COUN 519

Early Childhood (general)

- 2 to 6 (play years) - motor skills refinement - develop ties with peers - expansion of thoughts and language skills

Early adulthood (general)

- 25-40 years - INTIMACY VS ISOLATION

Later Adulthood

- 65+ - in 2014, 46.2 mil Americans (14.5%) were 65+ - by 2030, 70 mil or 20% will be this age - time period encompasses 4 decades bc people are living longer three categories include: - 65-74 (young old) - 75-84 (old) - 85+ (old old)

Middle Childhood (general)

- 7 to 11 - increase literacy and logical thinking - negotiate relationships with peers - acquire new interpersonal skills (get along, tolerance, patience, positive attitudes towards groups)

Developmental Theories & Founder

- Cognitive Theory (Piaget & Elkind) - Moral Development (Kohlberg & Gilligan) - Sociocultural Theory (Vygotsky) - Psychosocial Development (Erikson) - Developmental Psychopathology (Kazdin, Kovacs, and others) - Class Theories (Freud, Adler, Jung) - Attachment Theory (Ainsworth, Bowlsby, etc.) - Emotional Intelligence (Salovey & Mayer)

Nonaxial System of Diagnosis

- DSM-5! - single diagnostic recording system - mental health disorders, medical conditions, and psychosocial or environmental issues on one axis - principle diagnosis listed first... followed by other mental health disorders - medical conditions listed next... followed by other conditions that may be a focus in counseling (Z CODES)

Clinical Interviews

- Intake interviews - Structured clinical interview - Semi-structured interviews - Unstructured interviews - Mental status examination

Assessment

- MULTIFACETED activity that is integral to counseling process - ONGOING activity that takes place throughout counseling process - FORMAL and INFORMAL helps counselors gather info to determine 1) nature of client issue 2) prevalence of problems 3) strengths and skills 4) potential benefit of counseling

Other inventories include:

- Minnesota Multiphasic Personality Inventory-2 - NEO Personality Inventory-3 (NEO-PI-3) - Myers-Briggs Type Indicator (MBTI)

Rating Scales

- Rater indicates the degree or severity of the characteristic being measured - helpful in measuring a wide spectrum of behaviors - EXAMPLE: Conners 3TM

Counseling Men

- accept men where they are - don't push to express "softer feelings" - validate feelings - have a plan - introduce developmental issues - slowly encourage expression of new feelings - explore underlying issues and reinforce new ways of understanding world - encourage behavioral changes - encourage integration of new feelings, new cognitions, and new behaviors - group counseling

Middle Adulthood

- age 40 to 60-65 - midlife transition - physical changes include: wrinkles, gray hair, balding, bone density loss, weight changes, less susceptible to colds, accidents, and injuries, and drop in hormone levels (menopause and perimenopause)

Examples of Standardized Tests

- aptitude - achievement - personality - interests - values - skills

Counseling Woman

- balancing multiple roles and identities (emphasize self-care, holistic approach, help with assertiveness) - overvaluing approval of others (help them move to a place where they respect their own self-evaluations) - negative body image (use team approach for eating disorders)

Myers-Briggs Type Indicator (MBTI)

- based on the work of Carl Jung and Jungian theory - most widely used personality inventory for normal functioning - dichotomies: 1) Introversion vs. Extroversion 2) Sensing vs. Intuition 3) Thinking vs. Feeling 4) Judging vs. Perceiving - Think: Alex's assessment he likes for people to take! (ENFP, INFJ)

Counseling Implications for Middle Adulthood

- be aware of transitions - 4 S Transition Model

Counseling Implications for Emerging Adults

- become knowledgeable about this stage of life! - consider providing psychoeducation, individual counseling, group counseling to help emerging adults accomplish tasks (leaving home, relationships, individuation) - help normalize experiences and develop coping skills to deal with ambiguity - be aware of signs and symptoms of common issues that arise during adolescence and emerging adulthood

Mental disorder

- behaviors that are culturally sanctioned are NOT considered mental disorders - DSM diagnoses based on clinician's evluation - counselors aren't trained to work with every disorder, but should be knowledgeable - you should master DSM terminology and differential diagnosis

Adolescence: EGOCENTRISM

- belief in one's uniqueness and invulnerability - reflected in reckless behavior and grandiose ideas - being "on stage" or playing to an imaginary audience

Examples of Qualitative Methods

- card sorts - structured exercises - creative activities - genograms - timelines - other open-ended approaches

Social in BPS Model

- client's personal history - client support system - spouse or partner? what's that relationship like - who supports client? - children? relationships with them? - living situation - cultural factors relevant to client problem - level of education - work history - legal difficulties - financial situation

Checklists

- clients or observers simply mark words or phrases that apply to them or the situation - provide valuable info to counselors in a relatively brief time - often used during INTAKE interviews - EXAMPLES: Symptom Checklist-90-Revised, Brief Symptom Inventory

Minnesota Multiphasic Personality Inventory-2 (MMPI-2)

- consists of 567 affirmative statements - widely used in mental health settings - identifies individuals who may be experiencing psychiatric problems - helps discern important characteristics such as anger, alienation, depression, and social insecurity - assesses the BIG FIVE personality factors - six sub factors, or facets, associated with each primary factors - used to understand client, build empathy and support, provide feedback regarding personality traits, and guide treatment planning

Concerns affecting Children and Adolescents

- depression - eating disorders - ADHD - divorce - grief and loss - child maltreatment - substance abuse - cyberbullying

Dimensional approach to diagnosis

- diagnosis done using spectrum approach - DSM-5 has many specifiers for several disorders to enhance utility of diagnosis (course, severity, frequency, duration, description...) - aligns with ICD-10

Mental disorder categories (continued)

- elimination disorders - sleep-wake disorders - sexual dysfunctions - gender dysphoria - disruptive, impulse-control, and conduct disorders - substance-related and addictive disorders - neurocognitive disorders - personality disorders - paraphilic disorders - other

Building a Counseling Relationship

- establish rapport - clarify counseling role - explain confidentiality

Three Strategies that make Multicultural Feminist Therapy unique

- gender role analysis (examining gender socialization) - power analysis (helping clients explore how they use power and how it is used on them) - culture analysis (examine multiple identities that have shaped clients' lives and explore ways culture has impacted lives)

Single Adults

- increase dramatically since 1970 - 50%+ Americans over 18 are single - median for first marriage... MALES 29 FEMALES 27

Risks with Diagnosis

- labels can be stigmatizing and misinterpret clients - not consistent with holistic counseling approach - not absolute reality; historically contingent and socially constructed - can lead to a viewing of the client as the disorder rather than a person with symptoms - could negatively impact insurance and employment - DSM-5 and ICD-10 are very Western-based - can cause family stresses and have family pathologize the individual

Qualitative Methods

- less formal, allows for greater counselor and client flexibility and adaptability - diverse clientele

Counseling Implications for Later Adulthood

- life review (individual, group, or family) - life review has benefits, including increased ego integrity, life satisfaction, positive feelings, decreased feelings of depression and despair

Newly Married

- marriage can have many benefits (thrive when someone is committed to well-being, children benefit when two parents are dedicated to them) -honeymoon stage (first 6 months) are happiest - new couples must learn how to share space, meals, chores, leisure - new-couple stage is 2 years... most likely time for divorce

Biology (Bio) in the BPS Model

- medical conditions - has client had a physical? - genetic factors influencing wellbeing - thyroid hormone levels checked? - traumatic brain injury (TBI)? - birth control or medication? - allergies

Standardized Tests

- meet certain requirements for test construction, administration, and interpretation - use representative groups for scoring and interpretation - typically have been evaluated for reliability and validity - include uniform standards for administration

Research on Cohabitation

- mixed reports regarding benefits on marriage - research says cohabitation either leads to no differences or has a negative effect on marital satisfaction

Midlife relationships

- most midlife adults live in families with a spouse or partner - may raise children, launch children, remain childless, have grandchildren, and/or be caregivers for aging parents - relationship change -> parent-child relationship (role strain, boomerang generation (moving back home)) - possible divorce - some experience responsibility of caring for both aging parents and children (sandwich generation)

Adversity

- negative life events that impact people through lifespan examples: declining health, death of a spouse, financial burdens, chronic life stressors

Mental disorder categories

- neurodevelopmental - schizophrenia spectrum and other psychotic disorders - bipolar and related disorders - depressive disorders - anxiety disorders - obsessive-compulsive and related disorders - trauma- and stressor-related disorders - dissociative disorders - somatic symptom and related disorders - feeding and eating disorders

Parents with Young Children

- physically, psychologically, and interpersonally demanding - can influence living arrangements, marital relationship, stress level - family becomes unbalanced, at least temporarily, when a newborn enters a family - difficulties in juggling multiple roles

Counseling Implications for Young Adults

- premarital education and counseling - psychoeducation about normal, expected changed during early adulthood - groups designed to help people cope with unanticipated transitions (divorce) - exploration of patterns and recognition of transitions within families of origins (genogram)

Purpose of Diagnosis

- provide a common ground for understanding what a diagnostic category means - to help counselors determine efficacious treatment

Reasons for Being Skilled in Diagnosis

- provides framework and criteria for naming and describing mental disorders - helps understand client symptoms and course of a disorder - make use of research on treatment effectiveness - linked to standardized assessment inventories - demonstrate accountability and lessen malpractice suits - third-party reimbursement for services - can help clients understand symptoms - help counselors determine if they have training to help particular client

Gender-aware Counseling

- recognizing ways gender roles are socially constructed - recognizing gender development is influenced by a multitude of factors, including biology, cognition, culture, and socialization by caregivers - recognizing that gender refers to social constructed roles whereas biological sex refers to possession of an XY chromosome pair (healthy males) and an XX chromosome pair (healthy females)

Methods of Assessment

- standardized tests - checklists and rating scales - clinical interviews - qualitative methods

Diversity Considerations

- there is misuse of assessment instruments with ethnic and racial minorities, people with disabilities, women, people in poverty, etc. - counselors need to consider the client's cultural background, gender, language, etc. when selecting instruments

Levinson's Season-of-life Theory

- transition (40-45) - life structure (45-50) - culminating life structure (55-60)

Cohabitation

- unmarried couples living together in an intimate, sexual relationship - could be precursor to marriage - could be alternative to marriage

Psychological (Psycho) in BPS Model

- what brings them to counseling - history of concern - developmental, psychological, or psychopathological concerns - history of addiction or psychiatric disorders - what is client's mental status - suicidal or homicidal ideation?

Adolescence (general)

- young people transition from childhood to adulthood - mature physically, develop understanding of roles and relationships, acquire and refine skills for performing successfully as adults - puberty marks beginning!

Multicultural competencies:

-31 competencies organized into four categories: -Awareness of one's own personal worldview and the effect of cultural conditioning on personal development -Knowledge of the worldviews of culturally different clients -Counseling Relationship -Counseling and Advocacy skills needed to work with culturally different clients

Professional boundaries and roles with clients:

-A key aspect of acting ethically and legally as a counselor includes defining, maintaining, and respecting professional boundaries. -Boundaries help provide structure to the professional relationship and protect the welfare and vulnerability of clients -The 2014 A C A Code of Ethics delineates a number of prohibited counselor-client interactions: -Sexual and/or romantic relationships with current clients, their romantic partners, or their family members (in-person as well as virtual interactions or relationship) -Entering into counseling relationships with former romantic partners, friends, family members, students, fellow workers, and others with whom the have a preexisting relationship -Socializing or conducting business with clients

Professional counseling:

-A professional relationship that empowers diverse individuals, families, and groups to accomplish mental health, wellness, education, and career goals -20/20: A Vision for the Future of Counseling task group

Ethics and counseling:

-ACA (2014) Code of Ethics -Seventh version of the counseling profession's ethical code -Has been revised periodically since it was first adopted in 1961 -Ethics Desk Reference for Counselors -Ethical Standards Casebook -Separate codes of ethics within A C A divisions

Counseling and social media:

-According to Wheeler and Bertram (2015), counselors interacting with clients through social media without forethought and sound informed consent run the risk of causing harm to both themselves and their clients -Two of many concerns associated with social media and counseling: -Breach of confidentiality or invasion of privacy -Boundary violations

End-of-life decisions:

-According to the A C A 2014 Code of Ethics, counselors have the option of breaking or not breaking confidentiality in reference to end-of-life decisions -Before making decisions, counselors working with clients making end-of-life decisions should engage in consultation and/or supervision throughout the decision-making process

Hays ADDRESSING model:

-Age and generational influences -Disability (developmental) -Disability (acquired later in life) -Religion (and/or spirituality) -Ethnicity (which may include race) -Social status (or social class) -Sexual orientation -Indigenous heritage -National origin -Gender (and gender socialization)

Factors associated with increased rates of disability:

-Aging -Poverty -Medical Advances -Emerging Conditions

Autonomy:

-Allows an individual the freedom of choice and action -Counselors are responsible for helping clients make their own decisions and act on their own values -Responsible for helping clients consider the ramifications of their decisions and for protecting them from actions that may lead to harm of self and others

Chronological overview of counseling: 1950s

-American Personnel and Guidance Association (APGA) founded -Division 17 of the American Psychological Association (Society of Counseling Psychology) created -National Defense Education Act (NEDA) enacted, providing training for counselors -New theories formulated (e.g., systematic desensitization, rational-emotive therapy, transactional analysis) -Most impactful decade on counselors

Sexual orientation:

-An "invisible identity" in many ways -Also referred to as affectional orientation -Refers to past, present, and ideal feelings about who is attractive and desirable in sexual and/or romantic ways. -Can be heterosexual, homosexual, bisexual, or questioning -Multidimensional construct that many believe exists on a continuum from exclusively homosexual to heterosexual -Referring to someone as homosexual is discouraged because of the psychopathological connotations ascribed to that term in early editions of the DSM -A person may be erotically attracted (sexual attraction) to someone of the same sex but engage exclusively in heterosexual behavior (sexual behavior) -Includes both the affectional and sexual dimensions of self that are evidenced by thoughts, feelings, and behaviors

State licensure:

-Arguably most important way of defining an occupation as a profession -Defines scope of practice -Determines who can and cannot offer certain services -A governmentally sanctioned form of credentialing based on the concept of the regulatory power of the state -All 50 states, including the District of Columbia, Guam, and Puerto Rico, legally regulate the practice of counseling through licensure -State counseling licensure laws differ from state to state -Challenges professional identity and licensure portability

Professional recognition:

-As recently as 1960 counseling was not recognized legally -Bogust v. Iverson -1960 - Doctoral level counselors not liable for suicide because counselors were "mere teachers" -Iowa Law Review Note -1971 - Counselors legally recognized as professionals who provide personal as well as educational and vocational counseling -Weldon v. Virginia State Board of Psychologists Examiners -1974 - Counseling acknowledged as a profession distinct from psychology -U.S. House of Representatives -1976 - defined counseling as assisting in personal, educational, and career development

According to AMHCA, mental health counselors provide a full range of services including:

-Assessment and diagnosis -Psychotherapy -Treatment planning and utilization review -Brief and solution-focused therapy -Alcoholism and substance abuse treatment -Psychoeducational and prevention programs -Crisis management

Six moral principles:

-Autonomy -Nonmaleficence -Beneficence -Justice -Fidelity -Veracity

Racism:

-Based on prejudicial beliefs, which maintain that racial groups other than one' own are inferior -Extends the negative attitude into behavior that discriminates against a particular group

Self awareness:

-Beliefs, attitudes, and feelings associated with cultural differences -Understanding of one's own cultural values -Development of self awareness through self exploration

Chronological overview of counseling: 1980s

-CACREP is formed to accredit counseling programs, including community counseling -National Academy of Certified Clinical Mental Health Counselors (NACCMHC) continued to develop training standards and certify mental health counselors -National Board of Certified Counselors (NBCC) and Chi Sigma Iota (CSI) established -APGA changed its name to the American Association for Counseling and Development (AACD) -Carol Gilligan's (1982) seminal study on the development of moral values in females helped introduce feminist theory into the counseling arena

Culture:

-Can be conceptualized as a combination of the following: -Ethnographic variables (e.g., ethnicity, nationality, religion, language) -Demographic variables (e.g., age, gender, place of residence) -Status variables (e.g., social, economic, educational background) -Formal and informal memberships and affiliations

Clinical mental health counseling roles:

-Career and lifestyle issues -Marriage and family concerns -Addictions -Stress management -Crisis intervention -Disaster relief -Mental health disorders -Developmental concerns -Grief and loss -Help people develop psychologically, socially, spiritually, and educationally -Recognize the importance of biological, cultural, social, emotional, and psychological interactions -Provide counseling with individuals, groups, couples, and families

Chronological overview of counseling: 1940s

-Carl rogers developed client-centered approach to counseling and published Counseling and Psychotherapy -Changing role of counseling as a result of WWII -Selection and training of specialists for military and industry -Increased emphasis placed on personal freedom and vocational choice, due to questioning of traditional occupational sex roles -Provided care for military personnel suffering emotional breakdowns -Establishment of the National Institute of Mental Health -Passage of the National Mental Health Act (1946) which authorized funds for research and training to prevent and treat mental health disorders -Veterans Administration funded training of counselors and psychologists engaged in graduate study

Overview of changes made to the 2014 ACA Code of Ethics:

-Clarifies and highlights professional values -Emphasizes guidelines related to the use of technology in the counseling profession -Provides guidelines for the use of social media -Expands definition of relationship to prohibit counselors from having personal virtual relationships with clients -Eliminates the end-of-life exception to the referral rule -Clarifies counselors' duty to inform -Expands the concept of pro bono services -Clarifies counselors' responsibilities with mandated clients -Expands the role of confidentiality -Describes updated requirements for counselor educators and researchers

Privacy:

-Client's legal right to determine what information about himself or herself will be shared with others -Factors that can jeopardize a client's privacy: -Waiting in a general reception area -Using credit cards for billing -Disposing of records -Taping sessions -Documentary or business activities associated with the counseling setting

Factors that affect ways counselors select appropriate treatment modalities:

-Client's level of functioning -Psychosocial stressors -Cultural background

Informed consent:

-Client's rights to know what they are getting into when they engage in counseling -Allows clients to make informed decisions about their treatment -Provides clients with information about how the counseling process works and makes them active partners in the counseling relationship -Usually both verbal and written -Disclosure: providing clients with information they need to make informed decisions about entering and remaining in counseling -Free consent: clients choose to engage in activity without undue pressure or coercion -Capacity: ability to make rational decisions

Projections for the counseling profession:

-Continued unification and solidification of the counseling profession -Progression toward licensure portability -Greater emphasis on globalization of counseling -Focus on systemic theories -Understanding and responding ethically to rapidly evolving technology -Understanding connections between mental health and neurobiology, neuroplasticity, spirituality, and environmental-cultural factors

Chronological overview of counseling: 2000 - 2009

-Counseling celebrated its 50th anniversary in 2002 -A greater emphasis on holistic approaches, wellness, and spirituality -Need for outcome-based research to determine "best practice" options -Emergence of therapies such as EMDR, neurofeedback, hypnosis, and postmodern approaches -Greater emphasis given to crisis management -Increased need to support military families, accompanied by legislative activity to recognize counselors as service providers -Adoption of 2009 CACREP standards, merging community counseling and mental health counseling specialty areas to form clinical mental health counseling -Increased emphasis on working with special populations

Key points in definition of counseling:

-Counseling encourages wellness -Counseling is conducted with individuals, groups, and families -Counseling is diverse and multicultural -Counseling is a dynamic process -Counseling is lively and engaging

Informed consent includes the following topics:

-Counselor's background and professional affiliations -Therapeutic process issues -Risks, benefits, and alternatives -Fees -Confidentiality and privileged communication -Structure of the counseling relationship -Diagnostic labels -Emergency situations and interruptions in counseling -Involuntary clients

Initial phase:

-Counselors focus on building a therapeutic relationship and heling clients explore issues that directly affect them. -Role induction is completed in this phase -Counselors assess the seriousness of the concern presented, provide structure to the counseling process, help clients take initiative in the change process, develop initial case conceptualizations, and create treatment plans

Professional competence:

-Counselors practice within their boundaries of competence -Competence refers to the capability of providing the accepted standard of care required for working in a particular situation -Developed and maintained through education, formal training, and supervised practice in particular areas -Also involves an ability to work with diverse populations -Important to refer when client needs go beyond the scope of a counselor's professional competence

Family responses to disability:

-Crisis Phase -Waiting for a diagnosis or have just received one -Often experience feelings of shock, denial, anger, and depression -Chronic Phase -Coping with the day-to-day issues related to the disability -Degree to which help is needed depends on many factors including the nature and severity of the disability -Terminal Phase -Experiencing a lot of stress, and family interactions may be strained

Legal and ethical decision-making model:

-Define the problem, dilemma, and sub-issues -Identify relevant variables -Review/consult the law, ethics codes, and institutional policy -Be alert to personal influences -Obtain outside perspective -Enumerate options and consequences -Decide and take action -Document decision making and follow-up actions

ACA Code of Ethics:

-Delineates five core professional values -Enhancing human development throughout the lifespan -Honoring diversity and embracing a multicultural approach in support of the worth, dignity, potential, and uniqueness of people within their social and cultural contexts -Promoting social justice -Safeguarding the integrity of the counselor-client relationship -Practicing in a competent and ethical manner

Conveying cultural empathy (Chung and Bemak):

-Demonstrate a genuine interest in learning more about the client's culture -Convey genuine appreciation for cultural differences between the client and counselor -Recognize the cultural meaning clients attach to phenomena -Incorporate culturally appropriate interventions and outcome expectations into the counseling process -Understand and accept the context of family and community for clients -Recognize the psychosocial adjustment that must be made by clients -Be sensitive to oppression, discrimination, racism, and micro aggressions

Chronological overview of counseling: Before 1900

-Developed in the late 1890s and early 1900s -Informal and characterized by advice-giving and information-sharing -Created to improve people's lives affected by the Industrial Revolution -Impacted by the social welfare reform movement (i.e. social justice movement)

Clinical mental health counseling includes the following core areas:

-Diagnosis and psychopathology -Psychotherapy -Psychological testing and assessment -Professional orientation -Research and program evaluation -Group counseling -Human growth and development -Social and cultural foundations -Lifestyle and career development -Supervised practicum and internship

Intervention:

-Direct, time-limited strategies -Often implemented in crisis-like situations

Professional helpers:

-Educated to provide assistance on a preventive, developmental, and remedial level. Hold advanced degrees in fields such as social work, psychology, and mental health counseling

Etic perspective:

-Emphasizes the universal qualities of counseling that are culturally generalizable (e.g., good counseling is good counseling, regardless of culture) -Criticized for emphasizing universality at the expense of cultural differences

Homonegativity:

-Encompasses the concepts of both homophobia and heterosexism -Negative thoughts and feelings about sexual minorities

Using technology-assisted counseling responsibly:

-Establish methods to ascertain a client's identity -Transfer client information electronically to authorized third-party recipients only when both the counselor and the authorized recipient have secure transfer and acceptance capabilities -Make sure the clients provide informed consent before engaging in any form of technology-assisted counseling -Make sure the adequate security configuration is available -Provide technology-assisted counseling only in practice areas that are within your expertise -Do not provide technology-assisted counseling to clients in states where doing so would violate local licensure laws -Have a plan should emergency situations arise -Consult with others who are more experienced in using technology-assisted counseling -Refer to written resources to become well-versed in technology-assisted counseling -If you choose to become a distance credentialed counselor, participate in N B C C's training program

ACES description of community counseling:

-Favors a multifaceted approach that is developmental and educative -Focuses on prevention -Emphasizes the influence of community on clients -Focuses on empowerment of clients through advocacy

Chronological overview of counseling: 1920s

-First certification of counselors initiated in Boston and New York -Publication of Strong Interest Inventory (SVII) by Edward Strong -First marriage and family counseling center established by Abraham and Hannah Stone -Broadening of counseling focus beyond vocational interests

Chronological overview of counseling: 1930s

-First theory of counseling, counselor-centered, trait-factor approach, developed by E.G. Williamson and colleagues -John Brewer advocated for vocational decision-making to be included in education process -Dictionary of Occupational Titles (DOT) first published as a creation of the George-Dean Act in 1939 which became a major source of career information for vocational counselors in the US

Emic perspective:

-Focuses on the indigenous characteristics of each cultural group that influence the counseling process and consequently emphasizes counseling approaches that are culturally specific -Criticized for overemphasizing specific, culturally appropriate techniques to facilitate client change

Clifford Beers (1900s):

-Former mental patient -Advocated for better treatment of the mentally ill -Published, A Mind that Found Itself (1908)

Frank Parsons (1900s):

-Founder of guidance -Established the Boston Vocational Bureau -Wrote, Choosing a Vocation (1909) -Theorized that choosing a vocation was a matter of relating three factors: a knowledge of the world of work, a knowledge of self, and the use of true reasoning to match the two -Provided the foundation on which modern career counseling is based

Making ethical decisions:

-Four step process of separating personal values from professional values: -Marginalization (Lack of awareness related to personal or professional values) -Separation (Well developed moral values but lack of awareness of professional ethics) -Assimilation (adoption of new professional ethics and abandonment of former cultural values) -Integration (adoption of new profession's values while retaining important aspects of one's own personal values)

Three important persons for counseling in the 1900s:

-Frank Parsons -Jesse B. Davis -Clifford Beers

Types of sexual orientations:

-Gay - men who are sexually oriented to other men -Lesbian - women who are sexually oriented to other women -Bisexual - individuals who are sexually oriented to both men and women -Queer - individuals who identify outside of the heteronormative or gender binary community -Questioning - individuals who are beginning to explore their sexual understanding and orientation

Paraprofessional helpers:

-Generalist human services workers who have received some formal training but work as part of a team rather than individually

Chronological overview of counseling: 1960s

-Gilbert Wrenn publishes The Counselor in a Changing World (1962) -Behavioral counseling, led by John Krumboltz's Revolution in Counseling (1966), gains traction -Increased focus on cultural and social issues -Community Mental Health Centers Act (1963) passed which established a nationwide system of community mental health centers -Group counseling gains popularity -APGA publishes its first code of ethics -ERIC Clearinghouse on Counseling and Personnel Services (ERIC/CAPS) founded in 1966

Model of professional practice (Remley & Herlihy):

-Illustrates a balance between internal beliefs and values that drive counselors and the external forces that guide and support counseling practice -Internal beliefs and values: -Courage of convictions -Decision-making skills and models -Moral principles of helping professions -Intentionality -External forces: -Consultation, supervision, continuing professional development -Laws, Codes of ethics, System policies

Chronological overview of counseling: 2010 and Beyond

-Increased demands for evidenced-based accountability -Continued emphasis on holistic, wellness-based counseling -Continued emphasis on trauma-based interventions -Effectively counseling the growing aging population -Promoting social justice by continuing to confront social inequities -Working effectively with veterans and military families -Providing counseling to the unemployed and underemployed

According to AMHCA, mental health counselors practice in a variety of settings such as:

-Independent practice -Community agencies

Three phases of the counseling process:

-Initial phase -Working phase -Closing phase

Types of professional credentialing:

-Inspection -Registration -Certification -Licensure

Major future trends in counseling:

-Intersectionality of physical, mental, and environmental health, creating a need for more formal training in biopsychosocial aspects of life as well as pharmacology -Health insurance, particularly that provided under the Patient Protection and Affordable Care ACT -Counseling with immigrants and oppressed populations. -Integration with TRICARE -Service to veterans

License portability:

-Involves the ability to be licensed in a different state from the one a professional originally received a license without having to initiate a new application process in the new state -Recognition that the license a professional received in one state is acceptable and valid for the practice in another state

Privileged communication:

-Legal term that refers to the protection of confidentiality between two parties -Right of privilege belongs to clients not counselors -Communication must have been made in confidence with the intent that the information be kept confidential -State law governs whether privilege exists in counselor-client relationships

Coming out process:

-Letting other people know that one is lesbian, gay, or bisexual -Not a one-time event -On-going process, affected largely by an individual's life circumstances -Can have serious consequences, positive and negative -Can be positively associated with mental health and relationship satisfaction -Contributes to identity acceptance, integration, and authenticity -Carries risks of abandonment, ridicule, and disapproval -Can be psychologically painful, as the old sense of self is grieved before the new sense of self emerges

Work settings for clinical mental health counselors:

-Mental health centers -Work sites -Hospital environments -Substance abuse settings -Employee assistance programs -Universities -Individual practice -Geriatric centers -Government programs, such as the VA -Businesses and industries -Religious institutions -Maintenance organizations -Shelters for domestic violence victims -Hospice programs -Programs for people living with HIV/AIDS

Chronological overview of counseling: 1910s

-National Vocational Guidance Association (NVGA), forerunner to the American Counseling Association (ACA), is established -Smith-Hughes Act is passed, providing funding for vocational education in public schools -Army Alpha and Army Beta Intelligence tests developed by the U.S. Army -Psychometrics (psychological testing) embraced by vocational guidance movement after WWI -First university course on guidance offered at Harvard University

Multicultural counseling:

-No universally accepted definition exists -CACREP definition: Takes into account differences in areas such as language, social class, race, ethnicity, gender, sexual orientation, religion, and level of ability -West-Olatunji's (2001) definition: Multicultural counseling refers to "multiple perspectives or multiple cultural viewpoints within the counseling relationship in which none are dominant or considered more 'normal' than others"

Three levels of helping relationships in the mental health field:

-Nonprofessional helpers -Paraprofessional helpers -Professional helpers

Trait-factor Counseling:

-Often called the Minnesota Point of View -Pragmatic approach that emphasized the counselor's teaching, mentoring, and influencing skills -Theorized that a person had traits that could be integrated in a variety of ways from factors -Traits: people's aptitudes, interests, personalities, and achievement -Factors: constellation of individual characteristics -Based on scientific, problem-solving, empirical methods aimed at helping clients become more effective decision-makers

Use of technology:

-Online counseling, internet therapy, cybercounseling, and technology-assisted distance counseling are commonly used terms to describe the process of counseling through the internet -Synchronous counseling refers to counseling that occurs during the moment of connection -Asynchronous counseling refers to a time lapse between client-counselor communications

Transgender:

-People whose gender identity and expression conflicts with their biological manifestation of sex -Male-to-female (MTF) transgender persons are born with male genitalia but experiences their lives "gendered primarily as females" -Female-to-male (FTM) transgender individuals are born with female genitalia but experience their lives gendered primarily as males

Other guidelines for acting ethically:

-Personal and professional honesty -Acting in the best interest of clients -Acting without malice or personal gain -Justifying an action

Professional identity:

-Philosophy, training model, and scope of practice that characterize a particular profession -Important that CMHC counselors develop a professional identity and learn to explain that identity to others

Three categories of disabilities:

-Physical disabilities -Cognitive disabilities -Psychiatric disabilities

Prevention:

-Preventing disease or disability before it occurs -Increasing public awareness of activities or situations that lead to physical and/or emotional problems

Common ethical and legal concerns:

-Privacy, confidentiality, and privileged communication -Informed consent -Professional boundaries and roles with clients -Professional competence

Eight CACREP competency areas:

-Professional Counseling Orientation and Ethical Practice -Social and Cultural Diversity -Human Growth and Development -Career Development -Counseling and Helping Relationships -Group Counseling and Group Work -Assessment and Testing -Research and Program Evaluation

Confidentiality:

-Professional's promise not to disclose information revealed during the privacy of the counselor-client relationship, except under specific, mutually understood conditions -Tarasoff v. Board of Regents of the University of California (1976) -Duty to Warn: Counselors need to take reasonable action to help protect victims from dangerous clients -Mandatory duty does not exist in all states -Clinical mental health counselors should be aware of state laws that govern their practice and consult with colleagues and supervisors

Nonmaleficence:

-Refers to not harming other people -"Above all, do no harm" -Refrain from actions that may intentionally or unintentionally harm others

Worldview:

-Refers to the way people perceive their relationship with the world, including the following: -Nature -People -Objects -Religious experiences -Influences people's thoughts, feelings, behaviors, and perceptions

Justice:

-Refers to treating all people fairly -Should not discriminate based on race, socioeconomic status, gender, sexual orientation, or any other variable -Examine which justice is carried out through the policies of agencies, institutions, and laws that affect mental health practices

Postvention:

-Rehabilitation counseling, focused on helping people with permanent or chronic physical, cognitive, and psychiatric disabilities cope successfully and adjust to life with disability

Three variables that create a healing environment:

-Safety -Personalization -Softness

Sections of the ACA Code of Ethics:

-Section A - The Counseling Relationship -Section B - Confidentiality and Privacy -Section C - Professional Responsibility -Section D - Relationships with Other Professionals -Section E - Evaluation, Assessment, and Interpretation -Section F - Supervision, Training, and Teaching -Section G - Research and Publication -Section H - Distance Counseling, Technology, and Social Media -Section I - Resolving Ethical Issues

Five multicultural counseling themes:

-Sensitivity to the significant ways that cultural factors affect human development -Awareness of the competencies practitioners need to acquire to promote the healthy development of clients from diverse populations -Giving consideration to the professional training strategies that help foster the development of cultural competence among professionals -Having a broad knowledge of the research findings related to multicultural findings -Understanding present and future challenges that the counseling profession faces with a society that continues to be in a state of rapid flux in its racial/cultural demography

Veracity:

-Sixth principle considered key to ethical practice -Refers to truthfulness and integrity -Forms the foundation of a trusting relationship -Provides a fundamental framework for guiding clinical mental health counselors in making judgements about what actions they should take to promote their clients' welfare

Limitations of Ethical Codes:

-Some issues cannot be resolved by a code of ethics -Some codes are ambiguous, making them open to interpretation -Enforcing ethical codes is difficult -Conflicts may exist within ethical codes and among different organizations' codes -Some legal and ethical issues are not covered in codes -Conflicts may arise between ethical and legal codes -Some may be adapted to specific cultures -They do not address every possible situation, nor do they provide solutions for all situations -Ethical codes are historical documents -Knowledge of codes does not necessarily equate with ethical practice

Liu's Social Class Worldview Model:

-Step 1: Help client identify and understand his or her economic culture -Step 2: Help client identify the social class messages he or she has received -Step 3: Identify client's experiences with classism and help him or her move toward developing an adaptive, realistic, and healthy expectation of self -Step 4: Help the client integrate his or her experiences of classism

Gender dysphoria:

-Term used in the DSM-5 to describe individuals who experience incongruence between their expressed/experienced gender and their assigned gender -The term disorder, which implies a mental health condition and was used in the previous edition of the DSM, has been eliminated

Myths about disabilities:

-The Charity or Helplessness Myth -The Spread Phenomenon Myth -The Dehumanization or Damaged Merchandise Myth -The Feeling No Pain Myth -The Disabled Menace Myth

Chronological overview of counseling: 1970s

-The term, community counseling, coined -American Mental Health Counseling (AMHCA) formed -Basic helping skills programs initiated -State licensure for counselors begins -Creation of new divisions within the APGA

Heterosexism:

-The viewpoint that heterosexuality is the only acceptable sexual orientation -A pervasively oppressive institutional preference for heterosexuality

Role induction (structure) provides the client with information about:

-Time limits (e.g. 50-minute session) -Action limits (for prevention of destructive behavior) -Role limits (what will be expected of each participant) -Procedural limits (giving client responsibility to work on specific goals or needs)

Pyschiatric-mental health nursing:

-Training: -Accredited by the American Nurses Credentialing Center -Earn master's or doctoral degrees in psychiatric mental health nursing -Scope of Practice: -Assess, diagnosis, and treat individuals or families with psychiatric disorders -Contribute to policy development, practice evaluation, and healthcare reform -May choose to specialize in child and adolescent mental health nursing, gerontological-psychiatric nursing, forensics, or substance abuse disorders

Psychology:

-Training: -Accredited by the American Psychological Association -Most earn a PhD (doctor of philosophy) or PsyD (doctor of psychology) -Areas of specialization include clinical, social, cognitive, developmental, counseling, and school psychology -All states license psychologists, though licensure requirements differ -Since 1940s psychologists viewed as experts in psychological assessment -Fair Access Coalition on Testing (FACT)

Psychiatry:

-Training: -Medical degree (MD) -Four-year residency in psychiatry (specialty area in school of medicine) -Specialty areas: -Child or geriatric psychiatry -Psychopharmacology (authority to prescribe medications) -A particular mode of therapy -Represented by the American Psychiatric Association -Emphasizes a biomedical model

Counseling psychology:

-Training: -Specialization are represented by Division 17 of the APA -Doctoral degrees -There are 68 accredited counseling psychology programs in U.S. -Shares common roots and emphases with field of professional counseling -Work settings: -Employed in universities and other human service settings

Social work:

-Training: -Usually earned master's or social work degree. -Some have bachelor's degrees and others doctoral degrees -Credentials offered by National Association of Social Workers -Practice is regulated by licensure laws in all 50 states -Philosophy: -Often emphasize a systems and contextual approach, as opposed to the medical model -Work Settings: -Schools, medical and public health environments, mental health and substance abuse settings

Sources of professional identity confusion:

-Varied definitions of "counselor" -Multiple helping professions -Multiple titles for professional counselors, according to state licensure laws (LMHC, LPCC, LCPC, LPC, LCMHC) -Until recently, there were two CACREP specializations leading to the same license type: --Mental Health Counseling and Community Counseling.

Characteristics of Emerging Adulthood

1) age of identity explorations 2) age of instability 3) self-focused age 4) age of feeling in between 5) age of possibilities

All of the following are reasons to divide the process of counseling into three stages:

1. Conceptually it can be helpful 2. Various tasks and responsibilities are associated with each stage 3. Different client factors, such as motivation to change and responsive to treatment, are associated with each stage.

Stages of the family life cycle:

1. Unattached adult 2. New married adults 3. Childbearing adults 4. Preschool-age child 5. School-age child 6. Teenage child 7. Launching center 8. Middle-age adults 9. Retired adults

What year was clinical mental health counseling recognized as a distinct speciality?

2009

Knowledge:

A base of knowledge that guides clinical mental health counselors in their work with diverse clients

Group:

A collection of two or more individuals who meet in face-to-face interaction, interdependently, with the awareness that each belongs to the group and for the purpose of achieving individual and/or mutual agreed goals. The exception to this is found in some groups who meet on the internet, where there is no face-to-face interaction.

Disability:

A physical or mental impairment that substantially limits a major life activity

School guidance:

A preventative educational means of teaching students how to deal effectively with life events

Community counselor:

A professional counselor who functions in multidimensional roles regardless of employment setting

Certification:

A professional, statutory, or nonstatutory process by which an agency or association grants recognition to an individual for having met certain predetermined professional qualifications

Law:

A set of rules that governs particular activities in society

Safety:

A soundproof room that elicits feelings of comfort can help a client feel safe.

Inspection:

A state agency periodically examines the activities of a profession's practitioners to ascertain whether they are practicing the profession in a fashion consistent with the public safety, health, and welfare

Which of the following statements is true of trait-and-factor theory? A. The theory stresses that the traits of clients should first be assessed and then systematically matched with factors inherent in various occupations. B. The theory stresses the interpersonal nature of careers and associated lifestyles as well as the performance requirements of a work position C. The theory posits that career development is the lifelong process of implementing a self-concept. D. The theory suggests that four factors influence a person's career decision-making: genetic endowment, environmental conditions and event, learning experiences, and task-approach skills.

A. The theory stresses that the traits of clients should first be assessed and then systematically matched with factors inherent in various occupations.

Chronological overview of counseling: 1990s

AACD changes its name to the American Counseling Association (ACA) in 1992 -Diversity and multicultural issues are stressed -Spiritual issues in counseling are addressed more openly -Community counseling is recognized more as a specialty within the counseling profession -Managed care organizations increased resulting in counselor becoming providers of health maintenance organizations (HMOs)

Morphogenesis:

Ability of the family to modify its functioning to meet the changing demands of internal and external factors.

Biopsychosocial model:

Acknowledges the interaction of behavioral, psychological, and social factors in development and mental health

Communication:

All behavior is seen as communicative. Important to attend to content (i.e. factual information) and relationship (i.e. how the message is to be understood).

Four major professional organizations:

American Association for Marriage and Family Therapy (AMFT) International Association of Marriage and Family Counselors (IAMFC) Division 43 (Family Psychology) American Family Therapy Association (AFTA)

Psychological Test (formal definition)

An objective, STANDARDIZED measure of behavior, usually used for evaluation. (One of many methods used by counselors to collect client info)

Assessment (formal definition)

Any systematic method of obtaining info from tests and other sources, used to draw inferences about characteristics of people, objects, or programs.

Civil law:

Applies to acts committed that affect the civil rights of individuals or other bodies

Criminal law:

Applies to acts that are considered crimes against society and are prosecuted by the government

Task/work groups:

Assist group members in applying group dynamics, principles, and processes to improve work practices and to accomplish identified work goals. The prototype of a task/work group is a quality circle in which members of a work unit discuss the process under which they operate and try to make continuous improvements. There are diverse types of task/work groups, but all emphasize accomplishment and efficiency in completing identified work goals.

Aubri is beginning to explore the world of work and beginning to have some preferences in regards to particular careers. Based on Super's theory, in what age group would you place Aubri? A. Birth to age 14 B. Adolescence to early adulthood C. Middle adulthood D. Older adulthood

B. Adolescence to early adulthood

Which of the following is an example of an indirect community service? A. Outreach program for persons dealing with life transitions and difficult situations B. Advocacy for groups such as underserved populations dealing with chronic mental health problems C. Helping the local community organize to work for positive environmental change D. Educational programs on the nature of mental health

B. Advocacy for groups such as underserved populations dealing with chronic mental health problems

Which of the following prevention models emphasizes the need to bolster people's coping skills, self-esteem, and support systems? A. Configural equation B. Incidence formula C. Primary prevention calculation D. None of the above

B. Incidence formula

Children in middle childhood are in the process of resolving which of Erikson's developmental crises? A. Initiative versus guilt B. Industry versus inferiority C. Identity versus role confusion D. Ego integrity versus despair

B. Industry versus inferiority

In which case did the court rule that it was the duty of the mental health facility to provide care to patients based on patients' medical conditions, not on the needs of insurance companies? A. Wickline v. State of California B. Muse v. Charter Hospital of Winston-Salem, Inc. C. Tarasoff v. University of California - Berkeley D. Bogust v. Iverson

B. Muse v. Charter Hospital of Winston-Salem, Inc.

Which of the following describes the function of counseling groups? A. The prevention of personal or societal disorder through conveying information and/or the examining of values. B. To help group participants resolve the usual, yet often difficult, situations connected with living in an ever changing world as well as to help participants develop their existing interpersonal problem-solving competencies to better handle future problems C. To help individual group members resolve their in-depth and sometimes serious psychological problems D. To improve work practices and to accomplish identified work goals

B. To help group participants resolve the usual, yet often difficult, situations connected with living in an ever changing world as well as to help participants develop their existing interpersonal problem-solving competencies to better handle future problems

Family rules:

Based on both explicit and implicit rules. Provide expectations about roles and actions that govern family life.

Social class:

Based on components of SES and is hierarchical in nature

Case law:

Based on court decisions that interpret a law according to a specific case

Social class privilege:

Benefit or advantage given to a person by reason of social position

What term refers to adult children who return home for an indefinite period of time during difficult economic times?

Boomerang generation

What was formed to standardize counselor education training?

CACREP

Middle Childhood: Piaget's Cognitive Development

CONCRETE OPERATIONAL STAGE - children capable of logical reason about concrete, tangible info - can mentally reverse actions, but only generalize from concrete experiences - grasp logical concepts more readily - have difficulty reasoning about abstract ideas - learn best through questioning, exploring, manipulating, doing

What is a form of payment in which the provider is paid on a per-member basis?

Capitation

What refers to a process that helps individuals and organizations improve their performances?

Career coaching

Quality of effective group leaders:

Caring Meaning attribution - clarifying, explaining, and providing a cognitive framework for change Emotional stimulation - being active, challenging content, taking risks, and self-disclosing Executive functioning - developing norms, structuring, and suggesting procedures

________________ the expression of pent-up emotion, is a must according to object relations theory.

Catharsis

Socioeconomic status:

Classifies people according to social and economic dimensions (e.g., income, education level, access to health care)

Qualities of healthy families:

Committed to one another Appreciate each other Spend time together Have good communication patterns Have a high degree of religious or spiritual orientation Able to deal with crisis in a positive manner

What term devised in the mid to late 1970's identified counseling activities outside of educational settings?

Community counseling

Prior to 2009, clinical mental health counselors were known as:

Community counselors or mental health counselors

______________ represents Piaget's stage of cognitive development in which ability to reason logically about concrete, tangible information develops.

Concrete operational stage

CACREP:

Council for Accreditation of Counseling and Related Educational Programs

Couple and family enrichment:

Couple enrichment is based on the concept that couples, and consequently their families, stay healthy or get healthier by actively participating in certain activities with other couples. Couple retreats, engagement in interactive cooperative activities, and involvement in family-level councils are among the most recommended ways of achieving health in couples and families. Enrichment experiences, especially those involving couples encounter weekends, can be quite disruptive and damaging to distressed couples and can lead to further deterioration of their relationships. Care must be exercised in selecting couples and families to participate in these programs.

Couples couseling:

Couples counseling occurs when counselors work with two partners on their relationship for a wide variety of reasons such as: -finances -children -fidelity -communication -compatibility

Administrative law:

Created by government administrative agencies that develop regulations to help define the laws passed by the legislative body (HIPPA/HITECH)

Joseph Hersey Pratt

Credited with starting the first psychologically oriented group in 1905 with tuberculosis patients. Found the experience to be informative, supportive, and therapeutic.

Acculturation:

Cultural adaptation that occurs as a result of contact between multiple cultures Cultural socialization to the majority

What term describes any group of people who identify with one another on the basis of a common purpose, need, or similarity of background?

Culture

DO A CLIENT MAP Model

D-iagnosis O-bjectives of treament (treatment goals) A-ssessment procedures (formal and informal) C-linician (background, gender) L-ocation of treatment (in & outpatient, site) I-nterventions (approach and specific) E-mphasis of treatment (supportive, probing) N-umbers (individual, group, family) T-iming (duration, session schedule) M-edication (referral if needed) A-djunct services (additional activities needed) P-rognosis (based on diagnosis, level of support)

All of the following are advantages of group work for group members except: A. Recognizing that they are not alone, unique, or abnormal in their problems and concerns B. Learning more about themselves in social situations C. Trying out new behaviors and ways of interacting D. Creating a groupthink mentality

D. Creating a groupthink mentality

Mental Disorder definition

DSM-5 says "syndrome characterized by clinically significant disturbance in an individual's cognition, emotion regulation, or behavior that reflects a dysfunction in the psychological, biological, or developmental processes underlying mental functioning"

_____________________ is an example of a situational crisis.

Death of a loved one

Counseling psychology definition:

Defined by Super(1955) as more concerned with normal human growth and development an was influenced by both vocational counseling and humanistic psychotherapy

Family life stressors:

Developmental stressors -stressors that are age and life stage related Situational stressors -stressors that deal with interpersonal interactions Unexpected stressors -stressors that take family members by surprise or are beyond control of the family (life events come too soon, are delayed, or fail to materialize)

Gay and Lesbian Couples

Differ from heterosexuals in: - same-sex couples with children may be more likely to exhibit equal division in household labor

____________________ is a lack of emotional stability or balance.

Disequilibrium

All of the following are areas of assessment in the BATHE technique except: A. Background B. Empathy C. Trouble D. Handling E. Anatomy

E. Anatomy

Who created the first theory of counseling?

E.G. Williamson

Later Adulthood: Developmental Issues

EGO INTEGRITY VS DESPAIR Ego Integrity - belief one has accomplished what they set out to do Despair - regret for the way one has lived Gerotranscendence - period when older adults begin to withdraw from material world and focus on a spiritual world - may turn inward and do more self-reflection

Creative interventions with children and families

EXPRESSIVE ARTS TECHNIQUES - art, music, clay, puppetry, storytelling, drama, bibliotherapy, sand play, directive and nondirective play

Prevalent family stressors:

Economics and finances Children's behavior Insufficient couple time Communicating with children Insufficient personal time Insufficient family play time

College men and women are more likely to use _________________ strategies than __________________ strategies.

Emotion-focused; problem-focused

___________________ provide mental health services to employees, recognizing that personal and professional issues can affect work performance, health, and general well-being.

Employee assistance programs

Americans with disabilities act:

Enacted to protect people with disabilities from discrimination in employment, public accommodations, transportation, and telecommunication

What resulted in the deinstitutionalization of people with chronic and severe mental illness?

Enactment of the Community Mental Health Centers Act

_________________ refers to family environments in which members are overly dependent on each other or are undifferentiated.

Enmeshment

Family dysfunctionality:

Enmeshment -family environments in which members are overly dependent on each other or are undifferentiated Triangulation -Family fusion situations in which one person is pulled in two different directions by the other members of the triangle

What is true concerning the relationship between ethical codes and the law?

Ethical codes are not intended to supersede the law; they typically clarify existing law and policy

Skills:

Ethnically responsive counselors are able to help people resolve problems or make decisions in ways that are consistent with the realities of clients' cultural experiences

__________________ are identified based on the outcomes of randomized controlled trials.

Evidence-based treatments

Psychoeducational group leader:

Expertise in the topic being discussed In charged of group management and disseminating information

Big Five Personality Traits

Extroversion, Agreeableness, Conscientiousness, Emotional Stability (Neuroticism), and Openness

Adolescence: Piaget's Cognitive Development

FORMAL OPERATIONAL STAGE - usually reach at at least 15 - deal with abstractions, form hypotheses, engage in mental manipulation, and predict consequences - capable of reflective abstraction, reflect on knowledge, rearrange thoughts, discover alternative routes for solving probs

Circumplex model of martial and family systems:

Family cohesion: emotional bonding -disengaged to enmeshed Adaptability -rigid to chaotic Families that are high or low on either and of these dimensional spectrums seem dysfunctional. Families that are balanced seem to function more adequately.

__________________ concentrates on making changes in systems, whereas __________________ and _________________ primarily focus on intrapersonal and interpersonal changes.

Family counseling; individual counseling; group counseling

Circular causality:

Family members affect each other for better or worse, and the family as a whole, through their multiple interactions

Counselors who do not fulfill their obligations to clients are breaking which moral principle?

Fidelity

Adjourning:

Final stage in group development. Members say good-bye to one another and to the group experience. Members often feel conflicting emotions of fulfillment and emptiness. Celebration experience or closure ceremony often occurs.

Forming:

First stage of group development. Foundation laid for what is to come. Members often express anxiety and dependency. Members discuss nonproblematic issues.

Mandatory ethics:

Followed when clinical mental health counselors comply with the required minimal standards of the profession

Aspirational ethics:

Followed when counselors make decisions based on internalized principles and ideals of the profession, not just external considerations (self-aware; self-monitoring)

Moral principles:

Form the foundation for ethical guidelines and clarification for ethical decision-making

National Board for Certified Counselors (NBCC):

Formed in 1982, began to certify counselors on a national level

Stages of group development:

Forming Storming Norming Performing Adjourning

Who is known as the "founder of guidance"?

Frank Parsons

Middle Adulthood: psychosocial issues

GENERATIVITY VS STAGNATION Generativity - finding ways to give to and guide next generation - taking care of others, producing something that benefits society, meaningful work, etc. Stagnation - becoming detached from important relationships - becoming self-centered and even narcissistic

_______________ is a visual representation of a person's family tree depicted in geometric figures, lines, and words.

Genogram

According to Erchul, who is known as the father of the modern practice of mental health consultation?

Gerald Caplan

Advantages of groups:

Group members realizing that they are not alone, unique, or abnormal in their problems and concerns. Group members learning more about themselves in social situations. Group members trying out new behaviors and ways of interacting in a safe environment and receive feedback. Group members observing how others resolve problems. Group members seeking individual counseling or methods for attaining personal goals. Group counseling can promote support and skill building for adolescents who have been arrested for first-time misdemeanor offenses. School-based counseling groups using mindfulness meditation may help alternative high school students enhance their social, emotional, and academic strengths. Group counseling can help improve test scores and social skills of low-performing students. Groups can promote career development in general and vocational planning with some underserved populations, such as battered and abused women. Psychoeducational support groups for serious mental illness can help participants manage their illness better, combat social isolation, and increase self-esteem and hope. Group therapy is an efficient and cost-effective way to provide treatment for socially anxious college students. Support groups can be of benefit in helping older women cope with divorce and its aftermath. Group intervention with female adolescent offenders can help them increase their self-confidence and self-esteem and achieve a sense of relationship with others. Group counseling and psychoeducational programs can help persons who have sustained a heart attack improve their quality of life.

The place for groups in counseling:

Groups are an economical and effective means of helping individuals who share similar problems and concerns. With group interactions being a primary way in which humans interact, it makes sense that counselors would make use of this modality.

Adolescence: Erikson's Psychosocial Theory

IDENTITY VS ROLE CONFUSION - formulation of identity is key challenge - those with strong identities have definition of self, commitment to goals, values, beliefs, and life purpose - need opportunities to explore options, try on roles, responsibilities, and speculate about possibilities to develop their identity - ROLE CONFUSION: over identification with heroes or cliques

Middle Childhood: Erikson's Psychosocial Theory

INDUSTRY VS INFERIORITY - need opportunities to develop a sense of competence and capability - manageable tasks with encouragement helps children develop strong sense of industry and efficacy - experiences with family, teachers, and peers contribute to children's perception of efficacy and industry

Early Childhood: Erikson's Psychosocial Theory

INITIATIVE VERSUS GUILT - initiative: enterprising, energetic, purposeful - discovering who they are, esp. relating to gender - important to give children opportunities to explore, experiment, ask questions - play is important!!!!! they find out about themselves and world, helps express feelings and experinces, facilitate play with puppets, art, tools, figures

Genderqueer:

Individuals who do not identify with traditional labels of male and female

Transsexual:

Individuals who pursue hormonal treatment and/or sex reassignment surgery so that their externalized gender identification will match their internal gender identification

INTIMACY VS ISOLATION

Intimacy - making long term commitments - form meaningful relationships with others, even if they don't lead to marriage - effects: young adults who are cooperative, tolerant, and able to respond to the needs of a significant other Isolation - inability to develop a meaningful relationship with another - effects: loneliness, depression, diminished self-esteem

Morality:

Involves judgment or evaluation of actions, and is associated with words like good, bad, right, wrong, ought, and should

An ________________ is an activity undertaken for economic returns, whereas a(n) __________________ is a group of similar jobs found in different industries or organizations.

Job; occupation

Pioneers of group work:

Joseph Hersey Pratt Jacob L. Moreno Kurt Lewin Fritz Perls William Schutz and Jack Gibb Carol Rogers

__________________ is a general term used to describe the systems of businesses and organizations that arrange for the financing and delivery of medical and mental health services.

Managed care

Two types of ethics:

Mandatory and aspirational

Limitations of groups:

Many concerns and personalities are not well suited for groups. Group pressure may force a client into action, such as self-disclosure, before he/she is ready. Group members' problems may not be adequately dealt with. Potential for groups to lapse into groupthink mentality. May be used as an escape or for selfish purposes and thereby disrupt the group process. Difficulty in accommodating different schedules. Groups may become regressive and engage in nonproductive and even destructive behaviors such as scapegoating, group narcissism, and projection.

___________________ are 3.5 times more likely to die by suicide whereas ___________________ attempt suicide more.

Men; women

Therapeutic professionals:

Mental health professionals trained to help people with problems that manifest behaviorally or psychologically and that may have roots in physical, psychological, or spiritual dimensions -Social workers -Psychiatrists -Psychiatric-mental health nurses -Counseling psychologists -Professional counselors

Bronfenbrenner's Bioecological Model: Five Interactions

Microsystem, mesosystem, exosystem, macrosystem, chronosystem

____________________ is the dominate model for treating substance use disorders, and it is based on the disease concept of dependency.

Minnesota Model of Addiction treatment

Malpractice:

Most common cause of legal liability, in which counselors have been negligent in carrying out professional responsibilities or duties.

As defined by CACREP, _________________ takes into account differences in areas such as language, social class, race, ethnicity, gender, sexual orientation, religion, and level of ability.

Multiculturalism

What was the first professional organization in the counseling profession?

National Vocational Guidance Association

Prejudice:

Negative bias toward a particular group of people Mostly attitudinal in nature

Types of families:

Nuclear families -two parents and a child or children Minority ethnic families -families composed of ethnic minorities in the US Dual-career families -both marital partners engaged in developing careers Single-parent families -headed by either a mother or father as the sole parent responsible for taking care of the family Childless couple -a couple that does not have children voluntarily because of circumstances Remarried families -family where at least one spouse has been married previously Gay and lesbian families -families in which the parent is or spouses are gay or lesbian Aging families -one where both partners are age 65 or older Multigenerational families -households that include a child, parent, and a grandparent Military families -those that have at least one family member enlisted in the armed forces

Cultural racism:

Occurs when one cultural group considers another group inferior, and the first group has the power to impose its standards on the other group

Negligence:

Often unintentional torts, in which mental health professionals do not carry out their responsibilities in accordance with the standards of care outlined by the profession

Jesse B. Davis (1900s):

Organized first systematic guidance program in public school

Association for Counselor Education and Supervision (ACES):

Outlined the standards for a master's degree in counseling in 1973

Early Childhood: Piaget's Cognitive Development

PREOPERATIONAL STAGE OF COG. DEVELOPMENT - develop ability to represent objects and events through imitation, symbolic play, drawing, spoken language - egocentric - may attribute lifelike qualities to inanimate objects - represent and recall feelings - emotional self-regulation improvement

What provides information to clients about the counselor and about the counseling process?

Personal disclosure statement

Personalization:

Personalizing an office by displaying photographs, and objects that counselors consider meaningful or attractive

Family is defined as:

Persons who are biologically and/or psychologically related through historical, emotional, or economic bonds and who perceive themselves to be a part of the household. Dual emphasis on fostering the development of individuals while simultaneously offering family members stability, protection, and preservation of the family unit structure.

Ethics:

Philosophical discipline that is concerned with human conduct and moral decision making

_______________ is an extremely important activity in early childhood, in which children find out about themselves and the world.

Play

Psychoeducational groups:

Primary function: prevention of personal or societal disorder through the conveying of information and/or examining values These groups stress growth through knowledge An important process is group discussions of how members will personalize the information presented

Purpose of Assessment

Primary goal: collect data about clients' behaviors, characteristics, and contexts that will often facilitate clinical decision-making and evaluation Other ways: - inform clinicians and guide treatment planning - can serve directly as an intervention - provides evaluation data and accountability

What term refers to a client's legal right to determine what information about himself/herself will be shared with others?

Privacy

___________________ provides information about how well a program is being implemented.

Process evaluation, also called formative evaluation

Role of group leader during forming stage:

Provide activities for group members to engage with each other. Help group members relax by sharing expectations.

Couples counseling: theoretical approaches

Psychoanalytic Social learning Bowen family systems Structural-strategic Rational-emotive behavioral (REBT) Emotionally focused

Family counseling approaches:

Psychodynamic family counseling Experiential family counseling Behavioral family counseling Structural family counseling Strategic family counseling Brief solution-focused family counseling Narrative family therapy

Four types of groups:

Psychoeducational Counseling Psychotherapy Task/Work

What component of the BPS model include patterns of thinking, coping skills, judgment, perceptions, and emotional intelligence?

Psychological

____________________ includes constant verbal abuse, harassment, extreme possessiveness, deprivation of resources, isolation, and the destruction of physical property.

Psychological or emotional abuse

____________ is an objective, standardized measure of behavior and is usually used for evaluation.

Psychological testing

Bioecological Considerations

Psychological, biological, and genetic - temperament, attributional bias Contextual - school, peers, etc. Family - quality of relationship between children and caregivers is very important to well-being across lifespan - supportive and controlling behaviors School Cultural

Miller referred to time-limited treatments imposed by MCO's that result in early termination as:

Rationing

What involves the reexamination of all phases of the therapeutic process?

Recycling

Role induction:

Refers to counselor-client understanding about conditions, procedures, and nature of counseling

Institutionalized racism:

Refers to established use of policies, laws, customs, and norms to perpetuate discrimination and prejudice

Classism:

Refers to oppression, discrimination, or marginalization experienced by people who are negatively affected by socioeconomic disparity

Clinical mental health counseling:

Represents the merging of community counseling with mental health counseling and emphasizes wellness, prevention, personal growth, psychoeducation, treatment, and empowerment

Registration:

Requires practitioners to submit information to the state concerning the nature of their practice

Storming:

Second stage of group development. Sometimes called the transition stage. Often includes increased tension, turmoil, conflict, and unevenness occurs. Group members seek safety and understanding of relationships in the group during this stage. At times, the group leader is attacked at this stage. At other times, group become dependent on the leader at this stage.

Issues in groups:

Selection and preparation of group members Group size and duration Open versus closed groups Confidentiality Physical structure Co-leaders Self-disclosure Feedback Follow up

Theory of Selective Optimization with Compensation (S O C)

Selection: choose goals and activities that are meaningful and important Optimization: enhancing positive changes to achieve a set of desirable outcomes Compensation: counteracting certain losses in ways that make it possible to reach those outcomes

Gay and Lesbian couples

Similarity to heterosexual couples: - committed, faithful, supportive - over satisfaction similar - similar issues in communication, finance, abuse

4 S Transition Model (Middle Adulthood)

Situation (assess for. triggers, timing, control) Sense of Self (listen to them tell stories, evaluate client hardiness) Supports (assess what resources client has) Strategies (assess what client does to navigate transitions)

Softness refers to:

Soft surfaces and textures including things as sofas, comfortable chairs, movable furniture, and lamps.

Mixed groups:

Some groups do not fit well into any category. Encompass multiple ways of working with members and may change emphasis frequently. The prototype is a self-help group.

The acronym SLAP refers to:

Specificity Lethality Access to means Proximity of social support

Homeostasis:

Stable state of equilibrium exists in families unless forced to change.

Tort:

Term that refers to a wrong that legal action is designed to set right

Cultural pluralism:

Term used to describe minority groups who participate fully in the dominate society, yet maintain their distinct cultural differences

Community counseling:

Term used to identify counseling activities outside other established domains, such as educational settings

Poverty threshold:

The amount of cash income minimally required to support families of various sizes

Nonsummativity:

The family is greater than the sum of its parts.

Performing:

The fourth stage of group development. Group members become involved with each other and with their individual and collective goals. Group is most productive in this stage.

Enculturation:

The retention of one's culture of identity

Equifinality:

The same origin may lead to different outcomes, and the same outcome may result from different origins.

Licensure:

The statutory process by which an agency of government, usually a state, grants permission to a person meeting predetermined qualifications to engage in a given occupation and/or use a particular title and to perform specified functions

Psychoeducational group members:

These groups are designed to meet the needs of well-functioning people

Prevalent myths about groups:

They are artificial and unreal experiences. They are second-rate structures for dealing with problems. They force people to lose their identity by tearing down their psychological defenses. They required that people become emotional and spill their guts. They are touchy-feeling, confrontational, hostile, and brainwashing experiences.

Norming:

Third stage of development of groups. Group members decide upon goals Group members learn how to work with each other.

Self-help groups take two forms:

Those that are organized by an established professional helping organization or individual (i.e. support group). Those that originate spontaneously and stress the autonomy and internal group resources.

True or False: The DSM-5 uses a nonaxial system of diagnosis, in which mental health disorders, medical conditions, and psychosocial issues are listed on one axis.

True

Nonnormative event

Unexpected, acute demands that may alter course development. Example: parental divorce, death of a family member

Nonprofessional helpers:

Untrained and good-hearted volunteers

____________________ refers to changes that alter mental health professionals' views of themselves, others, and the world and is associated with disruption in helpers' views of safety, trust, esteem, intimacy, and control.

Vicarious traumatization

Selecting Instruments while Considering Diversity

When selecting, you should: - select instruments appropriate for population - use tests written in client's preferred language - make sure instrument accurately measures skills or aptitudes instead of characteristics associated with disabilities - consider potential effects of cultural differences between counselor-client

Appraisal and Assessment (formal definition)

Whiston (2017) uses the terms appraisal and assessment interchangeably as both process utilize formal and informal techniques, not just standardized tests

Perspective

an individual's appraisal of the transition

Normative events

anticipated, generic challenges that everyone encounters. Example: physical changes, school transitions, emerging sexuality

Biopsychosocial model (BPS)

approach to medicine and mental health that recognizes the interrelated, integral roles played by biology, psychology, and social/cultural factors in the maintenance of wellness and the understanding of illness - CACREP says we needs to know principles, models, and documentation of biopsychosocial case conceptualization and treatment planning

Exosystem

context that exerts an indirect influence on a child's development. Example: parent's workplace may affect parent and indirectly affect child

Assessment and Counselor Competence

counselors need to consider their levels of training and experience before using psychological assessment instruments! different instruments require different degrees of competence - tests are traditionally categorized by levels (A, B, and C). they are sold only to professionals who meet requirements for a particular level

Emerging adulthood

emerging adults do not view themselves as adolescents; however, many of them do not characterize themselves as fully adult either

Nonevents transitions

events that people expect to happen but do not occur (couple not being able to have children)

Chronosystem

evolution of the four systems over time

Context

factors such as environment, gender, culture, SES, and other variables that influence the effects transitions have on people

Feminist Therapy

focuses on influence of gender, oppression of women, and influence of politics

Ageism

form of prejudice exhibited when peopl are categorized and judged on the basis of chronological age - elderspeak, workplace discrimination, elder abuse

Systematic Assessment

helps counselors and clients: 1) develop an UNDERSTANDING of the presenting problem and issues 2) CONCEPTUALIZE the issue 3) SELECT and implement effective interventions 4) EVALUATE progress made in counseling

Designing and Implementing a Treatment Plan

intentionality and flexibility are important ask questions related to: - vision (What could be different?) - goal setting (What is going well?) - analysis (What is getting in the way of solving this problem?) - objective (What specifically does the child want to change?) - exploration of interventions (what has been tried?) select interventions from there

Mesosystem

interactions among two or more microsystems. Example: school issues affecting family issues, vice versa

Assessment and Evaluation

interviews to find: - specific concerns - physical, cognitive, emotional, and social development - relationships: child and his or her family and peers - child's school experiences (academic, attendance, attitude) - strengths, talents, support system informal and formal assessments

Anticipated transitions

normative or expected transitions that are somewhat predictable in sequence across the lifespan (leaving home, starting a job)

Macrosystem

overarching belief system culture that exerts its effects indirectly through cultural tools and institutions

Diagnosis

process of comparing the symptoms exhibited by client with the diagnostic criteria of some type of classification system - not a judgmental label - used to describe client in a way that can be understood by other professionals

Checklists and Rating Scales

provide subjective estimates of behaviors or attitudes based on observations made by the client or other observers

Role induction (structure) promotes counseling development by:

providing a framework in which the process can take place

Common clinical issues in Emerging Adults

schizophrenia anxiety depression bipolar eating disorders substance abuse inability to regulate or control emotions

Microsystem

specific environment in which an individual develops, such as family, peer groups, school, church

The intake interview helps:

the counselor determine the nature, severity, and duration of the presenting issue.

There is a relationship between initial levels of self-reported disturbance and:

the course of treatment

Unanticipated transitions

unscheduled events; not expected or predictable, and may be negative or positive (divorce, chronic illness, unexpected death of a family member)

Resilience

"ability to adapt in a positive way to difficult and trying situations" - may demonstrate resilience in one aspect of their lives but not in another

NBCC Code of Ethics:

-Agreeing to the N B C C Code of Ethics is a prerequisite to becoming a Nationally Certified Counselor (N C C) -Consists of seven sections that similar to the A C A Code of Ethics -The seven sections include a total of 95 directives

Homophobia (homoprejudice):

-An antigay bias, or a fear of individuals who are perceived as lesbian, gay, or bisexual -Homophobic attitudes evidenced by stereotyping and denigrating LGB individuals

Beneficence:

-Proactive concept that implies doing things that contributes to the welfare of the client -Avoid taking a paternalistic approach that undermines their autonomy

Family life cycle:

Stages a family goes through as it evolves. These stages often parallel and complement the individual life cycle. In the nine stages, there are practical, emotional, and relational challenges as well as potential crises to be addressed.

What is the purpose of consultation?

To help the consultee with the challenges presented by the consultee's client & to increase the consultee's skills for working independently with similar problems in the future

The goal of consultee-centered case consultation is:

To improve the consultee's ability to work effectively with a particular case as well as with similar cases

Three tenets of Feminist Theory

- personal is political - relationship between counselor and client is egalitarian - women's experiences have priority