to

School Consultation
Chapter Summary 548
 Contents xxix

chapter Crisis Intervention in Counseling 550

25
Understanding Crisis and Crisis Intervention 551
䊏 Definition of Crisis; Types of Crisis; Crisis in Culture; Characteristics of an

Effective Crisis Counselor

Differences Among Psychological Emergency, Crisis, and Trauma 555

䊏 Psychological Emergency; Crisis; Trauma

Crisis Response: The Six-Step Model of Intervention 559

䊏 Step 1: Define the Problem; Step 2: Ensure Safety; Step 3: Provide Support;

Step 4: Examine Alternatives; Step 5: Make Plans; Step 6: Obtain

Commitment

Crisis Assessment: Using the Triage Assessment Form 562

䊏 Assessment of Crisis Reactions; Severity Scales

Trends in Crisis Intervention 564

䊏 Contextual Models; Strength-Based Approach; Systemic Approach

chapter Addictions Counseling 568

26
Fundamentals of the Addictive Process 569
䊏 The Use–Dependence Continuum; Classifications of Dependence;

Progression; Hallmarks of Addictive Behavior; Tolerance and Withdrawal

Models of Addiction 572

䊏 Moral; Medical and Disease; Spirituality; Impulse Control; Genetic; Social

Learning; Bio-Psycho-Social; Cultural Implications for Addiction Models

Screening and Assessment 574

䊏 Physiological and Behavioral Assessment; Clinical Interviewing;

Psychometric Instruments; Diagnosis and Co-occurring Disorders;

Intervention Level Assessment

Intervention and Treatment Considerations 579

䊏 Crisis Management; Stages of Behavioral Change; Treatment Modalities;

Beyond Addiction Management; Dual Diagnosis; Pharmacological

Interventions; Special Populations; Defining Successful Treatment; Legal,
Ethical, and Professional Issues
xxx Contents

chapter Ecological-Transactional and Motivational Perspectives

27 in Counseling 586

Background to the Ecological-Transactional Model 587

䊏 Best Practices in Counselor Education: Emphasis on Context and Culture;

Deficits of Traditional Theories in Counselor Education

An Ecological-Transactional Developmental Framework 588

䊏 Learning Theory: Vygotsky; Attachment Theory: Bowlby; Bioecological

Human Development: Bronfenbrenner

The Ecological-Transactional Model and Professional Counseling 591

䊏 Developmental Psychopathology; Resilience; Assessing Risks and Protective

Factors

Self-Determination Theory? 593

䊏 Organismic and Dialectical Underpinnings of Self-Determination Theory;

Basic Psychological Needs and the Social Context; Reasons for

Nonintrinsic Actions; Motivation

Relating Self-Determination Theory to the Helping Professions 598

䊏 Blocks to Clients’ Motivation Toward Change; How Can Counselors Help

Motivate Clients for Change?; Empirical Evidence for Self-Determination

Theory and Autonomy Support; Recommendations for Providing an
Autonomy Supportive Context

Conclusion 603

chapter Neuroscience in Psychotherapeutic Practices 606

28
Neuroscience and Psychotherapeutic Practices 607
䊏 Neuroscience and Psychotherapy: Early Connections; What Is

Neuroscience and Why Is It Important to Therapists?

The Nervous System 607

䊏 Systems Within the Nervous System; Neurons; Action Potential;

Autonomic Nervous System

The Brain 609

䊏 The Cerebral Cortex; The Forebrain; Midbrain; Hindbrain

Facilitating Neural Change 613

䊏 How Does Neural Change Occur?; Principles for Brain-Based

Psychotherapy; Understanding Schemas; Dealing With Problematic

Schemas; Changing View About Incoming Stimuli; Impact of Stress on
Neural Change; Utilizing the Hemispheres
 Contents xxxi

Ensuring Lasting Neural Change 616

䊏 Automization of Internalized Processes; Monitoring Change in Client

Thinking; Monitoring Change in Clients’ Executive State; Techniques for

Engaging Emotional States
Clients With Processing Deficits 618
䊏 Effectiveness of Cognitive Remediation Therapy; Cautions When Using

Cognitive Rehabilitation
Attention-Related Processing Deficits 619
䊏 Individualizing the Length of Therapy Sessions; Use of Cues

Memory-Related Processing Deficits 620

䊏 Rehearsal; Mnemonic Strategies; Labels, Notebooks, and Calendars; Spaced

Retrieval
Executive Functions Deficits 621
䊏 Goal Management Training; Other Approaches to Helping Clients With

Executive Functioning Deficits

Summary 622

chapter Developmental Counseling and Therapy 624

29
Historical Context of Developmental Counseling and Therapy 625
䊏 Influences of Piagetian Cognitive-Emotional Developmental Theory;

Influences of Life-Span Developmental Theory; Influences of Postmodern

Theory; Influences of Wellness Theory and Research; Impact of Traditional
Theories of Counseling and Psychotherapy; Influence of Multicultural
Counseling
Underlying Philosophy of Developmental Counseling and Therapy 626
䊏 Developmental Nature of Being; Multidimensionality in Developmental

Counseling and Therapy; Cultural Relevancy of Developmental Counseling

and Therapy
Modes of Consciousness in Developmental Counseling and Therapy 628
䊏 Sensorimotor-Elemental Style; Concrete-Situational Style;

Formal-Operational Style; Dialectic-Systemic Style

Developmental Counseling and Therapy Approach to Wellness 632
䊏 The Indivisible Self: Evidence-Based Model of Wellness; Core Factors of

the Indivisible Self

Fundamentals of Systemic Cognitive Developmental Therapy 634
䊏 Defining Disorder from the Systemic Cognitive Developmental Therapy

Perspective; Assessment in Systemic Cognitive Developmental Therapy;

Treatment in Systemic Cognitive Developmental Therapy
xxxii Contents

Developmental Counseling and Therapy Techniques: Developmental Strategies

Questioning Sequence 636
䊏 Questioning Strategies in the Opening Presentation of Issue; Questioning

Strategies in the Sensorimotor-Elemental Style; Questioning Strategies in

the Concrete-Situational Style; Questioning Strategies in the
Formal-Pattern Style; Questioning Strategies in the
Dialectic-Systemic-Integrative Style

Role of the Therapist in Developmental Counseling and Therapy 639

䊏 Precision Matching; Active Engagement of the Therapist

Evaluation of Developmental Counseling and Therapy 640

chapter Counseling for Wellness 642

30
Historical Context of the Wellness Movement 643
䊏 Philosophical Groundwork of Wellness; Counseling-Based Approach to

Wellness

Modern Definitions of Wellness 643

䊏 Differentiation Between Health and Wellness; Multiple Understandings of

Wellness; Wellness Defined From a Counseling Perspective

Wellness Models 645

䊏 Wheel of Wellness Model; Indivisible Self (IS-WEL): Evidence-Based Model

of Wellness

Assessment Tools for Examining Wellness 648

䊏 The Wellness Evaluation of Lifestyle; The Five Factor Wellness Inventory

Counseling for Wellness 650

䊏 Step 1: Introduction of the Wellness Model; Step 2: Assessment of the

Components of the Wellness Models; Step 3: Intentional Interventions to

Enhance Wellness; Step 4: Evaluation and Follow-Up; Strengths and
Limitations

chapter Spirituality and Pastoral Counseling Practices 658

31
The Importance of Spirituality in Counseling 659
䊏 Spirituality in Professional Counseling and Psychology Organizations;

Spirituality in American Society

Pastoral Counseling and Related Ideology 660

䊏 Religion and Spirituality; Spirituality and Counseling; Evolution of Pastoral

Counseling
 Contents xxxiii

Ethics, Spirituality, and Counseling 663

䊏 Ethical Decision-Making Criteria; Purpose of Ethical Codes; Counselor

Competence; Supervision
Psychodynamic Theories and Spirituality 665
䊏 Freud and Psychoanalysis; Jungian Psychology

Existential and Phenomenological Theories and Spirituality 667

䊏 Frankl and Logotherapy; May and Existentialism; Rogers and

Client-Centered Theory; Perls and Gestalt Therapy

Behavioral Theories and Spirituality 671
䊏 Watson and Behaviorism; Skinner and Behavioral Conditioning; Lazarus

and Multimodal Therapy

Cognitive and Cognitive Behavioral Theories and Spirituality 673
䊏 Glasser and Choice Theory; Ellis and REBT

Conclusion 674

appendix Preparing for the National Counselor Exam:

A What You Need to Know 675

appendix Your Online Companion in Electronic Case Management:

B An Introduction to Penelope Software 721

appendix Hints, Helps, and FAQs About Working in a Managed Care

C Environment 731

References 741
Index 785
 Preface

THE STORY BEHIND THE COUNSELOR’S COMPANION

This book was born out of the belief that having a quick, reference-style resource
can provide new counselors not only with valuable information but also with a
sense of assuredness and a way to bridge the gap between what they learned in the
classroom and the challenges they meet in their practice.
In our interactions with newly graduated counselors and with students soon
to be completing their graduate programs, we often hear them express uncer-
tainty about how to proceed after graduation. While they are in the midst of their
counseling programs, students are surrounded by support systems. Professors
encourage and coach them as they work toward the goal of graduating; supervi-
sors and colleagues at practicum and internship sites provide critical feedback
that counselors can rely on to fine-tune their techniques and skills. Yet, once these
beginning practitioners are in the field and expected to fulfill their counseling
role, they often experience a sense of loss and even can become overwhelmed
with questions that arise in their clinical interactions. Each experience with a cli-
ent may make counselors aware of lapses in their formation. Even if they are able
to form a support system similar to the one they had in graduate school, there is
still little succinct and practical information available to help counselors who are
just getting started.
What students need is a reference tool to help them answer questions and pro-
vide them with the support they need after just graduating. This idea of a compre-
hensive reference book reminded us of similar books used in other fields, such as
the Physician’s Desk Reference (PDR) used by doctors or the Monthly Index of Medical
Specialties (MIMS) that aids pharmacists. We both agreed that this type of overall
reference book tailored to counseling topics would fill this gap for counselor
trainees and so this text was begun.

ORGANIZATION OF THE COUNSELOR’S COMPANION

The contents of this book are guided by the core curriculum of the Council for Ac-
creditation of Counseling and Related Programs (CACREP), and information is in-
tentionally presented in brief form so that the main points of each section are con-

xxxv
xxxvi Preface

cise, clear, visible, and easily accessible. Moreover, the information presented here
is a collection of contributions from counselor educators and professionals in the
field, each offering a chapter or chapters on the areas of their counseling expertise.
The use of various contributors adds a diversity of viewpoints and ensures that
knowledgeable and experienced counselor educators and practitioners provide
quality content. We hope that this book will become a support system for students
who have left their supervisors and teachers behind after graduation.
A wide variety of topics are introduced in this text that familiarize readers with
more traditional theories and ideas as well as some cutting-edge areas as seen in
the chapter on using neuroscience in counseling and the chapter describing an eco-
logical approach to therapeutic interventions. Students and new counselors will
find that this book is an important resource companion for the duration of their ed-
ucational careers and beyond.
To help readers get acquainted with the layout of the book, we briefly outline the
four main parts within which the contents are packaged. Each part is framed by a
broad question that we believe new counselors may ask of themselves as they be-
gin their professional endeavors.
Part I asks “What are the primary roles and responsibilities of the professional
counselor?” To answer this question, the first part of the book looks at the following
areas:

1. On Being a Professional Counselor.

2. The Demands and Obligations of Ethical Counseling.
3. The Legal Intrigues of Counseling Practice.
4. Multicultural Intricacies in Professional Counseling.
5. Supervision, an Essential for Professional Counselor Development.
6. Collaborative Supervision for the Novice Supervisor.

Part II asks, “What are the essential elements of counseling with which all coun-
selors must be familiar?” In response to this question, the second part of the book
addresses the following areas:

7. Understanding Human Growth and Development.

8. Counseling Across the Life Span.
9. Major Forces Behind Counseling Approaches.
10. Individual and Social Aspects of the Helping Relationship.
11. The Cultural Kaleidoscope: Eyeing Diverse Populations.
12. Approaches to Group Work.
13. Fundamentals of Group Work.
14. Multicultural Components of Group Work.
15. Counseling in the World of Work.
16. Multicultural Issues in Career and Lifestyle Counseling.
17. Fundamentals of Professional School Counseling.
18. Approaches to Family Counseling.
19. Understanding and Assessing Psychopathology.
 Preface xxxvii

Part III asks, “What are the fundamental components of appraisal and research
that new counselors should use in their practice?” To answer this inquiry, the third
part discusses the following areas:

20. Foundations of Measurement and Psychometrics.

21. Testing and Assessment in Counseling Practice.
22. Quantitative Research Designs.
23. Fundamentals of Qualitative Research.

Part IV asks, “What are the special topics and important trends that counselors
might encounter?” In response to this final query, the fourth part addresses the fol-
lowing areas:

24. A Look at Consultation.

25. Crisis Intervention in Counseling.
26. Addictions Counseling.
27. Ecological-Transactional and Motivational Perspectives in Counseling.
28. Neuroscience in Psychotherapeutic Practice.
29. Developmental Counseling and Therapy.
30. Counseling for Wellness.
31. Spirituality and Pastoral Counseling Practices.

SPECIAL FEATURES OF THE COUNSELOR’S COMPANION

There are several features and enclosures in this book that make it especially ap-
pealing to newly graduating counseling students and beginning practitioners.
These aspects transform the book from a text that counselors read to a tool they can
readily use.

䊏 NCE Sample Exam

One of special features of The Counselor’s Companion is the sample National Coun-
selor Exam (NCE) that is included in Appendix A. Most states today use the NCE
as the exam of choice in their licensure process. The types of questions that are
posed and the topic areas that are covered in the sample exam are modeled after the
NCE, and, as such, the sample exam is an invaluable preparation tool for graduat-
ing students and beginning counselors who are aimed at obtaining state licensure.

䊏 Penelope: Online Case Management Software

Another unique aspect of The Counselor’s Companion is the cutting-edge software

package to which users can subscribe at the introductory price of just $7.95 (for a
xxxviii Preface

120-day trial period) with the purchase of this text. Penelope is an online case man-
agement software package suitable for human services professionals that is down-
loadable or accessible via the World Wide Web. This piece of software is an excel-
lent example of the type of case management program that is utilized in counseling
offices and agencies today. By interacting with Penelope, users, and especially
newly graduating students, will have the chance to become familiar with how on-
line case management works and increase their marketability as professionals.
Penelope offers a multitude of unique features, only a few of which include a sys-
tem for creating client case notes, assessment tools, billing features, and much
more. Appendix B more fully introduces the software and walks users through
some of the basic steps in interacting with the program.

䊏 Tips and Hints for Working in the World of Managed Care

Included in Appendix C is a set of helpful tips and answers to frequently asked

questions about practical, day-to-day issues that practitioners encounter, such as,
“How do I go about purchasing liability insurance? How do third-party reimburse-
ments take place? How do I get approved as an insurance payee?” Many other sim-
ilar questions also are addressed.

SENDING YOU FORTH WITH THE COUNSELOR’S COMPANION

We hope that readers will find that The Counselor’s Companion complements their li-
brary of counseling books. In its usefulness and indispensability, we believe The
Counselor’s Companion will become the primary reference book for graduate coun-
seling students, beginning counselors, and even practitioners in the field—a text
they can access over and over again.
We encourage users to take full advantage of the special features of this book,
such as the sample NCE, the opportunity to subscribe to Penelope at a minimal
cost, and the helpful hints for working in a managed care environment. Most of all,
we hope that The Counselor’s Companion will be for you a reliable resource and tool
that enhances your professional practice, knowledge, and skill as a counselor!

—Jocelyn Gregoire & Christin M. Jungers

Acknowledgments

First and foremost, we wish to express our sincere gratitude to all of the contribu-
tors who have so willingly offered their time, talents, and expertise in order to en-
rich the quality of this book. Moreover, their cooperation and conscientiousness
helped to ensure that the entire editing process ran smoothly and in a timely man-
ner.
A special vote of thanks goes to Steve Rutter, our editor, whose vision, experi-
ence, and excitement helped us to see “outside the box” of possibilities for this
book, and also to Nicole Buchmann, our editorial and research coordinator, who
provided her valuable input. Both Steve and Nicole have been our greatest sup-
porters throughout the various phases of the writing, editing, and publication pro-
cesses. A sincere thank also goes to Sara Scudder, the production supervisor, and
the copy editing team at LEA, whose hard work and dedication not only contrib-
uted to the quality of the book, but also enabled us to stay on schedule with produc-
tion.
Our appreciation also goes to all those whose input and feedback has been in-
valuable throughout the process of compiling this manuscript. We would like to
thank Jonathan Impellizzeri and Jennifer Dougherty, who diligently helped us to
get the manuscripts organized. Thank you, as well, to all those close to us—family
and friends—who have supported and encouraged us throughout this process. To
each and every one: Your support has been priceless!

xxxix
Meet the Contributors

Elizabeth Antkowiak is a clinical counselor for the Perinatal Addiction Center, a

division of Western Psychiatric Institute and Clinic. She instructs counselors at
PAC in applying Dialectical Behavior Therapy to women who are pregnant and
dually diagnosed. Elizabeth can be contacted at: [email protected].

Paul Bernstein, PhD, is an Associate Professor at Duquesne University as well as

the founder and President of Pennsylvania Psychological Services. He is a certified
school psychologist, a licensed psychologist, and a licensed professional counselor.
He can be contacted at: [email protected].

Dan-Bush Bhusumane, MEd, is a doctoral candidate in the Counselor Education

and Supervision Program at Duquesne University and also teaches at the Univer-
sity of Botswana. He can be contacted at [email protected].

Kimberly A. Blair, PhD, is an Assistant Professor in the Department of Psychiatry,

University of Pittsburgh School of Medicine. She also serves as the Director of the
Matilda Theiss Child Development Center at Western Psychiatric Institute and
Clinic, which is part of the University of Pittsburgh Medical Center. Dr. Blair’s aca-
demic training is in applied developmental and school psychology, with a special-
ization in early childhood emotional and behavioral disorders. She can be con-
tacted at: [email protected].

Dr. Lancelot I. Brown is an Assistant Professor in the Department of Foundations

and Leadership at Duquesne University. His research interests focus on the Carib-
bean and address the role of school leadership and other organizational and wider
systemic factors that impact the effectiveness level of the school. He is an Associate
Editor for the journal Educational Measurement: Issues and Practice. Lancelot can be
contacted at: [email protected].

William J. Casile, PhD, is an Associate Professor in the Counseling, Psychology,

and Special Education Department at Duquesne University. He also is the coordi-
nator of the doctoral program in Counselor Education and Supervision at
Duquesne. Dr. Casile can be contacted by email at: [email protected].

Pamela Cogdal, PhD, is an Assistant Professor in the Counseling, Educational Psy-

chology and Research Department at the University of Memphis. Dr. Cogdal also

xli
xlii Meet the Contributors

serves as the coordinator of psychological assessment for the Center for Rehabilita-
tion and Employment Research. Dr. Cogdal is a licensed psychologist and has been
teaching in the field of counseling and counseling psychology since 1989. She can
be contacted at the University of Memphis at (901) 678-4931.

Christian Conte, PhD, is an Assistant Professor in the Counseling and Educational

Psychology Department at the University of Nevada, Reno. Questions or com-
ments can be directed to [email protected]; or by phone (775) 784-6637 ext 2068.

Hugh C. Crethar, PhD, is an Assistant Professor in the School Counseling and

Guidance Program of the Department of Educational Psychology at the University
of Arizona. He is on the Executive Board of the National Institute for Multicultural
Competence, has served in numerous positions within the American Counseling
Association, and is currently President Elect of Counselors for Social Justice. His
work centers on promoting multicultural competence and advocacy competence in
the field of counseling. He can be contacted at: [email protected].

Carol A. Dahir, EdD, is an Associate Professor in counselor education at the New

York Institute of Technology (NYIT). Carol has co-authored of The National Stan-
dards for School Counseling Programs (1997), School Counselor Accountability: A Mea-
sure of Student Success 2e (2007), and The Transformed School Counselor (2006) and
writes and presents extensively about school counseling programs and account-
ability. Carol can be contacted at NYIT, School of Education, 21 West 60th St. New
York, NY 10023, 516 686-7777 or by e-mail at [email protected]

David L. Delmonico, PhD, is an Associate Professor at Duquesne University. He is

the Editor-in-Chief of Sexual Addiction and Compulsivity: Journal of Treatment and Pre-
vention, as well the co-founder of Internet Behavior Consulting. He can be contacted
at [email protected].

Dr. Grafton Eliason is an Assistant Professor in the Department of Counselor Edu-

cation and Services at California University of Pennsylvania. He has taught courses
in death, dying, and spirituality and has a special interest in existential philosophy
and religion. He also has earned an MDiv from Princeton Theological Seminary
and an MEd in School Counseling from Shippensburg University. He is a National
Certified Counselor (NCC), Licensed Professional Counselor (LPC) in Pennsylva-
nia, Certified School Counselor (K-12) in Pennsylvania, and he is an Ordained Pres-
byterian Minister. He can be contacted through email at: [email protected].
Co-authors for Dr. Eliason’s chapter are Colleen Triffanoff, a counselor at Thomas
Jefferson High School, and Maria Leventis, who is associated with Pace University.

Tara Greene is a doctoral student in the School Psychology Program at Duquesne

University. She earned her BS from Allegheny College in Neuroscience and Psy-
chology and her Master’s degree from Duquesne University in Child Psychology.
She can be contacted by email at: [email protected].
 Meet the Contributors xliii

L. Jocelyn Gregoire, CSSp, EdD, co-editor of this text, is a Roman Catholic priest
and an Assistant Professor in the Counseling, Psychology, and Special Education
Department at Duquesne University. Dr. Gregoire splits his time between teaching
at Duquesne University and working as a missionary in the Republic of Mauritius
in the Indian Ocean. He can be contacted at: [email protected].

Elizabeth J. Griffin, MA, LMFT, is the co-founder of Internet Behavior Consulting

and works as a therapist, consultant, and trainer in the area sexual addiction. She
can be contacted at: [email protected].

Elizabeth A. Gruber is an Associate Professor in the Counselor Education and Ser-

vices Department at California University of Pennsylvania. She serves as the field
coordinator for the clinical experience in the department. She has been at California
University since 1988. During that time, she also worked in the University Coun-
seling Center and coordinated their drug and alcohol programs. She is currently a
doctoral candidate at Duquesne University. She can be contacted at: Gruber@
cup.edu.

Arpana Gupta, MEd, is a doctoral student in the Counseling Psychology program

at the University of Tennessee, Knoxville. She obtained her Master’s from Wake
Forest University in counseling. Her research interests include cultural/racial
identity issues, the process of acculturation, stereotype threat, and discrimination
experienced by Asian Americans, mental health problems specifically related to
suicide in Asian Americans, Asian American public policy, and quantitative re-
search methods such as meta-analyses and structural equation modeling. She can
be contacted at: [email protected].

Erin E. Hardin, PhD, is an Assistant Professor in the Counseling Psychology Pro-

gram in the Psychology Department at Texas Tech University. She is interested in
multicultural psychology, with a focus on cultural differences in the self (e.g.,
self-construal, self-discrepancy) and implications for both career and personal
counseling. She can be contacted at: [email protected].

Stephanie D. Helsel, MS Ed, is pursuing a doctoral degree at Duquesne Univer-

sity, in the Counselor Education and Supervision program. Her clinical work cur-
rently is in the areas of chemical dependency as well as employee assistance coun-
seling. She can be reached at: [email protected].

Tammy L. Hughes, PhD, is an Associate Professor of School Psychology with

Duquesne University and a certified school psychologist. Her work experience in-
cludes assessment, counseling,and consultation services in forensic and juvenile
justice settings focusing on parent–school–interagency treatment planning and in-
tegrity monitoring. She can be contacted at [email protected]. Coauthors are cur-
rently associated with the Duquesne University School Psychology Program and
include Erinn Obeldobel, MS Ed, [email protected], Susie
xliv Meet the Contributors

Mclaughlin, EdD, [email protected], and Jamie King, MS Ed,

[email protected].

Allen E. Ivey, EdD, ABPP is Distinguished University Professor at the University

of Massachusetts, Amherst and is Courtesy Professor at the University of South
Florida, Tampa. Allen also is the President of Microtraining Associates, Inc., and he
is known for defining the microskills of the interview and the integative theory De-
velopmental Counseling and Therapy. He is the author of over 40 books and 200
articles. Dr. Ivey’s recent focus is on spirituality in counseling and on neuro-
psychotherapy. He can be contacted at: [email protected].

Christin M. Jungers, MS Ed, co-editor of this text, is a doctoral candidate in the

Executive Counselor Education and Supervision (ExCES) Program at Duquesne
University. She is a Licensed Professional Counselor and a National Certified
Counselor. Her research interests lie in the area of aging and adult development as
well as counselor identity and development. She can be contacted by email at:
[email protected].

Steven P. Kachmar, MA, is a PhD candidate in the School Psychology Program at

Duquesne University. He received his Master of Arts degree in Counseling Psy-
chology from Kutztown University of Pennsylvania in May 2003. His interests in-
clude early childhood care and education center quality, appropriate early child-
hood assessment and intervention, and therapeutic interventions across the
lifespan. He can be contacted through email at: skachmar.msn.com.

Barbara Keaton, PhD, is the president and senior consultant of Keaton Resources.
She can be contacted through email at: [email protected].

Mariellen Kerr is completing her doctoral studies at Duquesne University and can
be contacted at [email protected]. She has had the pleasure of serving as
an elementary counselor and department head for 16 years and was awarded the
Pennsylvania Elementary School Counselor of the Year award for 2006.

Maura Krushinski, EdD, is an Assistant Professor in the Counseling, Psychology,

and Special Education Department at Duquesne University. Dr. Krushinski is the
Coordinator of the Counseling Department at Duquesne; she also is a Licensed
Psychologist, a Licensed Professional Counselor, and a National Certified Coun-
selor. She can be contacted by email at: [email protected].

Stacie A. Leffard, MS Ed, is a doctoral student in the School Psychology Program

at Duquesne University. She can be contacted at: [email protected].

Dr. Frederick T. Leong is Professor of Psychology at Michigan State University and

is affiliated with the Industrial/Organizational and Clinical Psychology programs.
He has authored or co-authored over 100 articles in various counseling and psy-
chology journals, 50 book chapters, and also edited or co-edited 8 books. He is Edi-
 Meet the Contributors xlv

tor-in-Chief of the Encyclopedia of Counseling, which is in preparation. Dr. Leong can

be reached at: [email protected].

Lisa Lopez Levers, PhD, is an Associate Professor in the Counseling, Psychology,

and Special Education Department at Duquesne University. Her research interests
include childhood trauma and, more recently, HIV/AIDS in Africa. She can be con-
tacted by email at: [email protected].

Martin F. Lynch, PhD, is an Assistant Professor at the University of South Florida/

Sarasota-Manatee. He can be contacted by email at: [email protected].

Jeffrey A. Miller, PhD, ABPP is an Associate Professor as well as the Associate

Dean for Graduate Studies and Research at Duquesne University. He also is the As-
sociate Editor for the Journal of Psychoeducational Assessment. He can be contacted by
email at: [email protected]. Nate Kegal and Julie Williams, co-authors for Dr.
Miller’s chapters, are associated with the Duquesne University School Psychology
Program.

Rick Myer, PhD, is an Associate Professor at Duquesne University and a licensed

psychologist with primary research interests in the area of crisis intervention. He is
the developer of the Triage Assessment Model, a tool widely used in crisis inter-
vention. Dr. Myer can be contacted by email at: [email protected].

Jane E. Myers, PhD, is a Professor in the Department of Counseling and Educa-

tional Development at the University of North Carolina-Greensboro. Jane can be
reached through email at: [email protected].

Sherlon P. Pack-Brown is a Professor in the Mental Health and School Counseling

Program at Bowling Green State University, Bowling Green, Ohio. She received her
doctorate in guidance and counseling from the University of Toledo, Toledo, Ohio.
She is an Ohio licensed professional clinical counselor with supervisory status, a
Fellow of the American Counseling Association (ACA), past president of the Asso-
ciation for Multicultural Counseling and Development, and past chair of the ACA
Ethics Committee. She can be contacted at: [email protected].

Sandra A. Rigazio-DiGilio, PhD, is a Professor in the Marriage and Family Ther-

apy Program at the University of Connecticut’s School of Family Studies. She can
be contacted by email at: [email protected].

Seth N. Rosenblatt is a doctoral candidate at Duquesne University in Pittsburgh,

Pennsylvania where he serves as a counselor supervisor, adjunct professor, univer-
sity counselor, and advisor. He received his master’s degree in Student Personnel
Services in Higher Education from Eastern Kentucky University. His dissertation
investigates the application of counseling theory and the cognitive exploration
process by which personal counseling philosophies are attained. He can be con-
tacted by email at: [email protected].
xlvi Meet the Contributors

Lori Russell-Chapin received her PhD from the University of Wyoming. She is a
Professor of Education at Bradley University in Peoria, Illinois where she teaches
graduate counseling practicum and internship courses and an introductory coun-
seling survey course. Lori currently is the Associate Dean of the College of Educa-
tion and Health Sciences. She has been conducting supervision workshops
throughout the world. Please contact her at 309-677-3186 and [email protected].

Dr. Gary Shank is a Professor of Educational Research at Duquesne University. He

is the author of numerous articles on qualitative research and semiotics. He is also
the author of Qualitative Research: A Personal Skills Approach (2nd Ed) and the co-au-
thor of Exploring Educational Research Literacy (forthcoming). Dr. Shank can be
reached at: [email protected].

Leslie Slagel, MS Ed, is a doctoral candidate in the Counselor Education and Su-
pervision Program at Duquesne University. She also is employed by the Women’s
Center and Shelter of Greater Pittsburgh where she counsels abused women. Leslie
can be contacted through email at: [email protected].

Rex Stockton, EdD, is a distinguished Chancellor’s Professor of Education at Indi-

ana University, Bloomington. He has spent his career investigating aspects of
group dynamics and factors of therapeutic change in groups. He can be contacted
by email at: [email protected].

Carolyn Stone, EdD, is an Associate Professor and co-program leader in the Col-
lege of Education and Human Services at the University of North Florida. Dr. Stone
specializes in the areas of counselor education and school counseling, with an em-
phasis on ethics and legal issues in school counseling. She is the president of the
American School Counselor Association (2006/2007). She can be contacted at:
[email protected].

Ellen Swaney, MS Ed, has 12 years of experience in career counseling and corpo-
rate consulting. She obtained her Master’s degree in counseling from Duquesne
University, and her Bachelor’s degree in business from Indiana University of Penn-
sylvania. She can be contacted by email at: [email protected].

Thomas J. Sweeney, PhD, is a Professor Emeritus in Counseling and Higher Edu-

cation at Ohio University. He can be contacted by email at: [email protected].

Leann J. Terry is a doctoral student in counseling psychology at Indiana Univer-

sity, Bloomington. Her research and scholarly interests include group counseling
trainings in Africa as a way to address psychosocial needs stemming from HIV/
AIDS and the unmet mental health needs of international students in the United
States. She can be contacted at [email protected] or through writing at: 201 N.
Rose Avenue, Bloomington, IN 47401.
 Meet the Contributors xlvii

Carol A. Thomas earned her master’s degree in school counseling from Duquesne
University and is currently a doctoral candidate in Duquesne University’s Coun-
selor Education and Supervision Program. She has worked as Director of School
Counseling in the Western Beaver County School District for the last seven years.
Carol can be reached by email at: [email protected].

Laurie Vargas, MS, is a mental health counselor with the San Francisco Unified
School District and spends much of her time working with the multi-cultural and
social justice issues her families face. She can be contacted by email at: l.vargas@
earthlink.net.
 part one

What Are the Primary Roles

and Responsibilities
of the Professional Counselor?
chapter On Being a Professional Counselor

1 Lisa Lopez Levers

Duquesne University

In This Chapter

䉴 A Brief History of the Counseling Profession

䊏 Theoretical Shifts

䊏 Specialization

䊏 Professionalization

䉴 The Counselor’s Identity

䊏 The Diversity of Counselor Identities

䊏 How Counseling Differs From Psychology and Social Work

䊏 Characteristics of an Effective Counselor

䉴 Professionalism
䊏 Training for Professional Counselors

䊏 Licensure

䊏 Certification

䊏 Professional Associations

䊏 Advocacy

䊏 Ethical Principles in Professional Counseling

䉴 Personal Health and Wellness

䊏 Countertransference

䊏 Burnout

䊏 Networking

2
CHAPTER ONE On Being a Professional Counselor 3

A BRIEF HISTORY OF THE COUNSELING PROFESSION

The counseling profession has evolved extensively from its early roots in the last
century. These roots are shared with the other schools of helping practices that
emerged from the works of 19th-century theoreticians like Freud, Jung, and Adler.

䊏 Theoretical Shifts

The field has seen four main theoretical phases:

1. Psychodynamic perspectives.
2. Person-centered therapy.
3. Behavioral and cognitive interventions.
4. Systemic and ecologically oriented approaches.

䊏 Specialization

During the latter half of the last century, counselor education programs moved
from a generalized training model for professional counselors to one that empha-
sizes specialization while still preserving a core counseling curriculum.

䊏 Professionalization

The momentum toward passing counselor licensure laws across the country was
one sign of professionalization. Another was the evolution of an association serv-
ing the field. The name changes that the association experienced represent the
field’s development:

1. The American Personnel and Guidance Association was inaugurated in 1952.

2. The name of the American Personnel and Guidance Association was changed
in 1983 to the American Association of Counseling and Development.
3. In 1992, the American Association of Counseling and Development became the
American Counseling Association (ACA).

It was not until relatively late in the 20th century that the terms professional coun-
seling and professional counselor were used, largely to designate a credentialed pro-
fession and a licensed professional. The ACA (1997) adopted this definition:

Professional counseling: “The application of mental health, psychological or

human development principles, through cognitive, affective, behavioral or
systemic interventions, strategies that address wellness, personal growth, or
career development, as well as pathology.”
4 What Are the Primary Roles and Responsibilities of the Professional Counselor? PART ONE

THE COUNSELOR’S IDENTITY

Professional counseling is an expanding field, with credentialed counselors pro-

viding a variety of mental health and human development services in a multitude
of settings. Given such a broad spectrum of helping roles, it is difficult to succinctly
characterize what a counselor is. However, some generalizations can be made.

Assumptions About Professional Identity

䊏 Because we live and practice in diverse contexts, counselors strive to develop a
mature multicultural perspective, one that includes sensitivity to race, ethnicity,
class, gender, ability, religion, sexual orientation, and other issues of diversity.
䊏 Because individual clients are whole persons with multiple and complex social
and cultural connections, and because their problems cannot be compartmental-
ized easily, counselors tend to operate from more or less holistic or ecological
frameworks and engage clients in a collaborative counseling process.
䊏 Counselors largely operate from a strengths-based model, even though we
routinely assist clients in working through problem areas, often involving diag-
nosis.
䊏 Counselors are mandated to engage in ethical practices and are bound ethically
to maintain confidentiality about clients, although privileged communication
varies from state to state, depending on state legal codes.
䊏 Effective counseling relies on the keen ability of the professional counselor to en-
gage in self-reflection.
䊏 Because such a significant portion of preservice training focuses on interpersonal
skill building, counselors typically value empathy, trust, respect, therapeutic re-
lationship building, empowerment, and process.

䊏 The Diversity of Counselor Identities

A number of specialty areas attract professional counselors, who provide services

to clients in situations that are highly diverse. The following lists include some of
the possibilities.

Specialty Areas
䊏 Clinical mental health.
䊏 Rehabilitation.
䊏 Family and marriage.
䊏 Pastoral counseling.
䊏 Wellness counseling.
䊏 Career counseling.
䊏 School and college counseling.
CHAPTER ONE On Being a Professional Counselor 5

䊏 Student affairs leadership.

䊏 Sports counseling.
䊏 Consulting on gender issues.
䊏 Gerontology.
䊏 Addictions counseling.
䊏 Forensics.

Specialty Populations
䊏 Children.
䊏 Adults.
䊏 Elders.
䊏 Couples.
䊏 Families.
䊏 Groups.
䊏 Persons with disabilities (physical, developmental, cognitive, and psychiatric).
䊏 Persons who have been traumatized.
䊏 Persons with addictions.
䊏 Persons who are or have been incarcerated.
䊏 Other counseling professionals (clinical and administrative supervision).
䊏 Business and policy organizations (consultation).

Settings
䊏 Community-based agencies.
䊏 Schools and institutions of higher education.
䊏 Nonprofit agencies.
䊏 Governmental organizations.
䊏 Nongovernmental organizations.
䊏 Hospitals.
䊏 Outpatient clinics.
䊏 Rehabilitation centers.
䊏 Nursing homes.
䊏 Respite care facilities.
䊏 Penal institutions.
䊏 Private practices.

䊏 How Counseling Differs From Psychology and Social Work

Many of the theories and techniques used by professional counselors (discussed

elsewhere in this book) are the same as those used by other helping professionals.
However, due to epistemological variations among different types of helpers, the
6 What Are the Primary Roles and Responsibilities of the Professional Counselor? PART ONE

ways in which counselors approach the helping process are often paradigmatically
different from others. Van Hesteren and Ivey (1990) postulated that counseling falls
somewhere between psychology and social work. The differences among the three
professions might be explicated as follows:

Psychological paradigm: Approach to the helping relationship that empha-

sizes the etiology of psychopathology as intrinsic to the individual.

Sociological paradigm: Approach to the helping relationship that focuses on

systems.

Professional counseling paradigm: Approach to the helping relationship

that pays particular attention to the interface between clients and their cul-
tural and systemic connections, with strong emphasis on interpersonal rela-
tionships.

It has been the province of professional counselors to focus on intra- and interper-
sonal factors, attending to both client risks and resiliencies.
An argument can be made that counseling is a highly interdisciplinary profession,
influenced not only by psychology and sociology, but also benefiting historically
from the influences of disciplines like education, anthropology, philosophy, theol-
ogy, other humanities, and the biological sciences. This argument is enhanced by the
fact that students matriculate into counseling master’s degree programs from a wide
variety of undergraduate disciplines (Zimpher, 1996; Zimpher & DeTrude, 1990).

An argument can be made that counseling is a

highly interdisciplinary profession, influenced not
only by psychology and sociology, but also
benefiting historically from the influences of
disciplines like education, anthropology,
philosophy, theology, other humanities, and the
biological sciences.

Although counseling is a separate mental health and human development pro-

fession, there is a great deal of overlap among all helping professionals in terms of
what we actually do with clients and in terms of the theories that drive our prac-
tices. These similarities and differences have been points of contention within the
counseling profession for some time. Interested readers can peruse lengthier dis-
cussions on their own (e.g., Gale & Austin, 2003; Hanna & Bemak, 1997; Ivey &
Ivey, 1998; Myers, Sweeney, & White, 2002; Skovholt, Rønnestad, & Jennings, 1997;
Van Hesteren & Ivey, 1990). It is sufficient to say here that the identity of profes-
sional counseling is marked by its emphasis on pluralism and multidisciplinary in-
fluences, both in terms of service delivery and professional affiliation, as well as by
its focus on clients’ interpersonal relationships.
CHAPTER ONE On Being a Professional Counselor 7

䊏 Characteristics of an Effective Counselor

The delivery of truly effective professional counseling requires the synthesis and
synergy of many professional and personal characteristics. However, one primary
and essential characteristic of the effective counselor is the mastery of at least base-
line technical competencies. These technical competencies, when used properly,
are enhanced by the infusion of certain values commonly adhered to within the
profession.

Technical Competencies (Ivey & Ivey, 2003)

䊏 Attending.
䊏 Focusing.
䊏 Listening actively.
䊏 Questioning.
䊏 Observing.
䊏 Reflecting feelings.
䊏 Confronting.
䊏 Interviewing.
䊏 Operating from an ethical framework.
䊏 Influencing.
䊏 Integrating technical skills.

Values
䊏 Respect.
䊏 Understanding.
䊏 Warmth.
䊏 Genuineness and authenticity.
䊏 Client empowerment.

The effective counselor also has a strong knowledge of theory, with a demon-
strated ability for application. Multicultural competencies and ethical competen-
cies are infused throughout the counselor’s skill level, values, and knowledge base.
The effective counselor is able to move beyond the mere technology of helping
to a more tacit dimension. This includes less tangible skills, such as focusing on cli-
ent meaning making and facilitating whatever form of self-actualization or self-ef-
ficacy the client desires or tolerates (Levers, 1997). The counselor must have a com-
plex array of not only technical skills, but also sensitivity, recursion, timing, and
maturity to manage this dimension. The counselor demonstrates an attitude of car-
ing by empathy, trust, respect, empowerment, and diversity.
There are no cookbook recipes for addressing the integration of the tacit dimen-
sion of counseling with the technology of helping. Perhaps one of the most important
nontechnical characteristics of an effective counselor, to embrace this array suffi-
ciently, is therefore the capacity for honest self-reflection and self-discovery. Al-
8 What Are the Primary Roles and Responsibilities of the Professional Counselor? PART ONE

though some theorists attempt to dichotomize the counseling process as either art or
science, the efficacious practice of counseling is probably best represented as a bal-
ance between mature self-knowledge and a keen mastery of theory and technique.

PROFESSIONALISM

The professional counseling literature offers divergent discussions of professional-

ism (e.g., Gale & Austin, 2003; Hanna & Bemak, 1997; Ivey & Ivey, 1998; Myers et
al., 2002; Ritchie, 1990; Van Hesteren & Ivey, 1990). Most can agree on the following
tenets of professionalism for individual counselors:

䊏 Graduation from an accredited program.

䊏 Acquisition of appropriate credentials.
䊏 Membership in professional associations.
䊏 Adherence to the profession’s code of ethics.

See Chapter 5 for more on professionalism.

䊏 Training for Professional Counselors

The master’s degree is the entry level for professional counselors. Most licensure
laws and professional certifications require at least a master’s degree from an ac-
credited university program, as well as postdegree supervision, to qualify for ap-
plication. Some licensure laws require additional graduate courses that address
specified clinical areas (e.g., the Professional Clinical Counselor credential under
Ohio’s licensure law).
Some professional counselors return to the university to acquire a doctoral de-
gree—a PhD or EdD—to enhance their clinical skills and theoretical knowledge.
The doctoral degree is often a basic requirement for teaching in a university coun-
selor education program (CEP) or in another related program. Nearly all instruc-
tors of counselor education have their doctorates; exceptions include when doc-
toral students teach or supervise master’s students in their CEPs, under the
supervision of their professors, or when counselors with master’s degrees—and
usually a lot of clinical experience—teach at universities at the instructor level.
A number of credentialing bodies govern the educational practices associated
with the preservice preparation of professional counselors, and numerous creden-
tials qualify counselors to practice.

Accreditation for Counselor Education Programs

䊏 Universities are accredited by regional accrediting bodies—for example, the
Middle States, New England, North Central, Northwest, Southern, and Western
CHAPTER ONE On Being a Professional Counselor 9

Associations of Colleges and Schools—and CEPs are a part of the larger univer-
sity environment.
䊏 As a part of a school or college environment, usually a school or college of educa-
tion, CEPs can be accredited, along with their schools or colleges, through the
National Council for the Accreditation of Teacher Education or the Teacher Edu-
cation Accreditation Council.
䊏 If a CEP offers a school counseling program, state department of education ac-
creditation is necessary.
䊏 The accreditations of most specific concern to counselors and counselor educators
are those of the Council for Accreditation of Counseling and Related Educational
Programs (CACREP) and the Council on Rehabilitation Education (CORE).

CACREP and CORE govern both master’s-level and doctoral programs.

The CACREP and CORE Web sites offer guidelines for rigorous
professional curricula and provide standards for academic training.
䉴 www.cacrep.org
䉴 www.core.org

䊏 Licensure

According to the ACA (2002), more than 80,000 professional counselors have been
licensed throughout the country.

Licensure Requirements
䊏 The applicant must have graduated from a master’s or doctoral program in
counseling or a closely related field.
䊏 The applicant must have a graduate degree that includes supervised practicum
and internship experiences.
䊏 The applicant must have passed an examination.
䊏 The applicant must have had 2 to 3 postdegree years of supervised clinical expe-
rience.

Licensure is a mandatory process for counselors who practice in states where the
profession has been legally codified; however, criteria vary, depending on whether
the law is a title-only law or a practice law. The licensee is responsible for under-
standing the mandates and restrictions of the particular law.
The primary reason for enacting laws that govern professional practices is to
protect consumers. In addition, mental health-related laws, in general, facilitate the
consumer’s freedom of choice of services.
10 What Are the Primary Roles and Responsibilities of the Professional Counselor? PART ONE

States Offering Licensure

䊏 The first law aimed at licensing professional counselors in the United States was
passed in Virginia in 1976.
䊏 As of the summer of 2004, licensure laws had been passed in 48 states and the
District of Columbia.
䊏 Only California and Nevada have not yet passed state laws to license profes-
sional counselors (California has a Board of Behavioral Sciences, but it does not
have a Professional Counseling Board, nor does it provide for the licensure of
professional counselors).

Because so much variability exists across licensure laws, many counselors have
experienced great difficulty when moving from one state to another. The American
Association of State Counseling Boards (AASCB) has facilitated coordination
among the state licensure boards. AASCB and other professional organizations
have worked hard on the portability issues surrounding professional counseling
credentials. Portability of a license means that once the counselor is licensed, he or
she can practice with that license in another state without necessarily repeating the
full application process. Because it is not unusual for a licensed counselor to move
to a new state or practice regionally in multiple states, portability is important for
professional development. Counselors need to be able to practice without unrea-
sonable restrictions on mobility. States need to have reciprocal portability agree-
ments, and the National Credentials Registry was recently inaugurated to address
the portability needs of the profession.

Keep tabs on the progress being made in coordinating the require-

ments of state licensure boards at the Web site of the National Board
for Certified Counselors.
䉴 www.nbcc.org
The American Counseling Association Web site provides information
about the licensure laws in individual states.
䉴 www.counseling.org

䊏 Certification

Certification is a voluntary process. Certifications tend to be based on best practice

standards, as determined by experts in the particular area of certification. Whereas
licensure has legal implications, certification usually is not encoded in the law, ex-
cept regarding school counselors. All states require school counselors to hold state
certifications (Bureau of Labor Statistics, 2004), but this is not the same as the na-
tional certification for school counselors.
CHAPTER ONE On Being a Professional Counselor 11

National Certifications
䊏 The National Certified Counselor, the National Certified School Counselor, and
the Master Addictions Counselor, all endorsed by the National Board of Cer-
tified Counselors (NBCC).
䊏 The Certified Rehabilitation Counselor, endorsed by the Council for the Certifi-
cation of Rehabilitation Counselors.
䊏 The Certified Clinical Mental Health Counselor, endorsed by the Academy of
Clinical Mental Health Counselors and NBCC.

Obtaining a professional certification involves an application process; the require-

ments for each type of application are set by the governing body of the specific cer-
tification and vary greatly across certifications.
In addition to national certifications, individual states may have state-specific
requirements for state-based certification of school counselors, addictions coun-
selors, and those employed at various levels of the mental health service delivery
system.

䊏 Professional Associations

The paramount professional association for counselors is the ACA, although nu-
merous other professional affiliations are also available. Professional associations
are important to the individual professional counselor’s professional growth and
development. Associations keep abreast of current issues in the field, mediate ad-
herence to the professional code of ethics, assist in maintaining necessary levels of
training, enhance professional identity, and advocate for needed changes in the
field.

Professional Counseling Organizations

䊏 ACA.
䊏 American School Counselor Association (ASCA).
䊏 National Rehabilitation Counseling Association.
䊏 National Rehabilitation Association.

The ACA has 18 divisions under its organizational umbrella, representing a

plethora of professional counseling interests.

Divisions of the ACA

䊏 Association for Assessment in Counseling and Education.
䊏 Association for Adult Development and Aging.
䊏 Association for Creativity in Counseling.
䊏 American College Counseling Association.
12 What Are the Primary Roles and Responsibilities of the Professional Counselor? PART ONE

䊏 Association for Counselors and Educators in Government.

䊏 Association for Counselor Education and Supervision.
䊏 Association for Gay, Lesbian, and Bisexual Issues in Counseling.
䊏 American Mental Health Counselors Association.
䊏 American Rehabilitation Counseling Association.
䊏 American School Counselor Association.
䊏 Association for Spiritual, Ethical, and Religious Values in Counseling.
䊏 Association for Specialists in Group Work.
䊏 Counseling Association for Humanistic Education and Development.
䊏 Counselors for Social Justice.
䊏 International Association of Addiction and Offender Counselors.
䊏 International Association of Marriage and Family Counselors.
䊏 National Career Development Association.
䊏 National Employment Counseling Association.

In addition to the national organization and its divisions, the ACA has regional-
and state-level associations and divisions. Most of the individual state associations
have their own Web sites, offering more information about state-specific issues and
activities.

Other Professional Associations

䊏 Chi Sigma Iota is the international honor society for professional counselors.
Membership in the society is contingent on academic achievement in a CEP. The
society operates through university-based local chapters and has members
throughout the world.
䊏 The American Educational Research Association has Division E for Counseling
and Human Development.
䊏 American Psychological Association Division 17 is for counseling psychologists.

Check out the following Web sites for basic information about each
association’s membership requirements and activities:
䉴 www.counseling.org (ACA)
䉴 www.schoolcounselor.org (ASCA)
䉴 www.nrca-net.org (National Rehabilitation Counseling Association)
䉴 www.nationalrehab.org (National Rehabilitation Association)
䉴 www.csi-net.org (Chi Sigma Iota)
CHAPTER ONE On Being a Professional Counselor 13

䊏 Advocacy

Client advocacy and professional advocacy are both significant elements of the
counseling profession. These two types of advocacy are profoundly intercon-
nected. It is difficult to advocate sufficiently for our clients if we have not advo-
cated adequately for the profession and are therefore operating from a weak pro-
fessional position.
Many people who seek counseling are marginalized or disenfranchised and
might not be in a position to advocate for themselves; therefore, professional coun-
selors often find themselves assuming an advocacy role with clients. Although not
all professional counselors are positioned well to assume the role of client advo-
cate, many counselors are attracted to the field precisely out of a strong sense of so-
cial justice. For these counselors, a social justice agenda might be nearly insepara-
ble from their counseling objectives.
Altruism is always admirable, and advocating for clients is important. However,
we must take a closer look when advocacy transgresses personal boundaries or
goes unrecognized as countertransference. Proper clinical supervision can help the
counselor avoid potential trouble in this area.

Aspects of Client Advocacy

䊏 Client advocacy might be prompted by the inadvertent neglect of some clients or
groups of clients on the part of an organization, agency, or school. It can be reme-
died easily by drawing attention to the resulting inequity or raising the con-
sciousness of those involved.
䊏 Client advocacy might be prompted by a benign acceptance of a more complex
situation.
䊏 Client advocacy might be prompted by cultural and social disparities arising
from issues related to race, ethnicity, class, gender, ability, religion, and sexual
orientation.

Wherever on the continuum the injustice might be found, counselors can have a
profound impact on people’s lives. Thus counselors have a duty to maintain dig-
nity, integrity, and ethics while advocating for clients.
Counseling has been around for a long time, and counselors have provided
services to people in need for a long time. However, the profession of counseling
needs to catch up to other licensed professions in its self-advocacy. One dimen-
sion of professionalism is keeping abreast of current affairs that could have an
impact on the profession, as well as on the profession’s ability to provide quality
services to clients.
The ACA, along with other counseling organizations, has initiated advocacy
strategies designed to affect policy and legislation surrounding issues that are cru-
cial to the profession.
14 What Are the Primary Roles and Responsibilities of the Professional Counselor? PART ONE

Professional Advocacy Initiatives

䊏 Of special historical significance is the ACA’s 1990 appointment of the Pro-
fessionalization Directorate, with a vision of guiding the progress of counselors’
developing professionalism.
䊏 The Directorate later became the Professionalization Committee, and since then
the work of the former Committee has been divided among several of the ACA’s
national professionalism-related committees.

Counselors must continue to pursue a stronger and better coordinated profes-

sional advocacy agenda (Myers & Sweeney, 2004). Individual professional counsel-
ors have ample opportunities to become involved with the work of ACA’s advo-
cacy committees at state, regional, and national levels.

EXAMPLE

Importance of Advocacy for Counselors

The importance of professional advocacy cannot be overstated, especially in light of the fact
that counselors arrived relatively late to the licensure table. Other licensed professionals have
ensured that their services were encoded in state laws. Counselors need to attend to this lack
of parity; while counselors continue high levels of advocacy for clients, counselors also need to
engage in vigorous, systematic, and unrelenting advocacy for the profession.

䊏 Ethical Principles in Professional Counseling

Adherence to professional ethics is arguably the most important aspect of profes-

sionalism with which a counselor must deal on a day-to-day basis. Licensed coun-
selors are required by state licensure laws to adhere to professional ethics.

Ethical Codes for Professional Counselors

䊏 The ethical standards for professional counselors are codified by the ACA Code of
Ethics. The Code was reauthorized recently (ACA, 2005).
䊏 School counselors adhere to the ACA Code of Ethics, as well as the ASCA’s (2004b)
Ethical Standards for School Counselors. State-certified school counselors also must
follow state-mandated ethical practices, often derived from ACA and ASCA eth-
ical standards.
䊏 The NBCC (2005b) requires board-certified counselors to adhere to the ACA Code
of Ethics.
CHAPTER ONE On Being a Professional Counselor 15

䊏 Certified Rehabilitation Counselors follow the Code of Professional Ethics for Reha-
bilitation Counselors, as established by the Commission on Rehabilitation Coun-
selor Certification (2002).

These various codes govern areas such as the counseling relationship, confidential-
ity, professional responsibility, relationships with other professionals, evaluation,
assessment, interpretation, supervision, training, teaching, research, publication,
and methods for resolving ethical issues.
Forester-Miller and Davis (1996) provided an excellent brief discussion of the
moral principles on which the codes of ethics are constructed; they also offered a
useful seven-step model for ethical decision making. Understanding the underly-
ing moral principles of ethical practice and having a ready model when facing ethi-
cal dilemmas can reinforce counselors in maintaining higher standards of profes-
sionalism.

See Chapter 3 for more on ethical codes for counselors.

PERSONAL HEALTH AND WELLNESS

Although the work of counselors can be highly fulfilling and rewarding, it also can
be challenging and stressful. Counselors see clients who are experiencing varying
degrees of problems, dilemmas, and crises. Without a personal sense of wellness,
accompanied by healthy outlets for stress, it is easier for counselors to become
overburdened or to take on their clients’ problems. Many senior members of the
profession emphasize the importance of counselors taking care of themselves. The
CACREP standards, and by extension, many CEPs, encourage counselors’ contin-
ued self-development. In the face of stressful work environments, counselors must
maintain optimum levels of personal health and wellness.

Refer to Chapter 30 for more information about wellness movements in counseling.

䊏 Countertransference

Countertransference arises from taking on client problems. It can potentially lead

to therapeutic misadventures. It is usually when countertransference goes unde-
tected or is denied that it becomes a potential clinical hazard.
Incidentally, countertransference is not necessarily a negative dynamic; it hap-
pens quite frequently in counseling, and the skilled and self-aware practitioner
knows how to identify it and then process it with a clinical supervisor. With proper
handling, a countertransference event can lead to dynamic and productive inter-
ventions with clients.
16 What Are the Primary Roles and Responsibilities of the Professional Counselor? PART ONE

EXAMPLE

Encountering and Managing Countertransference in Practice

I can provide an example from my own clinical work. I once was counseling a client diagnosed
with Borderline Personality Disorder. During one particular session, the client unleashed ex-
treme anger that unnerved me. I began to experience my own anger in response, then caught
myself engaging in countertransference. As soon as I was able to identify the counter-
transference, and quickly process it, my anger was replaced with compassion. I then was able
to reframe my perspective on this client and to understand better what it must be like in the cli-
ent’s world—especially how other people receive the client’s anger. Immediate acknowledg-
ment and self-reflection about my countertransference response assisted me in understanding
my client’s dilemma from a more visceral perspective. Failure to understand the counter-
transference dynamic in this situation could have led to a less productive, or even counterpro-
ductive, response.

䊏 Burnout

When counselors do not take care of themselves—emotionally, spiritually, existen-

tially, or physically—they run the risk of eventual professional burnout. Coun-
selors burn out in response to constant levels of high or intense stress.

Effects of Burnout on Personal and Professional Levels

䊏 Burned-out counselors can end up feeling helpless, hopeless, cynical, resentful,
and depressed.
䊏 Unchecked professional burnout eventually can affect job performance.
䊏 One’s health, career, and relationships with others could be threatened by high
levels of stress.
䊏 Unchecked professional burnout also easily progresses to professional impair-
ment.

Counselor impairment is an ethical issue that must be taken seriously and ad-
dressed responsibly—by the counselor, by professional peers, and by those in-
volved in supervisory relationships with the impaired counselor.
Counselors who work with survivors of trauma and clients with posttraumatic
stress disorder (PTSD) run the risk of experiencing secondary victimization, or vi-
carious trauma. Vicarious trauma can occur when bearing witness to the results of
extreme or unexpected harm or violence to another person. Counselors who offer
trauma counseling need to be vigilant about protecting the integrity of their own
emotional and existential constitutions.
CHAPTER ONE On Being a Professional Counselor 17

In the case of professional burnout or vicarious trauma, the age-old dictum,

“Doctor, heal thyself,” easily can read “Counselor, heal thyself.” The best line of de-
fense is prevention.

Strategies for Preventing Burnout

䊏 Seeking adequate clinical supervision.
䊏 Varying the daily routine.
䊏 Maintaining a healthy sense of humor.
䊏 Having a stress management plan.
䊏 Having a professional development plan.
䊏 Having a personal development plan.
䊏 Seeking personal counseling when needed

Knowing up front that counseling is a high-stress field can help the new counselor
to maintain personal health and wellness.

䊏 Networking

Networking with other professionals is an important aspect of the counselor’s

sphere of work and contributes to both client advocacy and professional growth.
Counselors can find opportunities to network with other professionals at work-
shops, conferences, and conventions, as well as through their professional associa-
tions.

Chapter 1: Key Terms

䉴 Professional counseling 䉴 Sociological paradigm 䉴 Burnout
䉴 Psychological paradigm 䉴 Professional counseling 䉴 Secondary victimization
paradigm
chapter The Demands and Obligations
of Ethical Counseling
2
Christian Conte
University of Nevada, Reno

In This Chapter

䉴 The Basics of Ethics in Counseling

䊏 Definition of Ethics

䊏 Ethical Codes

䊏 Ethical Codes and Cultural Diversity

䊏 Development of Ethical Codes

䊏 ACA Code of Ethics

䊏 Mandatory and Aspirational Ethics

䉴 Ethical Theory
䊏 Epicureanism

䊏 Utilitarianism

䊏 Kantianism

䊏 Situationalism

䉴 Ethical Principles and Decision Making

䊏 Nonmaleficence

䊏 Beneficence

䊏 Autonomy

䊏 Fidelity

䊏 Justice

䊏 An Ethical Decision-Making Model

䉴 Common Ethical Concerns for Professional Counselors

䊏 Confidentiality

䊏 Dual Relationships and Potentially Beneficial Interactions

䊏 Sexual Misconduct

䊏 Transference

䊏 Countertransference

䉴 Summary

18
CHAPTER TWO Demands and Obligations of Ethical Counseling 19

THE BASICS OF ETHICS IN COUNSELING

Ethics defines counseling as much as theory and practice define it. Conscious or
not, professional counselors all act under belief systems or ethical positions that
help or hinder their clients. Over the course of two millennia, ethical thought in
Western civilization has evolved into wide-ranging guidelines that provide a back-
ground against which the relationship between counselor and client can be as-
sessed. This chapter provides an overview of ethical thought as it relates to coun-
seling.

䊏 Definition of Ethics

Counseling is nothing if it is not about character, appropriate as the Greek word

ethos means character. Ethics can be understood in two contexts:

1. Ethics sometimes refers to the study of morality and specific moral choices.
2. Ethics can be understood as a philosophical discipline concerned with the stan-
dards that govern conduct perceived to be acceptable by a culture or society.

Ethical thought related to the counseling profession falls primarily within the sec-
ond context and has a direct impact on counselors’ relationships with their col-
leagues and their former and current clients. For counselors, ethics can be defined
as follows:

Ethics: The standards governing the conduct of members of the counseling

profession.

䊏 Ethical Codes

If ethics are the standards that govern conduct, ethical codes can be understood in
this way (Gladding, 2005):

Ethical codes: The written form of ethical conduct that is intended to improve
professionals’ ability to successfully and competently respond to clients’
needs.

Although not all encompassing, ethical codes provide detailed guidelines to which
counselors can refer when making decisions about their own behavior or actions
taken on behalf of the client. Thoughtful consideration and implementation of the
codes results in the protection of client welfare and the welfare of counseling pro-
fessionals. The general public gains trust in the integrity of a profession that re-
quires clinicians to live up to an ethical code, and professionals who act within the
recommendations of the codes are safeguarded from unfounded lawsuits.
20 What Are the Primary Roles and Responsibilities of the Professional Counselor? PART ONE

Consequences for breeches of the ethical code also ensure that the counseling
process will be safe for the general public. The American Counseling Association
(ACA) provides a governing body that establishes and enforces consequences for
ethical code violations. Although the ACA has subdivisions, some of which have
developed best practices statements, the national branch’s ethical codes serve as
the quintessential guidelines for all counselors.

䊏 Ethical Codes and Cultural Diversity

The general public the code of ethics strives to serve is recognizably diverse. Ac-
counting for variances in moral standards, values, and a range of interpretation
about human conduct is an important concern in developing ethical standards and
codes. Thus, the ethical codes must be rooted in standards that, while mirroring
some moral tenets, respect cultural diversity.

EXAMPLE

Cultural Issues and Ethical Codes

Respecting all cultures is a pragmatic contradiction. Some Satanic cultural ideals exonerate
torture and pain, whereas the majority of other cultures do not condone such ideals. Incorpo-
rating ethical codes that equally consider all cultural codes of conduct is not possible.

䊏 Development of Ethical Codes

Ethical codes are not static. New research and expanding awareness both contrib-
ute to the need for constant revision of the ethical codes.

Revisions of the ACA Code of Ethics and Standards of Practice

䊏 The American Personnel and Guidance Association adopted its first code of eth-
ics in 1961.
䊏 Since the first revision in 1974, the code has been revised every 7 years.
䊏 The latest revision of the ACA Code of Ethics was released in 2005.

䊏 ACA Code of Ethics

The most recent revision of the ACA Code of Ethics (2005a) contains eight sections
that address the following areas:

1. The counseling relationship.

2. Confidentiality, privileged communication, and privacy.
CHAPTER TWO Demands and Obligations of Ethical Counseling 21

3. Professional responsibility.
4. Relationships with other professionals.
5. Evaluation, assessment, and interpretation.
6. Supervision, training, and teaching.
7. Research and publication.
8. Resolving ethical issues.

Each section includes an introduction that clarifies the conduct toward which coun-
selors aspire and lets readers know what will be presented in the section. Briefly,
goals of the standards outlined in the ACA code can be summarized as follows.

Aims of the ACA Code of Ethics (ACA, 2005a)

䊏 Clarify the nature of ethical responsibility of ACA members.
䊏 Support the mission of the ACA organization.
䊏 Establish principles, ethical guidelines, and best practices for counselors.
䊏 Assist counselors to make the best decisions on behalf of clients and to support
the values of the profession.
䊏 Provide a reference against which complaints about counselors can be evaluated.

Use the following link to view a full text of the code.

www.counseling.org/Resources/CodeOfEthics

䊏 Mandatory and Aspirational Ethics

When acting in response to the code of ethics, a difference exists between what a
counselor has to do and what a counselor strives to do. That difference is summed
up in the concepts of mandatory ethics and aspirational ethics (Remley & Herlihy,
2001).

Mandatory ethics: The level of functioning counselors must exhibit to fulfill

the minimum ethical obligations.

Aspirational ethics: The highest standards of conduct to which counselors

aim to meet ethical standards.

The concept of mandatory ethics suggests that there are minimal requirements if
counselors are to act ethically. At the same time, the goal of ethical codes generally
is not to outline specific behaviors. The following example provides more detail
about the distinction between mandatory and aspirational ethics.
22 What Are the Primary Roles and Responsibilities of the Professional Counselor? PART ONE

EXAMPLE

Intimate Relationships With Clients

Section A.5.a. Current Clients of the ACA Code of Ethics (2005a) states that counselors cannot
have sexual intimacies with their clients. This code is a mandatory ethic. In other words, it
does not need to be interpreted, only read literally.
A.5.b. Former Clients of the same section, however, describes guidelines by which a healthy
length of time (5 years) is needed to pass before it is considered ethical to engage in sexual inti-
macies with former clients. Although 5 years is clearly stated, this code leaves room for coun-
selors to aspire to make sound ethical choices about the nature of their relationships to former
clients. It would be unethical, for example, to prematurely terminate counseling with a client
only to begin waiting 5 years with the hope that at the end of that time a sexually intimate rela-
tionship can begin. It is hoped that counselors will use aspirational ethics when considering
the most beneficial course of action when dealing with such issues.

It is imperative for counselors to contemplate and discuss current ethical issues,

although the answers will not always be addressed by a code of ethics. Because
codes of ethics are incomplete, counselors can benefit from understanding ethical
theories and the ethical principles on which the ethical codes are based.

ETHICAL THEORY

Like counseling theories, ethical theories are the groundwork on which profes-
sional counselors build uncompromising clinical practices. The ethical theories
presented here span more than 2,000 years and constitute only four of many possi-
ble views. Studying ethical theories in greater detail is essential to integrating per-
sonal beliefs with sound ethical reasoning.
In general, ethical systems or theories fall into four classes based on their foci,
identified as follows:

1. The best interest of the self.

2. The best interest of others.
3. A rational approach that leads to universal principles.
4. The best interest of an individual within a specific circumstance.

䊏 Epicureanism

Epicurus (341–270 B.C.) advocated an ethical theory that focused on the individual.
Tenets of Epicureanism include the following:

䊏 Mental pleasures are emphasized over physical pleasures.

䊏 Balance is the key to happiness.
CHAPTER TWO Demands and Obligations of Ethical Counseling 23

䊏 Happiness is the supreme good.

䊏 The goal of human activity is pleasure.

Epicureanism as an ethical system is relevant for counselors because it supports

phenomenology (i.e., it provides a philosophical rationale for accepting and sup-
porting clients’ desires). A drawback for counselors who accept Epicureanism as
their ethical system is that they could easily focus on their own, rather than their cli-
ents’ needs. Also, because Epicureanism technically supports pure relativism, it
might be used to justify a client’s decision to harm others.

䊏 Utilitarianism

John Stuart Mill (1806–1873) is an excellent envoy of utilitarian ethical theory. In the
context of utilitarianism, performing the greatest good for the greatest number is
the core of ethics. Accordingly, an action is considered good if it produces the great-
est amount of happiness for the greatest number of people.
Using utilitarian ethical theory can be advantageous for counselors because this
viewpoint encourages them to carefully consider whether or not their actions will
benefit the maximum number of people. However, strict adherence to utilitarian
ethical theory might not be practical if counselors must wait until all possible out-
comes have been considered before they act.

䊏 Kantianism

For Westerners, Immanuel Kant (1724–1804) is the hallmark philosopher of ethics.

Kant described a clear method for moral reasoning that can be summed up in this
statement: Whatever decision individuals make, they must be comfortable having
the decision become a universal law. In other words, people should make ethical
decisions based on the principle that, given the same circumstances, everyone in
the world would choose the same course of action.
Counselors may benefit from Kantian ethics because this viewpoint will push
them to thoroughly evaluate the decisions they make. A criticism of Kantian ethics
is that this perspective does not consider cultural differences that call into question
the possibility of universal law.

䊏 Situationalism

In the middle of the 20th century, from the wellspring of contextualism sprang an
ethical theory called situationalism. Joseph Fletcher (1905–1991) articulated this
perspective in his classic work, Situation Ethics: The New Morality (1966). These prin-
ciples characterize situationalism:
24 What Are the Primary Roles and Responsibilities of the Professional Counselor? PART ONE

䊏 Ethical decisions take into account individual circumstances.

䊏 Ethical decisions reflect a balance between legalism (law as an absolute) and
antinomianism (no laws whatsoever).
䊏 Ethical decisions use maxims and principles as guides rather than answers.

Situationalism as an ethical system provides counselors with two advantages: It

allows them to carry their own morals and values into the counseling process with-
out imposing their beliefs on others, and it enables counselors to evaluate unique
situations without violating laws or breaking professional codes. A criticism of
situationalism is that it has the potential to enable people to rationalize any action,
regardless of the consequences for self or others.

ETHICAL PRINCIPLES AND DECISION MAKING

Kitchener (1984) outlined the following five principles that serve as the basis of eth-
ics in the counseling profession act as the foundation on which the ACA Code of Eth-
ics is established:

1. Nonmaleficence.
2. Beneficence.
3. Autonomy.
4. Fidelity.
5. Justice.

䊏 Nonmaleficence

The first ethical principle, nonmaleficence, is the keystone of counselors’ ethical

obligations and can be defined in this way:

Nonmaleficence: The ethical principle stating that counselors should do no

harm.

Counselors must not knowingly engage in behavior they know will be harmful to
their clients. Harm can come in many forms. Implementing the principle of non-
maleficence means everything from counselors not practicing outside the scope of
their competence to counselors not attempting to use techniques that are inappro-
priate for addressing clients’ needs.

䊏 Beneficence

In addition to the mandate not to cause harm, counselors have an ethical obligation
to strive to do something beneficial for their clients.
CHAPTER TWO Demands and Obligations of Ethical Counseling 25

Beneficence: The ethical principle stating that counselors actively do some-

thing good for clients.

Beneficence can be as simple as providing referral numbers to clients who counsel-

ors decide they cannot ethically treat. Reading a book a client references time and
again in the hope of gaining further insight into the client can also be an act of be-
neficence. At its zenith, counselors who most effectively uphold the ethical princi-
ple of beneficence are authentic and intellectually and psychologically prepared to
engage in every counseling session.

䊏 Autonomy

Autonomy entails creating an atmosphere that allows clients to make well-in-

formed choices about every aspect of their involvement with the therapeutic pro-
cess. Counselors can adopt the following definition of autonomy:

Autonomy: The ethical precept stating that counselors respect clients’ right to
be self-governed.

Counselors respect the ethical precept of autonomy when they dialogue with cli-
ents about treatment options and accept the choices their clients make.

䊏 Fidelity

The concept of fidelity encourages counselors to be honest with clients and faithful
to the relationships they have established with them.

Fidelity: The ethical principle stipulating that counselors act faithfully and
honestly with their clients.

Counselors can adhere to this principle by being open with their clients. Kell and
Mueller (1966) noted that glossing over issues (e.g., “Don’t worry, everything will
be okay.”) trivializes clients’ problems and provides a false sense of security that
can be detrimental to clients’ psychological health.

䊏 Justice

Counselors who follow the principle of justice treat their clients with equal respect
for their religion, culture, ethnicity, gender, age, or any variable that visibly or in-
visibly differentiates clients from themselves. Justice can be defined as follows:

Justice: The ethical precept specifying that counselors act fairly toward all po-
tential, current, and past clients.
26 What Are the Primary Roles and Responsibilities of the Professional Counselor? PART ONE

An example of implementing justice is granting pro bono service to a client who

has no means of providing compensation. The ethical precept of justice ensures
counselors strive to interweave equal treatment into every facet of their practice.

EXAMPLE

Giving Advice: Ethical or Unethical?

Have you ever heard of counselors being equated to advice givers? Have you ever heard
people say they are going to counseling because they want someone to tell them how to get out
of a tough situation?
Giving advice is not a regular part of the counseling process because it breaks the ethical prin-
ciple of autonomy. If a client takes a counselor’s advice and it works, the client is likely to re-
turn to the counselor to get further successful advice. This creates a dependence on the coun-
selor, which disregards the client’s autonomy. If the counselor’s advice works out poorly, on
the other hand, the client will likely blame the counselor for the resulting misfortune, thus es-
chewing responsibility for his or her actions. Either result of advice giving is generally not
helpful. It should be noted, however, that never giving advice is an extreme position and also
unethical. Many crisis situations warrant providing direct advice to clients to protect the
safety of all involved.

The five underlying ethical principles are vital to the counseling profession. Al-
though all five have distinct properties, every ethical dilemma can be viewed in
light of these ethical principles. Professional counselors and counselor trainees
should know the five underlying ethical principles well.

䊏 An Ethical Decision-Making Model

The awareness of ethical principles coupled with an ethical decision-making model

provides counselors with a systematic way to approach ethical dilemmas. Because
ethical decisions are often made in minutes, and sometimes seconds, stopping to
reread a step-by-step ethical decision-making model is not practical. Thus, counsel-
ors should infuse into their everyday work an ethical decision-making process by
which they choose to approach ethical dilemmas.
The following seven-step model, based on the work of Kitchener (1984) and
Welfel (2002), is only one of many ethical decision-making models, but it provides a
useful, systematic approach to making ethical decisions. The seven steps are as fol-
lows:

1. Recognize ethical situations.

2. Play out alternative solutions.
3. Refer to the ACA ethical codes.
CHAPTER TWO Demands and Obligations of Ethical Counseling 27

4. Consider legal consequences.

5. Seek supervision.
6. Make a choice.
7. Reflect on your decision.

To understand the relevance of an ethical decision-making model, consider the

following example; then, visualize applying this model in your own counseling
situations.

EXAMPLE

Applying a Model of Ethical Decision Making

A 10th-grade student named Colton arrives in his guidance counselor’s office and tells her
two other students are picking on him by calling him names. His counselor, Miss Solana,
knows the two students well and realizes that she has a good enough rapport with them to
convince them to stop picking on Colton.
From her readings, course work, and training, Miss Solana adeptly follows Step 1 because she
recognizes this situation as an ethical dilemma. In Step 2, she begins to formulate options. For
instance, she realizes that if she approaches the other students, she might in fact help Colton to
experience relatively quick relief from his current situation. Also, by addressing the other stu-
dents, she might send a message, at least to the two antagonists, that bullying will not be toler-
ated in the school. In providing Colton with quick relief, however, she might also send an un-
derlying message to Colton that he needs to rely on others to solve his problems. Furthermore,
by addressing the bullies, it strikes Miss Solana that she will not be providing Colton any in-
sight into what behavior he contributed (if any) to the situation. Lastly, Miss Solana considers
that by addressing the bullies, she will not provide Colton with the skills necessary to handle
future situations in which he is “picked on.”
It is here that following Step 3 can be helpful. The ACA Code of Ethics encourages counselors
to avoid fostering dependent counseling relationships. Miss Solana must ask then, “Will my
decision respect Colton’s autonomy?” Next, Step 4 leads her to consider any legal conse-
quences. Applied to this case, gathering information on what specifically was said is the
first step. If it turns out that no threats were made, this is not likely to be a situation that
warrants legal consultation. Thus considered, Miss Solana can move on to Step 5 and seek
supervision. If Colton stopped by her office only briefly, with the intention of sitting down
with her at a later time, then she might in reality have an opportunity to seek supervision
ahead of time. If not, discussing her decision with her supervisor ex post facto is strongly
recommended.
After considering alternative solutions, consulting the ethical codes, taking into account un-
ethical and illegal ramifications, it is time for Step 6: Make a decision and act on it. The final
step of the ethical decision-making model, Step 7, entails reflecting on the decision made so
that psychological growth might result from the counseling interaction.
28 What Are the Primary Roles and Responsibilities of the Professional Counselor? PART ONE

Although following a decision-making model might appear to be a linear pro-

cess, the actual decision-making process is often recursive. Counselors might need
to revisit steps of the ethical decision-making model to reach a decision that is in the
best interests of the client.

COMMON ETHICAL CONCERNS FOR PROFESSIONAL

COUNSELORS

The scope of ethical dilemmas is vast and varied; however, some concerns are more
frequently encountered than others. Some common ethical concerns are addressed
next.

䊏 Confidentiality

Most people who have a secret betrayed by a close friend or confidant experience
feelings of fear, anger, or sadness; this introduces an element of mistrust into the re-
lationship. Preventing this type of psychological harm is just one reason confidenti-
ality is recognized as an essential component of the counseling process. An equally
important reason for maintaining confidentiality is to shield clients from the social
stigma that historically has been associated with mental illness. Counselors, there-
fore, keep disclosed information confidential to assure clients that they are engag-
ing in a safe process.
Confidentiality is not absolute, however, and clients have the right to under-
stand its limits.

Limits to Confidentiality
䊏 Client waiver of privilege for release of information to third parties (e.g., coun-
selors’ supervisors).
䊏 Prevention of clear and imminent danger that clients pose to themselves or others.
䊏 Court mandates that confidential information be revealed.

Clients must be made fully aware of the right to and limitations of confidentiality.
At the onset of counseling, counselors provide such awareness to clients through a
process called informed consent.

Informed Consent
䊏 Informed consent is the written and verbal disclosure to clients of what takes
place in the counseling process.
䊏 Informed consent should include the purpose, goals, techniques, procedures,
limitations, and potential risks and benefits of entering professional counseling.
䊏 Informed consent should not stop after clients give their initial consent; rather,
informed consent should be viewed as an ongoing process that holds the welfare
of clients and their best interests in the foreground of treatment.
CHAPTER TWO Demands and Obligations of Ethical Counseling 29

䊏 Dual Relationships and Potentially Beneficial Interactions

The ACA Code of Ethics states that counselors should avoid dual relationships when
possible. Dual relationships are deleterious to therapeutic relationships because
they can compromise counselors’ objectivity.

Dual relationship: Any significantly different relationship a counselor has

with a client outside of his or her counselor–client relationship.

Recent research, however, appears to indicate that dual relationships might not al-
ways be detrimental and at times can even be beneficial (Moleski & Kiselica, 2005). In
some rural areas, dual relationships are often unavoidable. In such cases, the goal is
not to go to extremes to avoid dual relationships, but rather to be keenly aware of the
impact the nontherapeutic relationship has on the therapeutic one. Section A.5.d. Po-
tentially Beneficial Interactions recognizes that in some circumstances, clients may
profit from an ethically appropriate dual relationship. Engaging in close supervision
can help counselors discern the impact of potentially beneficial interactions. Future
ethical codes may consider the effect community size and contact inevitability have
on dual relationships, but current ethical codes do not.

Engaging in close supervision can help

counselors discern the impact of potentially
beneficial interactions. Future ethical codes may
consider the effect community size and contact
inevitability have on dual relationships, but
current ethical codes do not.

Regardless of the stance one takes on dual relationships, boundaries in the coun-
seling process must be clearly defined. Boundaries can be understood in this way:

Boundaries: The physical and psychological limits that frame a professional

counseling relationship.

Boundaries such as professional language and mannerisms constitute a framework

from which a professional relationship can begin and help professionals to estab-
lish and maintain objectivity. Clients can feel confused without clear boundaries,
whereas counselors often feel overexposed when clear boundaries are not set.

䊏 Sexual Misconduct

Section A.5.a. Current Clients clearly states that sexual or romantic counselor–client
interactions or relationships with current clients, their romantic partners, or their
family members are prohibited.
30 What Are the Primary Roles and Responsibilities of the Professional Counselor? PART ONE

Although clients enter counseling with their whole selves, counselors are en-
couraged to remain veiled throughout the therapeutic process (Kell & Mueller,
1966). In other words, by offering only relevant self-disclosures, counselors remain
blank slates on whom clients project aspects of their unconscious. This is a great re-
sponsibility, as clients often project that counselors are capable helpers who only
hold the best of intentions. Such projections set up vulnerabilities that do not exist
in nontherapeutic relationships. Abusing the vulnerability of clients through sex-
ual misconduct can be detrimental to clients in a number of ways.

Detriments of Sexual Misconduct

䊏 When feelings of trust are used to elicit sexual activity, clients can feel overex-
posed, guilt ridden, and a general sense of mistrust of others.
䊏 Clients’ self-efficacy may become contingent on pleasing their counselors.
䊏 As a whole, sexual activity with clients exploits clients, counselors, and the repu-
tation of the counseling profession (Welfel, 2002).

䊏 Transference

The concept of transference was articulated by Sigmund Freud to specifically refer

to the phenomenon whereby people project the dynamics of their response pat-
terns to their parents onto their therapists. Perls (1973) expanded what is meant by
transference to encompass all the dynamics of response patterns clients project
onto their therapists, not just how clients reacted to their parents.

Transference: Projections clients cast on their counselors.

For example, consider the contemporary client that begins to describe her life using
an antiquated form of formal English. If this is not a part of her daily commun-
ication to others, she might be transferring onto the counselor the way she re-
sponds to perceived authority figures. By recognizing transference, counselors can
observe a historical chunk of a person’s psyche and raise clients’ awareness of their
dynamics.

䊏 Countertransference

Countertransference is the antithesis of transference. The concept can be defined

as follows:

Countertransference: Projections counselors cast on their clients.

In general, countertransference occurs when counselors project their own undis-

covered psyches onto their clients. For instance, a counselor who experienced
CHAPTER TWO Demands and Obligations of Ethical Counseling 31

abuse in the past might be guarded and unable to empathize with a client who is in
counseling to treat his abusive behaviors.
Countertransference is essential to a discussion of ethics because what counsel-
ors do not know about themselves can hurt their clients. In other words, when
counselors are not aware of what clients stir up in them, their unconscious reac-
tions hold no therapeutic intention, though, as Jung (1957) pointed out, the poten-
tial for therapeutic value is present in all human interaction. Countertransference is
detrimental to the counseling process because counselor–client interactions are di-
rected by unconscious agendas rather than systematic therapy. Understanding
countertransference sheds a new light on the relevance of self-awareness as a vital
part of the counseling process.

SUMMARY

The subject of ethics refers to the study of morals and the specific moral choices
people make. These choices relate to the standards that govern human conduct that
is perceived to be acceptable or not by a culture or society. Ethical codes are the
written form of the codes. A written code of ethics provides the public some assur-
ance that professional counselors are held accountable for their professionalism.
The ACA Code of Ethics is rooted in five underlying ethical principles: nonmale-
ficence, beneficence, autonomy, justice, and fidelity.
Ethical decisions can best be made through the use of a sound ethical deci-
sion-making model. Although following the letter of the law enables counselors to
perform mandatory ethics, it is hoped that counselors will follow the spirit of the
law and aspire to go above and beyond for their clients. Counselors should avoid
multiple relationships with their clients, unless doing so provides a benefit to their
clients.

Chapter 2: Key Terms

䉴 Aspirational ethics 䉴 Dual relationships 䉴 Justice
䉴 Autonomy 䉴 Ethics 䉴 Mandatory ethics
䉴 Beneficence 䉴 Ethical codes 䉴 Nonmaleficence
䉴 Boundaries 䉴 Fidelity 䉴 Transference
䉴 Countertransference 䉴 Informed consent
 chapter The Legal Intrigues of Counseling Practice

3 Carolyn Stone
University of North Florida

Christian Conte
University of Nevada, Reno

Elizabeth Antkowiak
Western Psychiatric Institute and Clinic

In This Chapter

䉴 Basics of Professional, Ethical, and Legal 䉴 Record Keeping

Practice for Counselors 䊏 School Records: Family Education Rights
䊏 A Look at Professions, Professionalism, and Privacy Act (FERPA)
and Professional Identity 䊏 ASCA Ethical Guidelines on Educational

䊏 Legal Issues Related to Counselors’ Profes- Records

sional Identity 䊏 Agency Records: Health Insurance Porta-

䊏 Ethical Codes and Standards of Practice bility and Accountability Act (HIPAA)
䊏 What Is Law?

䊏 Contracts in Counseling: Informed Con- 䉴 Dual Relationships in School

sent and Community Settings
䊏 Torts and Counselor Negligence 䊏 Ethical and Legal Considerations of Dual

Relationships
䉴 Professionalism for School Counselors 䊏 Complexity of Dual Relationships in

䊏 Building Collaborative Relationships Schools

䊏 Facing the Political Barriers of the School 䊏 Safeguarding Clients’ Emotional Health

System
䊏 Community Standards in School Coun- 䉴 Confidentiality, Privacy, and Privileged
selor Practice Communication
䊏 Protecting Students’ Best Interests 䊏 Ethical Standard of Confidentiality

䊏 Confidentiality for School Counselors

䉴 Legal and Ethical Aspects of Competence 䊏 Privacy

䊏 Consultation 䊏 Legal Facets of Privileged Communication
䊏 Continuing Education 䊏 Duty to Warn: Limit to Privileged Com-
䊏 Malpractice munication
䊏 Duty to Protect

32
CHAPTER THREE Legal Intrigues of Counseling Practice 33

BASICS OF PROFESSIONAL, ETHICAL, AND LEGAL PRACTICE

FOR COUNSELORS

Professional counseling in the 21st century is a developing discipline. Because

counseling involves working with complex human beings, the rapid growth and
many changes the field has experienced since its inception are likely to continue.
The professional, ethical, and legal principles that guide school and mental health
counselors are especially prone to advancements and evolution. With an emphasis
on this area, the aims of this chapter are to highlight professional, ethical, and legal
concerns relevant to school and mental health counselors as well as to review legal
and ethical obligations with respect to specific areas such as counselor competence,
record keeping, dual relationships, and confidentiality.

䊏 A Look at Professions, Professionalism, and Professional Identity

When talking about the ethical and legal obligations of professional counselors, it is
helpful to understand what is meant by both a profession and a professional. Pro-
fessions often are distinguished from occupations or jobs in that the former tends to
center on the betterment of others, whereas the latter tends to focus on the better-
ment of the self. Additionally, a profession usually is characterized by a body of
specialized knowledge that a group of people commit to acquire, sustain, and pro-
mote (Sperry, 2007). Professionals, or individuals who commit themselves to a cho-
sen profession, likewise have several notable characteristics. Krushinski (2005) de-
scribed the characteristics of professionals this way:

Four Traits of Professionals

1. Professionals have a graduate degree.
2. Professionals practice in a field that focuses work on others.
3. Professionals belong to an organization representative of their field.
4. Professionals contribute academically to their fields.

The idea that professions are rooted in a helping mode of behavior sets the founda-
tion for counseling as a profession and counselors as professionals. Professional-
ism in the counseling field suggests specific responsibilities of school and commu-
nity counselors.

Obligations of Professional Counselors

䊏 Attend to the welfare of others.
䊏 Serve students’ ongoing and ever-changing needs.
䊏 Remain current with the latest research, theory, and techniques.
䊏 Become members of counseling organizations.
䊏 Contribute academically to the profession.
䊏 Attend or present at local, state, and national conferences and workshops.
34 What Are the Primary Roles and Responsibilities of the Professional Counselor? PART ONE

䊏 Share experiences and clinical progress with both colleagues and the community.
䊏 Adhere to the standards of competency set by the field.

䊏 Legal Issues Related to Counselors’ Professional Identity

Counselors’ professional identity is influenced by a number of legal and, in some

cases political, arenas that affect how they represent themselves to the general pub-
lic and the ways they practice; a few of these areas include job titling, testing and di-
agnosis, and reimbursement.
Professional counselors have an obligation to accurately represent themselves.
Titling, such as “licensed professional counselor,” is a legal matter reserved for in-
dividuals who have fulfilled licensure requirements established by state licensing
boards. Moreover, counselors can only claim expertise in areas in which they re-
ceived formal professional training. For example, a master’s-level counselor who
earns a PhD in English literature cannot use the title “Dr.” to represent himself or
herself as a counselor.
Historically, counselors have had to fight to establish the legal right to engage in
testing and diagnosis practices. Yet most counselor education programs require
course work in these areas, and counselors long have been involved in the process
of testing and diagnosis. There is variation from state to state on counselors’ legal
right to use tests and diagnose mental and emotional disorders.
In the U.S. health care system, insurance reimbursements are often provided for
mental health intervention, and counselors who offer these services have fought to
be approved providers by insurance companies. Especially for private practitio-
ners, the ability to receive third-party payment (i.e., from insurance companies) is
crucial to their practices and clients.

䊏 Ethical Codes and Standards of Practice

Counseling professionals in all settings must comply with the ethical guidelines and
legal statutes that bring scrutiny to their conduct. When the welfare of any member
or group of the public is at stake, the law ultimately can override ethical guidelines;
nonetheless, legal issues are closely tied to and complement ethical guidelines.
Two national organizations that have done a great deal to set the ethical stan-
dards counselors follow are the American Counselor Association (ACA) and the
American School Counseling Association (ASCA). Adhering to the guidance of-
fered by these organizations through their ethical codes and standards of practice is
a means for counselors to avoid potential liability, defined as:

Liability: The legal responsibility one person has to another as a result of

committing a negligent act.

The codes of these national counseling organizations are mentioned next.

CHAPTER THREE Legal Intrigues of Counseling Practice 35

Codes of Ethics in School and Community Practice

䊏 The Ethical Standards for School Counselors were developed by ASCA (2004b) to
clarify the ethical responsibilities of its members to students, parents, colleagues,
the profession, the community, and school counselors.
䊏 The ACA Code of Ethics (ACA, 2005a) developed by ACA for community counsel-
ors is set forth for the welfare of the public, profession, and individual prac-
titioners.

Counselors have the responsibility to become knowledgeable and understand the

ethical standards to which they are bound. Although the codes cannot be all-en-
compassing or directly address every ethical dilemma, they do serve a number of
important purposes.

Functions of Ethical Codes

䊏 Offer guidelines and standards with which counselors must be familiar before
beginning their practices.
䊏 Reflect changes in the practice of ethical conduct with which counselors must re-
main current and to which counselors can turn in times of uncertainty.
䊏 Provide the community with a sense of security essential to a profession.
䊏 Enable the field of counseling to have a composite understanding of such con-
cepts as confidentiality, acceptance, and fairness.

Professionalism means knowing your professional association’s codes as well as

adhering to them. The ethical standards from ASCA that are most germane to being
a professional school counselor are characterized by the following behaviors:

䊏 Avoiding dual relationships when possible.

䊏 Establishing healthy relationships with peers.
䊏 Treating colleagues with respect, courtesy, and fairness.
䊏 Having knowledge of resources for students.
䊏 Establishing clear relationships with students’ other counselors.
䊏 Being a gatekeeper in regard to hiring new employees.
䊏 Maintaining well-being.
䊏 Not recruiting students for private practice clients.
䊏 Contributing to the profession.
䊏 Providing mentoring.
䊏 Making sound ethical decisions.

See Chapter 1 for more on professionalism and professional identity and Chapter 2 for
more on ethics in counseling.
36 What Are the Primary Roles and Responsibilities of the Professional Counselor? PART ONE

Check out these sites for a downloadable version of the ASCA and
ACA ethical codes:
http://www.schoolcounselor.org/files/ethical%20standards.pdf
http://www.counseling.org

䊏 What Is Law?

Professional counselors are bound to practice within ethical standards; likewise,

counselors also must abide by federal and state laws that govern their professional
behavior. Although law in the United States is complex and cumbersome, counsel-
ors can benefit from a cursory understanding of the law as it pertains to potential
legal ramifications to their practice. Generally, law is defined as the rule of conduct
established by society and enforced by that society’s government. Two distinct
types of law exist: criminal law and civil law. Anderson (1996) described the dis-
tinction between these two types of law this way:

Criminal law: Involves crimes punishable by fine, imprisonment, or death

and is prosecuted by the government.

Civil law: Includes everything that does not fall under the category of crimi-
nal law and is exemplified by lawsuits resulting in sanctions (generally mone-
tary awards).

According to Anderson (1996), counselors find that most of their legal involve-
ments fall under the category of civil law. Contracts and the law of torts also are
handled under civil law.

䊏 Contracts in Counseling: Informed Consent

Contracts are the soul of any commercial transaction (Bullis, 1993), and counseling
can in some sense been seen as a commercial transaction, with informed consent
serving as the contract between counselors and clients. More important, informed
consent defines the basic treatment relationship (Anderson, 1996). It is imperative
that clients participate in the process (Bullis) because informed consent is meant to
protect clients’ legal right to consent to or refuse treatment. Therefore, although in-
formed consent should be written, counselors also have an ethical responsibility to
explain the contract verbally. A special consideration with regard to informed con-
sent involves minors, who cannot legally consent to treatment. Counselors are
therefore required to obtain parental consent prior to treatment of minors.
CHAPTER THREE Legal Intrigues of Counseling Practice 37

EXAMPLE

What Are the Necessary Elements of an Informed Consent Document?

Duffy (2007b) defined at least 10 elements that should be included in an informed consent con-
tract, as follows:

1. Type of treatment that will be offered.

2. Professional qualifications of the therapist.
3. Nature of the confidential client–therapist relationship and exceptions to confidentiality.
4. Risks and benefits of therapy.
5. Treatment alternatives.
6. Right to refuse treatment without recourse.
7. Client’s statements of competence and lack of coercion.
8. Office hours, emergency and business contact information.
9. Fee schedule and payment options.
10. Privacy statement.

䊏 Torts and Counselor Negligence

Torts are civil wrongs recognized by law as grounds for a lawsuit. In regard to the
counseling profession, negligent torts occur when counselors harm clients and the
clients then seek compensation for the harm done. Negligence can be understood
as follows:

Negligence: Any conduct that does not meet the minimum requirements for
acceptable professional behavior.

Torts essentially fall into the two categories (Anderson, 1996) described here:

1. Unintentional violation may involve counselors not using all of their skill in
dealing with clients.
2. Negligence refers to a demonstrated failure to follow all the requirements of a
protective statute.

According to Anderson, four factors come into play for plaintiffs pursuing negli-
gent torts.

Factors That Define Counselor Negligence

1. A counselor–client relationship existed.
2. The clinical treatment fell below the minimally acceptable standard of care.
3. An actual loss or injury (harm) occurred.
4. The substandard treatment caused the harm.
38 What Are the Primary Roles and Responsibilities of the Professional Counselor? PART ONE

PROFESSIONALISM FOR SCHOOL COUNSELORS

All counselors are equally subject to ethical and legal standards within their profes-
sional organizations and with respect to the laws of the states in which they practice.
Additionally, school counselors have distinct professional responsibilities as a result
of the setting in which they practice. In this section we look at some of the unique as-
pects that come into play in the practice of professional school counseling.

䊏 Building Collaborative Relationships

Collaboration is a critical skill in the counseling profession but especially critical in

the school setting where optimum school counseling programs require that school
counselors be part of the leadership team (Idol, Nevin, & Paolucci-Whitcomb,
2000). Relationship development with the principal, teachers, parents, and other
stakeholders garners support for counselors and ultimately benefits the students.
After all, school counselors need the input of as many stakeholders as possible to
deliver programs that have the potential to reach as many students as possible. In
difficult political relationships, the key to success is the genuine offering of respect
and support to teachers within the sensitive positions in which they must operate.

Collaboration is a critical skill in the counseling

profession but especially critical in the school
setting where optimum school counseling
programs require that school counselors be part
of the leadership team

Collaborative efforts build trust within relationships. Consequently, having

firmly established confidences is important. When counselors have to share neces-
sary information, students’ privacy rights should be respected. Specifically, this
means counselors should only provide germane information to teachers, facilitat-
ing their ability to support students’ academic and social environments. If counsel-
ors are uncertain whether or not principals or teachers will deal deftly with a deli-
cate situation, they should prepare alternative plans. Identifying allies, such as the
assistant principal or someone who will use compassion and a nonjudgmental ap-
proach to problem solving, will help in the throes of a dilemma (Stone, 2005).

䊏 Facing the Political Barriers of the School System

Systemic barriers are a daily fact of life for school counselors. Effective school coun-
selors are vigilant in understanding policies, practices, attitudes, and beliefs that
stratify students’ opportunities and act as systemic change agents to remove these
barriers. Failure to understand the political climate will hinder a counselor’s efforts
to advocate for important policy changes. The ethical school counselor uses finesse
CHAPTER THREE Legal Intrigues of Counseling Practice 39

and diplomacy to navigate the political landscape and advocate for the needs of
students.

䊏 Community Standards in School Counselor Practice

Community and institutional standards can differ significantly from school to

school and community to community. It is difficult to accept the fact that profes-
sional behavior varies depending on the prevailing standards of the community;
however, it is counselors’ ethical obligation to be aware of and respectful toward
the standards of the community that the school serves (Stone, 2005).

EXAMPLE

Responding to Teen Pregnancy: Community Considerations

Community standards can have a significant impact on how counselors advocate for their stu-
dents in moments of crisis. For example, it is acceptable behavior for school counselors in cer-
tain schools and communities to refer pregnant students to agencies that assist pregnant mi-
nors. Yet, in many other communities this would be considered a serious breach of ethics,
infringing on parents’ rights to be the guiding voice in their children’s lives.

䊏 Protecting Students’ Best Interests

Acknowledging the prevailing standards of a community does not mean uncondi-

tionally accepting the standards. School counselors are respectful of the values of
their students and their families, diligently separating out their own values and be-
liefs and offering an objective voice in every situation. If school counselors believe a
practice, policy, or law of a particular school or community is in any way detrimen-
tal to a student, their ethical imperative is to work in a responsible manner and be
change agents to protect students (Stone, 2005). “The professional school counselor
supports and protects the educational program against any infringement not in
students’ best interest” (ASCA, 2004, D.1).

EXAMPLE

Advocating Against Corporal Punishment Standards

If the school’s discipline plan and the standards in the community accept the use of corporal
punishment, school counselors might have a difficult time beginning the change process
needed to promote the well-being of all students, and might also have a difficult time creating
an inviting place for students to work. It is the duty of school counselors to explore what
would be a good approach to influence the culture and climate of the school. School counsel-
40 What Are the Primary Roles and Responsibilities of the Professional Counselor? PART ONE

ors, for instance, could discuss with the administration the idea of forming a committee to de-
velop a revised discipline approach for the school that helps students feel “invited to work.”
School counselors could also involve community resources by interviewing supervisors in
Child Protective Services to determine what constitutes abuse, the incidence of abuse in the
community, the number of students who have been removed from homes for abuse, and per
capita the number of children who have died at the hands of parents locally as compared to
other parts of the United States. These data can inform and compare two communities in dif-
ferent locations with adverse views on the issue of corporal punishment. By actively directing
community members’ attention to the controversy of corporal punishment and using advo-
cacy skills, school counselors can ignite important conversations about topics that need to be
more thoroughly examined (Stone, 2005).

LEGAL AND ETHICAL ASPECTS OF COMPETENCE

Counselor competence is implied in the professional identity of helping practitio-

ners. At the very least, counselors are charged with complying with minimum ethi-
cal standards such as, “Do no harm.” However, because counselors are engaged in
interpersonal and organizational work aimed at serving others, they should aspire
to the maximum levels of competence. A couple recommendations for attaining
and maintaining competence are provided first in this section; ethical and legal
ramifications of incompetence also are mentioned.

䊏 Consultation

Mental health counselors who remain isolated in their clinical practice tend to limit
their awareness and understanding of the healing process in counseling. Although
experience is necessary for professional development, by itself, it is not sufficient
for providing effective services to the community. Palmer (1998) noted that teach-
ers who are isolated from each other in individual classrooms run the risk of be-
coming insipid; in the same way, counselors who are secluded (even for reasons of
confidentiality) run a similar risk of limiting their ability to provide effective ser-
vices. Thus, consultation is an important component of attaining a high level of
competence. Counselors need to communicate with other professionals to continu-
ally broaden their understanding of counseling, treatment, client issues, and their
own involvement in the therapeutic process.

See Chapter 24 for a more in-depth look at consultation.

䊏 Continuing Education

Continuing education is a means by which counselors can expand their knowl-

edge while engaging in clinical practice and, additionally, ensure their compe-
CHAPTER THREE Legal Intrigues of Counseling Practice 41

tence as practitioners. Both ethical and legal codes inform the area of continuing
education. The ACA Code of Ethics (ACA, 2005a), for example, specifies that coun-
selors recognize the need for ongoing education, take the steps necessary to
maintain competence in the skills they use, and keep current with the diverse
populations with whom they work (Section C.2.f). This ethical standard reinforces
public confidence in the profession because it ensures that professional counsel-
ors will continually strive to be informed on how to provide the best possible
level of care.
Credentialing bodies, such as state licensing boards, dictate the legal require-
ments associated with how much continuing education licensed practitioners are
required to have and which programs, workshops, or other activities (e.g., publi-
cations) are approved. There is no federal standard that addresses continuing ed-
ucation; therefore, individual states regulate how much continuing education is
essential to maintain licensure. Despite state-to-state variability, counselors typi-
cally should expect to acquire around 30 continuing education units every 2
years.

䊏 Malpractice

On the continuum of counselor competence, the extreme of unethical behavior is

incompetence, and counselors can be held legally accountable for malpractice.
Malpractice includes any harm done to clients due to counselor negligence. Ander-
son (1996) provided examples of types of malpractice lawsuits that can be brought
against counselors. Some of these cases are listed here.

Malpractice Suits Sometimes Brought Against Counselors

䊏 Abuse (physical, sexual, mental) of a client.
䊏 Sexual misconduct.
䊏 Incompetent practice (e.g., practicing outside the scope of professional training,
misdiagnosing clients).
䊏 Violations of confidentiality (e.g., communicating information to a third party
who has neither need or privilege to have the information).
䊏 Failure to treat or refer clients.
䊏 Breaches of the counselor–client contract.
䊏 Defamation of character.
䊏 Illegal search and seizure (e.g., attempting to unreasonably search a student or
community member for drugs).
䊏 Any act involving moral turpitude.

One way to avoid malpractice is to provide both written and verbal informed con-
sent to clients, because it is a statute of case law, not simply an ethical standard
(Crawford, 1994).
42 What Are the Primary Roles and Responsibilities of the Professional Counselor? PART ONE

RECORD KEEPING

Counselors keep records known as case notes to validate the clinical treatment of
clients. Record keeping is such an integral part of ethical behavior for counselors
that the adage, “If it wasn’t charted, it didn’t happen” emerged. More important
than the adage, however, is that counselors are charged with protecting the con-
tents of client records. Protecting client information is important in both school and
community settings. However, because the legislation defining record keeping in
these sites is unique, in this section we look at record keeping in both settings.

䊏 School Records: Family Education Rights and Privacy Act (FERPA)

Ideally, school counselors should not be in charge of managing education records,

but they still need a working knowledge of the legal guidelines to support their role
in advocating for the legal and ethical protection of any written information kept
on a student (ASCA, 2004). The 1974 Family Education Rights and Privacy Act
(FERPA) is federal legislation that governs education records and dictates how all
written information on a student will be handled and disseminated for the protec-
tion of the student and his or her family (Alexander & Alexander, 2005; Fischer &
Sorenson, 1996; Imber & Van Geel, 2004). FERPA, also known as the Buckley
Amendment, is administered by the Family Policy Compliance Office and has en-
acted safeguards so that parents can access their children’s education records and
have a voice in how that information is shared with others (Alexander & Alexan-
der, 2005; Fischer & Sorenson, 1996; Imber & Van Geel, 2004).

Purposes of and Protections Outlined by FERPA

(Alexander & Alexander, 2005)
䊏 FERPA was expressly written to identify parents’ right to view their children’s
education records and to decide, within certain parameters, who has access to
their child’s records.
䊏 Students who are at least 18 years of age or who are in postsecondary school are
eligible to access their records.
䊏 Noncustodial and certain stepparents are granted rights under FERPA (20 U.S.C.
§ 1232g; 34 CFR Part 99).
䊏 The FERPA legislation allows parents and eligible students to request that correc-
tions and amendments be made to records that could be erroneous or potentially
misleading.
䊏 FERPA requires that parents be given due process to protest the contents of
records when they disagree with the school district about the accuracy of the
record.
CHAPTER THREE Legal Intrigues of Counseling Practice 43

According to FERPA guidelines, schools must have written permission from par-
ents or the eligible student before any information is released from a student’s edu-
cation record. There are, however, a number of exceptions to the regulations on dis-
closing information.

Exceptions to FERPA Standards Pertaining to Release of Information

䊏 School officials with legitimate education interest (school counselors are consid-
ered school officials along with teachers).
䊏 Other schools to which a student is transferring.
䊏 Officials for purpose of audit or evaluation.
䊏 Persons involved with the financial aid of the student.
䊏 Those involved with conducting specific research studies for the school.
䊏 Organizations involved in accreditation.
䊏 Holders of a judicial order or lawfully issued subpoena.
䊏 Persons involved with emergencies or in cases of health and safety.
䊏 Local and state authorities in the juvenile justice system, in compliance with spe-
cific state law.

In addition to the exceptional cases in which release of information is permitted by

FERPA, the federal act further allows for the dissemination of directory information,
or public information on students such as their name, address, or telephone num-
ber without parent or eligible student consent. Within certain parameters, FERPA
allows states to define what they will classify as directory information. School dis-
tricts can establish policies and procedures regarding the release of directory infor-
mation and decide not to participate. It should be noted, however, that the military
cannot be excluded from directory information unless a student’s parents have
signed to opt out of releasing directory information (Alexander & Alexander, 2005).

Check out the U.S.Department of Education Web site for more infor-
mation about FERPA at:
http://www.ed.gov/policy/gen/guid/fpco/ferpa/index.html

䊏 ASCA Ethical Guidelines on Educational Records

The ethical standards from ASCA that are most germane to ethical and legal con-
siderations for educational records pertain to some of the following areas.
44 What Are the Primary Roles and Responsibilities of the Professional Counselor? PART ONE

ASCA Ethical Guidelines on Student Records

䊏 Maintaining and securing student records, including electronic transmissions.
䊏 Informing parents or guardians of the counselors’ role.
䊏 Making reasonable efforts to honor the wishes of parents or guardians.
䊏 Understanding limits and rights of sharing information.
䊏 Conducting appropriate research and protecting students’ identity when using
data.

䊏 Agency Records: Health Insurance Portability and Accountability Act (HIPAA)

In April 2003, with the implementation of the federal government’s 1996 Health In-
surance Portability and Accountability Act (HIPAA), protecting clients’ records
became a federal standard. HIPAA emerged to address the substandard level of
care in place to address sharing and releasing of client information. HIPAA forced
the Department of Health and Human Services to publish new standards ensuring
the protection of clients’ physical and mental health information. Essentially,
HIPAA guidelines were developed to improve health care organizations by two
primary means.

Ways HIPAA Protects Health Care Recipients’ Private Information

1. Standardization of how electronic data is transferred and kept (including ad-
ministrative and financial data).
2. Protection of the confidentiality, integrity, and security of individual health
care information through setting and enforcing standards and penalties.

The seriousness with which the HIPAA regulations are enforced for providers of
physical and mental health care becomes clear on examination of the fines and pen-
alties associated with breaches of privacy.

Examples of Penalties for HIPAA Violations

䊏 Fines up to $25,000 for multiple violations of the same standard in a calendar year.
䊏 Fines up to $250,000, imprisonment up to 10 years, or both for knowing misuse of
individually identifiable health information.

Check out the U.S. Department of Health and Human Services Web
site for HIPAA statutes and regulations at:
http://www.hhs.gov/ocr/hipaa
CHAPTER THREE Legal Intrigues of Counseling Practice 45

DUAL RELATIONSHIPS IN SCHOOL AND COMMUNITY

SETTINGS

Dual or multiple relationships are potentially harmful to clients in either commu-

nity or school settings because of the inherent power differential between counsel-
ors, who hold the position of power, and clients, who are more vulnerable.

䊏 Ethical and Legal Considerations of Dual Relationships

Some dual relationships, such as sexual relationships, are recognized as always un-
ethical because they exploit clients’ vulnerabilities (Duffy, 2007a). Sexual involve-
ment between therapists and clients, moreover, potentially can represent negli-
gence on the part of the counselor and be grounds for malpractice lawsuits. At the
same time, literature on dual relationships also suggests that, at times, multiple re-
lationships between counselors and clients might be unavoidable or potentially
beneficial (ACA, 2005a; Duffy, 2007a).

See Chapter 2 for more information about dual relationships in professional counseling.

䊏 Complexity of Dual Relationships in Schools

The reality of multiple relationships is particularly present in schools. Therefore,

counselors must be especially vigilant to maintain a professional distance with stu-
dents and parents. Professional distance is the appropriate familiarity and closeness
that a school counselor engages in with students and their family members (Stone,
2005). However, when professional distance is disregarded, dual relationships
transpire (ASCA, 2004b, A.4.). For example, accepting an invitation to attend a spe-
cial event might simply be a show of support for a student who needs to know
someone cares. However, when a counselor accompanies this with behaviors such
as trying to groom friendships with students and singling out a few on whom to
lavish attention, that counselor violates professional distance.
Not only do dual relationships involve an inappropriate boundary crossing, but
they also involve personal gains (Stone, 2005). Whereas professional school coun-
selors work vigilantly to ensure that they do not gain any unfair advantages
through their work, unethical counselors cross boundaries for personal gain.

Examples of Personal Gains From Boundary Crossing

䊏 Using the dual relationship to boost one’s ego or sense of self-worth.
䊏 Using the dual relationship to receive benefits from select parents.
46 What Are the Primary Roles and Responsibilities of the Professional Counselor? PART ONE

EXAMPLE

Dual Relationships in Schools: Whose Needs Is the Counselor Serving?

It is unethical for school counselors to nourish the belief they are “heroes” in advocating for
students, currying favor with students or their parents, or establishing themselves as heroes
for students (Stone, 2005). Professional school counselors must continually examine their ac-
tions and ask this question: Whose needs are being met by my behaviors? If the answer is
“only a select few students with whom I work” or “I am feeding my own personal needs by
my behavior,” then these counselors are in the midst of a significant ethical violation.

䊏 Safeguarding Clients’ Emotional Health

Both school and community counselors have a duty to guarantee the emotional
safety of their minor students or their clients. Dual relationships are to be
avoided because they have the potential to harm clients and the counseling pro-
fession, as well as put employers in jeopardy (Stone, 2005). Unfortunately, when
counselors work in small communities and in closed settings like schools where
everyone knows each other, dual relationships might be unavoidable. In such
cases, the counselor is responsible for eliminating or reducing the potential for
harm.

Safeguards Against Dual Relationships (ASCA, 2004b)

䊏 Informed consent.
䊏 Consultation.
䊏 Supervision.
䊏 Documentation.

CONFIDENTIALITY, PRIVACY, AND PRIVILEGED

COMMUNICATION

Whether working in schools or community settings, counselors need to under-

stand the meaning, implications, and limits of confidentiality as defined by their re-
spective ethical standards (e.g., ACA or ASCA). To understand confidentiality,
counselors also have to have a working knowledge of its legal aspects, encom-
passed in privileged communication and privacy. Corey, Corey, and Callanan
(2003) defined these three concepts this way:

Confidentiality: An ethical standard that safeguards clients from unautho-

rized disclosures of information given in a counseling relationship.
CHAPTER THREE Legal Intrigues of Counseling Practice 47

Privileged communication: A legal concept that guards against compulsory

disclosure in legal proceedings that breaks a promise of privacy.

Privacy: Refers to the constitutional right of people to decide the time, place,
manner, and extent of personal disclosure.

䊏 Ethical Standard of Confidentiality

Confidentiality is first an ethical guideline that charges counselors to protect client

disclosures in the therapeutic relationship. The ACA and ASCA codes regarding
confidentiality are grounded in ethical principles of beneficence and nonmale-
ficence.

For more on confidentiality and ethical principles, see Chapter 2.

䊏 Confidentiality for School Counselors

The legal and ethical complexities of working with minors in schools require that
school counselors remain vigilant to the rights and responsibilities of students and
their parents, as well as to the implications of these rights on their work (ACA,
2005a; ASCA, 2004b; Imber & Van Geel, 2004). The numerous responsibilities
school counselors have in a setting designed to deliver academic instruction fur-
ther complicate the legal and ethical world of school counseling (Baker & Gerler,
2004; Gibson & Mitchell, 2003; Sink, 2005; Stone, 2001). These complications are
acutely present in individual counseling (Thompson, Rudolph, & Henderson,
2004; Vernon, 2004) and even more so in group counseling, where confidentiality
cannot be guaranteed and sensitive information about the private world of stu-
dents and their families is often discussed (Corey, 2004b; Greenberg, 2003).

How School Counselors Can Protect Confidentiality

䊏 School counselors gather informed consent at the beginning of the counseling re-
lationship to inform the counselee of the purposes, goals, techniques, and rules
of procedure under which she or he may receive counseling.
䊏 The meaning of confidentiality is explained in developmentally appropriate terms.
䊏 The limits of confidentiality are outlined and include exceptions of danger to self
or others and court-ordered disclosures of information.

Confidentiality is difficult in school settings because of the competing interests

and obligations that extend beyond the students to parents, administrators, and
teachers. Working with clients who are minors poses special considerations with
parents but never more so than in a setting designed for academic instruction and
not counseling. In some instances, parents might demand and obtain information
that their child is discussing.
48 What Are the Primary Roles and Responsibilities of the Professional Counselor? PART ONE

Generally speaking, school counselors should feel free to discuss relevant but
controversial issues with students such as drug and alcohol abuse, sexual experi-
mentation, pregnancy, abortion, and birth control. When engaged in individual
and group counseling, professionals must carefully consider the developmental
and chronological levels, in loco parentis (to assume the responsibilities of the par-
ents), and parents’ rights to be the guiding voice in their children’s lives.

EXAMPLE

Implications of Court Rulings on Confidentiality in Schools

In Parents v. Williams-Port Area School District (1991) a psychologist could not use his profes-
sional confidentiality as a basis for refusing to reveal to parents what was said in an individual
counseling session recorded in individual case notes. This decision informs counselors that
parents probably have a right to their child’s information, especially information that is value
laden and revealed to a school counselor in a setting designed for academic instruction. Other
court cases have supported the school counselor’s confidentiality to the extent possible; how-
ever, the courts tell counselors to be ready to defend their competence in addressing issues of
interest with a student in isolation of his or her parents.

䊏 Privacy

Ensuring client privacy is the aim of confidentiality. A basic client right, privacy
suggests that clients have the autonomy to choose how and when they will disclose
personal information, and, additionally, that they are in control of their private
health and mental health records. Thus, counselors must only give germane infor-
mation when reporting to third-party payees to safeguard clients’ privacy.

䊏 Legal Facets of Privileged Communication

All states have some form of privileged communication, although the details of
that communication differ from state to state. Laws that address privileged com-
munication ensure that in legal proceedings, client disclosures of personal informa-
tion will be protected from exposure by therapists. In other words, based on privi-
leged communication, therapists can refuse to produce a client’s records in court.
Despite the protections afforded to clients by the law, there are a number of excep-
tions to privileged communication.

Exceptions to Privileged Information

䊏 A client consents to disclosure.
䊏 Child or elder abuse is occurring.
䊏 A duty to warn exists.
䊏 Legal rules require disclosure.
CHAPTER THREE Legal Intrigues of Counseling Practice 49

䊏 A client brings a lawsuit.

䊏 In the case of an emergency.

Typically, groups and family therapy do not fall under privileged communication.
Confidentiality, like privileged communication, also has limitations.

See Chapter 2 for more on the limits to confidentiality.

䊏 Duty to Warn: Limit to Privileged Communication

One of the most well-known and recognized limits to privileged communication is

the duty to warn, and probably the most well-known legal battle upholding the
duty to warn is the 1976 case of Tarasoff v. Regents of the University of California. Fol-
lowing the court decisions handed down in Tarasoff and similar landmark cases,
mandates have been put into place that require mental health professionals to oper-
ate under the obligation to warn of clear and imminent danger to the client or any
other identifiable persons that is disclosed in the process of counseling.

Duty to warn: The responsibility of a counselor or therapist to breach confi-

dentiality if a client or other identifiable person is in clear or imminent
danger.

In situations where there is clear evidence of danger to the client or other persons,
the counselor must determine the degree of seriousness of the threat and notify the
person in danger and others who are in a position to protect that person from harm
(Herlihy & Sheeley, 1988; Pate, 1992). For example, if a student tells the school
counselor that another student is planning to commit suicide, the counselor is
obliged to investigate and should not leave the indicated student alone until the
parents or guardians have arrived (Davis & Ritchie, 1993).

EXAMPLE

Landmark Case: Implications of the Tarasoff Decision to the Duty to Warn

The Tarasoff case was monumental in the formulation of counselors’ duty to warn others of im-
pending danger. On October 27, 1969, Prosenjit Poddar murdered Tatiana Tarasoff. Following
her death, Tarasoff’s parents claimed that 2 months earlier Poddar had confided his intentions
to kill their daughter to Dr. Lawrence Moore, a psychologist who was at that time a member of
the staff at the Cowell Memorial Hospital at the University of California at Berkeley. They fur-
ther claimed that on Moore’s request the university police briefly detained Poddar but re-
leased him when he appeared, to them, to be rational. Finally, Tarasoff’s parents claimed that
Moore’s supervisor, Dr. Harvey Powelson, directed that no further action needed to be taken
to detain Poddar and that no one ever warned them, or Tarasoff, of her impending peril.
50 What Are the Primary Roles and Responsibilities of the Professional Counselor? PART ONE

䊏 Duty to Protect

McWhinney, Haskins-Herkenham, and Hare (1992) noted the effects of the Tarasoff
case, stating that the case imposed an affirmative duty on therapists to warn a po-
tential victim of intended harm by the client. In short, the right to confidentiality
ends when public peril begins. This legal decision sets an affirmative duty prece-
dent in cases of harm to others that is generally accepted within the helping profes-
sions. According to Davis and Ritchie (1993), this case indicates that contacting the
police in the event of a threat does not meet the burden of counselor responsibility
under the duty to protect, and this action alone will not safeguard the counselor
from lawsuit if the threat is realized. In keeping with ripple effect of these circum-
stances counselors must diligently and tirelessly labor under the obligation of be-
ing sentinels that safeguard others through what was originally labeled a duty to
warn about possible harm and is now understood to be a duty to protect from the
same threat.

Chapter 3: Key Terms

䉴 Liability 䉴 Family Education Rights 䉴 Privileged communication
䉴 Law and Privacy Act (FERPA) 䉴 Privacy
䉴 Criminal law 䉴 Health Insurance Portabil- 䉴 Duty to warn
䉴 Civil law ity and Accountability Act
䉴 Torts (HIPAA)
䉴 䉴 Confidentiality
Negligence
 chapter Multicultural Intricacies
in Professional Counseling
4
Hugh C. Crethar
University of Arizona

Laurie Vargas
San Francisco Unified School District

In This Chapter

䉴 Cultural Influences in Counseling 䊏 Race

䊏 Influence of Eurocentric Perspectives on 䊏 Age
Counseling 䊏 Ability
䊏 Rationale for a Multicultural Approach in 䊏 Religion and Spirituality
Counseling
䊏 Multicultural Competencies for Profes- 䉴 Bias, Prejudice, Discrimination,
sional Counselors and Oppression
䊏 Bias

䉴 Essential Factors in Culture-Sensitive 䊏 Prejudice

Counseling 䊏 Discrimination

䊏 Culture Defined 䊏 Oppression

䊏 Cultural Convergence 䊏 Privilege

䊏 Etic and Emic Cultural Viewpoints

䊏 Cultural Encapsulation 䉴 Cultural Identity Development

䊏 Ethnocentrism 䊏 Racial and Cultural Identity Development
䊏 Acculturation and Assimilation Model
䊏 Alloplastic and Autoplastic Viewpoints 䊏 White Racial Identity Development

䉴 Cultural Constructs: A Closer Look 䉴 Multicultural Theories in Counseling

䊏 Sex and Gender 䊏 Multicultural Counseling and Therapy
䊏 Sexuality and Affectional Orientation 䊏 Benefits of Multicultural Counseling

and Therapy

52
CHAPTER FOUR Multicultural Intricacies in Professional Counseling 53

CULTURAL INFLUENCES IN COUNSELING

Our intent in this chapter is to introduce areas of cultural concern that are relevant
to counseling professionals by focusing on the contributions of diversity-sensitive
literature in the counseling profession. In particular, we will look at the impact of
culture on the counseling relationship, provide an overview of key concepts of
multicultural counseling, and address multiculturally sensitive approaches to
counseling.

䊏 Influence of Eurocentric Perspectives on Counseling

The United States is a diverse, multicultural, and constantly evolving nation. How-
ever, despite numerous peoples and cultures having long coexisted in the United
States, European and Western cultures traditionally have held a dominant position
in defining cultural norms, rules, laws, and mores, or convictions about the moral
rightness or wrongness of behavior. Early approaches to counseling, too, have been
defined from a Eurocentric perspective and have reflected the customs, values, lan-
guage, and philosophies of European cultures (Ponterotto & Casas, 1991).

䊏 Rationale for a Multicultural Approach in Counseling

Although the overwhelming majority of counseling and psychotherapy theories

arose from the dominant cultures found in Europe and the United States (Pon-
terotto & Casas, 1991), increasing attention is being paid to the influence of minor-
ity groups and, thus, to the elements of cultural differences in counseling relation-
ships. Ultimately every competent counselor is required to account for social and
cultural factors in her or his clinical work. New awareness in the field of counselor
education related to the need for a multicultural approach is grounded in a number
of rationales for the shift to a multicultural perspective.

Why a Multicultural Worldview Is Necessary

1. Every client comes to the counseling relationship with a worldview that is dis-
tinct from that of the counselor due to personal experience within an array of
cultural contexts (Ibrahim, 1991; Ivey & Ivey 2007).
2. Without cultural sensitivity, many counselors and psychologists fail to recog-
nize that they are approaching the counseling relationship from a perspective
that is quite different from their clientele.

To ground the rationales for adopting multicultural perspectives, one need only
consider the example of counselors who might not have gained awareness that the
great majority of cultures and societies in the world emphasize a collectivistic
rather than an individualistic perception of identity. In cultures that operate out of
collectivist values, individualism is seen more as a hindrance to healthy develop-
ment than as evidence of healthy development (White & Parham, 1990). When
54 What Are the Primary Roles and Responsibilities of the Professional Counselor? PART ONE

working with clients from collectivist-minded backgrounds, counselors who adopt

individualist perspectives must recognize the implications of differing values for
the counseling process.

䊏 Multicultural Competencies for Professional Counselors

In an article that was published in both The Journal of Counseling and Development
and The Journal for Multicultural Counseling and Development, Sue, Arredondo, and
McDavis (1992) outlined multicultural competencies that are now an integral and
foundational part of counselor training programs and practice. The authors out-
lined a number of rationales for adopting multicultural standards in the counseling
field, among them the ever-increasing diversity of the United States and the histori-
cal Eurocentric approach to psychological theory. The multicultural standards can
be summarized as follows.

Components of the Multicultural Standards for Counselors

(Sue et al., 1992)
1. Awareness of personal assumptions, values, and biases.
2. Knowledge about the worldview of the culturally different client.
3. Ability to develop appropriate strategies and techniques for culturally differ-
ent clients.

To download a copy of the multicultural competencies for profes-

sional counselors, see
www.counseling.org/Resources

ESSENTIAL FACTORS IN CULTURE-SENSITIVE COUNSELING

In this section, we focus on a review of concepts that provide a framework for talking
about and understanding social and cultural approaches to the helping process.

䊏 Culture Defined

Pedersen (1991) described multicultural counseling as the fourth force in counsel-

ing. Today, it can be argued that all counseling is multicultural in nature and that all
good counseling is multicultural in perspective (Pedersen). Understanding the
CHAPTER FOUR Multicultural Intricacies in Professional Counseling 55

complex arena of multiculturalism begins with creating a definition of culture that

is suitable to the counseling field. For the purposes of this text, counselors can
adopt this definition of culture:

Culture: A combination of learned behaviors, thoughts, and beliefs as well as

the results of learned behaviors, thoughts, and beliefs whose components and
elements are shared and transmitted by the members of a particular society.

Every society that shares and transmits these factors to its members has a culture.
The learned behaviors, thoughts, and beliefs supported by a culture also include
some of the more specific dimensions mentioned later (see, e.g., Falicov, 1998;
Lewis, Lewis, Daniels, & D’Andrea, 2003; Robinson & Howard-Hamilton, 2000).

Key Dimensions of Culture

䊏 Race or ethnicity.
䊏 Religion and spirituality.
䊏 Language.
䊏 Gender or sex.
䊏 Affectional orientation.
䊏 Age or cohort.
䊏 Physical ability.
䊏 Socioeconomic status.
䊏 Education (formal and informal).
䊏 Experience with trauma.
䊏 Migration history (including region of upbringing).

䊏 Cultural Convergence

Each of the key dimensions of culture just mentioned is important in its own right
and has a unique impact on individuals’ experiences; yet, all of the dimensions of
culture also overlap, interact, or converge. Robinson and Howard-Hamilton (2000)
referred to convergence this way:

Convergence: The phenomenon of overlapping cultural dimensions affect-

ing experience and identity.

The dimensions of culture converge in different ways based on people’s experi-

ences, contexts, and interpersonal interactions. To understand culture and the ef-
fect it has on clients, counselors must strive to develop clear understandings of
each cultural construct as well as awareness of the multiple ways in which the con-
structs converge.
56 What Are the Primary Roles and Responsibilities of the Professional Counselor? PART ONE

EXAMPLE

Convergence in a Counseling Relationship

Mayra, a 21-year-old Latina working in child care, comes to a public agency seeking couple’s
counseling. A culturally competent counselor working with her would need to attend to a
number of merging cultural constructs. Mayra is bicultural, as her mother was originally from
El Salvador and father was originally from Mexico. A daughter of Spanish-speaking farm
workers, Mayra was born and raised in the Central Valley of California. Reared as a Jehovah’s
Witness, Mayra attended religious services with her family on a weekly basis. She has a high
school diploma and is now attending night classes at the local community college to obtain
licensure to open her own child-care center. Because seeking help from a counselor is not in
concert with the precepts of her religion, once she steps into the counseling office she must face
how her actions reflect beliefs differing from those of her parents. Converging issues to con-
sider in this case include (a) language differences (not raised in an English-speaking home), (b)
religious differences (not raised in a mainstream Christian religion), (c) social class differences
(not middle class), and (d) sex or gender differences (as a woman, she does not have male priv-
ilege). As each of these issues has an impact on the reality of Mayra’s experiences, a culturally
competent counselor needs to take into account each issue as well as the convergence of all is-
sues when selecting a helping approach.

䊏 Etic and Emic Cultural Viewpoints

Literature that addresses multiculturalism recognizes two primary approaches to

the helping process: cultural universality, often referred to as the etic perspective,
and cultural relativism, known as the emic perspective. It is useful for counselors to
understand the distinction between these approaches.

What Is Cultural Universality?

䊏 Cultural universality, or the etic perspective, suggests that many aspects of hu-
man behavior are universal, and counselors, therefore, can apply therapeutic
techniques similarly across cultures and contexts.
䊏 The etic perspective attempts to find universal definitions of health and sickness,
normality and abnormality, and effectiveness and ineffectiveness of treatment
assessment across cultures.
䊏 Counselors who approach clients from an etic perspective use their own cultural
standards as the basis for interpretation.

What Is Cultural Relativism?

䊏 Cultural relativism, or the emic perspective, suggests that cultural values,
worldviews, and contexts all affect definitions of normal and deviant behavior.
CHAPTER FOUR Multicultural Intricacies in Professional Counseling 57

䊏 Counselors who function from this perspective are both receptive to and respect-
ful of various cultures’ meanings and evaluations of experiences.
䊏 Emic perspectives allow counselors to account for clients’ cultural contexts
rather than rely solely on universal or even stereotypical assumptions.

Few counseling professionals embrace the extremes of either cultural universality

or cultural relativism, as both have validity (Sue & Sue, 2003). Counselors who
approach their work from a multicultural perspective maintain the awareness,
knowledge, and skills necessary to adjust to multiple cultural and contextual vari-
ables, while responding to relatively universal psychological phenomena. Bal-
ancing these two approaches, counselors are able to accommodate diverse cultural
groups, while acknowledging that their own cultural values come into play in the
counseling relationship.

䊏 Cultural Encapsulation

As are all people, counselors are prone to being culturally encapsulated by their
own perceptions and, therefore, hindered in recognizing their biases that may be
harmful to clients. Skovholt and Rivers (2004) proposed this definition of cultural
encapsulation that counselors can adopt:

Cultural encapsulation: Counselors’ reliance on a narrow model of helping

that fails to account for cultural values, beliefs, and variables and interprets
health and wellness the same across cultures.

Wrenn (1962, 1985) suggested that counselors are vulnerable to the experience of
cultural encapsulation when five basic stances are present. The characteristics and
behaviors of culturally encapsulated counselors are presented next.

Identifying Behaviors of Culturally Encapsulated Counselors

1. Define truth and reality on a rigidly maintained set of cultural assumptions
that is presumed to be constant and unchanging.
2. Become trapped by their particular way of thinking that resists adaptation, re-
jects alternatives, and is insensitive to perspectives from other cultures.
3. Maintain perspectives based on unreasoned assumptions without proof and
regard to empirical reality and, when confronted with evidence contrary to
their encapsulated assumptions, ignore or otherwise invalidate the informa-
tion presented.
4. Fail to carefully evaluate the viewpoints of others when those viewpoints are
not similar their own and are not apt to accommodate the needs of others who
are different from them.
5. Make judgments of others based on the viewpoint of their own criterion with-
out regard for the cultural context of others.
58 What Are the Primary Roles and Responsibilities of the Professional Counselor? PART ONE

To challenge culturally encapsulated perspectives and attitudes, counselors can en-

gage in some of the following behaviors.

Ways to Challenge Culturally Encapsulated Perspectives

(Wrenn, 1962, 1985)
䊏 Become aware of personal culture and worldviews.
䊏 Seek out contact with groups of people that are culturally different than oneself.
䊏 Search for ways to recognize unique qualities within various cultures.
䊏 Avoid using one’s own group as the standard by which appropriate behavior is
assessed.

EXAMPLE

Vulnerability to Being Culturally Encapsulated

One of the challenges to confronting cultural encapsulation is the fact that many of the things
people do on a daily basis inherently reinforce its existence. The criteria counselors use in
self-referencing fosters ongoing cultural encapsulation because many of the labels that people
use to define themselves are based on culturally laden concepts. For example, a man who con-
sistently refers to himself as “self-made” and “independent” is choosing to define himself in
terms that highlight specific culturally encapsulated values. In this case, the preferred value is
individualism. The value-based use of such labels highlights one cultural perspective while
deemphasizing or even denigrating other cultural perspectives (e.g., collectivism). Even if
people do not say anything directly negative about another person or culture, their self-de-
scriptions automatically place priorities on certain values, actions, thoughts, and attitudes.

䊏 Ethnocentrism

Counselors who are culturally encapsulated generally approach clients from an

ethnocentric perspective. Ethnocentrism can be defined this way:

Ethnocentrism: The tendency to use one’s own cultural standards as the stan-
dards by which to evaluate other groups and to rank these standards higher
than all others (Berry, Poortinga, Segall, & Dasen, 1992).

䊏 Acculturation and Assimilation

Although acculturation and assimilation frequently have been used inter-

changeably, the two terms represent two distinct forms of adaptation. The distinc-
CHAPTER FOUR Multicultural Intricacies in Professional Counseling 59

tion between acculturation and assimilation can be understood this way

(Roysircar-Sodowsy & Maestas, 2000):

Acculturation: Suggests that minority groups adapt to the culture, values,

and norms of the dominant group rather than the dominant group adjusting
to the presence of the minority group.

Assimilation: Refers to adaptations that are made by the minority group to

the norms, values, and culture of the dominant group as well as structural ad-
aptations made by the dominant group to include portions of the culture, val-
ues, and norms of the minority group.

Although people who are highly acculturated have adopted the values, norms, lan-
guage, and behaviors of the core dominant society, the latter does not make any ad-
justments to meet those of the incoming people. In a fully assimilated society, con-
versely, members of various groups interact with each other as friends and equals
to the extent that even marriage partners are selected without biased regard to eth-
nic or racial identities. The dominant culture in assimilated societies adjusts to in-
clude key elements of the incoming culture.

EXAMPLE

Differences in Assimilating Cultural Groups in the United States

A good example of the variance in how minority groups are assimilated to the dominant cul-
ture can be seen by examining the way that U.S. culture has adapted more to Irish customs,
culture, and values than to Chinese customs, culture, and values. Despite the fact that large
numbers of both populations have resided in the United States for approximately the same
amount of time, assimilation has occurred to a greater extent with people of Irish descent than
with people of Chinese descent.

䊏 Alloplastic and Autoplastic Viewpoints

Related to the concepts of acculturation and assimilation are the concepts referred
to as alloplastic and autoplastic viewpoints. The terms define two different levels of
adaptation in society.

Autoplastic perspective: Suggests that people focus on adapting to the regu-

lations of the dominant social structure and setting.

Alloplastic perspective: Suggests that people focus primarily on working to

adjust society to better fit their needs and preferences.
60 What Are the Primary Roles and Responsibilities of the Professional Counselor? PART ONE

Counselors may work with their minority clientele to adopt the dominant culture,
make adaptations to it, or some combination thereof (Pedersen, 1976). Although
intentionality in this viewpoint is important, any choice does not take away from
the fact that assimilation will not occur without the dominant society adjusting to
meet the norms, values, and behaviors of the incoming culture.

EXAMPLE

Autoplastic and Alloplastic Perspectives

A counselor who encourages her minority clientele to strive for acculturation is working from
an autoplastic perspective. She is presuming that it is in the best interest of her clientele to
change to fit into society. She is also presuming that mainstream society cannot or should not
have to adjust to the diversity that her clientele bring. On the other hand, a counselor who en-
courages her minority clientele to strive for assimilation will help them develop heightened
understanding and sharpened abilities to advocate for structural changes in society around
their own culture, values, and norms.

CULTURAL CONSTRUCTS: A CLOSER LOOK

Counselors who strive to be multiculturally competent develop as clear an under-

standing of cultural constructs as possible. We present here a brief overview of
some of the significant concepts that counselors must understand to practice
competently.

䊏 Sex and Gender

Two important areas of cultural consideration are sex and gender. Because of the
influence these facets of personhood have on clients’ identity development and be-
cause of the role that sex and gender can play in the helping relationship, counsel-
ors need to be knowledgeable of these constructs. Additionally, counselors can in-
crease their effectiveness in the therapeutic relationship when they are aware of
and comfortable with their own sexual and gender identity. Although the terms sex
and gender have at times been used interchangeably, they are distinct concepts and
can be differentiated this way:

Sex: The system of sexual classification based on biological and physical dif-
ferences, such as primary and secondary sexual characteristics, which create
the categories of male and female.
CHAPTER FOUR Multicultural Intricacies in Professional Counseling 61

Gender: A system of sexual classification based on the social construction of

the categories of men and boys and women and girls and usually refers to a
person’s masculinity or femininity.

Although sex and gender refer broadly to the physical characteristics of men and
women or to the social construction of maleness and femaleness, there are also sex
and gender groups with more ambiguous characteristics. These groups are known
respectively as intersex and androgynous.

Intersex: A person who was born with genitalia, secondary sexual character-
istics, or both of indeterminate sex, or with features combined from both
sexes. A more archaic and less preferred term for people who are intersex is
hermaphrodite.

Androgynous: A person who has both feminine and masculine qualities and
who may assume female and male roles.

The area of gender, in particular, is receiving increasing attention in the helping

field, as professionals are recognizing the impact of gender and gender identity on
clients’ experiences. The interplay between gender and culture can have a signifi-
cant effect on the counseling relationship because the meaning of gender and gen-
der roles are socially constructed and may be understood differently by the coun-
selor and the client. Counselors can benefit from being aware of several more
concepts related to the area of gender, including gender roles, gender stereotypes,
transgender, cisgender, and androcentism.

Gender roles: Behaviors, attitudes, values, emotions, beliefs, and attire that a
particular cultural group considers appropriate for males and females on the
basis of their biological sex.

Gender role stereotypes: Socially determined models that contain the cul-
tural beliefs about what the gender roles should be.

Transgender: A person whose gender identity does not match her or his as-
signed gender (gender assignment is usually based on biological physical
sex).

Cisgender: People who possess a gender identity or perform a gender role so-
ciety considers appropriate for one’s sex.

Androcentrism: The practice, conscious or otherwise, of placing male human

beings or the masculine point of view at the center of one’s view of the world
and its culture and history.
62 What Are the Primary Roles and Responsibilities of the Professional Counselor? PART ONE

䊏 Sexuality and Affectional Orientation

The term affectional orientation is preferred today over the more traditional term sex-
ual orientation, as it presumes that the orientation of a person’s affections goes be-
yond sexuality.

Affectional orientation: Orientation toward the type of person with whom a

given individual is predisposed to bond emotionally and share personal
affection.

Although sexual attraction plays a role in affectional orientation, it is not the sum
of any relationship; therefore, a broader description of orientation allows for an
inclusion of interpersonal affection as significant to the relational bonds people
form.

䊏 Race

Race as a biological construct has become increasingly invalidated and controver-

sial (Jackson & Sellers, 1997); however, it continues to be used as a nominal cate-
gory within the human service fields (Helms & Cook, 1999). Viewed as an inher-
ently biological construct, Zuckerman (1990) defined race this way:

Race: “An inbreeding, geographically isolated population that differs in dis-

tinguishable physical traits from other members of the species” (p. 1297).

Scientists who interpret race biologically have created from as few as 3 categories of
race (Caucasoid, Mongoloid, and Negroid) to as many as 200 distinct racial catego-
ries, suggesting that there is little agreement on the empirical groundings of race as
a biological concept. With the completion of the human genome mapping, scien-
tists have been able to assess genetic differences in racial distinctions and, on re-
view of the empirical studies on race, have concluded that race as a biological con-
struct is fictional, whereas race as a social construct is real (Cornell & Hartmann,
1997; Smedley & Smedley, 2005; Zuckerman, 1990).
Although race is more accurately considered a social construction, understand-
ing the way it interfaces in society is key in developing empathic relationships with
clientele. According to West (1993), racial distinctions have long been used as a
method to differentiate, distinguish, separate, segregate, and oppress. The con-
structed variable of race is employed in decisions made by bankers, attorneys, law
enforcement, parents, teachers, and policy writers. People make assumptions
about others based on perceptions of race and ethnicity on a daily basis. Recently, it
has become apparent that racially biased attitudes have evolved from an uncon-
cealed and openly hostile approach to one that is more subtle and ambivalent
(Brief, Dietz, Cohen, Pugh, & Vaslow, 2000).
CHAPTER FOUR Multicultural Intricacies in Professional Counseling 63

䊏 Age

In U.S. society, the increasing need for competence in working with the aged is
clear. The demographic of the U.S. population is shifting toward growing numbers
of older adults, which suggests that counselors need to be aware of the issues and
potential biases related to ageism. At the same time, stereotypes and myths about
young adults also abound. Thus, the demographic factor of age also is of concern to
counselors who work with youth who might experience a type of prejudice known
as adultism.

䊏 Ability

Ability is another cultural dimension that is of immense concern to counselors be-

cause the profession is centered on helping individuals who experience impair-
ment on cognitive, emotional, and, at times, physical levels. Ableism is the term
that describes prejudice toward persons who are limited in ability. This type of prej-
udice creates a hostile, unfriendly, or unyielding environment for people whose
mental, physical, and sensory abilities are not within the scope of what is defined as
socially acceptable.

䊏 Religion and Spirituality

Although many forms of religious and spiritual bias and oppression exist, one of
the most significant in history is that of anti-Semitism. Historically, there are two
forms of anti-Semitism, religious anti-Semitism and racial anti-Semitism. Religious
anti-Semitism, or anti-Judaism, predominated throughout history up until the
mid-19th century. During this period of time, most anti-Semitism was primarily re-
ligious in nature, as Judaism was the largest minority religion in Christian Europe,
as well as in the Muslim world. This form of prejudice was directed at the religion
itself instead of at all people of Jewish ancestry.
By the late 19th century, racial anti-Semitism became the predominant form of
prejudice against Jewish people, emerging largely out of conceptualizations of
race that were prevalent during the Enlightenment. Racial anti-Semitism was
based on the belief that Jewish people were a racially discrete group regardless of
religious practice. This form of anti-Semitism effectively replaced the hatred of
Judaism as a religion. As a result of this shift, Jewish people as a race became tar-
gets of discrimination, segregation, and persecution regardless of religious per-
suasion.

See Chapter 31 for more information about pastoral counseling and spirituality
and counseling.
64 What Are the Primary Roles and Responsibilities of the Professional Counselor? PART ONE

BIAS, PREJUDICE, DISCRIMINATION, AND OPPRESSION

To effectively treat a diverse population of clients, counselors need to be aware of the

influences of bias, prejudice, discrimination, and oppression in their clients’ lives.
Moreover, counselors themselves consciously have to avoid biased viewpoints so
that they can treat clients with the dignity and respect afforded them as humans.

䊏 Bias

Prejudice, discrimination, and oppression stem from worldviews that are biased.
Skovholt and Rivers (2004) suggested that bias is a “preference, tendency, or inclina-
tion toward particular ideas, values, people, or groups” (p. 31). Bias tends to constrict
a person’s perspective and can lead to prejudiced beliefs or acts of discrimination.

䊏 Prejudice

Prejudice refers to generalizations or stereotypical beliefs about a group of individ-

uals that are not grounded in empirical evidence (Skovholt & Rivers, 2004). There
are countless examples of the effects of prejudice on minority groups in the United
States, some of the most well known of which include prejudice against African
Americans, women, and gay and lesbian persons. Like biased views, prejudicial
perspectives can lead to misuses and abuses of power as well as overt or covert acts
of aggression against groups who are seen as inferior.

䊏 Discrimination

Characterized by unfair and unequal treatment that systematically prevents cer-

tain groups from being afforded opportunities that are provided to other groups,
discrimination can have deleterious effects (Skovholt & Rivers, 2004). One of the
most widely recognized types of discrimination in the United States is racism,
which can be defined this way:

Racism: The belief that racial or ethnic groups other than one’s own are psy-
chologically, intellectually, or physically inferior (Ridley, 1989).

Racism is based on the view that there are qualitative differences across racial lines.
This form of discrimination results in a pattern of behavior that denies access to oppor-
tunities or privileges to members of one racial or cultural group while favoring access
to another racial or cultural group. There are at least three categories of racism, includ-
ing individual, institutional, and cultural racism; these are described briefly next.

Types of Racism
1. Individual racism is comprised of personal attitudes, beliefs, and behaviors de-
signed to convince oneself of the superiority of her or his race over other races.
CHAPTER FOUR Multicultural Intricacies in Professional Counseling 65

Acts of individual racism include various forms of oppression, discrimination,

and bias toward others based on conceptions of their race.
2. Institutional racism is manifested in the regulations, laws, public policy, and
practices in decision making that serve to maintain the social and economic ad-
vantage of the racial group currently in power. This is accomplished through
oppression, subjugation, and compulsory dependence on the larger society. In-
stitutional racism is commonly legal, or at least customary, and, therefore, is
embedded within laws, policy, traditions, and expectations throughout all lev-
els of institutional organizations.
3. Cultural racism includes societal beliefs and customs that promote the assump-
tion that the products of the dominant race (e.g., language, traditions, appear-
ance) are superior to those of other races. Cultural racism results in rigid defini-
tions of attractiveness, intellect, and capability and can curtail the range of a
person’s perceived choices, dreams, privileges, creative expression, and self-ac-
tualization.

Although racism is probably the best known type of discrimination, it is by no

means the only kind of discrimination that is perpetuated by biased viewpoints
and prejudiced beliefs. Some other forms of discrimination relate to a person’s sex-
uality, gender, age, ability, and religion.

Forms of Discrimination
䊏 Sexism is the belief that women and men are inherently and qualitatively differ-
ent, with men being presumed superior to women.
䊏 Cultural heterosexism is the stigmatization, repudiation, subjugation, or defa-
mation of sexual minorities within societal institutions.
䊏 Psychological heterosexism is the individual internalization of worldviews un-
derlying cultural heterosexism resulting in prejudice against people who are not
heterosexual.
䊏 Homophobia is the expression of irrational fears about people who exhibit signs
of accepting or using behaviors related to same-sex forms of sexual desire and
orientation.
䊏 Affectional prejudice subsumes homophobia as it incorporates negative atti-
tudes and biases based on affectional orientation, including homosexuality, bi-
sexuality, or heterosexuality.
䊏 Ageism is systematic and stereotypic prejudice against people simply because
they are old.
䊏 Adultism is prejudice and accompanying systematic discrimination against
young people.
䊏 Ableism is a pervasive system of discrimination and exclusion that oppresses
people who have mental, emotional, and physical disabilities.
䊏 Anti-Semitism is the systematic discrimination against, hatred, denigration, or
oppression of Judaism, Jews, and the cultural, religious, and intellectual heritage
of Jewish people.
66 What Are the Primary Roles and Responsibilities of the Professional Counselor? PART ONE

EXAMPLE

Combating Ableism
Eric is a 37-year-old man seeking counseling for help with career decisions and how his deci-
sions will affect his family. Although Eric has attempted counseling in the past and thought it
was not successful, a friend has referred Eric to a licensed marriage and family therapist. Dur-
ing the initial phone call, the therapist asked Eric if he required any modifications, which was a
question that no other therapist had ever asked him. Susan, the therapist to whom Eric was re-
ferred, was not aware that Eric was born with vision impairment and was considered legally
blind even with the aid of glasses. Asking about modifications was standard practice for Su-
san, who strives to be a culturally competent counselor.
Eric felt it was important to understand how his family history has played a role in his deci-
sion-making process. Susan understood that the use of a genogram would be helpful for Eric
and designed one using art materials. Following the concepts of a basic genogram, Susan used
pipe cleaners to represent males (squares) and females (circles). Sand was used to represent
substance abuse and mental health diagnosis. String was used to represent the relationships
between family members. Once presented to Eric, he was able to visually see some of the con-
cepts and, most important, feel his family history. Susan understood the importance of being
aware of ableism and discussed with Eric how this affected his decisions in the past.

䊏 Oppression

Counselors who approach their work from a multicultural perspective must take
into account the experience of oppression in the lives of the people they serve. Op-
pression affects the daily realities of most minority groups in a given society and
cannot be ignored as a significant part of clients’ life experience.

Oppression: The unjust or cruel exercise of authority or power that functions

to crush or burden by abuse of power, privilege, or authority; oppression may
also be an act of physical or psychological violence that hinders a person from
being entirely human or alive (Freire, 1988).

䊏 Privilege

Intentional oppression occurs when people are oppressive of others through

actions they choose, or through choosing to overlook inequities in society. How-
ever, oppression also can be unintentional, as is elucidated in the concept of
privilege.
CHAPTER FOUR Multicultural Intricacies in Professional Counseling 67

Privilege: The state of being preferred or favored in society combined with a

set of conditions that systematically empower select groups based on specific
variables such as race and gender, while systematically not empowering
others.

Counselors from privileged backgrounds commonly have difficulty acknowledg-

ing the privilege that they experience because they have been socialized not to rec-
ognize the results of privilege. Most White people do not make the effort to under-
stand and respond to the privileges they experience due to their racial status. By
ignoring the reality of privilege, White people take part in oppressing people of
color and potentially can engage in a form of unintentional racism. This difference
in rights and privileges is normative in society and commonly overlooked in dis-
cussions of racism. Privilege also exists in other arenas of oppression, such as gen-
der differences, class differences, ability differences, and so forth. For a deeper un-
derstanding of White privilege, readers are referred to McIntosh (1992), who wrote
of an invisible container of 46 unearned assets that a White person can count on
cashing in each day, but about which she or he is generally unmindful.

EXAMPLE

White Privilege and the Counseling Relationship

When White privilege is present in the counseling relationship, a counselor may inadvertently
harm the relationship and client. A counselor who is not aware of her or his own White privi-
lege might not understand the full impact of the stories that are relayed. For instance, a coun-
selor might not understand how difficult it is to be one of a handful of minorities in a large
business and feel as if he or she does not have a voice. Similarly, the counselor might not un-
derstand the impact of a family living in an ethnocentric neighborhood having to drive two
hours to obtain cultural foods. Culturally competent counselors acknowledge the privilege
they hold and their responsibilities to those who are not equivalently privileged. Whether it is
race, language, gender, or sexual orientation, the counselor remains aware of how the privi-
lege may or may not impinge on the counseling process.

CULTURAL IDENTITY DEVELOPMENT

To begin to understand others accurately, counselors first need to understand

themselves. A key area of awareness for counselors relates to their cultural identity
development. Numerous scholars have developed models to clarify the existence
of cultural identity development. Historically, these models were limited to de-
scribing the transformation that African Americans underwent in developing
awareness of themselves as racial beings (Cross, 1972; Jackson, 1975). Cross (1995),
68 What Are the Primary Roles and Responsibilities of the Professional Counselor? PART ONE

for example, developed a model of African American development that begins

with viewing the world through the dominant European-American lens, moves to
viewing the world based on one’s own personal experiences, progresses to full ac-
ceptance of the African American culture and nonacceptance of others (particu-
larly European Americans), and culminates with the desire to end racism for all in-
dividuals, both people of color and European Americans. More recently, models
have been developed that address the identity development of Latinos (Bernal &
Knight, 1993), Whites (Helms, 1995), and biracial people (Kerwin, Ponterotto, Jack-
son, & Harris, 1993). Models such as these function well to aid counselors in under-
standing the behaviors and attitudes of their clients from culturally different back-
grounds.

䊏 Racial and Cultural Identity Development Model

A few models have been developed that sum up the developmental process of ra-
cial and cultural identity (e.g., Atkinson, Morton, & Sue, 1998; Helms, 1995; Sue,
Ivey, & Pedersen, 1996; Sue & Sue, 2003). Sue and Sue (2003) developed the racial
and cultural identity development model (R/CID). The R/CID integrates the expe-
riences of oppressed people of various racial and cultural backgrounds as they
strive to understand themselves in relation to their own culture, the dominant cul-
ture, and the interface between these cultures. The model separates cultural iden-
tity development into five stages: (a) conformity, (b) dissonance, (c) resistance and
immersion, (d) introspection, and (e) integrative awareness. These stages view de-
velopment as moving from an ethnocentric perspective of self in relation to a multi-
cultural perspective of self in system. A brief outline of each stage is mentioned.

R/CID Stages (Sue & Sue, 2003)

䊏 In the conformity stage, people of minority backgrounds hold appreciative atti-
tudes toward the dominant group, while holding deprecating or neutral atti-
tudes toward themselves and others of the same minority group.
䊏 In the dissonance stage, people of minority backgrounds are in a state of internal
conflict about the dominant group as well as about themselves and others of the
same minority group.
䊏 In the resistance and immersion stage, people of minority backgrounds become
more appreciative of themselves and others of their minority group and are less
affirming toward the dominant culture.
䊏 In the introspection stage, people of minority backgrounds question the validity of
both blanket negativity toward the dominant group and unequivocal apprecia-
tion of the minority group.
䊏 The integrative awareness stage of development is a period characterized by secu-
rity in oneself and one’s cultural background and selective trust in and apprecia-
tion for the dominant group.
CHAPTER FOUR Multicultural Intricacies in Professional Counseling 69

The five stages within the R/CID suggest a progression from complete immersion
in the dominant culture to complete immersion in the minority culture to, finally,
an appreciation of both the minority and dominant cultures.

䊏 White Racial Identity Development

Racial identity is not limited to people of color. Helms’s (1984, 1995) model of White
racial identity development allows White Americans to assess their own beliefs
and identity development. Helms’s model is based on the idea that White Ameri-
cans have had to acknowledge their own identity. When White Americans move
through Helms’s stages, they are able to recognize their beliefs about minorities
and understand ways in which society views White Americans and people of color
as being different. White Americans, then, can have a positive sense of their own
culture, be able to question some of society’s norms, and ultimately engage in on-
going internal dialogue on racial identity.

MULTICULTURAL THEORIES IN COUNSELING

Despite the increasing diversity that characterizes the United States—a nation
where racial and ethnic minorities soon will become the numerical majority
(Atkinson, Morton, & Sue, 1998)—traditional counseling theories do not address
adequately the complexity of cultural diversity, social context, and ecological per-
spectives (Sue, 1995). Theories that do address social factors are overlooked in
counselor education. The difficulty with approaching counseling relationships
only from traditional theoretical approaches is that the worldviews inherent in
these perspectives favor individualism and often are at odds with the worldviews
of clients who do not embrace or originate from Euro-American cultures (Ibrahim,
1985; Sue et al., 1996). Therefore, the focus of this section is Multicultural Counsel-
ing and Therapy (MCT), an approach to understanding human behavior that spe-
cifically accounts for factors of culture and diversity.

The difficulty with approaching counseling

relationships only from traditional theoretical
approaches is that the worldviews inherent in
these perspectives favor individualism and often
are at odds with the worldviews of clients who
do not embrace or originate from
Euro-American cultures.
70 What Are the Primary Roles and Responsibilities of the Professional Counselor? PART ONE

䊏 Multicultural Counseling and Therapy

MCT (Sue et al., 1996) was designed as a metatheory (a theory about theories) to
help counselors develop an organizational framework for applying the multicul-
tural competencies to the counseling relationship. MCT is based on the accumula-
tion of years of research and theoretical development on counseling clients in a di-
verse society. A forward-looking theory, MCT is responsive to past data and
learning while calling for research to challenge and modify it in the future. The fol-
lowing are some key precepts followed by counselors who use MCT.

Key Behaviors of Counselors Employing MCT

䊏 MCT-oriented counselors work with the clients instead of on the clients, thus
helping them to serve as active and equal participants as they coconstruct defini-
tions of both the problems and the goals in the counseling relationship.
䊏 MCT-oriented counselors avoid overemphasizing either cultural differences or
cultural similarities but, instead, approach clients from a combined perspective.
䊏 MCT-oriented counselors are aware of and responsive to the fact that salient cul-
tural features (individual, group, or universal) change for clients during counsel-
ing, and, thus, track and respond to the various cultural affiliations of their cli-
ents instead of presuming stagnant, oversimplified definitions of culture.
䊏 MCT-oriented counselors are aware that cultural identity evolves in response to
a person’s experiences and context.
䊏 MCT-oriented counselors avoid treating the individual, family, or group in isola-
tion; therefore, the focus of work moves from a more traditional focus on
self-concept to a focus on self-in-relation.
䊏 MCT-oriented counselors avoid using theories of identity that disregard cultural
context and instead understand that identity is learned within cultural context.
䊏 MCT-oriented counselors realize that the client’s perspective must be under-
stood comprehensively and within historical context.
䊏 MCT-oriented counselors realize that a linear approach to thinking is appropri-
ate for some clients, whereas others are best served with a nonlinear approach.
䊏 MCT-oriented counselors differentiate between individual differences and cul-
tural differences.
䊏 MCT-oriented counselors continually strive to expand their repertoire of helping
responses as they realize that no single approach is equally effective across all
populations and situations.
䊏 MCT-oriented counselors realize that any theory or technique must be ap-
proached from a culturally appropriate frame of reference.
䊏 MCT-oriented counselors follow the Golden Rule of counseling: Do unto others
as they would have you do unto them. Avoid doing unto others as you would
have them do unto you, as they may prefer something very different.
䊏 MCT-oriented counselors approach helping from multiple roles, ranging from
one-to-one remedial work to systemic intervention and prevention.
CHAPTER FOUR Multicultural Intricacies in Professional Counseling 71

䊏 MCT-oriented counselors value and incorporate Western methods of helping as

well as traditional and non-Western methods.
䊏 MCT-oriented counselors focus on developing critical consciousness, or the rela-
tion of clients to their entire context, thus teaching their clients about the under-
lying cultural, sociological, and historical dimensions of presenting concerns
and creating potential liberation of consciousness.

䊏 Benefits of Multicultural Counseling and Therapy

Use of a metatheoretical approach such as MCT provides a number of benefits to

culturally sensitive counselors. A few of these advantages are highlighted here:

䊏 Allows for the understanding of multiple oppressions clients might experience.

䊏 Promotes recognition of the collectivist identity crucial to many cultures.
䊏 Allows clients to define wellness within their own context.
䊏 Encourages counselors to recognize the multiplicity of strengths clients bring to
bear from their diverse backgrounds.
䊏 Recognizes the numerous roles counselors may have to fill in response to client
diversity.

Chapter 4: Key Terms

䉴 Mores 䉴 Intersex 䉴 Sexism
䉴 Culture 䉴 Androgynous 䉴 Cultural heterosexism
䉴 Convergence 䉴 Gender roles 䉴 Psychological heterosexism
䉴 Etic perspective 䉴 Gender role stereotypes 䉴 Homophobia
䉴 Emic perspective 䉴 Transgender 䉴 Affectional prejudice
䉴 Cultural encapsulation 䉴 Cisgender 䉴 Ageism
䉴 Ethnocentrism 䉴 Androcentrism 䉴 Adultism
䉴 Acculturation 䉴 Affectional orientation 䉴 Ableism
䉴 Assimilation 䉴 Race 䉴 Anti-Semitism
䉴 Autoplastic perspective 䉴 Bias 䉴 Oppression
䉴 Alloplastic perspective 䉴 Prejudice 䉴 Privilege
䉴 Sex 䉴 Discrimination 䉴 Unintentional racism
䉴 Gender 䉴 Racism
chapter Supervision: An Essential for
Professional Counselor Development
5
Lori Russell-Chapin
Bradley University

In This Chapter

䉴 Basics of Clinical Supervision

䊏 Supervision: A Key to Professionalism

䊏 Benefits of Supervision

䊏 Supervision Defined

䉴 Models of Supervision
䊏 Developmental Models of Supervision

䊏 Theory-Specific Supervision Models

䊏 Social Role Models of Supervision: Discrimination Model

䊏 Integrated Model of Supervision

䊏 A Supervision Videotaping Method: Interpersonal Process Recall

72
CHAPTER FIVE Supervision 73

BASICS OF CLINICAL SUPERVISION

The counseling profession, like any discipline offering a public service, has a re-
sponsibility to assess continually its quality of service. Likewise, individual coun-
selors have the responsibility to analyze the degree to which counseling helps cli-
ents and to evaluate the overall effectiveness and outcome of the counseling
process (Nugent, 1990).
One of the most exciting and fruitful methods of achieving this professional atti-
tude and behavior is to engage in clinical supervision throughout the life span of a
counseling career.

䊏 Supervision: A Key to Professionalism

For many counselors, clinical supervision begins in graduate school, and once the
program of study is completed, so too are the days of supervision. However, as
Neukrug (2003) so eloquently stated:

Embracing a professional lifestyle does not end once one finishes graduate school, ob-
tains a job, becomes licensed, has ten years of experience or becomes a “master” thera-
pist. It is a lifelong commitment to a way of being, a way that says you are constantly
striving to make yourself a better person and a more effective counselor, committed to
professional activities. (p. 72)

Engaging in regular clinical supervision is one method of maintaining and regu-

lating counseling performance for the counselor and consumer. Additionally,
many counselors enhance their professionalism by becoming credentialed supervi-
sors who guide new counselors and trainees. Organizations such as the National
Board of Certified Counselors (NBCC) and the American Counseling Association
(ACA) support supervisory efforts, training, and practice.

Visit the Center for Credentialing and Education site for information
about the Approved Clinical Supervisor Credential:
䉴 www.cce-global.org/credentials-offered/acs

䊏 Benefits of Supervision

Helping professionals who understand the importance of clinical supervision

throughout the life span of counseling careers benefit in a number of ways:
74 What Are the Primary Roles and Responsibilities of the Professional Counselor? PART ONE

䊏 Committing to continual supervision adds to the professionalism of the counsel-

ing field as it keeps the supervisee and the supervisor on the cutting edge of best
practice methods.
䊏 Continued supervision allows for connectedness to others in the profession.
䊏 Supervision provides resources for coping with the stressors that the counseling
profession brings.

It does take a certain amount of courage to remain in supervision, expose and dem-
onstrate individual skills, and share overall knowledge. If counselors allow super-
vision to enhance their counseling outcome and overall effectiveness, the profes-
sion will continue to thrive.

䊏 Supervision Defined

Russell-Chapin and Ivey (2004b) provided a concise definition of supervision:

Supervision: A distinctive, structured approach in which an often more expe-

rienced professional counselor responds to a counselor trainee or super-
visee’s needs with attention to the supervisee’s differing developmental and
competency levels.

The supervisor usually will clarify and combine three aspects throughout supervi-
sion: roles, expectations, and functions. A brief description of the supervisor’s
roles, the joint expectations of the supervisor and supervisee, and functions of the
supervision process are given here.

Supervision Roles
䊏 Among the roles that supervisors assume, a number of common stances include
that of teacher, consultant, evaluator, and encourager (Bernard & Goodyear,
1998).
䊏 Based on an informal or formal assessment of the supervisee’s needs, the super-
visor decides which role or “hat” is most appropriate to the supervisee’s needs.

Supervision Expectations
䊏 Prior to every supervision session, the expectations of supervisor and supervisee
must be clarified because it is essential to know what is expected from each of the
team members.
䊏 The expectations of the supervisor and supervisee are shared throughout the
lifetime of supervisory experience.

Supervision Functions
䊏 The functions of supervision will vary based on the supervisee’s needs.
䊏 Major responsibilities of supervision include administration, education, and
support.
CHAPTER FIVE Supervision 75

Holloway and Carrol (1999) suggested that it is the supervision tasks and roles plus
the functions of those tasks that equal the supervision process. In other words,
when the roles and responsibilities of the supervisor are combined with the need of
the counselor in training, then a supervision process has begun.

EXAMPLE

Clarifying Expectations in Supervision

An example of a clarifying question that can be used to open the supervisory process is this:
“What do you need and want out of supervision today?”(Russell-Chapin & Ivey, 2004a,
2004b). This simple question is an effective way to illuminate the expectations of supervisees
in the supervision session.

MODELS OF SUPERVISION

Most supervision models emphasize the value of a healthy supervisee–supervisor

relationship, stress the importance of feedback and communication, and describe a
variety of supervisor tasks and functions. Four supervision models and one super-
vision method are presented here, including the following:

1. Developmental models.
2. Theory-specific models.
3. Social role models.
4. Integrated models.
5. Interpersonal Process Recall method.

䊏 Developmental Models of Supervision

A developmental model of supervision usually is selected if a major goal of super-

vision is to assess and better understand the developmental level and process of the
supervisee. One of the underlying assumptions of developmental models is that
supervisees grow at individual paces with differing needs and unique learning
styles. Some other generalizations about this approach also can be made.

Assumptions About the Developmental Approach to Supervision

䊏 There seem to be predictable stages or levels through which many supervisees
progress as they learn the skills of the counseling process.
76 What Are the Primary Roles and Responsibilities of the Professional Counselor? PART ONE

䊏 The work of supervision is to discover and articulate the individualized needs of

the supervisee (Stoltenberg, McNeill, & Delworth, 1998).
䊏 Strategies should maximize the supervisee’s strengths and minimize the liabili-
ties (Russell-Chapin & Ivey, 2004b).

In the developmental model, change and growth are not only assessed for the indi-
vidual supervisee, but are also reflected in the supervisory relationship. Supervisees
strive for cognitive advances and skills acquisition. As that growth takes place, the
interaction between supervisee and supervisor must evolve to meet the demands of
the supervisee. Another way of conceptualizing the developmental aspect of the su-
pervision relationship is to look at parallels between the supervision and counseling
relationships. In individual counseling, assessing the developmental level of the cli-
ent is essential to choosing an appropriate, corresponding intervention (Ivey & Ivey,
2003). A parallel process occurs within developmental supervision.
Two key figures who gave a detailed description of the characteristics of super-
visees’ developmental phases and parallels in the supervisory relationship are
Stoltenberg and Delworth (1987; see also Stoltenberg, 1981). They formulated a su-
pervision model describing four distinct assessment levels of supervisee growth.
Table 5.1 provides a brief synopsis of the four levels outlined by Stoltenberg and
Delworth along with the corresponding supervisee and supervisor behavior for
each level.
During each level or stage, the job of the supervisor is to structure supervision so
that it moves from imitative and demonstrative functions at the beginning level to
more competent and self-reliant functions at the advanced levels (Stoltenberg et al.,
1998). In this model, a strong emphasis is placed on understanding the supervisee’s
world, motivational levels, and degree of autonomy, as each of these is described in
the beginning, intermediate, advanced, and master counselor levels. Additionally,
nine growth areas are identified in each of the four levels.

TABLE 5.1
Developmental Levels of Supervisees

Levels Supervisee Behavior Supervisor Behavior

Beginning—Level 1 Little experience; Models needed skills and

dependent on the behaviors; teacher role
supervisor
Intermediate—Level 2 Less imitative; strives for Provides some structure
independence but encourages
exploration
Advanced—Level 3 More insightful and Listens and offers
motivated; more suggestions when asked
autonomous sharing
Master Counselor—Level 4 Skilled interpersonally, Provides collegial and
cognitively and consultative functions
professionally
CHAPTER FIVE Supervision 77

Supervisee Growth Areas in the Developmental Model

1. Intervention.
2. Skill competence.
3. Assessment techniques.
4. Interpersonal assessment.
5. Client conceptualization.
6. Individual differences.
7. Theoretical orientation.
8. Treatment goals and plans.
9. Professional ethics.

To evaluate the supervisee’s level of performance correctly and support the super-
visee throughout the supervision process, the supervisor who works from a devel-
opmental approach engages in a number of tasks.

Supervisor Tasks in the Developmental Model

(Stoltenberg, 1981; Stoltenberg & Delworth, 1987)
䊏 Use the supervisee’s questions and general skills to assess the supervisee’s devel-
opmental level of functioning from Levels 1 through 4 (e.g., if supervisees seem to
be aware of their impact on the client, functioning is likely at Level 2 and 3).
䊏 Attend to the supervisee’s levels of awareness of self and others, motivation to-
ward the developmental process, and the ability to think independently.
䊏 Highlight client conceptualization and treatment goals and plans.
䊏 Encourage the supervisee to gain confidence in skill development (Levels 2 and 3).
䊏 Listen more than lead and be collegial in nature (Level 4).

䊏 Theory-Specific Supervision Models

Helping professionals who adhere to a specific therapeutic orientation (e.g., cogni-

tive-behavioral, psychodynamic, person-centered) may believe it is wise to super-
vise from the same theoretical orientation. If supervisors choose to operate from a
discipline-specific perspective, the supervisor is typically guided by the tenets of
the chosen theory throughout the supervisory process. Theory-specific supervision
is selected when there is a need for expansion of knowledge of theory and its corre-
sponding techniques. There are a number of benefits to using theory-specific ap-
proaches to supervision.

Major Advantages of Theory-Specific Supervision Models

䊏 Supervisors and supervisees who share the same theoretical orientation can
maximize modeling that occurs in supervision (Bernard & Goodyear, 1998).
䊏 Supervisors can demonstrate discipline-specific skills as well as integrate neces-
sary theoretical constructs.
78 What Are the Primary Roles and Responsibilities of the Professional Counselor? PART ONE

The link between the counselor role and the tasks and function of the supervisor in
theory-specific supervision are highlighted next through a brief description of Ra-
tional Emotive Behavioral Therapy (REBT), psychodynamic, and person-centered
models of supervision.

Key Components of REBT Supervision

䊏 The supervisor identifies the problem and irrational thinking of both the super-
visee and the client.
䊏 The supervisor and supervisee select ways to dispute and challenge the irratio-
nal thoughts as a method for changing and learning new, productive thoughts
and behaviors (Ellis, 1989; Woods & Ellis, 1996).
䊏 Behavioral and cognitive-behavioral supervisors emphasize and expect demon-
stration of more technical mastery than most supervisors (Bernard & Goodyear,
1998).

Using REBT as a supervisory approach will require the supervisor to incorpo-

rate the general tenets of Ellis’s theory as outlined for counseling. Similarly, the
psychodynamic approach to supervision also reflects some of the main ideas that
underlie the psychodynamic theory of counseling.

Tenets of Psychodynamic Supervision Model

䊏 Parallel process (Doehrmann, 1976), or the dynamic that occurs in the cli-
ent–therapist relationship that is played out in the supervisee–supervisor rela-
tionship, is emphasized.
䊏 The supervisor focuses on client resistance during the session and investigates
the resistance the supervisee may have toward the client.

As is true of REBT and the psychodynamic approaches, a person-centered

supervision model also is highly reflective of the person-centered approach to
counseling.

Principles of Person-Centered Supervision Model

䊏 The supervisor ensures that the basic facilitative conditions are in process
throughout the supervision session.
䊏 The supervisor emphasizes establishing unconditional positive regard, building
trust, and creating a genuine environment for the supervisee to express
self-doubts and fears about confidence in the counseling process (Hackney &
Goodyear, 1984).

Whatever discipline-specific supervisory orientation is chosen, the continuity

from counseling to supervision will assist the supervisee in expanding skills, con-
structs, and self-confidence.
CHAPTER FIVE Supervision 79

䊏 Social Role Models of Supervision: Discrimination Model

The main premise of social role models is that the supervisor emphasizes the vary-
ing roles and foci required during the supervisory process. An example of one so-
cial role model of supervision is the discrimination model. The model has been
widely researched, and its supporters believe it is an inclusive approach to supervi-
sion. Its roots are in technical eclecticism (Bernard & Goodyear, 1998).
A main goal of the discrimination model is to focus on the needs of the super-
visee by having the supervisor respond flexibly with appropriate strategies,
techniques, and guidance. To respond to supervisees’ needs, the supervisor em-
phasizes two primary functions during each supervision session, namely the
supervisor’s role and the focus of the session. There are three possible supervisor
roles and three possible supervision functions identified in the discrimination
model.

Supervisor’s Roles in the Discrimination Model

(Bernard & Goodyear, 1998)
1. The teacher role is used to directly instruct or demonstrate constructs and
skills.
2. The counselor role is used to help supervisees locate “blind spots” or become
aware of countertransference issues.
3. The consultant role is used when the supervisor needs to act as a colleague or
during times when bouncing around intervention ideas about the client is re-
quired.

During the supervision process, the roles and focus of the work can change. The su-
pervisor might decide that the teacher’s role, a counselor’s role, or a consultant’s
role is best suited to a supervisee’s particular needs. Each of the supervisor roles ac-
cordingly emphasizes different foci of the session.

Supervision Foci in the Discrimination Model

1. The process focus is used to examine the communication between client and
counselor.
2. The conceptualization focus is used to explore intentions behind the chosen
skill intervention.
3. The personalization focus is used to identify mannerisms employed in interac-
tions with clients, such as body language and voice intonation.

The elegance of discrimination supervision is that as the supervisor continues to

supervise, the foci and roles change across and within sessions (Bernard & Good-
year, 1998). Supervisors may choose to focus on basic intervention skills by being in
the role of teacher and counselor during a first session, and they may actually teach
80 What Are the Primary Roles and Responsibilities of the Professional Counselor? PART ONE

new skills and work on the supervisee’s influence on the client. In later sessions,
the supervisor’s role may reflect that of a consultant more than a teacher. Through-
out the process, supervisors decide which foci to select and which role to use to ac-
complish identified supervision goals.

䊏 Integrated Model of Supervision

Much like eclectic orientations to counseling, integrated models of supervision

tend to be atheoretical but still operate from an organized framework. Supervisory
integrationists blend the best from each model and its corresponding interven-
tions. An example of an integrated model of supervision is the microcounseling su-
pervision model (MSM). Highlighted here are some of the key points in the history
of MSM’s development.

Evolution of MSM
䊏 The use of microcounseling skills was first reported by Ivey, Normington, Miller,
Morrill, and Haase (1968).
䊏 Baker and Daniels (1989) analyzed 81 studies on microcounseling skills training
and concluded that the microcounseling training surpassed both the no-training
and attention placebo control comparison.
䊏 Daniels (2003) continued his work by following microcounseling training over a
period of decades and identified more than 450 data-based studies on micro-
counseling skills training.
䊏 The research into microcounseling skills eventually led to an investigation into
the benefits of microcounseling skills and supervision (Russell-Chapin & Ivey,
2004b).

The initial goal of MSM is to help supervisees learn to identify and classify es-
sential interviewing counseling skills. Once that goal has been achieved, the super-
visor or supervisory team and supervisee can begin to process the flow of the ses-
sions and focus on case conceptualization, diagnosis, strengths, and liabilities.
Supervisors will select the MSM when essential micro- and macrocounseling skills
are not utilized effectively.
There are several terms that are unique to MSM, including intention, basic mas-
tery, and active mastery. Understanding these concepts is necessary for supervisors
who choose to use the MSM approach. The terms can be defined as follows:

Intention: Choosing the best potential response from among the many possi-
ble options (Russell-Chapin & Ivey, 2004b).

Basic mastery: The ability to demonstrate chosen counseling skills during the
counseling interview.
CHAPTER FIVE Supervision 81

Active mastery: The ability to produce specific and intentional results from
the chosen counseling skill.

Supervisors who use the MSM model should be familiar not only with key termi-
nology, but also with the three major stages of MSM:

1. Reviewing microcounseling skills with intention.

2. Classifying skills with mastery.
3. Summarizing and processing supervisory needs.

The first stage of MSM begins by practicing, defining, and reviewing all the
microcounseling skills and understanding how they are used with intention. Other
steps include those listed here.

Steps in Stage 1 of MSM: Reviewing Microcounseling Skills With Intention

䊏 Supervisees review each of the basic interviewing skills and understand their in-
tention until they are comfortable with how the skills are defined and used.
䊏 Supervisees learn not to look for the “right” solution and skill, but to select re-
sponses that adapt individual counseling style to the needs and culture of clients
(Ivey & Ivey, 2003).

Once the supervisee has illustrated an understanding of the microcounseling skills

and intention, the supervisor can assist the supervisee in rapidly entering into the
second phase of the supervision model.

Steps in Stage 2 of MSM: Classifying Skills With Mastery

䊏 Supervisors begin to teach mastery by having supervisees watch someone dem-
onstrate the microcounseling skills and their uses.
䊏 Supervisees are introduced to the Counseling Interview Rating Form (CIRF;
see Russell-Chapin & Sherman, 2000), an instrument designed to identify all
the micro- and macrocounseling skills plus the five stages of the counseling in-
terview.
䊏 Once supervisees are familiar with the CIRF, they can observe another counselor
conducting a counseling session and use the CIRF to identify and classify skills
being used with mastery and intention.
䊏 The supervisor and supervisee begin to observe tapes from the supervisee using
the CIRF as an evaluative tool.

The final stage of the MSM begins by summarizing and later processing the dem-
onstrated skills on the CIRF as well as other important dimensions of the session.
82 What Are the Primary Roles and Responsibilities of the Professional Counselor? PART ONE

Steps in Stage 3 of MSM: Summarizing and Processing Supervisory Needs

䊏 The supervisee presents the interview video and case presentation ahead of time
and is asked to formulate supervisory questions and concerns, which are ad-
dressed as a team in a round-robin fashion going over supervisory concerns,
strengths, and areas of improvement.
䊏 Using the CIRF and the interview video, supervisees summarize skill usage with
frequency tallies for each of the counseling responses.
䊏 At the end of the session or during each response, the counselor’s responses are
categorized as basic mastery or active mastery.
䊏 The CIRF is tallied by the members of the supervisory team so that the process-
ing aspect of microcounseling supervision can begin.
䊏 The counselor’s rating is compared with the supervisor’s rating and results are
discussed.
䊏 Scores can be assigned to the entire counseling session or tape or used just to
identify which skills are being used correctly and which skills are not being prac-
ticed at all.
䊏 The very last question asked during the process is, “What did you learn in super-
vision today that will assist you in more effectively working with this client?”

MSM successfully combines many skills from a variety of counseling theories

and supervision models and can be used in supervision with all orientations (Rus-
sell-Chapin & Ivey, 2004b). The cardinal rule of any integrative supervision is to
customize supervision to meet the needs of the individual supervisee. In other
words, “the ‘how’ of supervision should parallel the ‘what’ of supervision”
(Norcross & Halgin, 1997, p. 210).

䊏 A Supervision Videotaping Method: Interpersonal Process Recall

Four main supervisory models have been presented. Many of these models require
videotaping of counseling interviews or conducting counseling sessions in an ac-
tual live observation setting either digitally or with telephones. One of the most
widely used videotaping supervision methods is Kagan’s interpersonal process re-
call (IPR; Haynes, Corey, & Moulton, 2003). Borders and Leddick (1998) conducted
a national survey of counselor educators and found IPR to be one of two distinct
methods used during supervision courses.
Supervisors select IPR when immediacy is called for in a supervision session.
Kagan believes that most people act diplomatically and often do not say what they
actually mean or feel. This assumption is reflected in the goals of IPR.

Goals of IPR
䊏 Create a supervision environment where supervisees can safely analyze their
communication styles and strategies.
CHAPTER FIVE Supervision 83

䊏 Encourage the supervisee to reflect on and interpret his or her experience in the
counseling session (Kagan, 1980).
䊏 Generate discussion of essential personal or counseling issues through the use of
a videotaped counseling session that can be stopped at opportune moments.

Besides its distinctive use of videotaping, another hallmark of IPR is its focus on
raising awareness about supervisees’ communication styles as well as their own
processes and affect during the counseling session. IPR employs a variety of ques-
tions to tease out the supervisee’s feelings and thoughts during the counseling ses-
sion.

Questions Germane to IPR (Bernard & Goodyear 1998, p. 102)

䊏 What were your thoughts, feelings, and reactions? Did you want to express them
at any time?
䊏 What would you like to have said at this point?
䊏 What was it like for you in your role as counselor?
䊏 What thoughts were you having about the other person at that time?
䊏 Had you any ideas about what you wanted to do with that?
䊏 Were there any pictures, images, or memories flashing through your mind then?
䊏 How do you imagine the client was reacting to you?
䊏 How do you think the client was seeing you at this point?
䊏 Did you sense that the client had any expectations of you at that point?
䊏 What did you want to hear from the client?
䊏 What message did you want to give the client? What prevented you from doing
so?

These questions can be used with or without a videotaped counseling session in al-
most any of the supervision models presented in this chapter. Indeed, the flexibility
of the IPR method allows it to continue to be adapted and extended to many super-
vision needs. Examples of how IPR is used by or inspired the development of other
supervision approaches are given next.

Extensions of IPR to Other Supervision Needs

䊏 The work of Kagan (1980) and Ivey and Ivey (2003) inspired the development of
the MSM.
䊏 The creation of the CIRF for use while videotaping is an extension of Kagan’s
work of analysis and processing of the counseling interview.
䊏 IPR inspired the newly advanced supervision technology using Landro Play Ana-
lyzer, which is a customized program that allows for digital, tapeless counseling
sessions that have been created to assist supervisors in coding frame-by-frame
performance analysis of supervisees’ skills (Dandeneau & Guth, 2005).
84 What Are the Primary Roles and Responsibilities of the Professional Counselor? PART ONE

Our main purpose in this chapter was to present the main tenets of four supervi-
sion models and one supervision approach. Using this information, supervisees
and supervisors can ascertain how certain models might be more appropriate with
specific supervisee needs. Determining which approach might fit the supervisee’s
learning and counseling style is a journey that constantly changes as the supervisee
progresses and grows.

Chapter 5: Key Terms

䉴 Supervision 䉴 Intention 䉴 Active mastery
䉴 Parallel process 䉴 Basic mastery
 chapter Collaborative Supervision
for the Novice Supervisor
6 William J. Casile
Duquesne University

Elizabeth A. Gruber
California University of Pennsylvania

Seth N. Rosenblatt
Duquesne University

In This Chapter

䉴 A Look at Supervision 䉴 Professional Development of Novice

䊏 Purposes of Supervision Supervisors: Knowledge Competency
䊏 Importance of Supervision to the Coun- 䊏 Theoretical Foundations

seling Profession 䊏 Ethical and Legal Considerations

䊏 Supervision, Professional Development, 䊏 Multicultural Impact

and Credentialing
䉴 Professional Development of Novice
䉴 Becoming a Supervisor: Some Starting Supervisors: Disposition
Points 䊏 Collaborative, Learner-Focused Stance
䊏 Training Through Doctoral Programs 䊏 Supportive and Critical Dispositions:
䊏 Self-Developed Supervision Skills: Coexisting Roles
Modeling as a First Step
䊏 Self-Developed Supervision Skills: 䉴 Professional Development of Novice
Gathering Other Resources Supervisors: Strategies
䊏 The Inquiry Learning Cycle

䉴 A Collaborative Model of Supervision: 䊏 Building the Therapeutic Alliance

An Overview 䊏 Using the FERA Inquiry Model in the

䊏 Constructivist Roots of the Collaborative Therapeutic Alliance
Model 䊏 Promoting the Construction of Meaning
䊏 Meeting Competencies Through the Col- 䊏 Using the FERA Inquiry Model in the Con-

laborative Model struction of Meaning

䊏 Advantages of the Collaborative Model 䊏 Evaluating the Work of the Counselor

䊏 Using the FERA Inquiry Model for Evalu-

ating the Work of the Supervisee

䉴 Summary

86
CHAPTER SIX Collaborative Supervision for the Novice Supervisor 87

A LOOK AT SUPERVISION

This chapter is intended as a resource for counselors who find themselves in a su-
pervisory role for the first time. Although all master’s programs in counseling have
a supervision component during which counselor trainees are monitored, pro-
grams normally do not include formal training in counselor supervision. Thus,
graduates of a counselor training program typically have experienced supervision
only as a supervisee and have no specific training on how to be an effective clinical
supervisor. Although endorsing the profession’s efforts to establish training and
practice standards for counselor supervisors, we also recognize the immediate and
very practical needs of counselors faced with the day-to-day challenge of provid-
ing clinical supervision (Borders, Bernard, Dye, Fong, & Nance, 1991; Campbell,
2000). In response to those needs, this chapter, although not intended to be a com-
prehensive training program for counselor supervisors, introduces the collabora-
tive model of supervision as a starting point for novice or untrained supervisors
who need resources in their search for competency.

䊏 Purposes of Supervision

In their definition of supervision, Bernard and Goodyear (2004) incorporated three

equally important and essential purposes for this distinct intervention:

1. Enhance the professional competence of the supervisee.

2. Monitor the quality of counseling offered to the client.
3. Serve as a gatekeeper to the profession of counseling.

It is assumed that in the supervisory relationship, the supervisor, a more experi-

enced, better trained, more complete professional, will serve as a teacher, consul-
tant, counselor, and evaluator for a less experienced counselor, the supervisee (Ber-
nard, 1997). The ability to discriminate when and how to apply these multiple roles
to accomplish supervisory goals distinguishes the competent from the novice su-
pervisor (Bernard & Goodyear, 2004).

䊏 Importance of Supervision to the Counseling Profession

The place of clinical supervision in the process of providing professional counsel-

ing or any professional service is indisputable. The concern for the ethical, legal,
and effective professional practice of counseling and other related human services
requires that professionals participate in supervision of their work (Bernard &
Goodyear, 2004). Prudent counselors need supervision to ensure that their clients
receive appropriate and effective treatment and that they continue to engage in
personal and professional development, a hallmark of being a professional coun-
selor. The Ethical Guidelines for Counseling Supervisors (Hart, Borders, Nance, & Par-
88 What Are the Primary Roles and Responsibilities of the Professional Counselor? PART ONE

adise, 1995) substantiate the need for supervision by outlining some necessary re-
sponsibilities of supervision.

Responsibilities of Supervision (Hart et al., 1995)

䊏 Monitoring client welfare.
䊏 Ensuring compliance with applicable legal, ethical, and professional standards
of practice.
䊏 Evaluating clinical performance and professional development of supervisees.
䊏 Gatekeeping, or assuming responsibility to certify supervisee performance and
potential for academic selection, employment, and credentialing.

䊏 Supervision, Professional Development, and Credentialing

The counseling profession has consistently recognized the supervision of counsel-

ors as an essential component to the development of competent counselors and the
delivery of therapeutic services (Bernard & Goodyear, 2004; Bradley & Ladany,
2001).

State and Board Requirements for and Endorsements of Supervision

䊏 In each state that offers a professional license for counselors, the established pro-
cedures require all applicants to practice counseling for a significant number of
hours under the direct supervision of a licensed counselor capable of supervis-
ing their work (ACA, 2006).
䊏 The National Board of Certified Counselors (NBCC) recognized the unique prac-
tice of supervision by publishing the Standards for Ethical Practice of Clinical Super-
vision (NBCC, 1999).
䊏 The NBCC developed the Approved Clinical Supervisor (ACS) credential in
1997, a credential that identifies mental health professionals who have met the
national supervision standards, promoted professional identity, and encouraged
the professional growth of clinical supervisors. This certificate is now available
from the Center for Credentialing and Education, Inc. (CCE, 2001).

Clearly, the essential role of supervision in the development of a capable profes-

sional counselor is irrefutable.

Visit the CCE site for more information on the ACS credential and to
download an application form at:
䉴 www.cce-global.org
CHAPTER SIX Collaborative Supervision for the Novice Supervisor 89

BECOMING A SUPERVISOR: SOME STARTING POINTS

In the counseling profession, many practitioners are promoted to the supervisory

position as a result of their seniority, exceptional work as a counselor, or desire to be
a supervisor. Moreover, successful counselors often are promoted to supervisory
positions without systematic, formal training on how to supervise, despite the fact
that there is increasing agreement in the professional literature that counselor su-
pervision is a unique process requiring specific preparation and training and that
practicing supervision without appropriate training is an ethical violation (Haynes
et al., 2003). There are numerous obstacles counselors face to receiving the formal
supervisory training recommended by the profession.

Barriers to Professional Supervisory Training

䊏 Master’s-level counselor education programs typically do not prepare graduates
to be supervisors.
䊏 Most counselors work in organizations that do not provide their employees with
adequate clinical supervision.
䊏 Agencies or organizations that employ counselors normally do not commit the
resources to train counselors to become supervisors. Although essential to the
quality of treatment, supervisory training usually is not seen as a billable part of
the treatment model.

Counselors who want to develop supervision skills are practically limited to two
choices. They can join a doctoral program in counselor education and supervision,
or they can self-define and construct a personal route to competency.

䊏 Training Through Doctoral Programs

Most doctoral programs in counselor education emphasize a strand devoted to de-

veloping the knowledge base and skills needed to be successful as a counselor su-
pervisor. However, doctoral work is a long and expensive route of continuing edu-
cation that is available to only a few professional counselors. More frequently, the
novice supervisor is left alone to identify a course of self-development activities
that he or she deems appropriate.

䊏 Self-Developed Supervision Skills: Modeling as a First Step

Because all professionally trained counselors have at least experienced supervision

as a supervisee, they can begin the journey of becoming competent supervisors by
modeling the practice of past supervisors they have experienced. However, reli-
ance on modeling has several obvious limitations.
90 What Are the Primary Roles and Responsibilities of the Professional Counselor? PART ONE

Limitations of Modeling as the Predominant Supervisory

Training Experience
䊏 Many counselors in private practice, schools, or some agencies may not have a
current supervisor to model.
䊏 When available, there is no assurance that the existing supervision experiences
are worthy of emulation.
䊏 The power of a learning model that relies solely on modeling without the clarifi-
cation of reflection, feedback, and guided practice is undoubtedly a highly unre-
liable approach to preparing professionals for the complex demands of supervi-
sion (Schön, 1987).

䊏 Self-Developed Supervision Skills: Gathering Other Resources

Because of the limitations of modeling as a primarily approach to learning how to

supervise, counselors may attempt to assemble some combination of seminars,
workshops, conferences, and contracted supervision of supervision to enhance
their skills as a supervisor. This informal and self-structured approach of learning
to become a supervisor typically begins with many questions that emphasize learn-
ing needs.

Self-Inquiries That Guide Learning Needs of Untrained Supervisors

䊏 What is my role as a supervisor?
䊏 What are my ethical responsibilities and legal liabilities?
䊏 What theory and model of supervision do I use?
䊏 Do I focus on the client or the supervisee?
䊏 What do I have to document in supervision?
䊏 How do I supervise multiple supervisees?
䊏 Am I creating dual relationships with my supervisees?
䊏 How do I obtain supervision?

Unfortunately, these questions usually are generated out of desperation as

novice supervisors attempt to learn their new role and do not support a systematic
approach to becoming a supervisor (Allstetter-Neufeldt, 1999; Falendar &
Shafranske, 2004). Rather, reflections and questions generated in moments of stress
or desperation tend to promote a hodge-podge of activities cobbled together by the
aspiring supervisor. What counselors need, therefore, is a simple framework or
model of supervision that guides professional development and that can be used
by novice supervisors who might not have had the opportunity to receive formal
supervisory training. A collaborative approach to supervision offers the most effec-
tive map that beginning supervisors might use on their journey toward proficiency.
CHAPTER SIX Collaborative Supervision for the Novice Supervisor 91

A COLLABORATIVE MODEL OF SUPERVISION: AN OVERVIEW

The collaborative model of supervision described in this and subsequent sections is

a tool to assist experienced counselors in becoming effective supervisors. The
model borrows generously from the developmental and constructivist elements of
existing theories of supervision to provide novice supervisors with a structural
frame to begin constructing a personal approach to the practice of supervision.
Novice supervisors can gain confidence quickly as they discover that their prior
learning to become effective counselors also will support their learning to become
competent supervisors. Additionally, the use of a constructivist approach to learn-
ing helps novice supervisors understand their new roles and responsibilities by
emphasizing the isomorphic relation between counseling and supervision. Finally,
this model of supervision can assist novice supervisors in laying the philosophical
groundwork for their supervisory tasks and conceptualizing how and why they re-
spond the way they do in supervision sessions.

䊏 Constructivist Roots of the Collaborative Model

Constructivism is concerned with the nature of how knowledge is created and is

based on the assumption that people actively create meaning by connecting pre-
vious knowledge to new information gained through experience (Fosnot, 1996).
The result is the creation of new understanding and meaning (McAuliffe,
Eriksen, & Associates, 2000). The collaborative model of supervision takes ad-
vantage of the constructivist theory of learning and acts like a conceptual scaffold
that helps the counselor acquire the knowledge, disposition, and skills needed to
become a supervisor. The model allows competent counselors to begin conceptu-
alizing their practice of supervision by building on their current understanding
of the developmental processes in counseling. That is, the model encourages
counselors to become active creators of new meaning by helping them relate
what they already know about counseling to similar processes found in supervi-
sion.

䊏 Meeting Competencies Through the Collaborative Model

The collaborative model of supervision focuses on the fact that in both counseling
and supervision, one of the most important outcomes is that both supervisees and
clients develop, learn, and change in ways that allow them either to practice more
effectively or live healthier lives without the risk of harm in the process of growth.
Counselor education prepares counselors to facilitate and monitor this process
with clients. The collaborative model helps to bridge existing counseling compe-
tencies to the competencies required of successful supervisors.
92 What Are the Primary Roles and Responsibilities of the Professional Counselor? PART ONE

Knowledge, Disposition, and Strategies Competencies

1. Building a knowledge base: In the collaborative model, novice supervisors build a
knowledge base for supervision by beginning with what they have learned to
become effective professional counselors. Specifically, supervisors must ex-
plore, understand, and apply theoretical foundations, ethical and legal princi-
ples, and cultural awareness to the process of supervision.
2. Promoting a collaborative disposition: The collaborative model encourages super-
visors to approach supervision with a disposition that promotes a collabora-
tive partnership, the nature of which is characterized by a critical friendship.
3. Identifying strategies: The collaborative model identifies three essential tasks or
strategic areas that must be addressed to discharge the major responsibilities or
obligations of the supervisor. These tasks are building a therapeutic or working
alliance, promoting the construction of meaning, and evaluating and monitor-
ing the work of the counselor.

䊏 Advantages of the Collaborative Model

The use of this model has several advantages derived from its premise that the
competent counselor already has learned much that can be applied to supervision.
First, it provides a solid theoretical platform on which the novice supervisor can
stand confidently. Second, it encourages supervisors to emphasize the collabora-
tive perspective of supervision over the evaluative component in their relation-
ships with supervisees. Third, the model emphasizes the supervisor’s responsibil-
ity, parallel to that of the counselor, to create a safe environment where supervisees
become active partners, empowered to reflect and examine their own resources,
performance, and needs for development.

PROFESSIONAL DEVELOPMENT OF NOVICE SUPERVISORS:

KNOWLEDGE COMPETENCY

The knowledge base of the successful counselor can form a sturdy foundation on
which to build the new learning needed for working as a supervisor. Trained coun-
selors have assimilated much information about (a) theoretical foundations, (b)
ethical and legal principles, and (c) the impact of cultural variables on the process
of counseling; thus, these three areas are essential starting points for novice super-
visors to construct the knowledge needed to become effective clinical supervisors.

䊏 Theoretical Foundations

Counseling theories are the basis of successful clinical work; theoretical founda-
tions of supervision are equally essential to competent supervision. Supervisors
CHAPTER SIX Collaborative Supervision for the Novice Supervisor 93

must be grounded in a supervisory theory that speaks to their beliefs about how
supervisees and clients think, learn, grow, and change. The process of theory explo-
ration lays the foundation for how the novice supervisor begins to conceptualize
supervision. The emergence of an individualized theory of supervision ultimately
structures the practice of supervision, guiding what the supervisor attends and re-
sponds to during the supervisory session.

Supervisors must be grounded in a supervisory

theory that speaks to their beliefs about
how supervisees and clients think,
learn, grow, and change.

To develop a personalized supervision theory, practitioners first must read and

reflect on currently proposed theories. Most prevalent supervision theories in the
counselor supervision field have their roots in counseling theory. Only relatively
recently have dedicated theories of supervision been described. Bernard and
Goodyear (2004) presented a concise overview of three classifications of counselor
supervision models that are a useful starting point for creating a theoretical foun-
dation to supervision; the three categories are psychotherapy-based models, devel-
opmental models, and social role models.

Three Classifications of Counselor Supervision Models

(Bernard & Goodyear, 2004)
1. Psychotherapy theory-based supervision models are grounded in assump-
tions about human change, what change means, and how it occurs in the coun-
selor–client therapeutic alliance. These beliefs about the therapeutic alliance
are applied to the supervisor–supervisee relationship.
2. Developmental supervision models focus on how supervisees grow and
change during their personal and professional lives. The major tenet of the de-
velopmental philosophy holds that individual stages of growth occur among
the diverse pool of supervisees. The supervisor must recognize the individual
needs and growth potential of supervisees and then create an environment tai-
lored to fit the individual, developmental needs of each supervisee.
3. Social role supervision models recognize that supervisors and supervisees
bring a variety of professional role experiences, learned knowledge, and con-
ceptualizations about the process of counseling and supervision to the supervi-
sory experience. Social role theories presuppose that supervision acts as a
metarole used to monitor supervisee needs and guide the supervisor in the se-
lection of the most efficacious role (e.g., teaching, consulting, and counseling
roles) to meet supervisee needs.
94 What Are the Primary Roles and Responsibilities of the Professional Counselor? PART ONE

Although there is not space to describe the various theories that comprise the three
categories of supervision theory, a list of theories is given here for interested
readers.

Psychotherapy-Based Supervision Models

䊏 Psychodynamic model (Frawley-O’Dea & Sarnat, 2001; Gill, 2001).
䊏 Person-centered model (Lambers, 2000; Patterson, 1997).
䊏 Cognitive-behavioral model (Liese & Beck, 1997; Rosenbaum & Ronen, 1998).
䊏 Systemic/family therapy model (Liddle, Becker, & Diamond, 1997; Montgom-
ery, Hendricks, & Bradley, 2001).
䊏 Narrative model (Clifton, Doan, & Mitchell, 1990).
䊏 Solution-focused model (Marek, Sandifer, Beach, Coward, & Protinsky, 1994;
Rita, 1998)
䊏 Feminist model (Carta-Falsa & Anderson, 2001; Prouty, Thomas, Johnson, &
Long, 2001).

Developmental Theories of Supervision

䊏 The Littrell, Lee-Borden, and Lorenz model (Littrell, Lee-Borden, & Lorenz, 1979).
䊏 The Stoltenberg model (Stoltenberg, 1981).
䊏 The Loganbill, Hardy, and Delworth model (Loganbill, Hardy, & Delworth, 1982).
䊏 The Stoltenberg and Delworth model (Stoltenberg & Delworth, 1988).
䊏 The Skovholt and Rønnestad model (Rønnestad & Skovholt, 1993; Skovholt &
Rønnestad, 1992).

Social Role Theories of Supervision

䊏 The discrimination model (Bernard, 1979, 1997).
䊏 The Hawkins and Shohet model (Hawkins & Shohet, 1989, 2000).
䊏 The Holloway systems model (Holloway, 1995, 1997).

䊏 Ethical and Legal Considerations

No counselor can practice without a thorough understanding of the legal and ethi-
cal principles that guide appropriate professional behavior. Similarly, no supervi-
sor can operate responsibly without adhering to the principles that define legal and
ethical supervisory practice. The ACA Code of Ethics (2005a) outlines ethical issues
of importance for supervisors and supervisees. Additionally, the Association for
Counselor Education and Supervision (ACES), the professional organization for
counselor educators and supervisors, has developed Ethical Guidelines for Clini-
cal Supervisors (ACES, 1993).
CHAPTER SIX Collaborative Supervision for the Novice Supervisor 95

ACES Guidelines for Ethical Supervisory Behavior (ACES, 1993)

䊏 Observe ethical and legal protection of clients’ and supervisees’ rights.
䊏 Meet the training and professional development needs of supervisees in ways
consistent with clients’ welfare and programmatic requirements.
䊏 Establish policies, procedures, and standards for implementing programs.

These same Ethical Guidelines for Clinical Supervisors (ACES, 1993) also describe
the functions of the supervisory role.

Functions of the Ethical Supervisor (ACES, 1993)

䊏 Monitor client welfare.
䊏 Encourage compliance with relevant legal, ethical, and professional standards
for clinical practice.
䊏 Monitor supervisee clinical performance and professional development.
䊏 Evaluate and certify current performance and potential of supervisee.

Bernard and Goodyear (2004) categorized the major ethical issues facing coun-
selor supervisors. A summary of these issues is given here.

Key Ethical Issues Facing Counseling Supervisors

䊏 Due process refers to the procedures that guarantee notice and fair hearing prior
to the removal or abridgment of a person’s rights.
䊏 Informed consent is the client’s right to be fully informed of the parameters of
treatment, including potential harm.
䊏 Dual relationship refers to a relationship a supervisor forms with a client or
supervisee in addition to the therapeutic or supervisory relationship.
䊏 Competence is the ability to practice (therapy and supervision) effectively and
within the limits of the professional’s training and ability.
䊏 Confidentiality is the ethical responsibility of the counselor or supervisor not to
disclose information obtained in professional relationships with clients, except
when required to ensure safety or meet a judicial order.

Borders and Brown (2005) added to this list the issue of evaluation. Supervisors have
an ethical responsibility to provide their supervisees with continuous feedback
based on regular face-to-face review of actual performance samples.
It is clear that supervisors are both ethically and legally responsible for the qual-
ity of their supervisee’s work (Bernard & Goodyear, 2004; Borders & Brown, 2005;
Disney & Stephens, 1994; Falvey, 2002). Supervisors may be directly or vicariously
liable for the actions of the supervisee. Therefore, it is critical that supervisors learn
how to maintain careful documentation of their work so that they can promote the
professional development of their supervisees, ensure the appropriateness of treat-
ment for clients, and manage their own exposure to professional liability (Falvey).
96 What Are the Primary Roles and Responsibilities of the Professional Counselor? PART ONE

Allstetter-Neufeldt (1999), Campbell (2000), and Falvey et al. (2002) all provide
valuable information on documentation in supervision.

For more information on ethical and legal issues in counseling, see Chapters 2 and 3.

䊏 Multicultural Impact

Multicultural awareness and competence is perhaps the most important force

shaping the practice of counseling and supervision today. The recent revision of
the ACA Code of Ethics (ACA, 2005a) focused on the inclusion of multicultural
and diversity issues to all aspects of the counseling professional’s work. Indeed,
the code states, “Counseling supervisors are aware of and address the role of
multiculturalism/diversity in the supervisory relationship” (ACA, 2005a, F.2.b).
By maintaining contact with the ACA, the ACES, and the Association for Multi-
cultural Counseling and Development, supervisors integrate and reinforce the
multicultural aspects of relevant ethical standards into their work with super-
visees.
According to Sue and Sue (2003), the first step to becoming a multiculturally
competent counselor is increasing awareness of one’s own assumptions, values,
and biases that may affect the therapeutic alliance. Likewise, cultural competence
is central to the supervisory relationship to ensure that supervisors will not allow
cultural assumptions, values, and biases to interfere with the supervisee’s devel-
opment, affect the welfare of the supervisee’s clients, or interfere with the work-
ing alliance.

Ways to Ensure Cultural Sensitivity in the Supervisory Relationship

䊏 Identify and discuss explicitly multicultural issues present in both counseling
and supervisory relationships (Neufeldt, 1999).
䊏 Use the working alliance between supervisor and supervisee to collaboratively
and authentically examine the impact of culture on the supervisory work.
䊏 Develop trusting, open, and congruent avenues of communication about cul-
ture in the supervisory relationship to help counselors and supervisees con-
struct parallel discussions around culture in their therapeutic relationships
with clients.
䊏 Respond respectfully to differences and use culturally appropriate interven-
tions.

Counselors and supervisors must understand and integrate into practice the criti-
cal skills needed to be multiculturally competent professionals. Ignoring multicul-
tural issues potentially can lead to ineffective supervision or result in harm to the
supervisee or client. Thus, it is essential that cultural awareness and competence
underlie both counseling and supervision practice. Ladany, Brittan-Powell, and
Pannau (1997); Ladany, Inman, Constantine, and Nutt (1997); and Pope-Davis and
CHAPTER SIX Collaborative Supervision for the Novice Supervisor 97

Coleman (1997) all provided useful and more detailed reflections on multicultural
awareness in supervision.

See Chapter 4 for more information about multicultural competence in counseling.

PROFESSIONAL DEVELOPMENT OF NOVICE SUPERVISORS:

DISPOSITION

Constructing a wide knowledge base is one aim of the collaborative model of su-
pervision; additionally, the model suggests that novice supervisors will be most
successful if they consciously cultivate a professional disposition characterized by
an amalgam of support and critique. Through supportive, yet critical partnerships,
supervisees will be able to receive the feedback needed for their development, the
assurance that their practice will do no harm to their clients, and the validation that
their performance meets the standards demanded by the profession. Whether
working in the role of teacher, consultant, counselor, or evaluator, supervisors’ ef-
fectiveness will be enhanced if they are able to frame their work from a supportive
or critical or collaborative perspective.

䊏 Collaborative, Learner-Focused Stance

The collaborative model of supervision is consistent with a postmodern view of

learning and development in that it emphasizes an epistemological shift from
objectivism to constructivism. Implications of the shift to a constructivist philoso-
phy in the supervision relationship are mentioned here.

Characteristics of a Collaborative Supervisory Relationship

䊏 The “learners” or the clients and supervisees, as well as their social contexts, are
accentuated over the “content” that emerges during the supervision sessions
(Neufeldt, 1997; Sexton, 1997).
䊏 The expert authority, didactic, and abstract instructional paradigm that presup-
poses “expert” supervisors know what the novice supervisees need is deempha-
sized.
䊏 A collaborative disposition that creates a culture of trust, openness, and the mu-
tual or shared responsibility for the well-being and development of the client,
counselor, and supervisor is emphasized (Casile & Davison, 1998).
䊏 Supervisors working from a collaborative disposition do not abandon their
evaluative responsibility; rather, they invite the supervisee to treat it as another
problem to be solved and another mutual opportunity for learning.
98 What Are the Primary Roles and Responsibilities of the Professional Counselor? PART ONE

One way to understand the collaborative disposition is to examine the fundamen-

tal nature of the relationship between supervisor and supervisee that serves the de-
velopmental and evaluative aims of supervision.

䊏 Supportive and Critical Dispositions: Coexisting Roles

To simultaneously assume a supportive, friendly role and a critical stance in the

same supervisory relationship seems to be a contradiction. Indeed, combining the
roles and norms of both a critic and a friend may appear to pose a dilemma
(Achinstein & Meyer, 1997; Bambino, 2002; Hill, 2002). However, current conceptu-
alizations of the supervisory process are unable to avoid the merging of develop-
mental and evaluative roles that are both critical and supportive. It is, in fact, the
role of supervisors to be the critical friend of counselors who promote development
by holding counselors’ work up to the ethical and professional practice standards
that define competency. Costa and Kallick (1993) described the critical friend as
follows:

Critical friend: “[A] trusted person who asks provocative questions, pro-
vides data to be examined through another lens, and offers critiques of a per-
son’s work as a friend. A critical friend takes the time to fully understand the
context of the work presented and the outcomes that the person or group is
working toward. The friend is an advocate for the success of that work”
(p. 50).

Hill (2002) introduced a competency model for framing the work of a successful
critical friend in terms of knowledge, skills, and attitudes.

Characteristics of the Competent Critical Friend (Hill, 2002)

䊏 The critical friend is knowledgeable about a critical framework and how as-
sumptions underpin people’s justification for their practices.
䊏 The critical friend is skillful at reflective responding, scholarly and investigative
reframing, facilitated silence, encouraging documentation and data collection,
scholarly reading, articulating an inquiry paradigm, big-picture facilitation, and
encouraging publication.
䊏 The critical friend’s attitude is intricately linked to beliefs about one’s provi-
sion of critical friendship, the value of reflection as a professional skill, and
oneself.

Interactions between a supervisor and counselor should be a true dialogue be-

tween eager listeners, not a struggle between contending and defensive interests.
The critical friend or the supervisor who assumes a collaborative disposition en-
CHAPTER SIX Collaborative Supervision for the Novice Supervisor 99

courages the creation of effective therapeutic working alliances, the construction of

meaning, and the shared, formative evaluation of the practicing supervisor.

PROFESSIONAL DEVELOPMENT OF NOVICE SUPERVISORS:

STRATEGIES

As mentioned in the overview of the collaborative model, there are three strategies
employed by all supervisors:

1. The collaborative supervisor is the consultant or counselor who creates a sup-

portive and developmental relationship with the supervisee.
2. The collaborative supervisor is the teacher who cultivates the supervisee’s per-
sonal and professional growth by fostering new meaning and understanding
in the work.
3. The collaborative supervisor is the evaluator who assesses the supervisee’s
competence and effectiveness, ensuring that the work does no harm.

Although not meant to be an exhaustive description of supervisor tasks, these three

strategies are necessary and essential components of effective supervision. In addi-
tion, they provide a structural parallel between what counselors do and what su-
pervisors must learn to do. Thus, the novice supervisor can begin to construct or
learn the tasks of supervision by building on what he or she already knows about
the tasks associated with the counseling process.
Effective counselors have the ability to engage clients in working relationships,
similar to Bordin’s (1994) concept of a working alliance in supervision. The con-
struction of meaning through the exploration and understanding stages of the
counseling process described by Egan (1998, 2002) and others parallels the mean-
ing-making aspect of supervision facilitated in the collaborative model of supervi-
sion through the inquiry learning cycle (Hill & O’Brien, 1999). Finally, counselors
must develop strategies to evaluate and monitor the work and progress of their cli-
ents. Supervisors, too, must learn how to evaluate their supervisees’ work, its im-
pact on their clients, and the supervisors’ fitness for the profession.
These three strategies—developing the working alliance, generating new mean-
ing, and evaluating the work—are central to the work of collaborative supervision.
However, each of these functional tasks is dependent on the context of the unique
interpersonal role relationship that evolves between the supervisor and super-
visee. This supervisory relationship, like any other relationship, is susceptible to in-
terpersonal interferences such as transference and countertransference (Ladany
et al., 2000), attachment styles (Watkins, 1995), and power and influence (Holloway,
1995). To mitigate the effects of these and other factors that influence the working
alliance, the collaborative model of supervision uses the inquiry learning cycle as a
tool to guide the novice supervisor through the stages associated with learning and
100 What Are the Primary Roles and Responsibilities of the Professional Counselor? PART ONE

development. For more information on factors that influence the supervisory rela-
tionship, see Bernard and Goodyear (2004), Frawley-O’Dea and Sarnat (2001), and
Gill (2001).

䊏 The Inquiry Learning Cycle

In the collaborative model of supervision, the skills of inquiry learning are used to
structure and support the primary tasks of supervision in developing a working
relationship, constructing deeper meaning, and evaluating the performance of
supervisees and their impact on clients.
Collaborative supervisors can effectively address the developmental or learning
tasks and the evaluative tasks of supervision by applying the stages of the FERA
learning cycle—focusing, exploring, reflecting, and applying—to monitor their
work with counselors in supervision.
In the collaborative model, the process of supervision can be conceptualized as a
continuously recursive learning cycle that includes the use of the following stages
and associated methods to address the primary tasks of building the relationship,
fostering insight, and evaluating the work.

Stages of the FERA Learning Model in Supervision

1. Focus by engaging the counselor and determining what is known and what is
not known about both content and process. The supervisor must listen for and
determine what is explicit and what is implied in the counseling or supervision
relationship.
2. Explore by encouraging the counselor to frame questions, develop hypotheses,
and predict consequences of action that might be taken. This stage promotes
the investigation of issues and processes that are emerging in the counseling or
supervisory relationships.
3. Reflect through facilitating dialogue that promotes shared or mutual under-
standing and insight into the counseling and supervising experiences. New
learning and the removal of blind spots help both the counselor and the super-
visor gain different perspectives on the work and the relationships.
4. Apply by monitoring the implementation of new learning as it is used in the
practice of counseling and supervision. Each decisive action plan or action can
become the target of an investigation to determine if it is working and if the
practice is effective.

These stages of the FERA learning cycle can be applied to each task of supervision
identified in the collaborative model of supervision. One way to demonstrate the
use of the FERA model in the development of collaborative supervision is to exam-
ine some case examples. Each of the following three case studies provides exam-
ples of supervisor probes to move the work of supervision toward the accomplish-
ment of one of the primary tasks of supervision: building the therapeutic alliance,
promoting the constructing of meaning, and evaluating and monitoring the work
CHAPTER SIX Collaborative Supervision for the Novice Supervisor 101

of the counselor. It is important to note that some of the probes target the supervi-
sory relationship, and some questions are directed at the counseling relationship.
Although these are not addressed simultaneously, it is important for the supervisor
to ensure that both of these systems are examined in the course of supervision.

䊏 Building the Therapeutic Alliance

To best serve the purposes of supervision, the relationship between the supervisor
and supervisee must function as a therapeutic working alliance (Bordin, 1983). In
the context of supervision, the therapeutic working alliance can be described as fol-
lows:

Therapeutic working alliance: A supervisee-centered, collaborative relation-

ship driven by the clinical and developmental needs of the supervisee, in
which the process of identifying and addressing the supervisee’s needs as
they arise must be the mutual responsibility of both professionals.

The creation of a working alliance between the supervisor and supervisee that
emphasizes mutual responsibility for the work of supervision is the foundation of
collaborative supervision. This relationship is a precursor and necessary condition
to the construction of meaning and evaluation of outcomes in supervision. It is the
formation of this alliance that supports authentic learning for the supervisee, as
well as the supervisor, and it ensures that the supervisee’s and clients’ learning and
welfare are held to the highest level of professional standards of accountability.
The relationship or working alliance in collaborative supervision is fostered by
explicitly creating a safe and secure environment through the application of the
core Rogerian conditions for effective helping: genuineness, respect, and empathy
(Rogers, 1951). This parallels the relationship that the counselor is attempting to
develop with the client. However, the parallels also extend to the threats to these re-
lationships. Both are susceptible to defense mechanisms, projections, and other in-
terpersonal processes that can interfere with awareness and expression.
The inquiry learning cycle applied to the process of relationship development
will establish a supervision culture that emphasizes the development of healthy
supervisor–counselor attachments and decreases the probability that the attach-
ments will be anxious or compulsive as a result of an excessive emphasis on the hi-
erarchical power structure in the counseling or supervisory relationship. Spe-
cifically, as the counselor and supervisor move through the FERA cycle, their
awareness, or the ability to perceive what is going on with the client, counselor, and
supervisor systems, will be increased. The supervisor must learn to model and fa-
cilitate expression, or the willingness to verbalize questions, interpretations, and
confrontations that invite the pair into deeper, more accurate, and complete under-
standing of their experiences. The combination of increased awareness and risked
expression fuels the developmental process in supervision in the same way it does
in counseling.
102 What Are the Primary Roles and Responsibilities of the Professional Counselor? PART ONE

EXAMPLE

The Case of Gwen: Building the Relationship

Gwen was promoted to clinical supervisor 3 months ago. She has been with her agency for 4
years as a clinician. Gwen has a master’s degree in community counseling and is well re-
spected by her peers as a clinician. One of her supervisees presented the following case:
Margarita (supervisee) is counseling an 11-year-old female who was referred to counseling by
her grandmother. The client lost her mother about 6 months ago and is currently living with
her grandmother. She is suffering from sleep deprivation, grief and loss, panic attacks, and
separation anxiety. The separation anxiety intensifies when she is at school due to her fear that
if she is not with her grandmother, she may pass away like her mother. Margarita hopes in pre-
senting this case she can deal with her confusion of where to focus with this client, as well as
receive feedback on how effective she has been in forming a relationship with this client.
Gwen and Margarita have a positive working alliance. They have been colleagues for 2 years
and discussed their new supervisor and supervisee roles. There is trust in their relationship
and agreed-on goals in the supervision contract. Margarita, the counselor, is not sure if she
knows how to develop the relationship with a client this young. She wants to develop a safe
and trusting environment with the client. However, when she presents the case in supervision,
she focuses on the content of the child’s narrative. Gwen, the supervisor, wants the counselor
to focus more concretely on the counselor’s relationship with the client and with her as the su-
pervisor.

䊏 Using the FERA Inquiry Model in the Therapeutic Alliance

The first step in the FERA model is to focus, by engaging the counselor and deter-
mining what is known and what is not known, about both content and process. The
supervisor chooses interventions that first promote focusing on the mutual goals of
the supervisory dyad.

Probes That Focus on the Goals of the Supervisory Alliance

䊏 How do you perceive your relationship with me in supervision?
䊏 I feel that our supervisory relationship has benefited by our shared experience as
peer counselors.
䊏 Tell me about your relationship with this client.
䊏 What is not safe or trusting in your relationship with the client?
䊏 What are your thoughts when an 11-year-old tells you of her recent loss?

The second step in the inquiry model is to explore by encouraging the counselor to
frame questions, develop hypotheses, and predict consequences of action that
might be taken. Once the supervisor feels the counselor is focused on an aspect of
one of the relationships, the supervisor might shift to encouraging the counselor to
experiment with the situation.
CHAPTER SIX Collaborative Supervision for the Novice Supervisor 103

Probes That Help Supervisees Explore Their Relationships

䊏 How do you feel aspects of your culture affect your working relationship with
me in supervision?
䊏 What do you want to ask me about our work together in supervision?
䊏 Tell me what you need from me in supervision.
䊏 How do you explain the part of our work together that is least effective?
䊏 How might supervision be different if I did live supervision of your next session?
䊏 What questions have you formed or asked your client about her culture?
䊏 Does your ethnicity affect your working relationship with this client?
䊏 What are you curious about in your relationship with this client?
䊏 What might get in the way of building a trusting relationship with your client?
䊏 What might happen if you stopped taking responsibility for suggesting things
she could talk about?
䊏 What questions do you think you need to ask your client?

The third step in the FERA model is to reflect, which can be done by facilitating dia-
logue that promotes a shared understanding of the counseling and supervising ex-
periences. After exploring the supervisee’s experience and their shared experience,
the supervisor poses interventions that invite the counselor to derive new meaning
from these experiences. The supervisee constructs new meaning by building on
what is already known. Where appropriate, the supervisor adds meaning from al-
ternative perspectives.

Probes That Can Add Meaning to the Supervisory Experience

and the Working Alliance
䊏 Tell me what you have learned about our working relationship.
䊏 What has been difficult for you in our supervision?
䊏 How have you become more aware of yourself in supervision?
䊏 How have you become more aware of yourself in counseling?
䊏 How has this work been the same or different than your work with other clients?
䊏 What have you learned about your relationship with your client?
䊏 What do you think about most frequently when you see this client?
䊏 I am wondering what you hold back and do not say to your client.

In the last step, apply, the supervisor monitors the implementation of new learning
into the counseling and supervision process.

Probes That Facilitate the Use of New Learning About

the Therapeutic Alliance
䊏 What will you do to acknowledge cultural differences in supervision?
䊏 How will we know if we are addressing your issues and concerns in supervi-
sion?
104 What Are the Primary Roles and Responsibilities of the Professional Counselor? PART ONE

䊏 What are the most helpful ways for me to give you feedback on your responses to
this client?
䊏 How do you evaluate your effectiveness as a supervisee?
䊏 What have you learned about strengthening the therapeutic relationship with
this client?
䊏 What will you do to acknowledge cultural differences in counseling?
䊏 What techniques are you considering using in your next counseling session?
䊏 How will you know if you are developing a safer, more trusting relationship
with this child?

䊏 Promoting the Construction of Meaning

Inquiry-based learning utilizes questioning or probing techniques that promote an

applied research or active inquiry approach to learning. Examples of similar tech-
niques in current supervision practice include Kagan’s interpersonal process recall
(IPR) (1976, 1980) and Anderson’s (1987) use of reflecting teams. Inquiry is de-
signed to uncover or help construct meaning and promote insight in the use of in-
terventions, conceptualization of case issues, and the process of therapy and super-
vision.
In this phase of supervision, the supervisory alliance turns its attention to de-
veloping effectiveness. Focusing on the skills of counseling and supervision
(Rønnestad & Skovholt, 1993) and brainstorming possible and alternative re-
sponses to the expressed and implied content, as well as the process emerging in
the relationships between client and counselor and counselor and supervisor, new
insight and the possibility of a more effective future emerges.

EXAMPLE

The Case of Penina: Promoting Insight

Penina (supervisee) is working with a 19-year-old female college student who is abusing alco-
hol and other substances at least four times a week. Her grades have dropped over the past se-
mester and she is contemplating changing her major. She missed 30% of her classes before
11:00 a.m. She is in a verbally abusive relationship. She also reports mood swings and signs of
depression. Penina refers her for an assessment at an alcohol and drug treatment facility but
the client refuses to go, and she denies she has a problem with substances. The client believes
alcohol and drug use and abuse is just part of the college culture. The client’s goal for counsel-
ing is to control the mood swings to help her relationship improve. She has expressed an inter-
est in continuing to work with Penina. Penina is frustrated because the client will not follow
through with the recommendations she makes. She is seeking supervision to help her deal
with her frustration in this case.
CHAPTER SIX Collaborative Supervision for the Novice Supervisor 105

䊏 Using the FERA Inquiry Model in the Construction of Meaning

The questions in this section and the following three sections attempt to guide
supervisees in the construction of new meaning in the supervisory process. Focus,
the first step in the FERA model, calls supervisors to engage the counselor and de-
termine what is known and what is not known, about both content and process.

Probes That Help Focus the Counselor on Alternative Meanings

䊏 What are the major reasons for presenting this case in supervision?
䊏 What do you need from me?
䊏 How do I frustrate you?
䊏 How does the client frustrate you?
䊏 What do you know about substance abuse?
䊏 What do you know about the developmental levels of college students and the
norms of the college culture?
䊏 What is the client not telling you?

Next, the supervisor explores with the supervisee ways to frame questions, de-
velop hypotheses, and predict consequences of action that might be taken.

Probes That Explore New Meanings

䊏 What more do you need to know about me as your supervisor?
䊏 How has our progress been affected by working with a supervisor of a different
race or gender?
䊏 What ethical issues need to be addressed?
䊏 What are the challenges for you in this case?
䊏 How do you feel about addicts … this addict?
䊏 Tell me about your frustrations.
䊏 What more do you need to know about your client?
䊏 What are your concerns about the relationship your client is in?
䊏 What theories help you understand what this client is doing in therapy?

After exploring the supervisee’s experience and their shared experience, the su-
pervisor poses interventions that invite the counselor to reflect and to derive new
meaning for these experiences. The supervisee constructs new meaning by build-
ing on what he or she already knows. The supervisor facilitates this process and,
where appropriate, adds meaning from alternative perspectives.

Probes That Add Meaning for the Counseling and Supervisory Experience
䊏 What have you learned about working with me?
䊏 What do you struggle with in supervision?
䊏 How can we be more effective in supervision?
106 What Are the Primary Roles and Responsibilities of the Professional Counselor? PART ONE

䊏 What have you learned about working with this client?

䊏 How is your theory of counseling giving you a foundation to work with this cli-
ent?
䊏 How has new awareness changed your goals?

In the last step, apply, the supervisor monitors the implementation of new learning
into the counseling and supervision.

Probes That Facilitate the Use of New Learning

䊏 What can we do in supervision to deal with the frustration you feel when this cli-
ent does not follow through?
䊏 How do you evaluate your ability to understand your client’s behavior?
䊏 What have you learned working with this client that might help you with the
other clients we discuss?
䊏 How will you begin your next session with this client?
䊏 What homework can you do to gain more knowledge about this client’s addic-
tion?
䊏 What techniques will you use with this client?
䊏 What are the options and possible outcomes you have considered?

䊏 Evaluating the Work of the Counselor

One of the roles that a counselor supervisor must assume is that of an evaluator.
Evaluation in supervision can be defined this way:

Evaluation: The “objective appraisal of the supervisee’s performance based

on clearly defined criteria that are realistic and attainable” (Kadushin, 1992).

In the collaborative model of supervision, the process of evaluation can still be pro-
moted as a collaborative process and a shared responsibility. There is no question
that supervisors have the authority and ethical responsibility to evaluate counsel-
ors’ effectiveness and fitness for the professional practice of counseling (Bernard &
Goodyear, 2004; Borders & Brown, 2005). However, that does not preclude the use
of collaborative methods to discharge this functional duty.

Characteristics of Effective Coevaluation

in a Collaborative Supervisory Relationship
䊏 Coconstructed evaluation agendas, goals, and targets (What will be learned?).
䊏 Jointly selected performance criterion (How well will it be learned?).
䊏 Mutually agreed-on observable samples and products of performance (What
will be the evidence of learning?).
CHAPTER SIX Collaborative Supervision for the Novice Supervisor 107

This disposition toward evaluation promotes the explicit intention and reasons for
the assessment of the supervisee’s level of competency demonstration. It invites
supervisees to claim their level of competency by comparing evidence of their per-
formance to the competencies they have helped to construct. This approach to eval-
uation fosters the use of self, peer, and expert data collection and behavioral assess-
ment in formulating a conclusion about the effectiveness of the work. The use of a
written supervision agreement, mutually developed, fosters growth of the super-
visee and provides critical documentation of the supervision.

EXAMPLE

The Case of Marquel: Coevaluation and Feedback

Marquel (supervisee) is working with a 27-year-old woman who is engaged to be married. She
entered counseling to deal with anxiety she has been experiencing. The client recently re-
ported she was sexually abused as a child. Because the client feared no one would believe her,
she never disclosed this to anyone before, but she feels she is not able to keep it in any longer.
The perpetrator was a neighbor and the abuse occurred when she was 7 years old. The client
reports that she feels okay and believes this experience will not affect her relationship with her
fiancé, although she is worried that her fiancé may have difficulty with her past sexual abuse
and leave her. She wonders whether or not to tell him. Marquel has worked with other survi-
vors of sexual abuse, but he is concerned about this client and unable to stop thinking about
this situation. Marquel seeks supervision from his supervisor to help him with this case and
deal with his concerns for his client.

䊏 Using the FERA Inquiry Model for Evaluating the Work of the Supervisee

The first step in using the FERA process, again, is to focus, this time on the coun-
selor’s performance in both the counseling and supervisory relationships.

Probes That Help Focus on the Counselor’s Performance

䊏 What are your goals for supervision in this case?
䊏 What aspects of your work do you want to address?
䊏 What role do your discomfort or concerns for this client play in your work?
䊏 How do you judge if your concerns for this client inhibit or promote your effec-
tiveness with her?
䊏 What criteria do you use to evaluate your effectiveness with this goal?
䊏 How do you judge the effectiveness of your interventions with this client?
䊏 What does this client do to let you know if you are accurately empathic?
108 What Are the Primary Roles and Responsibilities of the Professional Counselor? PART ONE

The second step, exploration, encourages the counselor to frame questions, de-
velop hypotheses, and predict consequences of action that might be taken. Once
the supervisor feels the counselor is focused on an aspect of evaluation, he or she
might shift to encouraging the counselor to test the situation.

Probes That Test the Counselor’s Evaluation

䊏 What criteria should we choose to evaluate your work in supervision?
䊏 Where do you begin with your self-evaluation of your performance in this area?
䊏 What can we do differently to enhance the supervision experience for you?
䊏 What can we look at to evaluate your ability to … ?
䊏 What do you need to know next?
䊏 What skills do you want to develop next?

The third step in the FERA model, reflect, is engaged by facilitating dialogue that
promotes a shared understanding of the counseling and supervising experiences.
After exploring shared experiences regarding evaluation, the supervisor poses in-
terventions that invite the counselor to derive new meaning from these experi-
ences.

Probes That Add New Meaning for the Supervisee

in Relation to Evaluation
䊏 What does my evaluation of your work mean to you?
䊏 What have you learned about yourself today?
䊏 What have you learned about how you use or ignore your theoretical orienta-
tion?
䊏 How much do you trust your self-evaluation of your effectiveness with this cli-
ent?
䊏 What might you want to do differently with this client?
䊏 How have your goals for working with this client changed?
䊏 Tell me what you have learned about yourself working with someone from a dif-
ferent or similar culture.
䊏 Do you see this client differently?
䊏 How congruent has your behavior been with the goals you set with this client?

The final step, apply, calls on the supervisor to monitor the implementation of new
learning in the counseling and supervision.

Probes That Enhance the Use of New Learning About Evaluation

䊏 I am going to do … to improve my supervisory skills.
䊏 What outside work will you do for professional development in this area?
䊏 What are you going to do to improve your counseling skills?
CHAPTER SIX Collaborative Supervision for the Novice Supervisor 109

䊏 How will you gain the needed knowledge?

䊏 How will you integrate new learning into supervision? Counseling? Other areas?
䊏 What are your plans for your new learning with your client?
䊏 How can this supervision support your professional or career goals?

SUMMARY

It was our intent in this chapter to provide novice supervisors with a framework to
begin the formal professional development training needed if they are to become
ethical and effective supervisors. The collaborative model of supervision, like all
attempts to model complex human interactions, is a simplistic attempt to explain
the intricate process of supervisor development. However, it has been proposed as
one way to establish the essential elements of a map to guide the journey toward
supervisor maturity. The model suggests the needed knowledge acquisition, a
strategy for skill development, and the promotion of a collaborative disposition to-
ward the work of a supervisor. The model incorporates the application of an in-
quiry learning cycle, from focus through exploration, to reflection and application,
as a strategic approach to the tasks of supervision: building the therapeutic alli-
ance, constructing meaning, and evaluating the work of the supervisee.
It is through the application of a tangible model of supervision, in this case, the
collaborative model of supervision, that novice supervisors can begin to chart a
course of professional development that will promote their sense of self-as-super-
visor (Alonso, 1983; Hess, 1986). The concrete structure of this model allows begin-
ning supervisors to move quickly through the mechanical operations of acting like
a supervisor to a more fully integrated and autonomous supervisor, representative
of a more advanced stage of supervisor development (Stoltenberg et al., 1998). Al-
though the model may only be an outline for the first few steps on a much longer
and continuing journey, it provides clear indicators to ensure that the novice super-
visor gets off on the right foot and in the right direction.

Chapter 6: Key Terms

䉴 Therapeutic working 䉴 Focus 䉴 Apply
alliance 䉴 Explore 䉴 Critical friend
䉴 Evaluation 䉴 Reflect
 part two

What Are the Essential Elements

of Counseling With Which All
Counselors Must Be Familiar?
 chapter Understanding Human Growth
and Development
7
Kimberly Blair
University of Pittsburgh

Stephen P. Kachmar
Duquesne University

In This Chapter

䉴 Prenatal Development 䊏 Cognitive Development in Middle Child-

䊏 Influences on Prenatal Development hood
䊏 Genetic Makeup 䊏 Social-Emotional Development in Middle
䊏 Prenatal Developmental Periods Childhood
䊏 Risks During Prenatal Development

䉴 Adolescence: Transition From Childhood

䉴 Infancy: The First 2 Years of Life to Adulthood
䊏 Physical Development in Infancy 䊏 Physical Development in Adolescence
䊏 Cognitive Development in Infancy 䊏 Cognitive Development in Adolescence
䊏 Social-Emotional Development in Infancy 䊏 Social-Emotional Development in Adoles-

cence
䉴 Early Childhood: The Preschool Period
䊏 Physical Development in Early Child- 䉴 Adulthood
hood 䊏 Physical Development in Adulthood
䊏 Cognitive Development in Early Child- 䊏 Cognitive Development in Adulthood

hood 䊏 Social-Emotional Development in Adult-

䊏 Social-Emotional Development in Early hood
Childhood
䉴 Death, Dying, and Bereavement
䉴 Middle Childhood: Elementary School Years 䊏 Death and the Young
䊏 Physical Development in Middle Child- 䊏 Theory of Dying Process

hood 䊏 Grief and Bereavement

112
CHAPTER SEVEN Understanding Human Growth and Development 113

PRENATAL DEVELOPMENT

The study of human growth and development begins before an infant is ever born,
and, indeed, the development that occurs during prenatal periods has a significant
impact on a person’s health and well-being. Our aim in this chapter is to highlight
the significant physical, cognitive, and socioemotional gains that are part of the life
stages, beginning with the prenatal period and concluding with old age.

䊏 Influences on Prenatal Development

An individual’s genetic makeup and environmental influences combine to deter-

mine physical and behavioral characteristics and course of development. Reaction
range (Gottesman, 1963) and canalization (Waddington, 1957) are concepts that at-
tempt to explain the degrees of genetic and environmental influence on develop-
ment. These concepts are defined along with two other terms—genotype and phe-
notype—that are key to understanding prenatal development.

Genotype: The underlying genetic makeup of an organism.

Phenotype: An organism’s manifest physical and psychological characteris-

tics, which are determined by both genetic makeup and environmental factors.

Canalization: Refers to situations in which the environment has little impact

on inherited characteristics.

Reaction range: The range of possible phenotypes for a particular genotype

across all environmental influences (Scarr, 1984).

To understand development, it is necessary to know about the basic building

blocks of growth, such as genotypes and phenotypes. Additionally, one must un-
derstand something about the developmental process. Two terms that address the
’how’ of development are critical period and sensitive period, defined as followed:

Critical period: A limited time frame in which an organism is biologically

predisposed to acquire certain behaviors in the presence of the appropriate
environmental stimuli.

Sensitive periods: In humans, the periods that are optimal, but not exclusive,
for certain aspects of development.

䊏 Genetic Makeup

Genes are the basic unit of heredity and are carried on rod-shaped structures called
chromosomes. Each normal human has 46 chromosomes or 23 pairs of chromosomes,
114 What Are the Primary Roles and Responsibilities of the Professional Counselor? PART TWO

with each pair having one chromosome from each parent. Of the 23 chromosomal
pairs, 22 are matched pairs called autosomes; the 23rd pair is the sex chromosome.
Genes also come in matched pairs (one from each parent), but may have different
forms called alleles. If the alleles from each parent are alike, that trait is homozygous;
if the alleles are different, then the trait is heterozygous. Heterozygous pairings can
be dominant–recessive, in which the dominant gene determines the pattern of ge-
netic inheritance, or codominant, in which both alleles influence genetic inheritance.
Many traits appear to be polygenetic, a pattern of genetic inheritance in which many
genes affect the characteristic in question. Genetic mutations and chromosomal ab-
normalities are major causes of serious developmental problems.

䊏 Prenatal Developmental Periods

Prenatal development can be divided into three periods:

1. During the period of the ovum (Weeks 1–3 of pregnancy) implantation occurs
and the neural tube forms.
2. During the period of the embryo (Weeks 4–8 of pregnancy) most organ systems
develop, moving in cephalocaudal (from head to feet) and proximodistal
(from center of the body to extremities) directions.
3. During the fetal period (Week 8–birth) the reproductive system forms and
other systems mature.

䊏 Risks During Prenatal Development

During the prenatal stage of life, disruptions known as teratogens can occur that
have adverse effects on development. The term teratogen can be defined as follows:

Teratogens: Environmental agents capable of causing developmental abnor-

malities in utero.

Examples of teratogens that may cause immediate structural damage during pre-
natal development include drugs, alcohol, environmental pollutants, and infec-
tious diseases, as well as other maternal factors such as diet and stress. Some health
problems or neurological impairments caused by teratogens may not become evi-
dent until later in development.

INFANCY: THE FIRST 2 YEARS OF LIFE

Once an infant is born, the developmental domains expand beyond the largely bio-
logical aspects. Beginning with this section on infancy, we look at the physical, cog-
nitive, and socioemotional developmental domains in which changes and transi-
tions occur across the life span.
CHAPTER SEVEN Understanding Human Growth and Development 115

䊏 Physical Development in Infancy

When infants are born, they enter the world with a number of reflexes in place.
Some of these reflexes are necessary for survival and adaptation, and others do not
have apparent survival value and disappear during the first few months of life. A
number of survival and primitive reflexes are provided in the lists that follow.

Survival Reflexes
䊏 Breathing.
䊏 Rooting.
䊏 Sucking.
䊏 Papillary.
䊏 Eye blink.
䊏 Primitive Reflexes
䊏 Moro (startle).
䊏 Palmar.
䊏 Plantar.
䊏 Babinski.
䊏 Stepping.
䊏 Swimming.

As in prenatal development, physical and motor development in infancy contin-

ues to follow cephalocaudal and proximodistal patterns of development. Gross mo-
tor development generally follows a specific sequence. Some of the major accom-
plishments in gross and fine motor development during infancy are outlined here.

Gross and Fine Motor Skills Development in Infancy

䊏 Following a proximodistal pattern, infants first raise their heads and chest, and
then turn over, sit, crawl, stand, and walk.
䊏 Between 11 and 15 months of age, infants typically can walk unaided.
䊏 Fine motor skills such as uncoordinated reaching and grasping with the palm
(ulnar grasp) are initially evident and later transform into more coordinated pin-
cer grasping using thumb and forefinger.

In addition to making gains in motor ability, infants’ physical development in

the areas of vision and hearing also is significant. Infants are sensitive to a wide
range of sounds and can be soothed, alerted, or distressed depending on the fre-
quency or rhythm of the tones.

Facets of Auditory Development in Infancy

䊏 Infants can discriminate between speech and nonspeech sounds.
䊏 Infants show a preference for human voices.
116 What Are the Primary Roles and Responsibilities of the Professional Counselor? PART TWO

䊏 Infants tend to prefer their mother’s voice as compared to other voices by 4

months of age.

Vision also improves dramatically early in infancy. Some of the more prominent
gains are listed here.

Facets of Visual Development in Infancy

䊏 Infants develop abilities for focusing, color discrimination, and visual acuity
during the first few months.
䊏 Depth perception develops early in infancy, and studies using the “visual cliff”
demonstrate that infants can interpret spatial cues for depth.
䊏 Infants show a preference for human faces as compared to objects.

䊏 Cognitive Development in Infancy

Two of the more well-known approaches to understanding cognitive development

are the Piagetian theory of child development and the information processing per-
spective.
Piaget termed the developmental period of early infancy the sensorimotor stage.
This stage is characterized primarily by reflexive learning; one of the most impor-
tant achievements children make in this stage is known as object permanence.

Object permanence: The understanding that objects continue to exist even

when out of sight.

A number of other achievements that appear during the sensorimotor stage are
listed next.

Sensorimotor Stage: Cognitive Learning Gains in Infancy

䊏 Learning is reflexive and occurs through exploration with eyes, ears, hands, and
other sensorimotor equipment.
䊏 Toddlers become goal-oriented and capable of symbolic thought.
䊏 Young children achieve object permanence.
䊏 Infants develop the ability to categorize objects first perceptually, then conceptu-
ally during play.

By the second year of life, young children have achieved a number of cognitive
gains that require more than just reflexive learning. Some of the more salient con-
cepts promoted by the information processing perspective include deferred imita-
tion, habituation, and dishabituation. These are defined as follows:

Deferred imitation: An infant’s ability to imitate an adult’s sounds or behav-

iors after a delay of several hours or days.
CHAPTER SEVEN Understanding Human Growth and Development 117

Habituation: An infant’s waning interest in a stimulus that is repeatedly pre-

sented.

Dishabituation: An infant’s restored interest in a known stimulus.

A range of information processing developments are listed next.

Information Processing: Key Learning Gains in Infancy

䊏 Infants’ ability to understand and process information includes speed of habitu-
ation and dishabituation, visual novelty preference, and cross-modal transfer.
䊏 Infants become increasingly able to sustain and shift attention.
䊏 Toddlers are capable of recognition early in infancy and are able to engage in re-
call by the end of the first year.

Another aspect of cognitive development is communication and linguistic abil-

ity. Prior to the use of words, babies’ communication is prelinguistic and includes
crying, cooing, babbling, and imitating language sounds. Two theories of language
development have tried to explain how infants move from a prelinguistic to lin-
guistic stage. The first, learning theory, emphasizes the influence of reinforcement
and imitation, whereas the second, nativism, maintains that the ability to learn lan-
guage is innate. Today, both genetic and environmental influences on language de-
velopment are recognized, and early communication between caregivers and chil-
dren, such as motherese or child-directed speech, is seen to play a crucial role.
Between 9 months and 3 years, a significant amount of linguistic development
occurs.

Timeframe for Linguistic Development in Infancy

䊏 Babies are able to understand meaningful speech around 9 or 10 months of age.
䊏 Between 10 and 14 months of age, a baby typically says the first word that is often
considered holophrastic, or the expression of a complete thought as a single
word.
䊏 Between 16 and 24 months a child’s vocabulary explodes.
䊏 Between 18 and 24 months the emergence of two-word sentences, or telegraphic
expressions, generally occurs.
䊏 By age 3, grammar and syntax are fairly well developed; however, they are char-
acterized by the overregularization, underextending, and overextending of
word meanings.

䊏 Social-Emotional Development in Infancy

The foundation of early social-emotional development is built on the concepts of

temperament and attachment.
118 What Are the Primary Roles and Responsibilities of the Professional Counselor? PART TWO

Temperament: A child’s typical way of behaving and responding to the envi-

ronment.

Attachment: The bond between a child and the primary caregiver.

Although there are several theories of temperament, three patterns are typically
described.

Temperament Patterns (Santrock, 1999)

1. Easy tempered children usually respond positively to the environment.
2. Difficult tempered children typically respond negatively to the environment.
3. Slow-to-warm-up tempered children often have low activity levels.

Temperament characteristics appear to be largely innate but can be affected by

environmental circumstances. The goodness of fit between a child’s temperament
and the environment provided by caregivers is important for early emotional ad-
justment and the development of emotional bonds or attachments. As well, the re-
sponsiveness of a child’s primary caregiver predicts the quality of early attach-
ment. Three main patterns of attachment (Ainsworth, 1979) have been identified as
follows:

1. Secure attachment.
2. Anxious-ambivalent (resistant) attachment.
3. Avoidant attachment.

A secure attachment is generally evident when parenting is warm and nurturing,

resulting in a child who trusts that his or her needs will be met.

Characteristics of Children With Secure Attachments

䊏 Show distress at separation from their mother.
䊏 Can be easily comforted on the mother’s return.
䊏 Use the primary caregiver as a secure base from which to explore their world.

Ambivalent attachments are a type of insecure attachment often found to be associ-

ated with inconsistent caregiving.

Characteristics of Children With Ambivalent Attachments

䊏 Show distress at separation.
䊏 Cannot be easily comforted.
䊏 Alternate between approaching and resisting the mother.
CHAPTER SEVEN Understanding Human Growth and Development 119

In the case of avoidant attachment, also considered an insecure attachment, care-

givers typically show less warmth and affection to their babies as compared to
other mothers.

Characteristics of Children With Avoidant Attachments

䊏 Do not appear distressed by separations from the mother.
䊏 Actively avoid or ignore the mother.

A fourth pattern of attachment, called disorganized (Main & Solomon, 1986), is

thought to be the most insecure and most likely to be related to later social-emo-
tional adjustment difficulties.
During the second half of the first year, the issue of attachment becomes strik-
ingly prominent with the emergence of separation and stranger anxiety, which is
most intense around 18 months of age.
General emotional development is thought to be externally influenced by the re-
sponsiveness of parents during infancy and, over time, self-regulation becomes in-
ternalized. Self-awareness also emerges during the first few years of life; a few key
gains are noted here.

Sense of Self: Developmental Gains

䊏 Infants learn that they have their own existence, separate from others.
䊏 Infants begin to discover that their actions can have predictable effects on the
world around them.
䊏 During toddlerhood children become aware of their own physical features.

EARLY CHILDHOOD: THE PRESCHOOL PERIOD

Early childhood typically refers to the period between 3 and 5 years of age. In gen-
eral, children’s physical as well as cognitive and social-emotional gains are quite
outstanding. In this section, we look at the physical, cognitive, language, and so-
cial-emotional development.

䊏 Physical Development in Early Childhood

The general growth curve reflects rapid growth during infancy and adolescence
and slower, although noticeable gains in body size in early and middle childhood.
Some of the typical physical changes that occur in children from ages 3 to 5 are
mentioned here.
120 What Are the Primary Roles and Responsibilities of the Professional Counselor? PART TWO

Gross Motor and Fine Motor Gains in Early Childhood

䊏 Skeletal development includes the gradual hardening of bones through ossifica-
tion.
䊏 Individual differences in body size, including height and weight, become more
apparent.
䊏 Gross motor skills advance and become better coordinated with a shift of the
center of gravity toward the trunk.
䊏 Gaits become smooth and rhythmic, and gross motor skills show signs of auto-
maticity.
䊏 Fine motor skills also begin to show automaticity.

EXAMPLE

Gross Motor and Fine Motor Skill Development: Age 3 to 5

The gross and fine motor gains that girls and boys make in early childhood are manifested in
the new abilities that emerge on the scene. Preschoolers gradually begin to dress and feed
themselves with more ease. Children’s drawings show more complexity and realism and their
writing becomes more controlled. Handedness emerges during early childhood and children
begin to utilize a typical pencil grip for writing.

䊏 Cognitive Development in Early Childhood

Cognitive development in early childhood reflects what Piaget termed the pre-
operational level of thinking. Young children display thought processes that are
characterized by animism, reification, and egocentrism. These concepts can be un-
derstood in this way:

Animism: Attributing live characteristics to inanimate objects.

Reification: Treating concepts or abstractions as if they were real, concrete

things.

Egocentrism: A self-centered view of the world in which everything is per-

ceived in relation to oneself.

Some generalizations can be made about thought processes during the preopera-
tional level of cognition in early childhood.

Preoperational Stage: Cognitive Learning Gains in Early Childhood

䊏 Symbolic thinking, which began during infancy, continues to be refined.
䊏 Because thinking is not yet logical, children’s problem solving is concrete.
CHAPTER SEVEN Understanding Human Growth and Development 121

䊏 Thinking is characterized by centration and irreversibility, which leads to diffi-

culties with conservation and hierarchical classification.

In addition to the important contributions Piaget made about thought and

thought processes in early childhood, there are also gains in the information pro-
cessing abilities of young children. Around age 4, children are beginning to con-
struct a “theory of mind” and are becoming knowledgeable of their own meta-
cognitions. Metagcognition can be defined in this way:

Metacognition: The process of monitoring one’s own process of thinking and

memory.

Some highlights of development relative to information processing include the fol-

lowing.

Information Processing Achievements in Early Childhood

䊏 Although preschool-age children are considered to have relatively short atten-
tion spans, sustained and selective attention continues to advance during this
period of development.
䊏 Memory capacities improve, although recall memory is less well developed than
recognition memory at this age.
䊏 Episodic memory is well developed.
䊏 Young children become able to approach challenging tasks by trying out a vari-
ety of strategies, interpreting the individual success of different strategies, and
eventually selecting strategies that will work best in similar situations.

Vygotsky’s sociocultural theory also has applications to early childhood.

Vygotsky considered language to be the foundation of cognition, and private
speech to be important for helping children master challenging tasks within the
zone of proximal development. The processes known as fast mapping, syntactic
bootstrapping, and semantic bootstrapping (Gleitman, 1990) are explanations for
the explosion in language and vocabulary development that occurs in pre-
school-age children. These processes can be understood this way:

Fast mapping: The ability to build vocabularies very quickly by learning to

connect new words with their underlying concepts after only brief encounter.

Syntactic bootstrapping: The process of discovering the meaning of words

by observing how the words are used in syntax.

Semantic bootstrapping: A process of relying on word meanings to learn

grammatical rules.

A number of other important linguistic gains that appear in early childhood are
noted here.
122 What Are the Primary Roles and Responsibilities of the Professional Counselor? PART TWO

Linguistic Gains in Early Childhood

䊏 Grammar and syntax are fairly well developed by age 3.
䊏 Young children become more skilled at pragmatics, appropriately adapting their
speech to their listeners as the situation demands.

䊏 Social-Emotional Development in Early Childhood

The social-emotional development in early childhood begins to expand as the child

develops, including not just gains in the sense of self, but also influences from peer
relations and parenting styles.

Sense of Self: Early Childhood Advances

䊏 Preschoolers’ self-concepts primarily reflect observable characteristics and
beliefs.
䊏 Self-esteem, which is high in preschool, begins to differentiate or become associ-
ated with emerging skills.
䊏 Children feel good about themselves for having successfully accomplished cer-
tain tasks and judge themselves poorly for failures in performing other tasks.

Along with the development of self-understanding, the emergence of emotions

such as empathy, shame, and guilt reflect a child’s developing self-consciousness
and emotional and social competence. As children’s self-understanding and emo-
tional understanding improves, and, as children become more self-conscious, their
social behavior is affected. Empathetic emotional experiences, combined with the
influence of temperament and parenting styles, promote the expression of sympa-
thy and prosocial behavior.
A child’s propensity to exhibit prosocial behavior is often observable in peer in-
teractions. During early childhood, social interactions with peers primarily occur
in the context of play. Parten (1932) described the process of increasing social inter-
action in the context of five types of play. These categories of play include solitary
play, onlooker play, parallel play, associative play, and cooperative play; each type
of play is described briefly.

Types of Play
䊏 Solitary play involves children playing by themselves.
䊏 Onlooker play involves children who are playing passively while watching and
talking to other children.
䊏 Parallel play refers to instances where the child is playing alongside or in the
midst of other children, but remains engaged in his or her own independent play
activity.
CHAPTER SEVEN Understanding Human Growth and Development 123

䊏 Associative play is interactive, yet not coordinated with regard to play objectives.
䊏 Cooperative play refers to play interactions between children that are organized
and have specific goals, as in the case of games.

Positive peer interactions exhibited during children’s play may reflect their so-
cial problem-solving ability, whereas negative peer interactions may involve some
form of aggressive behavior. During early childhood, instrumental aggression de-
clines, whereas hostile aggression tends to increase. Hostile aggression may be in
the form of overt aggression or relational aggression.

Relational aggression: More common in girls and involves the act of damag-
ing social relationships and status.

Overt aggression: More common in boys and involves physically aggressive

acts.

Parents directly and indirectly influence a child’s early peer relationships and
socially competent behavior. Four parenting styles are commonly recognized: au-
thoritative, authoritarian, permissive, and uninvolved.

Parenting Styles
䊏 Authoritative parents tend to be highly accepting and involved, setting clear lim-
its and appropriate control techniques that help children observe the conse-
quences of their behavior in the emotional reactions of others.
䊏 Authoritarian parents tend to be cold and rejecting and adopt a coercive approach
to controlling child behavior.
䊏 Permissive parents are warm and accepting, but may exert little control on their
children, opting instead to be overindulging or inattentive.
䊏 Uninvolved parents (Maccoby & Martin, 1983) are emotionally detached, inatten-
tive, and indifferent to their children’s behavior.

According to Baumrind (1971) authoritative parents are the most successful, pro-
moting empathy and prosocial behavior as well as psychological adjustment.
Authoritarian, permissive, and uninvolved approaches to parenting are likely to
increase the possibility of maladaptive psychological adjustment in children, in-
cluding behaviors that are oppositional, anxious, or unhappy.

MIDDLE CHILDHOOD: ELEMENTARY SCHOOL YEARS

Middle childhood refers to the period of development that typically ranges from
ages 6 to 11. This period is marked especially by more sophisticated advances in
cognitive development and increasingly greater influences from the peer and so-
cial spheres.
124 What Are the Primary Roles and Responsibilities of the Professional Counselor? PART TWO

䊏 Physical Development in Middle Childhood

Physical development in middle childhood reflects slowed rates of body growth;

however, there are wide differences in growth rates that vary based on genetics, nu-
trition, emotional health, ethnicity, and culture. Marked improvements are ob-
served in gross and fine motor skills, strength, and agility. Gender differences in
physical development are apparent during this period.

䊏 Cognitive Development in Middle Childhood

During middle childhood, children enter Piaget’s concrete operational stage of

cognitive development. The ability to understand conservation is a major gain in
middle childhood. Conservation can be defined as follows:

Conservation: The ability to understand an object’s stability despite a change

in appearance.

Some other advances in cognitive ability noted by Piaget for this stage are provided
here.

Concrete Operational Stage: Cognitive Gains in Middle Childhood

䊏 Children are beginning to be able to engage in logical thinking to solve problems.
䊏 Reasoning is concrete and limited to tangible objects or concepts.
䊏 With the ability to think logically comes the ability to solve conservation prob-
lems, which includes identity conservation, reversibility, and decentration.
䊏 Children advance in their understanding of classification and class inclusion.
䊏 Children are not only better able to organize objects and concepts into logical
groups or categories, but they are beginning to understand seriation and transi-
tivity, demonstrated by their ability to compare objects and organize them ac-
cording to logical hierarchies or levels.

From an information processing perspective, middle childhood signals a time of

growth for children in their ability to learn new and more efficient strategies for
processing information.

Advances in Information Processing in Middle Childhood

䊏 Selective and sustained attention continues to improve.
䊏 Older children are better able to filter out irrelevant information to focus on what
is necessary.
䊏 Although children may begin using memory strategies in early childhood, they
do not begin using strategies such as rehearsal and organization efficiently until
middle childhood.
䊏 Children have a more advanced understanding of how learning and memory
occur.
CHAPTER SEVEN Understanding Human Growth and Development 125

An enhanced understanding of metacognition benefits the school-age children by

aiding them in academic skill development, such as reading, comprehension, writ-
ing, and problem solving. A sense of metacognition also helps developing children
become better at approaching problems and critical thinking.
By middle childhood, children demonstrate a comprehensive knowledge and
use of language. During this period there continue to be significant gains in vocab-
ulary, grammar, and pragmatic skills.

Refinements in Linguistic Ability in Middle Childhood

䊏 Children expand the number, richness, and complexity of the words available to
them.
䊏 Grammatical mistakes made in early childhood such as overregularization are
corrected.
䊏 Pragmatic skills increase in early childhood.
䊏 Children begin to understand how best to communicate with others given the
context.
䊏 Code switching is utilized as children learn to adapt their language to the indi-
vidual with whom they are speaking (Shatz & Gelman, 1973).

EXAMPLE

Code Switching in Middle Childhood

Interactions with peers may call for a restricted code or informal speech, whereas communica-
tions with adults may call for a more formal or elaborated code. Older children are able to pro-
cess hidden meanings in communications (i.e., idioms) as opposed to just the literal meaning
of words.

䊏 Social-Emotional Development in Middle Childhood

Children’s self-concepts continue to be refined and move beyond observable char-

acteristics and beliefs to include psychological traits. Some of the salient gains in
self-understanding are noted here.

Self-Concept: Developmental Gains in Middle Childhood

䊏 Children begin to make social comparisons, interpreting their own abilities and
behaviors in relation those around them.
䊏 The high self-esteem typical during early childhood drops to a more realistic
level as older children begin to incorporate feedback about their own skills and
competencies in comparison to the skills and abilities of others.
䊏 Self-esteem also differentiates in middle childhood, yielding at least four sepa-
rate categories including academic competence, social competence, physical and
athletic competence, and physical appearance.
126 What Are the Primary Roles and Responsibilities of the Professional Counselor? PART TWO

Emotionally, older children’s experience of self-conscious emotions is associated

with personal responsibility and occurs without adult prompting. Gains in cogni-
tive development and emotional understanding make possible better developed
social perspective taking. Children become able to interpret what others are think-
ing and feeling. Gradually, they become able to understand another’s perspective
and subsequently engage in third-party perspective taking.
Children make significant gains in their ability to self-regulate emotions during
middle childhood. Emotion regulation has been linked to numerous aspects of so-
cial functioning in preschoolers, including socially appropriate behavior, popular-
ity with peers, adjustment, shyness, empathy, sympathy, and prosocial behavior
(Eisenberg, Fabes, Guthrie, & Reiser, 2002). Two general strategies are outlined as a
way to cope with stress and regulate negative emotions.

Strategies for Emotional Regulation in Middle Childhood

(Lazarus & Lazarus, 1994)
1. Problem-centered coping suggests that children appraise the situation causing
the distress and, through problem solving, identify ways in which to change
the situation.
2. Emotion-centered coping strategy occurs within the individual.

By middle childhood, peer groups become increasingly important. Children

tend to choose friends who are similar to themselves in terms of age, gender, race,
ethnicity, socioeconomic status, popularity, achievement, and social behavior. Re-
search in which children report which peers they like and dislike suggests that peer
acceptance is organized into four basic groups of children: those who are popular,
rejected, controversial, and neglected.

Children tend to choose friends who are similar

to themselves in terms of age, gender, race,
ethnicity, socioeconomic status, popularity,
achievement, and social behavior.

Common Classifications of Peer Groups in Middle Childhood

1. Popular children are typically well liked by other children; two subtypes of
popular children reflect behavior that is popular-prosocial or popular-antiso-
cial. The popular-prosocial children tend to be socially competent, whereas
popular-antisocial children, although accepted by peers, tend to be highly ag-
gressive boys.
2. Rejected children are actively disliked and also tend to fall into two subtypes:
rejected-aggressive and rejected-withdrawn. Both groups often experience ad-
justment problems. The rejected-withdrawn group consists of children who
CHAPTER SEVEN Understanding Human Growth and Development 127

tend to be socially awkward, passive, and are often victims of peers’ aggres-
sion.
3. Controversial children, who are liked by some peers and disliked by others, of-
ten engage in both prosocial behavior and bullying of peers to maintain social
dominance.
4. Neglected children are typically not reported as liked or disliked by peers and,
although they appear to have limited social contacts, are often well adjusted
and socially skilled.

ADOLESCENCE: TRANSITION FROM CHILDHOOD

TO ADULTHOOD

The transition from middle childhood to adolescence begins to occur around age 12
and continues through age 19. This often tumultuous time is a period of great ad-
vancement, particularly in adolescents’ physical development and social-emo-
tional development as they strive to form their sense of identity.

䊏 Physical Development in Adolescence

The beginning of adolescence is marked by puberty. Growth hormone released

from the pituitary gland stimulates the release of other hormones by other glands.
Two basic types of physical pubertal changes occur as a result of the hormone
changes that direct puberty: sexual maturation and body growth.

Aspects of Sexual Maturation

䊏 Estrogens and androgens are released and trigger sexual maturation.
䊏 Bodily changes affect primary sexual characteristics such as the reproductive or-
gans and secondary sexual characteristics, such as external physical changes.
䊏 Menarche in girls and spermarche in boys are signals of sexual maturation.

Physical changes not directly related to sexual maturation also occur in adoles-
cence and tend to reflect a trend in reverse of the cephalocaudal growth characteris-
tic of childhood. When thyroxine is released by the thyroid gland, rapid gains in
height and weight take place. Some of the salient physical gains related to adoles-
cence are noted here.

Aspects of Physical Maturation in Adolescence

䊏 Adolescents grow 10 to 11 inches and gain 50 to 75 pounds.
䊏 Hands, legs, and feet grow first.
䊏 Boys’ shoulders broaden and girls’ hips broaden.
128 What Are the Primary Roles and Responsibilities of the Professional Counselor? PART TWO

䊏 Boys add more muscle and girls add more fat.

䊏 Gross motor skills improve, with boys demonstrating larger gains than girls.

The timing of maturation can have psychological effects. Early-maturing boys and
late-maturing girls tend to have more positive body images and psychological ad-
justment. Early-maturing girls and late-maturing boys tend to experience more
emotional and social difficulties.

䊏 Cognitive Development in Adolescence

With adolescence comes the capacity for abstract, scientific thinking, or what
Piaget called formal operations. Although not all adolescents or adults become ca-
pable of logical and abstract thought, a majority show the cognitive abilities de-
scribed next.

Formal Operations: Cognitive Learning Gains in Adolescence

䊏 Adolescents are able to engage in complex problem solving with hypothesis test-
ing, or hypothetico-deductive reasoning.
䊏 Adolescents are able to engage in propositional thought, reasoning without the
need for real-world evidence.

The information processing perspective is consistent with Piaget’s view of ado-

lescent cognitive development. Although other aspects of information processing,
such as attention, strategy use, knowledge, cognitive self-regulation, and process-
ing speed continue to advance, metacognition is thought to be central to the devel-
opment of abstract thought and scientific reasoning (Kuhn, 1999).
Adolescent argumentativeness, self-consciousness, and idealism appear to be
related to their newfound capacity for abstract thought. Two terms that describe
teenagers’ self-consciousness and self-centeredness are imaginary audience and
personal fable (Elkind & Bowen, 1979; Inhelder & Piaget, 1958).

Imaginary audience: A form of egocentrism that describes an adolescent’s

impression that he or she is the center of everyone’s attention and judgment.

Personal fable: Adolescents’ inflated opinion of themselves and their impor-

tance.

Although with adolescence often comes the advanced capacity of abstract think-
ing, adolescents also may have difficulty with everyday planning and decision
making (Berk, 2004).
CHAPTER SEVEN Understanding Human Growth and Development 129

䊏 Social-Emotional Development in Adolescence

As in other stages of development, adolescents make some characteristic strides in

self-concept.

Gains in Self-Concept During Adolescence

䊏 Adolescents begin to use qualifiers to describe themselves and their self-con-
cepts become more organized.
䊏 They begin to recognize that their self-concepts may change depending on the
situation.
䊏 Most adolescents lose some of the confidence and high self-esteem characteristic
of childhood.
䊏 Self-esteem continues to expand and differentiate to include dimensions such as
close friendship, romantic appeal, and job competence (Harter, 1999).

Adolescence is typically a time when teenagers search for their identity by ex-
ploring their values and life goals. The search for identity is classified into four cat-
egories of identity status: identity achievement, moratorium, identity foreclosure,
and identity diffusion.

Categories of Identity Status (Marcia, 1980)

1. Identity achievement reflects a commitment to self-chosen values and future
goals.
2. Identity moratorium refers to adolescents who have not yet made a commit-
ment—they are exploring possibilities and roles to find those that best fit them.
3. Identity-foreclosed adolescents have accepted another’s values and goals, of-
ten those of their parents.
4. Identity diffusion is characterized by a lack of direction; the identity-diffused
adolescents have not committed to any goals and are not actively trying to de-
termine what their future goals are to be.

Of the four identity statuses, identity achievement and moratorium are most indic-
ative of psychological well-being and a healthy search for a sense of self.
The influence of peers becomes increasingly significant during adolescence as
teenagers search for their sense of identity and belonging to a larger group. Some of
the more important manifestations of peer relations in adolescence are noted here.

Aspects of Peer Relations in Adolescence

䊏 Generally, adolescent friendships foster self-concept, perspective taking, iden-
tity, and the capacity for intimate relationships (Connolly & Goldberg, 1999).
䊏 Girls tend to place more emphasis on emotional bonds, whereas boys tend to em-
phasize status and mastery.
130 What Are the Primary Roles and Responsibilities of the Professional Counselor? PART TWO

䊏 Cliques are small groups of five to seven members who tend to resemble one an-
other in family background, interests, and social status, and form.
䊏 With the increased importance of peer affiliation, peer pressure and conformity
increases.
䊏 Adolescent romantic relationships serve as practice for the more mature bonds
of adulthood, although most dating relationships established during adoles-
cence dissolve or become less satisfying after identity formation occurs (Shaver,
Furman, & Buhrmester, 1985).

Adolescent emotional development includes the search for autonomy. As noted,

part of this search typically involves a shift away from the influence of the family to
include the greater influence of peers. However, parent–child relationships con-
tinue to be important. Parent–child conflict during adolescence is not unusual, but
serious relationship difficulties tend to have their roots earlier in childhood, rather
than being a product of adolescent turmoil.

EXAMPLE

Parenting Through Adolescence

Parenting styles and cultural identity can affect self-esteem. Adolescents with authoritative
parents tend to have higher self-esteem and are more able to resist unfavorable peer pressure.
African American culture, which benefits from large, warm, extended families and a sense of
ethnic pride tend to produce adolescents with higher self-esteem (Gray-Little & Hafdahl,
2000).

ADULTHOOD

The longest period of development, adulthood begins in the early 20s and extends
into late life and eventually to the point of death. Highlights of physical develop-
ment and decline, as well as facets of cognitive and social-emotional development
in adulthood are presented.

䊏 Physical Development in Adulthood

Body structures reach maximum capacity and efficiency in the teens and 20s. After
this period, biological aging or senescence, which refers to genetically influenced
declines in the performance of organs and systems, begins to occur (Cristofalo,
Tresini, Francis, & Volker, 1999). Individual variation in biological aging is great
CHAPTER SEVEN Understanding Human Growth and Development 131

and is influenced by many factors such as genetics, lifestyle, and living environ-
ment. Some of the genetic factors related to aging are mentioned here.

Genetic Factors Contributing to Aging

䊏 Biological aging may result from a complex blend of both the programmed ef-
fects of specific genes and the random events that may cause cells to deteriorate.
䊏 Age-related damage to DNA is thought to be due to the release of highly reactive
free radicals.
䊏 Genetic and cellular deterioration also affects organs and tissues when, over
time, protein fibers form links and become less elastic, producing declines in
many organs.
䊏 Endocrine and immune system declines may also contribute to aging.

Most of the gradual sensory changes that occur in adulthood begin around age
30, whereas other gradual changes in physical health begin to take place in early
adulthood and later accelerate. Some examples of common declines seen in adult-
hood are mentioned next.

Common Physical Declines in Adulthood

䊏 Athletic gross motor skills requiring speed, strength, and coordination peak in
the early 20s and begin to decline gradually.
䊏 Skills requiring endurance peak in the late 20s and early 30s before showing
gradual declines.
䊏 When tendons and ligaments stiffen with age, speed and flexibility of movement
diminishes.
䊏 Presbyopia, a major change in vision, results in diminished color discrimination,
night vision, and visual acuity of marked decline between ages 70 and 80.
䊏 Hearing loss, or presbycusis, usually affects a person’s ability to detect higher
frequencies first. Age-related hearing loss appears to begin earlier and show
more rapid declines for men than for women.
䊏 Reduced capacities of cardiovascular and respiratory systems occur, particularly
in late adulthood, as stiffening takes place in the connective tissues of the lungs,
chest muscles, and heart muscle.
䊏 After age 35, women’s reproductive capacity declines significantly and ends
with the occurrence of menopause.
䊏 For men, a gradual decrease is observed in the concentration and motility of
sperm after age 40 and reproductive capacity declines rather than ends.

䊏 Cognitive Development in Adulthood

A focus on intellectual ability is common to an examination of cognitive ability in

adulthood. Some theories of intelligence include the following.
132 What Are the Primary Roles and Responsibilities of the Professional Counselor? PART TWO

Understandings of Intelligence in Adulthood

䊏 A classic pattern of intelligence suggests that intelligence increases until early
adulthood and then declines through late adulthood in an inverted U-shaped
pattern (Botwinick, 1977).
䊏 Crystallized intelligence shows fewer age-related declines than fluid intelli-
gence.
䊏 Schaie’s (1996) Seattle Longitudinal Study has shown that intellectual declines in
adulthood do not occur significantly until late in life or evenly across intellectual
abilities.

Information processing continues to be a relevant area of interest in adulthood. For

example, speed of cognitive processing slows with age. Also, different memory
systems reflect differences in cognitive aging effects.

Effects of Aging on Memory

䊏 Episodic memory typically shows declines with advancing age, although some
research indicates that lifestyle may have an impact on how much decline occurs.
䊏 Semantic memory shows little in the way of age-related declines; in fact, research
has often discovered that the vocabulary of older adults is often better than
younger adults, although they may access the information more slowly.
䊏 Procedural memory appears to be relatively unaffected by aging.
䊏 Working memory for brief and simple tasks shows less in the way of age-related
declines than does working memory for tasks that involve processing more com-
plex information.

䊏 Social-Emotional Development in Adulthood

Adult development theorists describe social-emotional development throughout

adulthood in similar ways. Like Erikson, Levinson’s seasons of life theory (1978)
and Valliant’s (1977) psychosocial theories describe early adulthood as a time when
development is focused on the search for intimacy. Middle adulthood is character-
ized by generativity—reaching out to others by giving to and guiding the next gen-
eration, as well as becoming guardians of their culture (Valliant, 1977). During late
adulthood, the goal for individuals becomes looking back on their lives and com-
ing to terms with and being satisfied with their achievements.

Theories of Adult Development

䊏 Levinson described adult development in terms of a person’s life structure—
with the underlying design of life consisting of relationships with significant
others.
䊏 Valliant also explained development as being shaped by the quality of relation-
ships with important people.
CHAPTER SEVEN Understanding Human Growth and Development 133

䊏 Sternberg (1987, 1988) proposed a triangular theory of romantic love in which

there are three components that shift in emphasis as relationships develop: inti-
macy, passion, and commitment. The passionate love presents at the beginning
of a relationship giving way to intimacy and commitment, and forming the basis
of companionate love.

Another important influence on adult development is the social clock (Neu-

garten, 1968, 1979), which refers to life events such as marriage, a first job, a first
child, and so on, that follow age-graded patterns based on societal and cultural ex-
pectations. According to the family life cycle, the development of families pro-
gresses in a series of phases that is consistent in most families around the world.
Marriage, childbearing, and rearing occur in early adulthood. Children leave
home, diminishing parenting responsibilities in middle age. Retirement, growing
old, and the death of one’s spouse characterize late adulthood (Framo, 1994;
McGoldrick, Heiman, & Carter, 1993).
The changes that occur in our social networks as people age may be referred to
as the social convoy. Some bonds become closer, others are added, and still others
become more distant. There are a number of psychosocial theories that describe the
aging process. A few of these are briefly described next.

Psychosocial Theories of Aging

䊏 Disengagement theory describes this social withdrawal as a result of the desires
of the elderly to withdraw from society in anticipation of death (Cumming &
Henry, 1961).
䊏 Activity theory states that social barriers cause the decline in social interaction
late in life (Maddox, 1963).
䊏 Socioemotional selectivity theory proposes that social interaction does not sud-
denly decline in late adulthood, but that it is the physical and psychological
changes that occur over time that lead to changes in social interaction (Lang,
Staudinger, & Carstensen, 1998).

Overall, the goal of adult development is successful aging, which is defined as

maximizing gains and minimizing losses.

DEATH, DYING, AND BEREAVEMENT

Like all other phases of life, death and dying have physical, cognitive, and emo-
tional implications for the dying person and for that person’s loved ones. From a
physical perspective, there are generally three phases to the dying process:

1. The agonal phase refers to the initial moments in which the body can no longer
sustain life.
134 What Are the Primary Roles and Responsibilities of the Professional Counselor? PART TWO

2. Clinical death refers to a short interval in which resuscitation is still possible al-
though circulatory, respiratory, and brain functioning have stopped.
3. Mortality refers to death that is final and without possibility of resuscitation.

䊏 Death and the Young

To grasp the cognitive component of death, dying, and bereavement, it is helpful to

consider the age-related differences that exist with regards to understanding con-
cepts of and attitudes toward death. Young children typically rely on the magical
thinking characteristic of early childhood to make sense of death. However, be-
tween the ages of 7 and 10 (Kenyon, 2001), most children have mastered the three
primary concepts related to death.

Major Concepts Related to Death and Dying

1. The concept of permanence emerges first.
2. Children next come to the understanding of universality, or an acceptance that
all things eventually die.
3. Nonfunctionality emerges last, as children come to the understanding that all
living functions cease at death, including thought, feeling, and movement.

Although these three primary concepts are mastered during childhood, adoles-
cents often fail to apply their understanding that death can occur to anyone at any
time. Adolescents tend to not apply the possibility of death to their own personal
experiences, choosing instead to embrace ideas about life after death or reincarna-
tion.

䊏 Theory of Dying Process

Kübler-Ross (1969) developed a five-stage theory through which dying individuals

typically pass: denial, anger, bargaining, depression, and acceptance. These stages
should not be viewed as a fixed sequence and not all individuals display each re-
sponse.

䊏 Grief and Bereavement

The grief and bereavement process is a highly emotional one. Bereavement refers to
the experience of losing a loved one. Many theorists have concluded that the griev-
ing process usually unfolds through several phases. One phase is characterized by
avoidance, shock, or disbelief, which may last for hours, days, or weeks. Another
phase involves the individual’s confronting the loss and experiencing a number of
emotional reactions, which may include but are not limited to anxiety, sadness, an-
ger, depression, and yearning for the lost loved one. As grief subsides, the individ-
CHAPTER SEVEN Understanding Human Growth and Development 135

ual adjusts to life without the loved one and begins to engage again in the normal
processes of daily life.

Chapter 7: Key Terms

䉴 Genotype 䉴 Dishabituation 䉴 Semantic bootstrapping
䉴 Phenotype 䉴 Motherese 䉴 Relational aggression
䉴 Canalization 䉴 Holophrastic 䉴 Overt aggression
䉴 Reaction range 䉴 Telegraphic 䉴 Conservation
䉴 Critical period 䉴 Temperament 䉴 Imaginary audience
䉴 Sensitive periods 䉴 Attachment 䉴 Personal fable
䉴 Cephalocaudal 䉴 Animism 䉴 Cliques
䉴 Proximodistal 䉴 Reification 䉴 Senescence
䉴 Teratogens 䉴 Egocentrism 䉴 Presbyopia
䉴 Object permanence 䉴 Metacognition 䉴 Presbycusis
䉴 Deferred imitation 䉴 Fast mapping 䉴 Social clock
䉴 Habituation 䉴 Syntactic bootstrapping 䉴 Social convoy
chapter Counseling Across the Life Span

8 Stephen P. Kachmar
Duquesne University

Kimberly Blair
University of Pittsburgh

In This Chapter

䉴 Perspectives in Human Growth and Development

䊏 Nature and Nurture

䊏 Continuity and Discontinuity

䊏 Developmental Domains

䉴 Psychodynamic Theories of Human Development

䊏 The Psychoanalytic Approach

䊏 The Psychosocial Approach

䉴 Behavioral and Learning Theories of Human Development

䊏 Classical Conditioning

䊏 Stimulus–Response Model

䊏 Law of Effect

䊏 Skinnerian Approach

䊏 Social Learning Theory

䉴 Cognitive Theories of Human Development

䊏 Piagetian Theory of Cognitive Development

䊏 Theory of Moral Development

䊏 Sociocultural Theory of Development

䉴 Ethological and Maturational Theories of Human Development

䊏 Konrad Lorenz

䊏 Attachment Theory

䊏 Theory of Genetic Determination

䉴 Humanistic Theories of Human Development

䊏 Maslow’s Hierarchy of Needs

136
CHAPTER EIGHT Counseling Across the Life Span 137

PERSPECTIVES IN HUMAN GROWTH AND DEVELOPMENT

Understanding human growth and development is a blend of scientific study and

human reflection on the process of life-span development. This chapter highlights
some long-held, and at times opposing, opinions about development, describes the
main developmental domains, and, finally, outlines key tenets of various theories
of human development.

䊏 Nature and Nurture

One of the longest standing debates in the study of human development is the the-
oretical nature and nurture controversy. This debate reflects competing notions
about which forces drive development. Listed here are some of the assumptions
held by strict naturists and nurturists.

Assumptions of Naturists
䊏 Individual development is dictated by inherent genetic composition.
䊏 Development occurs unwaveringly, neither hastened nor thwarted by environ-
mental interactions.
䊏 People achieve developmental milestones at a similar pace, as prescribed by ge-
netic composition.

The naturist position contrasts with that held by nurturists and can be summarized
as follows.

Assumptions of Nurturists
䊏 Environmental interactions are the main force in determining development.
䊏 The types of interactions one has with the environment have an impact on an in-
dividual’s simple and complex behaviors.

An environmental factor that plays a significant role in explaining variations in de-

velopment is sociocultural context, which can be defined in this way:

Sociocultural context: A precise set of cultural, physical, socioeconomic, and

historical circumstances that have an impact on variations in human develop-
ment.

The variety of influences that are encompassed in a socio-cultural context includes

(a) interactions with parents, guardians, and caregivers, (b) interactions with soci-
etal institutions such as schools, religious entities, and community organizations,
and (c) compliance with cultural norms such as sleeping rituals.
Generally, theorists today believe that both genetic elements and environmental
interactions act in concert to shape development across the life span. Additionally,
138 What Are the Essential Elements of Counseling? PART TWO

the overall impact of individual differences is of colossal importance to development

across the life span. Variations in lived experience, individual genetic predisposi-
tion, and personal characteristics ultimately lead to differences in development.

EXAMPLE

Twins in the Nature–Nurture Debate

Identical twins are always of interest to researchers. Apart from having the same genetic
makeup, one might expect identical twins to share cultural background and socioeconomic
status and to be exposed to similar environmental factors. Yet, development of identical twins
is itself never absolutely identical. If one considers the phenomenon of twins from inside the
debate between nature and nurture, the role of individual differences is very powerful; ulti-
mately, the individual’s physical abilities, intellectual propensities, and quality of environ-
mental exposures must be taken into account.

See Chapter 7 for more information on genetics.

䊏 Continuity and Discontinuity

Related to the nature–nurture debate is the discussion about continuous and dis-
continuous development. Whether or not development happens fluidly or in dis-
tinct stages is summed up in the contrasting beliefs in continuous and discontinu-
ous development.

Continuous development: Development that occurs gradually over the

course of the life span in a fashion that may be thought of as cumulative or
quantitative in nature.

Discontinuous development: Development that occurs in distinct stages

throughout the life span.

EXAMPLE

Continuous and Discontinuous Development

The gradual growth that characterizes continuous development is exemplified in a child’s
ability to speak. When a child says a first word, it may be thought of as part of a continuous
process that has included listening to others, babbling, and making many attempts to vocalize.
Although such an event is monumental to parents and caregivers, it is, in fact, the result of
years of auditory processing, cognitive growth, and physical maturation.
CHAPTER EIGHT Counseling Across the Life Span 139

On the other hand, developmentalists often use the example of a caterpillar changing into a
butterfly to point to discontinuous development. Each stage of change in the butterfly’s evolu-
tion is different from that of the previous stage, and, as such, may be viewed as qualitative
rather than quantitative.

䊏 Developmental Domains

Across the life span, development occurs in physical, cognitive, and socioemo-
tional domains.

Physical development: Involves growth of a physical nature, including gains

in muscular strength and fine and gross motor skill development.

Cognitive development: Involves changes in inherent intellectual and lin-

guistic abilities through stimulating interactions with the surrounding envi-
ronment.

Socioemotional development: Involves changes in the ability to initiate and

maintain interactions with others, changes in personality, and emotional reg-
ulation.

Cognitive development is a lifelong process that is enhanced by environmental in-

teractions; however, stimulation in early childhood is essential to overall lifetime
achievement. Likewise, physical development is a long-term process; gains are
seen in the main areas of fine and gross motor skills. Fine motor skills are physical
abilities that require the use of small muscles and are needed for activities such as
reaching and grasping in infancy and early childhood and skills such as typing in
later development. Gross motor skills are physical abilities that require the use of
large muscles; these skills are necessary in infancy for crawling and are required for
walking from early childhood through adulthood. Socioemotional development is
central to a person’s ability to form new and lasting relationships with other as well
as to respond appropriately to the ups and downs of life experiences.

PSYCHODYNAMIC THEORIES OF HUMAN DEVELOPMENT

Psychodynamic approaches to human development include Freud and Erikson’s

psychoanalytic and psychosocial theories. Both theorists conceptualized develop-
ment in terms of stages and, thus, represent discontinuous approaches to develop-
ment. Developmental progress is determined by the degree of success one has in re-
solving intrapersonal, unconscious conflicts germane to each stage.
140 What Are the Essential Elements of Counseling? PART TWO

䊏 The Psychoanalytic Approach

Freud’s psychoanalytic or psychosexual theory of development proposed that chil-

dren progress through a series of distinct developmental stages in which they must
manage disparity between societal expectations and their own biological drives
and sexual energy. How an individual resolves these dilemmas ultimately deter-
mines development.
Three structures—the id, ego, and superego—comprise the personality in the
psychoanalytic perspective. Zimbardo, Weber, and Johnson (2000) understood
these systems this way:

Id: Structure of personality that is present at birth and may be considered the
primitive, unconscious segment of personality that motivates individuals to
seek immediate gratification of inherent desires (sexual, physical, emotional)
without regard for potential consequences.

Ego: Component of personality that relies on the reality principle to weigh the
desires of the id against the demands of the superego and the external world.

Superego: Structure of personality that serves as an individual’s conscience,

represents a moral code handed down from parent to child, and guides be-
havior to reflect rules that closely resemble societal norms or expectations.

In the psychoanalytic approach, emphasis is placed on parental management of

children’s sexual and aggressive drives. Freud suggested that parents are responsi-
ble for moderating the degree of gratification a child receives at each stage of devel-
opment. Becoming stuck in a developmental stage is possible; the terms fixation
and arrestment explain how stagnation in development occurs (Berk, 1997).

Fixation: Inability to move to a higher level of development because of exces-

sive gratification.

Arrestment: Inability to move to a higher level of development because of in-

adequate gratification.

Balance in gratification is the key to preventing fixated or arrested development.

Indeed, healthy development is a function of successful navigation through the
five stages of psychosexual personality development. Key tenets of each stage are
outlined here.

Oral Stage (Birth–1 Year)

䊏 The child is focused on the oral cavity and receives gratification through sucking,
babbling, eating, and crying.
CHAPTER EIGHT Counseling Across the Life Span 141

䊏 Oral fixation, or arrestment, manifests in habits including nail-biting and smok-

ing and interpersonal conflicts such as lack of trust and difficulty forming close
relationships.

Anal Stage (Ages 1–3)

䊏 Stimulation and function of one’s bowels and bladder provide gratification.
䊏 Too many or too few parental discipline demands related to toilet training and
bodily self-control can cause fixation or arrestment.
䊏 Excessive demands contribute to anal-retentive tendencies, whereas an absence
of discipline leads to anal-expulsive traits, such as messiness, reckless, and disor-
derliness.

Phallic Stage (Ages 3–6)

䊏 Gratification centers on the genital area and is characterized by finding pleasure
in stimulation of this bodily region and great interest in the genitals of others.
䊏 The child experiences incestuous desire for the opposite-sexed parent and
wishes for the removal of the same-sexed parent (known as the Oedipus complex
in males, Electra complex in females).
䊏 To remedy the Oedipus or Electra complex, the child abandons sexual desires
and adopts the characteristics and values of the same-sexed parent (Berk, 1997),
allowing the superego to form.

Latency Stage (Ages 6–11)

䊏 Sexual desires that were present in the phallic stage recede.
䊏 The primary focus turns away from the stressful conflicts of the phallic stage to
asexual pursuits such as school, athletics, and friendships.

Genital Stage (Ages 11–18)

䊏 Patterns of behavior that emerged as a result of the resolution of previous stages
are apparent.
䊏 Sexual desires that were repressed during the phallic stage reemerge to help fur-
ther mature sexual relationships, marriage, and the parenting of children.

Full development ultimately allows individuals to pursue the goals of love and
work and only can be attained if the dilemmas in each stage are successfully re-
solved.

For more information on the id, ego, and superego, and the application of this approach to
counseling, see Chapter 9.
142 What Are the Essential Elements of Counseling? PART TWO

䊏 The Psychosocial Approach

Erikson accepted the general principles underlying psychoanalytic personality

theory. However, he expanded the framework to emphasize the importance of
psychosocial aspects of human development. Additionally, Erikson conceptual-
ized personality development as extending beyond adolescence into a lifelong
phenomenon marked by crises needing to be resolved.
The psychosocial approach includes eight stages, the first five of which parallel
those proposed by Freud, especially with regard to the approximate age of engage-
ment. Individuals acquire new skills at each stage that allow them to be active, produc-
tive members of society (Berk, 1997). Adescription of the psychosocial stages follows.

Erikson’s Psychosocial Stages of Development

1. In the Basic Trust Versus Mistrust stage, children learn to trust the world
through warm and responsive interactions with caregivers, particularly
through maternal relations; mistrust forms from unresponsive and cold care-
giver relationships.
2. In the Autonomy Versus Shame and Guilt stage, a sense of autonomy is formed
when parents allow children to use newly developed gross and fine motor skills
to explore the surrounding world; shame and guilt results when parents stifle
free choice by fostering dependency or by shaming children for their behavior.
3. In the Initiative Versus Guilt stage, initiative is fostered when parents support
experimentation of newly developed skills through self-initiated activities;
however, when such actions are met with parental scolding due to a lack of
self-control, the child may form a sense of inadequacy or guilt (Zimbardo,
Weber, & Johnson, 2000).
4. In the Industry Versus Inferiority stage, a sense of industry forms when, in the
context of home or school environment, children employ skills that allow them
to complete tasks collaboratively with others; however, if such attempts are
coupled with negative experience, feelings of inferiority or incompetence may
emerge.
5. In the Identity Versus Identity Diffusion stage, teenagers attempt to define them-
selves in relation to society, test limits, and form an identity; unsuccessful reso-
lution of identity development leads to identity confusion.
6. In the Intimacy Versus Isolation stage, young adults attempt to establish mean-
ingful, intimate relationships with others; failure to establish such relation-
ships may result in a sense of isolation and a lack of meaningful interactions.
7. In the Generativity Versus Stagnation stage, adults strive to give to the next gen-
eration through productive work (Berk, 1997); a sense of stagnation or self-ab-
sorption occurs when an individual fails to achieve a sense of meaningful ac-
complishment.
8. In the Integrity Versus Despair stage, older adults who can identify value and
significance in their existence develop a sense of integrity, whereas adults who
believe their lives were dissatisfying or without value may develop a sense of
despair.
CHAPTER EIGHT Counseling Across the Life Span 143

BEHAVIORAL AND LEARNING THEORIES

OF HUMAN DEVELOPMENT

Unlike Freud and Erikson, who advocated a psychodynamic approach to under-

standing human development, some psychologists viewed mental structures and
intrapersonal conflicts as arbitrary. Behaviorists assumed that because personality
structures cannot be observed, their existence neither can be validated nor sup-
ported as a legitimate influence on human development. Subsequently, theorists,
such as Pavlov, Watson, Thorndike, Skinner, and Bandura, advocated for ap-
proaches that utilized the scientific method as a means to gather tangible—and
largely behavioral—data for observation, analysis, and interpretation about hu-
man growth and development. Some of the most well-known behavioral theories
of development briefly are described here.

䊏 Classical Conditioning

Pavlov is famous for the experiment in which he conditioned dogs to salivate at the
sound of a bell after the bell was repeatedly paired with the presence of meat pow-
der. Pavlov’s classical conditioning theory posited that when an unconditioned
stimulus (UCS) is presented, that stimulus elicits a response or reflex. If such a re-
sponse-provoking stimulus is paired with a nonprovoking stimulus over repeated
trials, the second, conditional stimulus will elicit an identical response when the
UCS is removed.

Unconditioned stimulus (UCS): Stimulus that evokes an unconditioned re-

sponse.

Conditioned stimulus (CS): Stimulus that is paired with the UCS with the
goal of evoking the same response as the UCS.

Unconditioned response (UR): The natural response an organism makes to

the UCS.

Conditioned response (CR): The response that is elicited in the presence of

the CS.

䊏 Stimulus–Response Model

Following Pavlov, Watson’s work in the early 1900s launched a new behavioral
movement in psychology that focused primarily on the use of objective, scientific
methods to explain human behavior. Watson’s stimulus–response model (S–R) to
human behavior and development is based on the premise that all human action,
even the most complex behavior, is a response to particular stimuli. Stimuli and be-
144 What Are the Essential Elements of Counseling? PART TWO

havior are inextricably linked in the S–R model, which almost wholly negated the
influence of mental phenomena.

䊏 Law of Effect

Thorndike conducted numerous experiments on animal intelligence over the early

half of the 20th century that led him to conclude that behavior is learned by trial
and error. Thorndike is known for describing the law of effect and the law of
exercise.

Law of effect: Behavior has a higher propensity to be repeated if the conse-

quence of that behavior is positively reinforcing.

Law of exercise: A behavior will occur more frequently if connections be-

tween the behavior and reinforcer or consequence routinely are practiced;
conversely, failure to support connections between the behavior and rein-
forcer through practice will result in weaker associations and a decreased
likelihood of reoccurrence.

䊏 Skinnerian Approach

Skinner used operant conditioning procedures to explain how people respond to

the environment and how behavior changes. A key component of Skinner’s theory
of development is operant conditioning, which can be defined this way:

Operant conditioning: Learning that relies on consequences that follow be-

havior.

Skinner suggested that learning occurs only through the presence of a reinforcing
stimulus that follows arbitrary behavior. Reinforcers, which can be either positive
or negative, increase the likelihood that a behavior will be repeated.

Positive reinforcement: Provision of a valued stimulus following a desired

behavior.

Negative reinforcement: The application of a desirable stimulus to decrease

a behavior.

Skinner proposed five schedules of reinforcement. These are described briefly

next.
CHAPTER EIGHT Counseling Across the Life Span 145

Skinnerian Reinforcement Schedules

1. A continuous schedule provides constant reinforcement, which tends to elicit a
high frequency of the preferred behavior.
2. A fixed-interval schedule provides reinforcement only after a predetermined
time interval has elapsed, despite the frequency of behavioral displays.
3. Fixed ratio schedules use a reinforcing stimulus only after a predetermined fre-
quency of the behavior has been demonstrated.
4. A variable interval schedule involves the constant alteration of reinforcing
time intervals.
5. A variable ratio schedule involves the adjustment of the behavior frequency re-
quired for the provision of the reinforcing stimulus.

Skinner is well known for his conceptualization of positive and negative rein-
forcement, which increase the probability of certain behavioral occurrences. Along
with other behavioralists, Skinner proposed several other methods of behavioral
modification, including extinction, shaping, and aversive conditioning.

Extinction: Withholding reinforcement from a formerly reinforced behavior.

Shaping: Reinforcing behaviors that increasingly resemble the desired be-

havior until the desired behavior is attained.

Aversive conditioning: An undesirable stimulus is presented after a target

behavior to decrease the probability that such behavior will happen again.

EXAMPLE

Behavioral Techniques in Practice: Using Extinction Methods

Consider the example of a first-grade teacher who has a student who continually gets out of
her seat to wander around the classroom. The teacher’s initial responses were either to lead the
child back to her seat or verbally to request that the child sit down. When these tactics failed to
work, the teacher began to implement the behavioral technique known as extinction. The
teacher consciously chose not to reinforce the child’s misbehavior with verbal or behavioral at-
tention. Eventually, the teacher’s approach of not reinforcing the behavior led the child to stop
wandering around the classroom.

See Chapter 9 for more information about behavioral modification.

146 What Are the Essential Elements of Counseling? PART TWO

䊏 Social Learning Theory

Bandura believed that early childhood experiences have a profound influence on

personality development (Mazur, 2002). To explain these influences, Bandura de-
veloped social learning theory, which suggests that learning occurs not only
through classical and operant conditioning, but also as a result of observational
learning or imitation. Observational learning is based on vicarious reinforcement,
which can be understood as follows:

Vicarious reinforcement: Learning that occurs vicariously or as a result of

watching someone model a particular behavior.

Bandura’s theory of social learning and vicarious reinforcement is linked closely to

studies he conducted on childhood aggression. The famous Bobo doll studies in-
volved a scenario in which a young woman treated an inflatable doll aggressively
and received favorable consequences. Bandura discovered that children who
watched the woman imitated her behavior by treating the doll similarly. Because
the children did not receive reinforcement for their behavior, Bandura concluded
that learning took place as a result of their observing how the young woman acted
and by noting the consequences of her behavior.
Bandura identified the following four factors that are essential to imitative be-
havior (Mazur, 2002):

1. Attention to what is being modeled.

2. Retention or the ability to remember what was demonstrated.
3. Ability to reproduce the behavior.
4. Motivation or drive to reproduce modeled behaviors.

COGNITIVE THEORIES OF HUMAN DEVELOPMENT

Cognitive theories of human development focus primarily on the development of

mental and verbal abilities. Piaget, Kohlberg, and Vygotsky’s theories have been
extremely influential in the fields of education and related sciences.

䊏 Piagetian Theory of Cognitive Development

Piaget viewed the developing child as an active organism who is constantly trying
to make sense of the world. Learning begins when children engage in a process of
either assimilation or accommodation. Both processes help children adjust to and
understand new experiences. As well, when they are adapting to new knowledge,
children form new schemas that promote learning by helping them understand
CHAPTER EIGHT Counseling Across the Life Span 147

new experiences. Assimilation, schemas, and accommodation are described as

follows:

Assimilation: Process of using preexisting knowledge to make sense of new

experiences.

Schemas: New ways of thinking that change with age, experience, and expo-
sure to new environmental circumstances.

Accommodation: Process of altering current ways of thinking or creating

new ways of thinking to understand new knowledge.

Through research and observation, Piaget determined that the development of

increasingly complex cognitive structures corresponds with four distinct, age-re-
lated stages of cognitive development:

1. Sensorimotor stage.
2. Preoperational stage.
3. Concrete operational stage.
4. Formal operational stage.

Cognitive gains in which children learn to think qualitatively differently about the
world characterize the movement through the four developmental stages.

Sensorimotor Stage (Birth–2 Years)

䊏 Understands the world primarily through physical and sensorimotor experi-
ences.
䊏 Begins to recognize familiar faces, coordinate simple movements, and engage in
goal-directed behavior.
䊏 Exhibits capacity for forming mental representations of objects and events and
forging primary memory.
䊏 Exhibits evidence, at the end of the stage, of grasping object permanence, or the
understanding that an object continues to exist even when it is out of sight.
䊏 Shows capacity for symbolic substitution, or the utilization of a word or other
symbol in the place of a specific action.

Preoperational Stage (Ages 2–7)

䊏 Exhibits monumental advances in the ability to make mental representations of
objects and events and to use those representations to solve simple problems.
䊏 Shows signs of being able to distinguish himself or herself from others.
䊏 Manifests increased language skills.
䊏 Remains limited by preoperational egocentrism, a self-centered view of the
world in which everything is perceived in relation to oneself; animistic thought,
148 What Are the Essential Elements of Counseling? PART TWO

or the belief that inanimate objects possess living qualities; and centration, or a
narrow topical focus.

Concrete Operational Stage (Ages 7–11; Berk, 1997)

䊏 Employs increasingly organized and logical thought processes.
䊏 Displays an understanding of conservation, or the ability to recognize that an
object’s physical properties remain constant despite alteration to the object’s ap-
pearance.
䊏 Exhibits the ability to use mental operations to solve problems through mental
manipulation.
䊏 Comprehends the concept of seriation, or the arrangement of items on a quan-
titative dimension, and uses cognitive maps, or mental representations of
large-scale spaces.

Formal Operational Stage (Ages 12 and up)

䊏 Develops the ability to think about complex concepts abstractly and determine
potential outcomes through hypothetico-deductive reasoning.
䊏 Exhibits egocentric qualities by believing that he or she is the focus of attention.
䊏 Displays a sense of personal importance that extends beyond realistic levels,
thus intensifying the experience of success and failure.

䊏 Theory of Moral Development

Kohlberg’s theory of moral development is very similar to Piaget’s cognitive-de-

velopmental stage theory in that both theories recognize the developing child’s at-
tempt to reason through new situations by applying experienced ethical conven-
tion. However, Kohlberg believed that the development of just, fair, and moral
reasoning was more complex than the process proposed by Piaget, a belief reflected
in his more intricate theory of moral development.
Kohlberg’s theory identifies three levels of moral development, each of which is
comprised of two distinct stages. Preconventional morality, conventional morality,
and postconventional morality, the three broad levels of moral development, can
be described as follows:

Preconventional morality: The first level of moral development in which

moral judgments reflect considerations for personal needs, but place little
emphasis on societal needs.

Conventional morality: The second level of moral development in which

ethical decision making is based on societal expectations and necessities for
the purpose of maintaining social norms.
CHAPTER EIGHT Counseling Across the Life Span 149

Postconventional morality: The third level of moral development in which

moral conclusions are internalized, and individuals make moral choices
based on their evaluation of alternate moral codes and ultimate subscription
to a personal moral code.

Six Stages of Moral Development (Green & Piel, 2002)

1. Heteronomous morality emphasizes compliance to rules and norms established
by authority figures, and decisions characteristically are made to avoid punish-
ment.
2. Individualistic morality reflects a level of development in which moral decision
making is based on fulfilling personal needs and desires.
3. Morality of interpersonal expectations, relations, and interpersonal conformity re-
flects a value on maintaining peer expectations and, therefore, decisions are
made to please others, despite consequences.
4. Morality of social systems and conscience is characterized by moral decisions
made in consideration of the universal social system and with the aim of better-
ing society, and not simply of fulfilling individual desires or those of an imme-
diate peer group.
5. Morality of social-contract, utility, and individual rights is a developmental level at
which individuals recognize and obey societal norms and rules and, concur-
rently, are capable of evaluating law in light of the individual, inherent rights,
such as life and liberty.
6. Morality of ethical principles is the highest level of development in which an indi-
vidual recognizes and abides by social laws but also is willing to break those
laws if they violate ethical standards.

䊏 Sociocultural Theory of Development

Vygotsky suggested that cognitive development is a product of the interaction be-

tween a child and the environment. By accounting for the dual influences of inher-
ent ability and the environment, Vygotsky differentiates his theory from that of
Piaget, in which inherent ability is believed to be the most influential variable in de-
velopment.
From a sociocultural perspective, once the child forms the ability mentally to de-
pict objects and events and develops language, the child actively can engage his or
her environment and further cognitive development. Vygotsky’s concept of the
zone of proximal development highlights the degree of the importance he placed
on social influences to development (Thomas, 1992).

Zone of proximal development: The dynamic and interactive process be-

tween what a child is capable of doing by him or herself and what a child can
do with the assistance of a parent, teacher, or mentor.
150 What Are the Essential Elements of Counseling? PART TWO

By completing tasks with the help of skilled individuals, children become more ca-
pable of independently completing demanding enterprises. Two other constructs
are related to the skilled assistant–child interaction learning partnership. Inter-
subjectivity is the process through which two individuals with differing views
modify their views to come to a mutual understanding. Scaffolding reflects the al-
tering degree of assistance that a child receives from the skilled adult to suit his or
her level of competence (Berk, 1997).

ETHOLOGICAL AND MATURATIONAL THEORIES

OF HUMAN DEVELOPMENT

Ethological theories of human development, such as those of Lorenz and Bowlby,

are based on Darwinian evolutionary theory and propose that behavior is the di-
rect result of biological factors. Maturational approaches to human development,
like that of Gesell, also focus primarily on growth trends that are dictated by biol-
ogy. Maturational approaches adequately describe the behaviors that may be ex-
pected by an individual at a particular developmental stage, however, they are
void of information relevant to how or why the changes in one’s development
occur.

䊏 Konrad Lorenz

Through studies with the greyleg goose, Lorenz is credited with discovering the
phenomenon of imprinting, a specialized learning process that occurs extremely
early in life (Schwartz, 1989).

Imprinting: A learning process driven by innate propensities to establish so-

cial bonds in the form of permanent attachments with the first living, moving
organisms a young animal or human notices and shadows.

Lorenz’s research showed that once initial bonds are formed with the first organ-
ism, even if it is of a varying species, the relationship with the imprinting organism
is irreversible. Additionally, Lorenz pioneered the concept of a critical or sensitive
period, defined as follows (Green & Piel, 2002; Lafreniere, 2000):

Critical period: Brief stage of development during which a developing child

is predisposed to learn a specific ability or function because of heightened
susceptibility to particular environmental stimuli.

Critical periods are crucial to a child’s development. In the presence of learning

opportunities, children can experience tremendous gains that prepare them for
greater cognitive, social, and emotional advances in later stages of development.
CHAPTER EIGHT Counseling Across the Life Span 151

䊏 Attachment Theory

Bowlby incorporated ideas from a number of distinct fields and his own work with
children and families to formulate attachment theory. Attachment theory empha-
sizes the importance of positive child–mother relations to healthy development. To
become a well-adjusted adolescent and adult, a child and mother must bond
through warm, intimate interactions that satisfy both the parent and child.

Attachment theory emphasizes the importance

of positive child–mother relations to healthy
development. To become a well-adjusted
adolescent and adult, a child and mother must
bond through warm, intimate interactions that
satisfy both the parent and child.

Although Bowlby emphasized the place of attachment in development, he did

so primarily with regard to the mother–child bond. Paternal relations are consid-
ered second in importance to the relationship between a mother and child. Etholog-
ical research out of which the concept of separation anxiety grew supported his
views about the mother–child bond. Separation anxiety can be defined as follows:

Separation anxiety: Extreme stress experienced by infants or young children

when they are separated from their mother.

The result of separation is infant or child protest or behavioral tantrums, a response

that suggests that the concept of attachment is viable. Bowlby also posited the con-
cept of despair as an elevated separation and grief response that occurs prior to de-
tachment.

䊏 Theory of Genetic Determination

A maturational approach, Gesell’s theory of genetic determination suggests that bi-

ology determines natural maturation and is considered the greatest force directing
one’s development. He posited that the development of all humans occurred in a
relatively predetermined fashion, allowing for developmental comparisons to be
made. Further, Gesell proposed that a child’s development might be viewed as cy-
clical, with children continuously alternating between better and worse stages,
with the better implying a balance between the child and his or her environment,
and worse implying the child’s unhappiness and confusion in relation to the physi-
cal and social realms (Thomas, 1992).
152 What Are the Essential Elements of Counseling? PART TWO

HUMANISTIC THEORIES OF HUMAN DEVELOPMENT

Humanistic theories of human development are based on the premise that people
are intrinsically good and make decisions that are in their best interest.

䊏 Maslow’s Hierarchy of Needs

Maslow proposed a needs hierarchy based on the notion that the drive to respond
to individual needs motivates behavior. The highest level in the hierarchy is self-ac-
tualization, which Maslow considered the goal of human existence. However, be-
fore people can achieve self-actualization, they must satisfy their most primitive
needs, which have the greatest influence and serve as the strongest motivating
force on behavior. Once basic needs are satisfied, the individual may move to
higher levels of the hierarchy in an effort to satisfy the needs at those respective lev-
els.

Levels of Maslow’s Hierarchy (Maslow, 1943)

䊏 The most primitive needs identified by Maslow are biological or physiological
needs, such as the need for sustenance, relaxation, and sex.
䊏 The second tier of Maslow’s hierarchy is safety, which may be characterized as an
individual’s need for security or an absence of danger.
䊏 Once physiological and security needs are met, people seek love and compan-
ionship with others to fulfill the need for love and belongingness.
䊏 Esteem needs emerge next and are characterized by an individual’s desire to
view himself or herself in a positive light and to be seen positively by others.
䊏 The highest level of need is self-actualization, or the drive to develop one’s full-
est potential and do what one must do to experience happiness.

Chapter 8: Key Terms

䉴 Sociocultural context 䉴 Id 䉴 Law of exercise
䉴 Continuous development 䉴 Ego 䉴 Operant conditioning
䉴 Discontinuous develop- 䉴 Superego 䉴 Positive reinforcement
ment 䉴 Fixation 䉴 Negative reinforcement
䉴 Cognitive development 䉴 Arrestment 䉴 Extinction
䉴 Physical development 䉴 Unconditioned stimulus 䉴 Shaping
䉴 Socioemotional develop- 䉴 Conditioned stimulus 䉴 Aversive conditioning
ment 䉴 Unconditioned response 䉴 Vicarious reinforcement
䉴 Fine motor skills 䉴 Conditioned response 䉴 Assimilation
䉴 Gross motor skills 䉴 Law of effect 䉴 Schemas
CHAPTER EIGHT Counseling Across the Life Span 153

䉴 Accommodation 䉴 Conservation 䉴 Conventional morality

䉴 Object permanence 䉴 Seriation 䉴 Postconventional morality
䉴 Symbolic substitution 䉴 Cognitive maps 䉴 Zone of proximal develop-
䉴 Egocentrism 䉴 Imprinting ment
䉴 Centration 䉴 Critical period 䉴 Intersubjectivity
䉴 Animistic thought 䉴 Preconventional morality 䉴 Separation anxiety
 chapter Major Forces Behind
Counseling Approaches
9
Paul Bernstein
Carol Thomas
Duquesne University

In This Chapter

䉴 Psychodynamic Approaches: 䉴 Psychodynamic Approaches:

Psychoanalysis Transactional Analysis
䊏 View of Human Nature 䊏 View of Human Nature

䊏 Theory of Personality 䊏 Theory of Personality

䊏 Key Theoretical Concepts 䊏 Key Theoretical Concepts

䊏 Goals of Therapy 䊏 Goals of Therapy

䊏 Therapeutic Techniques 䊏 Therapeutic Techniques

䊏 Role of Therapist 䊏 Role of Therapist

䊏 Strengths and Limitations 䊏 Strengths and Limitations

䉴 Psychodynamic Approaches: 䉴 Cognitive-Behavioral Approaches:

Analytic Psychology Behaviorism
䊏 View of Human Nature 䊏 View of Human Nature

䊏 Theory of Personality 䊏 Theory of Personality

䊏 Key Theoretical Concepts 䊏 Key Theoretical Concepts

䊏 Goals of Therapy 䊏 Goals of Therapy

䊏 Therapeutic Techniques 䊏 Therapeutic Techniques

䊏 Role of Therapist 䊏 Role of Therapist

䊏 Strengths and Limitations 䊏 Strengths and Limitations

䉴 Psychodynamic Approaches: 䉴 Cognitive-Behavioral Approaches:

Individual Psychology Neo-Behaviorism
䊏 View of Human Nature 䊏 View of Human Nature

䊏 Theory of Personality 䊏 Theory of Personality

䊏 Key Theoretical Concepts 䊏 Key Theoretical Concepts

䊏 Goals of Therapy 䊏 Goals of Therapy

䊏 Therapeutic Techniques 䊏 Therapeutic Techniques

䊏 Role of Therapist 䊏 Role of Therapist

䊏 Strengths and Limitations 䊏 Strengths and Limitations

154
In This Chapter (continued)

䉴 Cognitive-Behavioral Approaches: Cognitive 䊏 Goals of Therapy

Therapy 䊏 Therapeutic Techniques
䊏 View of Human Nature 䊏 Role of Therapist
䊏 Theory of Personality 䊏 Strengths and Limitations
䊏 Key Theoretical Concepts

䊏 Goals of Therapy 䉴 Existential-Humanistic Approaches:

䊏 Therapeutic Techniques Person-Centered
䊏 Role of Therapist 䊏 View of Human Nature

䊏 Strengths and Limitations 䊏 Theory of Personality

䊏 Key Theoretical Concepts

䉴 Cognitive-Behavioral Approaches: 䊏 Goals of Therapy

Rational-Emotive Therapy 䊏 Therapeutic Techniques

䊏 View of Human Nature 䊏 Role of Therapist

䊏 Theory of Personality 䊏 Strengths and Limitations

䊏 Key Theoretical Concepts

䊏 Goals of Therapy 䉴 Existential-Humanistic Approaches:

䊏 Therapeutic Techniques Gestalt
䊏 Role of Therapist 䊏 View of Human Nature

䊏 Strengths and Limitations 䊏 Theory of Personality

䊏 Key Theoretical Concepts

䉴 Cognitive-Behavioral Approaches: 䊏 Goals of Therapy

Reality Therapy 䊏 Therapeutic Techniques

䊏 View of Human Nature 䊏 Role of Therapist

䊏 Theory of Personality 䊏 Strengths and Limitations

䊏 Key Theoretical Concepts

䊏 Goals of Therapy 䉴 Existential-Humanistic Approaches:

䊏 Therapeutic Techniques Logotherapy
䊏 Role of Therapist 䊏 View of Human Nature

䊏 Strengths and Limitations 䊏 Theory of Personality

䊏 Key Theoretical Concepts

䉴 Cognitive-Behavioral Approaches: 䊏 Goals of Therapy

Multimodal Therapy 䊏 Therapeutic Techniques

䊏 View of Human Nature 䊏 Role of Therapist

䊏 Theory of Personality 䊏 Strengths and Limitations

䊏 Key Theoretical Concepts

155
156 What Are the Essential Elements of Counseling? PART TWO

PSYCHODYNAMIC APPROACHES: PSYCHOANALYSIS

In 1856, Sigmund Freud was born to a lower-middle-class Jewish couple. Spending

most of his life in Vienna, Freud excelled in academics and, in 1811, earned a medi-
cal degree. During this time, he married Martha Bernays, with whom he eventually
had six children. Freud began to formulate psychoanalysis while working with
Josef Breuer, a pioneer in hypnosis and talk therapy. Freud’s career exploded with
the publication of a book on dream interpretation, which ultimately lead to his
foundational contributions to the psychology field and Western culture. In 1938,
under Nazi occupation, Freud fled Vienna for London, England, where he died a
year later.

䊏 View of Human Nature

In the first 6 years of life, individuals progress through libidinally induced psycho-
sexual stages of development.

Freud’s Stages of Development

1. Oral stage: 0 to 12 months.
2. Anal stage: 12 months to 3 years.
3. Phallic stage: 3 to 4 years.
4. Latency period: 6 years to puberty.
5. Genital stage: Puberty to death.

One’s success in progressing through these early stages determines the quality of
psychological health