Counseling Today

Counseling Today
Foundations of Professional Identity
Second Edition
Darcy Haag Granello
The Ohio State University
Mark E. Young
University of Central Florida
330 Hudson Street, NY, NY 10013

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Library of Congress Cataloging-in-Publication Data
Names: Granello, Darcy Haag, author. | Young, Mark E., author.
Title: Counseling today : foundations of professional identity / Darcy Haag

Granello, The Ohio State University, Mark E. Young, University of Central
Florida.
Description: Second edition. | Boston : Pearson, 2019. | Includes

bibliographical references and index.
Identifiers: LCCN 2017042453| ISBN 9780134816425 | ISBN 0134816420
Subjects: LCSH: Counseling—Vocational guidance—United States. |

Educational counseling—United States. | Counselors—Professional
relationships—United States.
Classification: LCC BF636.64 .G73 2019 | DDC 158.3023—dc23 LC record

available at https://lccn.loc.gov/2017042453
1 18
ISBN 10: 0-13-481642-0

ISBN 13: 978-0-13-481642-5
To my dad, Douglas M. Haag, who gave me my roots, and to my husband,
Paul, who gives me my wings.
—DHG
To J. Melvin Witmer, Professor Emeritus, Ohio University, with deep

respect.
—MEY
About the Authors
Darcy Haag Granello, PhD
Darcy Haag Granello is Professor of Counselor Education at The Ohio State

University, a Licensed Professional Clinical Counselor in Ohio, and Director
of The Ohio State University Suicide Prevention Program. She has published
over 70 articles, co-authored three books, made more than 200 national and
international presentations, and secured more than $2 million in grants and
funding. Darcy’s research and interests are in the areas of suicide prevention
and assessment and in methods to promote the cognitive development of
counselors and counselors-in-training. She has received state and national
awards for her research in counselor development, and she seeks to find ways
to enhance the training and education of counselors to promote the
development of professional identity and cognitive complexity. She is
founder and listowner for COUNSGRADS, the national listserv for graduate
students in counselor education.
Mark E. Young, PhD
Mark Young is Professor of Counselor Education at the University of Central

Florida in Orlando. For more than 20 years, he worked as a counselor in
community mental health, college counseling centers, private practice, and
corrections. He has been a state and national leader in counseling. For the
past 14 years, he has conducted research and provided services for couples at
the UCF Marriage and Family Research Institute. His writing is focused on
practical issues that counselors face, including maintaining their personal
wellness, understanding clients’ religious and spiritual perspectives,
developing a theoretical orientation, and understanding the client/counselor
alliance. His most recent books are Learning the Art of Helping (2017) and
Counseling and Therapy for Couples (2007).
To Our Students
Welcome to the profession of counseling! As counselors, we are always
excited to see people follow their passion in life. We know that our
profession offers unlimited opportunities for you to evolve into the
professional you want to be and to have a career filled with meaning and
purpose. It is our hope that you will find the profession of counseling a
lifelong career that challenges you to learn and grow.
We think it only fair to let you know that you are in for quite a challenging
journey. Becoming a counselor changes you and tests you. Counseling is not
just something that you do, it is someone you become. Counseling requires
you to work on yourself as you constantly gain new knowledge and skills. In
your graduate program, you will be asked to read books, write papers, and
take tests. But even if you master all of these academic skills, you will not
have everything you need to be an outstanding counselor. Ultimately, you
will need to integrate everything you are learning with the person you already
are as you endeavor to become the counselor you wish to be.
As you begin your professional journey, we encourage you to strive to

become more intentional—to be clearer about what you want from your
graduate education, from your career, from your relationships with others,
and from yourself. To do this, you will need to adopt a self-reflective
approach. This means periodically stopping to think about what the material
you are learning means to you. A self-reflective approach can help guide you
to develop clarity about your goals. Rather than just allowing life (or classes,
or counseling skills) to happen to you, it is important that you take control of
your own experiences and learning. During your journey give yourself
permission to be in the moment, to learn new things, to take risks, and to not
know. We encourage you to allow yourself time to explore ideas and options,
and not to rush to a decision or conclusion. It’s okay to relax, take a deep
breath, and think before you respond. Moreover, try not to hold yourself to
unrealistic expectations about what you “should” know or how fast you
“should” learn. Your journey will require patience.
Our intent in writing this book is to share our passion and enthusiasm for
counseling, to give you an understanding of how your graduate training can
help shape you into a counselor, and to take a strong stand that all counselors
need to be trained to the highest possible standards. The world needs you to
be the absolute best counselor, with the strongest sense of professional
identity and the highest level of professional integrity that you can possibly
have. You, and your future clients, deserve no less.
Darcy Haag Granello
Mark E. Young
Preface
Helping students in counseling programs learn to develop a sense of
professional identity is one of the most important tasks that educators face.
As students learn about the profession of counseling, they must also begin to
see themselves as professionals. To do this, they must learn, and then begin
to internalize the knowledge, standards, ethics, and skills that are at the
foundation of the profession. We believe that this sense of internalized,
professional identity can be strengthened with an intentional and self-
reflective approach to learning that can begin from the very first course a
student takes in the counseling program. Thus, this book is intended to help
set a solid foundation for the student’s journey toward becoming a
professional counselor.
In this book, we use a developmental perspective that encourages students to

take a self-reflective stance toward becoming counselors. Counseling
students who are self-reflective continually stop and think about what the
material they are learning means to them; they consider how their own
personality, beliefs, values, thoughts, and experiences influence the way they
look at the world, and they reflect on their own development as professionals.
Throughout the book, we offer ideas and suggestions for students to adopt a
self-reflective approach to the topics that we cover. This approach to self-
discovery, however, should not stop at the end of this text or even at the end
of graduate school. Professional counselors who are self-reflective spend
their entire careers seeking to better understand themselves and their work so
that they can continually improve the care that they provide to others. Self-
reflection, then, is an ongoing process of self-evaluation and self-awareness
that enhances both our personal and professional lives. Helping counseling
students learn the skills and habits of self-reflection is a core idea that is
infused throughout this text.
One of the primary goals of this text is to get students excited and energized
about the counseling profession and to help them begin to see it as a vibrant,
ever-changing field that is populated with people who are trying to make a
difference. Thus, the text does not merely repeat static information about the
profession that will most certainly be covered in depth in other classes.
Instead, the text helps students envision themselves as part of the profession
by providing the context for application of their learning to their own lives.
For example, the chapter on theories of counseling (Chapter 6) is not simply
a recitation of existing counseling theories. Instead, this chapter discusses the
major underpinnings of counseling theories and then helps students
understand why counselors need theories, how counselors choose a theory,
and what steps they can take to begin to develop their own theoretical stance.
In short, the book provides content and then focuses on the application of that
information to the world of the counselor.
New to the Second Edition

We have made significant updates and additions to the content of this new
edition.
Clear learning objectives for each chapter list what students should
know and what they should be able to do at the conclusion of each
chapter.
2016 CACREP Professional Orientation and Ethical Practice Standards

are listed in the Advance Organizers and Reflective Questions sections
at the beginning of the chapters where chapter content supports those
standards. In addition, we have provided a correlation table on page xii
to provide a quick reference to which standards are applicable to those
chapters.
Direct and clear links to issues of social justice and advocacy are
provided in every chapter (for example, A Social Justice Approach to
Choosing a Theory in Chapter 6; Research as a Form of Social Justice
in Chapter 7; and A Social Justice Approach to Understanding Client
Expectations in Chapter 8).
The latest information about state licensure requirements, updates to the

ASCA National Model, and a discussion of licensure portability are
included.
This new edition provides even more first-person stories from diverse
counselors and counselors-in-training, including a first-person Snapshot
of a Marriage and Family Therapist (Chapter 2), a counselor in a RAMP
Certified School Counseling Program (Chapter 11), twins enrolled in a
graduate program in counseling (Chapter 4), and a counselor operating
from a Gestalt perspective (Chapter 6).
Chapter 4, now entitled How Do Counselors Integrate Personal and

Professional Identity?, is completely revised to help students understand
the personal aspects of becoming a counselor and to encourage them to
take control of their own personal and professional development.
Chapter 5 includes a section on success in online education for

counseling students learning in distance education programs, including a
list of tips and strategies compiled from counseling students enrolled in
online counseling programs.
Chapter 10, now entitled How Do Counselors Promote Social Justice

and Engage in Culturally Competent Counseling?, is completely revised
to link to the most recent Multicultural and Social Justice Advocacy
Counseling Competencies.
Chapter 13, How Do Counselors Support Wellness in Themselves and

Their Clients?, is completely revised to help counseling students
develop a foundation for wellness during their graduate training that can
extend into their work with clients.
Chapter 6 includes an updated Spotlight on Pastoral, Biblical, and

Christian Counseling to help students understand the role of counseling
from these perspectives.
Chapter 14 includes updated connections to the role of technology in

counseling and the use of technology for graduate students in training,
including an updated Snapshot by a counselor who uses advances in
technology in counseling training and practice.
New Counseling Controversies, including Coaching vs. Counseling,

Online Counseling, and High Stakes Testing, keep students engaged
with the latest trends and issues in the field.
More than 300 updated reference citations help ground the text in the
most up-to-date research on counselor professional identity
development, counselor training, and the practice of counseling.
Organization of This Book

Our organizational framework for the text first introduces students to the
profession of counseling by helping them understand how the profession fits
within the greater context of the helping professions (Chapter 1). It then
focuses on helping students build an understanding of the many facets of the
counseling profession. We are surprised to find that foundations textbooks do
not typically include information on what counselors actually do. Therefore,
we spend several chapters discussing the many roles of the counselor and
what a counseling session might look like in practice (Chapters 2, 8, and 9).
Also included are chapters to help students place the different content areas in
context, for instance, chapters on how counselors use theories (Chapter 6),
engage in research (Chapter 7), work in a diverse society (Chapter 10), and
apply ethics (Chapter 12). We also have included a chapter specifically
designed to help counseling students get the most from their graduate
programs (Chapter 5). Finally, because the process of becoming a counselor
can be emotionally as well as physically draining, we include a chapter on
maintaining wellness and balance in life as students go through the journey
toward becoming professional counselors (Chapter 13). The following
provides a brief overview of what you’ll find in each chapter:
Chapter 1 provides a brief historical overview of the profession of

counseling through a discussion of the key ideas and values that have
emerged and moved the profession forward. Students are encouraged to
understand how counseling differs from other helping professions as
well as how their own values and beliefs might coincide with—or differ
from—those at the foundation of the counseling profession.
Chapter 2 highlights the many roles of the counselor. This chapter

highlights 20 different counseling roles, stories from practicing
counselors about how they engage in these roles, and opportunities for
students to reflect on how they might fit in these roles.
Chapter 3 moves to a discussion of professional identity through an

exploration of the education and professional qualifications of
counselors and an introduction of the professional counseling
associations.
Chapter 4 introduces students to the developmental journey of

professional counselors. The chapter helps students understand the
complexity of mixing personal and professional identities, and provides
a perspective on lifelong learning and growth.
Chapter 5 helps students get the most from their graduate programs. The
chapter provides strategies for learning and then focuses on helping
students have healthy interactions with faculty, peers, and professionals
as well as setting appropriate expectations for relationships with family
and friends.
Chapter 6 gives students a framework to understand how counseling

theories can inform practice and helps students grapple with the decision
that counselors make as to whether or not they need to choose a theory
at all. Students are exposed to several major dimensions of counseling
theories that can help them explore the ever-changing role of theory in
practice.
Chapter 7 introduces students to the connection between research and

practice. With the introduction of a practitioner-scientist model, students
see how keeping up with the current research, as well as conducting
their own outcome studies, can enhance their counseling programs and
the care they give to their clients.
Chapter 8 gives students a peek into the counseling session. Students are
exposed to the counseling process from different perspectives, including
a first-person account by a counseling client about what she thought was
beneficial about the counseling process.
Chapter 9 introduces students to the many different settings where

counseling takes place. Through stories of visits to various counseling
offices as well as first-person accounts by those who work in these
settings, students learn that counseling is truly a diverse and exciting
profession.
Chapter 10 challenges students to think about the diverse world in which

they will practice. Although multicultural and social justice perspectives
are infused into every chapter, this chapter encourages students to stop
and reflect on their own cultural identity, to learn about the counseling
profession’s efforts to encourage a multicultural perspective, and to
consider the important role of social justice and advocacy.
Chapter 11 helps students understand the important role that assessment

has in counseling. Students learn that effective counseling is based on a
full understanding of the client’s problems and strengths.
Chapter 12 encourages students to understand the important role of

ethics and the law in the counseling profession and introduces the
concept of aspirational ethics. Students are introduced to several ethical
decision-making models to help them make appropriate ethical choices.
Chapter 13 reminds students that to help our clients, we must also take
care of ourselves. This chapter encourages students to develop their own
individualized wellness plans and provides resources and ideas for
staying mentally, emotionally, and physically healthy during graduate
school and beyond.
Chapter 14 is a glimpse into the future of counseling. Students reading

this text represent our profession’s future, and we provide some insights
and ideas about where the profession might be headed, including a first-
person account from a counselor (and his Web-based avatar) about the
role of technology in counseling.
Special Features
There are many special features throughout the text that help provide
differing perspectives and approaches to counseling. We believe it is
important to share these diverse ideas and expose students to the complexity
of the counseling world. Students need to understand these complexities so
that they are prepared to meet these challenges head on. To help convey these
complexities, we include the following in each chapter:
Words of Wisdom provide advice and guidance from experienced

counselors, clients, and famous people whose words can inspire.
Spotlights highlight current trends and important viewpoints that help

readers develop a sense of professional identity.
Snapshots are first-person stories by real counselors who work in the

field and have influenced the profession as well as counseling students
who will help shape the future of the profession.
Fast Facts offer interesting snippets of data about counseling and

counselors.
Counseling Controversies feature two sides of an issue that is currently

being debated in the field, such as, “Should counselors engage in
diagnosis of mental and emotional disorders?”
Informed by Research provides brief overviews of important research

studies to help students recognize the relationship of research to
practice.
Instructor’s Supplements
Online Instructor’s Manual with
Test Bank
The Instructor’s Manual with Test Bank is a comprehensive resource
available to adopting instructors. For each chapter, there is a chapter
overview, discussion questions, and sample test items with an answer key.
Online PowerPoint Lecture Slides

These lecture slides highlight key concepts and summarize key content from
each chapter of the text. Both the online Instructor’s Manual with Test Bank
and online PowerPoint Lecture Slides are available on the Instructor
Resource Center at www.pearsonhighered.com. To access these materials, go
to www.pearsonhighered.com and click on the Instructor Resource Center
button. Here professors can log in or complete a one-time registration for a
user name and password.
Acknowledgments
During the writing of this book, we were blessed by encouragement, support,
and care from family, friends, and colleagues. Chief among these are our
spouses, Paul Granello and Jora Young, both writers themselves, who offered
their love and opinions. We must also acknowledge Kevin Davis, our first
editor, who saw and immediately understood the vision for this rather
unconventional text. We also want to thank our newest editor, Rebecca Fox-
Gieg, who shepherded the book through its final stages.
We also wish to recognize our colleagues in counselor education who share

our passion for creating a strong sense of professional identity and upholding
the highest professional standards among future generations of counselors.
We hope that this text provides you with a starting place for these important
conversations with your students. We are particularly indebted to several
colleagues who have been instrumental in the development of the ideas in
this book, including Colette Dollarhide, Kara Ieva, Jonathan Ohrt, Daniel
Gutierrez, Marisol Tobey, and especially Tracy S. Hutchinson, who worked
on so many of the special features in this text. We would also like to thank
the reviewers who added insight into updating this new edition: Jennifer
Baggerly, University of North Texas at Dallas; Erika Raissa Nash Cameron,
University of San Diego; and Nancy Nolan, Vanderbilt University.
Finally, we wish to extend our heartfelt gratitude to the many students who
have been part of our counselor education programs over the years. You have
shared your excitement and passion with us, and you have taught us through
your learning. It is through you that we have defined and refined our ideas,
and it is because of you that we know that our profession is in good hands.
2016 CACREP Standards

This text addresses all of CACREP standards listed in Section I, Professional
Orientation and Ethical Practice. In each chapter that addresses specific
standards, the corresponding standards are included at the start of the chapter.
In addition, the chart below lists all of the standards for Professional
Orientation and Ethical Practice and lists the corresponding chapter in which
the standards are addressed.
CHAPTER
in which
Standards the
standard is
addressed
1. PROFESSIONAL ORIENTATION AND
ETHICAL PRACTICE:
a. history and philosophy of the counseling profession
1
and its specialty areas
b. the multiple professional roles and functions of
counselors across specialty areas, and their
relationships with human service and integrated 2
behavioral health care systems, including interagency
and interorganizational collaboration and consultation
c. counselors’ roles and responsibilities as members
of interdisciplinary community outreach and 2
emergency management response teams
d. the role and process of the professional counselor
2
advocating on behalf of the profession
e. advocacy processes needed to address institutional
and social barriers that impede access, equity, and 10
success for clients
f. professional counseling organizations, including
membership benefits, activities, services to members, 3
and current issues
g. professional counseling credentialing, including
certification, licensure, and accreditation practices and
3
standards, and the effects of public policy on these
issues
h. current labor market information relevant to
opportunities for practice within the counseling 3
profession
i. ethical standards of professional counseling
organizations and credentialing bodies, and
12
applications of ethical and legal considerations in
professional counseling
j. technology’s impact on the counseling profession 14
k. strategies for personal and professional self-
4
evaluation and implications for practice
l. self-care strategies appropriate to the counselor role 13
m. the role of counseling supervision in the profession 2
Brief Contents
1. Chapter 1 Who Are Counselors? 1
2. Chapter 2 What Do Counselors Do? 39
3. Chapter 3 How Are Counselors Trained and Regulated? 81
4. Chapter 4 How Do Counselors Integrate Personal and Professional

Identity? 117
5. Chapter 5 How Do Counseling Students Get the Most from Their

Graduate Programs? 146
6. Chapter 6 How Do Counselors Use Theories? 182
7. Chapter 7 How Do Counselors Use Research? 215
8. Chapter 8 What Happens in a Counseling Session? 250
9. Chapter 9 Where Do Counselors Work? 280
10. Chapter 10 How Do Counselors Promote Social Justice and Engage in

Culturally Competent Counseling? 309
11. Chapter 11 How Do Counselors Collect and Use Assessment

Information? 344
12. Chapter 12 How Do Counselors Make Legal and Ethical Decisions? 381
13. Chapter 13 How Do Counselors Support Wellness in Themselves and

Their Clients? 417
14. Chapter 14 Counseling Tomorrow 444

Inhalt
1. Chapter 1 Who Are Counselors? 1
1. Professional Counseling and Professional Identity 1
1. What Is a Professional Identity? 2
2. Reflecting on What You Are Learning 2
3. This Text Is a Field Guide to Counseling 3
2. What is Counseling? 4
3. The Helping Professions Today 6
1. What Is a Counselor? 6
2. Psychiatry 8
3. Social Work 9
4. Marriage and Family Therapy 9
5. Psychology 10
6. Comparing the Helping Professions 11
4. Counseling Yesterday: The History of the Counseling Profession

15
1. The Big Ideas of Counseling 16
5. Brief History of the American Counseling Association 33
1. Summary 35
2. End-of-Chapter Activities 36
2. Chapter 2 What Do Counselors Do? 39
1. Counseling: A Multi-Faceted Profession 45
1. Counselor as Therapist (Direct Service Provider) 46
2. Counselor as Group Leader 46
3. Counselor as K–12 Guidance Curriculum Expert 47
4. Counselor as Diagnostician 52
5. Counselor as Assessor 52
6. Counselor as Consultant 56
7. Counselor as Administrator or Program Planner 57
8. Counselor as Documenter or Record Keeper 60
9. Counselor as Researcher or Scientist 62
10. Counselor as Learner 63
11. Counselor as Teacher or Educator 64
12. Counselor as Supervisor or Supervisee 65
13. Counselor as Crisis Interventionist 66
14. Counselor as Advisor 67
15. Counselor as Expert Witness 68
16. Counselor as Prevention Specialist 68
17. Counselor as Businessperson or Entrepreneur 69

18. Counselor as Mediator 70
19. Counselor as Advocate or Agent of Social Change 71
20. Counselor as Member of Professional Associations 73
1. Summary 78
3. Chapter 3 How Are Counselors Trained and Regulated? 81
1. How Many Counselors are There? 82
2. The Education of Counselors 83
1. Educational Requirements 85
2. Core Curriculum 86
3. Beyond Graduate School 97
3. Counseling Licensure and Certification 97
1. Mental Health Counseling Licensure 97
2. School Counselor Licensure 99
3. Certification 100
4. Counseling Associations and Organizations 102
1. The American Counseling Association 102
2. The Divisions of ACA 105
3. Chi Sigma Iota 113
1. Summary 114

Identity? 117
1. Who are Counseling Students? 117
2. Why Do People Become Counselors? 121
3. What Types of People Become Counselors? 121
4. What are the Characteristics of Effective Counselors? 121
5. How Do People Determine Their Personal and Professional Fit

with the Counseling Profession? 132
6. What is the Personal Journey Toward Becoming a Counselor? 133
1. Counselor Professional Identity Development 134
2. Models of Counselor Development 135
7. How Do You Make Sure You Continue to Develop? 138
1. Self-Reflection 140
1. Summary 143

Graduate Programs? 146
1. Preparing for Success in your Graduate Program 149
2. Getting Ready to Start 152
1. Prepare Your Attitude 153

2. Prepare Your Support Network 153
3. Prepare Your Physical Space 154
4. Prepare Your Schedule 156
5. Prepare Your Mind 158
3. The Successful Graduate Student 163
1. Successful Peer Relationships 163
2. Successful Relationships with Faculty 165
3. Successful Interactions with Counselors and the Professional

Community 169
4. Success in the Classroom 172
5. Success in Online Education 173
6. Success in Navigating the Program Culture 174
7. Success in Maintaining Your Own Mental Health 175
4. Next Steps: Life After Graduate School 176
1. Preparing Your Resume 176
2. Getting a Ph.D. 176
3. Seeking References 179
1. Summary 179
6. Chapter 6 How Do Counselors Use Theories? 182
1. Theories of Change: Counseling Theories 183

1. What Are the Major Theoretical Positions? 183
2. Psychodynamic Theories 184
3. Behavioral/Cognitive Theories 185
4. Humanistic/Existential Theories 185
5. Eclectic/Integrative Theories 185
6. Other Approaches 187
7. A Social Justice Approach to Counseling Theory 189
8. Dimensions of Personality Applied to Counseling Theories

189
9. Focusing Your Search for a Theory 193
2. Behavioral, Cognitive, Eclectic/Integrative, and Rogerian/Person-

Centered Theories 195
1. Behavior Therapy 195
2. Cognitive Therapy 198
3. Eclectic/Integrative Counseling 201
4. Rogerian/Person-Centered Theory 204
3. How do Counselors Choose a Counseling Theory? 207
1. On What Basis Should I Choose a Counseling Theory? 210
1. Summary 211
7. Chapter 7 How Do Counselors Use Research? 215

1. Why Counselors Use Research 217
1. The Reactive Approach: Responding to External Pressures

217
2. The Proactive Approach—Responding to Internal Pressures

221
3. Research as Form of Social Justice 223
4. Resistance to Research: Why Counselors Don’t Engage in

Research 224
2. How Counselors Use Research 225
1. Using Existing Research and Scholarship to Inform Practice

226
3. Understanding the Major Classifications of Scholarly Research 227
1. Literature Reviews or Position Papers 227
2. Quantitative Research 230
3. Qualitative Research 236
4. Program Evaluation 238
5. Other Types of Articles and Research 241
4. Engaging in Your Own Research as a Counselor 242
1. Summary 247
8. Chapter 8 What Happens in a Counseling Session? 250
1. What Counseling Is Like for the Client 251

1. Before Counseling Begins: The Decision to Seek Counseling
251
2. What Clients Expect from Counseling 252
3. Using a Social Justice Approach to Understanding Client

Expectations 252
4. Hopes and Dreams: The Client’s Belief in the Process of

Counseling 253
5. Secrets and Lies: The Client’s Struggle to Open Up 254
2. What Counseling Is Like for the Counselor 256
1. The Joys and Satisfactions of Being a Counselor 256
2. Some of the Dissatisfactions of the Counselor Role 258
3. Responsibility 262
4. Countertransference 262
3. A Roadmap of the Counseling Process: The Shared Journey of

Counselor and Client 264
1. Stage I. Establishing the Relationship 264
2. Stage II Assessment 266
3. Stage III Treatment Planning 266
4. Stage IV Intervention and Action 267
5. Stage V Evaluation and Reflection 269
4. The Skills of Counseling 270
1. The Skills of the Therapeutic Relationship 270

2. Skills You Will Learn 271
3. Skills to Work on Now 272
4. Things to Eliminate Now 275
1. Summary 277
9. Chapter 9 Where Do Counselors Work? 280
1. Who is in the Room? 282
2. Counseling Modalities 284
1. Group Work Including Group Counseling, Group

Psychotherapy, and Psychoeducation 284
2. Couples Counseling 286
3. Family Counseling, Including Multiple Family Groups 287
4. Classroom Lessons (Also Called Classroom Guidance) 288
3. Counseling Specializations 289
1. A Social Justice Approach to Counseling Specializations 289
2. Counseling Specializations Based on the Interventions Used

289
3. Counseling Specializations Based on Setting 294
4. Counseling Specializations and Specific Training

Requirements 296
4. Counseling Settings: The Environment Where Counseling Takes

Place 296
1. A Traditional Counseling Office 299
2. Other Settings Where Counseling Takes Place 300
1. Summary 305

Culturally Competent Counseling? 309
1. You: A Culture of One 312
2. Counseling and Social Justice 316
3. The U.S. Population: A Testament to Diversity 322
1. Counseling and Diversity 323
2. Diversity and Oppression in the Lives of our Clients 334
4. Multicultural and Social Justice Counseling 335
1. Strategies to Enhance Your Own Multicultural and Social

Justice Competence 338
1. Summary 340

Information? 344
1. What Kinds of Assessments Do Counselors Use? 345
1. Interviewing 345
2. Questionnaires, Surveys, and Rating Scales 348

3. Standardized Tests or Instruments 348
4. Measures of Program Accountability or Counseling

Effectiveness 349
2. Why Should Counselors Spend So Much Time on Assessment? 349
1. Let’s Start with a Case Study: What’s Wrong with Raymond?

350
3. What Should Counselors Assess? 352
1. Strengths and Positive Psychology 352
2. What Is Assessed Varies by Client Problem, Population, and

Setting 353
3. Assessment in School Counseling 353
4. Assessment in Mental Health Counseling 355
5. Assessment in Marriage, Couples, and Family Counseling 356
4. Steps in the Assessment Process 357
1. Selecting Good, Developmentally and Culturally Appropriate,

and Comprehensive Methods 357
2. Establishing a Relationship 359
3. Administering the Assessment 360
4. Interpreting Assessment Data 361
5. Writing Up Assessment Results and Generating Suggestions

for Intervention 361
6. A Social Justice Approach to the Process of Assessment 362

7. What Do You Do After You Have Collected Information? 362
8. Assessment of Personality 363
9. Personality Assessment Theories 364
10. What Are Personality Theories? 364
11. Galen’s Four Temperaments (Example of a Type Theory) 365
12. Phrenology 365
13. Sheldon’s Body Types: Type Based on Body Shape 366
14. The “Big Five” Theory of Personality and NEO Personality

Inventory 366
15. John Holland’s Self-Directed Search (SDS): Personality in

Career Choice 368
16. Implicit Theories 370
5. Ethics in Assessment 371
1. Ethical Issues to Practice Now 371
1. Summary 377
12. Chapter 12 How Do Counselors Make Legal and Ethical Decisions? 381
1. The Purpose of Ethics in the Practice of Counseling 383
1. Professional Codes of Ethics 384
2. The Role of Personal Ethics and Values 385
1. The Role of the Counselor’s Personal Values 385

2. When Personal and Professional Values Collide 387
3. Understanding Ethical Practice from a Social Justice

Perspective 388
3. Major Ethical Issues in Counseling 390
1. Rules Related to Professional Responsibility 390
2. Rules Related to Competence 391
3. Rules Related to the Counselor’s Own Moral Standards and

Values 391
4. Rules Related to Confidentiality 391
5. Rules Related to the Welfare of the Client 392
6. Rules Related to Professional Relationships 394
4. Ethics and the Law 396
5. Major Legal Issues in Counseling 398
1. Legal Principle: Counselor Competency 399
2. Legal Principle: Client Rights and Informed Consent 400
3. Legal Principle: Privileged Communication and

Confidentiality 402
4. Legal Principle: Documentation and Records 405
5. Other Legal Requirements for Counselors 408
6. When Counselors Violate Ethical and Legal Requirements 409
7. Ethical Decision-Making in Practice 411

1. Summary 414

Their Clients? 417
1. A Brief Historical Sketch of Wellness in Counseling 418
2. Definitions and Dimensions of Wellness 420
1. Dimensions of Wellness 422
3. Wellness in Counseling 427
1. Strengths-Based Counseling 427
4. The Stress of Counseling and Potential for Burnout 431
1. A Social Justice Approach to Preventing Burnout 433
2. Insulating Yourself Against Stress and Burnout 435
5. Maintaining Your Wellness as a Counseling Student 436
1. Physical Wellness 436
2. Emotional Wellness 437
3. Intellectual Wellness 439
4. Spiritual Wellness 439
5. Relationship Wellness 439
6. Developing Your Own Personal Wellness Plan 440
1. Summary 441

14. Chapter 14 Counseling Tomorrow 444
1. Global and Societal Trends 445
1. Speeding Up: Technology, More Work, and Stress 445
2. Health, Healthcare, and Aging 447
3. Increasingly Diverse Society 448
2. The Experimental Prototype Counselor of Tomorrow (EPCOT) 449
1. Eclectic or Integrative 450
2. Culturally Aware and Competent 453
3. Understanding and Accepting of Differences 454
4. A Leader at Work 454
5. A Lifelong Learner 455
6. Technologically Competent 456
7. Planful and Intentional in Maintaining Personal Wellness 458
8. Able to Read and Evaluate Research 459
9. Active in Professional Organizations 460
10. Able to Work with Couples, Families, Individuals, and Groups

461
11. A Social Justice Advocate for Clients and the Profession 461
12. A Reflective Practitioner 462
13. Ethically Aware 462
14. Able to Use Assessment Data to Plan Intervention and

Treatment 463
3. In the Crystal Ball 463
1. The Rise of Ecotherapy 464
2. The Mainstreaming of Japanese Therapies, Meditation, Yoga,

and Eastern Perspectives 464
3. Increasing Problems with Process Addictions 464
4. The Death of Counseling Theories 465
5. A Focus on Health, Wellness, Prevention, Complementary and

Alternative Medicine, and Using Discoveries in Neuroscience
466
6. Virtual Reality Will Be Used to Train Counselors and Help

Clients Practice 467
4. Concluding Comments: Where’s My Jet Pack? 469
1. References 473
2. Name Index 504
3. Subject Index 514

Chapter 1 Who Are Counselors?
Advance Organizers and Reflective
Questions
By the end of this chapter, you should know . . .
What the term professional identity means.
The major events that shaped the history and philosophy of the
counseling profession.
The various specialties within counseling, such as mental health

counseling and school counseling.
By the end of this chapter, you should be able to . . .
Differentiate between the major mental health professions in terms of

their training and philosophies.
Define the term professional counselor.
Identify the key values that have emerged in counseling’s short history.
Develop a plan to involve yourself in reflective learning by reacting to

the material in this book from your own perspective using the exercises
in this book, through class discussion and journaling.
As you read the chapter, you might want to consider . . .
How do the important values and philosophical underpinnings of the

counseling profession fit with your own ideas and goals?
How can you start to develop collaborative relationships with members

of the other helping professions during your graduate school training?
This chapter addresses the following CACREP (2016) standards:
Professional Orientation & Ethical Practice:
1. history and philosophy of the counseling profession and its

specialty areas
Professional Counseling and
Professional Identity
Because this is an introductory counseling book, it is very likely that you are
exploring the field of counseling for the first time. Although professional
counseling may be new to you, helping will not be a novel experience. You
may already have mentored someone at work, listened to a friend’s romantic
difficulties, consoled someone after a loss, or tried to help mediate the
difficulties of family members. These experiences give you a background to
reflect on as you read about the profession of counseling. You probably have
also experienced some of the joys of helping others—and perhaps some of
the pitfalls as well. A few readers will already possess considerable helping
experience, perhaps working with children, in schools, in corrections, dealing
with substance abuse problems, or working in a social service agency.
Regardless of your background, you may not yet think of yourself as a
counselor. In other words, you may not have established your professional
identity.
What Is a Professional Identity?

Establishing a professional identity means more than completing the degree
requirements, passing the state or national examinations, and having a plaque
on the wall. It means finding a professional home in a field. Selecting a
professional identity as a counselor is a fork in the road. It means that you
have decided to become a counselor rather than a social worker, psychologist,
or some other mental health professional. It also means that you have made a
decision for something. You have selected the values, organizations, and
traditions of the counseling profession. It means that you take personal
responsibility for making the profession better, that you act in accordance
with its ethical standards, and that you are proud of your profession (Alves &
Gazzola, 2013). This step, like marriage, should not be undertaken
unadvisedly. You should take time in all of your introductory courses to
thoroughly investigate the profession you are entering and determine if
counseling is the proper fit for you. As you will soon learn, some of
counseling’s origins spring from career counseling; therefore, you may want
to consider receiving professional career counseling. At any rate, you should
visit practicing counselors, attend professional meetings, and see what the life
of a counselor is really like. In this book, we will suggest experiences and
provide you with information that will help you take the next step in your
entry into the field.
Since the last edition of this book, a spate of articles, dissertations, and
conference presentations have addressed this issue of a professional
counseling identity (Alves & Gazzola, 2013; Mellin, Hunt, & Nichols, 2011;
Moss, Gibson, & Dollarhide, 2014). There are even scales designed to
measure professional identity in counselors (Healey, Hays, & Fish, 2010;
Prosek & Hurt, 2014; Puglia, 2008). A key issue in these writings is the
necessity for adopting a strong unified counseling identity (we are all
professional counselors), while at the same time acknowledging the different
specializations (for example, school counseling; mental health counseling;
marriage, couple, and family counseling; rehabilitation counseling) (Reiner,
Dobmeier, & Hernandez, 2013). The authors of these studies say that the
main aims of establishing counselor professional identity are to help
counseling achieve parity with other mental health professions in the
marketplace and to create portability, which is the ability to carry your
license or certification with you wherever you go. Having a recognizable
professional identity makes portability easier as various states begin to
recognize that the title “Professional Counselor” means the same thing
everywhere.
Reflecting on What You Are

Lernen
Part of establishing a professional identity is to compare yourself with others
in the field. Do you find common values and interests? Although you need
basic knowledge of the counseling field, you also need to go through a
process of personal examination to see if this profession fits you. We have
tried to bring in those elements that will help you recognize the professional
standards, look at your own beliefs, and see if there is a match. For this
reason, we have adopted a “reflective practitioner” model in this book. This
model assumes that you must synthesize what you are learning with the
person you already are—comparing as you go along. At every new puzzling
step, at every uncomfortable thought, take the opportunity to grow through
reflection and consider what you are taking in. Thinking or reflecting can
take place in your head, but it is almost always better written down or
expressed aloud with another person or small group. That probably comes as
no surprise to you. After all, the idea that expressing your thoughts out loud
can be beneficial is the cornerstone of the counseling profession!
Reflection means weighing what you have learned through your previous
experiences and trying to put that together with new information. It means
critically evaluating what the text and teacher say rather than swallowing it
whole. It means being open to new ideas even if they challenge precious
beliefs. Reflecting can lead to “Aha” experiences (when an insight comes
suddenly) or, alternately, to a gradual recognition that you have changed over
time. The only way you may recognize these changes is to document them as
you grow. Therefore, you might find it useful to record your thoughts in a
diary or journal. In many ways, the process of change you will experience is
very much like what a client goes through. Frequently, clients do not
recognize the ways in which they have evolved unless they can compare their
states before and after counseling.
This Text Is a Field Guide to

Counseling
Entering a new field can be a bit like visiting a foreign country where the
customs and language are unfamiliar. We decided to write a book that gives
you the information you need in an easily accessible format similar to what
you would find in a travel guide to a foreign country. If we are successful,
you will find this book to be up-to-date and practical. You will hear stories of
other travelers, including their warnings and best experiences. You will also
find an introduction to the language and key definitions. Like a field guide,
this book will also show you some pictures of people and things you will
encounter. It will describe what is really out there.
To make this a useful guide, we included a number of special features that

appear in most chapters. Each chapter begins with Advance Organizers that
outline what you should be able to know and do by the time you have
completed reading the chapter, as well as some Reflective Questions to
consider as you read. These reflective questions frequently ask you to review
what you already know about the chapter topics and to think about the
personal importance of the topics.
Spotlights are sections in the chapter where we focus on current trends and
important viewpoints that help you develop a sense of professional identity.
For example, in this chapter, we look at the American Counseling
Association’s national convention where many counseling professionals find
like minds, continuing education, and a forum for common concerns.
Counseling Controversies highlight two sides of an issue that is currently
being debated in the field. We present both sides and then ask you to examine
your own thinking about this debate. In fact, this is the approach we have
tried to take throughout the text. Rather than give you the “party line” about
such issues as medication and insurance, we have tried to highlight the
disagreements, not just report the middle ground. Snapshots are words and
pictures about real people who are working in the field or who have
influenced the profession. Snapshots bring leaders and everyday counselors
from the field to the classroom. Informed by Research provides a brief
overview of an important research study bearing on the chapter’s topic. We
hope that counselors in training will appreciate from the beginning that they
can learn from the discoveries of others as well as from their own
experiences. As you become a professional, you will want to look at the
critical research in counseling and related fields as sources of ideas and
evidence for good practice. By helping you link what you are reading in the
chapter to the important research being conducted in the field, we hope you
will begin to see these important connections. In Words of Wisdom, we
have compiled helpful advice, comments, or quotes from counselors, clients,
or famous people whose words can inspire. Throughout the text you will also
see Key Definitions highlighted and Fast Facts, which are interesting data
about counseling and counselors.
What is Counseling?
Counseling happens when a professionally trained individual develops a
contractual relationship with a client and communicates with that person in a
way that is deemed helpful. By contrast, counseling is not the kind of help we
described earlier: when a friend gives advice to a friend, fellow church
members share their difficulties, or the school principal brings parents to a
conference to change a child’s behavior. These activities are better described
by the generic term helping. Helping occurs in a wide variety of settings, but
it is not counseling unless it involves the key provisions that the counselor is
professionally trained and that client and counselor have agreed on the issues
of remuneration, confidentiality, time limits, and responsibilities.
We believe it is important to help you make this distinction between helping

and counseling. Let’s take the example of plumbing. We like the comparison
to plumbing because, like counseling, plumbing is considered to be rather
simple, and most people think they could probably do it themselves if they
had the time. (Also, we believe that counselors should be paid at least as well
as plumbers!) Let us say that you have a dripping faucet. Although you might
be able to solve this problem yourself or have a next-door neighbor help you
change the washer, you are not a plumber! In the same way, most problems
that people face are handled alone or in collaboration with family and friends.
It is usually only when the situation is desperate that people seek professional
help. Your neighbor, trying to solve a major plumbing problem, may make
things worse. That is why we have licensure, professional organizations, and
state boards for plumbers and counselors. It is the best way of ensuring that
the client receives the most up-to-date procedures, a contract, the best-trained
person, and a means for redressing grievances. Nevertheless, there will
always be people who believe that they are born plumbers or counselors and
that they do not need any training or professional regulation.
Another term similar to counseling is psychotherapy. Psychotherapy is a

way of describing counseling as a treatment, something akin to medicine. The
term was coined in the late 19th century and originally referred to “suggestive
psychotherapy” and hypnotism (Jackson, 1999). The word went through
many permutations. By the beginning of the 20th century it meant treating
physical illness by psychological means. Sigmund Freud used it
synonymously with “catharsis,” or emotional venting. Today, the term
describes the entire spectrum of change theories and techniques.
Many writers have struggled to differentiate the process of counseling and

that of psychotherapy over the years, but most have decided to use the terms
interchangeably (Capuzzi & Gross, 2001; Gilbert, 1952; Patterson, 1973;
Wrenn, 1954). In many states counselors, psychologists, social workers,
psychiatrists, and marriage and family therapists can all practice
“psychotherapy.” In most cases, the techniques and theories employed are the
same whether they use one term or the other. The reason to call what we are
doing psychotherapy is mainly an economic one. Insurance forms require this
medical language. In truth, like the term counseling, psychotherapy has
become a generic term for professional helping.
Those who prefer the term psychotherapy may see themselves as operating
within a medical model and aiming more at longer-term personality change.
They may emphasize assessment and testing, arrive at a diagnosis, and
develop a treatment plan. This process from assessment to treatment plan is
called the diagnostic treatment planning model or the medical model
(Wampold & Imel, 2015). Others like to reserve the term psychotherapy for
their treatment of clients with severe problems. These individuals are more
likely to be licensed as psychologists or psychiatrists, although counselors
can work with these clients too. The term counseling is more likely to be used
by people trained in counseling programs and who may not rely on a
diagnostic treatment planning model but focus more on client-defined
problems, wellness, the therapeutic relationship, and client strengths. In the
end, counselors practice what psychotherapists call therapy, and
psychotherapists practice what counselors call counseling.
Guidance or guidance counseling is a term still used in schools, but it is

unpopular among counselors. Guidance has a historical connotation
connecting it with the term vocational guidance, as we will see when we look
at the history of the profession. Guidance suggests advice and a directive
approach, steering students into professions, college, or technical schools.
Certainly, many school counselors help students make major life decisions,
but it is doubtful that they do any more “guiding” than any other helping
professionals. Because school counselors are working mainly with children,
the quasi-parental term has stuck. Since 2003, however, the American School
Counselor Association has eliminated the term guidance counselor from its
literature and now uses the terms school counseling and professional school
counselors.
Fast Fact
In 2015, counselors held about 686,000 jobs in the United States. Of these,
about 274,000 worked in schools, 120,000 were rehabilitation counselors,
167,000 were mental health counselors, 98,000 specialized in substance
abuse and behavior disorders, and about 27,000 were in marriage, couple, and
family settings.
Source: Data courtesy of the Occupational Outlook Handbook, published by

the U.S. Department of Labor (2016), Bureau of Labor Statistics. The
handbook can be explored on the web at www.bls.gov.
The Helping Professions Today
Now that we have talked about the definitions of helping, counseling, and
psychotherapy, there are a few other terms that need clarification. We will
use the generic terms therapist, clinician, and professional helper to refer to a
member of one of the five major mental health professions: counseling, social
work, marriage and family therapy, psychology, and psychiatry. Although
these fields have many subspecialties, licensure (granted by state legislatures)
is normally given in one of these five professions. Training imbues each with
a certain perspective and a philosophy of helping. Space does not allow us to
adequately describe the entire training philosophy of each profession. Instead,
we will try to contrast the training of other professions with that of the
profession of counseling where possible. It is difficult to be objective in this
comparison because we tend to see other professions’ ideas through our own
counseling “lens.” As you explore your professional path in a helping
profession, you will want to carefully examine the issues and gain more
information about all of the helping professions by talking with other
clinicians, reading the Occupational Outlook Handbook, and examining the
websites of professional organizations.
Ideally, the five major helping professions should work together to help
clients benefit from their combined philosophies, tools, and skills. Everyone
benefits when professionals collaborate to help meet the varying needs of an
individual client or to advocate for the mental health needs of an entire school
or community. In our schools and mental health agencies counselors,
psychologists, social workers, marriage and family therapists, and
psychiatrists work together and ordinarily treat each other with professional
respect and dignity. In practice, most members of the helping professions
recognize the important and distinct contributions that each profession makes
to a mentally healthy society.
Unfortunately, the history of interdisciplinary cooperation of the helping

professions at the national or state organizational level has been quite sad at
times. Collaboration between professional organizations remains an
important, yet elusive goal. There are clearly strong commonalities that bind
us together, and we rely on the contributions of pioneers who have come
from all of the helping disciplines. Nevertheless, there is still a fierce rivalry.
For example, psychiatry has fought a long and expensive battle to contain the
profession of psychology. Today psychiatrists and psychologists are locked
in a struggle about prescribing medication. Psychologists and social workers
spent millions in the 1980s trying to defeat counselor licensure, while
counselors have consistently opposed the entrance of bachelor’s-level
practitioners into the licensure fold. These struggles continue today despite
the fact that in many agencies, schools, and even private practices,
professional helpers in all fields work in concert or even in teams for the
welfare of clients.
What Is a Counselor?
As we look to describe how we differ from other helping professions, we
must first take time to make sure you more fully understand our own
profession. As you enter the profession of counseling, you should know that
there are some unifying concepts that help define who we are and what we
do. In the following paragraphs, we highlight some of the foundational
principles of the counseling profession for you to consider.
A counselor has specific training.

Most counselors receive their degrees in colleges of education. Counselors
hold a master’s degree, Education Specialist (Ed.S.), or doctorate (PhD) in
counseling or counselor education. Many school counselors go on to achieve
an EdS degree to receive more advanced training. Doctoral-level counselors
work mostly in academia as counselor educators, supervisors, or private
practitioners.
Counselors typically have a degree in one of the following specialties:
School counseling
Working with students in public and private schools

Mental health counseling or community counseling
Working in community agencies, hospitals, private practice
Marriage and family therapy or marriage, couples, and family

counseling
Working in community agencies or private practice
Rehabilitation counseling
Working for private or government agencies or residential facilities

helping people cope with stresses associated with a disability,
including vocational counseling, training, and placement
College student counseling and personnel services
Working in college departments of student life. Student life is the

term universities use to jointly describe their departments of student
housing, Greek affairs, and student judiciary, among others.
Common core curricular

experiences.
The semester hour requirements for a master’s degree in counseling programs
is substantial compared to, say, a master’s in mechanical engineering, which
may be 36 hours. Counseling master’s programs normally range from 48 to
60 graduate hours, depending on the specialization, and take between two and
two and one-half years to complete on a full-time basis. Some programs offer
only a 72-hour Ed.S. degree, which is a middle degree between master’s and
doctorate.
More than 700 college and university counseling programs are accredited by
CACREP, the Council for Accreditation of Counseling and Related
Educational Programs. Eight areas of preparation are required for all
counseling specialties under CACREP, and these areas reflect the history and
values of the profession. You will learn more about the CACREP core areas
and other curricular requirements to become a counselor in Chapter 3.
A counselor belongs to professional

organizations.
Counselors are members of the following national organizations: the
American Counseling Association (ACA), the American Mental Health
Counselors Association (AMHCA), and/or the American School Counselor
Association (ASCA). AMHCA and ASCA were once part of ACA and now
are listed as affiliated divisions. Although these three organizations often
work together to promote school counseling and mental health legislation, all
three have separate executive directors and are self-governing. The American
Counseling Association has 20 divisions. Among these are divisions
specifically designed for marriage and family counseling (International
Association for Marriage and Family Counselors), college counseling
(American College Counseling Association), and rehabilitation counseling
(American Rehabilitation Counseling Association). You will learn more
about ACA and its divisions in Chapter 3.
Psychiatry
One of the oldest and most established of the helping professions is that of
psychiatry. Psychiatrists are licensed medical doctors, and there is probably
less confusion concerning how counseling differs from psychiatry than on
how it differs from the other helping professions.
Every state has licensure requirements for psychiatrists. Board-certified

psychiatrists are medical doctors (MDs or DOs) who, following medical
school, become residents in psychiatry, an internship program that may last
as long as five years. Residency training is accredited by the American
Medical Association. During this time, psychiatric residents learn about
therapeutic relationships and psychological and biological theories of
behavior. They are also trained in psychopathology and diagnosis and in
human development, and receive extensive training in psychopharmacology
and other biological treatments. The psychiatric residency places less
emphasis on skills and intervention methods and vastly more emphasis on
biological bases of behavior, organic brain syndromes, and prescribing
medication.
Psychiatrists are members of the American Psychiatric Association, which

also publishes the Diagnostic and Statistical Manual (DSM), the listing of
accepted mental disorders. In the past, psychiatry produced some of the
greatest thinkers in the mental health field, including many of its founders
and pioneers. This began with Sigmund Freud (who may have been the first
psychiatrist) and his contemporaries, such as Alfred Adler, Otto Rank, and
Karen Horney. Later, major contributions were made by J. L. Moreno
(psychodrama and group therapy), Fritz Perls (gestalt therapy), William
Glasser (reality therapy), Aaron Beck (cognitive therapy), Jerome Frank
(scientific study of psychiatry and social responsibility of psychiatrists),
Milton Erickson (clinical hypnosis, family therapy, neuro-linguistics
programming), Eric Berne (transactional analysis), and Irving Yalom (group
therapy, existential therapy), to name only a few.
Things have changed since the early days of psychiatry. Although some
psychiatrists practice as therapists today, the vast majority help determine
diagnoses and prescribe and evaluate the effects of medication, especially on
people with severe mental disorders such as schizophrenia or bipolar
disorder. Frequently, psychiatrists lead interdisciplinary teams in hospitals.
They often receive referrals from physicians and other mental health
professionals including counselors. Counselors rely on psychiatrists when a
client has confusing physical symptoms or needs an evaluation for
medication.
Social Work
A social worker may have a bachelor of social work (BSW) or a master of
social work (MSW). Social workers are licensed in all 50 states. Those who
work as licensed therapists possess the MSW. A doctoral degree (DSW) is
possible, but it is relatively rare and seems to be mainly confined to
academics. The typical length of master’s programs is about 60 semester
hours, but a proportion may be undergraduate hours. Thus, with 30
bachelor’s hours, in some programs, it is possible to finish an MSW degree in
one year. A comparison of social work training and master’s degree training
in counseling reveals that social workers are more extensively trained than
counselors in utilizing and understanding the environmental, social, and
economic forces on clients. They advocate on behalf of clients. They are
knowledgeable about social agencies and the workings of community referral
sources. Although counseling training has become more multicultural and
sensitive to special populations, social work training emphasizes this area
even more. Normally, psychological testing is not within the scope of
practice of a social worker.
Compared to social work, counseling prepares students more in the skills and
knowledge of the helping relationship. Counselors have more emphasis on
individual and group therapy techniques and interventions. Counselors rely
on and refer to social workers when clients need help making the transition
from inpatient to outpatient treatment, for example, or when the social
worker’s expertise in community resources is needed. The MSW degree is a
versatile, highly regarded degree because social work has a long history and
jobs have been available in hospitals and community services agencies. Some
state licensure boards and most training programs differentiate between
administrative MSWs and those trained as clinical social workers. Social
workers have been major players in family therapy and several are quite well
known, including solution-focused pioneers Steve de Shazer, Insoo Kim
Berg, and Michele Weiner Davis.
Marriage and Family Therapy

Marriage and family therapists are currently licensed in all 50 states and the
District of Columbia. The major professional organization representing
marriage and family therapists is the American Association for Marriage and
Family Therapy (AAMFT) with about 25,000 members. They are held
together by a belief that individuals are strongly influenced by their family
systems and that treatment requires recognizing systemic influences and
working with couples and families as well. The founders of AAMFT were
mainly psychiatrists, social workers, and psychologists who became
interested in couple and family work. AAMFT, through its accrediting body,
the Commission on Accreditation for Marriage and Family Therapy
Education (COAMFTE), certifies about 110 programs in North America. The
accreditation extends to both universities and private training institutes that
offer master’s, doctoral, or training certificates.
Fast Fact
Counselors are licensed in all 50 states and the District of Columbia.
Requirements vary. Counseling students who want to work in a state different
from where they are receiving their degree should consult the American
Counseling Association website, www.counseling.org, where state
professional counselor licensure boards are listed with their contact
information.
Counselors and psychologists have their own organizations for members

interested in couples and families. The American Psychological Association
(Division 43) and the American Counseling Association’s International
Association for Marriage and Family Counseling (IAMFC) are large and
active. By the way, counselors generally prefer the term Marriage, Couples
and Family Counseling because it recognizes that not all couples are married.
Other associations, such as the American Family Therapy Association
(http://afta.org), also represent family therapists from a variety of
professional backgrounds. Very few noted therapists or theorists were
originally trained in marriage and family therapy. Family therapist pioneers
such as Jay Haley (anthropology), James Framo (psychology), and Murray
Bowen (psychiatry) have come from other disciplines.
Psychology
Psychologists in the United States have a doctorate in psychology and are
members of the American Psychological Association (APA) or the American
Psychological Society (APS). The APA is the larger organization and
represents most clinical psychologists. APA does not offer full membership
to master’s-level practitioners, although it trains them. They are not eligible
for licensure as psychologists and frequently obtain licensure as counselors in
states where this is permitted. The doctoral training of psychologists is about
the same number of credit hours as doctoral training in counseling. The
difference is that counselors must have a master’s degree before entering the
doctoral program. Psychologists usually receive a master’s degree along the
way to the doctoral degree. In addition, counseling doctoral students
normally have several years of experience before entering doctoral training.
Therefore, psychology doctoral students are younger, usually going into
doctoral training directly out of a bachelor’s program. They do not usually
possess the 48 or 60 semester hours of master’s-level training in counseling
in addition to their doctoral training. Those who receive a master’s degree in
psychology cannot be full members of APA.
There are three major options for a doctorate in psychology that emphasizes
therapy. The most traditional is the clinical psychologist (PhD), whose
training is a heavy helping of research and testing along with a clinical
internship. This model of scientist/practitioner was challenged in the late
1970s by the development of a pure therapist doctorate, the PsyD or doctor
of psychology. The training necessary for a PsyD is similar to medical school
training for a three- or four-year period in the APA-accredited programs.
Nonaccredited programs vary in the length and type of training.
Psychologists with a PsyD work mostly in private practice and rarely teach in
universities. Like MDs, they are not academics but practitioners and therefore
university teaching departments may not hire them except in clinical or
supervisory roles.
Counseling psychologists have a PhD in counseling psychology. Their

primary province has been the college counseling center, although in recent
years, mental health counselors have been increasingly hired in these
positions. Counseling psychologists may be members of Division 17 of the
American Psychological Association, and some belong to the American
Counseling Association too. Division 17 was founded in 1945 and was
originally called the Division of Guidance and Counseling—now the
Division of Counseling Psychology. For most of the last century, counseling
programs and counseling psychology programs intermingled in universities
with a large percentage located in colleges of education. Counseling
psychologists frequently have more background in research than counselors,
and their internships may focus more on the college counseling arena rather
than on community agencies. There are now only about 65 APA-accredited
programs in counseling psychology in the United States and Canada, and the
specialty may be in decline.
The training of a psychologist.

Broadly speaking, psychology training emphasizes psychological testing,
research, and biological bases of behavior much more than counseling
programs. There is more emphasis on behavioral learning theory and
cognitive therapy. Counseling programs, by contrast, focus more on skill
development, the therapeutic relationship, career counseling, cultural issues,
group work, and the needs of children. Counseling programs philosophically
are closer to the humanistic versus the behavioral approach to helping clients.
Counseling and psychology have many overlaps and a shared history.

Counselors read psychology journals, especially the Journal of Counseling
Psychology, and often work side by side with psychologists in agencies,
educational institutions, and corporations. Counselors who are not trained in
psychological testing may refer to clinical psychologists, especially when
neurological issues are suspected. Psychologists who have contributed to and
influenced counseling include B. F. Skinner, Carl Rogers, Albert Ellis,
Arnold Lazarus, Donald Meichenbaum, Albert Bandura, and many, many
others.
Comparing the Helping Professions

As you just learned, there is significant overlap between all of the helping
professions. In fact, beginning counseling students often struggle to fully
understand the distinctions between these professions, even as they commit
themselves to the profession of counseling. Your family and friends might
share in this uncertainty, and perhaps they have asked you how your new
profession differs from psychology or social work. Many of our students say
they were unaware of the existence of the profession of counseling during
their undergraduate education, falsely believing that a career in psychology
was the only avenue available to them if they wanted to conduct therapy.
However, we are sure it is already becoming more evident to you as you read
this chapter that in spite of the clear overlap in practice, each of the mental
health professions has carved a distinct niche for itself. In the Spotlight you
just read, we removed our own voices and allowed each of these professions
to describe what they do in their own words. As you read through the
Spotlight, we hope you took some time to consider how each profession
chooses specific aspects of helping to highlight.
SPOTLIGHT In Their Own Words

—The Major Mental Health
Organizations Describe Their
Professions
Here you can read each professional association website’s description of
what their members do. Notice the language used by each of the associations
as they describe their practice. Do you notice any overlaps? Any differences?
You can explore more if you visit the association’s website.
The American Counseling

Association (ACA)
What is professional counseling?
Professional counselors work with individuals, families, groups, and
organizations. Counseling is a collaborative effort between the counselor and
client. Professional counselors help clients identify goals and potential
solutions to problems that cause emotional turmoil; seek to improve
communication and coping skills; strengthen self-esteem; and promote
behavior change and optimal mental health. Through counseling you examine
the behaviors, thoughts, and feelings that are causing difficulties in your life.
You learn effective ways to deal with your problems by building upon
personal strengths.
Source: www.counseling.org/consumers/FAQs.htm
Organization website: www.counseling.org
The American Psychological

Association (APA)
What is psychology?
Psychology is the study of mind and behavior. The discipline embraces all
aspects of the human experience—from the functions of the brain to the
actions of nations, from child development to care for the aged. In every
conceivable setting from scientific research centers to mental health care
services, “the understanding of behavior” is the enterprise of psychologists.
Source: www.apa.org/about/
Organization website: www.apa.org
The American Psychiatric

Association (APA)
What is a psychiatrist?
A psychiatrist is a physician who specializes in the diagnosis, treatment, and
prevention of mental illnesses and substance use disorders. Psychiatrists must
graduate from college and then medical school, and go on to complete four
years of residency training in the field of psychiatry. (Many psychiatrists
undergo additional training so that they can further specialize in such areas as
child and adolescent psychiatry, geriatric psychiatry, forensic psychiatry,
psychopharmacology, and/or psychoanalysis.) This extensive medical
training enables the psychiatrist to understand the body’s functions and the
complex relationship between emotional illness and other medical illnesses.
The psychiatrist is thus the mental health professional and physician best
qualified to distinguish between physical and psychological causes of both
mental and physical distress.
Source: www.psych.org/public_info/what_psych.cfm
Organization website: www.psych.org
National Association of Social

Workers (NASW)
What is the practice of social work?
Social work practice consists of the professional application of social work
values, principles, and techniques to one or more of the following ends:
helping people obtain tangible services; counseling and psychotherapy with
individuals, families, and groups; helping communities or groups provide or
improve social and health services; and participating in legislative processes.
The practice of social work requires knowledge of human development and
behavior; of social, economic, and cultural institutions; and of the interaction
of all these factors.
Source: www.socialworkers.org/pdev/default.asp
Organization website: www.socialworkers.org
American Association of Marriage

and Family Therapists (AAMFT)
What is a marriage and family
therapist?
Marriage and family therapists (MFTs) are mental health professionals
trained in psychotherapy and family systems, and licensed to diagnose and
treat mental and emotional disorders within the context of marriage, couples,
and family systems. Marriage and family therapists broaden the traditional
emphasis on the individual to attend to the nature and role of individuals in
primary relationship networks such as marriage and the family. MFTs take a
holistic perspective to health care; they are concerned with the overall, long-
term well-being of individuals and their families.
Source: www.aamft.org/faqs/index_nm.asp#what
Organization website: www.aamft.org
More recently, a new form of helping has become increasingly popular.

Sometimes called Life or Personal Coaches, these individuals seek to help
their clients become more confident and motivated. The International
Coaching Federation (2016) defines coaching as “partnering with clients in a
thought-provoking and creative process that inspires them to maximize their
personal and professional potential, which is particularly important in today’s
uncertain and complex environment. Coaches honor client as the experts in
their own life and work and believe every client is creative, resourceful and
whole.
Unlike the other helping professions discussed in this chapter (Professional
Counseling, Psychiatry, Social Work, Marriage and Family Therapy, and
Psychology), Life Coaches are not licensed, and there are no degree or
educational requirements, although coaches are encouraged to obtain
education and certification. Counseling (and the other helping professions)
are understandably wary of this new trend, and many question whether
coaching represents a new way of interacting with clients or is simply
conducting counseling without the formal educational and licensure
requirements. In this chapter’s Counseling Controversy, we explore Life
Coaching and ask whether it is, in fact, a unique approach to helping.
Counseling Controversy Coaching:

A Unique Approach or Counseling
by Another Name?
Background: Over the past decade, there has been an increasing number of
Life Coaches. Counselors are particularly wary of coaching, for several
important reasons:
There is no evidence that coaching works.
Coaches, like counselors, encounter people with mental disorders, and

coaches are not trained to recognize these people. Thus, harm can be
done with wrong or inadequate treatment.
Coaches are not responsible to a licensure board and, thus, there is no

redress for complaints or an enforceable body to whom the client can
report unethical activity.
Untrained coaches take business away from counselors.
In spite of these concerns, coaching is becoming more popular. Some argue

that coaching is a unique niche in the market, and that coaches do not
encroach upon the field of counseling. Others argue that coaching is simply
another name for counseling, which allows coaches to essentially conduct
counseling with neither training nor licensure.
COUNTERPOINT: COACHING
POINT: COACHING IS UNIQUE
= COUNSELING
• Coaching may sound less
• Many people are afraid of the stigma pathological, but there is no
of counseling or psychotherapy. The standardized preparation for
term coaching sounds less pathological. coaches, so there is no evidence for
its positive bias.
• Coaching is a great marketing tool. • It is deceptive and possibly
Providing both coaching and unethical to tell clients you are
counseling gives a private practitioner doing coaching if it fits the
an advantage and attracts people who definition of counseling or
may be afraid of counseling. psychotherapy as defined by law.
• Coaching is a positive activity and not • Counseling has always been
just about problems, it is about “positive psychology.” Counselors
maximizing your potential. It involves try to help clients achieve success in
the power of positive thinking and is their relationships and career
focused on success. training is a major focus.
• Counselors use their skills to help
• A coach provides accountability for
clients remain faithful to their goals.
the changes you want to make in your
Goal setting and confrontation are
life, not just talking about the past.
key skills.
• The coaching relationship is more • Most counselors believe in a
collegial and doesn’t set up a collegial, nonpathological approach
doctor/patient relationship. to the helping relationship.
Coaching offers a unique nonpathological approach
Coaching and counseling are the same
As with most controversies, there probably is truth on both sides of this

argument.
Counseling Yesterday: The History
of the Counseling Profession
When we read history, we tend to think that the story is a collection of facts.
Actually, all historians have biases and see the events from the fortress of
their own loyalties. Just as the history of the American Civil War can be told
from at least two opposing angles, the history of counseling has many
different threads. Frequently when we read about the history of counseling,
we learn what happened chronologically—as if each decade were a building
block leading to the present age of enlightenment. As you study the history of
counseling, we think you will see that things are not so cut and dried. There
have been both violent upheavals and gradual shifts, and along with the
forward steps there frequently have been backward ones and full-scale
retreats. While it might have been neater to arrange our story by decades, we
have decided to tell the history of counseling as a history of ideas. In other
words, what are the grand passions and philosophies that shaped the
profession, in some cases creating national movements? Along the way, we
will identify some of the influential people and historical figures who served
the profession. Finally, we will tell the story of the professional counseling
associations and look at how their actions and composition affect the life of
counselors today. We have portrayed the major ideas and their related
movements to convey how the ideas about counseling affected and interacted
with each other, creating a complex web of lived history, rather than a simple
chronology. Just as in counseling, where client stories seldom follow a simple
linear path, the story of the counseling profession requires us to listen to the
many related strands that weave together to form a history.
In telling this story, we have tried to be practical. What should a counselor

know about our profession’s origins? Why should we know about the history
of counseling ideas and philosophies? One reason is, as the song says,
“Everything old is new again.” In other words, ideas, enthusiasms, and
models appear and disappear over time. Popular books and professional
papers frequently fail to acknowledge that many of the same debates are still
going on and many of the so-called revolutions in therapy have been tried
before. Furthermore, we can solidify our sense of professional identity by
looking at the ideas that form the basis of the profession. As you read through
this history, you may want to take a moment to consider: Are these ideas
important to me? Are these values consistent with my own?
The ideas and philosophies that formed counseling are alive and well and can
be discovered in the professional writings, worldviews, and philosophies of
counselors. For example, the American Counseling Association (the main
professional organization for counselors) publishes books and advertises
them on the website www.counseling.org. The major headings in the newest
catalog are Multiculturalism, Advocacy and Empowerment, Holistic
Counseling, Child and Adolescent Development, and Career Counseling and
Development. If you peruse the list of new releases, you will find a number
of books on assessment, violence, research, working with children,
multicultural issues, social justice, and spirituality. The books published by
ACA and the subjects of conference presentations give you an idea of the
latest ideas within the counseling profession. However, as you read this
chapter, we think you will find that these ideas are not new but stem from
counseling’s roots at the turn of the 20th century. By being aware of these
ideas early in your career, you may be better able to critically evaluate them
and see if these professional clothes are a good fit for you.
The Big Ideas of Counseling

In the next sections of this chapter, we will highlight some of the most
important ideas that have influenced the development of the counseling
profession:
1. The values of equality, social justice, and client advocacy, and the
importance of career
2. The potential for personal growth
3. The belief in science
4. The influence of health, human development, and biology

Some of the core values of counseling were developed as a reaction to the
world wars, the Great Depression, waves of immigration, new laws, and other
external changes. Others grew from the minds of a few thinkers and
practitioners. All of these ideas have had strong adherents—people who
fervently believed in them and made them a part of the profession of
counseling through their work and their personal examples. As you read, we
hope you will be aware of your own personal reactions to these ideas. Note
where you become interested and excited, as well as where you disagree.
Two graphical representations of the contents of this chapter might help you
get an overview as well. Figure 1.1 shows the four major ideas and some of
the associated trends and movements associated with them. Figure 1.2
includes a traditional timeline so that you can trace the events we have talked
about in a more linear fashion.
Figure 1.1 The Big Ideas of

Counseling
Figure 1.1 Full Alternative Text
Figure 1.2 Events, High Points,

and Key Moments in
Counseling
World War II
gives impetus
World to
Events, Progressivist psychologists
Legislation, Movement and testing
& Takes Shape
Movements GI Bill offers
education to
vets
First
Frank
National
High Points Parson
Vocational
for the starts
Guidance
Profession Vocational
Convention,
Bureau
1910
Carl Rogers
Freud publishes
publishes Counseling &
Studies in Axelrod, Psychotherapy,
Hysteria, Adler and Strong Roe, & 1942
Key 1895 Jung publishes Super
Discoveries Frankl
& Parsons separate interest propound
publishes first
themselves test, theories of
Publications publishes version of
Choosing from Freud 1927 career
Man’s Search
a development
for Meaning
Vocation,
1909 Existentialism
flourishes
1900–
1910s 1920s 1930s 1940s
1910
The values of equality, social justice,

and client advocacy, and the
importance of career.
The values of equality, social justice, and client advocacy, and the importance
of career may seem to be separate entities, but it is hard to unfasten them
because they all began as part of a larger philosophy called progressivism.
The years 1900 to 1930 have been called the Progressive Era because a large
segment of the American population became awakened to negative changes
wrought by rapid industrialization, corruption, and the overwhelming influx
of immigrants in the late 1800s. Although Mark Twain referred to this era as
the Gilded Age, this was true mainly for the Carnegies and Rockefellers, not
for the masses of newly arrived Americans who swarmed into the northern
cities. Out of this confluence of events came the progressive movement.
Progressivism was a social philosophy affecting many fields of study. It
included election reform, antitrust legislation, women’s rights, immigration
reform, the needs of youth, and Prohibition. Leadership came from the
educational philosopher John Dewey and the Christian Socialist Jane
Addams. Both worked in Chicago, and that city became a stronghold of the
movement.
Progressivism affected school reformers who shared the common ideal that
education could be democratized without being reduced to the lowest
common denominator. Alternative schools flourished. Maria Montessori’s
ideas about early childhood education were compatible with progressivism.
The Montessori philosophy maintains that students should be allowed to
follow their own interests and respect others. Progressivist educational ideas
included character education and movement, and emphasized the importance
of work. Progressivist ideas such as physical education, experiential learning,
cooperative education interest stations in classrooms, industrial arts, technical
schools, and extracurricular activities are the remnants of this movement in
today’s schools. The election of the reformer Woodrow Wilson to the
American presidency was the culmination of the progressive movement’s
political aims. The administration was successful in passing legislation that
ended child labor and established vocational education.
Jesse B. Davis of Grand Rapids, Michigan, is considered to be the first

individual to utilize vocational guidance practices in the classroom, but it was
the charismatic reformer, Frank Parsons—one of the foundational figures in
the history of counseling—who opened the Vocation Bureau in Boston’s
Civic House and is most identified with the profession (McDaniels & Watts,
1994). Blocher (2000) points out that Parsons was not the founder of the field
of vocational guidance, nor was he an early pioneer, and his professional
experience as a counselor lasted only six months or so. However, Parsons’
book Choosing a Vocation (1909) has been immensely influential, probably
because there was virtually nothing else available at the time it was
published. In this chapter’s Snapshot, we introduce you to Frank Parsons.
As time went on, the emphasis on agencies to help unemployed youth gave
way to a focus on schools as the medium for guidance. This was partially due
to the new wave of mandatory education laws. In the 1920s and 1930s, the
progressive philosophy dominated school guidance, although teachers, not
counselors, mainly delivered these lessons. Group guidance and career or
vocational exploration was first used in this time period. The development of
specialists in guidance grew slowly but steadily because progressive ideas
were compatible with promoting the overall growth of the students.
SNAPSHOT Frank Parsons:

Counselor (1854–1908)
Frank Parsons, First Counselor
Parsons has been called the “Father of Vocational Guidance,” but some claim
that he was merely an easily identifiable symbol of the vocational guidance
movement, a shooting star rather than a founder (Blocher, 2000). Parsons was
trained both as an engineer and a lawyer. After being admitted to the bar, he
suffered from exhaustion and camped for three years in New Mexico. Later,
he taught art in public school and worked in publishing. During the
Depression, he was a laborer for an iron mill. He was a college professor in
social sciences in Kansas and later taught at Boston University Law School.
One of his students described him as having a great intellect with the heart of
a woman and the methods of a scientist (Davis, 1969). Throughout his life, he
was a social activist railing against the excesses of big corporations and the
“wild capitalism” of the time. He traveled widely, giving speeches that
influenced Theodore Roosevelt and his friend Oliver Wendell Holmes. It
must also be said that Parsons was prejudiced against some ethnic minorities
and used phrenology (the study of bumps on the skull) to assess personality
(Gummerre, 1988).
Parsons always considered his own career path to have been a series of
mistakes, so, in 1908 in Boston, he called a meeting of neighborhood boys
who were graduating to find out what they were planning to do and what they
knew about the world of work. When he discovered that they were woefully
uninformed, Parsons began advising them and established the Vocation
Bureau, the first vocational guidance center. His title was Director and
Vocational Counselor. The center grew and stimulated interest in vocational
guidance across the country. Parsons wrote 14 books including Choosing a
Vocation (1909), published posthumously. It is fitting that one who struggled
with so many abilities and careers became interested in helping others make
good choices. His tombstone reads “Frank Parsons, HERO–TEACHER–
PROPHET” (Davis, 1969).
What we owe to Parsons:
Developed the first self-inventory or questionnaire for interests and

aptitudes, and personality to match work environments. Designed the
first counseling agency.
Sparked the development of vocational guidance in schools.
Conceived of counseling as a mutual process involving cooperation, an

expert, and a client—and the client makes the final choice.
Left a legacy of activism and advocacy for clients.
Progressivism Today.
The anxieties of the cold war caused a fracture in the progressivist ideas, and
education in the United States became much more conservative. Still,
progressivist ideas are alive in counseling today. For example, the emphasis
on multiculturalism and social justice in counseling is a direct offshoot of
progressivist ideas of equality and mutuality. Multiculturalism is the idea that
culture is a prime ingredient in a person’s makeup and that counseling must
consider a person’s culture before appropriate treatment can be rendered.
More than that, counselors believe that all cultures should be celebrated, not
merely tolerated, and that counselors should possess skills, attitudes, and
knowledge about cultures and cultural differences to practice ethically and
effectively. The idea that individuals have differences but possess the same
rights—the value of equality—is a consistent value. Counselors still have a
reformist attitude. They frequently discuss, write about, and teach social
justice advocacy and ways of reforming organizations to make them more
humane. Counselors recognize that the passion that they have for helping
others extends beyond the individual counseling session to help create a more
just and equitable society.
Words of Wisdom
In the wise choice of a vocation there are three broad factors: (1) a clear
understanding of yourself, your aptitudes, abilities, interests, ambitions,
resources, limitations, and their causes; (2) a knowledge of the requirements
and conditions of success, advantages and disadvantages, compensation,
opportunities, and prospects in different lines of work; (3) true reasoning on
the relations of these two groups of facts. (p. 5)
Source: Parsons, F. (1909). Choosing a vocation. Boston, MA: Houghton

Mifflin.
Another artifact of the progressivist tradition is that counseling maintains a
strong focus on career counseling. The American Counseling Association has
two divisions specifically aimed at career counseling, the National Career
Development Association (NCDA) and the National Employment Counseling
Association (NECA). Eight universities have graduate degree programs in
career counseling accredited by CACREP, and career counseling is taught in
virtually every counseling program at the master’s and doctoral levels. In
your career counseling class, you will learn about career development
theories, career testing, and helping children and adults cope with vocational
choice and career planning. Counselors find that one’s career and work are
frequently tied to one’s self-esteem and overall wellness. Job stress and job
dissatisfaction can lead to significant mental health problems, and it is
sometimes difficult to differentiate problems caused by career difficulties
from a person’s overall mental health concerns.
The potential for personal growth.

One of the enduring values in counseling is that human beings are viewed as
being in the process of becoming. We are not finished, and what is unique
about each person should be allowed to flourish and not be bent by “tribal” or
societal pressure (Allport, 1955). We can change, adapt, create, and do more
than we expect. One of the founding divisions of the American Counseling
Association is the Counseling Association for Humanistic Education and
Development (C-AHEAD), now the Association for Humanistic Counseling
(AHC). AHC is the institutional keeper of the flame, but the value of
humanism still remains in the accreditation standards, in the curriculum, and
in the philosophies of professors and practitioners.
The Legacy of Rogers.

Carl Ransom Rogers is probably the most important name in counseling, not
because of his professional leadership but because of his ideas and to a large
extent because of his personal warmth and genuineness. Counseling and
Psychotherapy (1942) was the compilation of his revolutionary concepts and
research on the helping relationship. In 1951, he published his major work,
Client-Centered Therapy, which formed the basis, not just of a theory, but
also of a set of values. His work sparked a humanistic movement among
clinicians. On Becoming a Person (1961) has been cited as one of the most
influential books among counselors and counseling professors (Young &
Feiler, 1994). His idea that the counselor must create the “core conditions” of
genuineness, empathy, and unconditional positive regard has become
institutionalized in counseling. Rogers’ legacy is that counseling is a
profession that values the client and supports the belief that clients have the
inner potential to solve their own difficulties. Helping means implementing
the core conditions and allowing the growth potential within the client to be
released. This position implies the need for a counselor to become a mentally
healthy person. The counselor must be able to be warm, coherent, and
nonjudgmental to participate in the therapeutic relationship. Thus, Rogers’
ideas promoted respect for the capacities of the client and encouraged
counselors to work on themselves.
The Group Therapy Movement and

The Proliferation of Counseling
Theories.
During the late 1960s and the early 1970s, group therapy swept this country
both in the form of therapeutic groups run by clinicians and also
nonprofessionals. On college campuses and in community mental health
centers, hotels, and corporate boardrooms, the country became fascinated
with the power of the group to bring about personal growth. Groups
blossomed at a time in American history when people yearned for a
connection to community, having abandoned small towns and farms for the
suburbs. Many people found their new lives to be sterile and disconnected. A
sense of alienation between individuals and between generations had widened
into a “generation gap” and a felt lack of intimacy in personal relationships.
There were many innovations in group work during this time, and many
abuses too. Marathon group therapy was born, where participants worked for
an extended period of time (usually 24–48 hours) without respite. There were
harmful extremes, including nude group therapy and highly confrontive
group therapy (Yalom, 2005). The enthusiasm for groups waned in the 1980s,
but the American Counseling Association’s Association for Specialists in
Group Work remains a strong division whose members are interested in
therapeutic groups, task groups, and educational uses. Group work is a skill
that every counselor learns and needs not only because of its efficiency and
cost effectiveness, but because of its tremendous ability to produce
therapeutic change.
The prominence of group work in the 1960s and 1970s cannot really be
separated from the creative climate that was also affecting all of the helping
professions. New counseling theories and techniques proliferated during this
period. There was a good deal of rivalry between camps, and there were
frequent debates among the founders and their followers. During this time,
Rogers’ client-centered therapy was pitted against strict behaviorists.
Transactional analysis, rational emotive therapy, gestalt therapy, reality
therapy, and many, many smaller schools of therapy arose. It has been
estimated that by 1980, there were as many as 460 forms of therapy (Corsini,
2001; Herink, 1980; Parloff, 1979). Although this created controversy and
confusion, one result of this proliferation was a reduction in the stigma of
seeking help as well as the strengthening of one of counseling’s key values:
People can change, and counseling helps them grow.
The belief in science.

At the time that progressivist ideas were taking hold in the industrial cities, a
new appreciation was growing for the power of science. Americans came to
believe that science would be the answer to all of our problems, from world
hunger to the common cold. The emergence of mass-produced consumer
goods, inoculation against disease, and technologists like Thomas Edison
were creating a belief that science held the answers. Perhaps to call it a
religion is too strong a word, but the vehemence with which science and
scientific progress were promoted was not less than that of the most fervent
evangelist. People who grew up in the 1950s and 1960s were bombarded by
the dreams and horrors that science would someday make possible, from
atomic energy to flying cars and the three-day work week.
The reliance on scientific findings and the value of data to validate

counseling ideas has been a constant theme in the past and continues to
influence counseling today. However, it is not without controversy. For
example, Carl Rogers posed the question “Persons or Science?” in a
landmark article (1955), pointing out the difficulties of reconciling scientific
rigor and the need to recognize a person’s uniqueness as we try to understand
him or her. In essence, Rogers believed that a person is more than what can
be weighed or measured and that we need to appreciate the person as a
whole.
The Technology of Testing.

Wilhelm Wundt’s laboratory in Germany in 1879 showed that it was possible
to identify individual differences such as reaction time. These were perhaps
the first psychological tests. Thus, Wundt is given credit for putting
psychology on a scientific basis, separating it from philosophy and religion.
Later, in 1890, James McKeen Catell used the term mental tests (see Blocher,
2000). His notion that personality traits could be measured was one of the
most revolutionary psychological ideas of the time. In 1904, Alfred Binet and
his doctoral student, Théodore Simon, began describing and measuring
intelligence. Eventually they developed the first IQ test (Binet & Simon,
1916), which was based on Binet’s paper, “New Methods for the Diagnosis
of the Intellectual Level of Subnormals” (1905). As the title of Binet and
Simon’s article suggests, the purpose of such tests was to identify children
who would not have been appropriate for public school. From its origins,
testing has aimed at classifying individuals using quantitative methods so that
different educational and therapeutic treatments can be applied.
In 1927, E. K. Strong published the Strong Interest Inventory, the first

vocational interest test. Strong’s test was a bold step to move career
assessment to a new scientific plane. Following Strong’s lead, career testing
inventories proliferated. Testing became an industry and a trusted tool of
decision makers beginning in World War I, when American psychologists
developed the Army Alpha and Army Beta tests to classify millions of people
in the service. By the 1920s “applied psychology programs” using testing
were developed in universities around the country. World War II added more
impetus when the need arose to place individuals in appropriate military jobs.
After the war, the GI Bill funded both education and counseling for returning
service people. Career counseling and testing helped veterans enter new jobs.
Today in schools and clinics, testing is used to identify clients who are
depressed and suicidal, who have specific learning disabilities, and who may
be suffering from undiagnosed substance abuse problems. On the career side,
every high school, college, and university uses interests, values, and aptitude
testing to help students make decisions about higher education or
professional fields. As a counselor, you will definitely learn to use the
standard career instruments and probably use online and computer-assisted
career instruments as well.
Although psychologists and school psychologists usually have the most

training in testing, many counselors also possess this background. In many
states, counselors have the right to use psychological tests, providing they
have the requisite training. This remains a contentious issue, and undoubtedly
counselors and psychologists will continue to battle over this right and the
ability to use such terms as psychological test and psychological report.
The era of testing was part of the national enthusiasm for everything that
seemed scientific. By 1955, it became clear that many tests were being
interpreted in a non-scientific way and ethical concerns arose. For example,
I.Q. tests were sometimes given for job advancement. Testing was criticized
for its expense, cultural bias, and its limited clinical usefulness. Much has
been written, for example, about the cultural loading of intelligence tests
(Flanagan, Genshaft, & Harrison, 1997) but less has been said about the fact
that few tests accurately predict behavior. For example, testing cannot yet
reliably predict violence, suicide, or even success in graduate school! Many
argue, however, that even though tests are not yet accurate or cannot predict
the future with specificity, they remain some of the best tools to understand
our clients. Testing can also help us validate a client’s need for help such as
diagnosing traumatic brain injury or attention deficit disorder. Testing can
help educational personnel such as school psychologists identify kids who are
having personal and academic problems and offer them some help. As with
many aspects of the counseling profession, most counselors would argue that
it is not the tests themselves but more how they are (mis)used that causes
problems.
The overemphasis on testing by some members of the profession frequently

clashes with counseling’s main values, namely, the importance of personal
growth, uniqueness of the person, individuality, and autonomy. Counselors
who de-emphasize testing argue that personality and intelligence tests
categorize people and portray them as having a certain measurable potential.
In addition, they argue that tests do not necessarily benefit our clients by
providing them knowledge about themselves. Many people are given tests
(especially children) but never profit from the results, while institutions,
schools, and employers use this information to make decisions about the
person, or in some cases, the school or institution itself. In some ways, it is
like having a credit report that you cannot challenge or amend. The debate
about the uses and misuses of testing will continue as we try to solve the
dilemma posed by two contrasting values: the wish to be scientific and the
need to respect individuality.
Achievement Testing.
One of the most controversial uses of testing has been the trend in education
to use achievement testing to measure the effectiveness of the educational
curriculum (Kohn, 2000). The testing fervor was due to the perception that
student achievement had diminished and that to really improve achievement,
we need to establish a baseline and set quantifiable goals. There is no
national achievement test yet, so every state makes its own selection. Testing
is an expensive, time-consuming operation. The results of testing can
determine whether principals and administrative staff are retained, and in
some states schools receive grades (A, B, C, D, or F) based partially on the
results of the testing. In many school districts, teacher raises are based on
how well students do on tests. At the same time, a grassroots effort of
teachers, parents, and organizations has started a rebellion against this
emphasis on testing. The answer, according to critics, is to return assessment
to the classroom, allowing teachers to utilize individualized measures. This
would minimize the intervention of state and federal intervention into the
assessment of student learning.
How does the testing controversy affect counselors? Frequently school

counselors administer and safeguard the security of state achievement tests.
In many cases, counselors are asked to explain the results to parents and to
the students themselves. Recently, one of our counseling internship students
was asked to hold a “pep rally” to increase student motivation for the test (not
really a job for a professional). Some in the counseling profession have raised
concerns about the emphasis on testing. They argue that the idea of
standardized testing clashes with the values of counseling. If we look at the
developmental guidance movement, counselors generally believe in
maximizing the growth of all students. Testing means that teachers now
“teach to the test,” molding their curriculum around the standards, and they
must therefore be oblivious, to some extent, to children’s individual learning
needs. Children cannot follow their interests or the ideals of educational
experts but must study what legislators believe are the “basics.” More
importantly, we should be concerned about the stress it places on students.
For example, in high stakes testing, students may not pass to the next grade if
they fail the test. About 11% of elementary age children experience severe
physical and/or psychological symptoms related to standardized testing
(Segool, Carlson, Goforth, von der Embse, & Barterian, 2013). In some
states, there is even a protocol for collecting the data when the student vomits
during the test.
Behaviorism.
In 1953, B. F. Skinner, the American behaviorist, published Science and
Human Behavior, his appeal to apply science to human affairs. Skinner had
also published Walden II, a fictional account of what life would be like in a
utopian world governed by psychological science. Skinner, an English major
as an undergraduate, was persuasive in his ability to share his vision of a
scientific community. He suggested that in the future, humans would be
rational, and that we would need to work only a few hours per day. But his
most important predictions involved how we would manage each other. In
essence, we would learn to predict and control human behavior and engineer
society to reward good behavior and eliminate problems through withholding
rewards.
Behaviorism revolutionized psychology because it boldly asked to be

evaluated by the same tools as physical sciences. This idea flew in the face of
traditional methods of psychological inquiry and placed behaviorism in direct
opposition to the clinical science of the Freudian analysts and Rogerian
beliefs. Behaviorists began carefully collecting data and publishing their
results. Since the 1970s behaviorism or cognitive behaviorism has been the
major theoretical basis of most psychologists and most psychology programs.
The appeal of behaviorism is that it is quantitative, that is, behavior is
reduced to numbers and evaluated. Those who believe that therapy research,
in an attempt to be precise, also became too narrowly focused have criticized
this reductionism. It must be said that behaviorism and modern cognitive
behavioral therapy have contributed scores of important techniques and have
challenged counselors to be more systematic in their practice. The behavioral
approach to setting quantifiable goals has helped counselors evaluate client
improvement.
Sputnik and the National Defense

Education Act.
On October 4, 1957, the Soviets launched Sputnik, the first satellite (see
Figure 1.3). Sputnik was only 22 inches in diameter (about the size of a
basketball). It traveled at 18,000 miles per hour, crossing the United States
seven times a day. Although it burned up in the atmosphere 3 months later,
its incessant beeping, picked up by radio, and its visibility in the night sky
frightened the American public and embarrassed the government. America
recognized that it was behind in the space race and number two behind the
Soviets in science. In order to combat the newly perceived communist threat,
a number of initiatives were developed by Congress, including the creation of
the National Aeronautics and Space Administration (NASA). Another was
the National Defense Education Act (NDEA) of 1958, which appropriated
money for loans for teachers to go to graduate school for science, math, and
modern language instruction (like Russian). The section of NDEA that has
had a lasting impact on counseling was Title V, which gave money for
training secondary school counselors and funded guidance and counseling
institutes to train counselors. These counselors could then identify
academically talented students and encourage them to attend college to
pursue careers in math and science. Schoolteachers and counselors were
given stipends to attend university institutes that trained them in the
technology of helping. Some of the training lasted as long as a year or went
on for several summers, leading to a master’s degree. Over time, the
universities developed a complete curriculum, and by the 1960s counseling
had gained an institutional foothold, with dozens of new “guidance and
counseling” departments growing in colleges of education.
Figure 1.3 Sputnik

One of the authors (Mark) under a replica of Sputnik, the small
round silver object hanging from the ceiling of the Smithsonian Air
and Space Museum in Washington, D.C. In this photo, it is easy to
see how small Sputnik was (less than two feet in diameter). In spite
of its small size, the first artificial satellite to orbit the earth had a
large influence, including a significant boost to the profession of
counseling. (In an interesting coincidence, Sputnik mostly burned
up when it re-entered earth’s orbit, except for the piece that landed
in the middle of 8th Street and embedded itself into the pavement—
in the other author’s (Darcy) hometown of Manitowoc, Wisconsin!)
The influence of health, human
development, and biology: Is
biology destiny?
The idea that biology and psychology are intimately linked has a long history
in the helping professions. Many of the clinicians who made important
contributions to modern-day counseling began as physicians. The “big three”
of the psychoanalytic approach, Sigmund Freud, Alfred Adler, and Carl Jung,
were all trained as physicians and saw their work as the first scientific
approach to mental healing. All three showed sustained interest in the
interaction between the body and the mind. Freud once said that biology is
destiny, suggesting that we are inevitably affected by our physical makeup
and the changes our bodies go through over time. Freud began his serious
work in psychiatry treating what we now call conversion disorder.
Conversion disorder is the psychologically caused loss or change of a
physical function, suggestive of a physical disorder. For example, Freud
treated “hysterical blindness,” as it was called in those days. The affected
client reports being unable to see, but there is no physical cause for the
disability. Many of Freud’s original clients showed these kinds of symptoms,
but today such cases are rare. Freud’s theories about how the mind functions
are in part based on his training as a neurologist. His discovery that physical
illness can be caused or exacerbated by psychological problems is still with
us.
Biological Treatments.
Biological treatments have been tried for mental disorders, including
hydrotherapy (baths), insulin shock, and—the most infamous—
electroconvulsive or shock therapy (ECT). Today electroshock therapy
remains, and its use is confined to treating severe depression when the client
fails to respond to medication or cannot tolerate medication, or has severe
mania or agitated dementia. According to the National Institute of Mental
Health (2016), a number of other “brain stimulation” treatments are in
development.
By far the most prevalent biological treatment is medication. All mental

health professions have been deeply affected by advances in pharmaceuticals
for severe mental disorders. For example, few clients with schizophrenia
were significantly helped by “talk therapies” alone. With the introduction of
antipsychotic medications in the 1950s, clients with schizophrenia were able
to lead more normal lives with more freedom from confinement. This led to
the conclusion that most (if not all) mental disorders can be cured with
medications, and today, psychotropic medication is a major industry.
However, these drugs did not come without a physical price tag. Until the
1990s many antipsychotic drugs led to irreversible neurological damage and
had a beneficial effect on hallucinations (sensory experiences that a person
perceives as real) and delusions (fixed false beliefs about reality), but
frequently did nothing to help other symptoms of schizophrenia. Modern
medications have fewer side effects and eliminate more symptoms, but all
have considerable medical consequences (Muench & Hamer, 2010).
Since the 1980s new antidepressant medications have also been available.
Although these drugs may be considered important agents in the treatment of
severe and chronic depression, many clinicians worry that, due to advertising
by drug companies, the medications are overprescribed and overused by
people who have the normal “blues.” Prescription of antidepressant
medication has increased rapidly, and rates of adult use of antidepressants
tripled between 1994 and 2000. Between 1999 and 2012, antidepressant use
has increased from 6.8% of U.S. adults to 13% (Kantor, Rehm, Haas, Chan,
& Giovannucci, 2015).
One of the most frequently prescribed psychotropic drugs is Ritalin.

Although some alternatives are now available, Ritalin continues to be used to
treat attention deficit disorder and hyperactivity in children on a grand scale
(Greenhill & Osman, 2000). The United States now utilizes 90% of the
Ritalin produced in the world. Although it can significantly help many
children with attention problems, there are medical risks, and many mental
health professionals feel that it is prescribed more often than necessary and
for misbehavior rather than attention deficit disorder. Counselors in schools
are alarmed at the growing rate of prescription drugs given to children—even
preschoolers (Kalb, 2000).
In short, counselors work with clients who are taking medication, and so they
must be informed about the effects of these drugs. Counselors find
themselves in dilemmas at times because they want their clients to receive
proper dosages, be prudent consumers, and receive the best treatments
available. Yet they cannot advise their clients to discontinue a medication,
take a higher or lower dose, or disparage a physician’s treatment. Instead,
counselors often find that they can be helpful by teaching clients skills to
work with their doctors to make sure their medication is managed properly.
The Mental Health Movement.

At the same time Frank Parsons was establishing the Vocation Bureau,
Clifford W. Beers (1876–1943) was founding a movement to help mental
patients. Beers suffered a bout of manic depression illness, what we would
now call bipolar disorder. He survived a suicide attempt and was hospitalized
for three years. Following his recovery, he wrote his famous (and horrifying)
book, A Mind That Found Itself (1908). In his book, he describes how he
planned to die by suicide and his delusion that his brother was a spy. The
main aim of the book, however, was to expose the cruel and brutal treatment
that often existed within asylums. This book was so influential that it created
a national outcry for more humane treatment of mental patients. Beers went
on to organize the National Association for Mental Health (now Mental
Health America) to advocate for clients. He traveled widely and spread his
message abroad. Originally, the idea was called the “mental hygiene
movement,” a name suggested by the psychiatrist Adolf Meyer, presumably
to add a medical connotation. Using a biological/medical approach evoked
sympathy for the sufferers and decriminalized those with mental disorders.
The term mentally ill became widespread, although today the term person
with mental illness is preferred (Granello & Gibbs, 2016)
Beers and Meyer originated many of the modern ideas of agency work,
including outreach and prevention. The establishment of the National
Institute of Mental Health and the community mental health center approach
to care were built on Beers’ initial work. There are many organizations
(including those of the mental health professions) that advocate for persons
with mental health problems. Two of these national mental health advocacy
organizations are examples of the modern-day influence of the work of Beers
and Meyer. These organizations are the subject of the accompanying
Spotlight on Social Justice.
SPOTLIGHT Social Justice and

Advocacy for those with Mental
Illnesses
Mental Health America is the present-day organization that continues
Clifford Beers’ advocacy work. It has been instrumental in lobbying and
doing educational work for clients of mental health services. MHA is the
country’s oldest and largest nonprofit organization, addressing all aspects of
mental health and mental illness. With more than 340 affiliates nationwide,
MHA works to improve the mental health of all Americans, especially the 54
million individuals living with mental disorders. MHA engages in policy
work, advocacy, education, research, and service. They provide screening for
mental disorders and support for individuals and families. For more
information, see the MHA website: http://www.mentalhealthamerica.net
A second mental health advocacy organization is the National Alliance on

Mental Illness (NAMI), which is a nonprofit grassroots, self-help, support,
and advocacy organization dedicated to improving the lives of people living
with mental illness. With more than 220,000 members, NAMI is the largest
organization of its type. NAMI provides help for families and veterans, and
education for therapists. They provide an excellent handout called “Finding
Mental Health Care that Fits Your Cultural Background.” For more
information, see the NAMI website (www.nami.org) and NAMI’s Facebook
page.
Before 1960, most mental health treatment was provided to patients in

hospitals or private or state asylums. It is estimated that one of every two
hospital beds in the country was for mental patients. The development of
antipsychotic and antidepressant medication emptied hospitals of clients
diagnosed with schizophrenia and depression, the two largest diagnostic
categories. But it soon became evident that medication alone would not be
enough. Deinstitutionalization (moving patients out of large institutional
facilities such as state hospitals) required community support to make it
permanent. Under the Kennedy administration, the Community Mental
Health Center Act was conceived and finally passed in 1963. Communities
received funding through grants, and patients with mental disabilities became
eligible for benefits from Medicare, Medicaid, and Social Security. Every
community or “catchment area” was eligible to have a community mental
health center (CMHC) providing inpatient, outpatient, education and
consultation, partial hospitalization, and emergency services. At the same
time, counseling programs were creating graduate degree programs in mental
health counseling to meet the needs of the CMHCs. This new group of
counselors with mental health training and experience began to develop a
professional organization and vie for licensure.
Throughout the 1970s and 1980s, deinstitutionalization continued at a rapid

pace along with legal precedents allowing patients with mental disorders to
refuse treatment if they were not dangerous to themselves or others. In 1981,
the Omnibus Budget Reconciliation Act under the Reagan Administration
reduced funding for mental health services by 25%. In addition, money was
shifted away from prevention and outpatient services for the community as a
whole and was focused almost entirely on the treatment of people with severe
mental disabilities. The economic downturn of the 1980s,
deinstitutionalization, and decreased funding for community mental health
centers resulted in significant increases in homelessness among people with
mental illnesses. It is estimated that 20–25% of the homeless population
suffer from a severe mental disorder, a startling number that does not even
include those with substance abuse disorders, which probably would claim
another 25–30% (National Coalition for the Homeless, 2016). The federal
funding decline and shift in priorities means that community mental health
centers in most states have changed from a comprehensive education,
counseling, and prevention resource to an emergency hospitalization facility
and partial hospitalization program. Consumers of counseling services, or
their insurance companies if they have comprehensive mental health
insurance, must pay a high price for counseling offered by private
practitioners or community agencies.
The Importance of Human

Development.
Human beings go through physical, sexual, emotional, moral, spiritual,
social, and psychological changes throughout life. Stage theories have been
developed in each of these areas of human functioning to organize our
knowledge about what is happening. As you study human development more
deeply, you will find stage theories proposed by Freud (psychosexual),
Erikson (1950) (psychosocial), Piaget (1964) (cognitive), Kohlberg (1975)
(moral), Fowler (1995) (religious faith), Perry (1970) (cognitive complexity,
intellect and ethics), Loevinger (1987) (the ego), and many others. Most stage
models propose that like steps on a ladder, conquering each stage is a
prerequisite for taking the next leap. In other words, the stages are sequential
and cannot be skipped.
One of the first psychological stage theories was Sigmund Freud’s

controversial claim that children move through stages of psychosexual
development called the oral, anal, latency, phallic, and genital as they
physically mature. These stages were thought to be associated with
psychological changes and became the basis for predicting psychopathology.
For example, if a child was fixated at the oral stage, difficulties might
manifest as oral issues, such as drinking or eating disorders later in life.
Jean Piaget was a biologist who proposed a cognitive developmental model

based on physical maturation. Prior to his observations of children (including
his own offspring), Piaget worked primarily with mollusks. He held a
doctorate in natural history. He studied briefly with Carl Jung and began
working on intelligence testing at the Sorbonne. His human studies led to one
of the most persuasive models of how the human mind develops, the stage
model of cognitive development, which he began writing about in the
1920s. His model was most influential during the 1950s and 1960s. The
theory suggests that individuals move through four major stages of cognitive
development as they physically mature. These stages are sensorimotor,
preoperations, concrete operations, and formal operations. Piaget’s work has
been carefully studied, and it is safe to say that his ideas of human cognitive
development are good descriptions in “broad strokes,” but the exact
sequences and stages are not as tidy as we first guessed. For example, it has
been found that young infants have much more ability than Piaget suspected
(Baillargeon, 1992). Many notions about the steplike nature of these stages
have failed to hold water and have been criticized as sexist, culturally
inappropriate, and unsupported by data (Gilligan, 1982). Despite these
significant limitations, it must be recognized that Piaget’s developmental
ideas and extensions of his ideas had tremendous influence on education,
psychology, and counseling because we began to recognize that different
kinds of interventions are appropriate for different developmental stages.
One of the champions of the developmental emphasis in counseling was

Vanderbilt’s Roger F. Aubrey who believed that counseling’s identity crisis
could be solved by adopting a “unique perspective, a developmental
perspective” (1983, p. 81). By this he meant that counselors should focus on
the personal and social development of their clients and adapt counseling
methods to the developmental level of the client. We should treat children,
adolescents, and adults as discrete stages of life. In addition, he endorsed
embracing the social context—advocacy and social engagement instead of a
strictly intra-psychic, cognitive, or psychological approach. The emphasis on
developmental issues was a stage in counseling’s quest for a unique
perspective.
Other writers who promoted a developmental approach included Robert

Myrick (1989) and Norm Gysbers (see Gysbers & Henderson, 2012). They
used the term “developmental guidance” to describe this approach when
applied in the school systems. A developmental guidance approach in schools
is generally more preventive and educational than problem oriented, meaning
that school counselors spend less time on crises and more on teaching skills
through group guidance and improvement of the school climate. In a
developmental guidance program, the counselor is trying to influence the
development of all the children using knowledge of developmental,
educational, and preventive mental health principles (Gysbers & Henderson,
2012). So, for example, an elementary school counselor knows what the
typical social issues of sixth graders are and can develop a whole-grade
intervention to prevent the formation of unhealthy cliques.
The concept of development and the influence of stage theories have been
powerful in the counseling profession, much more so than in other mental
health professions. For example, in the 1990s our counseling organization
changed its name from the American Personnel and Guidance Association to
the Association for Counseling and Development, and our flagship journal
remains the Journal of Counseling and Development. In addition, among the
core standards for accrediting counseling programs, Human Growth and
Development is the first content area. There are two main reasons for its
prominence. First, counselors generally have a psychological growth
philosophy that is compatible (though not identical) with the notion of
physical growth. They see human beings as moving in a positive direction
and like the idea that a counselor is someone who helps clients through the
normal hurdles that each life stage produces. Second, counselors have always
struggled with how to treat people of differing ages and are attracted by a
comprehensive structure that will make sense of the vast differences in clients
at different ages. Many school counselors work primarily with children, and
college counselors work mostly with a very restricted age range. Counselors
frequently find that methods that work with adults fail miserably with first
graders or college sophomores because of differences in all areas of
development and because the environmental issues they are dealing with are
quite different. For example, eighth graders are dealing with complex social
situations, college students are trying to separate from parents and form
romantic relationships, and older adults are dealing with declining health and
isolation. Advocates of stage theories suggest that if we understand the
normal stages of physical and psychological development, we can utilize
stage-appropriate methods for helping the client move to the next step.
Stress and Wellness.

In the 1960s, the word stress entered the American vocabulary. The work of
Hans Selye (1974) awakened many in the medical and psychological field to
the dire consequences of psychological stress on many human illnesses
including heart disease, headaches, gastrointestinal disorders, and a wide
variety of other illnesses. It was found that coping techniques significantly
influenced the impact of negative life events on physiology (Folkman &
Lazarus, 1980). This finding led to the conclusion that people might lead
healthier lives if they could learn better coping techniques for living in a
stressful world.
One of the results of the renewed interest in the mind-body connection was a
flood of “stress workshops” given by professional and lay people during the
1970s and 1980s (Tubesing, 1981). In the field of psychology, a new term,
health psychology, was being utilized, and an American Psychological
Association Division by the same name was formed along with a related
journal. Psychology began to study coping and the benefits of psychotherapy
for health problems.
In the late 1970s, counseling began to focus on the word wellness. Wellness
is defined as “the whole person approach for improving the quality of life in
proactive and positive ways” (Witmer, 1985, p. 45). The term recognizes that
an individual’s outlook and self-care skills are an important part of health and
that physicians need to recognize and activate these healing forces (Travis,
1981). Since then, counselors have utilized holistic methods with their
clients, including encouraging good diet, exercise, stress reduction,
meditation, and other measures (Shannonhouse et al., 2014). In addition,
counselors have recognized that counselors need to constantly be aware of
their own wellness needs when facing the strains associated with the
counseling profession (Smith & Koltz, 2015).
A special issue of the Journal of Counseling and Development edited by

Myers, Emmerling, and Leafgren (1992) was apparently the high-water mark
for the wellness movement in counseling. It was suggested that this should
become the training paradigm for counseling that the developmental model
failed to provide (Myers, 1992; Witmer & Sweeney, 1992; Witmer & Young,
1996). The bold notion that counselors are wellness professionals aimed at
enhancing physical, mental, and emotional wellness across the lifespan never
became an organizing force for the profession. Some counseling programs
have courses in wellness that promote a holistic approach by exploring
physical, mental, and spiritual methods and techniques. The term wellness is
used in community health prevention facilities and in university campus
“wellness centers” that help students learn coping skills and preventive
strategies in a nonclinical environment. Despite the fact that wellness has not
become the overall paradigm for counseling, like “development,” “wellness”
continues to exert its influence in writing, research, and conference
presentations in counseling. Some are concerned that with the advent of new
health insurance legislation and the growing recognition of the interplay
between physical and psychological problems, counselors are not being
sufficiently trained in biological bases of behavior. They argue that a
wellness approach provides a paradigm for the integration of biology and
counseling. For example, in an article by Barden, Conley, and Young (2015),
the authors contend that counselors daily face clients suffering from eating
disorders, obesity, traumatic brain injury, and depression following cardiac
surgery, for example. Thus, counselors should become part of the healthcare
professions and prepare themselves for a future where the health, wellness,
and mental health of the client must be treated simultaneously.
Fast Fact
According to the National Ambulatory Medical Care Survey, between 60–
80% of office visits to family doctors are prompted by stress-related
symptoms.
Source: Avey, H., Matheny, K. B., Robbins, A., & Jacobson, T. A. (2003).
Health care providers’ training, perceptions, and practices regarding stress
and health outcomes. Journal of National Medical Association, 95(9), 836–
845.
The Affordable Care Act (ObamaCare) decreased the number of uninsured

Americans by almost 13 million from 2013 to 2016, and many of the newly
insured received mental health coverage for the first time when the law was
enacted. Nevertheless, nearly 29 million remained uninsured in 2016. Most of
the uninsured are members of low-income families (Kaiser Family
Foundation, 2016). Clearly, the role of insurance coverage remains an
important one for the field of counseling, particularly as it relates to mental
health care.
Brief History of the American
Counseling Association
The purpose of this final section of the chapter is to acquaint you with a few
facts about the origins of the counseling organization, the American
Counseling Association (ACA). Later on, in Chapter 3, we will take you
through its current aims and functions as well as its divisions. Here you can
see how the organization changed as a result of theoretical and social trends.
One fact that stands out is that its beginnings were in public schools and
especially in career education.
In 1910, the meeting of the National Society for the Promotion of Industrial
Education (NSPIE) was attended by Jane Addams, G. Stanley Hall, and Jesse
B. Davis and was hosted by Meyer Bloomfield, Frank Parsons’ successor at
the Vocation Bureau. The meeting invigorated this group of progressivists,
but some were more interested in political change than in changing
education. It was Jessie B. Davis, high school teacher and counseling pioneer,
who helped to found a breakaway organization at the NSPIE’s Grand Rapids
Conference in 1913. It was called the National Vocational Guidance
Association (NVGA), the forerunner of the American Counseling
Association. Rather than foster social change, the NVGA was a group of
practitioners who wanted to develop a profession (Blocher, 2000).
Over the years, the organization and its major journal have changed names
and focus several times. Until 1952, the organization’s focus was clearly on
vocational guidance. In 1952, the American College Personnel Association
(ACPA) merged with the NVGA. ACPA was an organization that
represented student life workers and administrators at colleges and
universities. The merger brought about the name change to the American
Personnel and Guidance Association (APGA). This compromise set of letters
was later discarded when ACPA disaffiliated in the early 1980s. At about the
same time, the American Mental Health Counselors joined APGA, creating a
new clinical division. One of the key events that triggered the change was the
first licensure law in Virginia in 1976. For the first time, counselors received
state licensure, allowing their members to conduct private practice and vie for
insurance dollars. The complexion of the organization changed with two
groups dominating, mental health counselors and school counselors.
In the early 1980s it was clear that counseling, not guidance, was the chosen
identity of the profession, but the organization was not ready to give up its
developmental roots. Another compromise name was accepted, and in 1983,
the organization temporarily became the American Association for
Counseling and Development. In 1992, the name was simplified to the
American Counseling Association. The name changes are important not
simply because they portray changes in thinking but because they also show
the diversity of the profession. The name changes emphasize that counseling
in its early years searched for a clear professional identity. They also reveal
some of the major values of the organization: the importance of career
guidance and a view of the individual as a developing entity.
SPOTLIGHT The American

Counseling Association Annual
Convention
Every year, the American Counseling Association (ACA) hosts an annual
conference and expo in a major city in North America. Counselors from
around the country and from many foreign nations come together to learn and
mingle. Visit the ACA website, www.counseling.org/conference, to get a
schedule of this year’s program. You can expect the following main events:
Keynote Speakers. Keynote sessions occur during the first two days of
the core conference. They are inspiring talks by important thinkers or
public figures.
Pre-Conference Learning Institutes. Full-day and half-day workshops by

noted experts in the field that take place before the core conference
begins. Some institutes are for those who are just beginning to explore a
topic, whereas others are more advanced.
Division Meetings. ACA’s 20 divisions represent counseling specialties
such as group work, counselor education and supervision, assessment,
and so on. Most groups hold board meetings and luncheons and give
national awards at the conference.
Exposition. Book publishers from all the major houses (including ACA)
display and sell titles, videos, and CDs at the conference. Testing
companies demonstrate the latest technology for administration. You
also find school counseling curriculum materials and play therapy
equipment.
30-Minute Project/Research Poster Sessions. These sessions present

research findings or innovative counseling methods. The format is
interactive with many people stopping for only a few minutes in a
session to get a handout while others can linger and go into more depth.
60-Minute Roundtable Sessions. These interactive, face-to-face sessions

provide a unique forum for presenters to share and discuss their work
and ideas related to research, programs, and practice applications.
90-Minute and 3-Hour Sessions. These sessions go into greater depth.

The following list is a sample of the workshop titles from a recent ACA
annual convention, and you can see the diversity of interests
represented:
“The Schoolyard Bully: Mean Kid or Victim Too?”
“Creating Employment Opportunities for First-Time Offenders”
“Gestalt Dreamwork in Group Counseling”
“Self-Injurious Behavior: Diagnosis, Assessment, and Intervention”
“Doctoral Written Exam Replaced with Portfolio Assessment”
“Dual Relationships in Academia”
“Attitudes toward Wheelchair Users”

“Hepatitis C and Substance Abuse”
“Family Counseling in School Settings: Measuring Outcomes”
“Facilitating Spiritual Wellness with Gay, Lesbian, and Bisexual

Clients”
Opening Night Celebration. ACA conferences always include one grand

get-together at the beginning of the conference.
Ancillary Receptions. Universities hold hotel-room receptions for their

alumni, and ACA divisions provide networking opportunities at hotel
salon gatherings.
Counseling Career Center. An opportunity to meet employers and

possibly be interviewed for a position.
What to Do at the Convention:
Volunteer. Students can volunteer to work for 12 hours and receive a

discounted registration fee. Sometimes this means clerical work, or you
might monitor education sessions, meet the presenter, and have a chance
to listen to workshops.
Browse the Exposition Exhibits. Take at least four hours to discover the
newest publications and technology.
Schmooze. Talk with presenters and attend division receptions and

parties. Some of the most interesting networking occurs when you are
on a shuttle bus, loitering in a lobby, or munching at a buffet table. The
value of the convention is making contact with other counselors. ACA
usually hosts a lounge for graduate students, where you can learn about
special events and meet other students.
Attend a First-Timers Orientation. Because the convention is vast, this

orientation can get you started in the right direction.
Go to Education Sessions. Go through the convention program and

circle the “must see” education sessions, keynote talks, and ancillary
meetings. Make a schedule for yourself. It is easy to get swept away
when so much is happening.
Go to Preconference Institutes. Here you can explore a topic in depth

and learn practical skills for a few hours or a day.
Summary
In this chapter, you learned about the historical roots of the counseling
profession. Rather than proceed in a linear fashion, we presented four major
ideas and discussed how these interrelated concepts have shaped the
counseling profession today. You learned that counselors share some
common values, including the belief in equality, a passion for client
advocacy, and an understanding that all human beings have great potential
for personal growth and development. You read about the importance of
science and the influence of health and biology to the counseling profession,
and how these values sometimes clash with the humanistic beliefs that are at
the core of the counseling profession. The overarching message in the story
of counseling, however, is one of change, growth, and dynamism. Counseling
continues to evolve and change as the profession evolves and steps up to
meet the ever-changing needs of society. Changes in technology, the
economy, health care, politics, education, cultural diversity, and the social
climate all will continue to influence the story of the counseling profession.
This chapter also highlighted the five major helping professions: counseling,
social work, marriage and family therapy, psychology, and psychiatry. The
story of counseling has been shaped by the identities of the other major
professions, and counselors today understand that they must find ways to be
collaborative with professionals with different training in order to best serve
the needs of their clients. Finally, this chapter introduced you to the layout of
this text and the premise that becoming a reflective practitioner will help you
develop a mindset that will be useful not just in reading this text, but in your
journey toward becoming a professional counselor.
End-of-Chapter Activities
The following activities might be part of your assignments for a class.
Whether they are required or not, we suggest that you complete them as a
way of reflecting on your new learning, arguing with new ideas in writing,
and thinking about questions you may want to pose in class.
Student Activities
1. Reflect. Now it’s time to think about the major topics that we have
covered in Chapter 1. Look back at the sections or the ideas you have
underlined. What stands out for you? What do you want to remember?
2. Take a look at the timeline in Figure 1.2. It gives a brief review of the
world events, highlights of the professional organizations, and new
discoveries and theories in the world of counseling. What particularly
interested or surprised you? What, if anything, did you find disturbing?
3. The four key values issues in this chapter were (1) equality, advocacy,
and career; (2) the importance of science; (3) biology, health, and
development; and (4) the potential for personal growth. Are there other
important values in counseling that you noticed? Any other reflections
or ideas that you want to get in writing so that you don’t forget them?
Journal Question
1.
Frank Parsons (1909, p. 5) was earlier quoted as saying that a good choice of
career involves: “(1) a clear understanding of yourself, your aptitudes,
abilities, interests, ambitions, resources, limitations, and their causes; (2) a
knowledge of the requirements and conditions of success, advantages and
disadvantages, compensation, opportunities, and prospects in different lines
of work; (3) true reasoning on the relations of these two groups of facts.”
As you look at the first two parts of Parson’s statement, what additional
knowledge do you need in each of these to make a good career choice?
Topics for Discussion
1. In this chapter, the authors try to justify the study of history by saying
that professional identity involves understanding the basic values of the
profession and that those values are revealed in its history. Do you
agree? Are there any other reasons to study history?
2. The reformist attitude is still alive in counseling today. Counselors are

trying to cure society’s ills by changing institutions and through client
advocacy. The American Counseling Association’s Counselors for
Social Justice division is an example of the fact that such sentiments are
still alive. Some writers believe that counselors must be activists to
really make changes in the forces that are creating mental health
problems and obstacles to optimal functioning. Do you think it is the
counselor’s job to take social action or is it sufficient to help individuals,
couples, and families lead happier, more productive lives? Reflect on the
standardized tests that you have taken in high school or college, perhaps
to get into college or graduate school or for career planning and
placement. Has a significant goal in your life hinged on your test
performance? For most students, a licensure test is in your future. How
will the results of that assessment affect your ability to become a
professional counselor?
Experiments
1. Look at some university websites or catalogs and compare social work,
counseling, and psychology master’s programs. Do you notice a
difference in emphasis on testing, administration, and practicum
experiences? Is a thesis required? What do you think is unique about the
training of each program?
2. Attend a state or national counseling conference. Students get very low

rates on conferences and on membership dues of professional
organizations. During the conference consider whether the ideas and the
topics presented pique your interest. Does this organization fit you?
Explore More
If you are interested in exploring more about the ideas presented in this
chapter, we recommend the following books and articles.
Books
Kaplan, B. (1964). The inner world of mental illness. New York, NY:
Harper & Row.
This is a collection of first-hand experiences by people with mental

disorders including Clifford Beers, Tolstoy, Saint Augustine,
Sartre, and many others.
Locke, D. C., Myers, J. E., & Herr, E. L. (Eds.) (2001). The handbook of
counseling (pp. 3–26). Thousand Oaks, CA: Sage.
This book includes Tom Sweeney’s history of counseling, which

helps link philosophy, history, and the idea of professional identity.
Rogers, C. R. (1961). On becoming a person. Boston, MA: Houghton

Mifflin.
Rogers’ manifesto for the client-centered (now person-centered)

movement in counseling explains the humanistic theory in
layperson’s terms.
Sweeney, T. J. (2001). Counseling: Historical origins and philosophical

roots. In J. D. West, C. J. Osborn, & D. L. Bubenzer (Eds.), Leaders and
legacies: Contributions to the counseling profession. New York, NY:
Brunner Routledge.
This is a series of biographies of key historical figures and current

leaders written by their peers. The editors use these biographies as
a springboard to discuss the notion of professional identity.
Chapter 2 What Do Counselors Do?
Questions
The many different roles that counselors can assume in their work.
How counselors in different practice settings take on different work

roles, and how a counselor’s personal, professional, and organizational
circumstances can affect their work life.
How social justice advocacy plays a key role for most counselors,
regardless of their practice setting.
Describe some of the most common counselor roles.
Determine which counseling roles are most appealing to you, at this

stage of your counselor development.
Complete a pie chart of the different counseling roles for your ideal
counseling job.
What image comes to your mind when you think about counselors? How
has this image been affected by the media? Your exploration of the
profession? Your own personal experiences of counseling? Do you think
your image is an accurate one?
What do you think counselors do on a day-to-day basis? How do they

spend their time? What components of the job do you think you would
like? Find stressful?
How will you decide what counselor roles are a good fit for you?
b. the multiple professional roles and functions of counselors across

specialty areas, and their relationships with human service and
integrated behavioral health care systems, including interagency
and interorganizational collaboration and consultation
c. counselors’ roles and responsibilities as members of

interdisciplinary community outreach and emergency management
response teams
d. the role and process of the professional counselor advocating on

behalf of the profession
e. advocacy processes needed to address institutional and social

barriers that impede access, equity, and success for clients
m. the role of counseling supervision in the profession

If you stop and think for a moment, you probably already have some ideas
about what counselors do. You undoubtedly were drawn to the profession
because you had an image of what counseling looks like, how people are
helped by counseling, and how you might fit into this process. You may even
want to close your eyes for a moment and engage in a bit of visualization.
What do you imagine the job is like? Can you picture yourself in the role of a
counselor? Take a moment and imagine yourself at the end of your graduate
training, the day after you graduate or receive your license. What are you
doing? What does it look like?
A picture may come immediately to your mind. Where did that picture come
from? Do you have images from television or the movies about what a
“typical” counseling session looks like? Are your pictures influenced by your
own experience in counseling? Or that of your friends or family members?
Did you imagine a client lying on a couch telling you about his past? Or a
teary-eyed child in your office, confiding in you? Did you see yourself out in
the community? Did you picture yourself actively solving problems, or do
you imagine yourself to be more quiet and reflective?
Perhaps you are having difficulty envisioning what a “typical” counselor

does or how or where you will fit into the role of the counselor. That’s not
unusual. Our images of counseling can be distorted by many factors. For
example, a quick search of YouTube finds hundreds of thousands of “hits”
for the words “counseling” or “counselor.” Yet very few of these videos give
an accurate representation of the world of the professional counselor.
The point is that there are many different images of counseling, and we all
come to the profession of counseling with our own preconceived ideas of
what counselors do. Some images are accurate, but others will require some
alteration and refinement over the course of your training. Whatever your
images of counseling, they have helped provide you with the motivation to
embark upon this career path.
Part of the difficulty many people have in developing a mental picture of

counseling may be related to the extremely large diversity of jobs, settings,
clients, and responsibilities within the counseling profession. To be sure,
some of the confusion comes from the word itself. Counseling is a generic
term that is used when two people work together to solve a problem. It is for
this reason that we see job titles like “financial counselor,” “camp counselor,”
“real estate counselor,” or even, as one of us recently experienced when
remodeling a house, “vinyl siding counselor.” Even in the context of mental
health, however, there is great diversity in where counselors work and what
they do.
In this chapter, we will discuss what counselors do by talking about the many
different roles that counselors take on. We will highlight some of the most
common roles, with the understanding that there are many more roles and
functions than we can possibly include here.
In Chapter 1, we discussed some of the ways that the role of the counselor
compares with that of other helping professionals. The emphasis was on the
differences in roles and functions between the helping professions. In this
chapter, youYou also will learn about the great diversity of roles within the
profession of counseling. What counselors do depends in great part upon
what roles they assume, and within the field of counseling, there are many,
many options.
Table 2.1 on pages 42–43 lists 20 different roles that counselors can engage
in, and it is a good place to begin the discussion of counselor roles. Clearly,
not all counselors engage in all of these roles, and not all counselors are
trained or qualified for every role. Additionally, there are other roles and
functions that counselors in highly specialized settings may perform, but the
chart will give you a general idea to get you started. As you read through the
list, you may wish to indicate which roles are particularly appealing to you
and which ones you are less enthusiastic about. You also may encounter
some roles that surprise or intrigue you, or which you know very little about.
Indicate this as well. This process of clarification may help you in your own
search for a personal sense of professional identity.
Table 2.1 The Many Roles of

the Counselor
My Level of
Interest in This
Counselor Role (Indicate
Major Responsibilities response, and
Role
jot down notes
to help clarify
your interests)

Counselor as Conducting individual or family A B
Therapist counseling; career counseling C !! ?
Comments:

Coordinating and running A B
Counselor as
psychoeducational or therapeutic C !! ?
Group Leader
groups
Comments:
Program planning; conducting

Counselor as
guidance lessons in K–12
K–12 A B
classrooms or through small
Guidance C !! ?
group guidance activities;
Curriculum
educating parents, conducting Comments:
Expert
teacher inservices

Counselor as Making appropriate mental A B
Diagnostician health diagnoses for clients C !! ?
Comments:
Assessing client strengths and

Counselor as weaknesses, personality traits, A B
Counselor as weaknesses, personality traits, A B
Assessor interests, etc., sometimes through C !! ?
the use of formalized instruments
Comments:
Working with other mental health

Counselor as
or educational professionals on A B
Consultant
specific clients, cases, or groups C !! ?
Scheduling clients, students, or

Counselor as projects; designing and

Administrator scheduling counseling programs;
A B
or Program organizing office responsibilities;
C !! ?
Planner managing and/or supervising
(nonclinical) staff
Completing paperwork,
scheduling, and billing; assisting
clients with functions of daily
Counselor as
living, including navigating
Documenter or A B
social services (e.g., housing,
Record Keeper C !! ?
food stamps) as well as ongoing
management of chronic mental
illnesses
Conducting research on
Counselor as counseling or program
Researcher or effectiveness; surveying clients, A B
Scientist families, parents about C !! ?
counseling programs
Keeping up-to-date with the

Counselor as
field, attending workshops, A B
Learner
classes, reading journals, etc. C !! ?
Teaching others within the

Counselor as context of a formalized
Educator or educational institution, through A B
Trainer workshops or writing, or other C !! ?
Trainer workshops or writing, or other C !! ?
venues
Counselor as Supervising counselors in

Supervisor or training, or being supervised by A B
Supervisee more advanced practitioners C !! ?
Stepping in to assist individuals

Counselor as
to cope during periods of
Crisis A B
individual or widespread crises
Interventionist C !! ?
and disasters
Assisting students and clients

Counselor as
with academic and/or career A B
Advisor
decisions C !! ?
Interacting with the legal system

Counselor as
to provide testimony on behalf of A B
Expert Witness
clients, agencies, etc. C !! ?
Working with individuals to

promote wellness and prevention;
Counselor as
working with systems (e.g.,
Prevention A B
schools, employers, public
specialist C !! ?
agencies) to promote wellness
and prevention
Setting up and maintaining a
private practice, developing
Counselor as
products or services for
Businessperson
commercial sale, obtaining A B
oder
funding for projects or social C !! ?
Entrepreneur
services agencies, writing grants
to provide services
Counselor as Assisting parties in a dispute to

Counselor as Assisting parties in a dispute to
Mediator find an amenable solution A B
C !! ?
Advocating for clients, for the

Counselor as profession, or for broader

Advocate or concerns (e.g., mental health,
A B
Agent of anti-stigma); working for systems
C !! ?
Social Change change, widespread political
and/or social activism
Participating in associations and
Counselor as
organizations that promote
Member of
professionalism and a sense of A B
Professional
professional identity within the C !! ?
Associations
profession
A = I am very interested in this role.
B = I am not sure if this would be a good fit for me.
C = I don’t believe that this would be a good fit for me.
!! = This role surprises or intrigues me. I want to learn more.
? = I don’t know enough about this role to have an opinion.
As you pay attention to the many roles of the counselor, notice that there are
some roles that you will not see in this chart. For example, you will not see
“Counselor as Disciplinarian,” a role that school counselors may sometimes
be asked to play. We argue that this is never an appropriate role for a school
counselor. School counselors are consultants, mediators, and advocates for
students. They are not disciplinarians and do not possess the proper
credentials for disciplining students. More importantly, stepping into the
punitive role undermines the school counselor’s credibility as a person a
student can go to for help. The American School Counselor Association
(ASCA, 2013) has developed a position paper on the issue. ASCA states that
school counselors can best make use of their education and experience not by
punishing students, but by helping them understand the consequences of their
behaviors and participating in schoolwide efforts to make schools safe and
healthy places for learning. Being a disciplinarian sets the counselor in an
adversarial role—against the student. Clearly these two roles—counselor and
disciplinarian—are generally at cross-purposes.
You also will not see the role of “guidance counselor.” Although this term
has been in use for many years, in 2003, the American School Counselor
Association developed national standards and replaced the term guidance
counselor with Professional School Counselor. Professional School
Counselors engage in a wide variety of the roles listed in the chart, and for
many reasons that will be discussed throughout the book, the term guidance
counselor has fallen into disuse.
Finally, a role that you will not see on the chart is “Counselor as
Multicultural Expert.” We did not include this as a separate role because we
do not see this as a distinct role nor something that is optional for counselors.
We believe that all counselors in all settings and all roles must be
multicultural experts, and multicultural counseling competence must be at the
foundation of all counseling roles, whether working directly with clients,
students, or families, running a private practice or agency, conducting
research, or supervising or teaching others.
Immediately following Table 2.1, you will read a Spotlight about some
appropriate and inappropriate roles for school counselors. We included this
Spotlight early in the discussion about counselor roles because there is a lot
of confusion within the general population, and sometimes even within the
profession, about the roles and functions of school counselors. Because of
this, we believe it is important to give some general information about this
counseling specialty in particular as we start our discussion of counseling
roles. In the following sections, you will read more in depth about each of the
counselor roles listed in Table 2.1. As you read more about each of these
roles, consider whether the description of the role has changed your initial
reaction to it and make a correction to your original ranking, if appropriate.
SPOTLIGHT Appropriate and

Inappropriate Activities for School
Counselors
The American School Counselor Association (ASCA) National Model for
school counseling programs helps school counselors contribute to the school
environment in ways that make the best use of their training and experience.
Although school counselors understand the need to be team players and
“pitch in” when necessary, they cannot be fully effective in schools if they
are not performing the roles that they are best trained to do. When school
counselors coordinate tests or schedule classes or engage in other
administrative duties, they are not available to implement the comprehensive
school counseling programs, and ultimately, the students suffer.
Consider this comment from one state’s survey of school counselors: “I am

filling out this survey based on my responsibilities last year. I was the testing
coordinator. Testing is a full-time job. I would work most weekends, Sunday
mornings included, to keep my head above water. It was awful. This year, my
high school hired a test coordinator. I love counseling! I’m working like a
dog, and it is great!” (North Carolina State Board of Education, 2007). It’s
clear from this comment that counselors are not afraid of hard work or taking
on their share of responsibilities—it’s that they want to (and should do) the
job they are trained and hired to do. On the same survey, another counselor
wrote, “So many children’s individual needs are going unmet because school
counselors are being forced to spend most of their time in classrooms,
cumulative records, testing, committee meetings, etc., rather than focusing on
the children’s needs” (North Carolina State Board of Education, 2007).
Inappropriate
Appropriate (Counseling)
(Noncounseling)
Responsibilities
Activities
Registering and
Designing individual student academic
scheduling all new
programs
students
Administering cognitive,
Interpreting cognitive, aptitude, and
aptitude, and achievement achievement tests
tests
Signing excuses for
Counseling students with excessive
students who are tardy or
tardiness or absenteeism
absent
Performing disciplinary Counseling students with disciplinary
actions problems
Sending home students
Counseling students about appropriate
who are not appropriately
school dress
dressed
Teaching classes when Collaborating with teachers to present
teachers are absent guidance curriculum lessons
Computing grade-point Analyzing grade-point averages in
averages relationship to achievement
Maintaining student
Interpreting student records
records
Providing teachers with suggestions for
Supervising study halls
better study hall management
Ensuring student records are
Clerical record keeping maintained in accordance with state
and federal regulations
Assisting the school principal with
Assisting with duties in
identifying and resolving student
the principal’s office
issues, needs, and problems
Working with one student Collaborating with teachers to present
at a time in a therapeutic, proactive, prevention-based guidance
clinical mode curriculum lessons.
Source: ASCA National Model: A Framework for School Counseling

Programs (2012, p. 56).
Counseling: A Multi-Faceted
Profession
Regardless of the setting, professional counselors are trained to help people
with personal, family, social, environmental, educational, and career
decisions. The American Counseling Association defines professional
counseling as “a professional relationship that empowers diverse individuals,
families, and groups to accomplish mental health, wellness, education, and
career goals” (ACA, 2014b). The American School Counselor Association
defines counseling as addressing “all students’ academic, personal/social, and
career development needs” (ASCA, 2012). Counseling is typically viewed as
a collaborative effort between the counselor and the client (and others, as
appropriate), rather than something that is done by the counselor “to” or even
“for” the client. In general, professional counselors help clients identify goals
and potential solutions to problems that cause emotional turmoil, seek to
improve communication and coping skills, strengthen self-esteem, and
promote behavior change and optimal mental health. The word counseling,
literally translated, means “To come alongside.” It doesn’t mean to fix or
solve someone else’s problems, but to travel the road to self-exploration
together with our clients. One of our former students added to this definition
by clarifying that counseling is more like “to come alongside and carry a
lantern.”
Within the broader field of counseling, the different specialties have specific
emphases. Professional counseling specialties include clinical mental health,
school, career, gerontological, rehabilitation, substance abuse and behavioral
disorders, marriage, couples, and family counseling, and many more. Each of
these specialties is more narrowly focused, requiring advanced knowledge in
the field and is founded on the premise that all Professional Counselors must
first meet the requirements for the general practice of professional counseling
(ACA, 2014b). That is, all counselors, regardless of setting and specialty, are
first and foremost counselors.
Counselor as Therapist (Direct
Service Provider)
When you decided to pursue the field of counseling, this is probably the role
that you envisioned as the core of your future practice. Counselors in many
different settings work with individuals, couples, and families to treat mental
and emotional disorders and conditions and to promote optimal mental
health. In this context, counselors apply a variety of therapeutic techniques
and theories to address a wide range of concerns, from mental health
diagnoses (e.g., depression, anxiety disorders, psychotic disorders), to
problem behaviors (e.g., suicidal impulses, bullying, addictions, parenting,
relationship issues), lifestyle concerns (e.g., stress management, job and
career concerns, issues associated with aging, educational decisions), and
other presenting problems (e.g., self-esteem, self-awareness; identity
development, interpersonal skill development; coping strategies). The role of
“counselor as therapist” is central to all professional counselors. In other
words, although not all counselors in all settings will work in intensive one-
on-one psychotherapy with clients, all counselors will work with individuals
in therapeutic ways to help clients make appropriate choices and changes in
their lives. Whether through brief interventions that focus on making
behavioral changes, assistance with a decision-making process that may
occur in career counseling, or long-term relationships that have the goal of
restructuring the personality, counselors serve in a therapeutic role.
In this chapter’s first Snapshot, you will read about Nakita Carroll, who
provides direct services to clients as both a licensed professional counselor
and an intern in marriage, couples, and family counseling. As you read about
her busy work life, you will see that although she engages in many
counseling roles, her primary focus is on the role of counselor as therapist.
Within your counseling program, you will have specific courses designed to
help you learn and practice the role of counselor as therapist. These classes
focus on topics such as theories of counseling and counseling techniques, and
the competencies taught in these courses are core requirements for all
counseling specialties.
Counselor as Group Leader
Some counseling interventions are done through group work. Counseling
groups can be particularly beneficial for individuals who share common
problems or who have interpersonal/relationship concerns. Group members
provide feedback, support, alternatives, and encouragement for behavior
changes. Often people in groups begin to feel less alone when they hear that
others face similar problems. Group counseling has been demonstrated to be
effective for many problems, including anxiety and panic, chronic pain and
illness, depression, eating disorders, social anxiety and other interpersonal
problems, substance abuse, and traumatic experiences, just to name a few. In
schools, groups are often used to help address problems such as difficulties
in relating to others, adjustment to parental divorce, behavior problems,
learning disabilities, teenage parenting and/or abstinence, and alcohol/drug
addiction or abstinence (Corey & Corey, 2013). Groups are particularly
powerful for children and adolescents, who typically see peer understanding
and acceptance as essential components of their own personal development.
Children and adolescents also benefit from interpersonal feedback as they try
out new ways of approaching their problems in a structured, safe, and
supportive environment. In schools, groups help counselors provide services
to greater numbers of students, which is particularly important given how
many students most school counselors are responsible for assisting.
Groups are used in many different settings, including schools, mental health
agencies, rehabilitation centers, and substance abuse settings. There are many
different types of groups, ranging from preventive and psychoeducational, to
remedial and therapeutic. The role of the group leader varies with the type of
group, clients, and setting. In general, however, the group leader establishes
the group, selects members, and facilitates group meetings.
Within your counselor education program, you will take at least one course in
group counseling, and chances are good that you will also be required to
participate in a small group counseling experience as a group member. We
often hear from students that they are hesitant to engage in group counseling,
and more introverted students in particular may struggle with the idea of
being a group leader. However, whether you are naturally drawn to group
counseling or not, rest assured that you will be given the appropriate skills
and training to tackle this important aspect of counseling. As with all the
roles of the counselor, we encourage you to keep an open mind, continue to
engage in self-reflection, and seek out experiences to help you gain
confidence.
Fast Facts
ASCA National Standards (ASCA, 2012) recommend that professional
school counselors spend a certain percentage of their time in the role of
implementing the guidance curriculum. For elementary counselors, 35–45%
of their time should be spent on curriculum; for middle school counselors, the
percentage is 25–35%; and for high school counselors, it is 15–25%.
A study of practicing school counselors in North Carolina found that 51% of

the elementary school counselors spent the recommended time on curriculum
activities. Comparatively, just 12% of the middle school counselors and 31%
of high school counselors spent the recommended time on guidance
curriculum.
Source: North Carolina State Board of Education (2007).
In a national study of over 1000 practicing school counselors at all three

levels (elementary, middle, and high), Paolini (2012) found the average
percentage of time counselors say they spent in classroom guidance was
14%, which is below the recommended amount for all three educational
levels.
Source: Paolini (2012).
Counselor as K–12 Guidance

Curriculum Expert
School counselors help students learn important developmental skills, such as
being safe on the Internet, preventing bullying, and finding ways to explore
career paths. To meet the needs of large numbers of students in their schools,
school counselors do much of this important work in classroom settings. In
this role, professional schools counselors develop and provide structured
lessons to students, parents, school staff, and the community that are
designed to help students “achieve desired competencies and to provide all
students with the knowledge and skills appropriate for their developmental
level” (ASCA, 2012). As guidance curriculum experts, school counselors
emphasize preventive and developmental counseling to provide students with
life skills needed to address problems before they occur and to enhance the
students’ mental health and wellness in three broad areas: academic
development, career development, and personal/social development. As you
learned in Chapter 1, school counseling has its historic roots in teaching and
education, and the belief that school counselors play an important role within
the classroom has endured. It is a widely accepted belief that the classroom
guidance curriculum remains a critical cornerstone for a developmental,
sequential, and systematic school counseling program (Gysbers &
Henderson, 2006), and an implicit assumption of classroom guidance is that it
is an effective way to impact student development (Akos, Cockland, &
Strickland, 2007).
SNAPSHOT Nakita Carroll,

Licensed Professional Counselor
and Marriage, Couple, and Family
Counseling Intern
Nakita Carroll
The greatest challenge in working full-time for an agency and launching a

private practice has been time. I have a position in a grant-funded agency
where I work 40 hours per week with low-income couples. It requires me to
work some evenings throughout the week as well as some Saturdays.
Protecting time to see couples in private practice has meant making myself
available evenings and weekends because of the 40-hour agency work. I must
be creative and be a good time manager, especially if I want to nurture my
own wellness and relationships. I need the time, and attention to make my
private practice successful. That means late nights to work on branding,
marketing, and advertisement. It is exciting, but most of the time I feel
overwhelmed trying to understand and meet the legal requirements of starting
and maintaining a private practice on my own. There is always more I could
and should be doing for my private practice, and there are times when I have
more capacity to do so than other times.
As a Registered Marriage and Family Therapist Intern, I must ensure that

there is a licensed person on-site when seeing clients. To address this, I
rented office space in a building that is owned by colleagues with whom I
worked previously. Surprisingly, most of my clients do not express much
concern about my still being in the process of earning my license. I clearly
explain what my intern status means and about my supervisor and restate that
in my informed consent documents.
Research shows that African Americans are less likely to seek professional
helping services than many other cultural groups, and that they tend to go to
spiritual leaders to address marital and emotional distress. It also suggests
that people tend to want a therapist who is culturally similar to them. In the
year I have been in private practice, most of my clients have been Black.
While I do not know this for sure, I imagine that the cultural similarities
influenced these clients’ decisions to seek services from me. I can also
remember wondering if the picture I chose for my profile (which featured my
hair in its natural Afro form) was something that would keep some clients
away. My supervisor reminds me that I have something unique and the
people who need what I have will come to me.
Nakita’s Breakdown of Time Spent on Daily Activities

Counselor as Therapist 10%
Counselor as Group Leader 10%
Counselor as Assessor 5%
Counselor as Consultant 1%
Counselor as Administrator or Program Planner 7%
Counselor as Documenter or Record Keeper 23%
Counselor as Researcher or Scientist 3%
Counselor as Learner 3%
Counselor as Educator or Trainer 10%
Counselor as Supervisor or Supervisee 6%
Counselor as Advisor 1%
Counselor as Businessperson or Entrepreneur 20%
Counselor as Member of Professional Organization 1%
2.1-3 Full Alternative Text
The accompanying Snapshot by Susie Boggs, Licensed Professional School

Counselor, will give you even more insight into the roles of a school
counselor. What you will discover as you learn more about school counseling
is that there is no “typical day” for school counselors, and Susie’s description
of her work in the school reinforces that idea. Nevertheless, Susie, like most
school counselors, makes the time to include “Counselor as K-12 Guidance
Curriculum Expert” in her schedule.
SNAPSHOT Susie Boggs, Licensed

Professional School Counselor
Susie Boggs
I was 40 years old when I finally figured out what I wanted to be when I grew
up! I had been many things during my work life—I taught music, and I
worked as a legal assistant, a customer service representative, and a trainer
and middle manager at a large insurance enterprise. Throughout this time, I
truly enjoyed each opportunity to learn and grow, and have really appreciated
the many transferrable skills I have accumulated. However, I never loved my
job. I missed young people and wanted to believe that I was making a
difference, so I enrolled in graduate school to become a professional school
counselor and I have never regretted it!
Since then I have spent the past eight years working as a school counselor at
a career- technical high school. Here junior and senior high school students
from seven different regional school districts enroll in technical laboratory
programs ranging from automotive technology and welding, to
firefighting/EMS, computer science, and nursing. Students work in their
technical programs for half of the day and take their core academic studies
the other half. My students are from very diverse economic, academic, and
racial/ethnic backgrounds who want to learn in a different way and get a head
start on a career of their choosing; it is very rewarding. Finally, I love my job.
If you choose this career, know these three things: (1) No two days will ever
be alike, (2) you will never accomplish everything you want to, or even
everything you think you should, and (3) you may never know the impact
you might have had on a young person’s life. But I promise, you will have an
impact, you may even save a life. Believe me, regardless of the frustrations,
it’s worth it!
The role of a school counselor is challenging to define. Due to our history,

and despite the profession’s many efforts, our “job description” is often
debated. What you may learn in your graduate program may not always be
what your administrator, and even seasoned colleagues, will say you should
do. Generally, you will be dividing your time between individual counseling
and planning, developing, and leading small groups and large
group/classroom lessons on academic, career, and personal/social needs.
Additionally there will be work on student academic records, counseling
notes, data collection and analysis, scheduling and enrolling students, parent
conferences, teacher consultations, as well as duties within your school
building. Do not be surprised to find a building colleague in your office
seeking your advice and needing a shoulder to lean on. Public education can
often be stressful and even isolating. Your fellow educators will see you as a
helper and sounding board. I will tell you what my graduate advisor told me
—at the end of the day, you will be tired!
As in any profession, you will find things you love and you will find things
you hate. Paperwork, however necessary, is the bane of my existence. My
best times are in direct contact with students, formally and planned, or as I
chat with them in the hallway or during lunch breaks. Remember that any
contact, however short or seemingly inconsequential, has the potential to
make the day for that student. Would I prefer not to have lunch duty? Of
course! Can I use it as an opportunity to talk with students? Absolutely!
If there was one piece of advice that I could give someone considering this
career, it would be to remember self-care. It is so easy to take your work
home with you, to internalize the issues your students face, and feel you must
“save” everyone—you can’t. You must take care of yourself physically and
mentally to avoid burnout and maintain your life outside of school. Focus on
stress reduction/relief—exercise, yoga, meditation, etc., and stay engaged in
your professional development and networking. Join the American School
Counselor Association and become active within your state association. I
remember my first year on the job when a fellow counselor invited me to call
anytime because “no one else really ever knows what you are going through
besides another school counselor.” How right he was.
This profession is not for the faint-hearted; each day is a challenge. But know
that each day is also a fresh opportunity to advocate for a child and have a
lasting impact on a young person’s life. Oh, did I mention that I love my job?
Susie’s Breakdown of Time Spent on Daily Activities

Counselor as Advisor 15%
Counselor as Crisis Interventionist 15%
Counselor as Group Leader 10%
Counselor as K–12 Guidance Curriculum Expert 10%
Counselor as Documenter or Record Keeper 25%
Counselor as Diagnostician
Many mental health counselors consider diagnosis of mental and emotional
disorders to be one of their major responsibilities as counselors (American
Counseling Association, 2011). Mental health professionals in America use a
common language to diagnose mental and emotional disorders. Criteria for
all recognized mental disorders are listed in the Diagnostic and Statistical
Manual of Mental Disorders, 5th edition, published by the American
Psychiatric Association (2013; DSM-5, for short). This manual contains over
300 different diagnoses grouped into 20 major categories. The DSM-5 is used
by clinicians and researchers in all fields related to mental health, and it
provides information that is usable and relevant across a variety of settings.
The DSM is a work in progress, and each iteration of the manual contains the
latest research and clinical expertise available at the time of going to press.
The diagnosis of mental and emotional disorders is not included within the
school counselor’s scope of practice, although many professional school
counselors recognize the need to receive training in the DSM so that they can
understand the impact students’ diagnoses can have on school performance
and so they can recognize when student problems and behaviors may be
indicative of a mental health diagnosis that requires further evaluation and
treatment outside the confines of the school. The ethical guidelines for the
American School Counselor Association note that school counselors:
A.A.1.c c. Do not diagnose but remain acutely aware of how a student’s

diagnosis can potentially affect the student’s academic success.
Not all states have counseling licensure laws that allow mental health
counselors to diagnose mental and emotional disorders. Of the 52 states and
territories with mental health counseling licensure, 29 states specifically
allow professional counselors to diagnose their clients. See Table 2.2 for a
breakdown of counselors and diagnosis by state. Even in states that allow
mental health counselors to diagnose their clients, not all counselors believe
that such a practice is appropriate or conforms to the philosophical
underpinnings of the counseling profession. As you will read in this chapter’s
Counseling Controversy, there are markedly different opinions among those
in the profession about whether or not counselors should participate in the
diagnosis of mental disorders. As you read through the arguments on either
side of the controversy, stop and think about what you believe. Do counselors
have a role to play in the diagnosis of their clients?
Table 2.2 Counselors and

Diagnosis: A Breakdown by
State (updated 10/16)
States in Which a Licensed States in Which Diagnosis Is
Counselor Can Diagnose Not Within the Scope of
Mental and Emotional Practice for Licensed
Disorders Counselors
1. Alabama
2. Alaska
3. Arizona
4. Colorado 1. Arkansas
5. Delaware 2. California
6. Florida 3. Connecticut
7. Hawaii 4. District of Columbia
8. Kentucky 5. Georgia
9. Louisiana 6. Idaho
10. Maryland 7. Illinois
11. Massachusetts 8. Indiana
12. Mississippi 9. Iowa
13. Montana 10. Kansas
14. New Hampshire 11. Maine
15. New Mexico 12. Michigan
16. North Carolina 13. Minnesota
17. North Dakota 14. Missouri
18. Ohio 15. Nebraska
19. Oklahoma 16. Nevada

20. South Carolina 17. New Jersey
21. South Dakota 18. New York
22. Tennessee 19. Oregon
23. Texas 20. Pennsylvania
24. Utah 21. Puerto Rico
25. Vermont 22. Rhode Island
26. Virginia 23. Wisconsin
27. Washington
28. West Virginia
29. Wyoming
Source: State licensure law documents as of 2016. Students are

reminded to always check with a state’s counseling licensure
board to find the most accurate and up-to-date information.
Counseling Controversy Should

mental health counselors engage in
diagnosis of mental and emotional
disorders?
Background. The Diagnostic and Statistical Manual of Mental Disorders is
the primary language of communication within the mental health system.
Those who argue against its use believe that diagnostic labels are contrary to
the positive and developmental approach of counseling.
POINT: PROPER DIAGNOSIS COUNTERPOINT: LABELING

LEADS TO PROPER CLIENTS IS HARMFUL TO
TREATMENT THEM
Diagnosis can be
Counselors who operate outside psychologically damaging to
of that system cannot engage in clients. Counseling has its roots
effective practice, receive third- in a humanistic stance that
party payments, or use the values the worth of individuals,
current research to implement rather than reducing them to
effective treatments. medical labels.
The process of diagnosis in and Medicalization of mental illness
of itself is not dehumanizing, has been challenged for decades.
and, in fact, can help ensure Szasz (1961), one of the fiercest
quality treatment based on best critics of psychiatry, argued that
practices. Many DSM-5 mental illness is defined based
classifications include specific on the prevailing norms of the
cultural information, and there is day. Individuals who deviate
nothing inherent in the diagnostic from society are labeled
system that limits the “abnormal,” and societies use
understanding of how culture the threat of that label to
affects behavior. constrain free will.
Diagnosis helps clients benefit The use of diagnostic labels
from concrete explanations for encourages counselors to look
their behaviors and experiences. for pathology and illness.
The practice of diagnosis allows Diagnosis leads to a self-
communication of complex ideas fulfilling prophecy, where
between treating professionals; clients begin to believe that their
allows researchers to compare situation is hopeless and they are
treatments which can improve indeed “sick”; narrowing a
outcomes; relieves clients’ guilt counselor’s focus to only the
and self-blame for their illness; ignoring the social
experiences; encourages family
members to be less blameful and context in which clients live that
more focused on the “external can perpetuate unproductive
enemy” of the illness: and helps behavior problems; imposing
clients feel understood and societal values on individuals;
validated. and ignoring the effects of
culture and diversity.
As with most controversies, there probably is some truth to both sides of this
argument.
Counselor as Assessor
Psychological assessment is any method used to measure characteristics of
people or programs. Proper assessment helps counselors and those they serve
to more fully understand the nature of problems, strengths, or interests; to
select appropriate interventions; to generate alternatives; and to evaluate the
effectiveness of treatments, programs, or education. In general, good
assessment practice includes skills in test selection, administration, and
interpretation (Tate, Bloom, Tassara, & Caperton, 2014). Simply put,
assessment means gathering information about a client or program (Leppma
& Jones, 2013). At its core, assessment recognizes that the quality and depth
of the information that you get from clients will depend on the type of
questions that you ask.
When counselors are in the role of assessor, they are investigators, and many
counselors’ natural inquisitiveness about people fits well with the role as
assessor. When counselors engage in assessment, they are seeking to learn
more about a person or situation so that they can formulate or evaluate
treatments, interventions, or programs. There is a substantial body of research
that demonstrates that counselors who integrate multiple types of assessment
into their counseling have improved quality of care (Leppma & Jones, 2013).
If counselors are not skillful at assessment, or they conduct an incomplete or
inaccurate assessment, everything else in the counseling process can be
negatively affected (Hays, 2013; Whiston, 2016). Assessment is used in
counseling by counselors in all settings.
Assessment in counseling can be formal or informal. Formal assessment can

consist of standardized instruments that have fixed instructions for
administration and scoring and yield specific information for individual
clients. Informal assessment makes use of intake interviews, reviews of
records or charts, observations of clients or students, completion of ratings
scales or checklists, or discussions with members of a client’s support
system, teachers, or other mental health professionals.
All counselors use informal assessments. In addition, most counselors,

regardless of setting or population, engage in some type of formal assessment
with their clients, and most counselors consider assessment fundamental to
the general practice of counseling. A 2014 national survey of nearly 1000
counselors found that both school and mental health counselors used a wide
variety of assessments, with some 98 different instruments identified by
participants in the survey. Clinical mental health counselors were more likely
to use clinical/behavioral and personality assessments, and school counselors
were most likely to use career or educational/achievement tests, but an
important finding was that all counselors used at least some assessment
instruments in all the major categories (personality, career, intelligence,
educational, clinical/behavioral, and environmental/interpersonal). In
addition, several of the highest ranked instruments were used by the majority
of respondents, regardless of setting or specialty (Peterson, Lomas, Neukrug,
& Bonner, 2014). This more recent study mirrors finding from earlier
research that underscores the importance of testing for counselors. A 1998
study of counselors in a variety of settings found that only 9% indicated that
they are never involved in formal assessment activities (Elmore, Ekstrom,
Shafer, & Webster, 1998). A 2004 survey of practicing school counseling
found that all respondents stated that they were involved in testing in some
way, with 98% stating that they had responsibility for referring students,
when appropriate, for additional assessment and appraisal. In addition, most
respondents had more direct involvement in testing, with 29% stating they
were responsible for selecting tests, 63% for administering tests, and 71% for
interpreting tests (Ekstrom, Elmore, Shafer, Trotter, & Webster, 2004).
Because of the importance of assessment in counseling, the American

Counseling Association, the American School Counselor Association, and
the Association for Assessment in Counseling all have developed lists of
competencies required of counselors who use tests. In addition, the American
Counseling Association Code of Ethics (2014a) includes standards for ethical
test use. Finally, the Association for Assessment in Counseling (2003) (now
called The Association for Assessment and Research in Counseling)
identified standards for appropriate multicultural assessment. Because of the
essential nature of the role of counselor as assessor, your counseling program
will have at least one course dedicated to assessment in counseling.
Counselor as Consultant
Consultation generally refers to a problem-solving process, and in
counseling, consultation is typically the term that is used for indirect services.
In other words, when counselors conduct individual or group counseling or
testing with their clients, it is considered direct services. When counselors
work with others in order to help improve their direct services, it is
consultation (Dougherty, 1990). Gelso and Fretz (1992) defined consultation
as “a professional service that uses knowledge of human behavior,
interpersonal relationships, and group and organizational processes to help
others become more effective in their roles” (p. 515). Formal consultation
involves contracts, goals, and outcomes. But consultation also can be a very
informal process that is done over the phone, at lunch, or in brief discussions.
A few examples may help. Counselors are consultants when:
A mental health counselor helps another mental health professional learn

options available for the hospitalization of a client with an eating
disorder.
A career counselor helps a worksite create job descriptions for the
variety of staff employed there.
A rehabilitation counselor receives a phone call asking what types of

assistive or adaptive technology are available for a colleague’s spouse
who is recovering from a stroke.
A school counselor works with a school teacher to discuss classroom

management techniques.
In short, consultation is a way for counselors to affect the direct services

provided by others. Consultation can be intra-agency, or within schools and
agencies (for example, when counselors work directly with teachers to
provide assistance for a child experiencing anxiety, or when counselors
provide information or assistance to their peers within an agency about
methods to assess a client for trauma). Consultation can occur as an inter-
agency or interorganizational experience. In these instances, counselors work
with professionals in other agencies to provide a collaborative approach to
consultation.
Consultation is always voluntary, nonjudgmental, and based on the premise

that the consultee is free to accept or reject any or all recommendations or
ideas provided by the consultant (Hershenson, Power, & Waldo, 2003).
Regardless of the setting or the informality of the consultation process, it is
important to remember that the rights of the client must be protected at all
times. Client names and/or identifying information should not be part of the
consultation process, and the consultant must protect the privacy and rights of
the consultee. There is an entire section of the ACA Code of Ethics (2014a)
that covers the ethical responsibilities of counselors when they act in the role
of consultant.
Informal consultation is a very common experience in the field of counseling.

In fact, it is so common for counselors to engage in informal consultation that
they often do not even realize when they are serving as consultants. Perhaps
it is not surprising that counselors, with specialized knowledge, training, and
experience, are sought after for input and recommendations regarding a wide
variety of problems. School counselors in particular find themselves serving
as consultants to teachers and administrators who may need assistance or
recommendations to work with a troubled student. School counselors also
may function as consultants to parents who are concerned about their child’s
behavioral or academic problems. Mental health counselors may serve as
consultants to their peers if they have expertise in a working with a particular
type of client or diagnosis that others may need assistance with. Consultation
is simply part of a collaborative and consultative approach toward being a
Counselor as Administrator or
Program Planner
Administrators are individuals who oversee or manage organizations or
agencies and thus are responsible for making and implementing major
decisions. The role of administrator is one that is seldom discussed in the
counseling community. Nevertheless, each year countless professional
counselors are asked to assume administrative roles in schools, colleges and
universities, state and federal government offices, community agencies, and
foundations (Herr, Heitzmann, & Rayman, 2005). Some counselors seek the
role of administrator, while others become administrators as they rise to
higher and higher levels of responsibility within an organization or agency. In
the role of administrator, counselors use many of the human relations skills
that are the hallmark of their counseling training, such as setting goals,
working with diverse staff, managing conflict, and working with difficult or
angry clients. They also are called upon to develop skills that may not have
been included in their counseling training, such as strategic planning,
budgeting, recruitment and development of staff, organizational risk
management, meeting with constituent groups or lawmakers, and facilities
management. For counselors to be successful administrators, they must
possess a range of diverse skills in both the counseling and business worlds
(Sullivan, 2006). In some small agencies, administrators have job
responsibilities that are incredibly diverse. Consider this “job description” by
N. J. Groetzinger, an executive director of a mental health agency in Chicago.
I was the executive director, I was also the chief financial officer; I did
all the financial work. I didn’t have a bookkeeper, let alone a controller.
I was the human resource manager, and I was the development officer.
Because of the size, I was even the backup receptionist. (Gumz, 2004, p.
364)
Not all administrative duties for counselors come from being in the role of
full-time positions as administrators. Even when counselors do not serve in
administrative capacities, they still have responsibilities in program planning
and management. When counselors plan and organize their interventions,
develop a calendar for upcoming workshops or trainings, or create flyers to
advertise their services, they are engaging in program planning, which is a
type of administrative endeavor. When school counselors spend time aligning
their programs to the ASCA national standards and developing strategies and
schedules for implementation, they are acting in the role of counselor as
administrator.
SNAPSHOT Grant Schroeder,

Licensed Professional Clinical
Counselor and Administrator
Grant Schroeder
I currently serve as the vice president and chief operating officer at

Maryhaven, a large behavioral health care organization in Columbus, Ohio,
that specializes in the treatment of substance dependence and co-existing
mental, emotional, and behavioral problems. Maryhaven offers 20 various
programs and services ranging from care of the homeless, to outpatient and
residential treatment, driver intervention programs, residential care for youth
under the temporary custody of children services, contractual services for
federal offenders, and halfway house services for women who have
completed primary treatment.
I initially served in a supervisory role and subsequently in administrative

roles with increased management responsibility at this agency for 25 years.
Prior to this I had worked in a variety of substance abuse counseling roles in
the public and private sector for more than ten years. I love the field of
addiction treatment and the challenges and successes of our clients! I was
driven to the management side of the work because of business and
management courses in my undergraduate degree and because I wanted to
lead and influence events that affect patient care.
My workdays are often a “wide-angle” view of all of what is happening in

our agency. As chief operating officer, I am the manager who makes sure that
we are providing effective services in a timely manner. This means being
concerned with staffing, incidents that arise, coverage issues, and clinical
decision making. I oversee our medical staff, supervisory staff, counseling
staff, nursing director and her staff, as well as the case aides, students, and
volunteers who all contribute to helping patients recover from addictive
illness and mental health problems. Although I frequently feel like a fireman,
running from one problem to the next, I very much enjoy the change of pace
and challenges my work offers me every day. In addition to my work at
Maryhaven, I have continued some private practice work and teaching
throughout my career to keep my skills fresh and to experience the pleasure
of providing direct counseling services. However, I am better suited for the
change of pace and challenges of the administrative functions. Earlier in my
career I found counseling all day—whether in group therapy or individual
counseling—caused me to get restless and somewhat burned out.
Today my struggles at work involve dealing with many things that require
essentially an immediate response, such as staff evaluations, budget and
utilization reviews, hiring and firing issues, staff meetings, and the many
meetings with funders and government agencies that are stakeholders in our
business. At times I see myself as balancing on a seesaw, the balancing point
being my day-to day responsibilities. At one end of the seesaw are meetings
with clients and staff and “managing by walking around” (MBWA). On the
other side of the seesaw is having the time to think, read, and plan on how we
might improve the effectiveness and efficiencies of our services.
Increasingly, I find great rewards when I take time to talk with clients about
our services and ask if they feel cared for, if they are receiving what they
need to recover, what our customer service is like, or what has upset them
about what we do or how we do it? Speaking with staff about the challenges
they face with paperwork, clients, and our agency policies is equally
rewarding. When I take time to do this and follow up with time to discuss my
thoughts and feelings with other trusted managers, I am almost always
rejuvenated and my thinking and planning for the future becomes more
focused.
Grant’s Breakdown of Time Spent on Daily Activities

Counselor as Supervisor 5%
The job of a counselor who becomes an administrator (either full-time, or as

one component of the overall job) is shaped by a range of forces, often
beyond the counselor’s control (e.g., accreditation policies, local/state/federal
contracts, state and federal laws and requirements, and accountability
demands). Effective administrators are able to manage these external
demands while simultaneously creating an environment that puts the
principles, purpose, and guiding beliefs of the organization first (Sullivan,
2006). Obviously, this is a significant challenge, and the role of counselor as
full-time administrator is not for everyone. But, for those who have the
temperament and skill set to become administrators, there is tremendous
opportunity to have a positive impact on the field of mental health, thereby
helping to improve the lives of clients in significant and meaningful ways.
The accompanying Snapshot of Grant Schroeder provides additional
highlights and insights into the role of a full-time counseling administrator.
Notice how Grant uses his role as administrator to help his agency more
closely align to the values and priorities that he developed from his time as a
counselor. In this way, counselors as administrators are able to help make
systemic changes that may be more difficult to accomplish in the counselor
role. Perhaps the role of administrator is something that you can envision for
yourself in the future.
Counselor as Documenter or
Record Keeper
Paperwork, paperwork, paperwork! It is probably no one’s favorite role, but
at least some of a counselor’s time must be spent on logistics—filling out
paperwork, keeping records, documenting progress or case notes, scheduling
(tests, groups, or clients), and billing. Counselors in all settings are
accountable for paperwork. They set up appointments for clients or schedule
groups or meetings. Mental health counselors often complete accountability
logs or billing paperwork. They make referrals for clients to receive social
services, follow up with other providers to coordinate intervention efforts, or
fill out paperwork to certify that court-ordered clients have attended their
mandated sessions. Counselors monitor ongoing services for persons with
chronic mental illness. School counselors often schedule and coordinate
testing. The accurate and timely completion of paperwork is an ethical
imperative for all counselors (ACA, 2014a; ASCA, 2016), as the quality and
availability of client care is often contingent upon this important task. There
is also evidence that appropriate documentation improves counseling itself.
For example, research demonstrates that when counselors are obligated
to document their suicide risk assessment, they are more likely to engage in a
more comprehensive and thorough assessment strategy (Granello & Granello,
2007).
Within schools, school counselors might also consider some of their

“building duties” as falling within this clerical role. Playground duty, lunch
duty, and assisting with school record keeping are all duties that school
counselors may be asked to complete. The American School Counselor
Association recommends limited engagement by professional school
counselors in these types of roles, and many professional school counselors
are able to distance themselves from these types of duties. However, in most
school buildings, school-wide responsibilities such as these as shared by the
staff, and school counselors may need to participate in these roles, at least
minimally, to help build collaborative relationships within the school. If
lunch duty or playground duty become one of your roles as a school
counselor, you may want to consider how to make the most of that time to
form more meaningful relationships with the students in your school.
In this chapter’s Informed by Research, we discuss results of a study of

school counselors, highlighting the importance of time spent in counseling
practice, rather than becoming overwhelmed by paperwork or clerical duties.
Informed by Research Does

Implementing a Research-Based
School Counseling Curriculum
Enhance Student Achievement?
The ASCA National Model (2012) delineates appropriate roles and functions
for professional school counselors that focus on implementing a
comprehensive school guidance curriculum, engaging in individual student
planning, using responsive services to needs that arise in the school, and
supporting students, teachers, and administrators as they work to enhance
student academic achievement. Nevertheless, school counselors have long
complained that they have been asked to perform clerical tasks and
paperwork in their schools, and principals continue to hold assumptions about
the role of the school counselor that are incongruent with the national
standards. For example, a 2004 study (Pérusse, Goodenough, Donegan, &
Jones) found that more than 80% of school principals identified the following
activities as appropriate for school counselors, even though they are not
endorsed by the ASCA standards: (a) registration and scheduling of all new
students; (b) administering achievement tests; and (c) maintaining student
records. Kaplan (1995) found that professional school counselors often view
themselves as misused because they are assigned to tasks such as scheduling,
handling disciplinary matters, and performing clerical functions.
One of the efforts of the Transforming School Counseling Initiative has been
to find ways to validate the effectiveness of time spent in appropriate school
counseling activities. The argument is that unless school counselors can
justify the effectiveness of the ASCA National Model, they will continue to
be asked to perform clerical duties. In 2003, one of the first rigorously
designed research studies on the effectiveness of a comprehensive school
counseling program investigated whether a combination of curriculum-based
and group-based interventions that focused on cognitive skills, social skills,
and self-management skills had a measurable impact on students’ test scores
on state standardized achievement tests.
Brigman and Campbell (2003) compared a treatment and a control group that
were randomly selected from middle schools with equivalent racial
composition and socioeconomic levels. Pretests demonstrated that both
groups were comparable on their achievement levels. The treatment group
included 185 students who engaged in classroom-based and small group
format interventions. The researchers found that school counseling
interventions that focus on the development of cognitive, social, and self-
management skills can result in sizable gains in students’ academic
achievement. Involvement in small group and classroom-based school
counseling interventions resulted in significant improvements on the math
and reading scores of the Florida Comprehensive Assessment Test.
This study represents an important milestone for school counselors who wish
to use research to support their claims that implementation of a
comprehensive school counseling curriculum can have positive effects on
student academic achievement. Clearly, more research will need to be
conducted, but these results are promising. High-quality research, such as this
study conducted by Brigman and Campbell (2003), allows school counselors
to say with confidence that their time is best spent in accordance with the
ASCA National Standards.
Counselor as Researcher or
Scientist
In order to make use of the accumulated knowledge in the field, to contribute
new knowledge to the field, and to understand the effectiveness of their own
practice and programs, counselors in all practice settings must be willing to
take on the roles of researcher and scientist. It is clear that today’s counseling
students will graduate to face an environment in which the ability to assess
treatment outcome and program effectiveness will be essential to success
(ASCA, 2012; Tate et al., 2014). As a result, counseling students can
graduate with outstanding clinical skills and a sound theoretical foundation,
but without the ability to choose treatments or interventions that have
research to support them, these same students will be at a disadvantage in a
competitive marketplace (Granello & Granello, 1998).
Sometimes counseling students are a bit nervous about this role, as they
envision researchers as people in white lab coats, working on complex
research designs. But being a researcher or scientist within the field of
counseling simply means investigating the counseling decisions that you
make so that you can provide the highest quality of care for your clients and
students. You might engage in your own research, or you might rely on the
available published research to help you make those decisions. In either case,
you will want to work with your clients in ways that maximize the potential
for success. It is important for counselors to understand the research base of
our profession, including its limitations. Bridging the gap between research
and practice is essential (Rieckmann, Bergmann, & Rasplica, 2011; Whiston
& Coker, 2000), and it serves as the foundation for a scientist-practitioner
model that is often used in counselor education.
In the current environment, access to information and research is readily

available through Internet resources, making it much easier for counselors to
keep up-to-date on the latest research in the field. The journals that
counselors receive when they belong to professional organizations also are
informative resources for the latest research. In 2003, the National Panel for
School Counseling Evidence-Based Practice was established to improve the
practice of school counseling by helping to develop the research base that is
necessary for responsible and effective practice. In 2013, the first annual
Evidence Based School Counseling National Conference was held to provide
school counselors with “critical information about successful practice,
evaluation, and relevant research to create dynamic and powerful school
counseling programs” (for more details, visit http://www.umass.edu/
schoolcounseling). In 2005, the American Counseling Association created the
Practice Research Network (ACA-PRN) to help collect and disseminate data
on evidence-based counseling practices.
Using evidence-based practice is also an ethical requirement. The 2014 ACA

Code of Ethics clearly states that “[c]ounselors have a responsibility to the
public to engage in counseling practices that are based on rigorous research
methodologies” (Section C, Professional Responsibility). The ASCA code of
ethics (2016) similarly states “school counselors maintain competence in
their skills by utilizing current interventions and best practices” (Section B-3,
Responsibility to Self). With all of the emphasis on evidence-based best-
practice interventions, it seems clear that evidence-based counseling practice
is the future of both the preparation of counselors and the practice of
professional counseling.
Counselor as Learner
As you engage in the role of learner during your counseling program, you can
see how much there is to understand and know about our profession.
However, what you will soon learn (if you haven’t already) is that you will
not be done learning when you earn your degree. The field of counseling
continues to grow and change, and competent counselors recognize that to be
effective in their careers, they must commit to being lifelong learners. The
role of counselors as learners encompasses both a personal innate desire and
a professional requirement. Ongoing learning is so important to professional
counseling that licensing and certification boards in all states require
continuing education to maintain the counseling credential. All licensing and
certification boards have specific requirements regarding continuing
education units (CEUs). The importance of engaging in ongoing learning is
encapsulated in the ACA Code of Ethics, where continuing education is
mandated.
Counselors recognize the need for continuing education to acquire and
maintain a reasonable level of awareness of current scientific and
professional information in their fields of activity. They take steps to
maintain competence in the skills they use, are open to new procedures,
and keep current with diverse populations and specific populations with
whom they work. (ACA, 2014a, C.2.f)
Most writers who discuss professional development in the helping

professions recognize that there are generally two options that professionals
can choose: continue to grow and change professionally and personally, or
stagnate and burn out (Echterling et al., 2007; Gladding, 2008). The
recognition that lifelong learning has a personal benefit, as well as a
professional advantage, is the reason that many practicing counselors find
that they more than fulfill the minimum number of hours of continuing
education for licensure or certification requirements. Clearly, graduate
training in counseling is not the end of the learning process, and a degree in
counseling is just one step in a lifelong process. In fact, both qualitative (e.g.,
Alves & Gazzola, 2011; Skovholt & Rønnestad, 1995) and quantitative (e.g.,
Granello, 2010) research support a model of professional development that
begins a trajectory of growth and development during graduate school and
continues throughout a counselor’s entire professional career. Adopting a
stance as a lifelong learner means seeking opportunities for new learning in a
multitude of contexts and situations. In fact, in their research to uncover
common characteristics of master therapists, Skovholt, Jennings, and
Mullenbach (2004) found that they are “insatiably curious” and have an
“intense will to grow” (pp. 134–136). Master therapists see themselves as
lifelong learners, active learners, and eager to learn.
Words of Wisdom
“The more we know, the more we know we don’t know. Right? We have that
equation in front of us all the time. Knowledge leads to the unknown. But,
it’s interesting and it’s fascinating and it’s all right, that search . . . [but] the
searching never stops. There’s never going to be a known. Isn’t that
exciting?” (respondent in a research study of master therapists, Skovholt &
Jennings, 2004, p. 34)
Counselor as Teacher or Educator
At times, counselors take on the role of teachers or educators. Sometimes this
is within the context of a counseling relationship, where, when done
sparingly and appropriately, it can help a client reach specific goals. At other
times, counselors teach graduate courses or conduct workshops or trainings.
In both of these circumstances, counselors impart information to help their
clients, students, or peers engage in new learning.
According to the REPLAN model, which provides a listing of factors that

improve therapeutic outcomes, providing new learning is an essential
component of the counseling relationship (Young, 2017). New learning can
be in the form of providing information or referrals to clients, or simply
arming clients with the facts they need to make wise decisions or goals. In
many therapeutic settings, giving clients important information about their
psychiatric diagnoses or medications can help them become partners in their
own behavioral health care. Once clients understand, for example, how panic
attacks affect the body’s physiology, they are more able to understand how to
get control over their bodies when a panic attack strikes. In other contexts,
new learning can be in the form of giving clients information that they can
then integrate into their own behaviors. For example, counselors might teach
their clients basic human relations skills or how to get along with others
(Ivey, 1976). This is the premise behind a particular type of group work
called psychoeducational groups. In psychoeducational groups, clients or
students learn about a concept (assertiveness, for example), and then learn
how to apply that concept to their own lives. In this example, without the
“education” of learning about assertiveness, the “psychological” portion of
the group, where the material is applied to one’s own life, would be
meaningless.
Counselors are also in the role of teacher or educator when they are
conducting trainings or workshops or teaching courses. At a professional
conference for counselors, the workshops are typically presented by
practicing counselors or counseling students or instructors. Counselors also
provide trainings in organizations and businesses, where they may provide
workshops on specific interpersonal skills or on methods to improve
organizational functions. The professor or instructor for whose course you are
reading this text is undoubtedly a counselor in the role of educator, and the
term counselor educator refers to a counselor who has taken on the role of
college professor or instructor. In this context, counselors use the skills,
training, and experience they have in the field, as well as specialized
knowledge and training in teaching, research, and supervision, to teach others
to become professional counselors. Of course, we recognize that you are still
in the beginning stages of your professional counseling career, and it may be
a while before you officially take on this role as educator, but you may want
to look for opportunities to try out this role during your graduate training. Is
there an opportunity to provide a presentation in a class about a topic related
to counseling? Can you teach your fellow students in a practicum class about
something you learned at your site? If you have an opportunity to go to a
conference or workshop, can you find a way to share your learning with your
peers?
Counselor as Supervisor or
Supervisee
When you begin your counseling field experiences, you will not have to do
so alone. You will be assigned a supervisor to help you along the way. In all
states, professional counselors in training must spend at least some of their
time in supervision, and supervised experience has long been considered one
of the most significant aspects in the training of professional counselors
(Bernard & Goodyear, 2014). Supervision requirements vary by state and
type of licensure, but minimum requirements set forth by the learned
association of the profession are 100 hours of supervised practicum and 600
hours of supervised internship for the master’s degree (CACREP, 2016). In
addition, many states require supervised experience (1500 to 4500 hours,
depending on the state) after the completion of the degree for those wishing
to become independently licensed clinical or mental health counselors.
Supervision is based on the belief that some type of learning occurs in
supervision that is qualitatively different from what occurs in the classroom.
That is, although classroom-based learning is essential to becoming a
counselor, it is not sufficient. Supervised experience in an actual setting, with
real clients or students, also is required. Supervised experience provides
meaningful learning, a diversity of experience, and an opportunity to put the
classroom learning into practice.
In this context, counselors take on the role of supervisors and supervisees.

Supervisors are more experienced counselors who guide supervisees as they
acquire the skills, experience, and professionalism needed to become
professional counselors. Bernard and Goodyear (2014) defined supervision as
“an intervention provided by a more senior member of a profession to a more
junior member or members of that same profession [based on a] relationship
that is evaluative, extends over time, and has the simultaneous purposes of
enhancing the professional functioning of the more junior person(s),
monitoring the quality of professional services offered to the clients . . . and
serving as a gatekeeper for those who are to enter the profession” (p. 8).
Hawkins and Shohet (1989) state that the goal of supervision is to help the
counselor-in-training develop a healthy internal supervisor, so that after the
required hours in supervision are completed, the professional counselor is
able to monitor and self-regulate counseling practice.
The requirements regarding who can become a counseling supervisor, who

needs to be supervised, and the rights and responsibilities of supervisors and
supervisees are all regulated by state licensing and credentialing boards and
by the ACA Code of Ethics (2014a). In spite of these very straightforward
requirements, other aspects of supervision are less clear cut. There is much
controversy and discussion in the professional literature about the many roles
and functions of counseling supervision, to what degree supervision is a
developmental process, the place of theory in supervision, how to implement
multiculturally appropriate supervision, and how the effectiveness of
supervision can be measured. Counseling supervision is a vibrant area of
research and study and a topic of lively debate within the field. When you
have the opportunity to be supervised, or when you eventually become a
supervisor, you will gain even more understanding of the complexity of these
counselor roles.
Counselor as Crisis Interventionist

When people experience crisis situations, having a counselor to help them
navigate the immediacy of the experience can make all the difference in their
ability to navigate the chaos and trauma. Many counselors find crisis
counseling to be an incredibly rewarding and meaningful experience.
Counselors in this role step in after a crisis to help individuals, families,
groups, or communities cope with tragedies. Crisis counseling is typically
short term (less than 3 months) and focuses on single or recurrent problems
that are devastating or traumatic. Crisis counseling often is a combination of
counseling, education, guidance, and support. It is not a substitute for long-
term counseling, but is intended to help individuals get through the
immediate trauma and its short-term effects.
Crisis counselors work in a variety of settings, and counselors in many types

of settings who do not focus primarily on crisis intervention may find
themselves put in the role of crisis interventionist. Crisis counselors may
conduct initial assessments, find referrals, and provide information to clients
who present in such places as emergency rooms, rape crisis centers, or
domestic violence shelters, or who call suicide hotlines. In other settings,
crisis counselors reach out into the community. Still others maintain regular
practices and are “on call” for crisis situations. The American Red Cross and
the Substance Abuse Mental Health Services Administration (SAMHSA)
train Disaster Mental Health Responders who come to the assistance of
everyone from individuals who lose their home to a fire, to families
devastated by school shootings, to thousands affected by natural disasters,
such as Hurricane Katrina. These individuals are licensed mental health or
school counseling professionals who go through additional training to serve
as mental health first responders. Trainings are often offered during annual
ACA or other national conferences. This type of mental health responder
became particularly well known within the counseling profession after the
attacks of September 11, 2001, when many licensed counselors across
America left their homes and practices to go to New York, Washington, DC,
and Pennsylvania, where they worked not only with the victims and their
families, but with the emergency personnel who were experiencing
“secondary trauma” from hearing the stories and seeing the effects of the
devastation.
Words of Wisdom
“I was left, like most Americans, wishing I could do something to help. Give
blood? Give money? Well, I had an opportunity to give something that I am
eternally grateful for, I gave myself.”
—Christopher Brown, assistant professor and Clinical Director of

Professional Counseling at Southwest Texas State University, commenting
on his decision to go to New York to participate as a mental health responder
after the 9/11/2001 attacks, quoted in Counseling Today (September 2002, p.
19).
Large-scale epidemiological studies of the general population consistently

find that about 70% of adults have experienced at least one extremely
traumatic event during their lives, most commonly in the form of witnessing
someone being critically injured or killed (36% men, 15% women), being
involved in a fire or natural disaster (19% men, 15% women), or being
involved in a life-threatening accident (25% men, 14% women) (Norris &
Slone, 2013; SAMHSA, 2016). Nearly half (48%) of all children have
experienced at least one traumatic event by age 17 (National Survey of
Children’s Health, 2011–12). These findings underscore the importance of
crisis counseling skills for all counselors in all settings. Many of the
counseling interventions needed for crisis counseling are the same as for
other types of counseling, such as developing rapport, expressing empathy,
and listening. Other skills are more specialized, such as creating survival
stories or teaching emotional ventilation (Echterling, Presbury, & McKee,
2005).
Working with individuals in crisis can be emotionally exhausting and can

make counselors feel overwhelmed by situations beyond their control. The
empathy and caring that is part of the temperament and training of counselors
can also lead to overidentification with the clients and their stories of trauma,
which can lead to compassion fatigue or burnout. Compassion fatigue occurs
when the stress and cumulative trauma of hearing clients’ stories begins to
affect the counselor’s well-being. All counselors must find ways to care for
themselves physically, mentally, and emotionally, and this is particularly true
for counselors who are operating in the role of crisis interventionist.
Counselor as Advisor
In counseling skills courses, beginning counselors are taught to resist the role
of advice-giving. In most situations, it is not particularly helpful for
counselors to give clients advice. Clients are unlikely to act upon the advice
that is given to them, and most individuals who engage in helping others
change behaviors recognize that there is far more involved in behavior
change than just being told what to do (Young, 2017). (If it were that easy,
we would all follow the advice of our doctors, be thin and fit, and always eat
nutritious meals!)
There is a type of advice-giving, however, that counselors do regularly

engage in, particularly in schools and colleges. When counselors are in the
role of advisor, they provide recommendations and suggestions (as well as
advice) to their students and clients. Career counselors offer career or
educational advice. In her book Career Advising, Virginia Gordon (2006)
reminds counselors that they must help clients see the connections between
their academic and career choices and the impact that their decisions have on
their future professional and personal lives. Academic advising is “a
developmental process which assists students in the clarification of their
life/career goals and in the development of educational plans for the
realization of these goals” (Habley & Crockett, 1988, p. 9). Academic
advisors in colleges and universities may help students with course selection
or meeting institutional requirements (Alexitch, 2006), and undergraduate
academic advising has been identified as a high priority by students
(Axelson, 2007; Hamed, Hussin, & Jam, 2015).
School and college counselors who engage in the role of academic advisor
take on a significant responsibility in the lives of their students and clients. A
2001 court case (Sain v. Cedar Rapids Community School District)
determined that school counselors must use reasonable care when providing
specific academic information to students. The court found that school
counselors can be held accountable for providing accurate information to
students about credits and courses needed to pursue post–high school goals.
Although this legal requirement may seem daunting, academic advising is an
important role for school counselors as it is a tangible way to help level the
playing field for students (Savitz-Romer, 2012). School counselors, who
provide academic advising to students, help close the information gap
between students who already know what they need to do to be eligible for
postsecondary education and those who do not have this information. In this
way, academic advising serves to help fulfill a social justice agenda.
Counselor as Expert Witness

Although this role is not particularly common in the counseling profession,
some counselors find that they enjoy the challenges of participating in the
legal system as expert witnesses. Expert witnesses are individuals who have
specialized knowledge, training, and experience in a particular field. Expert
witnesses are hired by either prosecutors or defendants, and they can be used
to evaluate documents, to provide insights, and to provide expert testimony in
court cases. Counselors can assist juries with understanding the complexities
of cases involving mental health; they can assist attorneys by reviewing
documents that may be difficult to comprehend without training in mental
health; and they can help judges and juries make informed decisions
(Kwartner & Boccaccini, 2008).
Counselors who serve in the role of an expert witness are obliged to follow
all ethical and legal guidelines of the counseling profession. Important court
cases, such as Murphy v. A. A. Mathews (1992), hold that even when mental
health professionals are hired to promote the stance of prosecutors or
defendants, this does not exonerate them from following the ethical mandates
of the profession (Shuman & Greenberg, 2003). Before you dismiss the
relevance of this role to your life, remember that by the time you are hired to
engage as an expert witness, you will have a lot more training and experience
under your belt. Perhaps, down the road, this is a role that you might really
enjoy.
Counselor as Prevention Specialist

Prevention is based on the belief that efforts to avoid behavioral or mental
health problems can be more cost-effective and productive than attempts to
control or cure the behavior or illness after it occurs. Just as within the
medical profession, where attention has turned to illness prevention in the last
several decades, there is an ever-increasing demand for prevention in
behavioral health care.
Philosophically, the concept of prevention is congruent with the profession of

counseling. In 1993, Kiselica and Look called prevention “a defining
characteristic of the [counseling] profession” (p. 3). An early survey of
experts in the field of counseling revealed that most described prevention as
one of the criteria that distinguished counselors from other mental health
professionals (Ginter, 1991). Indeed the focus on a proactive, rather than a
reactive, approach to mental health is intrinsically appealing to most
counselors, and you might find yourself particularly drawn to this role.
Prevention specialists in the field of mental health have more traditionally

been employed in the area of drug and alcohol prevention. Many K–12
school systems offer prevention programming to help students learn to make
smart choices, to resist harmful peer pressure, and to become more assertive
in standing up for their rights.
In more recent years, prevention services have been moving out of the
schools and into other areas of mental health care. There is evidence that with
appropriate preventive care, certain mental health problems can be prevented
altogether, while others can have delayed onset or less severe symptoms
(Matthews & Skowron, 2004). Prevention focuses on building resilience and
encouraging healthy development throughout the lifespan. Examples of
effective prevention programs include parenting education programs, school-
based social competency programs, and programs for persons experiencing
stressful circumstances, such as divorce or recent unemployment (National
Prevention Council, 2011).
In spite of the growing emphasis on prevention in mental health, however,

financial reimbursement remains a significant barrier to its widespread use
outside the school system. Just as the medical profession was slow to
promote prevention activities in health care, and insurance companies have
been slow to reimburse for health-related prevention activities, the same has
held true for mental health. It is only recently that businesses, agencies,
communities, and insurance companies have begun to advocate—and pay for
—mental health prevention.
Counselor as Businessperson or
Entrepreneur
Most people who enter the field of counseling are more oriented to the world
of people than to the world of business or finance. It is perhaps not
surprising, then, that there is little discussion in the field about the role of the
counselor as businessperson or entrepreneur. The lack of available
information can send the message to new counselors that somehow
discussing money is bad or inappropriate for persons who should be
interested in caring for people rather than making money.
The reality, however, is that the role of counselor as businessperson or

entrepreneur can be critical for counselors who need to finance their work,
whether through grants and contracts to fund programs or through
reimbursement agreements with insurance companies to pay their salaries.
Professional counselors must get paid for their work, and they must have
sufficient resources to implement needed programs.
Counselors can receive funding through grants and contracts, but in order to
receive this funding, they (or others, on their behalf) must write proposals to
organizations and foundations. Typically, grant proposals identify specific
programmatic objectives and how these objectives will be met. Foundations
are targeted whose missions align with those of the grant proposal. Grants are
available for many different types of counseling interventions, such as
specialized curricula in the schools, domestic violence prevention, suicide
prevention, and gerontological programming. Counselors can support their
work through contracts with schools, agencies, businesses, governmental
departments, or communities. For example, a counselor might contract with a
community to provide court-mandated counseling for individuals charged
with driving under the influence. Another counselor may contract with a
school to provide mental health services, or with a business to provide
employee assistance counseling. In these instances, counselors reach out to
those whose constituents may need their services and offer to provide
counseling or other programs for a set fee.
Fast Fact
Large corporations often have philanthropic outreach programs to fund
programs and projects that are important to the corporation or its founders.
For example, Wendy’s founder Dave Thomas was adopted. Each year, the
Dave Thomas Foundation gives out more than $6 million in grants and
awards to promote adoption and foster care services.
Source: www.davethomasfoundation.org.
Counselors also receive funding for their work from clients who pay for
counseling out-of-pocket or from insurance companies. Counselors in private
practice who wish to receive insurance reimbursement typically must get onto
provider panels with insurance companies or managed care organizations.
Counselors may have to advertise to attract clients, and learning how and
where to advertise in an effective, appropriate, and ethical manner requires
business acumen. Regardless of their funding source, counselors need to feel
comfortable in the role of entrepreneur—reaching out to potential funders or
clients to let them know the benefits of the programming and services that
they provide.
Counselor as Mediator
Mediators are individuals who help two or more parties involved in a dispute
reach a resolution that they can agree upon, rather than having a resolution
imposed on them by a third party. Mediators use many counseling
techniques, such as mechanisms to improve communication and listening,
increase problem-solving, and de-escalate emotions. Mediators are impartial
in the dispute, and they can offer opportunities for the involved parties to
hear different perspectives in a safe environment. Perhaps you have found
yourself in the mediator role in the past, when friends or family members
were engaged in an angry dispute. A natural desire to resolve disputes in a
way that meets everyone’s needs is an example of how the mediator role may
be particularly appealing to counselors.
Not all mediators are counselors by training, and there is a separate

credentialing process for professional mediators (although a mediation
credential is not required to engage in mediation). Many counselors engage in
informal mediation. For example, a school counselor may mediate between
students who have been caught fighting, or between a parent and a teacher,
when conflict escalates. Mental health counselors may mediate between
partners in a divorce to find a solution to parenting that is amenable to both
parties or between co-workers at a worksite.
There is a distinct and separate body of research on mediation styles and

theories. For example, a foundational theory of mediation posits that
mediator style exists on a continuum from one who is very passive to one
who is a leader and active problem solver (Gulliver, 1979; Kolb, 1983).
Regardless of the specific style, mediation can be extremely effective. One
study found that formal mediation settled 78% of legal cases, regardless of
whether the parties had been sent to mediation by a court or had selected the
process voluntarily. Mediation also was significantly less expensive than
arbitration, took less time, and was judged a more satisfactory process than
arbitration (Brett, Barsness, & Goldberg, 1996).
Counselor as Advocate or Agent of

Social Change
For counselors, advocacy means becoming agents of social change,
intervening not just to help individual clients, but to work to change the
world in which our clients live. When counselors are advocates, they fight
injustices through both individual and collective actions. Advocacy has been
termed “a professional imperative” for counselors (Myers, Sweeney, &
White, 2002, p. 394).
Within the counseling profession, advocacy is linked to the idea of social
justice, which highlights the need to advocate for marginalized groups and
recognizes the connection between oppression and mental health concerns
(Ratts, 2009). A social justice perspective encourages counselors to recognize
that clients do not live in a vacuum. There is a link between an individual’s
mental health and the harmful effects of toxic environmental conditions.
Whereas counseling has traditionally conceptualized mental health problems
as internal to the individual, a social justice approach recognizes that
environmental factors, such as racism, sexism, heterosexism, and classism,
can delay people’s growth and development and hinder people’s ability to
reach their potential. The negative effects of the environment are particularly
harmful for clients who have been historically marginalized in society, such
as people of color, those in poverty, and individuals who identify as
lesbian/gay/bisexual/transgender (LGBT).
Many counseling students are particularly attracted to this role. Counselors

want to change the world, and although we often do that work “one person at
a time,” we also see that systemic change can have a tremendous impact on
the lives of our clients. It is hard for most counselors to see injustices and not
feel passionate about wanting to make a difference. Fortunately, within the
field of counseling, there are clear mechanisms to help address social
inequities and to channel the passion you may feel into strategies that have
powerful and lasting outcomes for people who need our help the most.
The American Counseling Association (ACA) recognizes the importance of

advocacy for professional counselors, and in 2003, the Governing Council
endorsed a set of Advocacy Competencies (Lewis, Arnold, House, &
Toporek, 2001) that encourage counselors to empower their clients, make
systems change interventions, and negotiate relevant services and educational
systems on behalf of their clients. In 2004, ACA formed a new division to
emphasize this role, called Counselors for Social Justice (CSJ). A social
justice approach to counseling empowers counselors to actively confront
injustice and inequality in society. Counselors who work from a social justice
perspective use the guiding principles of equity (the right to be treated fairly),
access (the right to power, information, and opportunity), participation (the
right to be included in decisions that affect one’s life), and harmony (the right
to participate in endeavors that benefit the community as a whole) (Crethar &
Ratts, n.d.).
Fast Fact
In one national survey, more than half of all national, state, and local
counseling associations (52%) had a statement that required involvement in
advocacy activities for professional counselors.
Source: Myers & Sweeney (2004).
School counselors are ideally positioned within schools to become agents of

social change. There is a well-documented academic achievement gap
between poor and middle class students (Davis, Davis, & Mobley, 2013;
House & Hayes, 2002). When school counselors serve as educational leaders
who advocate for all students, they can help make systemic changes to ensure
all students have equal access to quality education that helps unlock their full
potential (Davis et al., 2013; House & Hayes, 2002; Trusty & Brown, 2005).
Professional school counselors have a set of advocacy competencies that
include (a) having the disposition to advocate on behalf of students; (b)
possessing the knowledge of resources, parameters, advocacy models, and
systems change to advocate for students; and (c) using communication,
collaboration, problem solving, organizational, and self-care skills to become
advocates in their schools (Trusty & Brown, 2005). Although speaking up
against the system can sometimes be uncomfortable, school counselors
should remind themselves that the goal of social and educational equality is
well worth the discomfort!
Mental health, community, and rehabilitation counselors also have an

important role to play in advocacy and social justice. Kiselica (2004)
reminded all counselors that they have a duty to advocate for clients who are
too overwhelmed or ill to advocate for themselves. This advocacy can occur
on an individual level, such as working with an insurance company to gain
approval for more counseling sessions, or on a systemic level, such as
lobbying for laws and regulations that will help improve clients’ lives.
Because of the importance of advocacy at the legislative level, many state-
level counseling associations offer “Legislative Days” when counselors can
learn to advocate for mental health. In the accompanying Spotlight, we
highlight counselors who are advocates for their clients and for the
profession. As you read through the stories of these counselors, take time to
consider your own emerging identity as an advocate and agent of social
change. You may want to ask yourself the following questions:
How might being an agent of social change and a social justice advocate
align with my values and beliefs?
How could a social justice perspective inform my emerging theoretical

counseling orientation?
What might I have already done in my life that aligns with the role of
social justice advocate?
What can I do now, while I am still in my counseling graduate program,

to help gain experience as an agent of social change or social justice
advocate?
Words of Wisdom
“The biggest misconception is that the effort of working toward social justice
has to be a Herculean effort. The reason many individual counselors enter the
profession is because they love being in the service of others. Simply looking
for opportunities to address inequities even on a smaller scale is a great act in
the name of social justice.”
—Carl Sheperis, 2010 winner of the ACA Counselor Educator Advocacy

Award
Counselor as Member of
Professional Associations
Counseling is an exciting and vibrant profession, but like all professions, it
requires active and engaged participation by all members in order to thrive.
Active involvement in professional associations is a benefit to the entire
counseling profession as well as the individual counselor. In order for the
counseling profession to achieve its goals (for example, recognition and
inclusion by legislators into important legislation, funding for increases in the
number of school counselors, recognition by third-party payors) and to set an
agenda for the future, counselors must unite to speak with a unified voice that
clearly articulates a cohesive professional identity. Counselors speak with
this unified voice through their counseling associations. The American
Counseling Association (ACA) is the world’s largest counseling association,
with more than 55,000 members. The American School Counselor
Association (ASCA) has over 33,000 members. Together, ACA and ASCA
work with many other professional associations to lead state, national, and
international efforts to advocate on behalf of the counseling profession. It is
clear that without these associations, professional counselors would be unable
to advocate for large-scale change on behalf of their clients and would have
difficulty educating consumers and policy makers about the benefits and
unique contributions of counseling as a profession (Reiner, Dobmeier, &
Hernandez, 2013). Therefore, it is an imperative to the health of the entire
profession that professional counselors become members of their professional
associations.
In addition to joining professional associations to help provide a unified voice

for lobbying and public awareness campaigns, associations help set standards
for the profession of counseling and develop ethical guidelines for members
to follow. Professional associations provide members with new knowledge
and information through books, journals, newsletters, and conferences.
Professional associations also provide leadership opportunities for
counselors. Those who wish to become involved can help create a vision for
the future of the profession and can use their knowledge, skills, and
motivation to encourage and support other counselors. Counselors who do
not belong to their professional associations can become isolated and
deprived of the newest information in the field (Lee & Remley, 1992).
Graduate school is an ideal time to begin what will (hopefully) be a lifelong

association with the professional counseling organizations, as there are
reduced rates and many benefits offered to students. You will learn more
about the benefits of joining professional associations as a graduate student in
Chapter 3. For now, take a moment to read the accompanying spotlight of a
professional clinical counselor, as she discusses her beliefs about the
importance of active involvement in professional counseling associations and
how her own career has been enhanced by her active membership and
involvement in these organizations.
Fast Fact
Most professional counselors recognize the importance of membership in
their state and national counseling associations. One study of school
counselors found that more than three-quarters (76%) were current members
in at least one state or national professional association (Wheaton, Bruno, &
Granello, 2016). A similar study of clinical counselors found that 81% were
members of these associations (Whitney, 2007).
SPOTLIGHT The Many Faces of

Advocacy
Sometimes, counselors can read or hear about tremendous social injustices,
the need that exists for social change, and the advocacy efforts of others in
the field and feel overwhelmed by the challenge. It is easy to believe that
counselors who are advocates must dedicate countless hours to big causes.
And for some advocates within the profession, that is certainly accurate.
Other counselors advocate on a much smaller scale, but their contributions
are still very important to their clients, to the profession, and to society as a
whole. This Spotlight briefly highlights 12 different counselors who have
taken up the role of advocate. The point is for beginning counselors to
recognize that advocacy can take many forms, and there is a place within this
role for everyone. Just as with all counseling roles, there are many different
paths to take within the overarching role of professional advocacy.
Rochelle Dunn is licensed as both a professional school counselor and a

mental health counselor. As a school counselor, she was frustrated by her
inability to meet the significant mental health needs of the many struggling
students in her school. As a mental health counselor, she found that she had
limited access to schools, where the kids who needed her the most were
located. To resolve this conflict, she developed a mental health clinic in her
high school. Staffed by mental health counselors and interns and working
closely with the school counselors in the building, the clinic was able to meet
the more advanced mental health needs of many of the students. Originally
funded through a grant, the clinic is now funded by the school system and has
been replicated in middle and high schools throughout the district.
Jenny Renfro is a counselor in New York City. She works in a mental health
setting in Spanish Harlem. Although Jenny didn’t know any Spanish when
she started her work, she is learning to speak the language and is actively
engaged in outreach and programming to the Latino/a culture.
Anita Young is a school counselor and consultant for the Education Trust
Transforming School Counseling Initiative. She is active in her state school
counseling association, and she co-authored a book on how school counselors
can use data to help improve students’ achievement. As a doctoral student,
she implemented a program in an urban high school that resulted in a 50%
increase in the number of high school seniors who applied and were accepted
to college.
Jerry Juhnke is a counselor and professor in Texas. After Hurricane Katrina,

more than 13,000 displaced people were transported to San Antonio, Texas.
Rather than sit helplessly by and watch this human drama unfold, Dr. Juhnke
organized his students, who provided more than 300 direct service hours of
counseling in the weeks following the disaster.
Erin Bruno is a college counselor who does outreach to urban high schools,
preparing low-income/first-generation college students for postsecondary
education.
Mark Kiselica is a counselor who began advocacy work by organizing

consciousness-raising events about the needs of Teenage Fathers, a group that
has been largely ignored by society. As his efforts grew, he brought attention
to the issue to a national level, including becoming the founder and
coordinator of the American School Counseling Association’s Taskforce on
Teenage Parents. In 1996, Dr. Kiselica served as a consulting scholar to the
Federal Fatherhood Initiative, advising officials from the U.S. Department of
Health and Human Services about how to better serve fathers in federally
sponsored social service programs.
Natalie Turner was a student in a master’s internship class working at the

homeless shelter in a large city. She was surprised to learn that the shelter did
not have a standard policy for mental health programming or standardized
access to mental health care. Rather than wait for someone else to develop
such a protocol, Natalie researched the project and developed one on her
own. When it was presented to her supervisor, word of Natalie’s initiative
quickly spread throughout the agency and was soon adopted by the board as
the official policy for the shelter. The protocol was widely shared with other
homeless shelters throughout the state and quickly became the standardized
policy in the state.
Suzanne Lynah is a counselor in Vermont. Suzanne is a deaf person born

into a hearing family. At age 16, she decided she wanted to be a counselor.
Now, she is the only licensed Deaf therapist in Vermont. She travels all over
the state to meet the needs of Deaf clients in schools and other agency
settings. Through her work and outreach, she advocates for deaf persons to
receive culturally and linguistically appropriate therapeutic care.
Barbara Mahaffey is a Licensed Professional Clinical Counselor in a small

Appalachian town. Late one Friday afternoon, she received a call from a
crisis worker at a local jail who said there was a man in custody who said he
planned to die by suicide that night. The man had asked the crisis worker to
contact Barbara, whom he had never met, because he heard from some
friends that she was a compassionate and caring person, and he wanted
Barbara to take care of his cats after his death. Barbara spent the rest of the
day and into the evening helping get the man the mental health care he so
desperately needed. After multiple calls to the psychiatric hospital, the
emergency room, the lieutenant at the jail, the insurance company, and a
judge, Barbara was able to get the man admitted to the hospital, many long
hours after she received the first phone call about a stranger in need. After a
long day, Barbara headed home, but not before stopping at the man’s house
to feed his cats.
Emily Clark is a licensed professional clinical counselor who had several

transgender clients on her caseload. Before long, she recognized that there
was a need in the local counseling community to improve counseling skills
for counselors working with transgender/gender nonconforming/gender
variant clients. Emily started the first clinical consultation group in her city to
help counselors improve their clinical skills and foster an increased
willingness to work with transgender clients.
Keith Liles is an LCDC (Licensed Chemical Dependency Counselor) in

Texas. He spent 12 years in the banking industry before beginning his
training as a counselor. He first became involved in the Texas Association of
Addiction Professionals as a student volunteer, then as a part-time counselor,
and now as director of clinical services for a behavioral health care
organization. Keith had a strong vision of what addiction professionals could
and should do in Texas and how they should be trained. He is a tireless
legislative advocate on behalf of persons with addiction. In 2005, Keith
received the National Association for Alcoholism and Drug Abuse
Counselors’ “Outstanding Professional of the Year” Award.
Anne Lombardi is a college counselor at a small liberal arts college. She is

passionate about student safety and ways that colleges can help students find
appropriate mental health care. She knew that if college counselors in her
state had a way to communicate with each other, they could share important
and life-saving ideas. As a result, she organized a statewide meeting for
college counselors, with an emphasis on mental health problems on small
college campuses where resources are often scarce. Thanks to Anne, college
counselors who used to work in isolation on small campuses now have an
entire statewide network to assist them in their important work.
YOU
Take a moment to think about what your contribution to
advocacy might be. What “story” would you like to read about your efforts?
Remember, there is plenty of work to be done to help advocate for clients and
for the profession. Find your niche, tap into your potential, and look for ways
to express your advocacy in ways that make sense for you.
SNAPSHOT Jean Underfer-Babalis,

Counselor, Counselor in Private
Practice, Supervisor, Advocate,
Leader in Professional Associations
Jean Underfer-Babalis
I have been a professional clinical counselor (PCC) for over 20 years, and it
is a passion for me. I have had a private practice for 15 years. I love the
independence, freedom, and autonomy of private practice, and with my
leadership responsibilities and speaking engagements, I need the flexibility in
my schedule.
Most days, my day starts at 9 a.m. and ends between 7–9 p.m. I work three to
four days a week. In the morning, before seeing clients, I review charts,
answer phone messages, and if time permits, I check my e-mails. I schedule
clients straight through without any breaks. I hold to a 45-minute clinical
billable hour and do my paperwork, return phone calls, call insurance
companies if needed, attend to office duties, and take care of personal needs
as time permits.
Anything can happen during the day. I can have large gaps with no clients, or
every client attends and has some kind of emergency. Fielding calls from
clients, family members, referrals, and anyone associated with a client is part
and parcel of what I do on a daily basis. Routine and structure are nonexistent
in my world.
I have learned to expect the unexpected, because it will happen. Some days I
go 12 hours right through, and I feel like I am on roller skates. At the end of
the day, I realize I have not eaten or even gone to the bathroom. Sometimes, I
have to deal with crises with clients, another health professional, an
emergency service, or something as boring as cleaning the office.
The days I do not see clients, I am usually involved in some sort of activity
related to professional counseling. I am an officer in several of the
professional counseling organizations, so I travel frequently and have
volunteer work to do in that capacity. Being a leader costs me money in lost
revenue, but it is my belief that it is important to be involved in the
counseling profession and represent what is happening in the clinical world.
When I am supervising interns or professional counselors working toward

independent licensure, I usually have them come to my office. I do site visits
about once a month. At times, I take a contract to provide supervision for an
entire group of beginning counselors at an agency. On those occasions, I go
to that agency on a specific day of the week for a half a day.
Watching clients gain strength and insight into their lives and situations is
such a joy to not only watch but to be a part of the process. To be there with a
client with empathy and compassion and share in the pain and the joy is a
privilege that cannot adequately be explained in words. One of the most
rewarding parts of my professional life is learning about the impact my
counseling has had on a human life.
The distasteful part of my career is dealing with insurance companies and
bureaucracy. It is terribly annoying and sometimes maddening to have a
reviewer tell me (the professional who has worked with the client directly)
that the client only needs a few more sessions to draw counseling to closure.
Of course, if I share my harsh thoughts with the reviewer, I might only hurt
the client, because the reviewer has the power to discontinue treatment.
The wisdom I would like to impart to an aspiring professional counselor

going into private practice is to surround yourself with excellent people.
Being in private practice requires flexibility, patience, and being able to
handle some level of anxiety (your income fluctuates). Learn to go with the
flow and hire people to do the things that are not directly related to seeing
clients. Your time is better spent generating income and paying someone to
file charts.
Most importantly, love what you do. Having a passion and love for being a
PCC will get you through those times when you wonder if what you are
doing is helpful. Beware, doubts will occur. Being in private practice requires
patience, self-motivation, tolerance, being able to weather the storm, and
being able to see the big picture.
Jean’s Breakdown of Time Spent on Daily Activities

Counselor as Diagnostician 5%
Counselor as Assessor 10%
Counselor as Researcher or Scientist 3%
Counselor as Supervisor 3%
Counselor as Crisis Interventionist 2%
Counselor as Advocate or Agent of Social Change 5%
Counselor as Expert Witness 2%
Counselor as Member of Professional Organization 20%
We put the snapshot of Jean here, under “Member of Professional

Organizations,” because she has been a leader in professional organizations at
the state and national level for many years. However, like many counselors,
her story could go under many of the different headings because, just like
many counselors, Jean’s professional life involves commitments to many
different roles. In fact, as you read Jean’s story and looked at her chart of
percentages of times spent in each of these roles, you discovered that she has
clearly mastered one of the keys to being a successful counselor: flexibility!
Summary
In this chapter, you learned about the many roles that professional counselors
play. Some of them were probably what you expected, while others may have
been new or surprising to you. Of course, the list of roles in this chapter is not
all-encompassing, and there are many other roles that, although less common,
are no less important. Since the profession of counseling began, counselors
have been carving out niche roles that use their special skills or interests. For
example, we have had students come into our programs who are already
lawyers, doctors, nurses, government executives, morticians, professional
athletes and coaches, or engineers, and they have combined the skills of their
existing professions with their newly learned counseling skills to establish
unique roles and employment niches. We have worked with counselors who
have very specialized clientele, and therefore, highly specialized roles. A
counselor who works primarily with burn victims and those who have
experienced facial disfigurement finds that although she engages in several
traditional counseling roles, such as direct service, advocacy, and assessment,
she also has some unique responsibilities. Among these are helping clients
maneuver the complex medical world of plastic surgery and facial
reconstruction. In this role, she accompanies clients on their visits to doctor’s
offices. Another counselor who works with athletes retiring from professional
sports found that he has added “media consultant” to his list of counseling
roles. A school counselor who is employed by an online high school found
that (limited) technical support is among her roles when one of her students is
frustrated by technical problems that keep him or her from learning.
The point is that with a strong background in counseling, you can create the
job of your dreams. If your ideal position doesn’t exist, then it is possible for
you to create it. Counselors are, by training and temperament, resourceful and
flexible individuals who look to find ways to help others and to apply their
skills and training where they are needed most.
Student Activities
1. Reflect. Now it’s time to reflect on the major topics that we have
underlined. What were your reactions as you read that portion of the
chapter? What do you want to remember?

2. Take a look at the Spotlight on the many faces of advocacy. Whose

stories did you connect with? What part of advocacy appeals to you?
What role do you see yourself playing in both the personal and
professional advocacy of the profession?

Journal Question
1.
A Counselor’s Professional Setting. Imagine for a moment that you’ve

completed your formal training in counseling and you’re in your ideal
counseling job. In what type of work setting do you see yourself? What kinds
of counseling interventions are you doing (e.g., individual, group, family,
rehabilitation, adventure therapy? Long-term or brief counseling?) What does
your client population look like? At this point, when considering your future
work setting, are there any clients or populations that you would not consider
working with or any setting that you would rule out? Why? What is it about
these clients/populations/settings that you believe would make it difficult for
you to be an effective counselor? Is there anything you could do in the
coming weeks and months to expose yourself to this population in order to
make sure you haven’t ruled them out prematurely?

1. Do you think counselors should focus on social justice and advocacy at
the systemic level, or should they focus on the needs of their individual
clients? Do counselors have the right to ask their clients to engage in
social justice issues? How can counselors find a balance between the
needs of individual clients and greater social needs?
2. Counselors clearly can engage in many different roles and functions.

This may contribute to an overall problem with professional identity. In
a field with such diversity, how can counselors develop an overall
definition of counseling that fits with all the specialties and roles?
Experiments
1. Look again at the chart on page XX and the chart that you completed
before you read this chapter. Now, complete the chart again, based on
your new understanding of these many roles that counselors can play.
What has changed? What has been confirmed? Do you have different
thoughts now about your future involvement in the profession?
2. Work with your instructor to help identify three different counselors to

interview, one in each of the following categories:
1. A counselor who holds a role that you are attracted to
2. A counselor who holds a role that you are not attracted to
3. A counselor who holds a role that you don’t know much about
After your interviews, consider what you learned about the many roles
of the profession based on your experiences. Did any of your
interactions change your beliefs about the kind of counselor you would
like to be?
3. Develop a brief (1–2 sentence) description of what it means to be a

counselor that could be shared with others outside the profession. Use
your own words, rather than descriptions taken from this text or
websites of the profession. Is it challenging to develop a brief but
inclusive definition for counseling? What are the difficulties you
encountered when you attempted this experiment?
Explore More
Books
Herr, E. L., Heitzmann, D. E., & Rayman, J. R. (2005). The professional
counselor as administrator: Perspectives on leadership and
management in counseling services. New York, NY: Routledge.
This book explores a role that many counselors find themselves in

with little preparation. Counselors who seek administrative roles, or
who find themselves in these positions, will benefit from the
practical advice and information.
Lewis, J. A., Ratts, M. J., Paladino, D. A., & Toporek, R. L. (2011).

Social justice counseling and advocacy: Developing new leadership
roles and competencies. Journal for Social Action in Counseling and
Psychology (3)1, 5–16.
This article helps counselors better understand how to incorporate

social justice and advocacy into their professional role.
Sullivan, W. P. (2006). Mental health leadership in a turbulent world. In.

J. Rosenberg & S. Rosenberg (Eds.), Community mental health:
Challenges for the 21st century (pp. 247–258). New York: Routledge.
Counselors in community mental health must find ways to use their

leadership skills for the good of their clients and of the profession.
This chapter (and the entire book) helps counselors find a way to
use these skills in their roles as professional counselors.
Trusty, J., & Brown, D. (2005). Advocacy competencies for professional

school counselors. Professional School Counseling, 8, 259–265.
School counselors have been called upon to become advocates for

all of their students, and this article provides not only a listing of
the necessary competencies, but practical strategies for
implementation of them.
Chapter 3 How Are Counselors
Trained and Regulated?
Questions
The education and training requirements to become a professional

counselor.
The professional associations and organizations to which counselors

belong.
Some of the current controversies and challenges related to licensure,

including issues surrounding licensure portability and about whether
counseling represents one profession or many.
What it means to have a strong sense of professional identity as a

counselor.
Identify professional organizations and associations that are most

relevant to your own path as a future counselor.
Determine where to find out more information about your own state’s
licensure requirements.
What do you think differentiates professional counselors from friends

who reach out to help others or other nonprofessional helpers?
How can a sense of professional identity help individual counselors and

the profession as a whole?
Whether you believe that all counselors, regardless of setting, have the
same core professional identity?
f. professional counseling organizations, including membership

benefits, activities, services to members, and current issues;
g. professional counseling credentialing, including certification,

licensure, and accreditation practices and standards, and the effects
of public policy on these issues;
h. current labor market information relevant to opportunities for

practice within the counseling profession.
Becoming a counselor certainly means different things for different people,
and the road you took to get to this moment in time is as unique as you are.
From now on, however, your path, at least in terms of professional
experience and training, will have some commonalities with all other
graduate students in counseling. These commonalities bind our profession
and give us all a sense of professional identity. Having an identity as a
professional counselor is not just a job title or the listing on your license.
Being a professional counselor means that you have achieved a high level of
education and training, have met agreed-upon standards of the profession,
and have committed to a vocation that upholds certain principles and ethics.
Being a counselor means that you believe that all human beings have value
and are worth helping, that people can and do change their lives, and that you
have something to offer them in their journey. Being a professional counselor
is both an awesome responsibility and a wonderful privilege. It is because of
this responsibility that professional counseling remains a tightly regulated
profession. As you learned in Chapter 2, almost anyone can use the term
counselor, but having identity as a professional counselor is much, much
more.
In this chapter, you will learn about the education and training of professional
counselors. You will learn about the professional associations that foster the
growth of counseling and about state licensing and certification boards that
regulate counselors. There is no national licensure for counselors. Regulation
of the profession is done on a state-by-state basis. Nevertheless, there are
some generally agreed-upon principles for the education of professional
counselors, and there are several national organizations and associations that
help regulate and promote the profession. Becoming a counselor and
maintaining your status as a professional counselor is a very involved
process, and this chapter will help you begin to negotiate the many diverse
and complicated regulations and guidelines for becoming a counselor.
How Many Counselors are There?
The American Counseling Association (ACA) states that there are over
120,000 professional counselors who are licensed in 50 states and the District
of Columbia. However, this number represents only mental health counselors
who are licensed by their state licensing boards. When all the counseling
specializations are included, the number of practicing counselors in the
United States is much higher. According to the U.S. Department of Labor’s
Bureau of Labor Statistics (2015), there were approximately 686,000
counselors in the United States in 2015. According to projections from this
same source, job opportunities for counselors in the next several decades
should be very good, with job openings expected to exceed the number of
graduates from counseling programs, although this varies by location and
occupational specialty. The overall employment of counselors is expected to
increase by 18% from 2014 to 2024, faster than the average for all
occupations (which is approximately 8%). Specifically, projections are that
demand for some specialties will increase dramatically:
Mental health counselors—20% growth
Substance abuse and behavioral disorder counselors—22% growth
Marriage and family therapists—15% growth
Rehabilitation counselors—9% growth
School counselors—9% growth
Fast Fact
Among all occupations requiring a master’s degree to practice, Mental Health
Counselors represent one of the top five fastest growing occupations. School
counselors represent one of the top five occupations projected to have the
largest increases in employment.
Source: U.S. Bureau of Labor Statistics (2015).
Because the federal government does not regulate counselors and there is no
national standard for what is included in these federal reports, there are
varying levels of education, experience, licensure, and certification
represented in this listing. Nevertheless, it is clear that counselors represent a
significant (and increasing!) proportion of the U.S. workforce.
The Education of Counselors
To become a professional counselor, most states generally require, at a
minimum, a master’s degree in counseling (in some, but not all, states a
master’s degree in a related field is acceptable). Graduate degrees in
counseling typically are offered through counselor education programs in
colleges of education, although at some universities, the programs are located
in other colleges or departments. There are many subspecialties in
counseling, and new counseling students may be surprised that they can
specialize in college student affairs; elementary or secondary school
counseling; gerontological counseling; marriage, couples, and family therapy;
substance abuse counseling; rehabilitation counseling; agency or community
counseling; clinical mental health counseling; and career counseling (U.S.
Bureau of Labor Statistics, 2015). Of course, not all universities or counselor
education programs offer all of these specializations. The most common ones
offered are school counseling and clinical/community counseling.
The specific course and education requirements for counselor licensure are
dictated by state laws and regulations. However, most states follow the
guidelines that have been established by CACREP—the Council for
Accreditation of Counseling and Related Educational Programs. CACREP is
an independent agency that was founded in 1981, after the American
Counseling Association (then the American Personnel and Guidance
Association) formed a task force in the late 1970s to look into the
development of national standards for counseling accreditation. As we
discussed in Chapter 1, during the 1970s and 1980s, counseling was not
licensed in most states, and there were no agreed-upon standards for the
training of counselors. Without licensure or certification to guide this
process, each counselor education program was free to develop its own
unique program. In fact, it was common for school counselors trained in the
late 1960s and early 1970s to have only one summer’s worth of counseling
classes before they began their school counseling careers. Even into the
1990s, colleges and universities (in states without counseling licensure) could
offer “counseling” programs with far fewer courses and credit hours than
were required in other states.
CACREP (and CORE—Commission on Rehabilitation Education in
rehabilitation counseling, which has merged with CACREP) represents a
professional accreditation standard. Professional accreditation is a process
whereby an educational program at a college or university voluntarily
undergoes review by an accrediting body. Professional accrediting bodies
evaluate and qualify educational programs that have met the standards for
accreditation. CACREP was developed so that training programs throughout
the country would train their students in the same basic curriculum and with
the same minimum standards. The eight core areas of counselor training that
were developed by CACREP serve as the basis for most counselor education
programs today. These are as follows:
1. Professional Orientation and Ethical Practice
2. Social and Cultural Diversity
3. Human Growth and Development
4. Career Development
5. Helping Relationships
6. Group Work
7. Assessment
8. Research and Program Evaluation
In addition, CACREP’s eight core areas are used as the basis for the
educational requirements for most states’ licensure requirements, and the core
areas serve as the foundation for the test questions in the National Counselor
Exam for Licensure and Certification (NCE). As a result, the curriculum
guidelines developed by CACREP have had a major influence on the
education of all counselors in all states. In this chapter’s Informed by
Research feature, you will read about a study conducted to help validate the
importance of each of the eight core areas of CACREP to the practice of
professional counseling. As you have already noticed, in this textHere we
highlight specific research studies that inform the counseling profession to
help underscore the importance of research in our profession. There is
perhaps no other topic in the text that has such a direct and immediate impact
on your life. Research into these core areas has a direct influence on the
curriculum that you will go through during your counselor education
program.
Colleges or universities can have their programs accredited by CACREP if

they meet certain criteria and voluntarily submit to the accreditation process.
CACREP accredits both master’s and doctoral programs in counselor
education. At the master’s level, CACREP accredits specific counseling
tracks, including Addiction Counseling; Career Counseling; Clinical Mental
Health Counseling; Clinical Rehabilitation Counseling; College Counseling
and Student Affairs; Marriage, Couple, and Family Counseling; and School
Counseling. The doctoral standards build upon the successful completion of a
master’s-level program in counseling. No accredited doctoral programs have
specific “tracks,” but rather are accredited as Counselor Education and
Supervision programs. At the doctoral level, students focus their educational
experiences primarily on research, teaching, supervision, and leadership as
well as advanced clinical practice within the counseling profession. As of
2016, CACREP had accredited 335 institutions in at least one of the
CACREP specializations. Of those, 73 institutions were CACREP accredited
at the doctoral level (CACREP, 2016). The number of programs accredited
through CACREP continues to increase.
Not all programs are CACREP accredited, and CACREP accreditation is not
necessarily a prerequisite for counselor education programs to train high-
quality counselors. What is important is that training programs meet the state
licensure requirements for the state within which the program is located. In
other words, since state licensure programs set out specific training and
education requirements before individuals are eligible to sit for licensure, it is
these requirements that a counselor education program must follow. As long
as your program meets your state’s licensure requirements for education and
training of counselors, regardless of whether the program is accredited by
CACREP, your degree will allow you to sit for the licensure exam within
your state.
Informed by Research The Eight
Core Areas of the Counseling
Curriculum
The eight core areas that make up the counseling curriculum in most states
and in all CACREP programs are firmly established and generally well
accepted within the counseling profession (Schmidt, 1999). Studies of
counseling students, faculty, and graduates consistently find support for the
relevance of the eight core areas to the counseling profession (McGlothlin &
Davis, 2004).
McGlothlin and Davis (2004) set out to explore whether graduates in

different specialties (school counseling and mental health counseling) and
faculty in counselor education programs had different perceptions of the
relative benefits of the eight core areas. They conducted a national survey of
practicing school counselors (N = 256), mental health counselors (N = 242),
and faculty members in counselor education (N = 143).
Results indicated that overall, all three groups had favorable perceptions of
all eight core areas (3.09 on a 4.0 scale). Helping Relationships and Human
Growth and Development were perceived as the most beneficial by all three
groups, with Social and Cultural Diversity ranking a close third and Group
Work fourth. Practicing school counselors saw the least benefit in Research
and Program Evaluation. Both practicing mental health counselors and
counselor education faculty ranked Career Development last, although
faculty, even though they ranked this core area last of the eight, still
perceived Career Development as significantly more beneficial (p < .05) than
did practicing mental health counselors.
It is perhaps not surprising, given the importance of counseling skills and the
developmental nature of counseling, that Helping Relationships and Human
Growth and Development were perceived to be the most beneficial core areas
for all three groups. The lower rankings of Research and Program Evaluation
and Career Development are consistent with how individuals score on the
National Counselor Examination (NCE), where counselors typically score
lowest on career, research, and assessment (Loesch & Vacc, 1994).
The results of the study support the inclusion of the eight core areas in the
counselor education curriculum. Even areas with the lowest level of support
are still perceived to be beneficial to the counseling curriculum. It is because
of the findings from these studies that the CACREP standards revision
committee elected to keep the eight core areas the same in the 2009 and in the
2016 CACREP revisions. Meaningful research conducted by McGlothlin &
Davis (2004), Schmidt (1999), and Loesch and Vacc (1994) all help
counselors, counselor educators, and accrediting bodies to make sound
decisions that are truly informed by research.
Educational Requirements
The education and training that you receive during your graduate program is
the result of many years of research and practice into the most effective
methods for training new counselors and professionally agreed-upon
standards regarding the core educational content and experiential components
of your training. Because of the awesome responsibility that professional
counselors face as they work with their students and clients, training
programs must be both far-reaching in content and rigorous in process. It is
not uncommon for students to feel overwhelmed by all that is required of
them in their counselor preparation programs. New students might look ahead
to the required curriculum and think that it seems almost insurmountable.
You may experience this, too. Each term, when you are handed a syllabus for
a course, you might be excited by the possibilities and energized by the
opportunities it presents, but you may feel a bit overwhelmed as well. You
may start to think that you are in over your head and that the requirements are
more than you will be able to complete. The good news is that this feeling is
very common among graduate students in counseling. The even better news
is that faculty in your program have worked hard to develop a program that
not only prepares you to become an outstanding counselor, but is done in a
way that best facilitates your success. Faculty frequently discuss how to
structure courses (or the entire counseling curriculum) in ways that both
support and challenge the student learners. Courses may challenge you in
ways that you have never been challenged before, but there are typically
supports in place to help you. Chapter 5 of this text will give you some
practical strategies to help you get the most from your graduate program.
Core Curriculum
The eight core areas that are required by CACREP and most state licensure
boards have remained the same since CACREP was founded in 1981,
although the specific information and educational experiences that are
contained within these core areas change with the needs of the profession. In
your graduate program, you will have at least one course or educational
experience in each of the eight core areas. What follows is a brief description
of each of these areas, which is intended to give you a broad overview of
your graduate program and to whet your appetite. More important than just
listing the content included in each of these areas, we will focus this
discussion on why the core areas serve as the foundation for your training.
You will have entire courses to help you understand the content that is
included in each of the core areas, and any overview we can give you of the
actual content would be cursory, at best. We believe that in a text that
introduces you to the profession, the most important thing for you to
understand about these core areas is their importance to your training and to
the counseling profession, and the rationale for building a curriculum around
these topics.
Professional orientation and ethical

practice.
Often called “Foundations of Counseling” or “Introduction to Counseling,”
the goal of this educational experience is to provide an overview of the
history and philosophy of the counseling profession as well as an
understanding of the current context within which counselors work.
Counselors-in-training learn about the professional roles and functions of
counselors, the professional organizations and agencies that license, regulate,
and promote the counseling profession, the importance of advocacy, and the
ethical standards of the profession. The goal of this core area is to help
counselors-in-training understand the profession and to begin to envision
themselves as future counselors. It is in the Professional Orientation course(s)
that the emerging sense of professional identity is forged. Clearly, we believe
that the Foundations of Counseling course is an important one to start you on
your journey, and the text you are holding (or reading electronically!) is part
of this important first step.
Words of Wisdom
“Contemporary definitions of professional identity highlight three themes:
self-labeling as a professional, integration of skills and attitudes as a
professional, and membership in a professional community. During training,
new professionals are immersed in a professional culture in which they learn
professional skills, attitudes, values, modes of thinking, and strategies for
problem solving. This equips new counselors with the tools they need to be
ethical, effective, and self-reflective professionals.”
Colette Dollarhide, counselor educator and researcher, on issues of

professional identity in counseling
A sense of identity as a professional counselor will frame all of your future

professional decisions and goals. The experiences you have in your
Professional Orientation course(s) are specifically designed to help you
understand this identity. Whether you are asked to interview practicing
counselors, attend local or state counseling meetings or conferences, or read
the journals of the counseling profession, the goal is to help you start to see
yourself as a member of the counseling profession.
Social and cultural diversity.

In a world of ever-increasing diversity, the counseling profession has taken a
strong stance in its efforts to be at the forefront of culturally appropriate
services. The need for culturally responsive counseling is evident, as the U.S.
population is becoming more multicultural, multiethnic, and multilingual.
According to the U.S. Census Bureau, by the 2040s, the United States will be
a majority-minority nation. In other words, non-Hispanic whites, traditionally
the majority of the population, will represent less than half of the U.S.
population. There will be significant increases in the percentages of the
population who are Hispanic American, African American, and Asian
American. Counselors must demonstrate an ability to work with clients who
represent a broad diversity in race, ethnicity, national origin or ancestry,
socioeconomic status, religion, sexual orientation, gender identity, and ability
or health status. In 1992, Sue, Arrendondo, and McDavis developed the
Multicultural Counseling Competencies (MCCs), which are comprised of
three domains: skills (behavioral component), attitudes and beliefs (affective
component), and knowledge of relevant research and theory (cognitive
component). Each domain has three layers: counselor self-awareness, client
worldview, and counseling relationship. These competencies were met with
wide acclaim within the counseling profession. The American Counseling
Association, as well as many of its divisions, has formally adopted a position
that supports the MCCs and recognizes multicultural counseling competence
as a priority for all counselors in all settings. In 2015, the MCCs were
updated to include Social Justice competencies (ACA, 2015).
The core area of social and cultural diversity emphasizes the need to train
counselors to be multiculturally competent in their counseling and to become
social justice advocates who take a strong stance to work with clients and
communities to remove barriers and promote change (Cook, Krell, Hayden,
Gracia, & Denitzio, 2016). Most professional counselors would agree that the
goal of multiculturally competent counseling and social justice advocacy is to
use our professional skills to promote and celebrate diversity (Hill, 2003). In
addition, counselors use a contextual approach to working with clients and
communities, recognizing that individuals are part of larger systems that
influence their mental and emotional health (Ratts, Singh, Nassar-McMillan,
Butler, & McCullough, 2016). The development of multicultural and social
justice competence is a lifelong process, in which “counselors aspire to
continuously further their understanding and commitment to multicultural
and social justice competence and practice cultural humility in their work”
(Ratts et al., 2016, p. 30). Traditional theories and techniques in counseling
and psychology have been criticized for perpetuating culture-bound value
systems (e.g., individualism) that may contradict the beliefs and values of
diverse clients. Multicultural counseling represents a paradigm shift beyond
this monocultural perspective, and the integration of a social justice paradigm
takes this one step further into a more complex understanding of the
interrelationship between the individual and the client’s environment.
Words of Wisdom
“We are stuck in a culture that continually punishes people for their trauma
responses. Children who live in worlds filled with violence, abuse, neglect,
and drugs ’act out’ in schools, and we punish them. When will we learn that
their bodies are responding to the toxic trauma of their environments? When
will we decide to reach out and help them, rather than reprimand and further
ostracize them for living in an unjust world?”
Research participant from a focus group on social justice and school

counseling
Although almost all graduate programs offer separate courses in multicultural

counseling, there is a strong emphasis in most training programs to infuse
issues of diversity in every course, regardless of course topic or sequence in
the curriculum. Training in multicultural counseling typically includes an
exploration of one’s own beliefs, attitudes, and understandings of diversity,
as well as information about theories of multicultural counseling and identity
development, social justice approaches, and specific counseling skills that
acknowledge the complex ways that power, privilege, and oppression play
out within the counseling relationship itself (Ratts et al., 2016).
Human growth and development.

As you learned in Chapter 1, one of the key identifying characteristics of
counseling is its emphasis on human development. Whereas other helping
professions focus on pathology and illness, counselors tend to see their
clients from a perspective of wellness and growth. Therefore, it is probably
not surprising to see that human growth and development is one of the core
content areas of the counseling curriculum. When counselors understand
clients and their problems from a developmental context, they are able to
intervene more appropriately. For example, two clients facing a similar
problem (let’s say, alcohol dependence) may need different interventions
based on their chronological age. The treatment protocol for an adolescent
with an alcohol problem would be very different from the protocol used with
a retiree—it would even be different from a person just a few years older than
the adolescent—a college student, for example. Each of these individuals
would need a very different type of intervention. In schools, counselors spend
much of their time addressing the developmental needs of their students.
Elementary school counselors, for example, provide a type of counseling that
is different from that of their high school counterparts, and these differences
include not just the content of what they do, but the process of how they do
it. When we work with clients, we strive to understand them in the context of
their developmental level so we can provide the most appropriate
interventions.
Many of the early theorists in counseling and psychology recognized the

importance of understanding people and their problems in the context of their
developmental life cycle. Freud theorized that children and adolescents go
through a series of psychosexual stages (oral, anal, phallic, and genital) that
include developmental tasks that had to be mastered to allow for healthy
transition to the next developmental stage. Later, Carl Jung recognized that
healthy development does not stop at adolescence. In his work The Stages of
Life (1931/1962), he wrote about important developmental milestones in
midlife and beyond. Erik Erikson famously proposed eight stages of human
development throughout life (1950). Because Erikson’s work provided a
framework that was based on a growth and wellness perspective that meshed
with the wellness perspective in counseling, it became an important
foundation that is frequently applied to the field of counseling. More recently,
these theories were challenged by feminists who argued that the existing
developmental models were “male-normative,” meaning that they assumed
that models based on healthy male development were applicable to females,
which may not be the case. Others argued that Erikson’s stages, like many
early models, were based on White populations and may not adequately
describe the experiences of diverse populations (Sneed, Schwartz, & Cross,
2006).
The body of knowledge represented by the core area of human growth and
development, like all of the core areas, constantly changes to incorporate the
latest research and thinking in the field. There are identity development
models that have been articulated as a way to help conceptualize the
developmental journeys of clients who identify as LGBT (e.g., Cass, 1979),
of clients who are racially or ethnically diverse (e.g., Helms, 2007), of clients
who have disabilities (e.g., Gibson, 2006), and countless others. The one
constant is the widespread belief that we must work to understand clients in
their developmental context, whether that means understanding the life tasks
they are facing because of their age or working through stages of healthy
identity development for a client who identifies as a sexual minority. Further,
because people are each a complex interplay of multiple identities, counselors
make efforts to understand the unique intersectionality of a client’s identities.
Intersectionality recognizes the interconnected nature of social
categorizations, such as race, class, and gender, as they apply to any
individual client. These concepts are complex, and you will learn about them
during your entire graduate program and beyond. For now, the main point is
that each of us is always in a process of change and growth, and counselors
use developmental approaches to help clients navigate those changes in
appropriate and healthy ways.
Career development.
The profession of counseling has its roots in career development. In Chapter
1, we discussed Frank Parsons, often called the Father of Vocational
Guidance. Nowadays, we recognize that career development is a lifelong
process that goes beyond just our initial selection of a field of work. Whereas
traditional vocational guidance focused on dispensing information about
career options, career counseling is now seen as complex, multifaceted, and
lifelong. Crites (1981) was among the first to recognize this shift. He
conceptualized career counseling as an interpersonal process. He wrote:
“Ideally, it [career counseling] involves active participation in the decisional
process, not simply passive-receptive input of information” (p. 11).
Unfortunately, career counseling is an area that many counseling students
struggle to find professionally relevant. Counseling students often have no
previous experience with career counseling and typically lack a framework
for understanding the purpose or value of career counseling. Research has
consistently demonstrated misconceptions of counseling students regarding
the interrelationships between career and personal counseling (e.g., Fulton &
Gonzalez, 2015; Lara, Kline, & Paulson, 2009). However, it only takes a
moment of contemplation for you to make the connection between career
choice and life satisfaction. Chances are, you are entering the field of
counseling because you are passionate about the work that counselors do, and
you have a deep and abiding desire to engage in this type of work yourself.
You recognize that this will be much more than just a job for you. You
expect that working as a counselor will be personally meaningful and will
enhance your life outside of the confines of the job. This is exactly the goal of
career counseling – helping individuals find careers that bring them the same
sort of meaning and purpose that counseling will bring to you. Although
some people may find their desired careers on their own or with involvement
and input from family and friends, many will not. Career counselors help
people find their path. When we look at career development from this
perspective, we can see how important this work is for our future clients.
Ultimately, career development is not just a counseling specialty for career

counselors; it is (or should be) an area of interest for all types of counselors.
Career development is one of the three major content areas (along with
academic development and personal/social development) in the American
School Counselor Association National Standards (ASCA, 2012). Within the
field of rehabilitation counseling, career interventions are so important that
the specialization of Vocational Rehabilitation specifically addresses the
specific career needs of individuals with disabilities. It should be clear to you
by now that the distinction between career counseling and mental health
counseling is rather artificial as well. Individuals unhappy in their careers
find that it is difficult to be happy in other areas of their lives. Alternatively,
persons with mental health problems typically find that these problems affect
their careers. People with depression, anxiety, substance abuse problems,
post-traumatic stress, and other mental health disorders may present at a
counselor’s office with vocational problems that affect—or are affected by—
their mental health status (Hinkelman & Luzzo, 2007).
Career development, like all of the core content areas in the counseling
curriculum, is a subject area that is constantly changing and growing.
Importantly, career counseling benefits greatly from the use of the Internet
and electronic resources. More and more career resources are available
online, and electronic delivery of career information is quickly becoming the
preferred method for high school and college students (Cavanagh, 2016;
Venable, 2008). Counseling professionals have identified career counseling
as the specialty area that most readily adapts to electronic format (Boer,
2001; Lewis & Coursol, 2007). Whatever the mechanism for delivery,
however, career counseling uses appropriate interventions, assessments,
resources, and techniques to help individuals make appropriate and
meaningful choices in their lives.
Helping relationships.
It is fair to say that most students enter graduate training in counseling
because they want to help others, and the topics included in this core area
give counselors-in-training the specific skills that they need to actually do
counseling. This is where “the rubber hits the road” so to speak, and
counseling students try out the skills they are learning, practicing on their
peers before they work with actual clients. Students learn counseling theories,
skills, and techniques as well as appropriate counselor characteristics and
behaviors. In Helping Relationships course(s), counselors-in-training practice
case conceptualization and interviewing skills. In these courses, you may be
asked to audio- and/or videotape your work, so you can get feedback on your
developing skills. And, although most of us “cringe” at the sight of ourselves
on camera or the sound of our own voices on recordings, it is important not to
miss the bigger picture here. We practice on peers and in laboratory settings,
where the stakes are lower and we can get feedback and support, so that when
we face our first clients, we are ready. Learning the basic helping skills can
be challenging, confusing, exhilarating, and overwhelming. The more open
you can be to the process of receiving feedback, the better your skills will
become.
Group work.
Group interventions are essential to counseling, and counselors in all types of
settings, with all types of clients, use groups in their work. Groups are an
important and meaningful type of intervention because human beings are
primarily social animals. We learn about ourselves from our interactions with
others. Each of us belongs to many different groups. For example, you may
identify as part of your family, your counseling cohort, your church or
religious congregation, your college graduating class, and your yoga class.
These connections that you feel are important, and they help define you.
Within the field of counseling, group work “involves the application of group
theory and process by a capable professional practitioner to assist an
interdependent collection of people to reach their mutual goals, which may be
personal, interpersonal, or task-related in nature” (Association for Specialists
in Group Work, 1991, p. 14). The purpose and goals of groups in counseling
can be conceptualized along a continuum, with one end representing groups
focused on preventive and growth and the other including groups that provide
remediation and therapy. Prevention- and growth-oriented groups are
intended for people who are relatively well functioning, but could benefit
from some specific life-skills training. Psychoeducational groups are a
particular type of group intervention that, as the name implies, employ both
psychological and educational constructs. These types of groups are often
used in schools and counseling settings to teach specific life skills (e.g.,
assertiveness training, stress management, parenting). Psychoeducational
groups help to educate and prepare individuals who are facing a potential
threat, a developmental life event, or an immediate life crisis (Brown, 2004).
For example, a child with a parent in the military who is being sent to active
duty may benefit from a psychoeducational group within a school setting that
includes other children in similar situations. Or, an adult recently diagnosed
with a chronic illness, such as diabetes, may benefit from a
psychoeducational group that includes both information about the condition
and therapeutic interactions with other adults who have diabetes. Therapy
groups, which are at the other end of the continuum, provide participants with
mental health problems opportunities to do more in-depth therapeutic work.
Counseling or therapy groups help individuals develop interpersonal
relationship, receive feedback, and practice new behaviors within the context
of the group.
Group counseling has been found to be effective for a wide variety of client
populations and presenting problems. Even a cursory review of the research
reveals hundreds upon hundreds of research articles demonstrating the overall
effectiveness of groups for many mental health diagnoses, including
substance abuse, eating disorders, anxiety disorders, depression, and
personality disorders. Groups have been demonstrated to be effective in
helping people without a psychiatric diagnosis as well. Survivors of sexual
abuse, persons living with HIV/AIDS, children of divorcing parents, persons
quitting smoking—all of these and countless others have been shown to be
helped by group interventions.
One of the most powerful components of counseling groups is the benefit that
members receive when they recognize that although everyone is different, we
all share universal struggles. This concept, called universality, is one of the
core curative factors identified by Irving Yalom. Yalom (1970) found that in
all counseling groups, regardless of population or setting, certain core
elements occur that are, in and of themselves, curative. He called these the
curative factors, and concepts such as universality, altruism (helping others in
the group), instillation of hope (allowing the experiences in the group to
make one feel hopeful about the future), and group cohesiveness (feeling
connected to the group), among others, are some of these curative factors.
Because working with clients in groups requires specialized training beyond

the individual counseling skills that are learned in the Helping Relationships
class(es), separate training experiences in group counseling are a required
part of the counseling curriculum. In addition to the classroom learning, this
core area includes a requirement for a minimum of 10 clock hours in a small
group setting. That is, students must not just learn about groups in a class,
they must experience a group as a member. Most students find this a very
powerful experience, and it is a good reminder of the power (and the
potential) of group counseling.
Assessment.
Assessment in counseling is broadly defined as “any method used to measure
characteristics of people, programs, or objects” (American Educational
Research Association, American Psychological Association, & National
Council on Measurement in Education, 1985, p. 89). The terms assessment
and testing are sometimes used interchangeably, although assessment is a
broader, more inclusive term that includes testing, interviews, observations,
and other formal and informal measurement procedures. Accurate assessment
is the key to any intervention. To use a medical analogy, why work on the
right leg, when the left leg is broken? In other words, the more we understand
about a person, program, or situation, the better and more effective our work
with clients can be. All counselors in all settings use both formal and
informal methods of assessment to better understand their clients, the needs
of their constituents, and the effectiveness of their interventions and
programs.
Assessment is the cornerstone of any intervention or decision. Counselors

who fully understand the domain of assessment and the appropriate use of
tests find that they have more complete and complex understandings of their
clients and programs and are better prepared to assist. Assessment can
include intake interviews, client or student observations, self-reports,
standardized tests, needs assessments, and program evaluations, just to name
a few. The American Counseling Association developed a core set of
assessment competencies required of all counselors in order to be considered
properly trained in the area of assessment (American Counseling Association,
2003). These seven competencies are as follows:
1. Understanding of the role of assessment in counseling, including the

practitioner’s counseling specialty
2. A thorough understanding of testing theory, including test construction,

reliability, and validity
3. A working knowledge of statistical concepts in testing
4. Ability to review, select, and administer tests appropriate for clients or

students
5. Skill in administration of tests and interpretation of test scores

6. Knowledge of the impact of diversity on testing accuracy
7. Knowledge and skill in the professional responsible use of assessment

and evaluation practice
Sadly, assessment is one of the core areas in which counselors are sometimes
not adequately trained. Students attracted to careers in the helping professions
are often less comfortable with concepts that involve math and statistics. As a
result, they may be reluctant to fully engage in assessment courses and may
perceive these classes as just “something to get through.” Prediger (1994)
wrote, “Unfortunately, the response to student preferences by some counselor
educators has been to water down [assessment] courses” (p. 228). Childs and
Eyde (2002) found that many assessment concepts receive only limited
coverage in counseling programs. In fact, standardized assessment training
has decreased in quality, intensity, and scope from previous decades (Dana,
2003). Counselor education faculty, themselves people who joined the
profession because of their interest in people rather than numbers, may be
intimidated by teaching assessment courses. That attitude may be perceived
by students as evidence that the testing course(s) are less important than other
counseling courses. One study found that assessment was identified as the
core counseling area met by the greatest amount of fear and apprehension by
counseling students (Wood & D’Agostino, 2010). Consider the reaction
described in one of the author’s experiences.
Darcy: When I was a practicing counselor in a day treatment program, I

conducted a lot of comprehensive psychological evaluations with clients,
and I eagerly read existing psychological evaluations of my clients in
order to more fully understand them in all of their complexities. When I
became a professor, I jumped at the chance to teach the testing classes
and was surprised when no one else on our faculty objected or
expressed any interest in teaching the classes. I had (mistakenly)
thought I would have to fight for the opportunity to teach these core
classes. After all, I knew so well how important assessment is to really
understanding our clients.
My experience working with students in these courses has taught me that

our students come to graduate school feeling rather “beat up” in the
area of testing and statistics. So many of our students have horror
stories. They have been taught to believe that they “can’t do math” or
that because they prefer working with people, it means they can’t work
with numbers. These are bright students. They are top achievers in their
undergraduate programs and people with confidence and self-
assuredness in other areas of their lives. Yet they have been told over
the years that they shouldn’t worry about math. That it’s too
complicated for them. That they will never “get it.” And, sadly, they’ve
learned to believe it.
I talk to my students about how their willingness to accept this

(inaccurate) assessment of themselves is not unlike what many of our
clients face. Our clients often have been told they are stupid, not worthy,
not likeable—whatever—and they have come to believe it about
themselves. Counselors help clients write new life stories, develop new
self-awareness, and make positive determinations about who they want
to be. I believe we have this opportunity in assessment as well. I think
it’s important that counselors refuse to see themselves as “stupid when
it comes to math” or believe assessment is something foreign or
irrelevant. Assessment isn’t difficult—or at least no more difficult than
any other area of counselor training. Like anything else, it takes effort
and a willingness to see the connection between the work in class and
the need in the profession. More importantly, it’s essential that
counselors-in-training recognize the negative self-messages that they
are perpetuating and work to challenge them. After all, it’s exactly what
we ask our clients to be willing to do.
The need for understanding and appropriate use of assessment has never been
greater. More counselors are using more types of tests in their work than ever
before. Since the 1980s, there has been a dramatic upsurge in the number and
types of tests used in counseling (Nugent, 2008). Surveys of school
counselors have found that as many as 91% say that they use assessments,
including interpretation and synthesis with sources of data, as often as three
times a week (Blacher, Murray-Ward, & Uellendahl, 2005; Ekstrom, Elmore,
Schafer, Trotter, & Webster, 2004). In this era of data-driven reform, high
assessment use by school counselors is perhaps not surprising. Within mental
health, clinical counselors are increasingly being asked to provide evidence
of positive treatment outcomes (Marotta & Watts, 2007). Whatever type of
counseling is in your future, you can rest assured that assessment will be an
important part of your scope of practice.
The wide availability of assessments, including electronic testing and

instruments available on the Internet, the pressure on counselors to make
quick decisions regarding diagnosis or treatment interventions, and the use of
computerized scoring and interpretation of tests mean that counselors have
access to more assessment information and resources than ever before. In
addition, the increasingly diverse society adds to the complexity of
assessment. In recognition of this diversity, the American Counseling
Association has adopted Standards for Multicultural Assessment (Association
for Assessment in Counseling, 2003). These standards adhere to an ethical
mandate to move counselors to cultural competence in all areas of their
counseling, including assessment (Dana, 2005).
Research and program evaluation.

The last core area, research, provides counselors with the knowledge, skills,
and confidence they need to read, understand, and use the latest research to
make decisions in their counseling. Research and evaluation courses also give
counselors skills to conduct their own research to determine the effectiveness
of their programs and interventions and to evaluate the impact of decisions to
implement a single treatment protocol or an entire counseling program. Just
as with the assessment area, counseling students may be reluctant to fully
engage with the research course(s). But just as with assessment, the skills
learned in this core area are fundamental to all other components of the
counseling program.
Let’s say, for example, that a client comes to you with an anxiety disorder.
What do you do? What interventions have been demonstrated to be effective?
How do you know? Perhaps you learned (or will learn) the fundamentals of
treating someone with an anxiety disorder in your program, but what if the
presenting problem is more complicated or more obscure? How will you
work with someone who has a hoarding compulsion? What if the client is a
9-year-old girl? Or an 80-year-old man? Does age make a difference in
treatment decisions? What if the client is a Somali refugee who has fled to the
United States from his own war-torn country? Is hoarding still a sign of
pathology? Is it a normal and expected response to stress? The point is, no
matter how comprehensive your graduate program, how much you learn, or
how great and experienced your professors might be, you can never learn in
graduate school all you need to know to work with the great diversity of
clients and presenting problems. You will need to learn to make extensive
and effective use of the vast amount of research that is available to help you
make appropriate decisions in your counseling. Classes in your research core
will help you. You will learn to analyze and evaluate existing research.
Through this process, you will learn how much confidence to place in
research results that have been published in professional journals and other
outlets. You also will learn how to conduct (and evaluate the quality of) your
own research.
Clinical experiences (practicum and

internship).
In addition to the eight core areas outlined above, graduate programs in
counseling require both a practicum and an internship, also called field
experiences. These supervised field experiences provide counseling students
with the opportunity to apply, evaluate, and refine their counseling skills, and
to integrate these skills with the theoretical knowledge gained through
coursework. The purpose of field experiences is to provide students with real-
world experiences while they are learning how to become effective
counselors. Field experiences provide students with opportunities to practice
individual and small group counseling skills, consultation, collaboration and
teaming, advocacy, and leadership skills. Both practicum and internship are
“on-site” field experiences, which means that the counseling students work
with actual clients in an agency or school, or in a university-based counseling
clinic.
Practicum differs from internship in both length and purpose. The practicum
(typically 100 hours) is intended to provide the student with a limited
supervised experience in a specialized area of counseling. Counseling
students in practicum are expected to see clients or students, develop relevant
paperwork, and discuss cases both with the on-site and university
supervisors. In addition to the hours that they spend at their sites each week,
practicum students are required to attend a university-based practicum class
for regular group supervision and to discuss other issues that arise at their
practicum sites. Reviewing recordings of counseling sessions, role playing,
presenting cases, learning about community resources, discussing how to
work effectively with clients and students from diverse cultures, and
evaluating relevant legal and ethical issues are examples of seminar activities.
Words of Wisdom
“Here, in my first week of practicum, I find myself experiencing a wide range
of emotions. I am angry about some of the situations these kids have faced in
the past and sad about the struggles they are dealing with now. I am also
inspired by the strength and resilience they have to keep moving forward,
grateful that they are letting me share their journey, and hopeful that I will be
able to assist. I know that it is a lot of pressure to put on myself during just
the first week—and I also want to be gentle and forgiving with myself. I
know I have a lot to learn, and I have to remind myself that it is okay to be
where I am in the process.”
Source: Carly H.—journal response during the first practicum experience
The internship (typically 600 hours, although certain specialty areas and/or
states may require more hours) is an arranged supervised experience with a
broad range of counseling functions. Internship is intended not only to
provide the student with counseling experience but with greater exposure to
all aspects of professional roles and functions.
The supervised field experience has long been considered one of the most
significant aspects in the training of professional counselors (Granello, 2000).
Learning and experiences that occur within the field experience simply
cannot be replicated in the classroom, and field experiences allow students to
capture, understand, and integrate the essence of the counseling process
(Holloway, 1992). As a result, counselor educators and supervisors generally
believe that the counseling practicum and internship experiences are an
integral and indispensable part of the total program of counselor education.
Ideally, practicum and internship should provide an opportunity for you to
begin to develop your own unique style of counseling while working within
the theoretical and therapeutic framework of the site. While we are discussing
field experiences, it is important for us to remind you that although you may
not feel quite “ready” to engage in these experiences when the time comes,
your program faculty and supervisors are there to provide support and
assistance during this transition from the classroom to practice. The
supervised field experience does more than give you skills and practice; it
also helps build your confidence and self-efficacy as a counselor. Open
communication with both your course instructor and your on-site supervisor
will help you normalize the complex emotions you may feel as you enter
your field work.
Other program courses and

experiences.
In addition to the eight core content areas and the supervised field
experiences, the graduate curriculum in counseling has many other courses,
workshops, and experiences that vary by specialty, state, or college/university
program. Examples include:
Consultation
Diagnosis and treatment planning
Counseling children
Crisis intervention and trauma counseling
Wellness and prevention
Theories of counseling supervision
Grief/bereavement counseling
Gender issues in counseling
Personality testing
Intelligence testing
Substance abuse counseling
Couples and family counseling
Psychopathology
Suicide prevention, assessment, and intervention
Counseling students in special education
Community and agency counseling
School counseling
Rehabilitation counseling
In addition to regularly structured courses, many counselor education

programs offer a variety of workshops, weekend classes, and other learning
opportunities to explore special topics. Taking advantage of these
opportunities is a wonderful way to learn about current and important issues
in counseling.
Beyond Graduate School

Learning does not stop at graduation. Professional counselors see themselves
as lifelong learners. The field of counseling is ever changing, ever growing.
There is new research, as well as new ideas, new client problems, and new
sources of inspiration for treatment and programming. Counselors recognize
that no matter how good their graduate training is, it represents only the
foundation of their professional knowledge. Counselors keep up-to-date
throughout their professional careers by taking university-based courses,
attending workshops and trainings, and keeping up with the latest research in
the professional journals. Counselors who wish to specialize with a particular
population or presenting problem know that they will need additional training
beyond what is offered in graduate school and perhaps even specialized
supervision. Continuing education and lifelong learning is a philosophical
stance that encourages counselors to provide the best possible service to their
clients.
Counseling Licensure and
Certification
Mental Health Counseling
Licensure
A counseling license, issued by the state, is what allows individual counselors
to practice mental health/community/clinical counseling in a particular state
or jurisdiction. There is no national counseling licensure. Licensure is a
government-sanctioned credential that is based on the legal concept of the
regulatory power of the state. States wishing to regulate the profession of
counseling have their state legislatures pass a licensure law. Once the
licensure law has passed, it becomes illegal for any individual who is not
licensed by the state or specifically exempted from licensure to engage in the
activities of the licensed occupation (American Counseling Association,
2009). In the accompanying Spotlight, you will read about the many different
acronyms that are used to describe professional mental health counselors in
states throughout the country. The different initials can contribute to the
public’s confusion about the profession, but the differences exist because the
titles are decided by the laws and rules governing counseling in each state,
rather than at the national level.
Each counseling law contains a “scope of practice,” which lists all of the
activities a counselor with a specific type of licensure can legally engage in
within the state. However, the state’s counseling scope of practice is typically
much broader than that of the individual counselor. For example, just because
a state law allows a counselor to diagnose a mental disorder or perform a
comprehensive psychological evaluation, individual counselors cannot claim
these tasks within their own individual scope of practice unless they have
appropriate education and training. A good analogy is a medical license.
Although a medical license technically allows a doctor to perform any type of
medicine, all doctors understand that they cannot do everything. Instead, they
choose to specialize and only claim their scope of practice to be those areas
of medicine that they are fully trained to perform.
SPOTLIGHT Counseling Licensure

—What’s in a Name?
Many states have several different types and levels of counseling licensure.
Some states have a single license for their mental health and community
counselors, while others have a two-tiered system. The names vary from state
to state. In fact, professional counselors are licensed under 35 different
license titles across the country! The lack of consistency in licensure titles
and scope of practice across states certainly contributes to the overall
confusion the general public has about the counseling profession. It is
important to check with the licensure board in your state to see what type of
licensure counselors in your state might hold.
Some of the most commonly used counseling licensure titles are the
following:
Licensed Professional Counselor (LPC)
Licensed Clinical Professional Counselor (LCPC)
Licensed Professional Clinical Counselor (LPCC)
Licensed Mental Health Counselor (LMHC)
Licensed Professional Mental Health Counselor (LPCMH)
Licensed Clinical Mental Health Counselor (LCMHC)
Licensed Professional Counselor—Mental Health (LPC-MH)
The primary purpose of professional licensure is to protect the citizens of the

state by ensuring that all licensed individuals meet the agreed-upon
professional standards in education and experience. There are other benefits
to professional licensure. For example, benefits of professional counseling
licensure for the consumer of counseling include the following:
Provides proof of competency to consumers and employers and assures

accountability
Provides consumers with a wide range of mental health professionals

who are competent to work with diverse populations, issues, and
programs
Protects consumers’ rights, as licensed mental health providers must

follow standardized protocols and ethics with regard to issues such as
record keeping confidentiality, and so on
Ensures consistency for minimum standards for training and

competency
Benefits for the licensed professional counselor include the following:
Enhances the standing and advancement of the profession
Helps maintain the integrity of the profession
Provides clear mandates for education, experience, and continuing

education
Assists with recognition outside of the profession, for insurance panels,

third-party payors, consumers, and so on
Counselors who wish to become licensed in a particular state must meet all
the standards and criteria written in that state’s licensure laws and in the rules
that regulate the profession in that state. In addition, all states require
applicants to pass a licensure examination, although the specific test(s)
required varies by state. The American Counseling Association has a listing
of the major criteria for each state’s licensure laws available on the ACA
website, accessible by individuals who are members of ACA.
School Counselor Licensure
Professional school counselors are required by law and/or regulation to be
credentialed in every state and the District of Columbia. In some states, this
credential is called licensure, while other states use the terms certification or
endorsement, although as you will see below, certification is typically
reserved for a specific type of voluntary credentialing. Just as with the
confusion caused by the many different licensure names within mental health
counseling, the use of different terms (licensure, certification, and
endorsement) increases the potential for confusion and misunderstanding
within school counseling as well. Adding to the confusion, many professional
school counselors continue to call themselves guidance counselors. The term
guidance counselor was transitioned to professional school counselor by
ASCA in 1990 because it was considered out of date and not an accurate
reflection of the role and function of the school counselor (ASCA, 2003).
Now, more than a quarter century after the professional association that
represents school counselors transitioned to the use of the title Professional
School Counselor, there are still schools and counselors that use the old term.
Clearly, there is much work to be done, even within the profession, to clarify
who we are and what we do.
Fast Fact
The American Association of State Counseling Boards (AASCB) facilitates
communication among state counseling licensure boards and supports
collaborative efforts among states to develop compatible standards and
procedures for counselor licensure. In addition, AASCB works to facilitate
counselor licensure portability, an important consideration as counselors
move from state to state. For more information about AASCB and portability
of counselor licensure, visit www.aascb.org.
Graduate education in school counseling is an entry-level prerequisite for all

states in order to practice as a professional school counselor. A master’s
degree in school counseling or a related field is required by 44 states and the
District of Columbia. Fifteen states and the District of Columbia require
applicants to have previous counseling or teaching experience. In 39 states, a
licensure test is required. Each state’s requirements are available through the
state’s Department of Education.
Certification
Certification is typically a voluntary action by a professional organization to
grant recognition to practitioners who have met some standard level of
training and experience (ACA, 2009). People who meet the standards set by
the credentialing organization are entitled to hold themselves out to the public
as having the certification. Licensed or credentialed counselors may hold a
variety of certifications indicating that they have specialized education or
experience. For example, counselors can be certified in Dialectical Behavior
Therapy (DBT), Eye Movement Desensitization and Reprocessing (EMDR),
Gestalt Therapy, or many other techniques or interventions in counseling.
Other types of certifications, such as Addictions Counseling, Gerontological
Counseling, or Art Therapy, are broader in scope than an individual
technique or intervention, and they may have their own specializations within
a college or university. None of these certifications are what allow a
counselor to practice, however. Only the state-issued license or credential
allows counselors to practice in the state. Given the very broad scope of
practice within the counseling profession in general, certifications are
sometimes used to suggest that counselors have highly specialized skills or
training. Although this may indeed be true, it is also true that, in most states,
the offering of a certification program is not regulated, and any person or
group (or for-profit institution) can certify nearly anyone in anything. We
caution you to be very careful about certification workshops or trainings.
They can be valuable and meaningful and contribute significant learning and
expertise to your practice. They can also be a scam designed to promote
questionable practices or line the pockets of unqualified or unethical
providers.
One counseling credential that is recognized nationally is offered through the

National Board for Certified Counselors (NBCC). NBCC offers a national
certification as a National Certified Counselor (NCC). Counselors certified
through NBCC have met certain standards that may be higher than those
required by some state counseling licensure boards. Thus, the NBCC assures
the public and employers that counselors with this certification have met
these agreed-upon standards. Founded in 1982, the NBCC is the largest
national counselor certification program in the world. Although certification
from NBCC is not a license to practice, in some states, holding a national
certification can assist the counselor in obtaining a state license. There are
more than 62,000 counselors worldwide who hold the NCC credential. For
more information on NBCC, visit their website: www.nbcc.org.
SPOTLIGHT Licensure Portability

One of the most frustrating scenarios counselors can face is moving to a new
state only to learn that they are not eligible to obtain a license to practice
counseling in that state. This can happen even if the counselor has been
licensed and practicing for years—or even decades—in the previous state.
This situation occurs because of the lack of portability of counseling
licensure across states, and it has been identified as the biggest challenge
facing the counseling profession today (Urofsky, 2013). Counselors licensed
in one state may not be eligible for licensure in another, primarily because of
the different requirements and qualifications for licensure. Remember,
counselor licensure was adopted by each state individually over a more than
30-year span. As a result, there are 50 different sets of rules and regulations,
and 50 different licensure boards, and navigating the system can be
challenging to say the least. Both of the authors of this text have worked with
numerous students who have graduated from our respective programs,
obtained their state license, and then contacted us years later when they
moved to a different state and were working with their new counselor
licensure board to obtain licensure. All of these situations are handled on a
case-by-case basis. Given the transient nature of the U.S. population and how
many professional counselors move to new states each year, something
clearly needs to be done.
The lack of consistent requirements for counselor licensure is more than just
an inconvenience for counselors, however. When counseling associations
work to advocate for inclusion in important national legislation, they are
often met with resistance from lawmakers. Why should counselors be
reimbursed by Medicare or included as providers from the Veteran’s
Association or for inmates in federal prisons, for example, if there are no
assurances of uniform training across the states? From this perspective, the
lack of portability has significant economic impact on all counselors—even
those who never leave their state.
ACA and the American Association of State Counseling Boards (AASCB)

are working on the problem, but it is an incredibly complex situation.
Because licensure requirements vary from state to state, counselors who were
trained in states with lower requirements (for example, with fewer credit
hours or less hours for internship) may not meet education or training
expectations in their new state. Even if the credit hours are the same, the
content of the coursework may be different. For example, as you learned in
Chapter 2, only 29 states allow counselors to diagnose and treat mental and
emotional disorders. What happens when a counselor moves from a state that
does not allow diagnosis and treatment (and therefore, did not have
coursework or experience in this) to a state that has this as part of the scope
of practice? Certainly no one would argue that counselors should be allowed
to do this difficult task without proper training or supervision.
School counselors also have challenges around portability, although they are
not as pronounced as within mental health counseling, as the scope of
practice does not tend to differ significantly state by state. Nevertheless,
differing training and experience requirements can affect school counselors
who move to other states, too.
One “solution” is to have all states adhere to a uniform professional title and
scope of practice with consistent training requirements. Of course, this is far
easier said than done. Nevertheless, you should know that there are many
people working on behalf of all counselors to help make counselor licensure
portability work. Perhaps someday, professional counselors moving across
the country will be concerned more about finding a house or making new
friends and less about what they will have to do to be able to continue to
practice the profession they love.
All of this attention to different types of licensure and certification, various

license titles, and differing qualifications and scope of practice used by
different states as well as the struggle that school counselors have to
differentiate themselves from the out-of-date term guidance counselor
reinforces the struggle that the counseling profession seems to have. The
issue of professional identity will remain an important and central topic for
discussion in the counseling profession for years to come. The lack of
consistent requirements and licensure has another result that may become
particularly meaningful to you. Because the requirements for licensure differ
by state, counselors who move to another state may find that they have
difficulty getting licensed in their new state, even if they held licensure in
their previous one. This is the concept of licensure portability, and it is the
topic of the Spotlight on the previous page. As you read through this
Spotlight, we hope you began to recognize how complex and challenging
licensure portability can be for the counseling profession.
What ought to be clear to you by now is that counseling is a very complex

profession, with a lot of different licensure types and requirements,
specializations, and titles. It is perhaps not surprising, therefore, that many
people are confused about who counselors are and what they do. Even your
friends and family members may be uncertain about this new profession you
are entering into, and it is typical for counseling students to get a lot of
questions. Maybe you have already heard some of these. “So, you’re
essentially going to be a psychologist, right?” or “My guidance counselor
handed out our proficiency tests or helped us fill out college applications—is
that what you will be doing?” This might be the time for you to begin to
develop your “elevator speech” to tell others what you are studying. As you
read through all of the material in this chapter, you may find that you wish to
further refine and clarify the information you share about your new
profession.
Counseling Associations and
Organizations
So far in this chapter, we’ve considered how counselors are educated and
licensed and the standards that regulate the profession. In this section, we
turn our attention to the associations and organizations that advance the
profession and advocate for professional counselors.
The American Counseling

Association
The American Counseling Association (ACA) is the world’s large association
representing professional counselors in all practice settings. With more than
55,000 members in all 50 states and the District of Columbia as well as many
international locations, ACA is the major voice of the counseling profession.
The mission of ACA is “to enhance the quality of life in society by
promoting the development of professional counselors, advancing the
counseling profession, and using the profession and practice of counseling to
promote respect for human dignity and diversity” (ACA, 2008).
ACA provides its members with services that benefit both the individual
counselor as well as the profession at large. Some examples include the
following:
Advocacy—ACA provides a single, powerful voice to the influence

national legislation and provides members of the association a voice in
policy development at the federal, state, and local levels. ACA
advocates on behalf of counselors (e.g., working to get counselors
reimbursed through Medicare) as well as on behalf of consumers
(advocating for mental health parity in insurance or working to get
appropriate mental health services for veterans).
Professional development—ACA provides members with up-to-date
information and guidelines on a variety of topics, such as ethical
guidelines, multicultural and social justice counseling competencies, or
spiritually counseling competencies.
Resources—ACA and its divisions participate in the publication of 20

different national counseling journals. In addition, ACA and each of its
divisions publish national newsletters and maintains websites with
information for counselors and consumers. ACA also publishes a variety
of books and video materials for counselors.
Networking and mentoring opportunities—ACA is well known for its

annual international conference, which attracts more than 3,000
counselors and counseling students each year.
Liability insurance—All counselors, regardless of setting, should carry

malpractice insurance, and ACA provides its members with insurance at
greatly reduced fees.
Ethical guidelines and support—In addition to developing the Code of

Ethics and Standards of Practice for the counseling profession, ACA
staff field thousands of individual ethics inquiries each year, assisting
counselors as they navigate the challenging ethical boundaries of the
ACA was founded in 1952 and originally was called the American Personnel
and Guidance Association (APGA). Today, there are 20 specialized divisions
of ACA that are organized around specific interest or practice areas.
Counselors or counseling students who join ACA may join one or more
divisions that relate to their practice area or special interest. In addition, there
are 56 branches that organize counselors based on locality (one branch in
each state, Washington, DC, and several specific territories in Latin America
and Europe). Counselors and counselors-in-training may choose to join their
state’s branch of ACA, which mirrors the larger national association, but on a
much smaller scale. For more information about ACA, visit
www.counseling.org.
In 1995, the executive councils of the American School Counselor

Association (ASCA) and the American Mental Health Counselors
Association (AMHCA) voted to disaffiliate from ACA in order to pursue
their own separate goals. Currently, ASCA maintains its status as a division
of ACA, but it does not require ASCA members to also be members of ACA,
so its status represents more of an affiliation with ACA, rather than a true
division. The decision by ASCA and AMHCA raises difficult questions about
whether an association originally formed to unify counselors from many
disparate practice settings can continue to do so when two of its major
divisions have disaffiliated from the association. The executive committees
from ACA, ASCA, and AMHCA continue to be in close communication, but
only time will tell how these decisions will ultimately affect the professional
identity of the counseling profession. In this chapter’s counseling
controversy, we present some of the ideas that have been used to emphasize
what unites all of us as one profession as well as the arguments that have
been made to argue for the specializations of counseling as distinct
professions.
Counseling Controversy Is
Counseling One Profession or
Many?
Background: Since the introduction of the first professional counseling
associations, counselors have struggled to develop a professional identity that
represented them both within the profession and to the external world. As
counselors become more and more specialized, some wonder whether the
original foundational roots that connected us all no longer apply.
COUNTERPOINT: THERE
ARE SIGNIFICANT
POINT: COUNSELORS ARE
DIFFERENCES BETWEEN
COUNSELORS, REGARDLESS OF
COUNSELORS, AND THEY
SETTING
REPRESENT TRULY
DISTINCT PROFESSIONS
There are multiple professions
A broad definition of counseling of counseling, not a single
allows all counselors to fit profession with multiple
comfortably within the identity of specializations.
“professional counselor.”
Artificially forcing members
The push for a solid, unified of different professions to
professional identity does not adhere to one model of
mean that counselors cannot professional counseling and
specialize. A specialty is a role that one organization with lots of
a counselor might assume on top of divisions means differing
the already existing role of viewpoints are lost in an effort
professional counselor. to speak with one voice.
The counseling profession is AMCHA and ASCA voted to

stronger and able to do more and disaffiliate from ACA because
better advocacy as a unified mental health counseling and
profession. The public, already school counseling are distinct
confused by the multitude of professional identities with
helping professionals, is only different missions, clientele,
further confused by the artificial licensing bodies, and
divisions within the profession. interventions.
When energy goes into Separate organizations and

divisiveness instead of unity, it professional identities means
keeps us from accomplishing the that counselors within each of
real mission of the counseling these professions can choose
profession: helping those in need. where to put their money and
efforts.
argument.
The 20/20 definition of counseling.

In 2005, representatives from (then) 19 divisions and four geographic regions
of ACA, as well as other related organizations and associations, established a
task force called 20/20: A vision for the future of counseling to continue to
strengthen the profession of counseling. Delegates continue to meet several
times a year to address what the counseling profession wants to be in the year
2020 and what it will take to get there. The seven principles identified by the
20/20 task force to help create a unified vision for the profession of
counseling are as follows:
1. Sharing a common professional identity is critical for counselors.
2. Presenting ourselves as a unified profession has multiple benefits.
3. Working together to improve the public perception of counseling and to

advocate for professional issues will strengthen the profession.
4. Creating a portability system for licensure will benefit counselors and

strengthen the counseling profession.
5. Expanding and promoting our research base is essential to the efficacy

of professional counselors and to the public perception of the profession.
6. Focusing on students and prospective students is necessary to ensure the

ongoing health of the counseling profession.
7. Promoting client welfare and advocating for the populations we serve is

a primary focus of the counseling profession.
By 2010, 29 of the 31 member organizations and associations of the 20/20

task force had agreed to a consensus definition of counseling, which has now
been adopted by ACA. Two divisions, the American School Counselor
Association and Counselors for Social Justice, declined to endorse this
definition (www.counseling.org).
ACA definition of counseling
Counseling is a professional relationship that empowers diverse

individuals, families, and groups to accomplish mental health, wellness,
education, and career goals.
The Divisions of ACA

ACA has 20 different divisions. As you read through the descriptions of each
of them, take time to consider which of these divisions might hold the most
interest for you (you may wish to make a mark in the box ☑ next to their
names to remind you to investigate these divisions further). If you can, visit
their websites or look through their journals or newsletters. Remember, most
divisions (and ACA itself) have student rates that are greatly reduced, making
graduate school the perfect time to try out membership.
Association for Adult Development and Aging (AADA)
Chartered in 1986, AADA serves as a focal point for information

sharing, professional development, and advocacy related to adult
development and aging issues. AADA’s mission is to improve the
standards of the professional service to adults of all ages by (1)
improving the skills and competence of members, (2) expanding
professional work opportunities in adult development and aging, (3)
promoting the lifelong development and well-being of adults, and (4)
promoting standards for professional preparation for counselors of
adults across the lifespan. The journal, Adultspan, is published twice per
year. For more information, visit www.aadaweb.org.
Association for Assessment and Research in Counseling (AARC)
Originally the Association for Measurement and Evaluation in

Guidance, and later the Association for Assessment in Counseling and
Education, AARC was chartered in 1965. The purpose of AARC is to
promote the effective use of assessment and research in the counseling
profession. AARC holds biennial national conferences and publishes
two journals: Measurement and Evaluation in Counseling and
Development (MECD) and Counseling Outcome Research and
Evaluation (CORE). AARC has developed or contributed to many
guidelines and practice models for assessment in counseling, including
the Rights and Responsibilities of Users of Standardized Tests (RUST
Statement) and Standards for Multicultural Assessment. The website for
AARC has much more information. Explore it at http://aarc-
counseling.org/
Association for Child and Adolescent Counseling (ACAC)
ACAC became ACA’s newest division in March of 2013. The mission

of ACAC is to promote a greater awareness, advocacy, and
understanding of children and adolescents among members of the
counseling profession and to promote the use of developmentally
appropriate prevention and intervention strategies for counseling
children and adolescents. ACAC welcomes counselors who work with
children and adolescents in all settings and with all different treatment
modalities. ACAC has plans to publish a journal, and currently has a
national newsletter and a blog. You can learn more about ACAC at:
http://acachild.org/
Association for Creativity in Counseling (ACC)
ACC is a forum for counselors, counselor educators, creative arts

therapists, and counselors in training to explore unique and diverse
approaches to counseling. Established in 2004, ACC’s goal is to
promote greater awareness, advocacy, and understanding of diverse and
creative approaches to counseling. The Journal for Creativity in Mental
Health focuses on interdisciplinary discussion and research on practical
applications of using creativity to help deepen self-awareness and build
healthy relationships. For more information, visit http://
www.creativecounselor.org/
American College Counseling Association (ACCA)
Chartered in 1991, the focus of ACCA is to help counselors in colleges,

universities, and community colleges foster student development. The
mission of ACCA is to “support and enhance the practice of college
counseling, to promote ethical and responsible professional practice, to
promote communication and exchange among college counselors …
[and to] provide leadership and advocacy for the profession of
counseling in higher education.” The Journal of College Counseling is
published twice a year, and ACCA holds biennial conferences. To
further explore ACCA, visit their website: http://
www.collegecounseling.org/
Association for Counselor Education and Supervision (ACES)
ACES was one of the founding divisions of ACA in 1952 under the
name of the National Association of Guidance and Counselor Trainers.
ACES emphasizes the need for quality education and supervision of
counselors in all work settings and strives to continue to improve the
education, credentialing, and supervision of counselors. The journal of
ACES, Counselor Education and Supervision, publishes information on
the preparation and supervision of counselors in all settings, and the
ACES national conference is a biennial occurrence. For more
information, visit http://www.acesonline.net/
Association for Humanistic Counseling (AHC)
The Association for Humanistic Counseling, formerly the Counseling

Association for Humanistic Education and Development (C-AHEAD),
was a founding division of ACA in 1952. The association changed its
name in 2011 to reflect a clearer focus on their mission. AHC provides a
forum for the exchange of information about humanistically oriented
counseling practices and promotes changes that reflect the growing body
of knowledge about humanistic principles applied to human
development and potential. The Journal for Humanistic Counseling is
published three times a year. In addition, this division hosts an annual
national conference. To explore more, visit their website: http://
afhc.camp9.org/
Association for Lesbian, Gay, Bisexual and Transgender Issues in

Counseling (ALGBTIC)
The mission of ALGBTIC is to educate counselors on the unique needs

of LGBT clients and communities and to promote greater awareness and
understanding of LGBT issues among members of the counseling
profession. In addition, ALGBTIC strives to identify conditions that
create barriers to the human growth and development of LGBT clients
and to develop counseling skills, programs, and efforts to help clients
overcome these barriers and promote development. The division
publishes the Journal of LGBT Issues in Counseling four times per year.
To learn more about ALGBTIC, visit www.algbtic.org.
Association for Multicultural Counseling and Development (AMCD)
Originally the Association of Non-White Concerns in Personnel and

Guidance, AMCD was chartered in 1972. AMCD strives to improve
cultural, ethnic, and racial empathy and understanding by programs to
advance and sustain personal growth. Additionally, AMCD seeks to
develop programs specifically to improve ethnic and racial empathy and
understanding and to advance and sustain personal growth for members
from diverse cultural backgrounds. The Multicultural Counseling and
Social Justice Competencies had their origins within this division, and
they are an important contribution for all counselors. AMCD publishes
the Journal of Multicultural Counseling and Development. For more
information, visit http://www.multiculturalcounseling.org/
American Mental Health Counselors Association (AMHCA)
Chartered in 1978, AMHCA represents mental health counselors,

advocating for client access to quality services within the health care
industry. AMHCA strives to be the national association representing
licensed mental health counselors with consistent standards for
education, training, practice, advocacy, and ethics. Although not
technically a division of ACA (it disaffiliated in 1995), AMHCA
remains closely connected to ACA through its executive committee.
AMHCA publishes the Journal of Mental Health Counseling and holds
an annual conference for its members. For more information, visit
www.amhca.org.
American Rehabilitation Counseling Association (ARCA)
ARCA is an organization of rehabilitation counseling practitioners,

educators, and students who are concerned with enhancing the
development of people with disabilities throughout their lifespan and in
promoting excellence in the rehabilitation counseling profession’s
practice, research, consultation, and professional development. ARCA
collaborates with other professional associations in rehabilitation
counseling to publish Rehabilitation Counseling Bulletin. Further
information can be found at the ARCA website: http://
www.arcaweb.org/
American School Counselor Association (ASCA)
Chartered in 1953, ASCA supports school counselors’ efforts to help

students focus on academic, personal/social, and career development so
they can achieve success in school and are prepared to lead fulfilling
lives as responsible members of society. ASCA members also work with
parents, educators, and community members to provide a positive
learning environment for students. ASCA provides professional
development, research, and advocacy to more than 24,000 professional
school counselors worldwide. Although not technically a division of
ACA (it disaffiliated in 1995), ASCA remains closely connected to
ACA through its executive committee. ASCA publishes the journal
Professional School Counseling and holds an annual conference that has
more than 2,000 school counselors in attendance. Learn more about
ASCA at www.schoolcounselor.org.
Association for Spiritual, Ethical, and Religious Values in Counseling

(ASERVIC)
Originally the National Catholic Guidance Conference, ASERVIC was

chartered in 1974. ASERVIC is devoted to counseling professionals
who believe that spiritual, ethical, religious, and other human values are
essential to the full development of the person and to the discipline of
counseling. ASERVIC defines itself as an organization of counselors
and human development professionals who believe spiritual, ethical, and
religious values are essential to the overall development of the person
and are committed to integrating these values into the counseling
process. ASERVIC holds national conferences and publishes the journal
Counseling and Values. For more information about ASERVIC, visit
their website: www.aservic.org
Association for Specialists in Group Work (ASGW)
Chartered in 1973, ASGW was founded to promote quality in group

work training, practice, and research. ASGW provides professional
leadership in the field of group work, establishes standards for
professional training, and supports research and the dissemination of
knowledge. In addition, ASGW seeks to extend counseling through the
use of group process; to provide a forum for examining innovative and
developing concepts in group work; to foster diversity and dignity in
groups; and to be a model of effective group practice. ASGW holds
national conferences and publishes the Journal for Specialists in Group
Work. There is much more information on their website: www.asgw.org
Counselors for Social Justice (CSJ)
CSJ is a community of counselors and counseling students who seek

equity and an end to oppression and injustice affecting clients, students,
counselors, families, communities, schools, workplaces, governments,
and other social and institutional systems. The mission of Counselors for
Social Justice is to work to promote social justice through confronting
oppressive systems of power and privilege that affect professional
counselors and clients and to assist in positive change through the
professional development of counselors. Together with the association
of psychologists for social responsibility, CSJ publishes the Journal for
Social Action in Counseling and Psychology. For more information, visit
the CSJ website: https://counseling-csj.org/
International Association of Addictions and Offender Counselors
(IAAOC)
Originally the Public Offender Counselor Association, IAAOC was

chartered in 1972. Members of IAAOC advocate the development of
effective counseling and rehabilitation programs for people with
substance abuse problems, other addictions, and adult and/or juvenile
public offenders. IAAOC members are concerned with improving the
lives of individuals exhibiting addictive and/or criminal behaviors. The
Journal of Addictions and Offender Counseling publishes reports of
research that focus on addictions and offender counseling. For more
information about IAAOC, visit www.iaaoc.org
International Association of Marriage and Family Counselors (IAMFC)
Chartered in 1989, IAMFC members help develop healthy family

systems through prevention, education, and therapy, regardless of
employment setting. The organization provides leadership, skill building
through workshops and training, and information and research through
publications in couples and family issues. IAMFC holds national
conferences and publishes The Family Journal. For more information on
IAMFC, one of the largest divisions within ACA, visit http://
www.iamfconline.org/
Military and Government Counseling Association (MGCA)
MGCA was originally chartered in 1984 under the name of Military

Educators and Counselors Association, and later was named the
Association of Counselors and Educators in Government. The name was
again changed in 2015 to reflect the more recent focus on counseling
members of the military and veterans, which hearkens back to the
original focus of this division. MGCA is dedicated to counseling clients
and their families in local, state, and federal government or in military-
related agencies. In 2013, MGCA began the publication of a journal,
The Journal of Military and Government Counseling, which is published
three times per year. More information can be found at their website:
http://acegonline.org/
National Career Development Association (NCDA)
Originally the National Vocational Guidance Association, NCDA was

one of the founding associations of ACA in 1952. The mission of
NCDA is to promote career development for all people across the
lifespan through public information, member services, conferences, and
publications. NCDA developed the National Career Development
Guidelines to assist career counselors in their work. They hold national
conferences and publish a journal, Career Development Quarterly. For
more information about NCDA, visit www.ncda.org.
National Employment Counseling Association (NECA)
NECA was originally the National Employment Counselors Association

and was chartered in 1966. The commitment of NECA is to offer
professional leadership to people who counsel in employment and/or
career development settings. Additionally, NECA promotes the use of
job information tools and techniques to better serve the client, advocates
for legislation that positively influences employment counseling and job
opportunities, and promotes research into employment counseling. The
association publishes the Journal of Employment Counseling. For more
information on NECA, visit www.employmentcounseling.org.
Other counseling organizations.

There are other counseling associations besides ACA and its divisions and
affiliated organizations. For example, you might have an active mental health
board in your community that provides workshops, trainings, and advocacy.
There are national associations for counselors that are not affiliated with
ACA, such as the American Association of Pastoral Counselors (AAPC), the
National Association for College Admissions Counselors (NACAC), the
National Association of Alcohol and Drug Abuse Counselors (NAADAC),
and the American Association for Marriage and Family Therapists
(AAMFT). School counselors are often members of their local or state
education associations, and college counselors might find themselves at
workshops and conferences for college student personnel.
In many cases, there are multiple professional associations with very similar
goals and memberships. For example, there are seven different national
rehabilitation counseling professional organizations, and all have adopted the
same definition of a rehabilitation counselor as “a counselor who possesses
the specialized knowledge, skills, and attitudes needed to collaborate in a
professional relationship with persons with disabilities to achieve their
personal, social, psychological, and vocational goals” (Rehabilitation
Counseling Consortium, 2005). Nevertheless, although the seven associations
can agree on the same definition of rehabilitation counseling, many in the
field believe that the multitude of professional associations is divisive and
confusing. A 2006 study of practicing rehabilitation counselors found the
most significant problem in professional identity among rehabilitation
counselors was “the extreme segmentation of the rehabilitation counseling
profession” (Shaw, Leahy, Chan, & Catalano, 2006, p. 176). They found that
rehabilitation counselors wanted better integration of rehabilitation
counseling into the counseling profession as a whole, recognizing that this
move is a “survival strategy” for rehabilitation counseling. Additionally,
participants in the study argued that the competing agendas of the multiple
organizations and the splinter groups within the profession were serving to
undermine the rehabilitation counseling profession. Since the publication of
this study, there have been many scholarly publications and national keynote
speeches about this very important topic in rehabilitation counseling.
With all of this context and information, it is perhaps a bit clearer to you why
we included the term Professional Identity in the name of this text. As you
continue to read and learn about your new profession, we encourage you to
take some time to consider your own emerging sense of professional identity.
We will come back to this concept in Chapters 4 and 5, but for now it is
important to recognize that you are developing your own sense of
professional identity within a profession that is still struggling to find and
define its identity. Although that sounds challenging, we believe it is also
encouraging. Our profession is not “settled” or “done”: It continues to grow
and change and respond to the world around us, and that means that you have
a very real opportunity to help shape the future of the profession.
Fast Fact
A survey of 450 practicing school counselors in one state found that 83%
belonged to at least one professional association. Of those who were
members:
89% believe professional organizations increase the visibility of the

field.
85% believe that their professional organizations help them keep current
in the field.
85% regularly read the newsletter of their professional organization.
69% believe membership in professional organizations is one of the

hallmarks of a professional person.
65% regularly read the scholarly journals published by the professional

organization.
63% regularly visit the organization’s website.
28% are actively involved in their local, state, or national professional

organization (e.g., hold office, serve on committees).
Source: Bauman (2008).
One way that you can begin to work on your own understanding of yourself
as a member of the counseling profession is to join a professional counseling
association. Membership in professional associations can help counselors
develop and maintain a strong sense of professional identity. Research tells
us that counselors who have a stronger sense of professional identity are
more likely to join their professional associations. In addition, professional
associations foster a stronger sense of professional identity in their members
(Lafleur, 2007; Reiner, Dobmeier, & Hernández, 2013). However, joining a
counseling association is an entirely voluntary decision. This is very different
from some other professions, such as law, for which the professional
association controls entry into the profession via the bar exam, thereby
virtually guaranteeing 100% membership. Nevertheless, state and national
counseling associations are essential if the profession is to remain viable and
strong. Counselors with a strong sense of professional identity join their
counseling associations.
SNAPSHOT Maureen Johnson,

Joining a Professional Counseling
Association During Graduate
School
When I first started my counseling program, my professors discussed the

importance of joining a professional organization. I talked to other graduate
students, explored websites, and decided to see what the organizations could
offer me. I joined ACA and my state counseling organization during the first
year of my program. I also joined a division of ACA, the Humanistic
Counseling Association. One of my professors was the president of the
association at the time, and I volunteered to help her with the web page and
listserv. I have continued serving in these roles and find them to be rewarding
and fun. I also became a member of my state’s government relations
committee, which helps update me on political issues important to
counselors. Although not everyone gets involved at this level, I have enjoyed
my experiences, and I plan to continue my involvement.
One very big reason to join now is that students get greatly discounted rates
but still get all the benefits that professional level members receive. ACA and
my state organization both have publications—journals with the latest
research, and newsletters with important and up-to-date trends within the
profession. Another reason to join as a student is that you will be able to add
these memberships to your resume. These associations speak volumes about
your commitment to the profession. Additionally, the networking experiences
may help you find a job. When you meet other students and other
professional counselors at events, you start building connections with your
colleagues that can help you with your professional practice. Once you join
organizations, you will get more information about upcoming events and
workshops from national and local providers. In addition, the liability
insurance through ACA has been great for practicum and internship.
Another important benefit is attending conferences and workshops at the

reduced cost of a student member. Students can volunteer at conferences,
with reduced cost or even free attendance. During my first year as a student, I
attended the ACA conference. It was a great experience, and the
presentations by practicing counselors gave me real-world information to
help me with my current (and future) work. During my second year as a
student, I participated in the student poster presentation at the state
conference. It was exciting to be one of the presenters, and it gave me a great
experience to put on my resume.
By joining organizations as a student, you will have a voice in the profession.

I was asked to provide my input on future presentations for the upcoming
ACA conference because I chose to be involved in a division of ACA. When
you attend conferences, your input is solicited about the presentations. In
short, you have an opportunity to help shape the future of the profession.
Joining professional organizations can be very valuable for graduate students.

I’ve enjoyed being a member of ACA, my state organization, and their
divisions, and it’s been interesting and fun to become active within the
divisions. There are so many benefits to joining a professional organization
while in graduate school. I encourage you to see what organizations have to
offer you as a student member. Like me, I hope you will find that the
numerous benefits and reduced cost make joining these organizations a very
wise professional decision.
State counseling associations.

State counseling associations serve as important connections between
counselors and the counseling profession. Most state associations hold annual
conferences, and there is added emphasis on networking and support as
members tend to live in closer proximity than the national association. State
associations provide an excellent mechanism for students to get more
involved in the counseling profession, and we encourage you to consider
involvement in your state branch of ACA and/or ASCA. In the Snapshot you
just read, a graduate student talked about her involvement with professional
counseling associations at the state and national level. As you read through
her story, we hope you thought about how you might become involved in
your state and/or national counseling associations.
Chi Sigma Iota

One professional association was developed specifically with graduate
students in counselor education in mind. Chi Sigma Iota (CSI) is the
international honor society for professional counselors, counselor educators,
and students in counselor education programs. CSI is intended to “promote
scholarship, research, professionalism, leadership and excellence in
counseling and to recognize high attainment in the pursuit of academic and
clinical excellence in the profession of counseling” (CSI, 2017). CSI was
established in 1985 at The Ohio University to provide recognition for
outstanding achievement and outstanding service within the profession.
There are over 250 active chapters of CSI, with over 12,000 active members
worldwide (more than 107,000 members have been initiated in the
organization). CSI chapters are often active at the local level. University
chapters might, for example, host workshops, guest speakers, and service
projects for the students in their counselor education programs. At the
national level, CSI has a fellowship program to promote leadership in the
profession, provides grants and funding for research on professional identity
and leadership, develops resources in the field of counseling, and publishes a
newsletter. CSI promotes the development of leaders within the counseling
profession, and if you are interested in becoming a leader in the profession,
CSI is a great place to start!
Your program faculty will know if your university has an active chapter of
Chi Sigma Iota. If it does, see what kinds of opportunities and projects are
sponsored by the chapter. Chances are, there is a lot going on. If you have an
active chapter, you will be invited to join after you complete one term of
graduate study in a counseling program, provided you have earned a grade
point average of 3.5 or better on a 4.0 scale. Membership in the local chapter
includes membership in the national organization. If your counseling
program does not have an active CSI chapter, it is not difficult to start one.
Talk with one of your faculty members about starting one. Full instructions
are available on the CSI website: www.csi-net.org.
Summary
In this chapter, you learned about the educational requirements for licensure
as a professional counselor. You learned how the eight core areas of
CACREP are incorporated into counselor training programs, and you were
challenged to think about why these core areas are important to the
development of a counselor. In this chapter, we also discussed the role of
credentialing and licensure and the many different ways that counselors can
become specialists within the profession. We discussed some of the
challenges that our profession faces, including a lack of consistency in
licensure and credentialing requirements between states, and the lack of a
unifying professional identity for counselors. We also covered the major
counseling associations and organizations that are important to the profession
and gave you some insights into how you might best use these associations
for your own professional development. Finally, we gave you lots of
information and websites for further exploration.
It is, of course, extremely important to remember that education and training

to be a professional counselor do not end at graduation, or even when you are
granted a license to practice. Learning to become a counselor is a lifelong
endeavor. Licensure and certification require counselors to continue their
education, but most counselors recognize that even without such a mandate,
ongoing learning is essential to stay current. Counselors who continually
challenge themselves to be lifelong learners are more fully engaged in the
profession and, as a result, are better counselors for their clients.
There are many facets to becoming a counselor. This chapter focused on the
required education, training, and licensure, but that is just part of the picture.
Becoming a counselor is much more than logistics—it is a pathway of
personal growth, development, and learning. It is developing the counselor as
a person, not just as a professional. This combination of the personal and
professional is both exciting and challenging, and it is to this that we turn our
attention in the next chapter.
Student Activities
2. Do you think the amount of regulation over the counseling profession

and the programs that regulate counselor training is appropriate? In what
way do you think the counseling profession can best determine who is
eligible to be a counselor? In your ideal world, what qualifications
should counselors have, and how should we determine who has them?
3. As you read the Snapshot of Maureen and her experiences in

professional associations during her years as a graduate student, what
are your reactions? What type of involvement in professional
associations is most interesting to you?
Journal Question
1.
Reactions to the Graduate Program. Think for a moment about the remainder
of your graduate program and your upcoming classes. Which classes are you
looking forward to? Which ones do you find intimidating? Boring? If there is
some flexibility in your program of study, how will you make decisions about
what classes to take and when to take them? How can you keep yourself
flexible enough to make changes in your program to accommodate your
changing and evolving interests as a counselor?

1. Consider the eight core areas of the counseling curriculum. Are there
other major areas that you think should be included? If so, what topics,
and why? Why do you think these eight areas have remained the core of
the educational experience for more than 30 years? Is it time for a
change? If yes, what do you recommend?
2. Do you think the counseling profession is made up of one profession or

many? Should there be an overarching counseling association that
includes of all the specialties, or does that make it too difficult for the
voices within every specialty to be heard?
3. What ways can you get involved in the counseling professional

associations during your graduate training? Are there local conferences
or workshops you can attend? How would you find out what is available
to you as a graduate student? What strategies can you use?
Experiments
1. Find out the specific qualifications licensure/certification for your
specialization within your state. You may need to contact your state
counselor board, the state’s Department of Education, or other licensing
bodies. In addition to the coursework and experiences required by your
graduate program, what else is required to become licensed?
2. Go to the ACA, ASCA, and/or AMHCA websites to explore what these

associations have to offer. As you explore these associations (and other
divisions of ACA or your state branch), what are your reactions? What
excites or engages you?
3. Attend a state workshop or conference to learn more about the

counseling profession in your state. If you have the opportunity,
volunteer to work at the conference for a reduced conference admission
fee and the opportunity to network with professionals in the field.
4. Write your “elevator speech” and include more of the specific

information and context that you learned in this chapter. Whereas
previously your focus may have been on how counseling differs from
other professions, you are starting to get a sense of what counseling is
like from within the profession. Think about how what you are learning
changes your ideas and understanding about the professional of
counseling. As you begin to recognize the complexities of the
profession, it may become more difficult to neatly summarize what you
are studying to others. That’s okay. There are no easy answers, and
living in complexities is what counselors often do!
Explore More
We encourage you to learn more about the topics in this chapter. For this
chapter, the best resources for exploration are the websites of the state and
national associations.
Check the website for your state-level licensure or certification to learn

more about the requirements for counselors in your state. Be sure to read
the rules that govern counselors, and check out the latest newsletters on
the site for the most up-to-date information.
Go to your state-level counseling association website for information

about upcoming conferences and workshops, as well as information
about current topics important to the counseling profession in your state.
Other websites to explore:
American Counseling Association: www.counseling.org
American School Counselors Association:

www.schoolcounselor.org
American Mental Health Counselors Association: www.amhca.org
Chi Sigma Iota: www.csi-net.org

Chapter 4 How Do Counselors
Integrate Personal and Professional
Identity?
Questions
Some of the personal aspects of counseling and of being a counselor,

including personality types of counselors and characteristics of those
drawn to the counseling profession.
How counselors develop, both personally and professionally, over time.
What it means to adopt a self-reflective approach to becoming a

counselor that involves synthesizing the new learning with the person
you already are—comparing as you go along and remaining open to new
ways of looking at the world.
Articulate what drew you to the counseling profession, identify your

strengths that will enhance your ability to be a counselor, and be aware
of your personality traits that might get in the way.
Describe the personality traits that counselors should possess and

discuss how people with many different temperaments can become
effectiveness counselors.
Develop strategies to help monitor your own growth and development as

a counselor and list activities that will help you become more self-
reflective as you move forward in your journey.
Do you believe people with all personality types can be effective

counselors? Are there any personality traits that would make it
particularly challenging for a person to become a counselor?
How can you use your personal strengths to help you become a better
counselor?
Professional Orientation and Ethical Practice k. strategies for personal

and professional self-evaluation and implications for practice
Who are Counseling Students?
Some students enter graduate training in counselor education directly from
their undergraduate programs. If you are in this category, you may have
majored in psychology or a related field and may even have known from an
early age that you wanted to pursue a career in mental health. Going to
graduate school in counselor education is just the next step on that path.
Maybe you majored in education, knowing that you wanted to work with
children in schools. Or perhaps you had a completely different major and
came to the realization during your undergraduate years that you wanted to
pursue a graduate degree in counseling. Maybe you’re coming to graduate
training in counseling because you want to stay in school, where you feel
comfortable and safe, and the choice of major is less important than just
continuing to be in college. You may even be among the group who came to
graduate training in counseling as your second choice after not being
accepted into a graduate program in another field.
Counselor education programs also attract adult learners—those of you who

have been out in the world for several or many years, either in a different
profession, or busy raising a family or serving in the military. You may be
embarking on a second or maybe even third or fourth career. You may be
returning to graduate school because you found your career to be personally
or professionally unfulfilling and you want a career that offers meaning. It is
not uncommon for students who come to counseling from the world of
business to talk about how their job left them feeling empty, or as one student
put it, “I just couldn’t sell one more insurance policy—I need to really make
a difference in people’s lives.” Perhaps you decided to come into the
counseling profession because somewhere along the line, a counselor helped
you and now you want to give back. This is particularly common in the
counseling specialty of substance abuse, where clients often believe that their
counselors and the mental health system “gave them their lives back” and
now they believe that they owe it to the profession, and to themselves, to
dedicate their lives to helping others get their lives back as well. Maybe you
are among those who have postponed your professional dreams until your
children were in school or grown, and now you can finally focus on yourself.
It could be that you want the prestige or money that graduate education can
offer. More than likely, it is a combination of your personal goals, beliefs,
and opportunities that brought you to a graduate program in counselor
education.
Some counseling students are scholars; others barely made it through their
undergraduate training. Some are the first in their family to go to college,
much less graduate school. Others are following a long tradition of education
in their families. Some have experienced firsthand the devastation that mental
illness can cause in families; others have more removed experiences with
mental illness. Still others are managing their own mental health problems.
The point is that there are as many motivations to enter graduate training as
there are students. Counselor education programs are often a mix of students
with diverse experiences and goals. The demographic data about counseling
students (primarily female, primarily Caucasian) can overshadow the reality
of the diversity of personal experiences in our profession.
Fast Fact
Large national studies have consistently found that most (82–88%) counselor
education students are female, with an average age of 33, but students in
these studies ranged in age from 21 to 65.
Source: Dobmeier & Reiner, 2012; Granello & Gibbs, 2016; Pease-Carter &
Minton, 2012.
In this chapter, we focus on the counselor as a person. Counseling is not

something that is external to self. In many professions, people learn to do a
particular task, and their ability to perform that task is sufficient. However,
becoming a counselor is not just learning to do a set of skills (solve a math
problem or make a meal). Counselors are who we are. We don’t do
counseling, we become a counselor. It isn’t enough to learn the skills,
theories, and techniques of counseling; you must also understand who you
are, and who you are becoming as a person. After all, the major tool you have
as a counselor is yourself. The entire process of becoming a counselor
changes you—and ultimately it becomes a part of everything you do.
As a graduate student, you may be prepared for the academic rigor of the
counseling program in which you are studying. However, you may be less
prepared for the expectations that you will face regarding your personal
development. Counseling is unlike other professions, where academic
preparation alone may be sufficient. Counselors are expected to attend to
their personal development, to their ever-changing personhood. Personhood
is the evolving sense and understanding of self, of being truly human and
aware of who you are. Understanding your own subjective experiences,
feelings, and private concepts and your own views of the world and self—
these are the key components of attending to your own personhood.
In this way, counseling is the blending of both personal and professional

identities. In fact, the expertise of the counselor is said to rely on a three-
legged stool, with each component absolutely essential to optimal
functioning: (1) experience/practice, (2) knowledge/learning, and (3) personal
life (Skovholt, 2010). Becoming a counselor changes you—it becomes a part
of everything you do. Counseling students are sometimes surprised how
difficult this blending of personal and professional identities can be. You may
be in the process of discovering how much personal work (e.g., self-
reflection, self-awareness) and personal growth is expected of you in this
profession. The good news is that this is a lifetime journey, and you are just
taking your first steps.
As a strategy to help you hear many different voices in the personal stories of
becoming counselors, we reached out to members of COUNSGRADS, the
national listserv for graduate students in counselor education, and asked them
to reflect on the question, “What have you noticed in yourself during your
first year of graduate training?” All of this chapter’s Words of Wisdom are
taken from their responses.
Words of Wisdom
Here’s the secret I learned. Becoming a counselor is not the goal. Becoming
yourself—who you are, who you will become, who you were meant to be—
that’s the goal. It sounds easy, but it is the hardest (and best) thing you will
ever do!
—Vicki P.
In this chapter’s first Snapshot, you will meet two counseling students who,
on the surface, would appear to have everything in common. Identical twins,
Bhuneshwar and Krishna, are in the same graduate counseling program
together. We believe that they are a perfect example of this blending of
personal and professional identities. In spite of very similar backgrounds and
the same graduate training, they are embarking on very different paths in
their journeys toward becoming counselors. Their stories highlight this
essential truth about the counseling profession: Each counselor is unique. It is
exactly because of this blending of the personal and the professional that each
counselor’s story is like no other. As you read through the Snapshot, you may
want to consider how your own personal story of becoming a counselor is
beginning to develop.
SNAPSHOT Bhuneshwar and

Krishna Arjune: Identical Twin
Brothers on a Shared Journey
Toward Individual Professional
Identities
Bhuneshwar and Krishna are identical twins who are in the same Clinical
Mental Health Counseling track in the same Counselor Education program at
the same university. They both received their bachelor’s degree in the same
major from the same university. So, you might think that they are on the
same path for their future. But, as you will read from their stories below, they
each have a very different vision for the future.
Bhuneshwar Arjune
Bhuneshwar: Finding the same counselor education program was not

planned, but in the program we have both developed our own identities as
counselors. I am very extroverted, with a strong interest in business and sales.
My brother Krishna is pretty introverted. I am hoping to pursue a career in
Private practice, EAP counseling, or as a director/administrator of a
community mental health agency. Krishna is interested in working in an
inpatient hospital setting. Both of us have a strong leadership background
from our undergraduate experience. Even though we come from such a
similar background, our counseling program has really helped us to find our
own concentration of counseling. Ultimately, we will both use the clinical
training we have to pursue a career in the mental health field.
Within the master’s program, we have both found an interest in group

counseling, multicultural counseling, and Cognitive Behavioral Counseling.
We have realized that our similar background shapes the decisions we have
made, but still creates opportunities for us to be unique. Learning to embrace
these differences has helped us to shape our professional identities as
counselors. I’m sure as we progress throughout the program, we will continue
to find populations within the field of counseling that we gravitate toward.
This will further differentiate us, yet unite us under the umbrella of being a
clinical counselor.
Krishna Arjune
Krishna: My twin brother and I are both interested in counseling but in

unique ways. I first heard about counseling from my psychology professor
during undergrad. After explaining what I wanted to do in life, she suggested
that I look into a counseling program. I am currently doing my practicum
placement at a community mental health agency. It has given me a new
perspective on my potential counseling clients. After graduation, I hope to
find employment in a local hospital. After observing various groups at my
practicum location, I look forward to working in groups at an inpatient
hospital setting. I did not know that I would grow to enjoy group counseling
as much as I do now. My graduate program has helped me to build the skills I
need to be successful in my future. My family, professors, and cohort
members have all been amazing in supporting my brother and me along our
journey to becoming licensed professional counselors. Wherever the future
takes us, I know we will both be grateful to our counseling program, and to
the counseling profession, for what they have given to us.
Why Do People Become
Counselors?
Most people who enter the field of counseling know they want to work with
people, to make a difference, to help where they can. They find counseling to
be an outgrowth of their personality, and they want to receive graduate
training to develop the necessary skills and education required by licensure or
certification bodies. Most counselors would agree that it is a privilege (as
well as a responsibility) to help people survive and thrive during difficult life
situations. Some counselors talk about their intrinsic desire to understand
people, to engage fully with others, to have a career that helps them live a life
of meaning and purpose. Others say they are fascinated to see the theories
and concepts of human nature come alive in their work with others. Day
(1994) conceptualized three main reasons why people entered the profession
of counseling: (1) to do for others what someone has done for me; (2) to do
for others what I wish someone had done for me; and (3) to share with others
certain insights I have acquired or to help inspire others to make changes in
their lives. Take a moment to think of the reasons that you decided to enter
the counseling field, and make some notes here.
What Types of People Become
Counselors?
As professors of counseling, we get this question a lot. Applicants to our
graduate programs ask us “what are you looking for?” or “do you think I
have the right personality to become a counselor?” We are happy to tell you
that there is room in the counseling profession for all types of people! There
is no “one personality type” of counselors. There is room in our profession
for introverts and extroverts, for people who are analytical and for those who
are more emotion-based. What is important is that each of us knows
ourselves well enough to find the place in the profession where we will excel
and grow.
In the accompanying Spotlight, we examine the role that personality plays in

the development of counseling professionals. The Myers-Briggs Type
Indicator (MBTI) is a popular assessment for identifying preferred ways of
interacting with the world, and it can be a useful tool to help beginning
counselors reflect on the strengths and limitations that they might bring to
their new profession. As you read through the Spotlight, be sure to consider
how your preferred ways of interacting with the world can influence the type
of counselor you will become.
What are the Characteristics of
Effective Counselors?
Your MBTI type can offer you insights into your personality, which is
generally understood to mean the traits that you were born with. In other
words, most of us are naturally more introverted or extroverted, or more of a
thinker or feeler. None of these personality traits is considered “better” or
“worse”—they are just different ways of interacting with the world around
us. People of all personality types can be effective counselors.
SPOTLIGHT Counselors and the

Myers-Briggs Type Indicator
(MBTI)
One of the ways that counselors help clients understand their strengths and
how their personality types can influence their interactions with others is
through an assessment called the Myers-Briggs Type Indicator (MBTI). This
same test can be used to help beginning counselors understand the potential
strengths and limitations they bring to their new profession.
The MBTI is based on the work of Carl Jung, a psychoanalyst and theorist
who was interested in understanding psychological types (Jungian
archetypes) that he believed were present across all cultures. During the
1930s, Katherine Cook Briggs and her mother, Isabel Briggs Myers, set out
to develop an instrument to measure these psychological types, believing that
such an instrument could help match soldiers to their ideal military jobs
during WWII. The MBTI is now the most popular measure of personality
typology in the world and has been translated into more than 30 languages
(Geyer, 2002). The MBTI measures personality traits on four continua:
extraversion versus introversion (E/I), intuitive versus sensing (N/S), thinking
versus feeling (T/F), and judging versus perceiving (J/P) (Myers &
McCaulley, 1985).
The extraversion/introversion (E/I) scale measures the degree to which a

person is oriented to the external world of people versus the internal world of
thoughts and ideas. Extraverts draw energy from action and recharge and get
their energy from spending time with people. Introverts seek depth (rather
than breadth) in interactions with others and recharge and get their energy
from spending time in reflection and quiet time alone. The sensing/intuitive
scale (S/N) measures the primary method for intake of information, either
through the concrete method of sensing or the more abstract method of
intuition. Sensing individuals like hands-on methods and are more realistic
and practical. Intuitive people prefer the big picture and are more conceptual,
seeking inspiration, rather than facts and details. The thinking/feeling scale
(T/F) measures how a person prefers to use information to make decisions.
Thinkers are more logical and rational, and they make decisions based on the
facts and information. Feelers are more emotion-based, subjective, and
relationship- oriented in their decision making. The T/F scale is the only one
affected by gender. More males (about 75%) score on the thinking side of the
continuum, and more females (about 75%) on the feeling side. Finally, the
judging/perceiving (J/P) scale defines how an individual interacts with the
environment. Persons who fit in the judging category face the world with a
plan. They are organized and structure their time. Conversely, those who fit
into the perceiving category take the world as it comes. They are more
spontaneous, easily distracted, and value creativity over neatness and order.
The results of each scale are brought together to form a four-letter personality
type. For example, a person who is primarily extraverted, intuitive, thinking,
and judging would be an ENTJ. Thus, there are 16 possible personality types.
Although the MBTI has been criticized for forcing the entire population of
the world into 16 code types (Dahlstrom, 1995) and for questionable validity
(Healy, 1989), the inherent usability of the results make it very appealing for
use in research and practice. Counselors use the MBTI to help clients
understand their basic temperaments. In career counseling, the MBTI helps
match people with jobs and work environments that suit their personalities. In
couples counseling, the MBTI helps partners realize the inherent strengths
that each partner brings to the relationship and to recognize differences in
temperament and the communication styles that result from those differences.
The MBTI is also used in education to help learners and teachers recognize
their different approaches to understanding the world.
There is no specific personality type necessary to be a counselor. Counselors

are represented in all 16 categories. However, counselors with different
personality types tend to have different strengths and enjoy different aspects
of the profession (Rashid & Duys, 2015). The most common personality type
for counselors is ENFP (extraverted, intuitive, feeling, and perceiving), and a
higher percentage of counselors are in this category than the percentage of
ENFPs in the general population (Vanpelt-Tess, 2001).
Bayne (2004) argued that counselors with certain MBTI personality types
will have particular strengths and areas for growth. These are listed in the
following table, and they may provide a good starting place as you consider
your own strengths and limitations as a counselor.
Likely Strengths Likely Aspects to Work On
Helping the client explore a Using silence

wide range of issues
Helping clients explore issues in
E
Easy initial contact sufficient depth
Thinking “on feet” Reaching the action stage too early
Helping the client explore a Helping clients move to action

few issues in depth
Helping clients explore all relevant
I
Reflecting on strategies, etc. issues
Using silence Ease of initial contact
Observing details Taking the overall picture into

account
Being realistic
S Helping clients decide on Brainstorming (strategies,
practical action plans challenges, and actions)
Using hunches
Being specific
Seeing the overall picture
Testing hunches
N Brainstorming
Helping clients decide on practical
Using hunches
action plans
“Picking up” feelings
Being objective Being empathetic (i.e., in client’s

frame of reference)
T Challenging (i.e., from
counselor’s frame of Being warmer
reference)
Challenging in a timely way (not
prematurely)
Taking thoughts into account as

well as feelings
Being warm Coping with conflict and

F “negative” feelings
Being empathetic
Being more objective
Challenging
Helping clients to make decisions

Being organized in a timely way (not prematurely)
J
Being decisive Being flexible
Being organized (keeping to time

Being spontaneous
P and structure of session)
Being flexible
Helping clients make decisions
Source: Bayne (2004), p. 137. Name of table in original text: Strengths and
aspects to work on for counsellors or coaches.
If you have an opportunity, you may wish to take the MBTI. Many people,
however, find that they are able to correctly identify their personality type
when they are presented with the descriptions of the four scales. Remember,
there is no “right or wrong” type—but having an understanding of how you
primarily view the world will help you in yo ur journey to better understand
yourself and the way you interact with your clients.
When we talk about the characteristics of counselors, however, we are

speaking more about character strengths. Unlike personality types, character
strengths only develop as a person matures over time. Character strengths are
generally believed to be based on a person’s beliefs and have a clear
connection to integrity. Character strengths are linked to moral principles,
such as honesty, integrity, and fairness. Most people believe that character
strengths are interconnected, and research supports the contribution of
positive character strengths to an individual’s overall wellness, happiness,
and meaning in life (Allan, 2015). It is perhaps not surprising, then, that
although people of all personality types can be effective counselors, people
with certain character strengths are likely to be more successful as counselors
than those without these strengths.
To understand the role of character strengths in counseling, we must first turn

to the first person who wrote about how personal characteristics of counselors
can affect the counseling process. Carl Rogers, one of the most important
figures in the history of counseling, wrote about the blending between
becoming a practitioner and growing as a person in one of his most
significant books, On Becoming a Person (Rogers, 1961). In it, Rogers
argued that the personhood of the counselor—and the counselor’s awareness
of that innate personhood—is more critical to the success of the counseling
session than scholarly knowledge, professional training, theoretical
orientation, or techniques. The premise is that as counselors, we must be
willing to work to understand ourselves before we can be truly present for our
clients.
Rogers believed that people who make the best counselors are those who are
naturally warm, spontaneous, real, understanding, and nonjudgmental
(Rogers & Stevens, 1967). He believed that the character strengths necessary
for counselors could be summed up by the core conditions of therapy:
congruence, unconditional positive regard, and empathy.
Congruence refers to congruence between thoughts and behaviors.

Counselors who are congruent are genuine in their behaviors. They act how
they feel. They do not put up a professional front or distance themselves from
their clients. Rogers described congruence as follows: “The feelings the
counselor is experiencing are available to him, available to his awareness,
that he is able to live these feelings, be them in the relationship, and able to
communicate them if appropriate” (Rogers & Stevens, 1967, p. 90).
Words of Wisdom
I believe that I am much more aware of the ecology of every person’s story,
including my own. By that I mean I take more time to understand the
complexity of their history, their personality, and their environment. When I
take the time to understand my clients, I am less quick to judge. When I take
the time to understand myself, I am more forgiving of myself and more
willing to give myself permission to really learn and grow.
—Jeri G.
Unconditional positive regard is the constant and unwavering respect that the
counselor has for the client. Clients can present themselves in a multitude of
ways, with a variety of problems, varying levels of insight or intelligence,
and the counselor always respects and values the client. Counselors
distinguish between people and actions—that is, even when the person in
front of you has committed terrible actions, the value of the person is not
diminished. Unconditional positive regard is what allows counselors to work
with people whose values are very different from their own, or who have
committed crimes (Hazler, 1988).
Empathy is the desire to fully understand the world view of the client, to have
a profound interest in sharing the “client’s world of meanings and feelings”
(Raskin & Rogers, 1989, p. 157). Empathy involves both understanding and
the ability to communicate that understanding to the client. True empathy
involves the moment-to-moment experiencing of the inner world of the
client. It is not merely acting “as if” you understand or using a standard
phrase or expression that labels the client’s feelings without true
understanding. Clients recognize when counselors are using empathetic
words but have no real empathy behind the words (Young, 2016). Rogers
acknowledged that complete empathy was probably unattainable, but saw the
ability to empathize as a lifelong goal that should always be under
development for counselors.
Rogers clearly believed that becoming a counselor was more about the
personhood of the counselor than the specific training the person received,
although he recognized that both were important. His approach was in direct
contrast to some of his predecessors, who either believed that the analyst
(counselor) should be a blank slate (e.g., Freud) or the therapist should use
specific skills to help the client change (e.g., Skinner). These differing beliefs
about the personhood of the counselor were the start of one of the longest-
running controversies within the counseling profession. As you will read in
this chapter’s Counseling Controversy, some people believe that anyone can
be trained to become a counselor while others argue that becoming a
counselor is more innate to the person. As you read through the controversy,
we encourage you to consider your own path. Do you believe you were “born
to do this?” or is becoming a counselor something that will grow out of your
professional training? Perhaps it is both?
Rogers’s core conditions of congruence, unconditional positive regard, and

empathy clearly are important for counselors. They have been validated as
important components of the counseling relationship through research studies
(Truax & Carkhuff, 1967). Many other writers and researchers have added to
the list of desirable strengths for counselors (e.g., Bayne, 1995; Carkhuff,
1987; Hackney & Cormier, 1996; Langman, 2001; Lent & Schwartz, 2012;
Shallcross, 2012; Weaver, 2000; Williams, 1999; Witmer, 1985). Several of
these strengths are listed in the following paragraphs. Although the list is not
exhaustive, you may notice as Witmer (1985) did that many of these
characteristics are similar to those of psychologically healthy individuals. In
fact, Witmer and Young (1996) made the important claim that “well
counselors are more likely to produce well clients” (p. 151). More recent
studies have confirmed the importance of the psychological well-being of
counselors and counselors-in-training (e.g., Lawson, 2007; Moorhead, Gill,
Minton, & Myers, 2012; Myers, Mobley, & Booth, 2003; Roach & Young,
2007; Wester, Trepal, & Myers, 2009). As you read the character strengths,
you may want to consider whether you believe they are important for
counselors. Additionally, you might want to consider the degree to which you
believe you possess each of these character strengths and any strategies you
might want to use to help further develop them.
Counseling Controversy Are

Counselors Born or Made?
Background: This argument highlights two sides of an important counselor
training issue. Some people believe that there are individuals who are
“naturally therapeutic,” while others argue that with proper training and
development, almost anyone can be a counselor. This argument also has been
cast as the “art versus science” argument in counseling. Read the two sides of
this argument, and then see what you think.
POINT: COUNSELORS ARE COUNTERPOINT:

BORN COUNSELORS ARE MADE
Counseling is a science. As the

profession of counseling
becomes more and more
Counseling is an art. From the
prescribed by laws and
birth of recorded history there
regulations, there is a greater
have been people recognized by
understanding that counseling is
their peers as having the gift of
more than just a “feel-good”
soothing a troubled soul or easing
approach filled with “warm
a painful passage. These people
fuzzies.” There is a science to
have a temperament and
counseling, and the advanced
sensitivity that cannot be taught.
training required of counselors
It is innate—it is who they are.
recognizes this.
Natural counselors have a
Counseling is supported by an
therapeutic way of being—they
extensive body of research that
don’t rely on formally taught
tells us what skills and
skills. The very being of the
techniques tend to benefit
counselor—the willingness to
which clients. It’s not about
take risks, to be fully present with
what feels good for the
the client, to help the client
counselors—it’s about what
become fully functioning—those
helps the clients.
cannot be taught, but come only
from life experience and the Counseling is an intentional
willingness to be fully present in process, and counselors choose
our own lives. interventions to help clients
develop self-understanding. The
Anyone can memorize a given set
counseling relationship is
of rules, but the key to counseling
obviously a key component for
lies in the power of the
change, but most counselors
relationship itself
agree that the counseling
relationship is a necessary, but
not sufficient condition for
therapeutic change.
argument.
Counselors are self-aware

(introspective).
Counselors understand themselves and are willing to examine their beliefs
and behaviors. Self-awareness helps counselors focus on who they are. Self-
reflection encourages counselors to evaluate what they have learned about
themselves, and self-discovery allows counselors to take risks and try out
new ways of becoming.
Counselors are trustworthy (have

personal integrity).
In order for the counseling relationship to grow, clients must feel safe.
Counselors must be trustworthy and have the ability to translate that
trustworthiness into behaviors that the client can see.
Counselors take risks.

Regardless of theoretical orientation, most counselors believe that you can
only take a client as far as you are willing to go yourself (Wilkins, 1997).
Therefore, counselors must be willing to take risks in their own lives if they
want to encourage clients to take risks and make changes in their lives. Risk-
taking can mean moving out of your comfort zone to try new behaviors or
interacting with people who are different from you. Risk-taking also is
important because there is no way any counselor can plan for every
eventuality in a counseling session. You always take a risk when you engage
with a client—you risk going to a place that forces you to change or grow.
Counselors have a sense of humor.

Counselors who can see the humor in life and can remember to laugh are less
likely to suffer from emotional burnout (Malinoski, 2013; Minich Crants,
2014; Sultanoff, 2013). In one study, 82% of therapists ranked maintaining a
sense of humor as the number one career-sustaining behavior (Kramen-Kahn
& Hansen, 1998). However, not all humor is the same. Affiliative humor that
is ironic or playful has been found to contribute positively to therapists’ well-
being whereas humor that is sarcastic or cynical has been found to be a
predictor of therapist burnout (Gladding & Drake Wallace, 2016;
Malinowski, 2013). Finally, it is important to note that in this context, we are
discussing the use of humor within the counselor’s own life and not within
the therapeutic relationship. Although the use of humor with clients can be
beneficial, it is also controversial and should be used carefully and only with
supervision and training (Middleton, 2007).
Counselors have an innate curiosity

about the world and the people in it.
Part of counseling is an investigation into the life of the client. Counselors
must have a desire to learn “what makes people tick” or how the world looks
from the eyes of their clients. This is not the same as voyeurism (simply
learning the details of a client’s life or story for your own enjoyment or even
morbid curiosity), but trying to understand the client so you can truly
empathize with the person’s situation. Counselors look for clues that further
their understanding of the world of their clients and become co-discoverers,
along with their clients, in the client’s journey to self-understanding.
Counselors are emotionally stable.
People who are emotionally volatile—whose temperament changes on a daily
or even hourly basis—do not provide the kind of consistency that is needed
by most clients. Clients in counseling must be allowed to work through their
own issues without regard to the changing emotional state of the counselor.
This is another reason counselors must be constantly aware of personal
reactions, so that they do not interfere with the client’s work.
Counselors believe that people can

change (optimistic).
Fatalistic people—those who believe we are powerless to make changes in
our lives—rarely become counselors. After all, the goal of most counseling is
to help clients make positive changes in their lives—even if that simply
means helping them to reframe their reactions to those negative aspects of
their lives that they truly are powerless to change (e.g., being diagnosed with
a terminal illness, having parents who are alcoholics).
Counselors are not afraid of

psychological pain and do not
shrink back from people in pain.
Counselors are not uncomfortable with tears and sadness and do not try to
“make things all better” for their clients. They allow clients to fully
experience their emotions, and in turn, counselors are willing to be present
and involved with their clients’ emotional reality. We sometimes tell our
students that counselors are like “firefighters of pain.” When a building is on
fire, our natural instinct is to run as far away as possible. Yet, firefighters run
toward the fire because they know they can be helpful. In this analogy,
psychological pain is like the fire. When people are in tremendous emotional
pain, most of the other people in their lives try to distance themselves from
that pain. Counselors, however, run toward the pain. Just like the firefighters
have the protective gear of their clothing and oxygen masks, we have the
protective gear of our training and experience. We go toward other people’s
pain because we know that we can help.
However, running toward pain has its limits. Firefighters know when they
need to remove themselves from dangerous situations, and likewise,
counselors must develop strategies to keep themselves emotionally safe.
Counselors cannot become so invested in the emotional lives of their clients
that they no longer can be objective or offer useful assistance. Counselors
walk the line between being fully present to allow clients to experience their
emotions and emotional contagion, which is the belief that other people’s
strong emotions will overcome the counselor as well. Research shows that
people in the helping professions who are susceptible to emotional contagion
are more vulnerable to stress and burnout (Austin, Goble, Leier, & Burn,
2009; Zaki, 2016). Thus, counselors must be open to experiencing the
psychological pain of their clients without finding themselves overcome and
paralyzed by it.
Counselors respect their clients.

Robert Carkhuff (1987) took Rogers’s unconditional positive regard and
operationalized it as respect. To respect a client means that you believe that
clients have the capacity to determine their own future. Counselors who
respect their clients do not offer simple answers to the complex problems in
clients’ lives; they believe that clients are the experts when it comes to
understanding and changing their own lives.
Counselors have an innate sense of

social justice.
Social justice takes the values of unconditional positive regard and respect
one step further. Counselors value the inherent worth of all of their clients
and believe that the dignity and worth of all human beings is worth fighting
for (advocacy). Advocacy is not a character strength, but it is the behavior
that grows out of the character strength of social justice. In other words,
counselors who believe in social justice recognize that their lives are
interdependent with the lives of their clients and that they have a social
responsibility to promote equity and self-determination for all human beings.
Counselors have the capacity for

self-denial.
People come to counselors when they are in emotional crises. Counselors
must be able to put aside whatever is going on in their own personal lives and
focus totally on the client. If you are having a bad day or have just had a fight
with your significant other, your mind cannot wander to your own life and
interfere with the attention you are giving to your clients. Clients cannot be
used for monetary gain when they do not need counseling, as a support
mechanism to validate or reassure the counselor, or as a source of sexual
satisfaction. The clients’ needs must come first.
Counselors are nonjudgmental

(open-minded, tolerant, accepting).
Counselors are open to new ideas and experiences. They are not critical or
judgmental of others who are different from themselves. They are careful to
avoid preconceived ideas or stereotypes about their clients. This open-minded
approach is an essential component of counseling in a multicultural and
diverse society. As a result, a nonjudgmental approach to others is often
considered one of the most critical character strengths of effective counselors
(Pope & Kline, 1999).
Counselors are comfortable with
their power.
Whether we like it or not, the role of counselor carries some inherent power.
Clients may see us as able to help them in ways other people can’t. A
counseling license or certification may “open doors” for us, both personally
and professionally. And even your family might now consider you “able to
read people’s minds” in ways they hadn’t before. The role of professional
counselor carries weight, and counselors are comfortable using their role to
advantage their clients (e.g., to advocate for a student in a school system or
negotiate with a managed care company for continued sessions for a client),
but counselors do not use the power and status that is ascribed to them for
their own benefit or to dominate their clients.
Counselors are verbally fluent; they

are effective communicators.
Talk therapy relies on counselors who have the ability to communicate with
others. That means that counselors typically have an innate ease in talking
with others and with listening. They tend to be social, to put other people at
ease, and to find it easy to talk with others. They communicate well, are
precise in their choice of words, and easily read the nonverbals of those
around them. One study found that the most common vocational personality
code of counseling students is Social, and that students who fit this category
were more likely to be successful in their graduate school training than those
who had personality types that were less congruent with the field of
counseling (Ding, Salyers, Kozelka, & Laux, 2015).
Counselors are flexible.

Beginning counselors often want their professors or supervisors to tell them
what to do. They might ask, “When a client says X, what should I say?” But
counselors-in-training soon realize that there are no scripts in counseling.
Counselors use a variety of techniques and interventions based on differing
theoretical approaches, and clients respond to lots of different kinds of
approaches. Therefore, counselor must have a repertoire of skills and
techniques, but even more importantly, counselors must be able to think on
their feet. The ability to be creative and to approach each session with
freshness is important to moving the session in a direction that is helpful to
the client, rather than in some predetermined or counselor-imposed direction.
Counselors tolerate ambiguity.

Most people like closure or definitive answers. But in counseling, clients and
their counselors have to live with not knowing, with being “in flux,” and with
not having clear right and wrong answers. Clients present with problems that
are complex and do not have solutions that respond to a “quick fix.”
Counselors are patient.

Sometimes clients make big changes in their lives and counseling sessions
move a client quickly toward resolution of a problem. Sometimes the changes
are small—almost imperceptible. Clients move and change at different rates,
and they need counselors who will stay with them and not become frustrated.
Sometimes beginning counselors make large and unrealistic goals for their
clients (e.g., by the end of the semester, my client will no longer be using
inappropriate methods to gain attention from his parents). Patient counselors
recognize that counseling must move at a pace that is beneficial to the client,
not at a pace determined by the counselor.
Counselors possess good mental

health and have a sense of their own
well-being.
Witmer and Sweeney (1992) used the work of Alfred Adler to develop a
model of well-being. They included in their model of a well person five life
tasks: (1) spirituality (a sense of purpose and connectedness), (2) self-
direction (including a sense of worth, sense of control, realistic beliefs,
emotional regulation, and self-care), (3) work and leisure (a sense of
accomplishment and a sense of enjoyment), (4) friendship (connections with
others), and (5) love (sustained, long-term, mutual commitment). Counselors
are aware that to be fully present with their clients, they need to be as
psychologically well as possible. Counselors can use this model, or more
recent updates to wellness models, to consider their own wellness and to
strive to achieve balance in their lives. (We will discuss the concept of
counselor wellness and how to work to achieve and maintain balance in your
life as a counselor in Chapter 13.)
Counselors are aware of their own

limitations.
Not all counselors can work with all clients, and there are limits to our scope
of practice. In other words, counselors recognize that just because legally
they have the credential to engage in a certain practice or counsel a particular
client does not mean that ethically they should. We recognize the limitations
of our professional training and our personal limitations as well. We refer
clients who need a counselor with a specialized type of training. We also take
care to make sure that our own personal issues—our “unfinished business”—
does not interfere with the work we are doing with our clients.
Words of Wisdom
I learned to make sure you’re not becoming a counselor in order to care for
someone else instead of yourself.
—Jerry D.
Counselors are human.

Remember, no one possesses all of these personality traits. No one is the
perfect listener, always empathetic, never judgmental, and always able to
give complete and full attention to the client. Counselors are human, and we
bring that humanity into the counseling session. Each of us has our strengths
and our areas to work on. The goal is not perfection, but a continued striving
to be the best counselor that you can be. Although it may be difficult and
painful at times to engage in self-awareness, self-reflection, and self-
discovery, it will become a cornerstone of who you are in the counseling
relationship. Some writers have referred to this concept as “self-as-
instrument”—when it is just you and the client in a counseling session—your
ability to be fully present, to engage with the other person from the essence of
your personhood, is all you have.
In the accompanying Spotlight, you will read about The Wounded Healer, a
concept at the core of the helping professions. Counselors often use their own
experiences of hardship and pain to help understand and empathize with their
clients. Although our own suffering can help us connect, it can also cause us
to lose perspective and put our own needs ahead of those of our clients.
SPOTLIGHT The Wounded Healer

The wounded healer is a concept that dates back to Greek mythology, and it
has become important to the helping professions. The belief is that many
people who are called to help others have themselves been through difficult
experiences, and those experiences sensitize them to the sufferings of others.
Wounded healers are assumed to have an unconscious connection with their
clients or a deep sense of empathy, which assists the clients in their healing
process. The counseling profession appears to have a disproportionate
number of people who are psychologically wounded, and studies have found
that counselors and counselor trainees have higher levels of psychopathology
than are found in the general population (see Hanshew, 1998).
Rollo May observed that many geniuses had physical illnesses or disabilities
(for example, Mozart, Beethoven), and that these challenges seemed to bring
out their genius. He noted that Harry Stack Sullivan, a noted psychiatrist, had
severe interpersonal problems—but he made his greatest contributions to
psychiatry in the field of interpersonal relations. Thus, May proposed “that
we heal others by virtue of our own wounds” (May, 1995, p. 98).
Being a wounded healer might provide you with some empathy into your
clients’ suffering, but it can also negatively affect your ability to be objective
and fully present with your clients. If your own suffering or personal
experiences are affecting your counseling session, then you might find
yourself responding more from your own “unfinished business” than to the
needs of your clients. All counselors, and particularly those who have had
difficult emotional experiences in their past or present, are reminded that
receiving your own counseling as a client can be an essential part of
becoming—and of being—a counselor.
How Do People Determine Their
Personal and Professional Fit with
the Counseling Profession?
Whether you have wanted to be a counselor your whole life or have come to
that decision more recently, there may be some lingering questions you might
have about whether you can do this, or whether this career is right for you.
One of the things we have tried to do in this text is to share stories and
perspectives from counseling students and professional counselors so you can
start to understand the inner working of your new profession. Even with these
differing viewpoints, however, it is sometimes hard to envision how you will
fit into this new world.
Although we cannot tell you whether this is the right profession for you (no
one can do that except you!), we can certainly help you think about how you
know whether counseling will be a personal and professional fit. In addition
to the character strengths listed above, you might want to ask:
What types of interpersonal interactions truly sustain you?
Of course, most counselors say that they want to help others. Wanting to
help, versus dedicating your life to helping, may be two different things.
Think about the ways you want to help—do you have a genuine interest
in others? Can you really listen to them? Can you read people’s
nonverbals and form meaningful connections? Are you comfortable
keeping their secrets (when appropriate)? Are you comfortable
interacting with all types of people? Can you withhold judgment?
What attributes of a job are important to you?
Counselors work in jobs that require a lot of flexibility, creativity, and

resourcefulness. Sometimes they must transition quickly between
clients, and they often must handle competing demands on their time.
Most counselors say that they never know what to expect when they
walk in the door each morning. Think about what you want from your
job—do you require certainty and a set schedule? Do you thrive in a
setting that requires multi-tasking and frequent transitions? Are you
interested in engaging in life-long learning and the multiple challenges
that come with a profession that continues to change and grow?
How much external validation do you need?
One of our favorite analogies is that counselors plant seeds, but they
don’t always get to see the flowers grow. We work with clients and help
them get back on track with their lives. But much of the change that
occurs can be weeks, months, or years down the road, long after our
counseling relationship has ended. We sometimes laughingly say to each
other that it would be nice to make chairs for a living. At the end of the
day, we would know exactly how many chairs we made. But counseling
isn’t like that. We simply have to believe that what we are doing has a
long-term impact. Because the counseling relationship is focused on the
client, counselors are more concerned with helping the client feel
validated and supported than on seeking that validation for themselves.
You might want to consider how this will fit with your own
interpersonal needs. Do you need a lot of validation? Do you require
praise from others? Do you have an inherent sense of optimism that will
help you believe in a better future for your clients, even if you don’t get
to see it happen?
If these ways of being and becoming sound like they would be a fit for you,
then the good news is that counseling is a wonderful, exciting, and important
profession! Further, not only does counseling help our clients, it helps us, too.
When practicing therapists reflect on their careers, they typically believe that
practicing their profession enhanced their positive character strengths. It
wasn’t so much that they believed that they had them all right from the start,
but that they grew into the strengths that they now value. Riessman (1965)
called this the “helper therapy principle” (p. 27). By this he meant that the
helper, as well as the client, benefits from the process of helping. A study by
Radeke and Mahoney (2000) confirmed the benefits of helping. They found
that high percentages of practicing therapists believe that their practice
positively influenced their character. They found that when reflecting on their
practice:
94% believed it “made me a better person.”
92% believed it “made me a wiser person.”
92% believed it “increased my self-awareness.”
90% believed it increased my “appreciation for human relationships.”
89% believed it “accelerated [my own] psychological development.”
81% believed it “increased my tolerance for ambiguity.”
75% believed it “increased my capacity to enjoy life.”
74% believed it “felt like a form of spiritual service.”
61% believed it “resulted in changes in my value system.”
Other studies have found similar results. For example, more than 75% of
therapists in one study agreed that being a therapist: (a) pushes me to study
and learn; (b) is very dynamic and almost never routine; (c) has caused me to
think more creatively; (d) has helped me to learn more about myself; and (e)
has caused me to improve myself. Conversely, in the same study, more than
75% of therapists disagreed that being a therapist (a) has helped me gain
intimacy that I lack in other areas of my life; (b) allows me to express
aggression in legitimate ways; (c) allows me to hear intimate details of my
clients’ lives, even if they are not relevant to the work; and (d) lessens my
feelings of loneliness (Lazar & Guttman, 2003). In other words, counselors
understand the core principle of altruism. When we help others, we benefit as
well.
Fast Fact
GRE scores and undergraduate GPA may not be useful as tools to predict
effectiveness as a counselor. One study of 88 graduate students in counselor
education from 8 different states found that several personality characteristics
(empathy, psychological mindedness, sense of well-being, and tolerance),
when taken together, could help predict counselor effectiveness, whereas
GRE scores and undergraduate GPA had no relationship to counselor
effectiveness.
Source: Weaver (2000).

What is the Personal Journey
Toward Becoming a Counselor?
By now you have certainly recognized that you are embarking on a lifetime
journey, but the specific path forward may seem a bit unclear. Of course you
know that you have certain classes, field experiences, or licensure exams
ahead of you, but the milestones that you will pass in your personal
development may be harder to envision. Of course, just as it is clear that not
all counselors come from the same mold, it would be foolish to suggest that
all counselors follow the exact same steps toward their personal and
professional development. Nevertheless, many counselors find that they do
follow a similar overall developmental trajectory.
Theorists have generated some ideas about how therapists develop over time.
Most of these models suggest that in the beginning of training, counseling
students are more dependent on others (particularly faculty or supervisors) to
tell them what to do. As students learn and grow over time, they become
more independent and more confident and able to make decisions on their
own (Bruss & Kopala, 1993; Kreiser, Ham, Wiggers, & Feldstein, 1991).
This sounds natural for any new learner, but it frequently becomes a
roadblock in counseling when you are practicing your skills without an expert
present. Beginning students often want their faculty or supervisors to provide
more answers, more didactic instruction, and more structure. Further in their
studies, students who are nearing the end of their programs often desire
faculty and supervisors to act more like consultants. Students at this stage do
not want answers and structure as much as they want the opportunity to try
out new ideas with more advanced practitioners who will provide guidance
and support (Stoltenberg & Delworth, 1987).
Counselor Professional Identity

Development
One way to conceptualize this developmental journey is through the concept
of Professional Identity Development, which is the integration of professional
training with personal attributes in the context of a professional community.
To identify as a counselor, new professionals first start to see themselves as
counselors; work to assimilate the knowledge, skills, and attitudes of the
profession of counseling; and then try out this new professional identity with
others, receiving corrective feedback as they grow (Gibson, Dollarhide, &
Moss, 2010). As you work to develop your identity as a professional
counselor, you may see this in your own life. You start to call yourself a
counselor in training (self-labeling), and ultimately, you call yourself a
counselor. You learn about the skills, knowledge, and attitudes of the
profession. As you do this, you become socialized into the profession by
more senior members of the counseling professions (supervisors, professors,
and professional colleagues). Along the way, these interactions with others
continually shape and refine your self-definition of what it means for you to
be a counselor.
In a qualitative study with counselors-in-training, Gibson et al. (2010) found

three transformational tasks as graduate students traveled the road to self-
identity as a professional counselor. The first is how the students defined
counseling. Students moved from more externally derived definitions of what
professional counseling means in a more generic form (taken from textbooks
or experts in the field) to a more internalized understanding of what being a
professional counselor means for the individual. The second task is about
responsibility. Beginning students sought more answers from external
sources for their questions about counseling whereas students later in the
process understood that they had to understand their own needs and develop a
more internalized initiation of the process for their learning goals. The third
task is moving from an external locus of identity (knowing you are a
professional counselor because you have appropriate licensure or education),
to a more internalized sense of identity (a more integrated sense of self with
the professional counseling community).
In the next section, we turn to a discussion of some of the broad

developmental models that may help you understand the journey toward
becoming a counselor. Some of the most commonly used models, taken from
the adult development literature, research on college student development,
and novice-to-expert literature, help us understand the path that many
counselors take in their development over time. Perhaps you will recognize
yourself in these models as you consider your own journey as a counselor.
The models might even provide a sense of relief. Your peers are going
through a similar journey, and you are not in this alone. There is even a name
given to the feelings that you may have right now. The imposter phenomenon
is a term that describes the feelings of incompetence that many new
professionals might feel. Beginning counselors sometimes feel guilty, as
though they have deceived or tricked others into believing that they are more
competent and more skilled than they actually are. Students in the beginning
of their graduate programs may look around at their peers and begin to feel
less competent, less able, and perhaps even as though they “slipped by” the
admissions committee. Counselors-in-training and beginning counselors
often comment that they believe they are “putting one over” on their clients,
that if the clients knew that the counselor trainee was so inexperienced and
unsure, they would certainly “run for the hills” rather than stay in the
counseling session. The imposter phenomenon has been linked with students
who are high achieving—have always been successful in the past—and now
fear that they might be “found out” (Harvey, 1981; King & Cooley, 1995). It
also has been associated more with women (Cokley et al., 2015), with
students with perfectionist tendencies (Henning, Ey, & Shaw, 1998), with
introverts (Langford & Clance, 1993), and with first-generation minority
students with low academic self-concept (Ewing, Richardson, James-Myers,
& Russell, 1996; Parkman, 2016).
Perhaps you find yourself feeling like an “imposter.” The good news is that
the feeling doesn’t last long, and that by the time you see your first client,
you actually will be more ready to see clients than you probably believe.
Trust the process. The counselor education program is designed to make you
ready to see clients. And there is hope—you won’t always stay at the very
concrete and structured place where you may find yourself right now!
Models of Counselor Development

There are several models that can be used as a foundation for understanding
the developmental path of graduate training and beyond. These models can
help you as you embark upon your journey toward becoming a counselor.
Adult developmental models.

Graduate students in counseling are adult learners. Adult learners typically
move quickly past the traditional model of learning—the model where an
instructor stands up and lectures on important material. Although lecture and
didactic instruction can be an important component of any graduate class in
counselor education, the “passive recipient model” of education no longer
applies. Adult learners tend to want to direct their own learning and to take
responsibility for their learning more than in traditional learning models.
Adult learners see their professors and supervisors as facilitators and their
student peers as collaborators, able to present alternative ways of thinking
and acting. Adult learners also typically have more life experience to
incorporate into their education and move quickly to incorporate what they
are learning into their lives (Brookfield, 1989).
Because adult learners typically have more demands on their schedules (job,
families), they are less likely to have “taken a moratorium from life” than are
younger learners. That is, many undergraduate students go away to college
and focus exclusively on their education. Adult learners, however, add their
graduate training onto already full lives.
College student developmental

models.
Although graduate students in counseling are no longer college
undergraduates, the college student models can provide some useful insights
as well. The most often cited model of undergraduate development is that of
Perry (1970). Perry conducted a 20-year study of undergraduate students at
Harvard University. He found that undergraduate students moved through a
three-stage model of cognitive development. In the first stage, students were
dualistic thinkers. Dualistic thinking is characterized by a black and white
approach where there are right answers to all questions. Students then move
into a multiplistic way of thinking—the belief that there are lots of possible
answers, so every position seems equally correct. Finally, students move into
a relativistic way of thinking—the recognition that although there may not be
absolute right and wrong answers, decisions still can be made based on the
best-available information. Perry’s work was conducted primarily with
Caucasian male undergraduate students, and clearly that limits the
applicability of his research. In spite of the significant limitations of his
sample, his model has been applied to graduate students in counselor
education by one of the authors and found to match the broad developmental
path of graduate students in counseling. In the accompanying Informed by
Research feature, you can read more about this strategy to measure graduate
student development.
Novice-to-expert models.
Another model that may help you understand your own developmental
journey is the novice-to-expert approach. This model is based on the
understanding that experts are better able than novices to encode (receive and
make sense of) information, organize memory, retrieve relevant knowledge,
observe inconsistencies, connect seemingly unrelated information, track
multiple tasks, and develop novel responses to situations (Etringer,
Hillerbrand, & Claiborn, 1995). Novices store information based on more
superficial and irrelevant cues that often have little or no relationship to
problem solving (Chi, Feltovich, & Glaser, 1981). Within the field of
counseling, novice counselors ask more questions about details, attempt to
learn by rote memorization, and have difficulty transferring classroom
learning to hands-on situations. More advanced students are more likely to
ask questions that connect classroom learning with practice, to relate
information to their experiences, to more quickly recognize the important
pieces of a problem, and to use their information more productively in
counseling (Etringer et al., 1995).
Informed by Research Counselor

Development
Research can help us understand clients and counseling, but it also can help
us better understand ourselves. Two series of studies, one qualitative and one
quantitative, have been conducted on the general development of counselors
and counseling students. The first, a series of qualitative studies (Rønnestad
& Skovholt, 1991, 1993, 1997, 1999; Skovholt & Rønnestad, 1995; Skovholt,
Rønnestad, & Jennings, 1997) used an interview format to track the personal
development of counselors and psychotherapists. They used both cross-
sectional (comparing different practitioners at different points in time) and
longitudinal (comparing the same practitioners at different points in time)
methodologies. These studies are summarized in several books, including The
Resilient Practitioner (Skovholt, 2001) and Master Therapists (Skovholt &
Jennings, 2004).
In general, Skovholt and Ronnestad found that as students enter graduate

programs in counseling, they try to take in as much information as they can,
leaving them feeling overwhelmed and exhausted. During the middle of their
training, most students continue to imitate their professors and supervisors
and feel uncertain of their own skills. By the time students graduate, they are
feeling more confident in their skills, but it is not until they are in practice for
a few years that they begin to develop a style that is more their own. As
professionals move into the middle stage of their careers, they start to feel
more authentic and genuine, leading ultimately to the self-understanding and
self-acceptance that come with a lifetime in the field.
The second set of studies used a quantitative methodology (cross-sectional

and longitudinal) to study the cognitive development of counseling students
and professionals (Granello, 2002, 2010a). In the first study, 205 counseling
graduate students at 13 different universities completed a measure of
cognitive complexity (designed to measure how people make sense of
available knowledge in the field of counseling).
Overall, beginning counseling students tended to be in the dualistic stage.

They believed that there are right and ways to do counseling, and they
expressed frustration because experts in the field do not have all the answers.
Students at the end of their counseling programs were more fully entrenched
in a multiplistic way of thinking—the belief that there is not so much a “right
or wrong” answer in counseling, but that one should seek the “best available”
answers that can be supported with data. The second part of the study used a
longitudinal design and found similar results.
Granello (2010a) also studied the developmental trajectory of practicing

counselors. The results found a long, slow development over the course of
counselors’ professional careers. The first major shift in cognitive complexity
occurred after counselors had been in practice between 5 and 10 years, with a
second major developmental shift occurring after 10 years of practice.
Overall, the Skovholt and Ronnestad and Granello studies remind us that
counselor development is a lifelong process. Many beginning counselors feel
pressured to have all the answers. Take comfort in knowing that you don’t
have to be the expert by the time graduation rolls around—it takes a lifetime
to hone the craft of counseling.
What is interesting about all these approaches is that it appears that even
though students may be more developed in other areas of their lives, the
models are content-specific. In other words, you may be cognitively
advanced in another profession—perhaps you came to counseling after years
as a mortgage broker. Chances are you were developmentally advanced in
that field, but when you enter counseling, you will probably need to progress
again through the developmental stages (Granello, 2002; Simpson, Dalgaard,
& O’Brien, 1986). Consider the following “Aha” moment taken from one of
the authors’ experiences:
Darcy: I was surprised at my own developmental journey as I became a

professor. Although I was cognitively advanced in other areas of my
life, had completed a PhD, and had spent time as a counseling
practitioner, when I became a professor, I immediately returned to a
“dualistic” way of being. I had a million questions, and I just wanted
someone to give me answers. I asked things like, “How do I write a
syllabus?” “How should I determine student participation grades?”
“What do I do if . . . .” It is a great example for me of how cognitive
complexity does not necessarily transfer from one experience to another.
When I study the development of counseling students, I am constantly
reminded of the frustration we all feel when we enter a new field. We
might be critical thinkers with advanced skills in other areas of our lives,
but we typically return to the lowest level of thinking when we enter a
new field. My own experiences in this cause me to have hope . . . I know
that when I enter a new endeavor, I might regress to more concrete and
dualistic thinking, but I won’t stay there forever!
Although the developmental models that help us conceptualize professional

growth can be useful, they have been met with criticism. For example, it is
clear that the models are overly simplistic insofar as the stages of
development appear more orderly on paper than they are in real life, and most
of the foundational research on these models has been conducted with men
(Granello & Hazler, 1998). This is particularly important, because in a series
of studies of counselor education students in their master’s internships,
researchers found that female students interacted differently with their
internship supervisors (Granello, 2003; Granello, Beamish, & Davis, 1997).
Female students were more likely to defer to the suggestions of their
supervisor (both male and female) and to ask their supervisors what they
should do next. Male students were asked their opinions and ideas more than
three times as often as female students. Additionally, female students were
much more likely to use relationship-building comments, such as telling the
supervisor that they agreed with the supervisor’s ideas, making pleasing
statements, smiling, or praising the supervisor. These studies lend support to
the idea that female students in counselor education interact in ways that are
different from—but neither better nor worse than—those of their male
counterparts.
How Do You Make Sure You
Continue to Develop?
It is clear both from research and from our own experiences with students
that the biggest changes in counselor development come after counselors-in-
training start seeing clients, and the most changes occur after graduation.
Development as a counselor is a lifelong process. Skovholt and Rønnestad’s
(1992) study and Granello’s (2010a) study with practicing therapists both
found support for the belief that counselor development evolves long after
formal schooling is completed.
Lifelong learning and continued development are important aspects of

counselor development. Ongoing continuing education is required by most
counselor licensure and certification laws. However, informal learning and
continued attention to self-awareness is essential to maintain a positive
personal and professional identity and to limit the possibility of burnout.
Burnout is an emotional and physical exhaustion that leads to cynicism and
ineffectiveness and “represents an erosion in values, dignity, spirit and will—
an erosion of the human soul” (Maslach & Leiter, 1997, p. 14). Perhaps you
have spoken with professionals who seem cynical and tired and not ready to
do their best for their clients. Researchers on the causes of professional
burnout are quick to note that even bright, energetic, and enthusiastic workers
can become burned out if they work in an environment that draws energy
from them, rather than reinvigorates them. Because of the high emotional
demands of being a counselor, counselors can be at risk for burnout. In fact,
burnout has been identified as the number one personal risk for counselors
(Morse, Salyers, Rollins, Monroe-DeVita, & Pfahler, 2012; Thompson,
Amatea, & Thompson, 2014). A study of school counselors found that factors
related to exhaustion, feelings of incompetence, negative work environment,
lack of emotional or empathetic connection to clients, and deterioration of
personal life all contributed to burnout (Gnilka, Karpinski, & Smith, 2015).
Although some of the inherent challenges of the profession that encourage

burnout may be out of the individual’s control, many of the methods for
helping prevent burnout are individual in nature. Counselors are encouraged
to take an active approach to preventing burnout by developing interests
outside of counseling, maintaining clear and solid professional boundaries,
and avoiding taking their work home with them. Additional methods to help
prevent burnout have been identified (Morse et al., 2012; Thompson et al.,
2014), and these can be categorized into four major coping skills:
1. Using problem-solving skills, including anticipating problems and

problem situations, using conflict resolution skills to mediate
relationship stressors in personal and professional life, engaging in
ongoing values clarification, and emphasizing flexibility and
adaptability
2. Finding a balance in life, including developing outside interests, going

on vacations, maintaining physical health (attending to proper nutrition,
exercise, and sleep), and attending to spiritual dimensions
3. Developing a social support network, including communicating and

collaborating with peers, finding support from mentors and supervisors
and obtaining ongoing peer supervision, even after formal licensure
requirements for supervision have ended, and making use of personal
support systems (friends, family, significant others, etc.)
4. Using stress management techniques, including using time management

skills, mindfulness, engaging in private reflection times for self-
generation, making use of relaxation skills, and minimizing the use of
substances, such as alcohol, caffeine, nicotine, or drugs
All of these strategies are important ones to engage in from the beginning of
your counseling career—not just to avoid burnout, but to make sure that you
are taking care of yourself as you balance self-care with “other-care” in an
emotionally demanding profession.
Words of Wisdom
“I now understand the high burnout rate involved in this profession.
Realizing the importance of having activities outside the counseling
profession and actually utilizing these activities are two different things. It
has been difficult to find time for myself. I really try to give 100% of myself
to everything I do. However, I am learning that in this profession it is a fine
line between giving it your all and giving too much.”
—Shawna G.
Self-Reflection
Throughout this text, we focus on the importance of self-reflection as you go
through your journey toward becoming a professional counselor. One
practice that can help us focus our thoughts and be open to learning about
ourselves is the practice of mindfulness. Originally based on a Buddhist
concept, mindfulness is an empirically supported component of treatment for
certain types of client problems (e.g., addictions, low sexual desire, anxiety
disorders) and in certain theoretical approaches (e.g., Dialectical Behavior
Therapy; Acceptance and Commitment Therapy). Mindfulness also has
application for counselors themselves. In general, mindfulness is a mental
state of relaxed and reflective awareness that focuses the person on the
present moment, without internal dialogue or judgment (Hick, 2009).
Research indicates that mindfulness can help counseling students prevent
burnout, compassion fatigue, and vicarious traumatization (Christopher &
Maris, 2010; Leppma & Young, 2016). If you have an opportunity to learn
more about mindfulness and how you can incorporate it into your counseling
practice and/or your own life, we encourage you to explore this specialized
technique for self-reflection.
Journaling can be another important method of self-discovery and self-

reflection. Some of what you write might surprise you. We often hear from
students that when they fully explore their own beliefs and experiences, they
come to a deeper and richer understanding of themselves that is energizing
and powerful. Other times, journaling can uncover material that is difficult
for you. In fact, many of the activities we engage in as counselors-in-training
(role plays, reading, discussions, working with clients) can remind us of our
own emotional vulnerabilities. Our own unfinished business often emerges
during the course of counselor training. When this occurs, it is important that
you find ways to address these difficulties. We would like to suggest that you
remain open to the idea of entering counseling as a client to help you work
through any difficulties that emerge, either as a result of journaling or of
other experiences you might have in your program. Many counselors have
benefited—and continue to do so—from their own personal counseling.
Fast Fact
Nearly two-thirds of graduate students in counseling programs say they have
gone through at least one episode of personal counseling.
Source: Byrne & Shufelt, 2014.
Finally, we remind you of the importance of social support to help you in

your counseling training program and in your life as a counselor. Mentoring,
supervision, peer support, and the support of family and friends are essential
to maintaining the well-being of people in the helping professions. In the
final two Snapshots of this chapter, two students in counseling reflect on their
own growth and development during their graduate programs. We have
included both of these Snapshots because they are students who, at the time
of their graduate training, were in very different life development stages, and
yet each had important lessons to learn (and to share) about their journey
toward becoming a counselor.
SNAPSHOT Patreece Hutcherson,

School Counseling Student
At the time of this writing, Patreece was 24 years old and a graduating
student in school counseling. Patreece was asked to reflect on her
development during graduate school and her transition from student to
professional school counselor. Here’s what she had to say.
Being a Student/Becoming a
Counselor
Patreece started her program firmly entrenched in the student role. She
thought she could be a passive recipient of knowledge. She stated,
When I started the Counselor Education program, I knew my purpose

was to learn. I had no questions or challenges other than to read and
listen and retain information. As I continued to develop, I realized that
being a student was not enough. I would not only have to read and
understand, I would also have to apply what I was learning. In short, I
had to become a critical thinker. It meant I had to become a professional.
At the beginning of my program I always had specific questions for my

professors. I asked, “How do I act if this situation occurs? If that
situation comes up, what will I do?” My professors always answered the
same way—that is to say, they wouldn’t give me the answer I wanted.
They turned the questions back on me, and we explored options
together. Although those were not the answers that I was looking for, it
was what I needed to hear in order to develop as a professional.
Learning my own counseling style would never be in a book, or an
article, or even in my professors. The answers were locked away inside
that mini-developing professional otherwise known as myself, the
counselor-in-training.
As Patreece became more confident in her own developing skills, she began
to recognize that simply transferring knowledge from the classroom to the
client was not sufficient. She had to learn to integrate her new knowledge
with her own personality.
As I apply the information that I have learned, my main focus is on

whether or not this concept truly works for me. In this profession it is
imperative to use concepts that fit your personality style—to remain
genuine. Everyone cannot apply one technique or theory in the same
way. Although the concepts hold consistent, the delivery varies. The
theories and techniques help to guide us through the counseling process
similar to an anatomy book guiding a brain surgeon. However, we must
remember that the books are only a guide; no two surgeries are ever the
same, just as no two counseling sessions or clients are ever the same.
Finally, Patreece reflected on where she currently is in her journey toward

becoming a counselor.
Do I still have questions . . . yes. Am I still sometimes confused as to

what my next step will be . . . absolutely! But the difference between
these questions at the beginning of this program and now is that I am no
longer looking for someone else to answer my questions. Instead, I use
the expertise of others as a guide, not as a mandate. And given all that I
have learned so far—about the profession and about myself—I look
forward to my continued development.
SNAPSHOT FRANK PALMER,

Clinical Counseling Student
At the time of this writing, Frank was a graduating student in clinical mental
counseling. He was 39 years old and came to the counseling profession after
holding a wide variety of jobs, most recently as a truck driver. Here is Frank
reflecting on his development:
From a writing prompt in his first graduate class:
My overarching concern going into this is that I will not be good at it.
That I don’t have the skills and gifts required to be an effective
counselor, and I’ll find myself lost and unfocused as I reach my 40
birthday. I don’t want to give too much power to that fear, but I would
be an idiot to believe that it didn’t affect me. I also know that it’s not
enough for me to be just adequate, I want to be good—to really make a
difference. I am not really afraid that I will do any damage to clients, but
it is on my mind. The real question for me is: Do I have what it takes to
be effective and be as empathetic as I will need to be?
From a writing prompt at the end of practicum:
I don’t think my initial hopes and fears have changed much, except that
my fears seem to have a clearer face. This is difficult to explain. Things
are coming SLOWLY into focus and I think some of my anxiety is
pressing on my patience. I mean, I realize I cannot be in a rush, but I
guess I am a bit impatient. The good news is that if I can see where the
mistakes might lie, I can eliminate them and then move on to other
potential avenues. My hopes are getting clearer as well. They are
becoming more focused on my specific hopes with this particular client.
Finally, as Frank got ready to graduate, he reflected on his journey:
Overwhelmed. That is the word that most accurately reflects my

thoughts and feelings the first year of the counseling program. My brain
was being loaded with ideas and information, and my emotions were
being taxed with self-analysis of both my past and my present. This was
a far cry from rolling around in a semitractor-trailer, which I was doing
just a year earlier. Being in a counseling program and the life change it
symbolized for me made it something of an adventure as well:
exhausting, challenging, and exciting. Both directly and indirectly I was
challenged to reflect on who I am and to realize how my personality and
worldview might impact (positively and negatively) my professional
persona and my work with clients in counseling. I often questioned my
ability to be an effective counselor. These doubts continued through the
second year when the shock of being in graduate school and the work it
requires had subsided. The learning obviously does not end, but it now
has eminently more meaning and practicality. Slowly, very slowly, the
question of whether I can be a competent, effective counselor is being
answered affirmatively. I am also realizing that counseling, for me at
least, is a true vocation. It is a calling where the learning will never stop
as long as I am open to being a student.
Summary
In this chapter, you learned about the developmental trajectory that is part of
the process of becoming a counselor. Although each counselor takes an
individualized journey, understanding the typical path can help counseling
students feel comfortable to explore and take risks, being in the process,
rather than in a hurry to get to the end. We encouraged you to slow down and
engage with what you are learning about the profession and about yourself.
Certain personality traits, such as flexibility, patience, self-reflection, and

curiosity, can be of great benefit to beginning counselors as they approach
their new profession. Although healthy counselors (and healthy people!)
share many positive traits, it is not necessary to have mastered all of these
before you start your new career. Becoming a counselor is a long journey that
extends throughout one’s professional life. Graduate school is just the first
step.
Student Activities
1. In this chapter, we considered the personal aspects of counseling and of
being a counselor. We talked about different personality types and how
people of each type might bring different strengths to the counseling
relationship. We also discussed a long list of character strengths that can
help counselors be successful. Perhaps you would like to look back at
that section or the ideas you have underlined. What were your reactions
as you read this portion of the chapter, and what do you think, feel, and
believe about the personality types and character strengths of counselors
—especially as it applies to you? What are your strengths that will
enhance your ability to be a counselor, and what are your personality
traits that might get in the way?
2. We also wrote about the development of counselors, both personally and

professionally, during their counseling programs and beyond. We
recognized that although there are some similarities in major
developmental stages, everyone takes an individual path toward
becoming a counselor. What were your reactions as you read this
portion of the chapter? How will you monitor your own growth and
development as a counselor? What sorts of activities can you engage in
to help you become more self-reflective? Will you be able to recognize
normal stages of counselor development in your own training? How will
you respond?
3. As you read the Snapshot of Bhuneshwar and Krishna and that of
Patreece and Frank, or the comments from students across the country
on their development during their graduate training, what aspects of the
stories are familiar to you? How can reading about the experiences of
these students help you better understand—and prepare for—your
journey as a counseling student?
4. Is there anything else from Chapter 4 that you want to jot down? Any
other reflections or ideas that you want to get on paper so you don’t
forget them? Now is your chance. Write them here, or if you would
prefer (or need more room), write them in a journal.
Journal Question
1.
Counselor Development. Beginning counselors often state that they feel

overwhelmed with the importance of the role they are about to undertake,
with the responsibility they will have in helping others, and with the fact that
there is so much they do not yet know. This can lead to frustration with
faculty who don’t supply you with all the “right” answers, to anger at
yourself for not learning as fast as you want, and to fear that you will
somehow harm clients by your inexperience. All these feelings may exist
even though you understand intellectually that learning to be a counselor is a
long process. How are you handling these feelings? What strategies can you
use to help yourself accept the fact that you are a beginner?

1. One of the reasons we included the discussion of counselor development
in this chapter was to “normalize” the experiences that beginners
encounter. Do you think it is helpful to recognize that you are normal
and on track? How can a practicing counselor normalize client
experiences?
2. This chapter included a long list of ideal character strengths for

counselors. What were your reactions as you read that list? Do you
believe that these strengths can be learned? Are there strategies that you
can use to help develop these character strengths?
Experiments
1. Talk with someone who is an expert at something (other than
counseling) and ask how that person came to be an expert. What was the
path they took? Can they reflect on the developmental process they went
through? Have the person try to articulate how they know what they
know about their area of expertise. Can you compare the person’s
developmental path with the path you will take in counseling?
2. Take the Myers-Briggs Type Inventory (MBTI) and consider your

results in the context of being a counselor. (You can also take a free test
similar to the MBTI called the Jung Typology Test on the website
humanmetrics.com.) If you have clients who are of a different
personality type than you, what difficulties might you have, and how
might your differences enhance the counseling session? What if you
have clients who are similar to you? Are there any traps or pitfalls that
you will need to avoid with those clients? Any strengths that the
similarities will enhance?
3. Consider the personal characteristics of an ideal counselor. Make three

columns on a sheet of paper. Pretend that you are going to select a
counselor for yourself. In the first column, list the background
(experience, education, life experiences), demographic information
(such as gender or ethnic origin), and personality traits or character
strengths that you might want that counselor to possess. As an
experiment, select a family member or friend and think how that person
might answer that question. List those traits in the second column. Now
check your assumptions by actually posing this same question to that
family member or friend and write that person’s answers in the third
column. Reflect in writing about what you learned from developing and
comparing these three lists.
4. Join the national listserv for graduate students in counseling programs

(COUNSGRADS). Instructions to join are available through the
American Counseling Association website (www.counseling.org) under
“students.” This very active listserv averages over 1000 graduate
students in counseling who are all seeking to get the most from their
developmental journey toward becoming a counselor.
Explore More
chapter, we recommend the following books and articles:
Echterling, L. G., et al. (2002). Thriving: A manual for students in the

helping professions. Boston, MA: Lahaska Press.
This book is an easy-to-read guidebook for students in counseling that

includes tips and first-person accounts from students in the helping
profession.
Schon, D. A. (1983). The reflective practitioner: How professionals

think in action. New York, NY: Basic Books.
This book is a bit difficult to read, but provides an excellent and

thought-provoking analysis of the importance of becoming self-
reflective in our work as well as providing key strategies for how to
infuse self-reflection into our lives.
Skovholt, T. M. (2001). The resilient practitioner: Burnout prevention

and self-care strategies for counselors, therapists, teachers, and health
professionals. Boston, MA: Allyn & Bacon.
Based on the research of Skovholt and Ronnestad (discussed in this

chapter), this book uses the developmental perspective to help
practitioners make plans to stay psychologically well.
Chapter 5 How Do Counseling
Students Get the Most from Their
Graduate Programs?
Questions
Several strategies to help you prepare for graduate school, including

preparing your friends and family for what to expect.
Specific study strategies for better understanding course material.
Methods for getting the most from interactions with peers, professors,
and the professional community.
What you need to do to be intentional and purposeful to help you get the
most from your graduate education.
Identify specific study skills (including writing and reading skills) that
you may need to enhance to perform your best in graduate school and
describe strategies you can use to help improve them.
Use foundational skills to give and receive feedback on your graduate

work.
As you read this chapter, you might want to consider . . .

What do you need to do to get the most from your graduate education?
How can you be intentional and purposeful in your role as a counseling

graduate student?

As you have already learned in the first four chapters of this book, becoming
a professional counselor is a lifelong journey that began long before you
entered your graduate program and will continue long after you graduate with
your degree. The life experiences, education, and passion you bring to your
graduate training are critical components of your development as a counselor.
Additionally, the lifetime of experiences you have after you become a
counselor will shape your professional journey. However, the education and
experiences you receive during your graduate program can have a significant
impact on the type of counselor you will become. As such, it is important that
you work to make the most of your graduate education in counseling.
It may seem odd to you that this chapter on graduate school success isn’t the
first chapter in the text. We sometimes get asked about this. What we have
learned from our own work with graduate students is that they are not yet
ready to think about their journey as graduate students when they first start
their Foundations of Counseling class. For many students, this class is their
first graduate course. They tell us that they have to be at least a month or so
into their graduate curriculum before they can start to see how it differs from
undergraduate work, how the intensity and rigor of the classes will affect
them, and how they can start to be planful and intentional about the kind of
student they wish to be. That makes sense to us, and so we tried to place this
chapter appropriately. Regardless of where you are in your graduate study
when you are asked to read this chapter, we hope you will take this
opportunity to think about your plan for success in graduate school.
Words of Wisdom
“I came to graduate school right after finishing my undergraduate degree in
psychology. I kept thinking, ‘I wonder what they [my professors] think
happened to me over the summer?’ I couldn’t believe how much more
intense it was, how much harder it was, and how much more I was expected
to learn on my own.”
—Sharon S., clinical mental health counseling student

This chapter is designed to help you approach your graduate program in
counseling in an intentional manner that enhances your learning and gives
you the foundational skills, knowledge, and awareness you need to become a
counselor. As you will soon discover (if you have not already), graduate
school is very different from undergraduate education. Students are
sometimes surprised to learn that graduate school is not just an extension of
their undergraduate years.
Students find that graduate school in counseling differs from undergraduate

education in several significant ways. The following list can help you get
started thinking about these differences, and you may wish to add any
observations of your own.
1. Difference in intensity. Coursework in graduate school isn’t just more

difficult than undergraduate work, it is more rigorous and intense.
Beginning students often talk about the amount of material that is
covered in classes and the amount of work that is required outside of
class. Students who went through entire undergraduate programs with
only a few required term papers now find that they have multiple
research papers due each academic term. Of course, you would not have
been admitted into your graduate program if your faculty did not believe
that you could handle this extra work, but most students nevertheless
find it a bit daunting when they first get started. In this chapter, we’ll
talk about some strategies to help you manage this intensity of work.
2. Difference in focus. During undergraduate training, most students find

that many of their classes do not relate to one another. Students taking
required courses in biology, history, algebra, and psychology see these
as separate, stand-alone curricular requirements. During your graduate
program in counseling, you will find that all of your courses are
interrelated. Learning experiences in each class have applications and
significance for other classes. Although this can be exciting and
energizing, it can also be a bit confusing and overwhelming at first.
Students who have had a lifetime of learning in educational “silos” (the
content from each class is discrete and separate from the others) will
need to learn how to synthesize material across classes each term and
across the entire counseling curricula over time. There are some
strategies in this chapter that may help you learn to integrate the material
from your different classes in ways that make the most sense for you.
3. Difference in responsibility. One of the hallmarks of graduate education

is increased self-directed learning (Brookfield, 1989). Graduate students
are expected to take more leadership in planning, managing, and
evaluating their own learning experiences (Granello & Hazler, 1998).
During your undergraduate education, your instructors were probably
much more likely to give you strict guidelines to follow, to “hold your
hand” through every step of the process, and to provide concrete
answers to your questions. The faculty in your graduate program,
however, are far more likely to give you some space to try to figure
things out for yourself. That doesn’t mean that you will be left to
solitary learning without guidance and mentoring. Quite the contrary.
You will often work in groups and will spend time talking or writing
about your learning experiences. Additionally, your faculty will provide
you with lots of feedback and support. The difference is that you will be
more and more responsible for taking charge of your own learning. If
you don’t understand something, you will need to find answers or seek
advice or mentoring. If you are not being challenged, you will need to
find ways to make your education meaningful. Successful graduate
students take initiative. They are tenacious. They have good ideas, and
they carry them out. Most graduate students are relieved to find that they
are treated as adult learners, but many find that they have to work to
learn this new way of being in the classroom. This chapter will offer you
some strategies to help you begin this process of self-direction.
4. Difference in meaning. As an undergraduate student, you probably had

to take classes whose subject matter was not particularly interesting to
you. Maybe you told yourself, “I just have to get through this,” and that
probably worked for you. However, now that you are in your counseling
program, all of the counseling courses have particular meaning for you.
Even if you are less enthused about a particular course, you can still see
the connection of the content to your future career. Most students find
that it is energizing to be so passionate about all of their courses.
However, it can also be a bit draining to have all of your courses
compete for your passion and attention, and you will need to find ways
to engage in other activities, besides your school work, to help you stay
healthy. Chapter 13 of this text will provide you some strategies for
keeping your life in balance during graduate school.
5. Differences in peers. In graduate school, you are surrounded by bright,

energetic, passionate people who are interested in the same topics that
interest you. It’s exciting and fun—but it can also feel intimidating.
Students may find themselves feeling competitive with their classmates
instead of cooperative. Students who are used to being “the smartest
one” or “the best student in the program” in their undergraduate careers
are suddenly surrounded by others who were also the “smartest” and
“best” in their undergraduate programs. Although these feelings of
inferiority or competitiveness are natural, they are not particularly
useful. We hope that you will learn to recognize when these feelings are
getting in the way of your education so you can work to manage them or
seek assistance from others to help keep these feelings in check.
6. Other differences. Perhaps you have already uncovered some differences

between your undergraduate and graduate education. Take a moment to
jot down any differences you have noticed as well as your reactions to
these differences. If there is time in class, you may want to discuss your
ideas with your classmates to see if they have noticed these differences,
too.
Preparing for Success in your
Graduate Program
One of the concepts that we come back to again and again in this text is that
of intentionality. That is, rather than just letting things happen, we ask our
students (and our clients) to think about what they want to happen, how they
wish to behave, or where they desire to end up so that they can be more
intentional about the process of getting there. In this chapter, we use the
concept of intentionality to help remind you how important it is that you
assume responsibility for making the most of your graduate program. Being
intentional means thinking about how you want to approach your education
and planning to optimize the potential for your success. Being intentional is
not the same thing as being inflexible. In other words, we are not asking you
to micromanage every class or experience or to develop one strict way of
approaching your education. In fact, rigid and inflexible ways of being are
not compatible with success as a counselor, much less with happiness as a
human being! Rather, we are asking you to step back and think about the
process of your education while you are going through it. At each step of the
way, ask yourself: What am I doing that is enhancing my learning? What is
getting in the way of my learning, and what can I do about it? Starting on the
process of self-reflection and intentionality now can help you develop good
mental habits that will last throughout your professional career.
When we interview potential students in our counseling programs, we often

ask them, “What kind of student do you plan to be?” Are you quiet and
withdrawn? Do you participate in every conversation? Do you talk first and
then think? Or do you think about what you want to say so much that you
miss the conversation? Are you a planner who includes every deadline in an
academic planner? Do you get assignments done early or do you work well
under pressure? Most students answer by describing the type of student they
were during their undergraduate programs. When pressed, however, they say
they never really thought about it, they just “did what came naturally” for
them. We are asking you to think about it—to plan for your success, not just
hope it will happen. In most cases that doesn’t mean ignoring what has
worked for you in the past, but it does mean making a conscious decision to
build upon your strengths in intentional ways and to make plans for success.
As you read the accompanying Spotlight, take heart in knowing that there are
many different paths to success in graduate school as a counseling student.
Our profession will be stronger and better because of what each of you brings
to it. We encourage you to think about your own journey as your read about
the different paths that led each of the students in this Spotlight to graduate
school in counselor education. In Chapter 4, we talked about the many
different paths that bring adult learners to graduate study in counselor
education. Recall that there is no one “right” path nor one “right” type of
person who makes a successful counselor. The counseling field benefits from
counselors who represent the diversity of the human experience, in every
imaginable facet. In this chapter, as we discuss the idea of being successful in
graduate school, it is important to remember that the diversity of experiences
among counselors begins with the diverse range of experiences among
counseling graduate students. Although it may be tempting to compare
yourself with your classmates and perhaps even question whether you belong,
remember that your program faculty recognized great potential in you. Your
life experiences and your story are important to your journey as a counselor.
Celebrate who you are and who you will become.

Graduate School Success
Sometimes counseling students look around to the faces of their peers and
start to think that they are alone in the challenges they face. In this feature,
we remind you that there are many different paths to success in graduate
school and students with many different stories become successful graduate
students and outstanding counselors.
Val and her guide dog, Vail. Val has been legally blind since birth. As a
graduate student training to be a counselor, she is working to make sure all
her clients have the opportunities they deserve, regardless of their personal
circumstances.
Andy is an army veteran who was stationed in the Middle East, where he saw
soldiers suffering unimaginable horrors. He used his G.I. bill to help fund his
graduate degree in counseling. His unique perspective was an important part
of the classroom and interpersonal learning for his peers.
Carla gave birth to two children during the 2½ years of her master’s program
in counseling. Other students were amazed and inspired that she was able to
balance the challenges of graduate school and her young family.
Alex entered his graduate training as a woman named Teresa. He transitioned

during the summer between his first and second year of the master’s degree
program. His courage was applauded by his faculty, supervisors, and peers,
and his contributions to classroom discussions challenged binary perspectives
of gender.
Scott started his own recovery from drugs and alcohol during his teens.
When he entered graduate school, he assumed he would work as an
addictions counselor. Instead, he became a college counselor. He now
recognizes that his experience in addiction is part of who he is as a counselor,
but it is not the defining feature of either his personal or his professional life.
Luciana had a successful career as a lawyer and children’s advocate. After

years of working with victimized children, she decided she could have a
larger impact on their lives as a school counselor. Today, her unique
perspective helps school systems advocate for children before they become
victims.
Jennifer had a stroke during college, which left the left side of her face and
body paralyzed. Although she spoke with a significant impediment, she
worked tirelessly to improve her speech and communication so she could
become an effective counselor.
Malichi (Ki) is a first generation college student from rural Appalachia. He

decided to become a school counselor and return to his home town to work
with underserved students and help them envision a better future.
Joyce is in her 40s, a mother, and a full-time worker. She decided to obtain
her graduate training in an online program, which she believes is a better fit
than a traditional program and accommodates her busy life.
Afet left behind her native Turkey so she could go to graduate school in the
United States. She works to empower and engage women who believe they
have no voice in their own decisions.
Larry was already a medical doctor when he decided to return to receive his
master’s degree in counseling. He was frustrated that his medical training did
not prepare him for the types of interactions he really wanted to have with his
patients, and he now uses his counseling skills to enhance his medical
practice.
Layton has bipolar disorder. He spent his life learning to manage the
symptoms of his own mental illness. During graduate school, he worked
closely with his counselor to make sure that the stress of his training didn’t
exacerbate his own symptoms. He learned how to use his own experiences to
help him become a better counselor and advocate for his clients.
Dorothy retired from a long career in middle management at a large book

repository. Faced with a long stretch of her life before her, and not ready to
“quit,” she obtained her master’s degree in counseling and reinvented herself
in her 60s.
Lijuan was an international student who was worried about fitting in and
embarrassed that her classmates couldn’t pronounce her name. At the start of
her graduate program, she adopted an “English” name to make it easier for
her classmates. By graduation, she had reclaimed her Chinese name and
recognized that she did not have to change who she was to be an effective
counselor.
Javier had a difficult childhood, with many of his family members involved
in gangs, violence, and drug addiction. In spite of the odds against him, he
remained in school. He credits his high school counselor for believing in him
and giving him the confidence and skills to apply to college. Years later, that
same high school counselor attended Javier’s graduation from his school
counseling graduate program.
Feliciana and Abebi were already licensed psychologists in their home

countries. When they came to the United States, they discovered they were
unable to transfer their psychology licenses from their home countries. Faced
with a choice, they each intentionally sought out counseling as their new
profession, believing that it more accurately reflected their interests and
values.
Khadra was born in a refugee camp in war-torn Somalia. She came to the
United States at age 4. Khadra knew she wanted to help change the stigma
attached to seeking mental health care in her culture. As a future counselor,
she will provide culturally supportive care to other Somalian refugees in her
native Somali language.
You. Stop for a moment and think about your own journey and how you can
create your own story of graduate school success.
Now it’s your turn to think about becoming the successful graduate student
you wish to be. Take a moment to complete the following mental imagery
task.
It’s graduation day. You are wearing your academic gown and sitting in
the crowded auditorium with all the other graduates. You can see your
family sitting in the audience, looking so proud and happy. You open
your program and find your name among the list of graduates. As you
listen to the speaker on the stage, your mind starts to wander. You can’t
believe graduation day is finally here. Finally, you are ready to leave
school behind and begin your professional practice as a counselor. As
you look back over your years of graduate preparation, you smile at the
student you were when you entered the program—you hardly recognize
that person anymore! Now, you see yourself in such a different place.
You recognize that you are more confident in your skills, more
empathetic with your clients, more patient with yourself, and more
willing to take risks and face new challenges. As you think about your
path from the person you were when you entered graduate school,
consider what aspects of your personality allowed you to grow into this
new, confident counselor. Where did you have the most difficulties?
Where did you have to work to let go of the parts of your previous self
in order to become who you are today? Relax, and think about the
journey that was necessary for you to become who you are today. What
do you wish you could go back and tell yourself as you started your
graduate program? What do you think you needed to do in order to be
successful? Close your eyes for a moment and imagine this journey.
Then take a few moments to write down some notes. What would your
“future self”—the one looking back from graduation day—want you to
know about how best to prepare for your journey through graduate
school?
Notes to myself:
1. In order to be the most successful I can be in my graduate program in
counseling, I need to remember:
2. In order to be the most successful I can be in my graduate program in

counseling, I will:
3. At times (particularly when I am under stress or overwhelmed), I may be

tempted to:
4. I have many strengths that I bring to my graduate counseling program.

These will help me through my journey, and they are important parts of
who I am. Specifically, I want to remember to draw upon my strengths
in:
Getting Ready to Start
Everyone who comes to graduate school has a life outside of school that
needs to accommodate the changes that graduate school will bring. The better
you prepare yourself, as well as your family and friends, the greater the
likelihood for success—and the greater the probability that you will
encounter your program in the most productive way. In the following
paragraphs, we share some of the preparation you might wish to do early in
your program to maximize your potential for success.
Prepare Your Attitude

Becoming a counselor is a life-changing experience. It is not just learning
about something, it is becoming someone different from who you are now.
Students who have the best experiences in counseling programs share some
common traits. They enter their programs:
Open to new possibilities
Energetic and passionate
Willing to suspend “knowing” or their need to have immediate answers
Unfortunately, sometimes when people are under stress (say, for example, the
stress of starting graduate school), they often revert back to rigid and
inflexible ways of thinking and behaving. It’s a natural response. When we
feel stressed, our bodies (and our minds) try to protect us by blocking out any
new stimuli. In order to be open to the new learning presented to you in your
counseling program, you will need to actively fight against this tendency.
One of the best ways to help prepare your attitude for graduate school is to
actively work to overcome your self-defeating thoughts and emotions.
Sometimes, we are our own worst critics. We convince ourselves that others
are smarter, better students, or have more appropriate life experiences that we
can never match. Some students worry that faculty will “find out that they
made a mistake” in admitting them once the students are in class, or they
obsess over GRE scores or other admission requirements, comparing
themselves to other students and worrying that they cannot measure up.
Negative self-messages (“I can’t do this,” “I’ll never be a good counselor,”
“Everyone will laugh at me when they see my practice counseling video”)
can really get in the way of learning to become a counselor. There is no
magic solution to this. However, the good news is that if you were admitted
to a graduate program, your faculty saw in you the potential to become a
professional counselor, and they are there to help you make your dream a
reality. Trust the process—and seek help when you need it.
Prepare Your Support Network

To paraphrase John Donne, “No graduate student is an island.” You have
friends, family, and loved ones who are important parts of your life.
Undoubtedly most, if not all, of these people really want you to succeed in
your graduate program. But, when the thought of graduate school clashes
with the reality of your new schedule, there is bound to be conflict.
Graduate students often talk about stressors they feel trying to stay connected
with their friends and family as they transition into their counseling
programs. Students may feel pressure from parents (“What do you mean
you’re going to miss your grandmother’s birthday? Our family always gets
together to celebrate”) or friends (“We never see you anymore!”) or partners
(“You are never around to help with the cooking and expect me to just have
dinner waiting when you come home from class.” Or “I need you to pick up
the kids from school today, and I don’t want to hear that you’re too busy with
your study group to help!”) These conflicts are the result of natural and
expected changes, but addressing them ahead of time, as well as when they
occur, may help.
Hazler and Kottler (2005) recommend preparing your friends and family
ahead of time for the new life you are embarking upon. Sit down with them
and talk about your classes and the work you are doing. Show them your
schedule and let them see how your time is allotted. Finally, and perhaps
most importantly, remind them that they are important to you, and you still
care about them, even if you are not able to spend as much time with them as
you had previously.
In our experience, finding ways to include your friends and loved ones in
your new life is important, too. They may worry that you are “growing out of
them” and be fearful that you won’t need them anymore or will prefer your
new graduate school friends instead. It’s natural for you to be excited about
what you are learning and the people you are meeting in graduate school. But
talking about these experiences with your family and friends can make them
feel excluded. Finding ways to help your loved ones understand your new
world better can make them feel less threatened by your graduate experience.
In the accompanying Snapshot, you will learn from a counseling student who
was in the second year of her master’s degree program about the importance
of preparing friends and family for what to expect. As you read through
Nimo’s story, think about what you can do to help stay connected to the
important people in your life during your graduate education.
Prepare Your Physical Space

Preparing your physical space means creating the ideal learning environment
in your home or apartment as well as finding a place to study on or near to
campus (if you are in a traditional face-to-face counselor education program).
A campus study spot is the ideal place to do some work between classes or
when there are too many distractions at home.
Words of Wisdom
“During the first week of classes in my program, I spent a significant amount
of time exploring different places in the library and around campus that
would be conducive to studying. This is something I could have probably
done ahead of time, if I had thought about it.”
—Lauren Schell, first-year school counseling student

Some suggestions for finding an ideal study spot:
Get comfortable (but not too comfortable). You may enjoy lying on your
bed to read, but if it is lulling you to sleep, sit up and find a better place
to study.
Set the right tone. Some students study at home, while others use the
library or a local coffee shop. Find a place that is right for you,
preferably with few distractions and adequate space and lighting.
Make sure the space is ergonomically correct. Ergonomics is the science

of designing the job, the equipment, and the workplace to fit the worker.
Having a workspace that is engineered to fit your specific needs reduces
stress on the body, fatigue, and the possibility of repetitive strain
injuries.
Have plenty of room to spread out. You may need to have many books
and articles open and available simultaneously. Don’t crowd yourself
with stacks of papers—have plenty of storage space for files and books
that you are not using at the moment.
Organize your space. Use boxes, file drawers, organizers—whatever

works best for you. In graduate school, you will create, and collect, a lot
of information. Early in your program, you will want to consider how
you will manage all of the different types of material and data that you
will receive as well as the papers and research that you will generate.
Most students find that they need to use a combination of paper files and
electronic storage.
Paper storage. You will receive handouts in class or at conferences,

and you’ll have hard copies of journal articles that you want to
retain. Make sure you have a filing cabinet for storage, and buy
plenty of file folders to organize everything. Resist the temptation
to skimp on file folders by putting too many different kinds of
materials in one folder. While it may save you a few pennies in
folders now, in the long run, it will not be worth the extra time and
effort needed to find the information you need (Kuther, 2008).
Electronic storage. Graduate students use computers not only to
write class papers, but to organize much of the material that they
encounter in their programs. Kuther (2008) offers the following
suggestions for organizing electronic information in graduate
school:
Neaten your hard drive or storage on the cloud. Set up an

organizational system that creates folders and subfolders with
simple, clear names. For example, you may have a folder
named Coursework, with subfolders for each of your classes.
Another folder might be named Research or Presentations.
Develop a system early so that you organize your material as
you go through the program, rather than trying to fix it later
on.
Streamline your e-mail. Keep your inbox clean (or at least

well organized). Check your university-issued e-mail account,
or have the messages sent to that account automatically
forwarded to the e-mail account you use. In many graduate
programs, messages to students’ university e-mail addresses
are used for important updates and information.
Purchase (and use!) antivirus and firewall software to help

protect your computer from viruses. Many graduate students
have horror stories about viruses that destroyed their computer
files or papers that were lost.
Back up your computer early and often. All electronic

information is vulnerable. Protect your important files with
backups. Some students e-mail their papers to themselves to
serve as a backup system. Others use storage in the cloud.
Whatever your system, make sure you have an organized
approach to storing your important documents.
Keep visual reminders of your projects and deadlines. A

bulletin board or white board can be divided into sections
for current or future projects and can help you keep from
feeling bogged down or overwhelmed.
Limit distractions. Turn off the television, your cell
phone, messaging, and whatever other distractions might
be available. Prepare a space to study that helps you
focus on your work.
SNAPSHOT Nimarta (Nimo) Singh
The biggest challenge I had with my friends and family during the first year
of my graduate program in counseling was educating them about what I was
doing. It was important to help them understand exactly what my program
was like and how time consuming it could get. Many of my friends and all of
my family members did not have a clear picture of how the program was
structured. Further, they did not really understand what school counseling is
and did not seem to appreciate my professional goal. I remember my parents
were frustrated when I did not drive home on some weekends because they
did not realize how busy I was at school. Looking back, I think the main
reason they did not realize this was because I had never told them about the
structure of the program, the profession of school counseling, and how busy I
would get, especially during practicum and internship.
Now that I am in my second year in the program, my parents and friends are
much more understanding because I talked to them all about my schedule and
the classes I am taking. I informed them about my 20 hours/week internship
at a middle school and my Graduate Teaching Associate position. I let them
know about my passion for counseling and the importance of counselors. I
even wrote out my schedule and showed it to my family so that they can be
aware of where I am and what I’m doing each day. They now understand
how busy I am and do not complain if I cannot take a whole weekend off to
go see the Steelers game or come home for a weekend visit. If I had
discussed all of these issues with my friends and family early on in the
program, I think that I could have avoided many of the stressful arguments
that arose throughout my first year. Once they understood exactly how
passionate I was about becoming a counselor and how important it was for
me to commit as much time and effort as I could during the program in order
to maximize my experience and knowledge, they became much more
understanding.
I would like to encourage all graduate students in counseling programs to

stop and think for a moment. What can you do to help prepare your friends
and family for your role as a graduate student in counseling?
Prepare Your Schedule

Chances are good that when you entered your graduate program, you already
had a busy life and quite a full schedule. Most students find it hard to make
room for the many demands of graduate school without making appropriate
accommodations to their schedules. Doing this in a planful and intentional
way means that you are more likely to keep the things that are most
meaningful and important and drop the activities that are least useful to your
life. Not everyone is a planner, and not everyone likes to schedule every
moment of time, but most graduate students find that they have to rely on
these skills to make it through graduate school.
Many graduate students wonder about their ability to maintain a job while
they are in their counseling programs. This is a topic you should discuss with
your program faculty, as scheduling of classes and field experiences are
specific to each university program. Your university may offer the possibility
of Graduate Associateships (GAs), which can be a cost-effective method to
pay for your education. There are clearly trade-offs. If you are working full
time you may need to take fewer courses each academic term, and you will
undoubtedly have to miss some of the activities associated with the
counseling program. Nevertheless, counseling faculty recognize that not all
graduate students have the luxury of quitting their jobs and taking a
moratorium on life to go to school.
Fast Fact
Students who engage in media multi-tasking (e.g., checking social media,
surfing the Internet, watching videos) during study or classroom time have
reduced understanding of the learning material. Media multi-tasking can
reduce comprehension by 20%, primarily due to the limits of cognitive
processing. One study videotaped college students engaged in 3-hour solitary
study/homework sessions and found they engaged in an average of 35 media
distractions of more than 6 seconds, with an average overall duration of 25
minutes (Calderwood, Ackerman, & Conklin, 2014). Another study found
that during study time college students spent, on average, only 6 minutes on
task before switching to a media distraction (Rosen, Mark Carrier, &
Cheever, 2013). Large-scale studies consistently demonstrate that students
who engage in media multi-tasking during classroom or study have reduced
recall and retention, lower levels of engagement, lower levels of productivity,
and overall lower GPAs. Research demonstrates that media multi-tasking
also has detrimental effects on faculty who engage in it (Baran, 2013).
Obviously, professors are not immune to the lure of media multi-tasking.
Clearly this is something that students and faculty must address together.
Removing media temptations during class time is important. One solution
might be taking “technology breaks” during classes of long duration. What
other ideas can you and your class come up with to help all of us—students
and professors—stay focused on our important work?
Scheduling your life in graduate school can be a challenge. The following

tips, offered by Caroline Baker, a graduate student in counseling at the time
of this writing, might help:
Words of Wisdom
“Graduate school means a lot of sunny Saturdays in the library.”
—Paula G., graduate student in counseling
1. Treat social events or personal time as a schedule item—block out time

each week and treat these commitments as importantly as you would a
class or meeting.
2. Even if you are single or have no family nearby, remember that your
time is as valuable as that of your classmates who have partners and kids
and other family commitments. It sometimes looks easier for the single
person to take on more tasks in a group project or accommodate
everyone else’s schedule, but that’s not fair. Everyone’s time is
valuable.
3. Learn to say "no" and choose your commitments wisely. Think: How
will this help me in my development as a professional? Balance that
with your social needs to help you maintain your stamina.
4. Find something that you really like to do that has nothing to do with
counseling or your graduate program, and make sure you do it at least
once every few weeks.
5. Pay attention to sleep and exercise and diet.
6. Give yourself lots of praise for the work you are doing. Notice the days
when you accomplish everything on your list and keep to your schedule,
and give yourself permission to have an “off” day when things don’t get
done. No one has to be perfect.
7. Schedule time for quiet reflection to consider your progress and future
direction.
8. Seek help when you need it. Don’t wait until you are so overwhelmed
you are immobilized. Reach out to family, friends, faculty members, or a
counselor.
No one is suggesting that being in graduate school means giving up all other
commitments in your life. Rather, it’s about making intentional choices about
how you spend your time. Many students find that it is energizing for them to
maintain at least some of the activities from their lives before graduate
school, such as singing in the choir or coaching a Little League team.
Ultimately, preparing your schedule is about finding a balance, maintaining
your priorities, and seeking assistance when you need it.
Prepare Your Mind

The fact that you have been accepted into a graduate program means that you
undoubtedly have a strong academic foundation upon which to build.
Nevertheless, many graduate students find that to make the most of their
counseling programs, they would benefit from enhanced study skills.
Graduate students who were high achievers in college often admit that they
did not have to do too much to earn their successes. In fact, if grades and
school always came easily to you, it may be particularly challenging to
motivate yourself when you are faced with the academic challenges of
graduate school. If you haven’t learned specific study skills to help you, you
may be unprepared for the new challenges of your academic work and
uncertain of how to proceed. In addition, you may find that many of the
strategies that were particularly successful for the kinds of learning necessary
in undergraduate courses are not appropriate for graduate school. For
example, although undergraduate learning often has an emphasis on rote
memorization, this skill is rarely utilized in graduate school, where the
emphasis is more on understanding and application. Thus, if you always used
flash cards or mnemonics to memorize lists, you will need to make sure you
have additional study skills to complement your academic repertoire.
Although no two people study the same way, you may find the following tips
to be helpful as you face your graduate work.
Complete the reading before class. Try to keep up with the reading. Do
not assume that the material covered in class will mirror the information
in the book. In fact, in many graduate courses, professors assume that
the students have already mastered the background information found in
the textbook. If you haven’t done the reading, you will quickly become
lost.
Learn how to read for the class. In some classes, students are meant to
read each portion of the textbook carefully, learning the specific
information included. In other classes, textbooks are meant to be used as
reference guides, and the assigned reading is intended as a general
overview. In many graduate classes, there is a lot of reading. We once
had a student enter the program after a successful career as a mechanical
engineer. Early in his first term, he announced that he had to quit the
program because he couldn’t keep up with the reading. Turns out he was
“reading like an engineer”—taking detailed notes on every chapter,
memorizing facts and data, and trying to remember everything. He did
not understand that when there are a hundred pages of reading or more
for a class each week, the goal is general understanding rather than
memorizing the details. Know what is expected of you in your classes.
Ask questions of your professors. Learn to read like a graduate student.
Use specific strategies to read for understanding. Many undergraduates

never learn how to read complex material. In fact, as many as 69% of
college graduates are not proficient readers, where proficient is defined
as the ability to read “lengthy, complex, abstract prose texts” (National
Endowment for the Arts, 2014, p. 63). Of course, this is exactly the type
of reading that is required in graduate education. If you haven’t been
exposed to specific reading strategies before, now is the time to learn.
For example:
Look over the entire chapter or article first to get a feel for the
structure of the reading, the main arguments, and the flow.
Pay particular attention to introductions and conclusions, as these

often contain summaries or highlight important points.
Look for certain words or phrases, such as “in summary” or “the

most important thing to remember is,” as these can help you track
the major points of the reading.
Consider reading the conclusion first. That way, you will know
where you are headed, and that may make it easier to follow the
reading.
Look up words you do not know. Don’t just skip over them. Write
the definitions in the margins.
Look back over the reading the next day, reading only the material
you highlighted. Do this again in about a week. This will help you
retain the information better.
Take notes on the reading. Write in the margins, highlight text, or

whatever you need to do to engage with the reading. Some students use
different colors of highlighters (e.g., one color for something that they
think is very important to know, another for something about which they
have questions). Other students use multicolored tabs to mark important
information and make it easy to find. Take care when using a
highlighter, however, as some students end up highlighting nearly
everything in the text, which defeats the purpose. Try not to highlight
more than about 20% of the reading. It may also be useful to make a
notation in the margin about why you highlighted particular information
—what made it important to remember? This will help with retention.
The important thing to remember (and if you were highlighting or
making notes on this text, this would be a cue to tune in to the rest of
this sentence) is that there is no one specific strategy that will work for
everyone. Find a system that works for you. This takes patience and
practice.
Fast Fact
The Diagnostic and Statistical Manual of Mental Disorders (DSM) is an
example of a textbook used in the counseling program that is intended to
be a reference guide. Although you will be asked to read the information
about the disorders before class, it is typically not expected that you
would memorize all of the information within the book. When you
diagnose clients with mental disorders, you will have the DSM with you
to help guide your decision making.
Keep your textbooks. We know it is tempting to sell your textbooks

back at the end of the term, but in graduate school this is seldom a good
idea. You will refer to your textbooks throughout your graduate program
and into your professional life, and you will need them to study for your
counseling licensure exam. The few dollars that you will make in the
short-term won’t be worth it if you lose access to the information and
notes that you will need.
Take good notes in class. Some professors provide students with

detailed handouts or links to websites with copies of PowerPoint®
slides. Although this can be helpful, it should not be used to replace
active learning strategies. Note taking that focuses on summarizing
material (rather than just verbatim copying of the lecture) has been
demonstrated to improve retention and test scores (Hadwin, Kirby, &
Woodhouse, 1999). Consider taking notes by laptop computer, if that is
easier for you and approved by your professor. (Note: Not all professors
allow laptops in their classroom, and it is important to ask permission
first.) Regardless of the notetaking strategy you use, make sure that you
are intentional about using approaches that help you succeed. For
example, one study found that students who took class notes on laptops
wrote more than those who wrote their notes longhand. However,
because most people can type quite quickly, the computerized notes
tended to be more verbatim quotations while the handwritten notes
contained more summaries and paraphrasing. In the end, those who took
notes with pen and paper had better comprehension and retention of the
classroom material (Mueller & Oppenheimer, 2014).
Review your notes between classes. In graduate school, most classes

meet only once a week. That is a long time to try to retain information,
and most students find that they need to pull out their notes and books
between classes to keep the material fresh in their minds.
Organize your class notes and materials. Keep notes for each class in a
separate binder or computer file.
Immediately begin the practice of collecting and maintaining copies of

all of your course syllabi. You will need these to obtain licensure,
particularly if you move out of state. Both of us are contacted frequently
by former students who need copies of very specific course syllabi for
specific instructors who taught during a specific semester.
Unfortunately, many programs (including ours) do not always have
access to these documents, particularly if they are years (or even
decades) old. Do not rely on universities to keep this information for
you. Download copies of syllabi from course websites (or scan
electronic copies of paper documents) and keep them in a secure
location throughout your professional career. We simply cannot
overemphasize the importance of this task!
Learn how to write in APA style. The Publication Manual of the

American Psychological Association contains a set of rules for scientific
writing that are referred to as APA style. APA style is used in the
counseling profession, and many professors expect graduate students to
write in this style. There can be significant penalties for papers not
submitted in this format, and the purchase of the most up-to-date edition
of the APA manual is typically one of the first requirements of graduate
counseling programs. Students are strongly cautioned not to rely on
computerized programs for APA formatting, as these are notoriously
fraught with errors. For more information about APA style, visit http://
www.apastyle.org. For an easy-to-use style guide, we recommend the
Purdue Online Writing Lab, which is interactive, easy to use, and free:
https://owl.english.purdue.edu/owl/
Consider strategies to work on your writing skills. If your university has

a writing center, consider a visit. Any writer can benefit from additional
training and feedback.
Learn and use metacognitive strategies to help you improve your written
work. One of this text’s authors has written an article to help students
improve the quality of their graduate writing, with specific strategies to
focus on writing cognitively complex literature reviews, which is the
type of writing that will most often be required by your graduate
program. If you would like to learn more about these strategies, check
out the following article through your university’s library:
Granello, D. H. (2001). Promoting cognitive complexity in
graduate written work: Using Bloom’s Taxonomy as a pedagogical
tool to improve literature reviews. Counselor Education and
Supervision, 40(4), 292–307.
For international/non-native speakers. Many English as a Second

Language (ESL) students find themselves a bit overwhelmed with the
high expectations for written and oral English proficiency in counseling
programs. Of course, counseling is all about communication, so the
emphasis on these skills is not surprising. Try to find places to practice
your spoken English, such as your university’s English conversation
groups or through volunteer opportunities. Resist the temptation to
spend your free time with other students from your home country
speaking your native language. Although this can be comforting when
you are far from home, it doesn’t help with your English language skills.
For students with disabilities. If you will require assistance with your
classes, classroom materials, and tests (e.g., large print, electronic
versions of materials, extra time for tests), it is important that you work
with your university’s Office for Disability Services. Register with them
early in your program (even if you are not certain that you will need
these accommodations). Registering ahead of time means that you will
complete all the necessary paperwork and certifications before they are
needed. If you wait until you are having problems in a class before you
register, it may be too late in the term to get the accommodations you
need. Your professors will not know that you are registered with this
office unless you determine that you need to implement these strategies
for a particular class.
You have just read a lot of ideas to help prepare your mind for graduate
school. The overarching message, however, is that you may need to step back
and think more intentionally (there’s that word again!) about the kind of
student you want to be and develop or adopt strategies to get there.
Completion of an undergraduate program, even as a star student, does not
guarantee academic success in graduate school. We have found, for example,
that some graduate students enter our programs without ever having to write
a research paper or without significant feedback on their written work. Faced
with their first real critiques, these students are surprised to learn that their
writing needs improvement. A student in one of our classes was surprised to
see her feedback on a class assignment and the suggestion to attend the
university’s writing center for assistance. She said that she had always
received a “check-plus” on her writing assignments in undergraduate classes,
so she assumed that her writing was strong. In graduate school, the standards
are higher. Take charge of your own learning. You can find even more
strategies and ideas for success in your counseling graduate program in the
Top Ten List that is part of the accompanying Spotlight.
SPOTLIGHT Top 10 List

Strategies for Getting the Most from Your Counseling Graduate Program
The officers of the counseling honor society, Chi Sigma Iota, at The Ohio
State University developed this “Top 10 List” for incoming master’s degree
students.
1. 10. Get to know other students in the program. Counseling is all

about collaboration, and you will need support. As students, you are all
on the same team, so work together, including forming study groups and
proofreading each other’s papers. Ask more advanced students for
support, as they’ve been in your shoes. Be proactive. Seek advice and
assistance.
2. 9. Learn about the program faculty. Each professor is unique, and

specializes in different areas of counseling. Professors are great assets
who want to help us become great counselors. Get to know your
professors and consult them when making important decisions.
3. 8. Pay attention to APA writing style. Purchase the APA handbook as

soon as possible. There are several helpful websites about APA style,
but trust the printed text as your final guide.
4. 7. Textbooks are usually cheaper online than at the bookstore. Do

your best to find out what books you will need before classes start and
shop for them online. Keep your textbooks. Many are important
resources for the profession.
5. 6. Start a filing system (paper and electronic) for all of the great
handouts and resources you will collect. You will want these
resources during your academic and professional careers, so save
everything! The earlier you start a system for organizing your
counseling recourses, the easier it will be to maintain.
6. 5. Join a professional counseling association. These organizations will

provide you with access to important information, resources, and current
research. Also, you will need the malpractice insurance they provide.
7. 4. Don’t procrastinate. There is a lot to fit into each academic term,

and time really flies! Do not save any coursework until the last minute.
Graduate school requires a greater time commitment than undergraduate
programs. Start your research early in the term to prepare for projects
that are due later on. Map out syllabi due dates to see when weeks may
be the busiest.
8. 3. Prepare your family and friends for the time commitment your
program requires. Balancing work, family, friends, and school with
other activities can be stressful not only to you but to others who are
used to seeing you on a regular basis. Family and friends may not
understand your preoccupation with school. Explain your schedule to
them early so they can be prepared for how busy you may be in the
upcoming year.
9. 2. Expect to be challenged academically and personally from day

one. The more open you are to learning about yourself and taking risks,
the more opportunity you will have to grow as a person and as a
counselor.
10. 1. Enjoy your program. Take advantage of unique opportunities to

learn and be involved. Because your program requires hard work and
dedication to the field, it is crucial that you keep a healthy balance by
taking care of your whole self (physically, emotionally, spiritually). Use
your university’s resources, including the recreation centers, counseling
services, health services, student wellness centers, and spiritual or retreat
centers. Enjoy the experience of your graduate program, learn a lot, take
care of yourself, and have fun!
The Successful Graduate Student
So far in this chapter, we’ve talked about what you can do to prepare for
graduate school, and the focus has been on getting started. Your entire
graduate program in counseling, however, will require the same level of
intentionality and commitment that you have at the start. We remind our
students that their graduate study is a long-term commitment that sets up a
lifelong professional career. Sadly, many of the commercially available
books for students in graduate programs are focused on “surviving graduate
school,” as though it is something to be endured. We take a different
approach. We think your graduate education in counseling is a time to thrive,
to grow, to be energized and challenged. Of course, there will be times when
you feel overwhelmed or eager for the academic term to end, but we argue
that these feelings should be the exception, rather than the rule. In the
following section, we offer some tips and ideas to get the most from your
graduate program. Because of the unique experiences that some students
bring to their graduate programs, the accompanying Spotlight offers some
specific strategies and ideas to help minority students navigate their graduate
school programs. Of course, although these strategies make sense for all
graduate students, they may be a bit more pressing for students who are from
underrepresented groups within their graduate programs.
Words of Wisdom
“I got an A on my group proposal from Professor X, one of the most difficult
and challenging professors in our program. When I told my parents, they
said, ‘Of course you got an A. You always do. You’re very smart.’ It was
only when I told one of my peers in the class, and she said, ‘An A? From
Professor X? Wow. I’m impressed!’ that I felt like anyone really understood
this accomplishment. I learned that if I really want to feel supported in this
program, I’m going to have to rely on my colleagues.”
—Priscilla M., counseling graduate student

Successful Peer Relationships
In your undergraduate program, you probably had a core group of friends you
interacted with outside of class, and perhaps you gave little thought to the
role of your peers and classmates in your courses. Graduate school is
different. You will probably encounter many of the same classmates in many
of your graduate courses. You will quickly learn that your academic peers are
invaluable to your learning experience.
SPOTLIGHT Minority Students,

Diversity, and Graduate School
Although graduate programs in counseling are becoming more and more
ethnically and culturally diverse, the number of minority students in most
programs is still disproportionately small. Nearly 70% of all graduate
students in the United States self-identify as Caucasian, and nearly 75% of all
students receiving master’s degrees in education (where most Counselor
Education programs are housed) are Caucasian (National Center for
Education Statistics, 2016). Several hypotheses have been put forward to
explain the lack of diversity in graduate school, including a lack of faculty
from diverse groups, few diverse role models in the professional community,
and a graduate educational system that does not sufficiently value diversity.
Regardless of the reasons, if you are a member of a racial, ethnic, or cultural
minority entering a counseling graduate program, you may find yourself
feeling quite isolated. Many students of color note the lack of a “critical
mass” of minority students within their academic programs (Ulloa & Herrera,
2008, p. 362). Other minority graduate students say that they feel pressured to
represent the larger racial or ethnic group in class discussion, being asked, for
example, to offer “the Asian” or “the Black” perspective on an issue. Others
say that they struggle with defeating stereotypes or facing a lack of cultural
understanding from faculty and other students. Some minority graduate
students say they are challenged trying to figure out when to stand out from
others in the department and when to blend in, in effect juggling their two
identities.
The following tips may help facilitate the success of minority graduate
students in counseling programs (adapted from the University of Georgia
Graduate School, 2006):
1. Be aware of the pressures. Research shows that there is often undue

pressure on minority students to succeed in graduate school.
2. Reach out to other minority students and faculty, even if you have to go
outside your department to do so.
3. Don’t take on so much that you set yourself up for failure. Be careful
that your desire to present a positive representation of your cultural
group does not cause you to take on too many responsibilities and
commitments.
4. Cultivate a dual identity. Recognize that you will have to think of

yourself both as a member of your profession and as a member of your
racial, ethnic, or cultural group.
5. Find a mentor. A faculty member or advanced graduate student who is a

member of your same minority group can offer advice about the
challenges of navigating graduate school as a minority student.
6. Build cross-cultural alliances. Join campus organizations that represent

your own culture and work with organizations representing other
minority groups to help promote cross-cultural understanding.
7. Graduate, and get a job. Figure out what you need to do to be successful,
and do it. You will be the role model to a future generation of minority
graduate students, and you will change and diversify the profession from
the inside.
Your peers in the graduate program will provide support and encouragement.
Students in our programs often comment that the peers in their classes are the
only people in their lives who truly understand what they are experiencing. In
many programs where the same students are together in several classes, peers
can challenge you to grow, push you to higher levels of learning, and
confront you when you are not living up to your potential. They can also
provide you with invaluable support and assistance. Many graduate students
form study groups with peers, read each other’s papers before they are turned
in, and offer important interpersonal feedback. After graduation, your
academic peers become your professional colleagues. In our programs, we
have seen former students set up counseling practices together, engage in
peer supervision together, recruit each other for counseling positions, and
hire our program graduates when counseling positions become available.
Finally, your peers will play an important role in the development of your
counseling skills. In techniques classes, peers often portray clients for role
plays. In group counseling experiences, academic peers provide interpersonal
feedback. In practicum and internship, your classmates will help you
conceptualize client cases or classroom guidance activities and provide
suggestions and ideas for next steps. In short, your academic peers are critical
to your success.
Because of the both the importance and the prevalence of peer feedback
within counseling programs, we thought it was important to take some time
within the chapter to focus on strategies to give and receive feedback. Most
of us have been called on to give feedback to others before, and we all
certainly have received it. We know and understand that it can be difficult to
be on either end of this task. People who give feedback, out of a desire to be
kind or to not hurt feelings, may give generic positive feedback, like “you did
great” or “that was awesome!” But such feedback isn’t helpful or useful, and
ironically, it typically doesn’t make the person feel particularly good. Generic
praise rings hollow. You may be learning in your techniques class that clients
don’t particularly need—or like—this kind of praise, either. The truth is,
generic praise neither helps individuals grow nor helps them understand what
aspects of their current behaviors are particularly good or appropriate.
Counselors learn to give specific feedback about specific behaviors in ways
that others can hear and appreciate. Practicing with your peers is an excellent
place to start. Of course, receiving feedback also can be challenging. It is
hard not to be defensive, and that is a natural reaction. In fact, we recognize it
in our own lives, too. When we receive corrective feedback, our natural
response is to explain or rationalize our actions to the other person. It’s
frustrating to hear people say “don’t be defensive” when you receive
feedback, because it simply isn’t that easy. For most of us, our defensiveness
isn’t something we can turn off and on. So, we simply encourage you to be
aware of this tendency and work to manage your defensiveness so that you
can hear—and use—the important feedback you are receiving. In the
accompanying Spotlight, we give you some concrete suggestions for making
the most of peer-to-peer feedback during your graduate counseling program.
Words of Wisdom
“The paradox of self-awareness is that you can’t accomplish it alone. You
need feedback from others to really understand who you are.”
—Bob Towner-Larsen, Ph.D., Licensed Professional Counselor
Successful Relationships with

Faculty
Your program faculty is there to help you develop as a professional
counselor. They act as professional role models, provide support and
encouragement, challenge you to grow and change, and provide guidance in
your professional journey. Hazler and Kottler (2005) and Kuther (2008) offer
several ideas for getting the most from your program faculty.
SPOTLIGHT Obtaining Feedback

on Your Emerging Counseling
Skills
Beginning counselors need feedback from their professors, supervisors, and
peers as they practice their counseling skills. Even though we know feedback
is good for us, it isn’t always easy to hear without becoming defensive. At its
best, feedback both supports our current efforts and challenges us to grow. In
undergraduate training, most feedback comes from professors, but in
graduate school, much of the feedback is peer-to-peer. All counseling
students have a responsibility to their colleagues and to themselves to learn
how to both give and receive feedback.
Criteria for giving feedback

1. It is descriptive rather than evaluative.
UNHELPFUL: “You did a terrible job figuring out the client’s

presenting problem.”
MORE HELPFUL: “I heard you use probing, which is clearly an

important skill. But when you use probes without reflecting the
client’s thoughts or feelings, the result can feel more like
interrogation, instead of counseling.”
2. It is specific rather than general.
UNHELPFUL: “I don’t think you’re using the skills we are

learning in class.”
MORE HELPFUL: “In class we learned how to paraphrase, and

there are some times in your work with this client when
paraphrasing could have helped clarify the situation. Let’s review
your session and look for those opportunities.”
3. It takes into account both your needs and the needs of the other person.
UNHELPFUL: “You aren’t taking this seriously, and I don’t have

time to work with someone who thinks this practice session is a
joke.”
MORE HELPFUL: “I know it is difficult to hear feedback. When

you make jokes, however, it makes me feel frustrated, as if you are
not taking this seriously. I wonder what we can do so you feel
comfortable enough to accept the feedback without making jokes?”
4. It is directed toward behavior that the receiver can do something about.
UNHELPFUL: “Your accent is so thick—it makes it really hard for

me to understand what you are saying to your client!”
MORE HELPFUL: “Because of your accent, you will need to slow

down your speech so clients are sure to understand you. It might
also be helpful to remind your clients that if they are uncertain of
what you are saying, they should ask you to repeat yourself or ask
you for clarification.”
5. It is solicited rather than imposed.
UNHELPFUL: “I know you’re tired and frustrated by how hard

this is, but you should know that I think you still have a long way
to go before you’re ready to see clients.”
MORE HELPFUL: “I know you’re tired and frustrated by this

process. There is still work to be done, and I want to help you
improve your skills. But right now, it seems as if you need a break.
Should we take a few minutes before we continue?”
6. It is well timed, typically immediately after the given behavior has

occurred (depending, of course, on the person’s readiness to listen).
UNHELPFUL: “I noticed that last semester you never confronted

any of your clients, even when it would have been useful for you to
do so.”
MORE HELPFUL “I know confrontation is difficult for you. You

agreed last week that you would confront this client on the
inconsistencies between his statements and his actions, but I don’t
hear that confrontation in this recording. Let’s talk about what
stood in the way of your ability to confront the client and practice
ways that you can use this skill in your upcoming session with
him.”
7. It is checked for clarity.
UNHELPFUL: “. . . So, that’s what I think you should do.”
MORE HELPFUL: “Okay, I’ve given you feedback in two

essential counseling skills: facial expressions and eye contact. I
wonder if you could repeat back to me your understanding of my
assessment of your skills in each of these areas.”
Methods for receiving feedback

When we are on the receiving end of feedback, it’s easy to let our emotions
get in the way of our ability to truly hear and use the information. When the
feedback comes from a professor or a more advanced counseling student,
feelings of embarrassment or defensiveness can be amplified. After all, these
are the very people that you might be trying to impress (or at least to reassure
that allowing you into the counseling program was a good decision on their
part!). Our students often tell us that when they are practicing with a partner
in class, the moment that we stand beside them to listen, they suddenly freeze
and have trouble remembering what to do. One student said that the
“Murphy’s Law” of counselor training is that a student’s very best counseling
intervention will never be caught on a recording! It’s natural to feel
threatened by feedback, particularly as you learn a new skill. But there are
some things that you can do when others provide you with feedback.
1. Seek feedback. It is the best way to learn. Students who openly seek
feedback will typically find instructors and supervisors who are eager to
assist.
2. Be open. Listen without interruptions or objections. Agree to hear the

whole message until you respond. Once you take the focus off how you
will defend yourself, you will listen more attentively.
3. Write down as much of the feedback as possible, using as many of the

original words that the speaker uses as possible. That way, you can
review the feedback later, when you are feeling less defensive.
4. Be respectful. Giving feedback is difficult. Recognize the courage it

takes for others to be honest and forthright. Try to be thankful for the
risks they are taking and for their desire to help you improve. Don’t
sulk, withdraw, or lash out, as that seldom improves the process!
5. Be engaged and interested. Ask for clarification when needed.

Summarize the feedback to be sure you understand the main points.
6. Consider which part(s) of the feedback you will use and accept. If you
can’t agree to all of the feedback, consider using the “Three P’s for
Receiving Feedback”:
1. Agree in Part—find one part that you can agree with:
“I know you said I’m not taking this seriously and didn’t give
it my best effort in tonight’s class. I agree that tonight I was
tired and distracted, but I want you to know that I am
interested in becoming a great counselor. In next week’s class,
I hope you will see that I am 100% engaged.”
2. Agree to Probability—decide to what degree you agree:
“You said that I don’t look interested in what my client is

saying, and it’s possible that I am not aware of how my facial
expressions are interpreted as I listen to my client. Could you
tell me more?”
3. Agree in Principle—agree to the underlying principle you share,

without agreeing to all of the other person’s statements:
“I agree that it is important to be engaged with our clients and

demonstrate that engagement through our nonverbal as well as
our verbal interactions. It sounds as if you have some ideas
about how I could do a better job with this. Could you tell me
more?”
Remember, becoming a counselor is a process, and feedback is an important
method to help you on your journey.
Ask for feedback, when appropriate. Seek input into your developing
counseling skills, your academic work, and your interpersonal
communication style. Remember, your program faculty are themselves
professional counselors, and they notice your interactions inside and
outside the classroom.
Seek help from faculty if you need it. Don’t wait until you are
completely lost in a class or too far behind on a project to recover. To
succeed as a graduate student, you must set aside your fears about
asking for help or being intimidated and reach out to get the assistance
you need.
Read your program faculty’s published research and writing. Not only
does this provide you with insights about your faculty’s passions, but it
gives you the opportunity to engage in conversations with them about
their research agenda and ideas.
Volunteer to collaborate with faculty in their research or projects. Most

faculty members are engaged in a wide variety of research projects and
service commitments, and students who volunteer to assist can gain
invaluable experience.
Make use of professors’ office hours. This is a time when professors are
in their offices and available to meet with students. Faculty members are
often surprised at how few graduate students take advantage of this
opportunity. Use this time to get to know your program faculty. You
may wish to discuss an upcoming paper or project or talk about your
future career plans. Most professors are busy, and we are not suggesting
that you just go by the office to “hang out” (unless that professor has
indicated this is appropriate). Rather, come to the office hours with
specific ideas or questions. Do some preparation ahead of time. For
example, narrow the topic of your paper down to several ideas, or bring
specific questions about a group you are conducting.
Seek out a faculty mentor who can help you on your journey. Sometimes
this will be your advisor, but it may be another professor or supervisor.
Be proactive in getting what you need.
Attend social gatherings in which program faculty will be available for

informal conversations. Although not all programs or faculty offer these
opportunities, it is always nice to see faculty members outside of their
professorial role.
Learn how faculty members prefer to be addressed. Some use first

names, others use their full titles, and some use a combination, such as
“Dr. G” or “Dr. Darcy.” Until you are told otherwise, it is probably best
to use the professor’s academic title (for example, “Dr. Smith”). If you
don’t know what is preferred, ask. Use similar formality in e-mail
formats. One of us (Darcy) once received an e-mail from an applicant to
the graduate program that began “Hey Girl . . .” and although it wasn’t a
big problem, it did communicate a certain lack of understanding of
professionalism on the part of the potential student!
Don’t be afraid to set boundaries. Unfortunately, there have been times

when graduate students have been asked to do a professor’s work or
have been sexually or emotionally exploited by faculty. Professors are in
a position of power, and they have an ethical responsibility not to abuse
their authority by acting inappropriately with students. Be aware of your
rights and protect yourself from harm.
In general, the relationships between students and faculty in graduate school

are more collegial and less formal than those in undergraduate education.
Multiple relationships (e.g., instructor, supervisor, mentor, advisor, role
model) are common between faculty and graduate students. Learning to
manage the differing expectations of these roles is an important part of
graduate education. The relationships you develop with your program faculty
will last far beyond your graduate education. One of the best parts of any
faculty member’s job is watching the success of their graduate students as
they move through their careers and make significant contributions to the
A Note about Department Politics
Counseling programs are made up of people. Students can form cliques.
Faculty can have interpersonal conflicts and petty jealousies. Rumors
and gossip can be rampant. Try not to engage or “choose sides” in
departmental politics. Stay focused on your work and your own
development as a counselor. Remember that all of these students and
faculty will be your professional colleagues someday. It is best not to
burn any bridges.
Successful Interactions with

Counselors and the Professional
Gemeinschaft
The relationships that you develop with your faculty, supervisors, peers, and
other professionals in the field will have a significant impact on your
professional life. Use opportunities to interact with other professionals to
your advantage. Most programs have relationships with professional
counselors in the community, and you may have opportunities to meet these
individuals at department-sponsored events. Conferences and workshops are
another place to network, not only in the educational workshops, but at
conference social events and meals. We often find our program’s graduate
students sitting together or talking with each other at these events, and we
have to remind them that this is their opportunity to branch out and meet
others in the profession. It makes little sense to attend a conference, sit with
your program colleagues, and attend workshops by your professors. Use the
opportunity to branch out and spread your wings. Professionals are often
thrilled to speak with graduate students. Remember, these are counselors,
who are very much interested in the personal and professional growth of
others and who will often go out of their way to be kind and welcoming to
you. There are many examples in our programs of students who meet
professionals at conferences or interview them for a class assignment and
then later use that contact to help secure internship or job placements.
Counseling students in other graduate programs are also an important part of

your professional network. As you attend conferences or workshops, reach
out to other students to form relationships. Interactions with students who are
in other programs will broaden your understanding of the counseling
profession and can be important resources for the rest of your professional
career. There is a listserv for graduate students in counselor education
programs throughout the United States to communicate with each other, share
ideas and support, and provide learning opportunities that transcend the
limitations of an individual program or university. Students can talk about
classes, internships, papers, and ideas about the profession. The listserv,
called COUNSGRADS, was founded in 1998 by one of the authors of this
text. With more than 1000 members at any given time, it is a way for
counseling students to talk to others with similar interests, and it underscores
the importance of communication among emerging counseling professionals.
Some other tips for networking:
If you read an interesting article in a journal or section in a textbook and

have questions or ideas about it, it is perfectly acceptable to e-mail the
author (contact information is always included in journals or books).
Authors typically love feedback on their work, and they are often happy
to offer assistance in your professional development. Remember,
however, that these are busy professionals, and we are not suggesting
that you ask them to do your work for you. For example, we have both
received e-mails from students around the country that are clearly
requests for us to do their classroom work, which is inappropriate. Not
long ago, Darcy received an e-mail from a student in another state that
read, “I read your article on suicide assessment. I wonder if you could
compare and contrast the use of two different counseling theories of
your choice when working with a high school student with a drug
problem. I need your answer today, please.” It wasn’t hard to figure out
that this was a class assignment that had clearly been intended for the
student to complete.
Create a short speech about who you are, your research or practice
interests, and your future goals. This is sometimes called an elevator
speech, and you learned about it in Chapter 3. You may want to create a
specific version for people within your profession. This is not the “who
are counselors” speech that we discussed earlier in the text, but more
like “who am I as an emerging counselor”—what would you tell the
president of your state association if you were alone on an elevator with
him or her?
When talking with a counseling professional, make sure you ask the
other person about their work. If you have read the person’s work or
attended a workshop that person presented, ask specific questions.
After the encounter, follow up with a brief e-mail or note to help

maintain the connections that you made.
It is more and more common for interactions with others to take place via
social networking sites on the Internet. As you read the accompanying
Spotlight on counselors’ use of social media outlets, think about what you
believe is the appropriate role for online communication and networking in
the field of counseling.
SPOTLIGHT Social Media and

Your Public Image as a Counselor-
in-Training
As you enter your graduate program in counseling, chances are you already
have personal pages and accounts on social networking sites. In fact, more
than 90% of college students have a Facebook page, and more than 75% log
into their accounts daily. Most college students also use a host of other social
media outlets. Although you probably created an account on one or more of
these sites for social interactions, things are more complicated now that you
are becoming a professional. Of course, some social media sites (LinkedIn,
for example) are set up specifically for professional networking. But when it
comes to your personal profiles on social sites, there are no hard and fast
rules about whether to keep your account or what to include. Counselors (and
counseling students) can be faced with difficult dilemmas. What types of
pictures and personal information will you include? What will you do, for
example, if a client wants to “friend” you? Who will be granted access to
your pages? An informal survey of professionals (Levy, 2007) resulted in
three major paths professionals can take:
1. Share Everything. Professionals who opted for this strategy gave all
access to everyone. They argued that this shows your co-workers and
professional network that you have nothing to hide. However, new
counselors might want to think seriously about this option before they
employ it. Do you really want your clients and professors to know
everything about you?
2. Share Nothing. The opposite stance is to share nothing. Either eliminate

your Facebook or other social media pages altogether (and many
counselors-in-training come to this decision), or limit access only to
very close friends. This requires, however, refusing the friend requests
of clients, colleagues, and peers. Think this through.
3. Go Half and Half. Some professionals say that they keep their
professional lives separate by setting privacy settings so that only certain
friends or groups can see certain aspects of their profiles. Think through
how you will divide your personal and professional lives.
The most important thing is to adopt a strategy early and revisit your decision
often. Be cautious and thoughtful. Talk with other professionals and
colleagues to respond to the ever-changing electronic environment. In
general:
Do not post inappropriate pictures (e.g., nudity, drunkenness).
Talk with your friends about the pictures of you that they post. This is
one of the most difficult things for counseling students. They complain
that their friends don’t understand “what the big deal is” about posting
pictures of them partying with friends. Remember, once an image is on
the Internet, it is impossible to ever truly eradicate it.
Don’t use foul or inappropriate (racist, sexist) language. In the words of

one graduate student, “If you wouldn’t show it to your professor, don’t
include it on your social media.”
When you “become a fan” or join a group, remember that other people
may think you are endorsing certain ideas/services/products. Be careful.
Review your privacy settings frequently.
No one is asking you to forego who you are when you become a graduate
student. But your role as a counselor-in-training does complicate your life a
bit, and you want to be thoughtful and intentional about all of your choices,
including the ones you make in the electronic world.
Success in the Classroom

One of the major components of graduate education is the coursework that is
part of the counseling program. Graduate classes tend to be less didactic
(lecture-based) than undergraduate classes, and there is more room for
dialogue and discussion. Graduate students are expected to be active learners
who engage in class discussions, listen to other students, and bring outside
information and learning into the classroom. Research supports the use of
classroom discussion as an important method to enhance participants’ critical
thinking, self-awareness, appreciation for diverse perspectives, and self-
confidence to take action (Brookfield & Preskill, 1999). In fact, one of the
core premises underlying the counseling process is that talking through one’s
ideas and experiences is a meaningful process that allows the speaker to
come to a deeper level of self-understanding.
Passive learners who do only the minimum of what is expected or who sit
quietly taking notes during class discussions can be labeled by faculty as
disengaged or unprepared. Some students argue that they are actively
engaged with the discussion, even though they are silent. Many counseling
faculty, however, argue that such silence not only deprives the students
themselves of the opportunity to test their ideas in a public forum, it also
deprives their classmates of the knowledge, ideas, and perspectives that
would contribute to the discussion. It also deprives students of the
opportunity to develop oral communication skills that are essential for the
workplace. Thus, even students who are introverted or shy are expected to
participate in class discussions, and this may take some practice. Active
participation in professional discussions is an important skill in all counseling
settings, and it is worthwhile to develop this skill while in graduate school.
In addition to active participation in classroom discussions, there are some

specific classroom strategies that can both enhance your learning and
communicate to your professor that you are a serious and motivated learner.
For example:
Show up on time for class.
Turn off your cell phone or set it to vibrate.
Don’t start putting your materials away before the end of class.
Pay attention. Stay focused and appear focused. That is, don’t look out
the window or close your eyes. Don’t do work for other classes, read the
paper, surf the Internet, or read or send text messages.
Be respectful. Don’t roll your eyes when someone else is talking or use
other body language to convey boredom or disagreement. If you would
like to challenge something that another person has said, do so in a
respectful manner.
Submit assignments on time. If you have a problem meeting the

deadline, consult with the professor.
Use appropriate body language. Make it easy and fun to teach to you
(professors are people, too!). All instructors find themselves giving more
attention to students who make eye contact, nod, and in general, look
interested in the class material.
Dress appropriately. Most graduate classes do not require professional

attire for each class meeting, but there are standards for appropriate
dress and grooming that demonstrate that you take the experience
seriously and respect the professor, your classmates, the process, and
yourself. Wearing your pajamas to class or dressing in clothing that is
inappropriately revealing does not convey the professionalism and
maturity that is appropriate for graduate school.
Success in Online Education

For students in online counseling programs, there are no traditional
classrooms, and interactions with peers and professors is done electronically.
Although many of the strategies discussed in this chapter apply equally to
face-to-face or online learning, there are some additional challenges (and
benefits!) that students in distance education courses may face.
Counseling is about relationships. It is perhaps not surprising, then, that

counseling classes have traditionally tended to value student-faculty and
student-student relationships. Counseling programs typically emphasize the
importance of community and interpersonal interactions as part of the
learning environment. In online education, these relationships may be more
difficult to foster. In face-to-face environments, student-faculty relationships
are enhanced through informal or impromptu conversations, and spontaneous
and informal student-to-student interactions are also important to developing
bonds that allow for a sense of connectedness and trust (Hall, Nielsen,
Nelson, & Buchholz, 2010). These interactions may be more difficult in
online learning environments, but that does not mean these important
relationships within the class have to suffer. There is a growing body of
research that demonstrates that a strong sense of community can exist within
online classes, and students can develop strong and lasting relationships with
each other and with their faculty (e.g., Ke & Hoadley 2009; Murdock &
Williams, 2011; Palloff & Pratt 2007; Rovai, 2002). There are active choices
online learning communities can make in order to promote successful
relationships. The Distance Education and Training Council (DETC)
recommends that instructors and students work intentionally to (1) encourage
contact between students and instructors, (2) develop mutually beneficial
interactions and cooperation among students, (3) encourage active learning,
(4) communicate high expectations, and (5) respect . . . different ways of
learning (2009).
In addition to all of the suggestions already listed, graduate counseling
students in Dr. Elizabeth (Bea) Keller-Dupree’s online Foundations of
Counseling class at Northeastern State University in Oklahoma offer these
suggestions for graduate students in online counseling programs. With
appreciation to Dr. Keller-Dupree, and her graduate students (Kimberly
Coats, Drue Donovan Day, Shawn Dayan, Domini Jones, Cathryn Klarich,
Jessica Ward, Jordan Westcott, and Danielle Young), we are happy to pass
along their tips for being successful in an online environment. In general, all
of these online learners want you to hear a very important message: You can
learn just as much through an online course, but you must apply yourself, be
motivated and persistent, and take responsibility for your own learning.
Complete the reading, communicate with the professor, and really

engage in the learning process. Taking the time to engage with the
material and reflect on it in a meaningful way helped me understand it
and remember it later when I was taking the exams.
Setting aside a specific time each week when I would work on my

assignments from my online class provided some of the structure I need
that is typically provided in a traditional learning environment.
Stay engaged as much as possible. Self-discipline plays a large role in

online learning.
Stay current with the reading. I found it is beneficial to take notes as I

read so I will have them later before taking the counseling licensure
exam.
Really try to stay ahead of your deadlines. Try to schedule a time at least
a few days early for your assignments. It will free you up to enjoy
everything in your life a bit more.
Graduate school simply has so many things coming at you from all sides
that it is easy to get tripped up. Think of it as being like double dutch.
Anticipate the rope, and find your rhythm, knowing sometimes there
will be tricks along the way.
Keep a planner with artificial deadlines. Schedule time to read, look at

course material, and start projects. Go through the course syllabi and
make a weekly “to do” list to stay on track.
Communicate with your professor. Ask questions. Be up front and

honest with them, and ask for assistance when you need it. They are
there to help you learn.
Read the chapter for the week in one sitting and take notes on the
chapter while reading. This may seem obvious, but at the start of the
semester, I tried to read a few pages here and there when I had spare
moments. That method resulted in having the ideas from the courses
jumbled in my head, and it was hard to keep it all straight.
Success in Navigating the Program

Culture
Perhaps one of the most difficult things for graduate students to understand is
that there are expectations in graduate school that are not clearly defined, not
expressed out loud, and not attached to any specific course. These
expectations encompass the intellectual life of the department that exists
beyond the classroom, sometimes called the informal or hidden curriculum
(Sullivan, 1991). Examples include lectures by visiting scholars or
professionals, workshops, training sessions, service and leadership
opportunities in local associations or the department’s chapter of Chi Sigma
Iota, study groups, and brown bag lunches. The ability to successfully
navigate this curriculum is often hindered by the fact that many graduate
students do not understand the importance of these opportunities or in some
cases, do not even know that they exist. Faculty, supervisors, or doctoral
students may announce upcoming events but typically note that they are
optional. As a result, if you are a student who struggles to understand the
culture of graduate school, you may miss out on these chances to enhance
your professional development. Participating in these activities and/or
volunteering in schools and mental health agencies is an important way for
you to continue to hone your skills, network with professionals, and learn
more about the profession. We encourage you to find out what opportunities
exist in your program, and speak with faculty or more experienced students to
better understand the program’s expectations for your involvement.
Success in Maintaining Your Own

Mental Health
As important as it is to attend to the externally imposed demands of graduate
school, counseling students should not neglect the demands and challenges
that will arise from within. It is essential not to neglect your own mental
health as you go through your graduate program. Graduate students who are
training to be counselors can feel enormous pressure to perform and may feel
overwhelmed and anxious (Rønnestad & Skovholt, 2003). They may have
jobs, families, and other responsibilities. Many of the activities counselors-in-
training engage in (role plays, reading, discussions, working with clients) can
tap into the student’s own emotional vulnerabilities, and listening to clients
tell their stories can make all of us feel sad or anxious. In some cases, we can
even develop secondary trauma, a term that is used to describe the emotional
distress that can happen when we hear about the trauma experiences of
others. When you find yourself overwhelmed by everything you are
experiencing, it is important to find ways to address these difficulties. We
would like to suggest that you remain open to the idea of entering counseling
as a client. Most colleges and universities offer counseling for their students,
and there are resources in the community as well. Many counselors have
benefited—and continue to do so—from their own personal counseling.
About 75% of practicing therapists (counselors and psychologists) have had
at least one experience of personal therapy (Norcross & Guy, 2005). Among
students in graduate mental health counseling programs in another study,
76% stated that they had received their own personal counseling at some
point, and 70% reported that their most recent counseling occurred during
their graduate counseling education. That same study found that only 50% of
school counseling students had received their own personal counseling.
Perhaps the most distressing aspect of this study, however, was that 39% of
the students in the study stated that they had never read about nor discussed
the idea of pursuing personal counseling during their graduate training
(Byrne & Shufelt, 2014). We find that disturbing, and we want to make sure
that you know that personal counseling can be an important aspect of
maintaining your own mental health during graduate school and beyond.
Further, there is no shame in counselors seeking their own professional help.
Finally, seeking counseling during your graduate program can set up a
lifetime of better mental health that will not only help you become a better
counselor, but also a happier, healthier, more fully functioning person. After
all, it would be rather hypocritical of us to think that other people can always
benefit from counseling, and somehow think we are immune? As the old
adage goes, you don’t have to be sick to feel better!
According to numerous research studies (e.g., Byrne & Shufelt, 2014; Daw &
Joseph, 2007; Macaskill & Macaskill, 1992; Murphy, 2005; Neukrug &
Williams, 1993; Von Haenisch, 2011), counselors and counseling students
who participated in their own counseling experienced the following:
An increase in their own emotional health
Better self-awareness and self-understanding
Higher levels of self-esteem and more self-compassion
Improved self-care and decreased burnout
Higher levels of empathy and compassion toward others
A decrease in therapeutic “blind spots”
An increase in their belief in their own ability to do therapeutic work
An increased respect for the process of counseling and for the resilience
of clients
A decrease in burnout
Next Steps: Life After Graduate
School
Ultimately, of course, the purpose of your graduate training is to secure a
position as a professional counselor. Although for most students in an
introductory graduate course in counseling the job search is off in the
distance, it’s never too early to start thinking about ways to prepare yourself.
Keeping an open mind to the possibilities presented for career paths during
your graduate education, networking with professional counselors, attending
counseling conferences and workshops, and joining professional associations
are all strategies that will assist with your job search.
Preparing Your Resume

It is extremely important to prepare your resume (in academia, a resume is
sometimes called a curriculum vitae or CV) early in your program and keep it
up to date. CVs do not need to adhere to the standard one-page format of a
resume and typically include information about education, licensure or
certification, honors and awards, counseling experience, publications,
presentations, research involvement, teaching, professional service, and
professional affiliations. Some master’s students also list trainings attended,
which is appropriate. In general, CVs do not contain personal information,
such as age, marital status, ethnicity, or hobbies. As you enter practicum,
submit a proposal for a conference, or apply for a graduate associateship or
counseling job, others will ask for a current copy of your CV. It’s best to
keep yours active and consistently updated. Remember that the first
impression that many professionals will have of you is your CV. Make sure it
is comprehensive, accurately portrays your experiences and competencies,
and does not have typos or grammatical errors. Have other people read
through your CV to give you feedback. If your university has a career office,
it is a good idea to work with their staff, who are trained in developing high-
quality CVs and resumes.
Getting a Ph.D.
Some master’s-level students ultimately decide that a Ph.D. is right for them.
If you are interested in pursuing doctoral work, it is important to discuss this
possibility with your advisor early in your academic program so that your
advisor can help you get the experiences you need to prepare you for doctoral
work.
In the following Snapshots, two doctoral students discuss their decision to

obtain a Ph.D. In the first, Marjorie Adams talks about her decision to go into
a doctoral program directly from her master’s program. In the second
Snapshot, Felice Kassoy discusses her decision to return to school for her
Ph.D. after years of practice as a school counselor. As you will see, neither of
these decisions would be “right” for everyone, but you will learn the factors
that went into their decisions to help inform your choices about the
possibility of doctoral study.
SNAPSHOT Marjorie Adams, A

Direct Path from M.A. to Ph.D.
At the age of five, I informed my parents that I was going to get a Ph.D. Of
course, I had no idea of what that actually meant, but I knew that I loved
school and enjoyed learning new things. During college, I jumped from a
major to major. By graduation, I had researched graduate programs and
decided that I wanted to be a counselor. The idea of helping people change
their lives got me excited and motivated.
At the beginning of my master’s program, I was unsure whether it made more

sense for me to pursue a Ph.D. right away or to wait until later. I knew that a
Ph.D. would help me to become a leader in the field, and I would to learn to
teach, supervise, conduct research, and find unique ways to contribute to the
body of knowledge in the field. The more I learned about doctoral programs
in counselor education, the more I believed that the Ph.D. program would be
a great fit for me. However, I also realized that in order to be a great
counselor educator I would need to be a great clinician. I worried that I would
not be ready by the end of the master’s program.
Two things happened in my master’s program that made me believe that I

could continue straight through to pursue a Ph.D. First, I was accepted to a
wonderful internship site, and I knew I would spend an intense but rewarding
year dedicated to my development as a clinician. Second, my advisor
reminded me that every doctoral student has strengths and limitations, and it
would be my responsibility to develop in the areas where I was less
experienced.
I knew that if I were to continue into a doctoral program I had to be ready to

dedicate a huge portion of my life to the endeavor. I worried about the
amount of work as well as the commitment. However, I could not ignore the
fact that I was finally passionate about what I was doing. Even though parts
of doctoral work, like the dissertation, seemed overwhelming, I was excited
about the possibilities. Ultimately my passion and excitement for counseling
influenced my decision to go straight through.
I was very hopeful when I entered the Ph.D. program, but I must admit that I
also was worried that I was too young and taking on too many new identities
at one time. I worried that other professionals would not take me seriously
because of my age and inexperience. Looking back, however, I am very
satisfied with my decision. As it turned out, some of my concerns, such as not
having much experience as a counselor and being new to the field, were just
things that I had to consider when determining my plan of study. They were
not things that automatically discounted me or lessened my ability to
contribute to the field. I just had to make accommodations for them. For
instance, since I chose to go straight through, I have also committed to doing
a substantial amount of clinical work while in the Ph.D. program to help
overcome my lack of experience.
I believe that there are some benefits to my decision. Because I never took
time away from school, I am still in “apprentice mode,” and I am very
comfortable seeing myself as a student and feel comfortable learning. I am
aware of my strengths as a student and can use those strengths to help me
develop as a counselor educator.
The one thing I’ve learned throughout this entire process is that there is no
direct map to my dreams. This can be freeing, but also uncomfortable.
Without a clear path, there is always uncertainty. I encourage you to relax
and think about what gets you excited. I believe that if you find a passion and
follow it, you will be motivated enough to make whatever academic or career
goals you choose a brilliant step in achieving your dream.
SNAPSHOT Felice Kassoy, A

Returning Student’s Journey to a
Ph.D.
It was a winter day in February 1981. I was a young 24-year-old newlywed
living in Yucca Valley. I was a third-year teacher, coach, and cheerleading
advisor when one of my freshman cheerleaders, Missy, a quiet, petite young
lady, confided in me that she was pregnant. That moment was the beginning
of a long professional journey. After 11 years in the classroom, the births of
my own three children, and a steady part-time pursuit of my master’s degree
and professional counseling licensure, I became a counselor. For the past 20
years, I have been an elementary and middle school counselor, and most
recently, a doctoral student in counseling.
Pursuing a doctoral degree in counselor education will enable me to reach my

career goals for the next phase of my professional development. As a doctoral
student, I will have the opportunity to engage in departmental research and
begin my own original work. I will acquire the training and credentials
necessary to teach and provide leadership at the college level and become an
advocate for counselors both locally and nationally.
Having spent the last 20 years “in the trenches,” I am eager to become more
involved in academia. As schools have evolved over the last few decades,
there are many critical matters we must address. I would like to have the
opportunity to make a scholarly contribution that will provide useful
information to enhance the work of current and future counselors.
In addition, I have always had a passion for teaching, guiding, and mentoring
others. Taking my experience and enthusiasm into a graduate school
classroom as a professor is a fulfilling prospect. Extensive experience as a
school counselor coupled with my education in the doctoral program will
make me well equipped to provide a “reality-based and research-guided
experience” for the next generation of school counselors. After 20 years as a
school counselor, I feel strongly about the integrity and value of our
profession. One way that I can “give back” is to provide leadership both on
the local and national levels.
The biggest obstacle to starting a Ph.D. program was me. I was intimidated
by the thought of taking the GREs at age 51. I tried endlessly to uncover a
“loophole” that might excuse me from this dreaded exam, but after running
into multiple dead ends, I decided not to let my fear win. I hired a tutor, spent
an entire summer studying, and then reluctantly sat for the exam. My hope
was that my acceptance into the program would weigh more heavily on my
30 years of experience and not one standardized test. It wasn’t easy, but I
survived!
Once I was admitted into the program, I created another obstacle for myself. I
began almost every sentence with an apology for my age. Thank goodness, I
had a very caring professor during my first quarter who gently pointed out to
me that this was unnecessary. As my confidence began to build, it was easy
to let go of that “qualifying statement” and flip the lens. I began to view
myself as a lifelong learner and a positive role model for others.
So last Christmas, my family and I went to Zionsville, Indiana. There we had

the privilege of making 15 dozen authentic tamales with Missy, that little
brown-eyed cheerleader from Yucca Valley, California. We were joined in
this amazing family tradition by Monica, her 26-year-old daughter, and Mike,
Monica’s father and Missy’s husband. With an enormous amount of hard
work, unwavering commitment, and the support of many caring people, these
two loving adults have overcome incredible odds to stay together and raise
both of their children. I am proud to be one of those “caring people.” I hope
to utilize my doctoral degree to help train others in this vital profession, so
they, too, can make a difference in the lives of the Missys of the world.
Seeking References
All counseling positions will require professional references. Ask your
faculty and supervisors if they are willing to serve as a “strong professional
reference” for you—be sure to ask; don’t just assume they will! If they are
not prepared to speak highly of your work, then you will want to find others
who can. Make sure the people who are serving as your references know you
well and can provide specific details about your counseling or academic
skills, your motivation, and your interpersonal skills. Finally, offer to send a
copy of your CV to the person who will serve as a reference to remind him or
her what you have done. If you are asking for a reference letter, it is
appropriate to ask if the person could highlight a specific experience or
personality trait that you have. (“Professor X, would you be willing to write a
strong professional reference for me for this position? It would be very
helpful if you would highlight the work that I did on your research team so
that the person in charge of hiring could see that I am a responsible and
motivated member of a work team.”)
Summary
In this chapter, we discussed some important strategies to help you get the
most from your graduate program in counseling. Even extremely bright and
talented students find that they will benefit from introducing intentionality
into their graduate experiences. Finding ways to prepare yourself as well as
your loved ones about what to expect can help avoid difficulties in the future.
Brushing up your study skills and preparing your work space also can be
useful. Finally, making intentional choices in how you navigate the courses,
the hidden curriculum, and relationships with faculty and peers can help you
in your journey toward becoming a counselor.
Student Activities
1. Now it’s time to reflect on the major topics that we have covered in this
chapter. Look back at the sections or the ideas you have underlined.
What were your reactions as you read those portions of the chapter?
What do you want to remember?
2. As you read Caroline’s tips on managing your schedule in graduate

school, what specific strategies (from the list or other ideas) would you
like to use to help maintain balance during your graduate program?
3. What type of student are you (or will you be) in your graduate program?
Think about this with intentionality. What will it take for you to make
the most of your classes and education, and what strategies can you use
to ensure you get the best experience possible?
Journal Question
1.
Obtaining Counseling as a Client. Many counseling programs encourage

counseling students to go into counseling as a client. What do you think
might be the benefits of this practice? What might be some risks? What
concerns might you have about entering counseling? Might you think, “I
should be able to work things out for myself,” or “I must be weak,” or “I’m
supposed to be the healer,” or “I wouldn’t want other people to know about
this,” or even, “I’m busy with my graduate program—I don’t want to stir
things up in my personal life”? If you are already a client in counseling, what
fears and negative self-talk did you face when you decided to enter
counseling? Reflecting on these reactions, what does this experience tell you
about what it might be like to be a client in counseling?

1. What are the differences that you have seen between your undergraduate
and graduate education? Have your classmates noticed these same
differences? What are the positive aspects of these differences, and
where are you struggling to adjust?
2. What can you do to help your family and friends understand your life as
a graduate student? Do your peers have suggestions that might be
helpful?
3. The Spotlight on giving and receiving feedback points out some of the
benefits—and challenges—of using your peers for feedback. How can
you develop and maintain a culture among your peers that supports and
promotes this type of professional feedback?
4. What is the role of social media outlets for professional counselors?

Experiments
1. Improving your study, reading, and writing skills. Find out if your
university has a study center or a writing center. If so, make
arrangements to visit so you can learn more about ways to enhance your
academic success in graduate school.
2. Take a Learning Style Quiz. Learn more about how you learn and the
best ways to facilitate your learning by taking a learning style quiz.
Many are available for free on the Internet, or your university’s own
study skills center may have one for you to take.
3. Review your own social media pages and accounts and consider what
changes, additions, or deletions you would like to make as you enter
your new role as a counselor.
4. Review the CV of professional counselors or other counseling

students and get started writing your own. If available, use your
university’s career services to get feedback on developing an appropriate
format for your CV or resume.
5. Join COUNSGRADS, the national listserv for students in graduate

programs in Counselor Education. Ask questions, engage in dialogue,
or just read what is on the minds of other students in the profession.
Directions to subscribe or unsubscribe are always available on the ACA
website (http://www.counseling.org), under “students.” To subscribe, go
to: http://go.osu.edu/COUNSGRADS
Explore More
Ellis, D. (2014). Becoming a master student (15th ed.). Belmont, CA:
Wadsworth.
Although this text was written for undergraduates, many graduate

students find that the information and strategies are extremely helpful
for navigating graduate courses, too.
Johnson, W. B., & Huwe, J. M. (2003). Getting mentored in graduate

school. Washington, DC: American Psychological Association.
Finding a mentor can be an important component of graduate education.

This book offers practical advice and strategies for getting the most out
of this important relationship.
Sheperis, C. J., & Davis, R. J. (2015). Online counselor education. New

York, NY: Sage.
Students in online counselor education programs can face unique

challenges that can put them at a disadvantage. This book offers to help
counseling students navigate the online learning environment.
Walfish, S., & Hess, A. K. (2001). Succeeding in graduate school: The

career guide for psychology students. Mahwah, NJ: Lawrence Erlbaum.
This book offers strategies, advice, and guidance for navigating graduate
education in the helping professions, including maintaining an ethical
focus, making the most of internships, and building a career beyond the
degree.
Chapter 6 How Do Counselors Use
Theories?
Questions
The basic assumptions about human nature that underlie the major
counseling theories.
Basic tenets, appropriate uses, effectiveness, and the important

contributors of four major counseling theories.
Some of the common therapeutic factors that all counseling theories

share.
Differentiate between personality theories and theories of change.
Match your own beliefs with the underlying assumptions of at least four
major counseling theories.
Identify those theories which you want to explore more deeply.
What you believe about human nature and the nature of change, and
how this might influence your adoption of a theory or theories.
Whether you think it is better to choose one theory to identify with or it

is better to be theoretically “agnostic.”
Professional Orientation and Ethical Practice
a. history and philosophy of the counseling profession and its

specialty areas
In the quote in the Words of Wisdom box on this page, Lewin is suggesting
that theories of counseling are like flashlights; they help us find our way. The
course of a counseling relationship is like a labyrinth, and counselors need
theories as guides to look at the big picture and to choose methods and
techniques that make sense. Theories provide you with a map and a rationale
for your approach. They provide counselors with an orderly way to explain
and conduct our practice.
Words of Wisdom
“There is nothing more practical than a good theory.”
—Kurt Lewin (1952, p. 169)
Studying counseling theories is one way to get in touch with the wisdom of
our elders. The struggles that you face with clients are not so different from
those that the great therapists and theorists had to deal with. They started out
like you, feeling that they were in the dark and that someone must be able to
show them the way. Their writings provide us with courage and good
practical ideas. With a theory, you have a rough idea about what information
you need to gather and what to expect in the therapeutic process. Along with
a theory, you learn some techniques that are consistent with the theory. When
you have this map, you are more confident and that helps you and the client.
Maybe clients need theories too. Recently we found an online guide to

selecting a counselor. It said that any counselor you choose should be able to
describe the theoretical approach that will be used in counseling—if not, keep
looking. A theoretical orientation can reassure a client by describing the
process of therapy. Knowing where you are going helps to instill hope and
realistic expectations, and that can help a demoralized client (Frank & Frank,
1991). It is still an open question from a research perspective as to whether a
counselor with a coherent theory is any better than one without. In fact, you
may be asking yourself, do I really need to adhere to a counseling theory?
In this chapter, we will not attempt to help you make a final selection of a
personal theoretical orientation, or even convince you of whether or not you
need one. Instead, we introduce terms and concepts so you can talk about
theories with your instructors and fellow learners. We take you through the
basic ideas about how some theories work in practice, and we review some of
the evidence supporting these theories. In your theories of counseling course,
you will have a chance to gain a deeper understanding, and we think it would
spoil the surprise and make us unpopular if you had to read these theories
twice. So, what we have done is continue our field guide metaphor. First you
need to be able to tell the beetles from the butterflies. What may be helpful, at
this point, is to recognize some basic ideas of each of the most common
counseling theories. Then you will be able to see the underlying assumptions
when they appear in a new technique you encounter. For example, Imago
therapy is a popular couples counseling approach. Although the research
behind it is limited, participants are generally enthusiastic. Imago is based on
the theory that your early childhood experiences unconsciously affect your
choice of mate and your relationship with him or her. In short, it is
psychoanalytic. In order to practice Imago, you must subscribe to the belief
that the unconscious and the past are crucial to mending a troubled
relationship. Our rationale for acquainting you with the underlying premises
of the major theories is so that you can detect these hidden assumptions—so
you can recognize them in the wild and identify those that fit with you and
those that do not.
Theories of Change: Counseling
Theories
What Are the Major Theoretical
Positions?
The history of mental healing goes back to the beginning of human history
from the magical incantations of the Babylonians to the practice of yogic self-
control in India and the analysis of dreams by the ancient Greeks (Ehrenwald,
1991; Jackson, 1999). But “talking cures” where people sit down and have a
helping conversation only became a distinct profession in the latter part of the
19th century (Bankart, 1997). Freud’s psychoanalysis became the reigning
paradigm. Now, there are now as many as 460 theoretical positions (Corsini,
2001; Herink, 1980; Parloff, 1979). In this forest of ideas, how can you, as a
beginning counselor, find your own way? Our approach is to help you
become familiar with a few of the most admired theories, so that you know
what people are talking about.
Twelve theoretical orientations are identified in Table 6.1. These are the
major theories that are being practiced today. Traditionally, three big rivers of
therapeutic thought (behavioral, psychodynamic, and humanistic/existential)
have dominated the landscape. Many older, more established theories fall
into these three categories. Because of its emergence as a very popular
orientation, we must consider Eclectic/Integrative as a fourth category. Of the
twelve specific orientations listed in the table, all but three (constructivist,
family systems, and multicultural) fall under one of these four categories.
Table 6.1 Theoretical

Orientations of
Psychotherapists in the United
States
Source: From Table 1.1, Theoretical orientations of
psychotherapists in the United States. In J. Prochaska & J. C.
Norcross. (2010). Systems of psychotherapy: A transtheoretical
analysis (7th ed., p. 3). Reprinted with permission.
Clinical Counseling Social

Orientation Counselors
Psychologists Psychologists Workers
Behavioral 10% 5% 11% 8%
Cognitive 28% 19% 19% 29%
Constructivist 2% 1% 2% 2%
Eclectic/Integrative 29% 34% 26% 23%
Existential/Humanistic 1% 5% 4% 5%
Gestalt/Experiential 1% 2% 1% 2%
Interpersonal 4% 4% 3% 3%
Multicultural 1% ---- 1% 1%
Psychoanalytic 3% 1% 5% 2%
Psychodynamic 12% 10% 9% 5%
Rogerian/Person-
1% 3% 1% 10%
Centered
Systems 3% 5% 14% 7%
Other 5% 9% 4% 3%
Psychodynamic Theories
Psychodynamic theories (also called Freudian psychoanalysis,
psychodynamic psychotherapy, or interpersonal psychotherapy) share a
common belief that therapy takes place through psychological archaeology.
By understanding the conflicting forces within each person, bringing them
into consciousness, and recognizing the influences of the past (especially
childhood), the client can live more consciously, rather than be propelled
through life by unconscious drives. The notion of a Freudian analyst sitting
behind the couch has been replaced by modern psychodynamic therapists
who utilize the therapeutic relationship as a way of helping the person
understand past relationships and resolve conflicts.
Behavioral/Cognitive Theories
Behavioral and cognitive behavioral therapists help clients achieve behavioral
change through self-control procedures, exposure treatments, and changing
self-defeating thoughts and perceptions. Cognitive and behavioral therapies
are often used together, based on the belief that the solutions to many
problems require intervention at both the mental and behavioral levels. For
example, when you expect your spouse to blow up, you avoid interacting.
Your thoughts and behaviors are connected. Changing your expectations
(thoughts) or changing your behavior (avoidance) can work together to
produce change. That’s important, because we have the ability to change our
thinking or our behaviors (whereas changing our feelings can be very hard to
do!).
Humanistic/Existential Theories
The predominant humanistic/existential theories are Rogerian person-
centered therapy, gestalt, and existential therapy. As a group, these theories
agree that clients are best served when they are allowed to discover their own
paths. The therapist is a facilitator who encourages clients to accept their own
truths by bringing these out in the counseling session. The change in clients
does not come about primarily through learning but by accepting disowned
parts of the self. The counselor’s job is to create an accepting environment
where clients can take charge of their own life.
In this chapter’s Snapshot, you will meet a counselor who operates primarily
from a gestalt perspective. David sought advanced training and practice to
become an expert in this very specific type of counseling. As you read his
story, you may wish to consider whether you think you would like to develop
expertise in one specific form of counseling.
Eclectic/Integrative Theories
Eclectic or integrative counselors attempt to tailor the treatment to the client.
They employ techniques or interventions that fit the client and the situation,
rather than adhere to the counselor’s theoretical approach. Integrative
counselors might blend two theories, such as psychoanalysis and behaviorism
(Beier, 1962). Alternately they may retain their general allegiance to a
specific theory but acquire techniques from other theories. For example, a
behavior therapist might use role playing that originated in psychodrama to
teach a client new behavior, such as being assertive.
SNAPSHOT David R. Dagg-Murry

M.A. Licensed Professional Clinical
Counselor and Supervisor.
Counselor working from a Gestalt
Orientation
When someone asks, “Why did you become a counselor?” I respond, “It was
my calling.” This is similar to the experience of people who become spiritual
leaders. It was never a conscious choice, just something I always understood
in the deepest part of myself. There was a drive to help people as a counselor,
a hunger that needed to be fed. Some of this came from personal experiences
with psychotherapy as an adolescent, some from surviving a chaotic family,
and some is just who I am as a person.
I have been exceptionally lucky in my path to becoming a counselor. I had

many years of life experience that helped build a foundation for my learning,
and the faculty in my counselor education program supported my growth as a
person and a professional. This support shaped how I developed during my
graduate program but more importantly how I became dedicated to growth
after graduation.
A few years of practicing as a clinical counselor brought an understanding

that I wouldn’t survive as a clinician unless I continued to seek growth
opportunities. I was already starting to burn out because I was taking
responsibility for the change in my clients. If I didn’t alter how and why I did
counseling, I would have left the profession. I was going home each day
exhausted after trying to implement cognitive behavioral change strategies
and trying to convince clients to change. This exhaustion was also about a
growing incongruence between how I practiced as a counselor and who I was
as a person. As a person I believed in the importance of awareness, the
energy of therapeutic contact, and the power of being present with a client.
My early practice ignored all of these things, and I wasn’t sure how to bring
these ideals into my clinical work.
Out of desperation and curiosity I applied to a 4-year post-graduate Gestalt

Therapy training. Gestalt Therapy aligned with my beliefs as a person, and I
was hoping it would help change my plodding counseling technique to
something else. The program consisted of extended weekend trainings every
other month for four years, a weekly individual growth group, and individual
psychotherapy with a gestalt-trained therapist for the duration of the training.
My post-graduate Gestalt Therapy training opened a new world of

understanding. I practiced awareness of contact and awareness of myself with
clients. I understood my process of thinking, emotions, and awareness at a
much deeper level. Instead of trying to change clients I experimented with
what was happening in the present. I became a phenomenologist. I learned
how to survive as a counselor.
I am humbled by the knowledge and experience I gained from my instructors.

Gestalt Therapy fit my growth as a professional and as a person—it requires
both to become an effective counselor. My continued hunger to learn and
grow led me to a 2-year post-graduate Gestalt Therapy training in
Developmental Somatic Psychotherapy. I continue to explore how awareness,
movement, and energy exist in every session with every client. I love what I
do. It is my calling.
Other Approaches
Of course, not all theories fit neatly into the four categories listed above.
Some of the newer theories that are emerging in the profession may someday
become prominent. But for now, we simply list them under “other
approaches” and encourage you to explore them as you think about your own
developing theoretical approach.
Systems theory or family systems.
People are part of complex systems, and those systems influence our
thoughts, feelings, and behaviors. Many marriage, couple, and family
counselors utilize a family systems approach in their work. Family systems
theorists believe that the family is an interacting whole that is both the basis
for pathology and the nexus for change. The counselor must understand a
family’s rules, roles, and relationships. The client’s family of origin (parents
and siblings) is a crucial avenue of self-exploration for the counselor because
this history forms the basis for the client’s later relationships. Systems
theorists believe that changing family and couple relationships are the best
ways to help an individual. When seeing the couple or the family is not
possible, systems-oriented counselors try to help an individual adapt and deal
with the larger family system.
Constructivist theories.
Constructivist theories such as narrative and solution-focused therapy believe
that the client is the expert, not the counselor. The client has developed an
individualized story about life, which may not be a productive or useful way
of looking at the world. In this approach, the counselor aids the client in
rewriting the life story and developing more effective frames of reference.
Counselors who use these theories work with their clients in a collaborative
approach to create meaning and new potential futures for the client.
Solution Focused Brief Therapy (SFBT) is an approach that is rooted in a

social constructivist philosophy and a systems approach to counseling. SFBT
is not typically considered a theory of counseling, but a set of techniques and
interventions that use a positive approach focusing on what clients want to
achieve in counseling, rather than on the problem(s) that made them seek
help or keep them stuck. The specific techniques and steps involved in the
practice of SFBT are largely attributed to the husband-and-wife team of Steve
de Shazer and Insoo Kim Berg (de Jong & Berg, 2002). SFBT is highly
focused on the present and future, with very limited attention to the past.
Counselors adopt a stance of “respectful curiosity” and invite clients to
envision what they wish their lives could be. Counselors who use SFBT are
highly attuned to any movement toward positive goals, no matter how small.
Clients are encouraged to notice when things go well or times when their
current life is closer to the preferred future that they envision for themselves.
By bringing small successes to clients’ awareness and helping them repeat
actions they are taking at moments when the problem is not there or is less
severe, counselors help clients move toward their goals. In the accompanying
Spotlight, you will learn some of the techniques that are often used in SFBT.
As you read these techniques, you will see how SFBT is firmly rooted in a
constructivist approach that helps the client create new life narratives.
SPOTLIGHT Solution Focused

Brief Therapy: Techniques to Help
Clients Create New Narratives
SFBT uses some very specific techniques to help move clients in the
direction of their preferred futures. Some of the more commonly used
techniques are in the form of questions.
The Miracle Question. Counselors ask their clients a version of this

question: “If you went to sleep tonight and a miracle occurred and your
problems disappeared, when you woke up in the morning, how would
you know the miracle had occurred? What would you notice? What
would be different, and how would you know it was different?” Focusing
clients on the changes that they can make helps them uncover the
solutions that are already within them.
Scaling Questions. These questions help clients determine where they

are in their achievement of their goals. For example: “On a scale of 1–
10, with 1 being the worst [the problem] has ever been and 10 being the
best it could be, where are you right now?” Clients are then asked what
it would take to make a small incremental step in the right direction:
“Okay, you say you are a 3 right now. What would it take for you to get
to a 4?”
Exception Questions. Tell me about a time when the problem is
completely absent. Often when people are in distress, they use terms like
“always” or “never.” (Recognizing these catastrophizing approaches is
important in cognitive therapy, too.) Recognizing when the problem
doesn’t occur can help counselors understand what conditions should be
created to eliminate the problem.
Coping Questions. Recognizing the work that clients are already doing
to cope with the situation (even when the problem does exist) is
important. A stance that combines genuine curiosity and admiration can
be useful: “I know that you said coming to school is really hard for you
because the other kids tease you, and yet you were able to get through
the day today. I know it must have been very difficult for you. How did
you do that?” Such a question is another way to help clients recognize
what they are doing well.
SFBT is used in a variety of settings and with many different client problems.
It is an approach that has been widely embraced by school counselors
(Murphy, 2015). Research has supported its use for a variety of academic and
behavioral outcomes (Franklin, Moore, & Hoptson, 2008; Kim, 2008). The
social constructivist approach behind SFBT encourages involvement by
parents and teachers, which fits with the mission of the school environment.
The focus on interventions that lead to quick results to overcome current
problems (rather than extensive understanding of past troubles or underlying
personality problems) is consistent with the type of counseling that occurs in
school settings. Critics of SFBT have argued that the approach is too
simplistic to meet the complexity of human problems and does not pay
enough attention to the therapeutic relationship or working alliance. Other
critics say the focus on behavioral changes fails to help clients understand or
alter underlying personality traits or embedded ways of thinking. These
detractors argue that SFBT does not give clients lasting skills for change
(Wettersten, Lichtenberg, & Mallinckrodt, 2005).
Multicultural theories.
The profession of counseling has been at the forefront in recognizing the
important role of multicultural counseling (Ratts, Singh, Nassar-McMillan,
Butler, & McCullough, 2016). There is clear awareness within the profession
that to some extent, all counseling is multicultural, and there are numerous
models for multicultural counseling, multicultural identity development, and
multicultural training. However, multicultural counseling, as a theoretical
stance, has not been clearly articulated. Multicultural counseling theories are
in their early stages of development, and more must be done to develop these
theories in ways that contribute to the counseling profession (Comas-Díaz &
Brown, 2016; Kiselica, 2005). In general, counselors who adopt a
multicultural orientation believe one’s culture is the primary determinant of
personality and must be considered when applying therapeutic techniques.
Regardless of whether this approach has developed into a free-standing
theoretical orientation, cultural differences are among the most common
roadblocks to a therapeutic counselor/client relationship. Every counselor
must understand how culturally instilled values and background affect
interactions with clients.
A Social Justice Approach to

Counseling Theory
Multicultural and feminist approaches to counseling theory recognize that
client empowerment is critical to counseling success. More recently, there has
been attention to understanding how all of the existing counseling theories
are embedded with assumptions and values, regardless of whether they are
the more traditional approaches or the more recent post-modern responses. A
social justice approach, called emancipatory communitarianism, reminds
counselors that we must fully understand our own values, assumptions, and
biases before we can ascribe to any particularly counseling theory. If we do
not do this important work on ourselves first, we are likely to continue the
values and assumptions of our chosen counseling theory without awareness
or recognition of how we may be perpetuating oppression and social injustice
(Brubaker, Puig, Reese, & Young, 2010). It is for this reason that as we begin
to discuss the underlying personality assumptions behind each of the major
counseling theories, we ask you to explore your own beliefs and rate yourself
on each of these continua. As you engage in this activity, consider how
finding a theory that aligns to your closely held beliefs and assumptions
might be both helpful (your theory becomes an outgrowth of who you are)
and potentially detrimental (because your theory aligns with your
fundamental beliefs, it may be hard for you to see what assumptions you are
making about clients and their needs within counseling).
Dimensions of Personality Applied

to Counseling Theories
Personality theory and counseling theories are two different animals. In this
chapter, we focus on counseling theories, which are models for cognitive,
affective, and behavioral change. Contrast this with the notion of personality
theories, which are hypotheses about human nature: what makes us tick, what
motivates us, and our basic needs. You can now probably see that most
theories of counseling also contain a personality theory. If we know what
peoples’ needs are, we can find ways to help them change and meet those
needs in a more adaptive way. Rather than go into detail concerning the core
assumptions and underlying philosophical tenets of each theory, let us look at
some common dimensions of personality that shape counseling theories.
Hjelle and Ziegler (1982) identified nine dimensions or controversies about

human personality that are common to all personality theories. Their system
helps us understand the similarities and differences among theories based on
their philosophies about life. We have selected five of these dimensions that
are the most relevant to the therapeutic endeavor. We hope this helps you
understand your own view of human nature and how it might affect your
perceptions of clients and your selection of a counseling theory. As you read
about these dimensions, try to indicate where on the continuum you might
fall. After each of these five dimensions, we ask you to think about personal
experiences that may have shaped your assumption. For example, what life
events made you come to believe that human beings are largely shaped by
their environment rather than by their own choices?
1. Freedom versus Determinism Are human beings the “captains of their

fates” or are we mostly playing out the hand that we were dealt?
Sigmund Freud, parent of psychoanalysis, believed that we were at the
mercy of unconscious forces such as impulses originating in the id. He
also felt that our early lives were the determinants of pathology (e.g.,
oral personality, anal personality). At the opposite end of the continuum
Carl Rogers, the humanistic psychologist, believed that human beings
are free to choose the course of their lives. This assumption about
human nature affects how a counselor proceeds (see Wilks, 2003). Can
everyone grow and change? Must we address the traumas and adverse
events of the past to understand our present and future?
Where do you stand? Think of an experience that influenced your idea

and note it here.
2. Rationality vs. Irrationality Do people make their decisions rationally

and logically, or are they mostly driven by their emotions and other
irrational influences? Is being rational the same as being mentally
healthy? Albert Ellis (1989), founder of Rational Emotive Behavior
Therapy, believed that human beings live best when they are rational.
Their neurotic behavior is based on infantile and unrealistic goals, such
as, “I must be loved!” “I must be perfect!” Psychodynamic therapists
(influenced by Freud) might agree that humans function best when they
are rational but they argue that we are usually driven by irrational forces,
such as sex and aggression. If you believe people should be more
rational, you will be attracted to cognitive therapy. If you believe we
must tame the irrational beast within, you may like psychodynamic
approaches.

and note it here.
3. Proactivity versus Reactivity Does change occur from within or from

without? Does a person decide to change or do outer circumstances
control human behavior? Alfred Adler (1927), a contemporary of Freud,
was one of the first theorists to assert that it is the subjective meaning of
an event that is important and not the event itself. For example, being
the youngest child only affects you if you see yourself as the “baby.”
The causes of human behavior are, therefore, internal. On the flip side,
Skinner’s radical behaviorism asserts that behavior is the result of its
consequences. Thus, people change because the world rewards or
punishes certain behaviors. If you believe change is external, you will
help clients focus on rewards and punishments for the behaviors they are
trying to change. If you believe that humans are proactive, you will
empower them to move toward their inner goals.

and note it here.
4. Homeostasis versus Heterostasis Are people motivated to maintain the

status quo (homeostasis), reduce stress, and maintain equilibrium, or are
they motivated to grow and change (heterostasis)? Are they, like the
turtle, more likely to pull their heads into a shell, or do they stick their
necks out to move forward? Are we basically comfort seeking, or do we
have a need to challenge ourselves to be fulfilled? Are both true at
different times? Family systems theories generally believe that families
seek a state of balance and homeostasis (even when this is unhealthy),
whereas existential/humanistic therapists see people as naturally seeking
growth, expansion, and change. Theorists like Maslow thought that self-
actualization (to be all that you can be) was an inborn potential. If you
believe that we are all trying to achieve homeostasis, you will help
clients find acceptable ways to achieve a healthy balance in life. If you
believe people need to embrace change, you will encourage your clients
to live through the discomfort of personal growth on their way to
something better.

and note it here.
5. Changeability versus Unchangeability There are two competing popular

viewpoints about change. One is that people just do not change or that
they change very little. This point of view is summed up in the
expression, “A leopard never changes its spots.” Another viewpoint is
that people are constantly changing because we grow, develop, and react
to the changes that the environment forces upon us—thus becoming
different people (Watzlawick, Weakland, & Fisch, 1974). Alfred Adler,
one of the most important counseling theorists, said that all human
qualities can be used either on the useful side of life or on the useless
side of life (cf. Adler et al., 1999). The con man can adapt his
enterprising personality to legal pursuits, such as being a car salesman.
Shyness may be difficult to eliminate, but through counseling it is
possible to learn to make small talk, become more assertive, and
recognize the positive aspects of being socially sensitive (Carducci,
2000) (see also, http://www.shyness.com). Overall, counseling theories
mainly agree that people can change. That is our enterprise. They differ
on the degree to which it is possible. If you believe that people do not
change much, then therapy is more a matter of adapting to life rather
than changing one’s basic approach to life.

and note it here.
Some counselors believe that focusing on these core underlying

constructs, such as the ones suggested by Hjelle and Ziegler (1982), is
more important than the theories themselves. In this chapter’s Informed
by Research, you will read about a common factors approach to
counseling, which relies on discovering core conditions that facilitate
change and growth instead of selecting one theoretical approach over
another.
Focusing Your Search for a Theory

To help you gain a little more depth, we have selected four theories of the
twelve listed in Table 6.1. They were chosen because they represent the four
orientations most used by counselors; behavioral, cognitive,
eclectic/integrative, and Rogerian/person-centered (see Table 6.1). These are
not the “cutting edge” methodologies but represent what counselors subscribe
to now. By focusing on these four theories-of-the-moment, we are leaving out
significant (but currently less popular) theories, most notably psychoanalytic
therapy, originated by Freud.
Sadly, we also must leave many interesting theories in the drawer that fall
under the category of “Other.” Among these is William Glasser’s (1965)
reality therapy. In an earlier study, we found that many counselors endorsed
reality therapy as their primary orientation (Young & Feiler, 1994), but in
recent years, reality therapy has received little mention in the professional
literature and little research support. Therefore, we have left it for your own
discovery. We also have not included a complete discussion of systems
theory here. Previously, nearly all marriage, couple, and family counselors
adopted this stance; now, despite the increase in the number of marriage,
couple, and family counselors, their allegiance to systems theory has slipped
considerably (Bike, Norcross, & Schatz, 2009; Freeman, Hayes, Kuch, &
Taub, 2007; Young & Feiler, 1994). Nor have we included feminist
theoretical approaches (Popadiuk, 2015) that every counselor should study
because sexism affects our world, our relationships, and the therapeutic
environment. So, with apologies, and with an understanding that you will
have many more opportunities to explore counseling theories, we now focus
on four theoretical approaches—behavioral, cognitive, Rogerian/person-
centered, and eclectic/integrative—with the reminder that we see our job as
acquainting you with the big picture while hoping we can help you appreciate
the richness of the road ahead.
Informed by Research Common

Factors in Counseling
Effectiveness research into counseling and psychotherapy allows counselors
to state with confidence that, in general, counseling is effective in helping
clients with a wide variety of presenting problems. More than seven decades
of research supports several basic assumptions about counseling: (1)
Counseling helps clients solve problems, reduce symptoms, and improve
interpersonal functioning; (2) the positive effects of counseling can be
achieved in a relatively short amount of time (5–10 sessions) for about half of
all clients in all settings; (3) counseling outcome does not appear to be a
function of any particular theoretical orientation of the counselor (Wampold
& Imel, 2015); and (4) the best predictor of success in counseling can be
attributed to counselor-client relationship factors (Lambert & Cattani-
Thompson, 1996).
Research has not found that any single counseling theory is superior to others
(#3 above), although there are certainly some theories that have more
research studies behind them. One possible explanation for the curative
nature of a wide variety of counseling methods is that all the counseling
theories have similar features at their core, and therapeutic change is
attributed to these common factors. In fact, common factors appear to
account for the most therapeutic change (Lambert & Ogles, 2004).
Michael Lambert, together with his colleagues, has dedicated his professional
life to researching client outcomes in therapy, and his work on common
factors is considered foundational in the field of counseling and
psychotherapy. Specifically, Lambert and his colleagues reviewed decades of
outcome research and meta-analytic studies to draw conclusions about the
contribution of these common factors to therapy outcomes (Lambert &
Barley, 2001). They concluded that the percentages of improvement in client
outcomes that can be attributed to therapeutic factors are the following:
40% extra therapeutic change (external or environmental changes, for

example, client gets a job, or relationship that was causing stress ends)
30% common factors
15% specific techniques employed by the counselor
15% expectancy effect (placebo)
The 40% of improvement that comes from extra therapeutic change is, by its
nature, outside the counselor’s control. This means that the largest percentage
of client change that the counselor can influence comes from the common (or
curative) factors, the most important of which is the therapeutic relationship.
In fact, studies show that the amount of empathy the client perceives in the
counselor is, by far, the best predictor of counseling success. Even studies of
behavior therapies (traditionally less invested in the counselor/client
relationship) support this finding.
In this introductory chapter on counseling theories, there are two very

important “take home” messages from the lifelong work of Lambert:
1. There is no “magic” counseling theory—or at least no empirically

derived answer to what counseling theory is best. Thus, there is no
pressure for new counselors to choose the “right” theory—only the
theory that is right for you.
2. Among variables that are within the counselor’s control, the counseling
relationship is the best predictor of client outcome. The development of
skills and knowledge to enhance the counseling relationship, which has
counselor empathy as its cornerstone, is the best investment of a new
counselor’s time and energy.
Behavioral, Cognitive,
Eclectic/Integrative,
and Rogerian/Person-
Centered Theories
We now address our four theories, chosen from Table 6.1, by talking about
the basic ideas or tenets, the historical contributors, and the settings and
problems that have been helped by the approach. In so doing, we utilize
Hjelle and Ziegler’s (1982) personality dimensions to analyze the theories so
that you can understand their underlying beliefs and compare them with
yours.
Behavior Therapy
There is not one unified approach to behavioral counseling. The big
difference among behaviorists is between those who focus on the role of
thinking (cognition) and those who focus on changing behavior directly.
More cognitively oriented counselors look at the role of thoughts and beliefs,
whereas more behaviorally oriented counselors examine triggers for
behaviors and the patterns that reward or reinforce behavior. Here, we will try
to focus mostly on classical behavior therapy approaches (focusing on
triggers and environmental rewards) while recognizing that there are
relatively few purely behavioral counselors. Most also use cognitive
(thinking) techniques.
Basic tenets of behavior therapy.

Words of Wisdom
“The time has come when psychology must discard all reference to
consciousness . . . . Its sole task is the prediction and control of behavior; and
introspection can form no part of that method.”
—J. B. Watson (1913, p. 158).
Behavior therapy begins with assessment. Assessment is the process of

collecting information necessary for treatment. Assessment in behavior
therapy often uses functional analysis. Functional analysis is a way of
understanding a problem by looking at what precedes it (antecedents) and
what happens after it (consequences). For example, a counselor could use
functional analysis to help a client quit smoking. The counselor assesses what
happens before smoking (antecedents), such as spending time with friends
who smoke or feeling anxious. Next the counselor analyzes the client’s
responses. How much does the client smoke? When does the client smoke?
Where does the client smoke? Finally, the counselor analyzes the things that
are rewarding the client’s smoking behavior. Does the client experience
reduced anxiety, acceptance by peers at the local bar, and so on? Armed with
this information, the behavioral counselor then helps the client identify the
current level of smoking (baseline) and set goals for reduction (target). By the
way, most behavioral counselors would incorporate the client’s thinking
patterns and emotions as an important part of the assessment process. They
would look at the client’s beliefs about smoking such as, “It’s not that bad for
me,” “I would gain weight,” and try to change them. These counselors might
be better labeled cognitive behavioral in their approach.
Learning is important in causing behavior and changing behavior. We learn

to be afraid for a variety of reasons. We saw our parent jump when lightning
struck (vicarious learning); we learned that certain foods made us sick, and
after that, the mere smell could make us queasy (classical conditioning); and
we are rewarded for pretending to be ill by getting extra attention (respondent
conditioning). Similarly, we can unlearn these negative behaviors and replace
them with positive ones. For example, we can learn to respond assertively to
stressful situations rather than adopt the passive attitude that we learned from
our parents. This makes the behavior therapist a teacher who helps us practice
new behaviors and weaken unhealthy ones.
Behavior change is the gold standard. From its inception, behavior therapy
has focused on behavior change rather than emotional change because
behaviors can be measured more easily and reliably. Counselors practicing
this theory normally set targets that can be defined in behavioral terms. For
example, when a client says the goal is to socialize more, the counselor might
get the client to agree to three social events per week and spending at least 15
minutes at each event, chatting with two or more persons. This is a
hypothetical example, but it points out how specific and simple behavioral
contracts can be. When you begin working as a counselor or in your
internship, you might be required to determine behavioral goals for your
clients even if you are not practicing this theory. Agencies and insurance
companies like these kinds of measurable goals. There are a variety of books
that help you think about this and write these kinds of goals, objectives, and
choose interventions.
Problems and settings where

behavior theory is used.
Behavior therapy is often used with children, people with mental disabilities,
individuals who are developmentally delayed, people with phobias, and those
who suffer from disturbing habits. It is frequently used in mental hospital
systems where patients earn points to achieve more freedoms. A behavioral
counselor might help someone overcome fearful stimuli by exposing the
person little by little to the things that are being avoided, such as crowds,
cockroaches, or public speaking. A counselor practicing behavior therapy
might treat a child’s misbehavior by getting the parents to deliver and
withhold rewards to strengthen good behavior and eliminate negative actions,
or help an adult to control eating behavior.
Some counselors shy away from behavior therapy because they see it as
mechanical, reductionist, and manipulative. But behavior therapy is not just
something that the counselor inflicts on the client. Behavior therapy is based
on a theory of how people learn. Many psychoeducational procedures, such
as assertiveness training and anger management, are best taught using
behavioral principles. In fact, behavior therapy is often aimed at giving
clients more self-control. The counselor might teach clients methods and
techniques of contingency management or self-control procedures such as
rewarding or withholding reinforcement to achieve a desired end (e.g.,
Bellack & Hersen, 1985). For example, right now, I (Mark) have made a
contract with myself to write for two hours on this chapter, after which I will
give myself a bowl of ice cream—a big bowl. Can you see that clients can
also use ordinary rewards such as watching TV to gain control over behaviors
that they want to change (Premack Principle)?
Let’s talk about another common behavioral treatment, exposure. Exposure

means repeatedly facing a situation that creates an undesirable emotion or
behavior. Usually, exposure is used when people have debilitating fears such
as thunderstorms or public speaking. Eventually, through exposure, the
situation loses its power, because the feared consequence does not take place
and the person no longer thinks of it as frightening. For example, you might
fear heights because you are afraid you will fall. Repeated exposure to
heights teaches you that you can be safe, lessening the fear that you
traditionally associated with heights. Exposure can be done using imagery or
in vivo by taking the client to the distressing place or slowly showing the
client the feared object. For example, an exposure treatment for those afraid
of flying involves gradually and repeatedly going on airplanes until the
individual eventually actually flies in the plane. Exposure is a common
treatment used by counselors of all theoretical persuasions. Even Freud
advocated getting off the couch and facing fears.
Is behavior therapy effective?

Behavior therapy involves counting and charting success. Thus, research
comes naturally to behavior therapists, and they are more prolific number
crunchers than their counterparts from other theories. Also, the number of
cigarettes smoked is a lot easier to count than the severity of an Oedipal
complex. Compared to other theories, behavioral techniques have been well
researched and have been shown to be effective. Behavior therapy and
cognitive therapy are hard to separate in practice and in research (Horesh,
Qian, Freedman, & Shaley, 2016). Behavior theory has been shown to be
effective in dealing with anger and aggression, anxiety disorders, cigarette
smoking, children’s behavior problems, and marital and family problems, to
name just a few (Gottman & Notarius, 2000; Zinbarg & Griffin, 2008).
Common dimensions of human

nature applied to behavior therapy.
Previously, we discussed Hjelle & Ziegler’s dimensions applied to
personality theory. If we think about how they exist within each of the
counseling theories presented, we will get an idea about their differences on
these dimensions. In the case of behavior therapy, the underlying
assumptions about change are as follows:
1. Freedom vs. determinism: Human behavior is largely determined.

Freedom is a myth (Skinner, 1972).
2. Rationality vs. irrationality: This concept is not applicable to the theory.

Human beings are shaped by the world and whether they are rational or
irrational is not relevant.
3. Proactive vs. reactive: Human behavior is the result of what the

environment rewards and punishes. Therefore, humans are reactive.
4. Homeostasis vs. heterostasis: This concept is not applicable because

behaviorists make no assumptions about human personality, growth, or
balance as human goals or drives.
5. Changeability vs. unchangeability: Behavior therapy falls strongly on

the changeability side of the continuum, but human behavior change
over the lifespan is due to changes in the world and in the manipulation
of rewards and punishments rather than human development.
Important contributors to behavior
counseling.
John Watson showed that anxiety could be classically conditioned in
the famous Little Albert experiments. Watson paired unpleasant noise
with furry stuffed animals to cause Albert to fear furry animals.
Unfortunately, 8-month-old Albert left the hospital before he could be
treated for his fear of furry things that was caused by the experiment.
B. F. Skinner used animal models to understand human behavior. The

Skinner box was created to conduct these experiments. Skinner kept his
daughter in a similar environment. He showed that learning could be
increased using positive and negative reinforcers and decreased by
punishment. Thus, mentally healthy behavior could be learned and
unhealthy behavior could be unlearned. His work has influenced both
counseling and education.
Joseph Wolpe developed systematic desensitization, which theorized

that relaxation was incompatible with fear. Thus, through graded
exposure and simultaneous relaxation, phobias could be treated. Wolpe
once treated a woman for fear of bugs without success until he found out
that her husband was nicknamed after an insect. Marital therapy was
eventually effective in helping her overcome her fears.
Albert Bandura demonstrated the power of models in his Bobo doll

experiments, in which children exposed to violent models acted
violently. His discovery of the role of models to teach positive behaviors
has been a major contribution to therapy and education. In other words,
we learn a great deal by watching others. Bandura has always been
interested in how people disengage from immoral acts and has written
about responses to homelessness, substance abuse, and terrorism. He is
among the most influential psychologists in history.
Cognitive Therapy
Cognitive therapy proposes that changing people’s cognitions is the way to
help them lead happier lives. For example, people who are depressed dwell
on discouraging thoughts. They possess negative beliefs about themselves,
others, and the future. Cognitions are not just thoughts. They include our
“perceptions, memories, expectations, standards, images, attributions, goals
and tacit beliefs” (Reinecke & Freeman, 2005, p. 230). We can easily see that
someone’s misery is often caused by a belief the person holds. For example,
if someone believes that they have been passed over unfairly at work, the
belief can lead to anger, revenge, and depression. But it is not just thinking
about specific past or present difficulties that causes emotional problems.
Some common negative thought patterns also can be the source of emotional
upset: irrational beliefs and cognitive distortions. Irrational beliefs include
such things as believing that one should be perfect in all areas of human
functioning. This thought makes us first anxious and then depressed when we
inevitably fail. Cognitive distortions, on the other hand, are less specific
errors in thinking. An example is magnification, which is the tendency of
some people to make mountains out of molehills, to see things as more
important than they are. The basis of the approach is to get clients to
recognize their irrational beliefs or cognitive errors, challenge them, and
replace them with more constructive beliefs and thoughts.
Although it seems obvious that negative and erroneous thinking is the cause
of much human suffering, exclusively attempting to change people’s thoughts
and beliefs as the major emphasis of counseling did not take hold until the
1960s when Aaron Beck (1964) developed Cognitive Therapy and Albert
Ellis (1962) developed Rational Emotive Therapy. Ellis later started calling
his approach Rational Emotive Behavior Therapy as he recognized the
important role that behaviors play in making changes (Ellis, 1989, 1999).
Many people refer to both as examples of cognitive behavioral therapy (CBT)
or merely cognitive therapy. Most practitioners combine behavioral and
cognitive theories. In other words, it is an integrative approach. The aim is
not just to change behavior but to reduce distress-causing emotions that are
preceded by disturbing thoughts.
Basic tenets of cognitive therapy.

Individuals interpret events in a unique way that affects their behavior and
how they feel. They interpret the world based on schemas, which are
psychological structures that process information and guide behaviors.
Schemas are like maps that are referred to again and again as life progresses.
For example, we may have a schema that guides our interaction with other
people. We may automatically be cautious and untrusting because of
experiences in our early life or the exhortations of our parents. These
schemas are evoked automatically in corresponding environments.
Mental health is another name for having effective behavior patterns and
realistic and rational beliefs. Pathology, on the other hand, is having
unrealistic ideas that cause emotional distress and being unable to achieve
one’s goals because of self-limiting ideas (Kellogg & Young, 2008).
The major method of treatment is to uncover the client’s dysfunctional belief

system and to change it. Cognitive counselors help their clients understand
cognitions that are sources of problems, as well as themes of cognition,
emotions, and behaviors (Sharf, 2000). This involves assessment, individual
or group treatment, and homework.
Words of Wisdom
“The best years of your life are the ones in which you decide your problems
are your own. You do not blame them on your mother, the ecology, or the
president. You realize that you control your own destiny.”
—Albert Ellis

cognitive therapy is used.
Cognitive therapy has been widely used in inpatient and outpatient therapy,
substance abuse treatment, couple relationship enhancement, and marriage
therapy. Ellis’s Rational Emotive Behavior Therapy (REBT) is often used to
treat adults, adolescents, and children in individual counseling and group
therapy. Beck’s cognitive therapy has been the treatment of choice for many
clinicians for the individual treatment of depression, but it has also been used
for panic and social anxiety and in group and couples counseling.
Is cognitive therapy effective?

Cognitive therapy gained support initially because of its effectiveness in
treating depression (Beck, Rush, Shaw, & Emery, 1979; Dobson, 1989) and
anxiety (Butler, Chapman, Forman, & Beck, 2006; Mitte, 2005). Today more
research is being conducted on cognitive therapies than on any other
approach. Prochaska and Norcross (2010) called it the “blue chip growth
selection” because it is “relatively brief, extensively evaluated, medication
compatible, problem focused, and demonstrably effective” (p. 332).
Anxiety disorders such as social anxiety, panic disorder, specific phobia, and
post-traumatic stress disorder have all been found to respond to cognitive
therapy. In addition, cognitive therapy has been used extensively for the
treatment of alcohol and drug addiction (Marlatt & Donovan, 2005) and as a
treatment for couple relationships (Baucom, Epstein, & Taillade, 2002). In
some instances, cognitive therapy has been effective with children and
adolescents (see Butler et al., 2006), but it has been mainly used with adults.
On the other hand, in many studies, there appears to be little difference
between the cognitive therapy and comparison treatments, and some argue
that the success of cognitive therapy seems to have been overblown (Miller,
2015; Wampold & Imel, 2015).

nature applied to cognitive therapy.
1. Freedom vs. determinism: Human beings are not only free but are
responsible for their lives.
2. Rationality vs. irrationality: Both Beck and Ellis believe that human
beings would be better off if they were more rational, but it would be
wrong to conclude that they suggest that human nature is basically
rational. Rationality and irrationality are at war in human beings.
3. Proactive vs. reactive: Human beings are more on the reactive end of the
continuum. Ellis frequently quoted Epictetus, the Stoic philosopher, who
said that it is not what happens to you, but how you react to it that
matters. On the other hand, some branches of cognitive therapy
(constructivists) believe that humans are natural meaning-makers and
actively construct their worlds and it is this construction that must be
changed (Mahoney, 1991).
4. Homeostasis vs. heterostasis: It appears that most cognitive therapies see

human behavior as homeostatic. In other words, human beings are not
motivated to grow as much as they are motivated to reduce negative
emotions. As Ellis (2003) said, the goal is to stop “upsetting” oneself (p.
71).
5. Changeability vs. unchangeability: Cognitive therapy falls towards the

changeable end of the continuum, like all psychotherapies; however,
changing thoughts and beliefs is still considered very difficult. Albert
Ellis said that it can be as hard as convincing a Catholic priest that there
is no God.
Important contributors to cognitive

counseling.
Both Aaron Beck and Albert Ellis, the two key founders of cognitive therapy,
were former psychoanalysts who independently recognized the role of
cognition in emotional distress. Both have been named among the most
influential therapists in history.
Aaron Beck developed cognitive therapy based on his work with

depressed patients. He identified the cognitive triad, a schema that
involved negative views of self, others, and the world. His Socratic
method and guided discovery techniques involve uncovering the client’s
schemas and helping clients develop experiments that can prove that
their view of the world needs to change. The client weighs the options of
keeping or revising core beliefs. Beck published 17 books and about 500
articles.
Albert Ellis developed Rational Emotive Behavior Therapy in its

original form in the 1950s. Until his death in 2007 at the age of 93, he
continued to write and lecture in his charismatic, colorful, evangelical
fashion. His confrontational approach as a therapist and in responding to
critics as well as his espoused atheism and antagonism to religion made
him unpopular.
Ellis once claimed that he overcame his shyness at age 19 by

introducing himself to 100 eligible women at the Bronx Botanical
Gardens (with no luck). This incident taught him that one must test
one’s beliefs (such as “I will die if a woman rejects me!”). Ellis authored
or co-authored about 80 books and more than 1100 articles.
Eclectic/Integrative Counseling
Eclecticism and integration are two words that essentially mean the same
thing. However, integration sounds more like you know what you are doing,
so most of us prefer this term. Either way, it means that you do not have only
one theory that guides you; you may either combine two or more theories or
have one central theory and utilize techniques from a variety of therapies.
This hybrid seems attractive, but it has been roundly criticized, too. Eysenck
(1970) declared that eclecticism is a “mishmash of theories, a hugger-mugger
of procedures, a gallimaufry of therapies and a charivari of activities having
no proper rationale and incapable of being tested or evaluated” (p. 19). Big
words! But eclecticism has come a long way in the 40-plus years since
Eysenck’s statement, and eclecticism/integration has gone beyond the
mishmash stage and, in fact, has much to recommend it. For example,
Prochaska and Norcross (2010) identify the following findings that have
come to light since Eysenck’s comments that support the progress of
eclectic/integrative counseling:
1. There is no evidence that a single theory works for all clients or all
problems.
2. In head-to-head comparisons, no one theory has emerged as superior

(Wampold & Imel, 2016).
3. Common factors such as the therapeutic relationship are far better

predictors of outcome than any theory of the counselor.
4. Clients and third-party payers prefer brief, solution-focused treatment.
5. Clinicians are now more exposed to other theoretical orientations and

techniques, allowing us to see value in other points of view.
6. There are now organizations and journals that publish on eclectic and
integrative practice (e.g., Society for the Exploration of Psychotherapy
Integration and their International Journal of Psychotherapy
Integration).
A systematic eclecticism is best. There is certainly a recognition that sloppy,

wishy-washy eclecticism in which theories are unsystematically combined is
theoretically unsound and rationally indefensible. On the other hand, a
systematic integration is more than a combination; it is a new model that
allows for the blending of what is best and what works. An apt metaphor is
that of quilt making. One way would be to gather the pieces and fit them
together one by one until you have a blanket. Another way is to develop a
pattern and fit available pieces systematically in place (Norcross & Newman,
2003; Young, 2017). An example of a systematic eclectic/integrative theory
is Lazarus’s multimodal therapy (1981), which methodically assesses a
client’s BASIC ID: Behavior, Affect (emotions), Sensations (pain, etc.),
Imagery, Cognitions (thoughts and beliefs), Interpersonal functioning, and
Drugs (including biological issues). Then a treatment plan addresses each of
the excesses and deficits in these areas using techniques from a variety of
therapies. Lazarus uses a behavioral base and then collects appropriate
techniques. Using one theory and including interventions from other theories
is called technical eclecticism.
Eclecticism/integration is practical. Because eclecticism/integration cannot
rely on its theory, it must defend itself on pragmatic grounds.
Eclectic/integrative counselors use what works rather than what is
theoretically consistent. Thus, an eclectic/integrative practitioner is able and
willing to adopt newly developed and evidence-based practices more readily
than one who is entrenched in one theory.
Eclecticism/integration means tailoring counseling to the client. Much more

than other theoretical positions, eclectic and integrative models start with the
client and develop an array of interventions to fit the client’s needs and
problems. Thus, eclecticism/integration easily includes client preferences,
religious and spiritual beliefs, and multicultural considerations. As you can
imagine, some counseling techniques might be culturally or religiously
unacceptable to the client. Thus, the flexible, integrative counselor can utilize
a wider variety of methods, while one who chooses a single theoretical
position normally stays with techniques associated with the theory.

integrative/eclectic counseling is
used.
All counselors learn common curative factors (an integrative notion) when
they learn the basic skills of counseling (Young, 2017). For example, they
learn the importance of establishing a confiding alliance with the client that
connects all the therapeutic approaches (Gelso & Carter, 1985). Although
theories vary widely, the necessity of developing a relationship built on trust
and mutual respect is vital. Thus, most counselors use a common therapeutic
element or a curative factor every day in their work.
There are few settings or populations that have not been exposed to
integrative therapies (Kellogg & Young, 2008). Integrative approaches have
been used in settings that range from play therapy (Gold, 1996) to couples
counseling (Long & Young, 2007). Because integrative therapies often
attempt to modify the treatment to fit the client characteristics (see Beutler’s
Systematic Treatment Selection and Prescriptive Psychotherapy; Beutler,
Consoli, & Lane, 2005), the populations and conditions treated are diverse.
Is eclectic/integrative counseling
effective?
The difficulty in assessing the effectiveness of integrative approaches to
counseling is that there is no standard treatment. The approaches are suited to
the specific client and specific situation. Thus, the process of counseling
differs in each case. Still, the findings of a few studies have found integrative
therapies to be as effective or more effective than control groups over a wide
range of problems (Gold & Stricker, 2013; Schottenbauer, Glass, & Arnkoff,
2005).

nature applied to eclectic/integrative
therapy.
Eclecticism, by its very nature, does not have a unitary theoretical base, and
thus it takes no stand on the basic assumptions about human nature applied to
counseling theory. Thus, the answers of counselors with an
eclectic/integrative perspective would vary. Each counselor who practices
eclectic/integrative counseling probably has individual answers to these
questions based on experience, beliefs, and study of other counseling
theories.
Important contributors to
eclectic/integrative counseling.
Arnold Lazarus (1981) developed multimodal therapy and introduced
the concept of technical eclecticism. This approach advocated adding
and modifying techniques to fit the therapist’s own theory rather than
merging or melding theories. Lazarus made “broad spectrum”
assessment and client-specific interventions key components of
integrative therapy.
Paul Wachtel (1977) developed ideas on integrating behavior therapy

and psychoanalysis, and his focus on the therapeutic relationship has
been influential.
Marvin Goldfried (1980, 1995) and Jerome Frank (1961, 1974) both
identified common factors and basic therapeutic principles as crucial to
counseling success.
James Prochaska and Carlo DiClemente’s Transtheoretical model

(1994) and stages of change have been significant contributions to
research and treatment of addictions of all kinds. They identify client
movement from precontemplation to relapse and recommend different
treatments based on different levels of client readiness (Prochaska,
Norcross, & DiClemente, 1994).
John Norcross, coeditor of the Handbook of Integrative Psychotherapy

with Marvin Goldfried (2005), is the most prolific writer, supporter, and
critic of integrative psychotherapy.
Rogerian/Person-Centered Theory
Carl Ransom Rogers developed an approach to counseling that he first called
client-centered and later person-centered. As we have said, it is widely
considered the most influential theory for counselors, and Carl Rogers has
been identified as the most influential therapist of all time (Kirschenbaum,
2007). Rogers’s 1957 article, “The Necessary and Sufficient Conditions of
Therapeutic Personality Change,” has been cited more than 1000 times since
1980 alone (Elliott & Freire, 2007). In this paper, Rogers advanced his idea
that the counselor must be genuine, have unconditional positive regard, and
have accurate empathy (deeply understand the world of the client). Only
when these conditions exist can the client make real change. What was so
earth-shattering about this little nine-page paper? For one thing, Rogers
focused on empathy rather than diagnosis as the first step. In postwar
America, the medical model, testing, and diagnosis were in fashion. For
another, Rogers focused the therapeutic endeavor squarely on the
relationship. These relationship conditions were not only necessary but also
sufficient—meaning no other methods were necessary. It was not what the
counselor did, but who the counselor was. Rogers rejected the idea that any
list of techniques was crucial for therapeutic change. Acceptance and
understanding by the counselor were the vital elements. The therapy was
nondirective, not emphasizing the counselor’s expertise or cleverness but
rather each person’s humanity.
At least part of the decline of popularity that we see today in person-centered

therapy may be due to its lack of “branding.” All the newest approaches have
a corresponding certification program. Counselors who adopt a new
technique get a diploma and some letters after their name indicating that they
are part of the cognoscenti. But, in the United States, Rogers never formed
such an accrediting body and rejected attempts to standardize or regulate the
practice of person-centered therapy (Thorne, 2003).
In the 1950s, Rogers had conducted and emphasized research to support his
ideas. But by 1964, he had all but given up university teaching, research, and
individual therapy. He became involved in group therapy and world peace
efforts. His absence from research in his later career certainly affected the
direction and standing of the therapy he had created. Those interested in the
fascinating life of Rogers should read Howard Kirschenbaum’s biography
and articles, which are informed by Rogers’s personal diaries and extensive
interviews (Kirschenbaum, 2007).
Fast Fact
Carl Rogers was once named the most influential psychotherapist (Smith,
1982). More than 25 years after Smith’s study, Cook, Biyanova, and Coyne
(2009) polled nearly 2600 therapists and again found Carl Rogers to be the
most influential therapist by a landslide.
Despite Rogers’s absence from research, person-centered therapy became

immensely successful through the end of the 20th century. In fact, it is
probably the success of the Rogerian approach that hastened its decline
because it was accepted as an article of faith rather than a set of challenging
ideas. It was up to others such as Truax and Carkhuff (1967) and Ivey and
Authier (1971) to make Rogers’s approach more available by extracting the
key techniques and describing them in detail so that they could be taught.
Thus, Rogerian techniques became the basic skills that all helping
professionals learn, and they are usually presented apart from the theory (see
Hill, 2004; Young, 2017). For example, empathy has been operationalized as
skills such as paraphrasing, reflecting feelings, and reflecting meaning. These
skills have been incorporated into other therapies (see Patterson, 1985) and
now are considered necessary but not sufficient for therapeutic change.
Although person-centered therapy is changing in the United States, person-
centered therapy is not dead. Today, European counselors are rediscovering
the teachings of Rogers, and there are ever-increasing numbers of
conferences, research studies, and institutes available.
Basic tenets of Rogerian person-

centered theory.
Counseling should be nondirective in terms of allowing clients to talk about
issues that are important to them. Nevertheless, the counselor keeps the client
focused on both cognitive and emotional experience of the problem, not just a
recitation of the facts. Only the client understands the “true subtleties and
complexities” of that person’s own life (Bohart, 2005).
Clients need to arrive at their own decisions. In this regard, Rogers tells a
story (Kirschenbaum & Henderson, 1989) that deeply affected him. In his
early years, a prominent psychologist tried to talk him out of pursuing
psychotherapy as a career. It was described as a mistake that “could never
lead anywhere” (p. 24). Rogers’s decision to continue in his career path and
his ultimate success in the profession reinforced his belief that individuals
know what is best for them. Goal setting is usually not a part of person-
centered counseling. The person-centered counselor accepts people as they
are and takes them where they want to go.
The counselor tries to express unconditional positive regard for the client, not
judging or evaluating the client’s story. The counselor strives to provide
support, which is the optimal condition for growth. The counselor does not
impose conditions of worth on the client, which helps increase the client’s
own sense of positive self-regard.
The counselor shows warmth, which allows an emotional connection to the

client. Warmth allows clients to feel connected to their counselors in a
manner that is accepting and nonthreatening. Warmth may be a difficult
concept to quantify, but for person-centered counselors, it is important to
express positive regard.
The counselor strives to be genuine. Counselors who are genuine act as their
authentic selves and are not phony or superior. This includes self-disclosure
by the counselor, when it is appropriate. It also means being congruent—
where the counselor’s thoughts, feelings, and words match.
The work of the counselor is to reflect what the client is experiencing through
empathy. Empathy is not merely reflecting the client’s feelings but truly
tuning in to the world of the client. The problem of low self-esteem is caused
by the breach between “what I should be” and “how I experience myself.”
Empathy communicates acceptance, which allows the client to accept him- or
herself.

person-centered therapy is used.
Because it is based on acceptance of the client, the person-centered approach
has been influential in counseling clients who are culturally different (see
Cooper & McLeod, 2011; Glauser & Bozarth, 2001). Much of the early
studies were done with students (Champney & Schulz, 1983), including
college counseling centers. Rogers’s work with institutionalized individuals
with schizophrenia had limited success (Rogers, Gendlin, Kiesler, & Truax,
1967). Rice (1988) found that person-centered therapy improved self-esteem
more than other orientations.
In 1947, Virginia Axline published the book Play Therapy, extending

nondirective counseling to children (Axline, 1989). Axline was among the
founders of play therapy, and her work still forms the basis for much of what
is practiced today. Person-centered counseling has become a mainstay of the
approach to working with children and adolescents (Presbury, McKee, &
Echterling, 2007). Unfortunately, person-centered work with young people
has not been shown to be superior to other treatments (Weisz, Weiss, Han et
al., 1995).
Is person-centered therapy
effective?
In the 1980s, person-centered therapy became less popular in the United
States due to the factors mentioned above. Also, there were concerns about
its effectiveness (Lambert, Dejulio, & Stein, 1978). In head-to-head
comparisons, person-centered therapy has not been as effective as cognitive
behavioral approaches with some disorders (cf. Cottraux, Note, Yao, de Mey
Guillard, Bonasse et al., 2008; Reicherts, 1998) but it is certainly better than
no treatment (Greenberg, Elliot, & Litaer, 1994). What these conclusions
miss is that person-centered therapy’s emphasis on the therapeutic
relationship has been incorporated into other therapies such as cognitive
therapy.
Instead of leaving you with these ideas about the shortcomings of person-
centered therapy research, we want to highlight two current trends: (1) the
rise of motivational interviewing, and (2) a new emphasis on the centrality of
the relationship as a common curative factor in all therapies. Motivational
Interviewing (MI) (Miller & Rollnick, 2002) is a person-centered approach
that includes a more directive therapist and an emphasis on focusing on the
client’s ambivalence about change. Motivational interviewing has been
acclaimed by addiction professionals and other health care providers, and its
effectiveness is well documented. The second point is that when we look at
curative factors, those curative elements that we find in most therapies, the
therapeutic relationship is associated with change more than any specific
technique, and the therapist is a crucial element in treatment outcome
(Lambert & Okiishi, 1997; Wampold & Imel, 2015). Norcross’s edited book,
Psychotherapy Relationships That Work (2011), documents the kinds of
therapy relationships that are empirically supported relationships. In short,
research is revealing the importance of the counseling relationship,
something that Rogers espoused from the beginning.

nature applied to person-centered
therapy.
1. Freedom vs. determinism: Rogers’s long experience as a counselor and
working in groups convinced him that people make choices in their
lives. On the continuum, he would be on the extreme end. Freedom is
part of the basic makeup of human beings. People naturally grow
throughout life toward more inner direction, and they should be given
that freedom in the counseling relationship.
2. Rationality vs. irrationality: Although Rogers may have believed that

rationality was part of the basic personality of people and was enhanced
as they grew, he did not necessarily believe that it was the best way to
make decisions or deal with life. He sometimes talked about how he
made some of his best decisions based on inner promptings and intuition
(Kirschenbaum & Henderson, 1989).
3. Proactive vs. reactive: Again, we find Rogers on the extreme proactive

end of the scale. In Rogers’s view, the fully functioning person was
growing and was aimed at the future. People are naturally growing; what
they need are the right conditions to flourish.
4. Homeostasis vs. heterostasis: Rogers believed that people are motivated
to self-actualize, to be all that they can be. This places him firmly in the
heterostasis camp. Thus, the goal of human life is not to achieve
balance, but to embrace challenge and growth.
5. Changeability vs. unchangeability: While counseling theories all fall

toward the changeability end of this scale, Rogers tips the scale with an
emphasis on changeability built into the very fabric of his theory. People
are constantly growing and changing due to the master motivating
principle of self-actualization. Change is inevitable and you become
more free and more realistic through personal growth because you are
true to yourself.
Important contributors to person-

centered counseling.
C. R. Rogers formulated the basic tenets and did the initial research into
person-centered counseling. His books and films had such an impact that
he has frequently been named the most influential psychotherapist.
W. R. Miller (Miller & Rollnick, 2002) was not a disciple of Carl

Rogers but developed his treatment of addictions based on person-
centered treatment and rigorous research. His approach, Motivational
Interviewing, involves expressing empathy, developing discrepancies,
rolling with the resistance, and supporting self-efficacy (seeing the self
as capable).
How do Counselors Choose a
Counseling Theory?
Sometimes the selection of a theoretical approach is predicated on the
foundational beliefs a person holds and the type of counseling they wish to
practice. For example, in this chapter’s Spotlight on Pastoral, Biblical, and
Christian Counseling, the setting and the religion prescribe the approach that
the counselor will use.
For most counselors, however, the choice of a theoretical orientation is

strongly influenced by their initial training program. We admire the views of
our teachers and supervisors. Some counseling programs ask students to
adhere to a specific theory or philosophy, but most ask students to select one
and use it as the initial foundation for their work with the understanding that
they may later change their minds. As a personal research project, we suggest
you talk to your professors and fellow students. Does your program subscribe
to a viewpoint? Do most the professors hold similar views? What are the
theoretical orientations of your teachers?
SPOTLIGHT Pastoral, Biblical, and

Christian Counseling*
Professional counselors, whether they are working within a pastoral setting or
not, should acknowledge and accept that a client’s religious and spiritual
beliefs are crucial in their counseling. However, since the time of Freud, there
has also been an assumption that religious faith is psychologically unhealthy.
About 80% of Americans consider religion to be important and about 70%
Americans call themselves Christians (Pew Research Center, 2017). If the
counselor does not acknowledge this perspective, counseling will be missing
an important part of the client’s worldview. Some conservative Christians
may be afraid to seek counseling from someone who is not labeled a
“Christian Counselor” (Belaire, Young, & Elder, 2005). Yet, as the title of
this Spotlight suggests, Christians who are counselors vary in the way that
they approach Christian Counseling. In this Spotlight, we try to describe the
forms of Christian counseling because when a client wishes to have faith
incorporated in counseling, it is important to know the contrasting approaches
that are available (McMinn, Staley, Webb, & Seegobin, 2010).
Pastoral Counseling
Pastoral counseling is counseling provided by ministers, priests, rabbis, and
other religious leaders primarily, but not exclusively, to their congregations.
The American Association of Pastoral Counselors (AAPC) is an organization
of ministers who work or practice counseling. The AAPC website (http://
aapc.org) provides a registry of pastoral counselors with advanced degrees.
Another related organization is the Association for Clinical Pastoral
Education (ACPE) (http://www.acpe.edu). ACPE is primarily an educational
organization that promotes better pastoral helping in all religious traditions.
Their well-known training program leads to certification in clinical pastoral
education and, as of this writing, has no requirement that members be
ordained ministers.
Biblical or Nouthetic Counseling

Biblical counseling is an approach that rejects mainstream counseling and
psychology and believes that counseling should be based solely on the Bible
and focused on Christ. Thus, many such counselors work in church
counseling centers and may not be licensed. This is possible because many
states exempt churches from licensure requirements. Biblical counselors have
their own professional organizations, and there is a clear divide in the
community between biblical and other Christian counselors. Attempting to
bridge the gap, the American Association of Christian Counselors (AACC) is
a Protestant evangelical organization that represents both biblical and
Christian counselors. On its website, it offers referrals to licensed mental
health providers.
Christian Counseling
There is no a single definition for Christian counseling because Christianity is
a multifaceted religion (from Roman Catholics to Evangelical Protestants). In
contrast to biblical counseling, most Christian counselors are integrative,
believing that the findings of counseling and psychology can be utilized in
concert with the Christian faith. The Christian Association for Psychological
Studies (CAPS) is an interdisciplinary organization for therapy professionals.
Their publication, Journal of Psychology & Christianity, is peer reviewed
and melds religion and therapy. For example, a recent article examined
acceptance and commitment therapy from a Christian perspective.
*Thanks to Jesse Fox, Bryce Hagedorn, and Elizabeth Pennock for their
review of this Spotlight.
When you reach the field experience component of your counseling program,
you will no longer be under the sway of your teachers’ ideas and may be
more influenced by your field supervisors. Some students radically shift
theoretical positions during practicum or internship in favor of their
supervisor’s position. After all, these people are working in the field and
certainly they must have the answers. They seem to know what is practical.
But there are counselors working in the real world with a variety of
orientations. Ultimately, it is not a question of finding “the answers” but
rather finding “your answer” (Halibur & Vess Halibur, 2006).
Words of Wisdom
“For most therapists, the choice of theory is a slowly evolving process, the
result of study and, most important, supervised psychotherapy or counseling
experience.”
Source: Sharf (2000, p. 22).
Your answer to the question about which theory to adopt might be to find one
that is consistent with your personal life philosophy and past experiences. For
example, Alfred Adler, whom we have referred to before (yes, he is a
favorite), identified one basic human drive as the desire to overcome feelings
of inferiority and to be superior (Adler, 1907). In fact, Adler had many
physical infirmities that influenced his decision to become a physician.
Similarly, some students choose theories because they have been through an
existential crisis, struggled with an addiction, experienced family problems,
or suffered abuse. It need not be a personal weakness or trauma that pushes
you in a certain direction. It may be a strength. Your personal warmth,
growth philosophy, and nonjudgmental nature may make person-centered
therapy the right fit for you. Throughout this chapter, we hope you have
reflected on the tenets of some theoretical positions and considered how well
they fit with your own viewpoint.
Counselors also choose or change their theories as they gain experience.

They see what works and what fits. In many ways, this makes sense, because
a theory should be effective in the field. In fact, your theory might be shaped
by the kinds of clients you encounter. If you counsel adolescents, you might
easily be persuaded to adopt choice theory (Glasser, 1998) (the new version
of reality therapy). This theory places a great deal of emphasis, as the name
suggests, on helping people recognize that the only person we can control is
ourselves and that our choices are internal, not forced on us by the
environment. You can imagine that this approach is effective with
adolescents, who may have difficulty accepting responsibility for their
actions. Similarly, if you work in a clinic where clients are limited to six
sessions or in a school where you have limited time to interact with students,
you might find that Brief Solution Focused Therapy or some other brief
approach makes sense.
Finally, you might work in a place where everyone subscribes to the same
theory. For example, a substance abuse treatment center might require
counselors to be familiar with the “disease concept” of alcoholism or with
motivational interviewing. You might work in a family support center where
everyone practices functional family therapy and receives training and
supervision in that approach. So, your practicing theory might be guided by
your place of employment rather than personal choice.
Counseling Controversy One
Theory or Many?
Background: Some believe that counselors should, early in training, adopt a
single theoretical position, while others believe that students should be
exposed to a variety of theories.
COUNTERPOINT: LEARN MANY

POINT: LEARN ONE THEORY THEORIES AND POSSIBLY
COMBINE THEM
Counseling is complex.
Utilizing one theory simplifies
the process. It is too early in One theory is severely limiting.
your training to branch out. What happens when a client does
Eclecticism or integration not respond to your theoretical
requires complete knowledge position? For example, what if the
of many theories. client feels early childhood issues
are irrelevant?
If you know one theory
completely, you, as a beginning In general, no theory has been
counselor, will feel more shown to be more effective than
confident. It is better to be fully others, but some specific
versed in one theory than to techniques have been shown to be
have a little knowledge of effective. It’s better to learn the
many. most effective techniques,
regardless of theory.
Deciding on a technique to use
with a client is simplified with Probably no one except the
one theory. You learn the founder agrees with all the tenets
techniques associated with your of a theory. Not every aspect of a
theory and you apply them with theory will be palatable to you.
everyone.
How can a counselor change and
When using more than one adapt to new findings while
theory, might a counselor holding fast to one theory? If
include elements from one some effective new technique is
theory that are incompatible developed that does not fit with
with another? Having one your theory, would you not use it?
guiding theory means that you
are being consistent.
Questions to Consider

argument.
On What Basis Should I Choose a

Counseling Theory?
In true Rogerian fashion, we recognize that we cannot make this choice for
you. It would be like buying a suit without knowing your size. But we do
have some suggestions to help you think about it. First, we suggest that you
read extensively and, at the same time, withhold judgment if you can. Many
people reject Freud out of hand until they read his work (try On Dreams,
1952). In short, you need more exposure to the varieties of theories before
you can make a reasonable choice. After all, in this chapter, we only touched
on four theories of the many hundreds that exist. Watch videos of famous and
non-famous people practice specific theories. Leave your options open as you
collect the data on a wide range of theories.
Second, do not be afraid to consider the research evidence behind a theory or

a technique. Just because a lot of people have faith in a theory does not mean
that it works. Of course, one of the problems here is that behaviorists and
cognitive behaviorists do most of the research. That does not mean that one
should abandon everything else. Still, if a theory has no evidence beyond the
fame of the theorist, you might be skeptical.
Third, engage in self-examination. Go back over this chapter to see how your
ideas match with the common dimensions of human nature that undergird the
various theories. Reconsider those incidents and experiences that we asked
you to note when you were thinking about those common dimensions. Does
any pattern start to form? Another way to reflect is to engage and debate with
fellow students. Their ideas can help you become more aware of your own
thinking. Ultimately, before you can pick a theory of counseling, you must
know yourself and your values. The opportunities for reflection at the end of
this chapter and other chapters are ways of thinking about what you have
learned, may help you consider whether you agree or disagree, and allow you
to explore those theories that interest you.
Finally, in this chapter’s Counseling Controversy, we asked you to consider

the question that we raised in the very beginning of the chapter: Does a
counselor need a theory to be effective? Now that you have had a chance to
explore how counselors use theories, and what underlying beliefs about
personality and how people change inform the major theories of counseling,
we offered to opposing opinion about the selection of a theory to guide your
work: one theory or many . As you read through the controversy, what did
you think about the two ideas presented? What strategy do you think you will
follow?
Summary
In this chapter, we discussed the role of theories in the practice of counseling.
Counselors use theories of personality to help them conceptualize how people
grow and develop, get their needs met, and interact with others and the
environment. On the other hand, counselors use theories of counseling to help
them understand how people change. There are hundreds of theories that help
counselors plan treatment for a client, but most counselors use one (or more)
of about a dozen common theories of counseling. None of these theories has
been shown to be convincingly superior to the others, although some have
more research supporting their use with specific client groups or diagnoses.
Theories are constantly evolving and changing, and counselors who adopt a
theory (or theories) to guide their practice will want to continue to stay
abreast of the research and writing in the field.
Student Activities
What were your reactions as you read that portion of the chapter? What
do you want to remember?
2. As you learned in the chapter, one of the reasons counselors adopt a

theory is because of their own personal experiences. Select a theory
from this chapter that most appeals to you. Consider messages from
your family or experiences that you had as a child that align with this
theory. How do your early experiences and messages influence your
choice of theory?
3. Now consider one of the theories that is not appealing to you. What is it
about that theory that makes it challenging for you to accept? Instead of
just tossing the theory aside without further exploration, what can you
do to more fully explore the theory so you have a clearer understanding
of it?
Journal Question
1.
Review the common dimensions of human nature as the starting point for
your journal. Recall your answers to the question “Where do you stand?”
(freedom vs. determinism, rationality vs. irrationality, homeostasis vs.
heterostasis, proactivity vs. reactivity, and changeability vs. unchangeability).
As you think about these dimensions, what experiences shaped your beliefs?
Did these beliefs mainly come from family, church, teachers, or were they the
result of personal experiences? What personal factors other than these might
influence you to adopt a counseling theory?

1.
In this chapter we presented some research that claims counselors are

more likely to embrace cognitive and Rogerian/person-centered
positions than other mental health professionals. As we said in Chapter
1, the person-centered theory of Carl Rogers is a foundational and
historical element of the counseling profession. Because Rogers is
widely loved by counselors, the diametrically opposite theory,
psychoanalysis, may be less popular. But why have counselors adopted
cognitive therapy to such an extent?
Of the theories described in this chapter, which seem most attractive to

you now? Why?
We have not discussed psychodynamic/psychoanalytic theory very
much in this chapter. We have mentioned Freud, but not those
psychodynamic thinkers who came after him. Just because this theory is
not popular, should it be neglected? Should every counselor understand
the 12 theories identified in our list?
Experiments
1. Next time you listen to a friend’s problem, try using Carl Rogers’s
approach of listening, just being genuine, providing unconditional
positive regard (being neutral and yet supportive), letting the other
person know that you understand. How hard was it to give up being
judgmental and giving advice?
2. Consider the following list of words and phrases:
1. I did great on the test, I was awful
2. Large and small
3. Easy and hard
4. You are for me or against me
Now try to find a word or description that falls in the middle of each of
these two positions. Human beings create these false dichotomies as if
they must choose between two extreme positions. For example: I am
good in math, I am terrible in math. In cognitive therapy, this is called
black-and-white thinking. When a crisis occurs, do you imagine the
worst that could happen or the best that could happen? Or do you
recognize that the most likely outcome is somewhere in the middle?
What are the consequences of thinking in extremes? What feelings
might be activated by these opposing thoughts? Can you see how a
client’s problems might be caused or worsened by this kind of thinking?
Explore More
1.
Books
Greenberger, D., & Padesky, C. (2016). Mind over mood: Change how
you feel by changing the way you think. New York, NY: Guilford.
Halibur, D. A., & Vess Halibur, K. (2015). Developing your theoretical

orientation in counseling and psychotherapy (3rd ed.). Upper Saddle
River, NJ: Pearson.
Rogers, C. R. (1961). On becoming a person: A therapist’s view of

psychotherapy. New York, NY: Houghton Mifflin.
Articles
Skovholt, T. M., & Rønnestad, M. H. (1992). Themes in therapist and
counselor development. Journal of Counseling & Development, 70(4),
505–515.
Spruill, D. A., & Benshoff, J. M. (2000). Developing a personal theory

of counseling: A theory
building model for counselor trainees. Counselor Education and

Supervision, 40, 70–80.
Watts, R. E. (1993). Developing a personal theory of counseling: A brief

guide for students. TCA Journal, 21(1), 103–104.
Films
Kirschenbaum, H. (2003). Carl Rogers and the person-centered
approach [60-minute DVD].
Distributed by American Counseling Association, Alexandria, VA.
Shostrom, E. L. (Producer). (1965). Three approaches to psychotherapy

[Motion picture]. (Available from Psychological Films, Inc., 110 N.
Wheeler, Orange, CA 92669)
These are the classic Gloria films. While the clothing and the words
may seem dated, it is a chance to see three master counselors work with
the same client. You may also find these at online video sites.
Chapter 7 How Do Counselors Use
Research?
Questions
How professional counselors use existing research to help make

decisions about their counseling practice.
Why counselors conduct their own research to understand their own

counseling effectiveness.
Describe the major types of research that counselors can use to assess
the effectiveness of their counseling.
Differentiate between academic and popular media sources for research

and knowledge in the counseling profession.
Understand how to assess the quality of information found on the

Internet.
Use specific strategies to read and understand a research article.
How do counselors know that what they do works?
What steps might you take as a counselor to know if the interventions

and programs you are implementing have the best chance of success?
What is your belief about the role of research in counseling? How will
your beliefs affect your willingness to read and use, or conduct your
own, research?

There is evidence that, in general, counseling works. When clients go to
counseling, most of them improve more than they would have if they were in
a placebo or control group. More than 60 years’ worth of research supports
this statement. In fact, a seminal study by Smith, Glass, and Miller (1980)
concluded that at the end of treatment, the average psychotherapy client is
better off than 80% of the untreated sample. The difference in improvement
has been found in school counseling, too, where study after study has found
significant improvements in discipline problems, problem-solving ability,
career readiness, and academic achievement (see Whiston & Quinby, 2009,
for a review of the research). Clearly it is important for new counselors to
know that there is strong evidence that counseling is effective for a multitude
of client problems and concerns. But knowing that the general practice of
counseling is effective does not mean that any individual counselor can have
confidence that any specific client is improving, that any isolated technique
or intervention is working, or that any particular program is effective. This is
the goal of research. Counselors use research in a multitude of ways.
1. Counselors read existing research and scholarly writing in books and

journals to know the most up-to-date interventions and programming
that have been supported in the research.
2. Counselors measure the effectiveness of their own interventions and

programs, typically with outcome studies that use pre- and
postassessments.
3. Counselors engage in action research to better understand the process of

their counseling and to reflect on the data they collect in order to
develop an action plan for their counseling.
4. Counselors share the results of their research with others in the

profession through conference presentations, publications, or reports, so
that others might use the results to enhance their own counseling.
This chapter is about learning to think like a researcher, to be an investigator

of understanding your clients, their world, and how best to help them. In
some ways, adopting an investigative stance is like becoming a detective, and
your client (or counseling program) is the mystery to be explored.
A note to the “statistic phobic”: Most people enter the field of counseling
because they prefer people over numbers. In fact, we have found that many of
our students prefer not to engage in “number crunching,” and, in fact, are
extremely anxious about the whole idea of statistics and research. Many have
had bad experiences in math or statistics classes and face their graduate-level
statistics or research classes with dread. Rest assured. This chapter is not
about statistics or math. It is about developing an inquisitive mindset—
becoming an investigator—adapting a stance where you are constantly
reflecting on your own work and looking for ways to make it better. Sigmund
Freud viewed every case as its own research study. He believed the analyst
(counselor) should become an investigator, learning the subjective world of
the client and understanding the effects of the therapy for that person. That
investigative nature has become a core belief in many more contemporary
theories. Using scholarly research and writing and conducting research on
your own counseling means carrying that inquisitive stance one step further
—moving that investigative nature from a system of beliefs to a method of
action.
Many counselors are hesitant to engage in research because they think it

means complex methodologies and statistics. You might think that because
those are most often the types of research studies that you see published in
professional journals. But the reality is that collecting your own research can
be as simple as asking a few questions before and after an intervention, and
then making a graph of the results. It can mean collecting some written
responses to open-ended questions after the completion of a program. Yes,
research can be complex and statistically sophisticated, but it doesn’t have to
be. As long as your research answers the questions that you pose (“Do my
students learn how to make assertive statements?” “Did my client become
less depressed?” “Do the parents value the newsletters that I send home?”),
then your research meets your needs.
Why Counselors Use Research
In an age of ever-increasing accountability, counselors are being called upon
to show evidence that what they do works. Schools, agencies, hospitals,
businesses, higher education—all of these settings have moved toward
accountability-based operations. Traditionally, however, counselors have
been more concerned about their relationships with their clients than with
proving that what they do is effective. In the past, counselors might have
said, “I think that my clients improve—or at least I hope they do. I know that
I have very good relationships with my clients, and I put a lot of effort into
working with them.” Or, in the schools, “I know my work is successful
because I am helping students develop essential life skills.” However, that
approach is no longer acceptable. Counselors must be prepared to back up
their claims with data.
But how do counselors really know that what they do works? How do they
know what interventions have the best likelihood of success, and which ones
may actually harm the client? How do they know that the programs they
implement have the intended results? In this chapter, we will see why
counselors need to use the existing research and literature to make decisions
and how those decisions are made. We also will discuss how counselors can
conduct their own research to determine the effectiveness of their counseling
or counseling programs. This chapter is not intended to take the place of a
statistics or research class. Rather, we will encourage you to consider how
research can inform your counseling practice and give you some general
guidelines for how to use research effectively.
There are at least two major reasons why counselors use research. The first is
a reactive approach that considers research as a response to external
pressures. From this view, counselors use research because other people,
primarily those who pay for our services, want us to prove that what we do
works. The second is a proactive approach that uses research to enhance the
quality of client care. In this approach, research is a response to internal
pressures—we want to know that we are providing the best possible care for
our clients. Both the reactive and proactive approaches are valid reasons for
using research, and taken together, they underscore the importance of the role
of research in counseling.
The Reactive Approach:

Responding to External Pressures
More and more Americans are using mental health services. Estimates are
that one in five adults will have a diagnosable mental disorder sometime
during their life that will require treatment. In addition, many children require
mental health intervention, and even more would benefit from interventions
by a school counselor. Given this tremendous need, it is clear that there are
insufficient resources. Therefore, priorities for funding must be determined.
Fast Fact
More than 75% of practicing counselors in one study said that they regularly
read research.
(Source: Bezyak, Kubota, & Rosenthal, 2010).
In community agencies and schools with limited funding, there is constant

pressure to make sure funds are used in the most cost-effective way. There
are a limited number of treatment hours available, or a limited number of
groups or outreach programs that can be supported. Counselors who can
prove the effectiveness of their interventions will have a greater likelihood of
support for their programs, groups, and clients. In many hospitals and
agencies, quality assurance models require ongoing investigation into the
effectiveness of interventions in order to receive accreditation. Even
counselors who do not conduct research on their own interventions must be
sure that they are using the most up-to-date and relevant treatments for their
clients.
Clinical and community mental health counselors as well as marriage, couple,

and family therapists and rehabilitation counselors are faced with managed
care and other third-party payors, such as insurance companies, that limit
treatment. They also face funding for community treatment centers that is
always inadequate to meet the needs. In this environment, counselors are
increasingly being called upon to demonstrate the effectiveness of their
counseling interventions. The ability to demonstrate treatment success is
rapidly becoming the standard by which reimbursement is determined. In
other words, counselors who cannot demonstrate the effectiveness of their
interventions may have difficulty getting on managed care provider panels or
convincing insurance companies to pay for treatment.
The argument presented by these external funding sources is that counselors,

just like all professionals, must be able to prove that what they do works.
They must demonstrate that, in general, they use the most up-to-date and
empirically supported treatment interventions. Further, they must support
their claim that these interventions lead to treatment success. In this vein,
insurers might argue, “We wouldn’t allow treatment by medical doctors who
couldn’t prove that they were using the latest treatment with the greatest
chances of success. Even if the doctor was using the most up-to-date
treatment, we would also require that the doctor demonstrate that the patient
actually gets better. The same standard should hold true for the counseling
profession.”
Words of Wisdom
The question has often been posed, “What do school counselors do?” The
more important question, and one that you will want to answer in your role as
a school counselor, is: “How are students different because of what school
counselors do?”
ASCA National Model, 2012.
Within school systems in general, there is a large-scale movement toward

accountability. Most people agree that what school counselors contribute to a
school is important. However, in times of tight budgets, school counseling
programs may be at risk. Whereas everyone in the school understands what
the math teacher does—and math class is specifically linked to proficiency
tests and other measures of accountability—fewer people understand and can
demonstrate the direct impact that school counselors have on the success of
the school and the students in it. School counselors must be able to show the
effectiveness of their interventions, demonstrate to the principal and parents
how their time is spent, and whenever possible, link their interventions to
academic success. School counselors who can speak the language of
accountability in relation to their own programs have a greater chance of
receiving the support they need. The ASCA National Model recognizes the
importance of evaluation of effectiveness. A core component of the model is
that comprehensive school counseling programs are multifaceted and
designed with continuous evaluation and modification in mind (ASCA,
2012).
External pressures to work from a research base also can come from the legal
system. Counseling professionals must operate within the standards of care of
the profession. Standards of care can be defined as professional conduct as
practiced by “reasonable and prudent practitioners who have special
knowledge and ability for the diagnosis and treatment of the relevant clinical
conditions” (Granello & Witmer, 1998, p. 372). These standards are
determined by what others in the same discipline would do under similar
circumstances. In order for counselors to prove that they are operating within
the standards of care of the profession, they must be able to prove that the
interventions that they used for a particular client are “either considered
standard practice or at least accepted by a significant minority of other
professionals” (Meyer, Landis, & Hays, 1988, p. 15). One very effective way
to support that what you are doing is considered the standard practice in the
field is to point to existing research that supports your intervention. For
example, if a counselor were using cognitive therapy with a client suffering
from depression, the counselor could point to a large body of research that
supports this intervention. If, on the other hand, the counselor were using
primal scream therapy with the same client, the counselor would have a more
difficult time proving that this intervention was supported by the most up-to-
date knowledge in the profession. Not meeting the professional standards of
care is considered negligence, which can ultimately lead to a determination of
malpractice (Granello & Witmer, 1998).
The reactive approaches, or pressures from external sources, are indicative of

the environment in which most counselors practice. Proving effectiveness to
these external sources may well influence—or perhaps even determine—
whether you will be paid for your work (Granello & Granello, 2001). Using
treatments and designing programs that are well situated in the research and
scholarly literature is called Evidence Based Practice (EBP). Using EBPs can
help justify to courts, third-party payers, and school administrators why the
chosen interventions have the greatest chance of success. They can reassure
clients that we are engaging in appropriate counseling practices, and they can
help justify the importance of counseling to state legislatures, to healthcare
providers, and to constituents in school districts deciding whether to support
school levies to pay for more school counselors. All of these are valid and
appropriate reasons to keep abreast of the current research in the field and to
initiate your own research into the effectiveness of your own counseling.
Although most in the profession agree that this evidence-based approach is
beneficial, it is not without its critics. Some argue that an overreliance on
EBPs can limit clinical innovation and stifle creative approaches to
counseling. In this chapter’s Counseling Controversy, you will read about the
arguments on both sides of this issue. In reality, few counselors believe we
should throw away all the research and do simply what “feels right”—and
few believe that every statement we make or intervention we do must be tied
100% to conclusive empirical research. Nevertheless, most counselors find
that they lean toward one side of this continuum or the other. As you read
through the controversy, think about what you believe to be the role of
evidence based practice in your own future work as a counselor.

Counselors Use Only Evidence-
Based Interventions or Should they
Rely on Clinical Wisdom?
Background. A major trend in medicine and in mental health is a call for
evidence-based treatment. This is the idea that clinicians should use only
scientifically validated treatments. However, practitioners have long relied on
“clinical wisdom” in their work, measuring success through experiences with
clients.
COUNTERPOINT: COUNSELORS
POINT: COUNSELORS
SHOULD RELY ON THEIR OWN
SHOULD USE EVIDENCE-
EXPERIENCE AND CLINICAL
BASED INTERVENTIONS
WISDOM
A “seat-of-the pants” approach

to counseling means that Counseling is an art. The great
counselors use whatever is therapists are artists, not scientists.
familiar rather than what has The core of counseling is the
been proven to work. As the relationship, which is not
saying goes, when you only quantifiable or measureable.
have a hammer, everything Reducing all counseling to
looks like a nail. evidence-based practice
undermines the counseling
Scientific study is the only relationship.
rational method for
determining what works. We Research is mainly based on
can then develop protocols to averages. Individual clients do not
guide treatment, giving always respond to the standard
counseling the best chance of treatment because of their
success. This is the care our differences.
clients deserve.
Through the accumulation of
Counselors sometimes use fad experience, a counselor gains
treatments rather than those important knowledge about what
that have been tested. works in the real world.
Scientific study frequently Outcome research limits clinical

reveals that commonly used innovation by encouraging
approaches do not lead to clinicians to do only what has been
improvement. Intuition and proven effective, rather than to try
“wisdom” are subject to error. new ideas and techniques. How
can the profession ever move
forward?
If counselors don’t understand It is clear that many practicing
how to read existing research counselors neither read research
or conduct their own research, nor engage in their own research.
that is an issue of training. It Clearly, research-driven practice is
does not mean we should not valued by practicing
abandon the use of research in counselors.
our counseling practice.

argument.
The Proactive Approach—

Responding to Internal Pressures
On the proactive side, counselors use research and data to make sure that
their programs and interventions with their students and clients are the most
up-to-date, have the greatest chances of success, and give every client the
greatest opportunity for improvement. Keeping up with the research and
literature as well as monitoring your own counseling and interventions is a
form of quality assurance.
Imagine that you are a counselor working with a client who has come to
counseling because she has panic disorder, a mental health disorder that is
characterized by frequent and uncontrollable panic attacks. The panic attacks
seemingly come out of nowhere and immobilize the client with fear. During
these attacks, her heart races, her breathing becomes shallow, and her arms
and legs begin to tingle. She thinks she is having a heart attack or running out
of air. Her own cognitive reactions to the attack—thinking that she is dying—
simply serve to escalate the physical sensations of panic. As her counselor,
you use a variety of interventions, including teaching the client a relaxation
technique called “progressive muscle relaxation.” You reason that if the
client is anxious and panicked, you should use several different techniques to
try to teach her to relax, and you know that Progressive Muscle Relaxation
(PMR) is a standard relaxation exercise. Although this reasoning appears to
make sense, the research shows that PMR actually has mixed results for
clients with panic disorder, with some studies demonstrating that this
technique can lead to higher rates of dropout among clients and may reduce
the effectiveness of other interventions that may be used in conjunction with
PMR (Beamish et al., 1996). Or, let’s say you are a school counselor working
with a child with Oppositional Defiant Disorder (ODD), characterized by
recurrent hostile, negative, and threatening interactions. The parents of the
child have tried everything, and they are desperate for assistance. Their
child’s counselor has recommended a boot camp specifically designed for
children with this disorder. They are also considering a “shock incarceration.”
You have seen television programs about these interventions, essentially
designed to scare children into compliance. The research, however, does not
support these types of fear-inducing programs. In fact, exposure to these
scenarios only serves to worsen such aggressive behaviors through
heightening the fear-aggression reaction or modeling deviant over-reactions
and may, in fact, increase odds of future delinquency (Petrosino, Turpin-
Petrosino, Hollis-Peel, & Lavenberg, 2013; Steiner & Remsing, 2007).
In other words, even though you may know the general methods for
interventions, and even though you may have the best of intentions for
improving your client’s functioning, not knowing the research in both of
these instances could have unintended consequences. Although there are
certainly external pressures to know the research, these cases represent an
internal pressure. As a practicing counselor, you will want to know that what
you are doing with your clients has the greatest chance of success—or at the
very least, the minimal chance of harm. As these cases represent, keeping up
with the research literature is essential.
In addition to making individual counseling decisions, research can be used

to justify, alter, or withdraw support for larger scale counseling programs.
For example, between 1983 and 2009, millions of school children in the
United States were exposed to the D.A.R.E. (Drug Abuse Resistance
Education) Program, which was implemented in more than 75% of public
schools. Maybe you were part of a D.A.R.E. Program, and you may recall
that it was designed to teach children to say no to illegal drugs. Although well
intentioned, the program’s effectiveness began to be called into question as
early as 1998, when research demonstrated that it had little to no effect.
Beginning in 2009, the program was completely redone based on available
research. Among children who were already using illicit drugs, completion of
the new D.A.R.E. program resulted in a 72% reduction of drug use, compared
to those in the control group (Kulis, Nieri, Yabiku, Stromwell, & Marsiglia,
2007). In this case, research was used to alter this intervention program to
make sure it was providing the desired outcomes. One researcher who
published some of the most unfavorable research results from the original
D.A.R.E. program said about the new program “They are going the right
route now—it’s based on science” (S. West, as quoted in Nordrum, 2014).
Critical Incident Stress Debriefing (CISD) is yet another example of a large-

scale intervention that was well intentioned and originally thought to work,
but is no longer considered a counseling best-practice. After the attacks of
September 11, 2001, there were many efforts by counselors and others in the
helping professions to relieve the suffering of those affected and to help
minimize the potential of Post-Traumatic Stress Disorder. CISD is a highly
structured, group-based intervention that relies on recall of images and
emotions of the trauma and normalization of the trauma reactions. Research
on CISD prior to 2001 had been sporadic because of the relatively low
frequency of group exposure to trauma prior to that time. The large-scale
nature of the 9/11 attacks and the mandate that CISD be required for all
emergency first responders made large-scale research into the effectiveness
of CISD possible. Results of these large studies demonstrated that individuals
who received CISD, as traditionally implemented, had outcomes that were
the same as or worse than individuals who received no assistance at all (Litz,
2008; Talbot, 2009). In the case of CISD, research was used to make the
decision to withdraw support for CISD and to implement other types of
counseling assistance for those who have experienced traumatic stress. In this
way, research allowed counselors to make the very best decisions for the
people they serve.
Regardless of whether professional counselors are motivated by a reactive or
proactive approach, or both, the overwhelming majority of practicing
counselors say that they use research to inform their work. Your graduate
program is an excellent time to start thinking about how you will adopt a
professional identity that includes using research to inform your practice. In
this chapter’s Informed by Research, you will read about a study designed to
help understand how master’s degree students in counseling start to see
themselves as researchers. As you read through this feature, you might want
to think about how you can start to make intentional choices during your
graduate program to obtain the research skills you need that will give you the
confidence to engage in research when you are in practice.
Informed by Research
Understanding How Master’s
Degree Students in Counseling
Develop a Research Identity
There is an ever-increasing emphasis on the use of research to inform practice
within master’s degree programs in counseling. However, when it comes to
helping students develop a research identity, nearly all focus is on helping
doctoral students become researchers. The only study to date on helping
master’s degree counseling students develop a research identity was a
qualitative (grounded theory) study by Jorgensen and Duncan (2015). In
general, they found that all participants in their study had adopted a
researcher identity by graduation, primarily because of a recognition that it
was a necessity to provide the highest possible care for their clients. One
participant in their study stated “To me, it’s more of a duty to the clients I
serve to be involved in research rather than I like it or it is really super fun or
super interesting to me. But I want to be really good at what I do, and to do
that, I have to be involved in research” (p. 24).
Participants in their study came to develop their research identity through

both external and internal factors. External factors, such as program
expectations, messages from supervisors and practicing counselors, and
directives from faculty all contributed to the development of a research
identity. For most participants, internal factors were not as salient,
particularly at the start of their graduate programs. Many felt unprepared or
uninterested in research, and it was not until they fully understood how
research could help them be better counselors that they started to develop an
internalized motivation for research. One of the most important themes to
emerge was that as participants better understood how research is
conceptualized within the field, they had more interest in participation in
research. When a more simplistic view of research (e.g., large data sets with
complex analysis performed by statisticians in labs) was replaced with a more
complex understanding of how many different types of data can be used to
help clients, there was more buy-in from the participants.
We hope that you will continue to be intentional about the development of

your own research identity. Helping you understand the role that research
plays in counseling is the major reason why we include an Informed by
Research feature in each chapter. When you are able to see how research
helps inform everything we do—from learning about counseling techniques,
to determining what content should be included in graduate coursework, to
promoting a social justice agenda, to our daily work with clients—we hope
you will get excited about the development of your own research identity.
Research as Form of Social Justice

One of the major themes throughout this text is that counselors have an
obligation to engage in social justice and advocacy on behalf of the clients
and students they serve. We have found that helping students think about
research from a social justice perspective can be a promising way to help you
link your passion for helping others with the process of research (for which
you may not have the same passion).
One of us (Darcy) does a lot of work in suicide prevention, assessment,

and intervention. This is a passion of mine, based on my own
experiences as a suicide survivor (someone who has lost a loved one to
suicide). Currently, I am on a research team that has a large federal grant
to help provide interventions for suicidal youth at a drop-in homeless
shelter for adolescents. The current state of the research shows strong
support for a very specific type of intervention (a modified form of
Cognitive Behavioral Therapy) for suicidal youth. The research studies
conducted to date have been very convincing for the efficacy of this type
of research, and many different demographic groups (age, gender,
sexual orientation, race, SES, suicide severity) have been included in the
previous research. Who was not included in the previous studies,
however, was youth who are homeless. The research funding we
received was to test this suicide intervention with this very specific
population. No one really questioned the ability of this intervention to be
successful with suicidal youth who are homeless— after all, the research
showed strong support across many different groups. Why would
adolescents with unstable housing be any different? A year into the
project, however, it became clear that this population was different.
Without stable housing (and even the minimal support provided by
others in the household, the school system, or other supports), the
intervention didn’t work. More precisely, the suicidal adolescents
randomly assigned to the treatment group often refused to come in for
their counseling appointments. The suicidal adolescents randomly
assigned to the control group, a more generic form of counseling already
occurring at the center, were far more willing to show up for
appointments. Just a year into the research study, it was clear that we
had to change course and develop a specialized intervention for the
suicidal youth that first convinced them to come into counseling before
any of the CBT-based interventions could possibly work.
The suicidal adolescents who use the services of the drop-in homeless
shelter deserve the very best interventions we can offer them. Yet, the
very best, state-of-the-art research lets them down. They deserve
services specifically tailored to their needs, even if that means
developing whole new protocols and procedures that are not relevant to
other populations. We believe that this is research as social justice.
Resistance to Research: Why

Counselors Don’t Engage in
Forschung
Given all the reactive and proactive reasons, and even a social justice
rationale to use research, it seems a bit difficult to understand why all
counselors don’t use research to guide their counseling practices.
Nevertheless, studies consistently reveal that there continues to be a segment
of the profession who say they do not read research, do not engage in
research, and believe that research has little or no impact on their counseling
practices (e.g., Bauman, 2004; Bezyak et al., 2010; Peterson, Hall, & Buser,
2016; Bradley, Sexton, & Smith, 2005; Young & Kaffenberger, 2011).
Counselors who have resisted using research in their own work have
articulated several major reasons for this stance. First, some clinicians have
argued against research from a philosophical point of view. These counselors
argue that the invasion of accountability into practice negatively affects
therapeutic decision making and that to relinquish the selection of treatments
or counseling interventions to other persons is to relinquish control of the
counseling. We agree that there are some important philosophical reasons not
to base every therapeutic decision only on research or accountability.
However, we argue that research and accountability can be useful ways to
inform practice, not completely dictate every move a counselor makes.
A second reason that some counselors have resisted using research is based
on the belief that the therapeutic process itself is not quantifiable. These
individuals argue that describing what happens within a counseling session is
impossible—even if a researcher were able to articulate the major therapeutic
techniques or theories used, the interaction between the counselor and client
is so highly individualized, it could never be repeated. Therefore, it does not
make sense to try to describe it, replicate it, or measure it. We argue that the
process of counseling may be difficult to capture (although not impossible, as
you will see later in the chapter), but that the outcome or impact of
counseling is more easily measured.
Words of Wisdom
“It is comforting to know that what I do works. I have always believed it
does, but now I can say with confidence that my counseling makes a real
difference for my clients.”
—John S., practicing counselor, after his agency engaged in an outcome

study of counseling effectiveness.
A third reason why practitioners resist research involves practical concerns.

Some practitioners argue that they do not have access to journals and other
venues for research, and if they do have access, they do not have the skills to
interpret what they are reading. Others argue that engaging in their own
research would be overwhelming, time-consuming, and complex. However,
access to research is quickly becoming less and less of a problem as more and
more information is available through the Internet and online journals. In
addition, counselors who are members of the American Counseling
Association, the American School Counselor Association, and other
professional organizations receive journals with the most recent and up-to-
date research as a part of their membership benefits. As for skills, we argue
that counselors must develop the skills to read, understand, and use research,
and it is not sufficient to plead ignorance on this issue. Finally, we argue that
conducting your own research need not be difficult. Research conducted by
practitioners to measure their own effectiveness is not necessarily like the
large-scale and statistically complex studies that are found in the published
research. This chapter, and other training that you will receive in your
counseling courses, will help you understand how small studies with simple
designs often are sufficient to answer the questions that you have about your
counseling practice.
How Counselors Use Research
We hope that we have convinced you that research is a fundamental
component of the counseling process, regardless of setting. When counselors
adopt an inquisitive stance about their counseling and clients, when they seek
to find better ways to do their work, and when they look for alternative
solutions—we argue that all of these represent a “research approach” to
counseling. In this section, we turn to a discussion of how specific types of
research can inform practice.
In his book on using research to inform counseling practice, Rick Houser

advocates for a “practitioner-scientist” model for counseling. This stands in
contrast to the “scientist-practitioner” model, a common term in the field of
psychology. The scientist-practitioner model emphasizes science and research
as the most important responsibility that practitioners have. Houser (2014)
turns the model around and argues that counselors are practitioners first,
hence practitioner-scientist. However, counselors are not only practitioners,
they must also be actively involved with the research in the field. Even
though practitioner-scientists do not focus primarily on conducting their own
research, they must be comfortable as consumers of research. They must use
published research and literature for the benefit of enhancing practice.
Practitioner-scientists use the existing research and literature to make
practice-based decisions; they evaluate the quality of the information
presented in the research and professional journals; and they determine the
appropriateness of the research and literature for the populations with whom
they work. Practitioner-scientists also typically engage in small-scale
research studies on the job. That is, they evaluate the effectiveness of their
own interventions and programs and make adjustments, as necessary, based
on their results. This practitioner-scientist model is precisely the model that
we advocate for in this chapter. When you become a practitioner-scientist as
a counselor (and we certainly hope you will take on this identity!), you will
use research, as well as education and practice, to make decisions in
counseling.
Using Existing Research and
Scholarship to Inform Practice
By far the most common way that counselors use research is to read existing
research and literature in order to help guide their counseling interventions
and practice. You will undoubtedly be asked to use the existing research as
you go through your graduate training. For example, you might be asked to
develop a program or intervention that is based in the research literature,
discuss appropriate interventions for certain types of clients or client
problems, or analyze the appropriateness of specific assessment instruments
for a particular underrepresented population. You may be asked to write a
research paper on working with clients with a particular diagnosis or students
with a specific behavioral problem. All of these assignments require you to
use the research and scholarly literature in ways that are designed not only to
answer a specific question, but also to prepare you for continuing to use the
research literature after you graduate from your program.
When you complete your search of the literature and have copies (electronic
or paper) of your articles, chapters, and books, you will see that the type of
information you have collected comes in many different formats. Most
notably, most of the information will come from academic sources. Academic
sources are scholarly articles and books that are written with the primary goal
of advancing knowledge in a particular field. Academic (or scholarly) sources
differ from information in the general knowledge base. Academic journal
articles or books are rigorous, scholarly works that go through an extensive
review process and are intended to help other scholars or practitioners in the
field in their work. Typically, graduate school papers and projects require you
to use only academic sources in your work, although your instructor may
allow the use of popular media, depending on the assignment. When you do
use non-academic sources for your work, we encourage you to be very
careful about the conclusions you draw, recognizing that there is no required
external review system in place for these sources.
Of course, not all academic or scholarly work is published in research

journals. Counselors might also use information they learn from attending
professional presentations and counseling workshops to inform their practice.
However, in general, information contained in professional presentations
does not undergo the same systematic and rigorous review as published
scholarly resources, and counselors must take care to use a critical eye in
assessing the quality and relevance of information included in presentations.
Finally, we recognize that in addition to electronic access to scholarly

journals, there is a lot of other useful information available on the Internet.
Limiting the information you use to inform your counseling practice only to
articles contained in published academic journals would mean that you would
miss a lot of important, credible, and useful material. Clearly, access to the
Internet and online research databases has become the foundation for research
in counseling. Counselors, and counseling students, use the Internet as the
starting place for all of their inquiries, but using online resources for
scholarly research requires specialized knowledge and skills. The
accompanying Spotlight is intended to help you make the most of the Internet
for your research, both as a graduate student and in your future work as a
professional counselor. Most people understand that not all information on
the Internet is accurate or up-to-date and that the information available is
highly variable in terms of credibility, objectivity, and rigor. Knowing that
this variety exists, however, is not the same thing as understanding how to
assess and understand the quality of what you find in your online searches.
We hope that this Spotlight will give you some useful tools to find
appropriate online resources.
Understanding the Major
Classifications
of Scholarly Research
There are many types of academic literature, and each contributes something
important and useful to the overall knowledge base. The major classifications
of published scholarship and research are discussed below. As each type of
scholarship is described, we offer a sampling of relevant articles from recent
American Counseling Association journals. We hope you will start to get a
feel for the breadth of topics that are covered within the journals and the ways
that different types of scholarship can be used to help inform your counseling
decisions.
Literature Reviews or Position

Papers
Much of the information in counseling books and journals is in the format of
a literature review or position paper. These narrative manuscripts do not
include any new or original research, but instead organize, integrate, and
evaluate previously published material into a meaningful and useful summary
(Bem, 1995). As such, they clearly define and clarify a problem; summarize
previous work in the area; identify relationships, contradictions, gaps, and
inconsistencies in the literature; and typically suggest the next step or steps in
solving the problem (American Psychological Association [APA], 2010). The
authors of literature reviews and position papers contribute to knowledge in
the field not by creating new knowledge, but by aggregating existing
knowledge in a way that others will find practical and useful. Position papers
help set new agendas for the field, identify current trends, or pull together
information from different sources in meaningful ways to help guide
counselors in their work. Practitioners often rely on literature reviews or
position papers to sum up existing research and provide insights for making
practical use of the information.
SPOTLIGHT Using the Internet for

Academic Research
The availability of information on the Internet and its near-universal
accessibility make it a tremendously useful tool for research. More and more,
students are conducting their research exclusively on the Internet. Although
the Internet can be a valuable source of information, it is important for
counseling students, emerging scholars in the field, to recognize that the
material on the Internet is of uneven quality. Academic journals and books
have already been evaluated by scholars and publishers, but information on
the Internet has no filters or review process. Thus, conducting academic
research on the Internet is a specialized skill that requires thought, patience,
perseverance, and a critical approach to the information.
Electronic Databases and Online

Journals
Academic libraries at colleges and universities participate in a scholarly
community of resources that includes electronic databases. These databases
catalog academic journals and books that are available either online or
through print resources. Electronic databases that catalog only scholarly
works serve, in essence, as a clearinghouse for scholars. Material included in
these databases, most commonly journal articles and scholarly books, has met
the rigorous standards of the academic discipline. At present, many (but not
all) academic journals are available in both electronic and print format. The
electronic copy is a duplicate of what appears in print and has met the same
rigorous standards of peer review. Your university pays a fee to allow
students and faculty to access this material, just as they would pay a
subscription fee to have print copies available in the library. Other journal
articles are not available electronically or do not have copies of the journal
from previous years available in electronic format, and you will need to
physically go to the library to obtain this information. There are hundreds of
different electronic databases, and many are specifically tailored to particular
disciplines. For example, your university might have access to PsychLit®,
PsychInfo®, ERIC®, or MedLine®. All of these databases include scholarly
information related to the field of counseling (PsychLit® and PsychInfo® are
primarily for psychology and the social sciences, whereas ERIC® is an
educational clearinghouse, and MedLine® contains information about
medicine and health). Other databases are available and may be relevant to
scholars in the field. You will need to search your library’s electronic
database collection to know what material can be accessed from your
university. EBSCOHost® is a popular, very inclusive database that many
universities have available for their students and faculty. However,
EBSCOHost® contains both academic and nonacademic (general) resources,
and users must differentiate between scholarly and general information. It
may be useful for you to ask the faculty in your program which electronic
databases they use and recommend for your college or university.
Search Engines
Popular search engines (e.g., Google®, Yahoo®, Bing®) allow users to
access billions of websites that are available on the Internet. However, access
to information is not the same as access to high-quality, accurate, useful
information. Google Scholar® is a freely accessible search engine that
indexes the full text of scholarly literature across a wide variety of
disciplines. Students who have access to university libraries, however, will
find that they often must pay a subscription fee to access the full text of
articles in Google Scholar®, whereas this same information may be available
for free through the university’s electronic databases. Thus, Google Scholar®
and other academic search engines (e.g., Elsevier®, Web of Science®) may
be useful places to start an academic search, but to access the full text of
articles, it may be most cost-effective to use the university’s databases.
Websites
The Internet is a level playing field. Anyone can develop a web page, and all
information, from the highest quality to the most questionable, is equally
available to anyone who browses the Internet. The Internet epitomizes the
concept of Caveat lector (Let the reader beware). Students should exercise
extreme caution in including information from commercial websites in their
scholarly work, as most professors do not consider this information to meet
criteria for academic work. If websites are to be used for scholarly purposes,
there are five major criteria to help evaluate the quality of a website:
Accuracy
Who is the author?
What are the author’s credentials and affiliation(s)?
Do the affiliations indicate possibility of bias?
Does the website include contact information?
Is the information presented factual?
Does the author support information with evidence?
Authority/Credibility
Who published the website (check the URL)?
If information is included from other sources, is it properly cited?
What is the domain designation:
.com: commercial, hosted by a company
.org: nonprofit organization
.mil: military branch of the government

.net: usually an Internet service provider
.gov: governmental website
.edu: educational institution
Objectivity
What are the goals/objectives of the website?
What opinions (if any) are expressed?
Is the website a “mask” for advertising?
Use a critical eye and ask, Why was this written and for whom?
Timeliness
When was the website produced? Has it been updated?
Are the links updated frequently?
Coverage
Is the information accessible?
Do you have to pay an additional fee to access any of the material?
Consider some literature reviews or position papers published by ACA

journals.
Assessing and responding to threats of targeted violence by adolescents:

A guide for counselors.
(2016). By J. Winer & R. P. Halgin. Journal of Mental Health

Counseling, 38(3), 248–262.
Counseling for wellness with older adults.

(2016). By M. C. Fullen. Adultspan, 15(2), 109–123.
Addressing social injustice with urban African American young men

through Hip-hop: Suggestions for school counselors.
(2016). By A. R. Washington. Journal for Social Action in Counseling

& Psychology, 7(1), 101–121.
Counseling students who write research papers in their graduate courses are
essentially writing literature reviews. Students are expected to make use of
the existing scholarly research and literature to develop a synthesis that
would be useful to practitioners or other scholars. That is, unless you have
been given other requirements by the course instructor, the research papers
that you write in graduate school should mimic the format and outline of a
publishable literature review. A well-written paper in graduate school follows
the same criteria for a well-written journal article and, in fact, can be
submitted for publication in a professional counseling journal, as so aptly
demonstrated by the graduate student authors in the accompanying Snapshot.
As you read their experiences, you might want to consider if publishing
something in your graduate program is of interest to you. If it is, we
encourage you to work with your program faculty to help guide you in the
process.
Quantitative Research
Much of the actual research that is conducted within the field of counseling is
done through quantitative research. Quantitative research is a systematic,
scientific investigation that uses quantifiable measures and employs statistical
approaches to help understand certain phenomena under study. Quantitative
research begins with the development of a research hypothesis, moves into
collection of data, and then uses statistical methods to measure relationships
or associations among the data collected.
Quantitative studies use statistical procedures to determine relationships

between variables. For example, if researchers want to know if a particular
intervention is more successful for people who are hospitalized versus those
who are in outpatient treatment, they would measure the differences between
the hospitalized and non-hospitalized groups on some measure of treatment
outcome through statistical tests such as t-tests, ANOVAs, and MANOVAs. If
researchers wanted to determine whether treatment outcome was related to
other variables, they might use correlations or regression equations. All of
these statistical tests (and others) are types of quantitative methods.
All quantitative methods make use of the concept of statistical significance,

which is a mathematical tool used to determine whether the outcome of a
study is the result of a relationship between specific factors or due to chance.
If a finding is deemed statistically significant, it means that the phenomenon
observed in the research is a significant departure from what might be
expected by chance alone. Undoubtedly, you have heard this term before, and
perhaps you are tempted to gloss over this section—but take a moment to
really understand this concept, as well as the concept of effect sizes, which
follows. We’ll give you some examples to see why these terms really matter
to your work as a counselor.
The significance level is usually represented as p < .05 (or sometimes, p <
.01). In the social sciences, significance levels are typically set at .05 (less
commonly, .01). Thus, if a finding is considered statistically significant, there
is less than a 5% (or 1%) chance that the findings occurred simply by chance.
Put another way, there is a 95% (99%) chance (the researcher has a 95%
[99%] confidence level) that whatever phenomenon occurred did not happen
by chance. A “statistically significant difference” simply means there is
statistical evidence that there is a difference; it does not mean the difference
is necessarily large, important, or practically useful.
SNAPSHOT Graduate Student

Authors
Graduate students may not think of themselves as potential authors or
contributors to the professional counseling literature. Students typically see
themselves as the consumers of journal articles, not the producers of them.
Nevertheless, a well-written paper for a counseling class can be submitted for
publication. Consider the experiences of these four student authors, all of
whom had their class papers published in counseling journals while they were
in their master’s degree programs.
Maria Elliott was a first-year MA student when she wrote a paper for
an assessment class. The assignment for the class was to use the existing
research and literature to help counseling practitioners understand what
they need to know when using a psychological assessment with a
specific population. Maria submitted her paper to a state counseling
journal, where it was published.
Elliott, M. (2008). The Minnesota Multiphasic Personality

Inventory (MMPI-2 and MMPI-A) and victims of childhood sexual
abuse: A review of the literature. Journal of Professional
Counseling: Practice, Theory, & Research, 36, 25–37.
Sometimes students work more extensively with faculty members or other

mentors to significantly expand upon work completed by the student. In these
instances, students and faculty members might publish together, as in the
following examples:
Matthew Fleming was in the second year of his MA program in

counseling when he was struggling in his personal life to care for aging
parents with Alzheimer’s disease. Matt channeled his personal interest
in the topic of caregivers into a class paper that eventually turned into an
article in a national counseling journal. The article won the journal’s
Article of the Year Award in 2008.
Granello, P. F., & Fleming, M. S. (2008). Providing counseling for

individuals with Alzheimer’s Disease and their caregivers.
Adultspan: Theory, Research, and Practice, 7, 13–25.
Danielle Hayes was a first-year MA student who wrote a paper on using

the psychological test, the Minnesota Multiphasic Personality Inventory,
for persons diagnosed with multiple sclerosis. She worked with her
professor and eventually submitted the paper to a national counseling
journal, where it was published.
Hayes, D., & Granello, D. H. (2009). Use of the Minnesota
Multiphasic Personality Inventory-2 with persons diagnosed with
Multiple Sclerosis. Journal of Counseling and Development, 87(2):
227–233.
The point is that all of these students (and countless others who have
published their work) were in their master’s degree programs at the time they
wrote these papers. All of them recognized (or were helped to recognize!) the
potential use these papers had for other counseling professionals. We believe
that this represents an important shift in how counseling students see
themselves—moving from identity as a student to identity as a professional.
As you continue your work in your graduate program, why not consider
moving one of your classroom assignments toward professional publication?
We encourage you to talk with your instructor(s) if you are interested, to
learn more about the process.
Once a finding is determined to be statistically significant, the next step is to

look at the magnitude of the difference between the groups being studies,
which is expressed in effect size. Effect sizes help counselors who read
research to know the amount of change that the treatment produced.
Remember, just because a research study finds a statistically significant
difference between two groups does not mean that the difference is very large
or very useful to know. As a general rule, the stronger (or higher) the effect
size, the more compelling the evidence that the statistically significant results
are useful for counseling practice. Small effect sizes mean that the
intervention being investigated produced very slight differences. Savvy
consumers of research know that there is a difference between statistically
significant findings and findings that are practically significant. Consider this
example. Let’s say an agency moves into your town and advertises that they
have research that proves their clients have statistically significant
improvement on their scores on the Graduate Record Exam (GRE). In fact,
they advertise that if you are willing to participate in their program, they
guarantee your score will improve. Here’s the catch. The program costs
$4,000 and takes 7 weeks of study. Would you do it? What if you needed to
improve your GRE scores to get into graduate school, and this was very, very
important to you? Would this be worth it? It might be tempting to do so,
especially when you hear that the results are statistically significant at the p <
.01 level. That sounds impressive. However, the point of effect sizes is to
recognize that it’s hard to make a decision without knowing the amount of
change (effect size) that is a result of their program. What if their research
shows that the average improvement is 2 points on the GRE? If there were
enough individuals in the study, the 2-point difference on the GRE between
the treatment and control group might be statistically significant. However,
the practical significance of the intervention is less impressive. Few students
would be willing to engage in an expensive and exhaustive GRE preparation
program for a 2-point improvement in their scores. Thus, the effect size is
small, limiting the practical utility of the intervention. Counselors will want
to know the effect size, or expected magnitude of the change that results from
the treatment, before they implement interventions or programs based on the
research.
Efficacy studies.
Efficacy studies have their roots in medicine, where the goal of this type of
research is to determine if a particular drug or procedure helps patients with
specific diseases or disorders. In these studies, people are randomly assigned
to a specific treatment group or to a placebo or control group, and researchers
look to see if there is a difference in outcomes. Everyone in the study must
meet stringent criteria for the diagnosis or disorder being studied, and all
intervention protocols must be rigidly adhered to. Everything in the study is
held constant except for the actual treatment or intervention. As you might
expect, this represents quite a challenge in the field of mental health.
Therefore, although efficacy studies exist in counseling, they are not the
“gold standard” that they are considered to be within the field of medicine.
Efficacy studies have high internal validity. That is, researchers have
confidence that any differences between the groups at the end of the study are
due to the differences in treatment interventions, as all other factors are
controlled for by the random assignment (in other words, both the treatment
and control group have the same demographic makeup, the same level of
symptom severity, the same amount of time elapsed, etc.). For example, a
study that compared Cognitive-Behavioral Therapy (CBT) versus a waitlist
(no treatment) for clients with panic disorder could allow clinicians to know
whether CBT is better than nothing for treating anxiety. More realistically,
antianxiety medications might be used as an alternative treatment (instead of
a waitlist) for a comparison between two types of interventions. Results
would allow counselors to know whether clients with panic disorder would
benefit more from CBT or medication.
However, there are some significant problems that efficacy studies cannot
overcome (Granello & Granello, 2001). For example, although in laboratory
studies it is possible to find clients who have just the highly specific disorder
under study, in the real world, clients come to counseling with a multitude of
coexisting problems and disorders, a situation called comorbidity. It is
impossible to know whether the treatment that was supported in the efficacy
study would work well for these clients, too. Further, efficacy studies support
only a very specific treatment intervention. Again, this might work well in
laboratory settings, but in clinical practice, clients might have several
problems and might receive several different types of intervention (for
example, CBT for panic disorder, medications for high blood pressure,
vocational counseling, and case management for problems with housing due
to unemployment). Thus, it is impossible to say which of these interventions
(or all of them combined) truly had an effect on the client’s outcomes.
Additionally, most counseling is not for a specified period of time (as is the
case in efficacy studies). Counseling continues until there is significant
improvement. Counselors who use a particular type of intervention change
course if clients don’t improve. In other words, just because an efficacy study
might support CBT for clients with panic disorder, a counselor might switch
to another type of intervention if CBT does not help a specific individual
client improve in a reasonable amount of time. Finally, in many real-world
situations, there is no opportunity for “random assignment.” School
counselors do interventions with classrooms, and all students must be
included. Half of the students can’t be put into the hall as part of a control
group. Clients who are suicidal must be given the best available treatment;
they can’t be put into a placebo group. The point is that efficacy studies,
while important, cannot answer all questions. They have high internal
validity but low external validity, meaning that the results of these highly
controlled laboratory studies cannot be easily generalized to clients and
programs in the real world. Counselors use efficacy studies to inform their
counseling, but they must be open to using other types of research as well.
Consider some of the efficacy studies published by ACA journals. Each uses
random assignment, but instead of a true control group for comparison, each
of these studies compares the effects of an intervention versus an alternative
treatment.
Early pathways therapy for young children in poverty: A randomized

controlled trial.
(2015). By S. E. Harris, R. A. Fox, & J. R. Love. Counseling Outcome

Research and Evaluation, 6(1), 3–17.
Examining the effects of Jyoti meditation on stress and the moderating

role of emotional intelligence.
(2016). By D. Gutierrez, A. H. Conley, & M. E. Young. Counselor

Education and Supervision, 55(2), 109–122.
Evaluating a safe space training for school counselors and trainees using
a randomized control group design.
(2013). By R. Byrd & D. G. Hays. Professional School Counseling,

17(1), 20–31.
Effectiveness studies.
Effectiveness studies attempt to assess outcomes in the less than ideal
situations that often exist in the real world, focusing on how well clients fare
under treatment as it is actually practiced in the field (Granello, Granello, &
Lee, 2000). Effectiveness studies recognize that random assignment of clients
may not be possible; that clients come with comorbid disorders, multiple
treating professionals, and different interventions; and that everyone must
receive the best clinical care possible, making placebo and control groups
unethical in practice, at least for some client populations. As a result,
effectiveness studies have high external validity (if clients in the study get
better, in spite of all of the problems inherent in the design, then chances are
the clients on the caseload of the counselor reading the study will improve,
too), but low internal validity (it is impossible to say what exactly helped the
client improve, since the variables in the study are not isolated). Clearly,
effectiveness studies have a place in counseling research, but they do not
answer all the questions raised about effective treatment. When you engage in
your own outcome research, involving pre- and postassessments of your
counseling programs or interventions, then you will be engaging in a type of
effectiveness study.
Consider some of the effectiveness studies published by ACA journals. Each

explores the effectiveness of an intervention, but none uses true random
assignment and several do not use a control or comparison group.
The relationship between retention and college counseling for high-risk

students.
(2016). By K. K. Bishop. Journal of College Counseling, 19(3), 205–

217.
Career decision-making self-efficacy change in Italian high school

students.
(2016). By R. Chiesa, F. Massei, & D. Guglielmi. Journal of Counseling

& Development, 94(2), 210–224.
Child-centered group play therapy: Impact on social-emotional assets of

kindergarten children.
(2016). By Y-J Cheng & C. Dee. Journal for Specialists in Group Work,
41(3), 209–237.
Meta-analyses.
Meta-analysis is a specific quantitative methodology where the results of
many efficacy or effectiveness studies are combined into one large study to
measure the overall effect of an intervention. Researchers who use meta-
analyses do not conduct their own research. Instead, they use existing
published research, pull out the data from these studies, and combine these
existing data together. Meta-analyses use highly specialized statistical
techniques to combine the data from all the published research into one large
data set so that the study has greater statistical power, or ability to uncover
differences between groups in research. Small studies tend to have low
statistical power. Studies with low statistical power often cannot distinguish
differences between treatment groups, even if such differences do exist.
Larger studies (either through large numbers in a single study or through
combining several individual studies in a meta-analysis) are more powerful
and can more easily detect these differences. Statistical power is an important
concept in all quantitative research, not just meta-analysis.
Consider some of the meta-analyses published by ACA journals. Each

combines data from existing efficacy or effectiveness studies to allow
summative statements to be made about the results of research for certain
types of interventions or programs.
Meta-analysis of counseling outcomes for the treatment of posttraumatic

stress disorder.
(2016). By B. T. Erford, C. Gunther, K. Duncan, G. Bardhoshi, B.

Dummett, J. Kraft, K. Deferio, M. Falco, & M. Ross. Journal of
Counseling & Development, 94(1), 13–30.
Meta-analysis of randomized controlled trials of Motivational

Enhancement Therapy for reducing substance use.
(2016). By. A. S. Lenz, L. Rosenbaum, & D. Sheperis. International

Journal of Addictions and Offender Counseling, 37, 66–87.
Meta-analysis of group mindfulness-based cognitive therapy for

decreasing symptoms of acute depression.
(2016). By A. S. Lenz, J. Hall, & L. B. Smith. Journal for Specialists in

Group Work, 41(1), 44–70.
Nonexperimental quantitative
research.
Not all research involves implementing a treatment or intervention. Some
research is based on the one-time administration of surveys to counselors,
counseling students, clients, or parents. Other research involves comparing
characteristics, behaviors, or personality traits of different segments of the
population or observing people in specific situations. Still other research
attempts to develop assessments or determine their appropriateness for
certain groups.
Even without the introduction of an intervention to measure, this research is

still quantitative because it involves careful quantification of the variables
involved. Researchers use a variety of statistical methods, many of which
may be familiar to you (e.g., ANOVAs, regression analysis, factor analysis,
correlations, chi-square) to conduct these studies.
Consider some of the nonexperimental studies published by ACA journals.
Perceived and actual effectiveness of coping strategies used when

forgiving.
(2016). By W. K. Jeter & L. A. Brannon. Counseling and Values, 61(2),

176–191.
Emotional intelligence and the counselor: Examining the relationship of

trait emotional intelligence to counselor burnout.
(2016). By D. Gutierrez & P. R. Mullen. Journal of Mental Health

Counseling, 38(3), 187–200.
Rehabilitation service utilization among African American women

living with HIV/AIDS: Applying the behavioral model for vulnerable
populations.
(2016). By A. E. Shamburger-Rousseau, L. M. Conyers, & A. J.

Armstrong. Rehabilitation Counseling Bulletin, 60(1), 27–39.
Fast Fact
A review of the research in Journal of Counseling & Development from
1990–2001 found that 85% of all the research articles were in the category of
nonexperimental research.
Source: Bangert & Baumberger (2005).
Qualitative Research
Qualitative research is used to gather a more in-depth understanding of
behavior and the reasons that motivate that behavior. Qualitative
methodologies are many (e.g., ethnographic studies, grounded theory,
phenomenological research), but the primary purpose is for the researcher to
gain an in-depth understanding of the “why” of a phenomenon, whereas
quantitative research often focuses on the “what” or the “how.” According to
Kline, the promise of qualitative research is that it will “further the
conversation . . . deepen [our] understanding . . . and challenge what we
believe we know about our profession” (2008, p. 214). Unlike quantitative
research, qualitative research is not concerned with concepts like
generalizability, random sampling, or statistical significance. Rather,
qualitative research seeks to describe in more detail the lived experiences of a
few individuals to provide depth, rather than breadth, to the research.
Qualitative history does not share the same history as quantitative research in
the counseling profession, and it has only been relatively recently that
counseling journals have become open to publishing research with qualitative
designs. Most in the profession see this shift toward acceptance of qualitative
research as particularly appropriate for counseling, which by philosophy and
approach shares many core principles with qualitative research. For example,
qualitative research is open to describing the experiences of diverse people, to
exploring emotions, and to abandoning search for “the truth” in favor of a
search for understanding. Whereas quantitative research seeks to categorize
the experiences of participants, qualitative research seeks to explore these
experiences.
Words of Wisdom
“I see now that before I started to really read the therapy research on my own,
my work was really narrow—basically reflective of my own theoretical views
or that of my professors or program. This is understandable, all systems have
constraints. Through delving into the research my eyes were opened to many,
many new ways of working with clients.”
—Kate V., Marriage, couple and family therapist trainee, California State
University, Sacramento
Qualitative research, just as quantitative research, requires high standards of

rigor. It may be tempting to assume that the more narrative approaches and
thematic results of qualitative research mean that there is not the same level
of research quality that there is with quantitative research. However, this is
far from accurate. A study of qualitative research published from 1999–2014
in the Journal of Counseling and Development found an ever-increasing
standard in rigor over time (Hays, Wood, Dahl, & Kirk-Jenkins, 2016). This
means that as acceptance of qualitative research within the profession grows,
the quality of the work that is published using this methodology is improving
as well. This is of critical importance. Whether quantitative or qualitative, the
research upon which we base our counseling decisions must be of the highest
quality, and the conclusions drawn by the researchers must be accurate,
precise, and meaningful. When research of any type lacks rigor or when the
conclusions drawn are overstated or misleading, the real result can be harm to
clients when counselors use that research to make clinical decisions (Balkin,
2014).
As a graduate student, you may find it difficult to assess the quality and rigor
of qualitative research studies, particularly if your previous research courses
focused only on quantitative methodologies. There are some foundational
criteria that are typically used to determine the trustworthiness of qualitative
research designs (Hays et al., 2016), and you may find it useful to keep these
in mind as you read qualitative studies. Among the criteria are (a) credibility
(believability, accuracy), (b) confirmability (genuine reflections of
participants’ perspectives without researcher interference), (c) coherence
(congruence between the purpose of the research and the approach used to
collect and analyze data), (d) sampling (use of appropriate participants given
the questions asked), (e) substantive validation (degree to which findings are
meaningful or beneficial to society or to the profession), and (f) ethical
validation (the degree to which the inquiry addresses real world problems and
transforms counselors’ actions).
Consider some of the qualitative studies published by ACA journals.
A qualitative exploration of a music experience within a counselor

education sexuality course.
(2016). By E. Lenes, J. M. Swank, & S. Nash. Journal of Creativity in

Mental Health, 10(2), 216–231.
A qualitative investigation of college students’ Facebook usage and

romantic relationships: Implications for college counselors.
(2016). By R. S. Sherrell & G. W. Lambie. Journal of College

Counseling, 19(2), 138–153.
Hearing the voices of youth at risk for academic failure: What

professional school counselors need to know.
(2015). By C. D. Slaten, Z. M. Elison, H. Hughes, M. Yough, & D.

Shemwell. Journal of Humanistic Counseling 54(3), 203–220.
Neither quantitative nor qualitative research offers THE answer for the
counseling profession. Both have important strengths as well as significant
limitations. Taken together, however, they can provide a complementary
approach to assisting counselors to satisfy their innate curiosity about the
counseling profession, clients, and the “research approach” to being a
practitioner-scientist. In general, the combination of quantitative research, in
tandem with and often informed by qualitative research, helps counselor
educators, supervisors, counseling students, and practicing counselors make
informed choices about what interventions they choose to employ, or avoid,
in their work. In fact, some studies make use of both quantitative and
qualitative components, called mixed methods, that allow for the strengths of
each type of research to support the investigation. The important take-home
is that counseling research is at its best when it helps all of us as counselors
work with all of our clients in ways that are effective and appropriate and
with interventions that respect the inherent worth and dignity of everyone we
encounter.
Program Evaluation
Program evaluation is used to measure the effectiveness of either a specific
activity (e.g., a group counseling intervention for college students who self-
injure) or an entire counseling program (e.g., a comprehensive school
counseling program). There are four major types of program evaluation:
context evaluation (needs assessment), input evaluation, process evaluation,
and product evaluation (Gredler, 1996), and each of these will be briefly
described below. Within each of these types of evaluation, researchers use
quantitative and qualitative data to inform decision making. Thus, this
methodology does not fit neatly under the heading of either quantitative or
qualitative design.
The central decision for all organizations is, what is the best way to spend the
available resources, including time, money, and organizational efforts, to
meet all the demands (needs) that compete for them? Such decisions may be
based on intuition, political pressures, past practices, or personal preferences,
but one of the most effective ways to decide such issues is through a context
evaluation or needs assessment (Witkin & Altschuld, 1995). A needs
assessment, the first type of program evaluation, is a systemic set of
procedures to determine the most pressing needs of any organization in order
to set priorities. A needs assessment is, essentially, examining the gap
between “what is” and “what should be.” To conduct needs assessments,
counselors gather information from a variety of sources (e.g., key informants,
existing data, surveys of affected constituents) and develop action plans to
implement the findings.
Input evaluation is the second type of program evaluation. It essentially

means conducting an assessment of the available resources, or what is
available as an input into the program being evaluated (Loesch & Ritchie,
2005). For example, school counseling students might engage in community
mapping, a strategy designed to better understand the resources available in
the neighborhood surrounding a school building. Developing an
understanding of the existing resources is essential. It is easy to say “we don’t
have enough”—but in an age of tight budgets, it is important to make the best
use of all available assets.
Process evaluation, the third type of program evaluation, involves evaluating

a program as it is occurring, rather than waiting until after its completion to
measure the outcomes (Hadley & Mitchell, 1995). The goal of process
evaluation is to determine whether the program should continue as is, be
altered, or be discarded (Loesch & Ritchie, 2005). Process evaluation is
appropriate for all counseling activities. Process evaluations use questions to
prompt the counselor to critically analyze the progress to date and make
intentional choices about next steps. For example, counselors engaged in any
counseling program or service might ask:
What are the goals and specific objectives of this counseling program?
For each objective, what steps have been taken?
How have those steps been accomplished?
What resources were/are needed for each step?
Does the number of clients receiving services match the projected goal?
If not, why not?
How satisfied are the clients with the services provided?
How satisfied are the counselors or other staff? Are there any aspects of
the program’s operation that the clients or the staff believe should be
changed? Why?
Product evaluation is the final type of program evaluation, and it is

synonymous with outcome research. It involves assessing outcomes of a
program after the program is complete. With product evaluation, the focus is
on the program being evaluated, not the clients. Therefore, research not only
answers whether clients improved, but, if possible, what components of the
program were most effective in producing change.
Consider some of the program evaluation studies published by ACA journals.
Effect of brief staff-assisted career service delivery on drop-in clients.
(2016). By D. S. Osborn, S. W. Hayden, G. W. Peterson, & J. P.

Sampson. Career Development Quarterly, 64(2), 181–187.
Evaluation of service-learning-infused courses with refugee families.
(2016). By A. Midgett & D. M. Doumas. Journal of Multicultural

A mindfulness experiential small group to help students tolerate

ambiguity.
(2016). By L. Bohecker, L. G. Vereent, P. C. Wells, & C. C. Wathen.

(2016). Counselor Education & Supervision 55(1), 16–30.
In the accompanying Spotlight, we discuss the essential skill of learning to

read a research article that counselors must develop in order to make the most
of the available research. Whereas in your undergraduate program you may
have been able to read summaries of research, in your graduate program you
will be expected to read and understand research articles as well as apply the
information you learn to your own counseling practice. We hope that this
Spotlight provides a review (for those already familiar with this task), or a
good starting place if this is new to you. This may be a good place to remind
you that Research and Evaluation is one of the courses that will be required
during your graduate program. As such, this chapter is not designed to teach
you everything you need to know about how to read, understand, and conduct
research. You will have many opportunities to work on these skills during
your graduate program and beyond.
SPOTLIGHT How to Read a

Research Article
Reading and understanding research articles are important skills for
professional counselors. Students in counseling programs sometimes argue
that they cannot read research articles because they do not understand all of
the statistical methods employed. However, even novice researchers find that
with the proper skills, they are well on their way to deconstructing the
knowledge encoded in research.
Empirical (research) articles vary in format, but they generally follow a

particular sequence (Granello, 2007). Understanding this sequence helps
students decode the information in the article and provides a road map for
making sense of the information.
Typical Components of a Research

Article
Title, authors, and affiliations.
After the title of the manuscript are the authors’ names, generally in order of
contribution to the research, with the project leader as first author.
Institutions, affiliations, and contact information are always included. It has
been our experience that students often fail to realize that this contact
information is provided so that readers can engage with study authors if they
have follow-up questions or wish to learn more. Although authors are
typically busy professionals who do not have time to do students’ research
for them, most authors are thrilled to receive an e-mail from a student who is
using the author’s work in counseling or academic work. We always
encourage students to follow up with authors of articles that they find
particularly compelling—it may even lead to a mentoring or networking
relationship.
Abstract.
The abstract is an “accurate, succinct, quickly comprehensible, and
informative” summary of the manuscript (APA, 2010, p. 15). Abstracts are
self-contained, and readers who have access only to an abstract should have
a basic understanding of all components of a manuscript. Typically, abstracts
are written after the rest of the manuscript has been completed, thus allowing
the author to identify and highlight the major findings of the research.
Introduction and Literature

Review.
The beginning of a research article introduces the specific problem and
provides the reader with a background literature review. This review is
focused and includes only research and writing that is relevant to the
problem. The literature review is intended to “demonstrate the logical
continuity between previous and present work” and to “develop the problem
with enough breadth and clarity to make it generally understood by a wide
professional audience” (APA, 2010, p. 16).
Methods.
This section provides details on how the research was conducted. It typically
includes the research design (what steps or procedures were undertaken,
including an explanation of the treatment or intervention for experimental
designs); sample (who was studied, the response rate if survey methodology
was used, and sample demographics); and instrumentation (surveys,
assessments, or other methods to measure quantitative data or record
qualitative findings).
Results.
The results section “summarizes the data collected and the statistical or data
analytic treatment used” (APA, 2010, p. 20). In the results section, results
from all statistical tests are included, whether or not they support the original
hypotheses or are statistically significant. In many cases, data can be
presented with the aid of tables or figures. When reporting statistical
information, authors should provide “sufficient information to help the reader
fully understand the analyses conducted” (APA, 2010, p. 23). The results
section is not a place for commentary or discussion. For quantitative studies,
the results section should include the power of the statistical tests (the ability
of the statistics to detect relationships between variables) and the effect size
(or magnitude of the relationship between the variables).
Discussion.
The discussion section of a manuscript focuses on “credibility,
generalizability, and robustness” of the research (Wilkinson et al., 1999, p.
602). In this section, authors “examine, interpret, and qualify the results [of
the study, and] . . . draw inferences from them” (APA, 2010, p. 26). This is
where authors compare their results with those from previous studies and
theory. Also included in this section is a discussion of the limitations of the
current research. Careful and thoughtful recommendations or implications for
future research are essential components of the discussion section.
References.
Scholars know that the reference section of any journal article is a good place
to look for additional resources and references.
Appendices.
Following the references are any appendices needed to fully understand the
research, such as tables of findings, transcripts from qualitative research, and
questionnaires, surveys, or examples of forms used in the research.
Tips for Reading a Research Article
In Chapter 5, we discussed some strategies for getting the most from your
reading in graduate school. In addition to those general strategies, there is a
specific standard, recognized strategy for reading a research article.
Typically, research articles are not read from beginning to end. Most
beginning researchers find the following strategy particularly useful as they
learn to read research (adapted from Wadsworth Cengage Learning, n.d.)
1. Read the abstract first. It is a brief summary of the research questions,

methods, and findings. Abstracts often contain dense psychological
language, and it may be helpful to read it over a couple of times and try
to restate it in your own (nontechnical) language.
2. Read the introduction and literature review. This helps contextualize the
research in the current state of research and professional literature about
the topic. The literature review ends by stating the research hypotheses
or purpose of the current study.
3. Read the discussion section. Skip over the methods and results for the
moment. The discussion section will explain the major findings of the
research in detail. This is particularly useful for students who are
uncertain about their ability to comprehend the statistics and
methodology employed in the study, as it will provide an important
overview of the research.
4. Read the methods section. Now that you know the results and what the
researchers claim the results mean, you are prepared to read about the
methods. This section explains the type of research and the techniques
and assessment instruments used.
5. Read the results section. This is the most technically challenging part of
a research report, but since you already know the findings (you read
about them in the discussion section), this section will be far more
manageable. Don’t get bogged down in the details of the statistics, but
read for a general understanding of what was done.
6. Read the discussion section again. This time, it should make even more
sense. Remember, this section often contains suggestions for future
research, including issues that the researchers became aware of in the
course of the study.
Other Types of Articles and

Forschung
There are, of course, other formats for professional literature as well as other
types of research that counselors might use. For example, counselors might
read single case studies that discuss one counselor’s experience with one
particular client. Clearly there are problems with the generalizability of this
research. Nevertheless, it can provide important insights and information and
allows for an in-depth exploration of one case.
Examples of a single case study from an ACA journal are as follows:
Dialectical behavior therapy techniques for counseling incarcerated

female adolescents: A case illustration.
(2016). By B. P. Banks & M. M. Gibbons. Journal of Addiction &

Offender Counseling, 37(1), 49–62.
A case study of cross-dressing.
(2016). By M. Gallo. Family Journal, 24(1), 77–84.
Counselors might also read anecdotal reports, where the author has not
conducted any research nor engaged in any analysis of the existing research
or literature, but simply writes about the individual’s own experiences to help
other counselors benefit. This can also include stories about or tributes to
outstanding leaders or historical figures in the field of counseling.
Although this is the type of writing that is most commonly seen in

professional newsletters, anecdotal reports can also be included in counseling
journals, as in the following examples from ACA journal:
Moving from words to action: Reflections of a first year counselor

educator for social justice.
(2013). By J. M. Williams. Journal for Social Action in Counseling and

Psychology, 5(1), 79–87.
Education with mind, heart, and soul: An interview with Mary Finn
Maples.
(2016). By A. W. Wood. Counseling & Values, 61(1), 3–9.
In the preceding pages, you have learned about a lot of different types of
research that you can use to inform your counseling practice. However,
accessing these different types of studies is just the first step. You will also
need to become an informed consumer of this research. In a large-scale
national study of nearly 1000 practicing counselors, more than 80% of
counselors in all settings stated that an essential skill for their practice was
recognizing “good and weak” research in the literature, and more than two-
thirds of counselors stated that they had read a research article within the past
year (Peterson et al., 2016).
Engaging in Your Own Research as
a Counselor
The move from consumers of research to producers of research represents an
important developmental milestone for counselors. Whereas many counselors
are willing to read and use existing research, there appears to be more general
reluctance about engaging in their own research. In fact, only 42% of
practicing school counselors believe they have the skills to conduct research
independently (Bauman, 2004). Nevertheless, counselors in all settings
understand that research skills are essential for their jobs. In fact, a large
majority of counselors in a national study stated that counselors must be able
to engage in their own research as well as read the existing research. Across
the board, in all settings and across all states, counselors recognized a high
need for research skills on the job. More than 50% of school and mental
health counselors rated 41 of the 43 research skills listed on the survey as
essential to their jobs. More than 80% of school counselors rated at least 20
of those 43 research skills as essential, including such tasks as “develop and
test my own measures of outcomes,” “set up and organize my data in a
database,” “combine outcome data for different students into overall
measures of outcomes,” and “interpret and explain results to myself and
others.” Among clinical mental health counselors, there was less consistency
in the specific research skills needed, perhaps owing to more specialized
settings that require only specific types of research skills. Nevertheless,
among the 41 research skills endorsed by more than half the participants, 18
were listed as essential by more than two-thirds of participants. Some of the
more commonly endorsed items were “find existing measures of client
outcomes,” “calculate change in a single client over time,” and “define
outcomes in measureable terms” (Peterson et al., 2016).
The results of this study and others demonstrate a clear disconnect between
understanding the importance of research and conducting one’s own research.
Part of this disconnect comes from a lack of training in research and
evaluation skills. Counselors in all settings believe that they would benefit
from more research training, with the highest priority needs in the areas of
conducting outcome research and engaging in single-case outcome studies
(Peterson et al., 2016). However, we believe that this disconnect between
understanding and engaging in research is also due, at least in part, to a
misunderstanding about the skills needed to conduct research. As we have
said several times in this chapter, assessing your work as a counselor need
not be complex or overwhelming, and your research need not mirror the
scientific rigor and scope of published articles.
Here are some examples of research you could do with your clients:
Give one of your clients in an individual counseling session a pre/post

measure of depression or anxiety (such as the Beck Depression
Inventory® or the Beck Anxiety Disorder) or a more global measure of
distress (such as the Brief Symptom Inventory®). Compare the results
on the pre- and post-tests, either through simple statistics or by simply
looking at the results to see if there are changes. Graph the pre and post
scores to share with your client and supervisor. Or give the inventory
each time you see the client to track changes over the course of
treatment. You might find, for example, results that look like this
(higher scores represent more distress):
Beck Depression Inventory

Week One: 19
Score:
Week Two: 16
Score:
Week Three: 18
Score:
Week Four: 14
Score:
Week Five: 14
Score:
Week Six: 09
Score:
Week Seven: 11
Score:
Week Eight
(Discharge): Beck Depression Inventory Score 08
Count the number of times a student in a school setting has a

confrontation on the playground every day for a week. Average these
findings to establish a baseline number of confrontations per day. After
your anger management intervention, count the number of
confrontations on the playground every day for a week. Did your
intervention help?
Perhaps your intervention might look something like Figure 7.1.
You would not need much more information than this to know that after
5 weeks of the intervention, the number of playground confrontations
has clearly been reduced.
Figure 7.1 Sample Graph of

Average Fights at Baseline and
Intervention.
How about these examples?
Give parents or teachers an open-ended questionnaire to assess any

changes in behavior that they have noticed following a classroom
guidance intervention in a school.
Ask clients to rate their symptoms of depression on a scale of 1–10

every day and use that information when you meet with them in
counseling. Assess the progress over time. Have the ratings improved,
overall, with counseling? If so, why? Talk with the client to understand
the client’s perspectives about what is contributing to improvement. If
there is no improvement, why not? Again, talk with the client about the
roadblocks that remain.
Give all of the clients on your caseload a measure of symptom distress as

pre/post and 6-month follow-up. Imagine you found a result something like
Figure 7.2. You would learn that your clients improve between admission and
discharge. At 6-month follow-up, they are still improved when compared to
admission, but they are not as well as when they were first discharged.
(Incidentally, this graph, as well as the previous one, is actually taken from a
research study that we conducted. Thus, this is exactly the type of
information that you can get from your own research.)
Figure 7.2 Sample Graph of

Client Distress on a Measure of
Symptomatology at Pre-Test,
Post-Test, and 6-Month Follow-
up.
We could go on, but the point is, conducting your own research should be
part of your ongoing approach to counseling. Any effort to assess the process
or product of your own counseling will improve the work that you do.
Ultimately, when you conduct your own research, you, your clients, and your
entire counseling practice benefits.
For students who are willing to do more, we strongly suggest finding a

faculty member who can mentor you in research. Becoming a part of a
research team is a tremendous way to learn, and faculty members are often
grateful for the additional assistance that student team members provide.
Research mentorship benefits everyone. Students learn research expertise and
contribute to the project’s success while mentors gain valuable assistance and
benefit from sharing their knowledge (Briggs & Pehrsson, 2008). In fact,
research mentorship in Counselor Education is so highly valued that
counseling is one of the few professions (medicine is another) that has
adopted formalized research mentorship guidelines. The Association for
Counselor Education and Supervision adopted these research mentorship
guidelines in 2009, and they have been operationalized into strategies for
implementation (Borders et al., 2012).
We hope that this chapter has inspired you to think about the role of research
in counseling and how you can be part of this important work. Expanding and
promoting the research base in counseling has been identified by the
American Counseling Association’s 20/20 vision statement as essential to the
efficacy of professional counselors and to enhancing the public perception of
the profession. We believe it is important for you to begin your research
while you are still in your graduate program. To help get you inspired, you
can read about the experiences of a counseling student who engaged in
research during her master’s degree program in the accompanying Snapshot.
As you read her story, perhaps you might think about how you can get
involved in research even before you begin your counseling practice.
SNAPSHOT Michelle Bruno,

Clinical Counseling Student
Michelle was a master’s student in a clinical counseling program when she
wrote this piece. Through her work in her counseling program, she came to
understand the importance of collecting data on her clients to evaluate her
own counseling. Like many agencies, the agency where Michelle did her
internship had a lot of data on clients, but no one had ever moved that data
out of the individual client files and into a format that could help inform the
agency.
Michelle:
As I enter my last quarter of my master’s internship, I have experienced
a paradigm shift in terms of the meaning of research. I have always been
someone who valued research and believed that it was an important part
of learning, but it was not until recently that the impact of research in
counseling became clear to me. I guess I always envisioned research as
something that my professors and other experts in the field were
responsible for conducting. I thought of it as something I would
probably become involved in “later” in my career and did not really see
how it fit in with my day-to-day work as a student. What I have learned
this quarter is that research is a process that has importance and
relevance for all of us as counselors and students. It can answer
questions that have direct relevance to clients and the staff providing
treatment to those clients.
As part of our internship course, we are required to conduct an outcomes
research project with clients at our sites. My internship is in an adult
partial hospitalization program, so I approached the clinical director with
my assignment so that I could get permission and consent to gather
some data. Because this program is part of a large hospital, they are
required to collect certain data on clients anyway. The results from a
report last year showed that some clients were leaving the program more
anxious than others, which left the staff wondering what they could do
differently. Along with my advisor, we set up a few meetings with the
clinical director. We are now in the process of learning more about how
we can better serve our clients, especially those with high levels of
anxiety, through an outcome study.
The results of this study will have an impact on how we do counseling,

what group sessions we continue, and which ones we adapt or eliminate.
As I have engaged in this process, it makes so much sense to gather
information like this so we have some objective measures of how are
clients are doing in our program. Conducting this research will help me
have a better understanding of the clients I work with and has shown me
how to find answers to questions that we as a staff were asking. This
study will also have impact in other areas, too, such as future funding in
the program. What we learn from this phase of the research can help
decide if we need to add more to our program in order to focus more on
clients with high anxiety. Conducting research is not just something to
read about in journals, but should be looked at as another way to impact
our clients. This course assignment and subsequent large-scale study
reduced the looming ambiguous “research monster” I had created in my
mind, and provided guidance and clarification on how to use research as
a student to help strengthen the program and impact clients.
Summary
In this chapter, we discussed how counselors who adopt an inquisitive
mindset can inform their counseling practice both by using existing research
and by conducting their own studies of effectiveness. Ultimately, counselors
with a research perspective engage in ongoing critical reflection about their
work, seeking to make adjustments and improvements as they continue to
learn and grow. Counselors who are practitioner-scientists see the benefit of
incorporating a research perspective into all of their work.
Counselors who read scholarly books and journals, and who have the skills
and knowledge to critically analyze what they read, become better
counselors. Counselors who write articles, engage in their own research,
participate in research teams, or present information at conferences and
workshops not only benefit themselves and their own clients, but the entire
field of professional counseling. We hope you are inspired to become a
counselor who is always learning, always investigating, always improving.
Student Activities
2. What are your reactions to using existing research and conducting your
own? What messages have you received in the past about research
(either your ability or desire to conduct research, or simply other
people’s reactions to the idea of research), and how do you think these
messages have affected your attitudes about research?
3. As you read about the graduate student authors, what are your reactions?
Have you thought about publishing or presenting your work as a
graduate student? What excites you about the possibility? What about
this would be challenging for you?
Journal Question
1.
As you think about your future as a professional counselor, what are some of
the topics, problems, or populations that you would like to study? You don’t
have to commit to a research agenda, but just take a few moments to think
about what questions you have that could lend themselves to research
projects. Can you envision yourself as a researcher tackling these questions,
either through the use of existing (published) research, or through your own
exploration? What would it mean for you, as a person and as a professional,
to be able to investigate these questions? In what ways would thinking of
yourself as a researcher fit with your beliefs about yourself, and in what ways
would your identity need to shift to accommodate this new role?

1. Why do you think so many counselors are resistant to conducting their
own research? What can you do to make sure that you have the
necessary skills to read existing research and conduct research on your
own?
2. Think about the type of setting where you might work as a counselor.
What research question(s) might you have about your clients or setting?
What types of research (general categories, not specific research
designs) might help you answer your research questions?
Experiments
1. Individually or as a class, select a recent issue of a counseling journal,
such as Journal of Counseling and Development, and classify all the
articles as research (quantitative or qualitative), literature
review/position paper, program evaluation, case study, or anecdotal
report.
2. As you talk with counselors at professional conferences or meetings or

interview them for class projects, be sure to ask them what the role of
research is in their counseling practice.
3. Imagine you were a client who was considering going to counseling. Go

on the Internet and select six websites that clients might explore to learn
more about counseling. Don’t look for the “best” websites or the
“professional” websites—just six that might catch the eye of a person
who is considering counseling. Use the criteria listed in the Spotlight in
this chapter to review the quality of the information on the website.
Consider what you discovered as you think about the messages the
general public gets about counseling from the Internet.
Explore More
Borders, L. D., Wester, K. L., Granello, D. H., Chang, C. Y., Hayes, D.
G., Pepperell, J., & Spurgeon, S. L. (2012). ACES Guidelines for
Research Mentorship: Development and implementation. Counselor
Education and Supervision, 51, 162–175.
This article operationalizes the ACES Research Mentorship Guidelines

with specific strategies for implementation
Granello, D. H. (2001). Promoting cognitive complexity in graduate

written work: Using Bloom’s Taxonomy as a pedagogical tool to
improve literature reviews. Counselor Education and Supervision,
40(4), 292–307.
This article describes a model for writing cognitively complex literature

reviews that counseling students can use during their graduate programs.
Granello, D. H. (2007). Publishing quantitative manuscripts in
Counselor Education and Supervision: General guidelines and
expectations. Counselor Education and Supervision, 47, 66–75.
This article gives general information on how to conduct

methodologically sound quantitative research and present the results in a
way that is suitable for publication.
Kline, W. B. (2008). Developing and submitting credible qualitative

manuscripts. Counselor Education and Supervision, 47, 210–217.
This article gives general information on how to conduct

methodologically sound qualitative research and present the results in a
way that is suitable for publication.
Sexton, T. L., Whiston, S. C., Bleuer, J. C., & Walz, G. R. (1997).

Integrating outcome research into counseling practice and training.
Alexandria, VA: American Counseling Association.
This foundational text on the use of outcome research in counseling

practice offers ideas and strategies that remain relevant and useful for
today’s counselors.
Young, A., Gonzalez, I., Owen, L., & Heltzer, J. V. (2014). Journey
from counselor-in-training to practitioner researcher. Professional
School Counseling, 18(1), 217–226.
This article gives strategies to help recent graduates move to the

practitioner-scientist role as they begin their professional counseling
careers.
Zyromski, B., & Mariani, M. (2016). Facilitating evidence-based, data-

driven school counseling: A manual for practice. Thousand Oaks, CA:
Corwin.
This manual was developed by one of the founders of the Evidence

Based School Counseling Conference.
Chapter 8 What Happens in a
Counseling Session?
Questions
By the end of this chapter, you will know . . .
How to recognize some of the barriers clients face in the decision to

seek counseling.
What clients believe is helpful and harmful in counseling.
The elements of a working alliance between counselor and client.
The joys and stresses of therapeutic work for the counselor.
The process of counseling from building the relationship to termination.
The basic skills you will need to develop a therapeutic relationship.
By the end of the chapter, you should be able to . . .
Identify the counselor characteristics you need to develop to form a

therapeutic relationship.
Decide if you are willing to confront the challenges of self-care, fears,

and self-examination that the profession requires.
Identify key skills that you should develop next and what unhelpful
behaviors you need to eliminate.

What are the personal joys and challenges you can anticipate in your
role as a professional counselor?
Are you ready to embark on a profession where you have to think about
your own reactions to clients and how your reactions might be helping
or hurting them?
Are you excited to be in a profession that requires you to stay on top of

your own mental health and constantly be involved in self-care?
In this chapter, we turn our attention to what happens behind the closed doors
of the counseling office. By now we hope you are developing a sense of who
counselors are and what they do, but in many ways, the intricacies of the
counseling session itself can remain hard to grasp. That’s perfectly
understandable because, in many ways, our profession is cloaked in privacy.
With very few exceptions, counselors simply cannot talk about our clients or
our counseling relationships with other people in our lives. It would be
unethical to allow our students to peek inside our counseling offices to give
them a sense of what actually occurs in a session. There is simply no way to
witness a counseling session, unless you have been in counseling as a client
yourself. (Incidentally, we believe this is an excellent way to learn about
counseling from the inside.) In this chapter, we will do our best to describe to
you what happens behind the counselor’s door.
What Counseling Is Like for the
Client
Counseling is about clients. As you go through your counselor training, much
of the focus will be on you as a developing counselor. But let us never forget
that everything we do, every decision we make, and everything we hope to
accomplish is always about our clients. In fact, a common mantra for
counselors is to ask whose needs are being met? It reminds us that we must
always do what is in the best interests of our clients. With that in mind, let us
start from the perspective of the client.
Before Counseling Begins: The

Decision to Seek Counseling
Stop for a moment and imagine what it is like to go to a counselor, or, if you
have been to counseling, remember what it felt like to make the decision.
When you recognize you need the help of a professional counselor, you must
admit to yourself that you cannot handle your problems alone (Wills, 1992).
Deciding to go to counseling can feel like an act of weakness or can be like
admitting that you are “crazy” (Sibicky & Davidio, 1986). Moreover, you
might think that the problem is too personal or too deeply disturbing to
explore, as though speaking it aloud will somehow make it seem too real
(Cramer, 1999). You may put off making the appointment, like going to the
dentist. When you decide to see a counselor, it may mean that you have
reached the point where none of your family or friends seem to be a source of
real help. In the end, things must be bad to make that call. Finally, you break
down and schedule a time or walk into the counselor’s office. It is a last
resort.
As difficult as these internal conflicts can be for the client, the anticipated or
actual opinions of others also can influence the decision to seek counseling.
For centuries, people in need of mental health care have faced the additional
burden of public stigma. Society has taught people who have a mental illness
or require assistance for their problems that they are flawed, that they should
feel shame, and that they have a character weakness. In fact, only 25% of
those with mental health problems say that the people in their lives express
understanding or compassion about their illness, and stigma is cited as a
major reason that up to two-thirds of people with significant mental health
problems do not receive care (Health & Human Services, 2017).
For many people, compounding the public stigma are cultural beliefs and
family rules (Rickwood & Braithwaite, 1994), such as “Don’t share your
dirty linen with anyone outside of your family or ethnic community.” These
cultural injunctions can further dissuade people from seeking help from a
counselor and can even affect what is disclosed within the counseling session
(Deane & Chamberlin, 1994). Conversely, people are more likely to try
counseling if there is support and encouragement for the process from other
people in their lives (Rickwood & Braithwaite, 1994).
One study (Kakhnovets, 2011) looked at the factors people consider when
deciding to go to counseling. Potential clients were more likely to choose
counseling if they were comfortable with self-disclosure, if they believed that
counseling would likely be helpful, and if they had support to seek
counseling (and a certain degree of that support) from the important people in
their lives. Further, there is evidence that people are more likely to choose
counseling if they have received counseling in the past. On the other hand,
another study found that people were less likely to seek professional help if
they believed that they had a strong social support group and if they
perceived going to counseling as a stigma (Vogel, Wester, Wei, & Boysen,
2005). This research suggests that the counselor must address a client’s fears
right away and provide him or her with information about the counseling
process, including the kinds of problems that counseling can help. By
educating the client, talking directly about the attitudes of others, and
confronting the social stigma, the counselor can help reduce the roadblocks to
counseling. When clients understand that they are in control of what will be
discussed, fears about disclosure are lessened.
What Clients Expect from
Counseling
Once people have made the decision to seek counseling, they may have ideas
about counseling, based on depictions in the media or stories from friends
and families. Of course, the expectations that a person has about what will
happen in counseling can have a direct impact on even the decision to follow
through and seek help. There are important gender, racial, age, and other
cultural variables that influence expectations of counseling. In general,
however, people who enter counseling expecting to form a trusting
relationship and to receive help from a nurturing and caring individual have
more positive outcomes in counseling. Further, clients who have generally
positive expectations about counseling show higher levels of involvement
and significantly better outcomes than those with negative expectations
(Constantino, 2012; Kakhnovets, 2011). In other words, expectations about
counseling can affect both the process of counseling and the outcomes,
reinforcing the need for counselors to understand early in the process what
clients expect from their engagement in counseling and to clarify
misconceptions.
Using a Social Justice Approach to

Understanding Client Expectations
Because of the important role that client expectations have on the
development of a therapeutic working alliance and ultimately on therapeutic
outcomes, it is important that the counselor and client develop some shared
expectations about the process of counseling. Importantly, the client must
feel understood and respected, and they must believe that the development of
the counseling relationship will proceed as a shared experience, not as an
approach used by the counselor to which the client must conform.
Clients who have experienced oppression may be particularly inclined to

believe that entering a professional relationship means that they have to
adhere to the counselor’s expectations. They may have had interactions with
professionals in other settings (at a doctor’s office or with a school
administrator) where they learned that they had little voice in or control over
what would happen to them. Thus, it may be particularly important for the
counselor to openly discuss the client’s experiences, including those that may
be difficult for the counselor to hear, such as those involving bias,
oppression, and racism (Fuertes, Brady-Amoon, Thind, & Chang, 2015) and
to explore with the client how these experiences have affected the
expectations for counseling. Although these conversations may be difficult to
initiate, counselors who use a social justice approach understand that helping
empower clients by treating them as equal partners can have lasting effects on
the relationship.
Hopes and Dreams: The Client’s

Belief in the Process of Counseling
Ironically, most of the research on why clients choose to go to counseling
focuses on why people do not make this choice, or what barriers they face in
the decision-making process. Although these are clearly important for
counselors to understand, there is also benefit from understanding why
people make the active choice to receive psychological help.
When people choose to go to counseling, each has unique hopes about what
the process will bring. They might go because they feel distressed and
overwhelmed, because others in their lives are pressuring them to go, or
because they have suffered a trauma or are struggling with substance abuse.
Students might seek the assistance of their school counselor because they are
being bullied, because they are failing school, or because they are struggling
with their emerging identity. For most people, though, counseling isn’t just
about reacting to negative experiences or struggling to remove negative
emotions. Counseling is also about enhancing positive experiences and
emotions. For example, clients might want to focus on developing better self-
esteem and self-acceptance, enhancing relationships, developing better
communication skills, or making better decisions. Some clients say that their
time in counseling is the only time during the week that they can completely
and entirely focus on themselves, their own needs and desires, and their own
hopes and dreams. After all, coming to counseling is a hopeful decision. It
means that although life may seem bleak and overwhelming, there is at least
one small part of the client that believes that change is possible.
In his classic book, Persuasion and Healing, Frank (1961) agreed that for
therapy to be successful, the client must believe that there is hope for
improvement. According to Frank, people enter counseling because they are
demoralized, and restoring hope and positive expectation is a powerful
ingredient for change. Most counselors recognize the importance of instilling
hope early in counseling, and hope has been recognized as a transtheoretical
mechanism for change in counseling, estimated to account for 15% of
counseling outcome (Lambert, 1992; Snyder, Michaels, & Cheavens, 1999).
In fact, an entire body of research supports the finding that much of the early
progress within counseling can be attributed to hope (see Chamodraka,
Fitzpatrick, & Janzen, 2017), and of course, once clients see some progress,
they become even more hopeful for future gains. Ultimately, clients who are
hopeful as they begin counseling are more likely to have higher levels of
overall well-being as counseling continues, better regulation of their
emotional distress, fewer symptoms, and better outcomes (Irving et al.,
2004).
The hope that brings clients into counseling can be integrated into the
therapeutic process in three ways: instilling hope through the counseling
relationship, finding hope by uncovering seeds already present, and creating
hope through the counseling intervention (Larsen, Edey, & Lamay, 2007).
Constantino and colleagues (2011) used this understanding to remind us to
early and often reinforce this hope and the positive expectations of
counseling. They suggest making a concerted effort to use statements that
inspire hope but don’t oversimplify the process or set up unrealistic timelines
for change. For example, you might say, “It makes sense that you sought
treatment for your problems” or “I am confident that working together we can
effectively deal with your depression” (p. 190). Other strengths-based
approaches to validating hope are comments such as “You have already
conquered two major hurdles, by admitting to yourself that you have a
problem and seeking help, which is not easy to do” (p. 190).
Fast Fact
Research indicates that client perceptions of the relationship with the
counselor are the most consistent predictor of improvement, even more so
than the therapist’s perception of the relationship.
Source: Manthei (2007), p. 261.
Secrets and Lies: The Client’s

Struggle to Open Up
Once clients have made the often-difficult decision to see a counselor, it may
seem counterintuitive to think that within the counselor’s office, many people
struggle with the pressure to self-disclose. We have already mentioned the
cultural and familial injunctions that might inhibit the client, but there is a
more immediate reason. In his book Why Am I Afraid to Tell You Who I Am?
John Powell (1995) says that we do not open up to others because we fear
that disclosure will result in rejection. In the counseling room, clients
recognize that if they tell their stories, the counselor may discover what a bad
or unworthy person they really are, and perhaps even more threatening, the
client must face that fact, too (Goldberg, 2002).
It may surprise you to learn that for many clients, the struggle to engage in
self-disclosure within the counseling session goes even deeper than having
difficulty opening up. About 50% of clients say that they intentionally keep
secrets from their counselor about major life experiences and key facts and
emotions (Baumann & Hill, 2016). Some of the common themes include
secret attractions, sexual secrets, health problems, drug and alcohol use, and
lying in their important relationships. More than any other reason, clients say
they did not reveal secrets because they did not want to express their feelings
aloud. A second reason is that they were ashamed or embarrassed to tell the
counselor. Interestingly, one study found that more than half of clients
wished that their counselor would pursue their secrets a bit more actively
(Farber, Berano, & Capobianco, 2004).
Moreover, recent research has found that more than 93% of clients say that
they have lied to their therapist, with 73% admitting that they have lied about
at least one therapy-related topic, such as negative reactions to the therapists’
comments or pretending to find aspects of the therapy effective (Blanchard &
Farber, 2016). The issue of disclosure and concealment in psychotherapy has
gained renewed interest in recent years with a special issue of the Journal of
Clinical Psychology devoted to the topic (Knox & Hill, 2016). Also, see
Kottler and Carlson’s (2010) book, Duped: Lies and Deception in
Psychotherapy, which is a compendium of counselor stories about client
deception.
In schools, counselors might know their student clients from interactions in

the hallways or classrooms or from referrals by teachers or parents.
Nevertheless, it is quite clear that even in school settings, students keep many
secrets from their counselors. For example, national surveys consistently find
that only 25% of adolescents say they would tell an adult if they knew a peer
was suicidal (Granello & Granello, 2007). Other secrets that students often
keep from their school counselors include self-injury, sexual activity, drug or
alcohol use, or bullying/victimization.
Words of Wisdom
[Participants in a research study on the effects of keeping secrets from one’s
counselor]:
“It’s probably self-defeating. If I don’t do the work, I won’t learn anything

new about myself.” “If you want to work through problems, the relevant
stories and secrets must be told.” “The effect of not telling is that I don’t
grow.”
Source: Farber et al. (2004, p. 343).
Keeping secrets and telling lies is an issue in all types of counseling,

including individual, group, family, and couples counseling. Couples may
conceal infidelities from the counselor even when they are affecting their
primary relationship (Bass & Quimby, 2006; Cottone & Mannis, 1996), and
families struggle with disclosing family histories and problems (McCurdy &
Murray, 2003). Certainly, people who are having affairs, abusing drugs, or
engaging in other addictive behaviors may have difficulty sharing these
experiences. Within counseling, however, it is important for clients who are
keeping secrets to come clean. When keeping secrets, clients may be
misleading the counselor and delaying their own progress. For example,
people who are in group therapy seem to benefit less if they keep important
secrets (Wright, Ingraham, Chemtob, & Perez-Arce, 1985), and clients who
withheld “relevant secrets” had poorer relationships with their therapists than
those who did not (Kelly & Yuan, 2009). Yet thinking of client’s secrets and
lies as always negative and deceitful may not be productive. It is tempting to
judge because you, as the counselor, feel as if you have been fooled. What is
more useful is to try to understand why our clients are engaging in these
tactics.
One way to think of this is that, when we lie or conceal, we are describing
our possible selves (Markus & Nurius, 1986). Clients construct an identity in
counseling that they wish they had, and that may not be such a bad thing. Let
us say that you meet someone at the airport who presents herself to a fellow
traveler as happily married and successful in business when in reality, she is
single and struggling financially. One view of this is simply that the person is
a liar. But it is also possible that the person is articulating a goal rather than
reflecting reality. It is possible from this vantage point to see that that your
client does not lie to you merely to mislead you but is afraid to face him- or
herself by telling you the truth. The counselor tries to see what the client is
intending, what is beneath the surface, what the client says sotto voce, in a
whisper. When we are lied to as counselors, we do not react angrily to the
client as if that person were a friend or a partner. When we discover a
deception our response is: “I wonder what you were trying to say to me by
not telling me the truth?” This chapter’s Snapshot describes the process of
counseling, as written by a client. As you read the client’s narrative, think
about how the counselor allowed her to express her true self, rather than the
self that others wanted her to be. It is a powerful story, and one that reminds
us how important it is for others to validate our experiences.
SNAPSHOT My Counseling
Experience by Ashley R.
Authors’ note: Ashley was having problems finishing her master’s degree in
accounting. To most of the people she knew, she appeared depressed and
unmotivated. She came to the college counseling center feeling that she
needed to recover quickly from the fact that she and her fiancée had called it
quits. This is her account.
I sought counseling in hopes of trying to move past the breakup of my

engagement. As it had been almost a year since the relationship had
ended, I was concerned that I was still struggling to let go of the pain
and move forward. Although I quickly established rapport with my
counselor and found it easy to open up and share my story with her, I
soon realized that it would take time for me to be able to address one of
my core issues . . . the shame and embarrassment I felt for still missing
someone who had treated me so poorly and in the end, had rejected me.
Initially my friends and family tried to be there for me but after some
time had passed, I started to feel as though they were all saying,
“You’ve cried and held onto this past relationship long enough. It’s not
okay to still be this upset.” I started to feel embarrassed that I could not
let go of my pain because everyone around me seemed to be sending me
the message that there is a time limit to grieving and yours is up. The
one person who made me feel like where I was at was okay was my
counselor. She validated my experience and created an environment in
which I felt comfortable to begin the process of healing. She helped me
to feel empowered, which allowed me to verbalize to my family and
friends that yes, I was still grieving, and that I had to work this out in my
own time and not on their time line. It is hard to put into words what
strength that gave me. My counselor’s constant support and validation
set in motion my ability to eventually start to let go of my shame and
embarrassment attached to still longing for my ex. My counseling
experience also allowed me to gain insight into why I held onto the pain
for so long.
What Counseling Is Like for the
Counselor
It is now time to turn our attention away from the client to the other person in
the room during the counseling session: the counselor. In this section, we will
talk about how the process of counseling affects the counselor. Even though
the primary focus of counseling is always on the client, counselors, as it turns
out, experience many joys (and struggles) in the counseling relationship too.
The Joys and Satisfactions of Being

a Counselor
One of the few studies that examined what counselors like about their
profession was conducted by Barry Farber and Louis Heifetz (1981). They
asked therapists to rate dimensions of their work on a 7-point scale. The
therapists saw about 21 client hours per week and had on the average 10
years’ experience. In Table 8.1, we graphically summarize their responses.
As you can see, the least satisfying parts of the job are having access to the
interesting details in client stories and being a mysterious figure. Even the
status aspect of the profession was not deemed as very satisfying. Among the
most satisfying elements were enhancing growth in self and in clients,
learning more about clients, and using therapeutic expertise. Perhaps this last
and most highly rated satisfaction requires some explanation. This response
reflects a need by a highly trained person to utilize the skills acquired as a
professional. It is like the gardener who sees a neglected lawn and knows that
with the right skills, something beautiful can be made. Counselors want to
exercise those skills.
Table 8.1 What

Counselors Say They Like
(and Don’t Like) About
Their Jobs
1 2 3 4 5 6 7
Not at All a Source Moderate Source Major Source of
of Satisfaction of Satisfaction Satisfaction
(Least) (Most)
Rankings from most important to least

Score
important
1. Using therapeutic expertise 5.65
2. Enhancing growth in clients 5.47
3. Learning about many types of people 5.42
4. Self-growth 5.35
5. Self-knowledge 5.31
6. Being socially useful 5.09
7. Being valued by clients 4.60
8. Achieving intimacy 4.56
9. Status 4.53
10. Learning the intimate details 3.10
11. The mystique of the therapist 2.43
The counselors in this study had many years of experience, and perhaps you
will not experience this “high” early in your training. But look at some of the
other joys. Counselors like the fact that their job involves self-awareness and
personal growth, and they like the interpersonal aspects of the jobs. They like
getting to know people at a deeper level, being helpful to and valued by their
clients. As you look at this list, you will see that financial compensation does
not even appear. As you think about becoming a counselor, this might be a
good time to ask yourself: Is this what I am looking for in a career—
becoming deeply involved with people?
Research demonstrates that school counselors who implement the ASCA

model are, in general, more satisfied with their counseling jobs than school
counselors who do not conform to the ASCA model (Pyne, 2011). In other
words, school counselors who work from a clear student-focused program
philosophy and who believe that all students in the school are assisted in
some way from the school counseling program were more likely to be highly
satisfied with their school counseling jobs. This study highlights the
importance that school counselors place on the belief that they are making a
difference in the lives of all children in the school.
Finally, a national study of practicing African American counselors who were

members of the American Counseling Association found that 87% were
either satisfied or very satisfied with their career choice, and satisfied or very
satisfied with 19 out of 20 facets of their job (opportunity for advancement
within their current agency was the only job facet that received a dissatisfied
rating). The components of their jobs that offered the most satisfaction (in
order) were Social Service, Moral Values, Achievement, Activity,
Independence, Ability, Creativity, Responsibility, Variety, Working
Conditions, Security, Social Status, Authority, Co-Workers, Recognition,
Supervision of Human Relations, Supervision of Technical Skills, Policies &
Procedures, and Compensation (see Jones, Hohenshil, & Burge, 2009 for
more information and detailed descriptions of these job facets).
Some of the Dissatisfactions of the

Counselor Role
In spite of the many joys and satisfactions of being a counselor, counselors,
like any professional, experience dissatisfactions and frustrations with their
job. Table 8.2 is also a summary of the study by Farber and Heifetz (1981).
This table shows how therapists in the study, on average, rated the most
stressful aspects of their jobs. Note that several of the biggest stressors such
as Excessive Workload (#1), Organizational Politics (#3), and Excessive
Paperwork (#6) are not actually counseling problems but workplace
problems. Later in the text, when we discuss self-care, we will look at the
stressors on this list more carefully and think about ways of surviving and
thriving with these challenges.
Table 8.2 What

Counselors Say Causes the
Most (and Least) Stress in
Their Jobs
1 2 3 4 5 6 7
Not at All a Source Moderate Source Major Source
of Stress of Stress of Stress
(Least) (Most)
Rankings from most to least amount of stress: Score

1. Excessive workload 4.10
2. Difficulty working with disturbed people 4.03
3. Organizational politics 3.73
4. Emotional depletion 3.67
5. Responsibilities for patients’ lives 3.67
6. Excessive paperwork 3.29
7. Controlling one’s emotions 3.28
8. Difficulty evaluating progress 3.28
9. Physical exhaustion 3.10
10. Doubts regarding efficacy of therapy 2.95
11. Inevitable need to relinquish patients 2.88
12. Constraints of the “50-minute hour” 2.57
13. Difficulty leaving “psychodynamics” at office 2.52
14. Professional conflicts 2.46
15. Lack of gratitude from patients 2.38
16. The monotony of work 2.37
17. Social difficulties after work 2.10
Words of Wisdom
“Anyone who is going to see a patient tomorrow should, at some point,
experience fear.”
Source: Bion (1990, p. 5).
Counselor fears
As Bion suggests in the accompanying quote, fear is normal and can provide
us with the motivation to improve. Fear is often the result of feeling
inadequate, especially when the client’s problems are severe or unusual.
Clients face situations, problems, and diagnoses that may be new to the
counselor. Changes in technology and the social world of teenagers mean that
students in school face stressors and problems that most adults never
experienced during their school years. No one can be an expert on all the
problems and mental disorders our clients face. Over time, you will begin to
recognize that you cannot prepare for every twist and turn in the road. You
will learn that the best thing we can do to help our clients who are
encountering these new situations is to take your time, understand the
problem, listen to the client, and get help from others. On the other hand, in
the beginning, counseling students can become so overwhelmed by fear that
they cannot properly concentrate on the client. This usually happens about
the time you are seeing your first real clients. Your fear makes you sit in
stony silence rather than risk making a fool of yourself. You may need some
counseling of your own to get past this anxiety, or you may want to learn
some stress-reducing techniques so that you can learn to be yourself in the
session. At any rate, this is an expected roadblock on the way to becoming a
counselor, and in many ways, is much better than naïve overconfidence. It
suggests that the endeavor is important to you and you want to do your best.
Countering the fear of client suicide
One of the times we feel the weight of responsibility is when the client
appears to be suicidal. We include a brief discussion on this topic because it
is an area that many counseling students identify as their biggest fear when
they envision themselves as a counselor. There are four things you can do
immediately to counter this fear and potentially help clients. First, gain more
knowledge about suicide risk from workshops and reading. Get specific
training in assessing and intervening with suicidal clients. Second, when you
are doing counseling, develop a relationship with the client and take the time
to fully understand the situation. This includes continuing assessment of
depression and anxiety, which usually accompany suicidal thinking. Third,
stay current and know the available community resources that you can fall
back upon. Fourth, consult regularly with a supervisor. Find one who is
experienced and whom you can rely on to help you identify and help clients
who are threatening to harm themselves.
Although fear among practicing counselors is common, very little research

has been done on the topic. A qualitative study of seasoned counselors
identified three main fears: fear of losing control of the session and being
overwhelmed, fear of being negatively evaluated by supervisors, and fear of
being assaulted by the client (Smith, 2003). In addition, counselors have
reported the following fears (Curtis, Matise, & Glass, 2003; Pope &
Tabachnick, 1993; Smith, 2003):
1. Saying or doing the wrong thing when dealing with clients from
different cultures
2. Dealing with clients that might be considering suicide or who might

harm the counselor
3. Getting sued (although very few actually are)
4. Being overwhelmed by a client’s problems and feeling unable to help
5. Crying in the session

6. Missing important information, such as when a child is being abused
7. Knowing when clients need additional resources
8. Handling client reactions to difficult confrontations.
Many of these fears are irrational or overblown. The best reaction to fear or
worry is to use it as motivation to learn more by education, workshops, and
readings. For example, every counselor in practice should periodically attend
a training session on legal and ethical issues, as laws and rules regulating the
profession change and develop over time. Knowing what is legal and ethical
can reduce your fear of practicing out of the bounds of your own professional
competence. The real key to handling fear is having a good supervisory
relationship. Experienced counselors and supervisors can help you sort out
real concerns from common problems. Even informal discussions with your
peers can help you recognize that many fears are shared by other counselors,
and your peers can help you find solutions. Consider the information
included in the accompanying Informed by Research section of this chapter.
As you read through the feature, consider how understanding the common
emotional experiences of beginning counselors can help you know what is
normal in your professional journey.
Informed by Research The Inner

World of Counseling Students
Helping counselors-in-training become more aware of their internalized
thoughts, feelings, and beliefs during counseling sessions is an important step
toward developing self-reflective practitioners. As you read about these two
qualitative studies, consider how the counseling students’ emotional reactions
to their clients’ stories and to their own responses to the stories can influence
the counseling session.
In a qualitative study, researchers had 34 first-year M.A. counseling students

record their inner experiences (thoughts, feelings, beliefs) that occurred
during counseling directly after their practice counseling sessions had ended
(Melton, Nofzinger-Collins, Wynne, & Susman, 2005). They found four
predominant affective themes:
1. Anger/frustration. The beginning counselors were often quick to

recognize their own shortcomings or inappropriate counseling
interventions.
2. Disappointment/regret. The students in the study expressed regret that

they did not know how to connect with their clients or were
disappointed with their lack of progress in skill development.
3. Anxiety/fear. The counselor trainees were often anxious or fearful about

trying out their new skills or using the skills to express empathy.
4. Happiness/excitement. Student counselors in the study at times felt

happiness or excitement when they used a technique appropriately or
believed that their clients were making progress.
An important finding in this study was that all four of these emotional
experiences were mixed throughout the sessions, leaving new counselors to
feel as though they were on “emotional roller coasters” (p. 88). Recognizing
these internalized emotional states can help beginning counselors distinguish
when the emotions are becoming so intense that they are having difficulty
focusing on the client. But for now, just knowing that these emotional
reactions are a common experience for new counselors can be reassuring.
You are not the only one who is experiencing them.
In another study, Sackett, Lawson, and Burge (2012) asked master’s

counseling students about their most meaningful experiences with their
clients. In other words, “What touches you in the counseling session?” The
qualitative study revealed that counseling students identified the counseling
relationship as most important. They appreciated counseling relationships
that had depth of connection and understanding, trust, boundaries, and
collaboration most meaningful. In addition, they listed the following events:
Insight: When counselors or clients had insights or “aha moments.”
Immediacy: When the counselor or client initiated a discussion of the

relationship or of the counseling process in the current moment such as,
“How do you think things are going in our relationship right now?”, or
when the counselor trainee disclosed their experience of the client, such
as “I experience you as . . .”
Goals: When trainees were successful in helping, clients set goals, make
plans, and identify meaningful homework.
Emotions: When the client or counselor experienced a significant

emotion, as well as the avoidance or lack of emotion.
Nonverbals: When the trainees became aware of their own or their

client’s nonverbal messages that spoke “louder than words.”
Transference and Countertransference: When the trainee dealt with a

transference or countertransference issue in the session. For example,
when the counselor says, “Do you think that you are responding to me
as if I am a parent trying to make you behave in a certain way?” or when
the counselor experiences countertransference because the client is
struggling with something the counselor is facing as well or the client
reminds the counselor of someone in their lives or of themselves.
Trainees Negotiating the Counseling Process and Their Role: When

trainees reflected on their performance in the session. Although this
occurs in supervision, reflecting on their own turned out to be
meaningful to the student.
Responsibility
“I must fix my client’s problems.” Maybe you do not say this out loud, but
you may think it and feel it when you are a counselor. After all, the client has
come to you, maybe as a last resort. The pressure to make it all better is one
of the first barriers a counselor must eliminate before there is any real
possibility for a therapeutic interaction. Feeling solely responsible is not
rational, nor is it reasonable to think you are going to solve a client’s
problems in an hour—issues that the client has been struggling with for
weeks or years, or even for a lifetime. In this chapter’s Counseling
Controversy, we examine the idea of the counselor’s responsibility for the
session through the debate over directive versus nondirective counseling. As
you read through the controversy, consider what you believe about how we
can best help our clients achieve their counseling goals.
Countertransference
Countertransference is a word used to describe the counselor’s conscious or
unconscious emotional reaction to the client (Curtis et al., 2003). Many
people think this is Freudian mumbo jumbo, and the word does sound like
something said by a “shrink.” Yet, inappropriate feelings toward a client,
both positive and negative, are very common. Here the term inappropriate is
used advisedly. These feelings are inappropriate because they are felt in the
wrong context. They are not appropriate in the counseling relationship. Due
to our previous relationships, upbringing, cultural background, family of
origin, and personality, we react automatically to others before we even get to
know them (Kottler & Balkin, 2017).
In his book, Love’s Executioner (1989), Irvin Yalom writes about a client he
calls the “fat lady.” From the beginning, he was repulsed by her, and she
notices the fact that he never looks at her and never even shakes her hand.
Yalom realizes what he is doing and traces its origins to the obese women in
his own family who were very controlling. Thus, the counselor’s feelings
cannot be truly hidden from the client. We do not always know why we have
these prejudices, but when we have them with our clients, we react
automatically.
Emotional reactions can be educational if we are aware of them and

potentially harmful if we accept them uncritically. Even positive emotions
can blur our judgment. For example, consider a client who appears to be a
middle-class woman with a husband and three children who is abusing
prescription medication. Are you likely, because of your own background, to
make assumptions about her prognosis (likelihood of getting better)? “She
looks just like my aunt,” or “She’s from Long Island just like me.” You
might think, “A financially stable, attractive woman with a supportive family
has so much going for her.” This countertransference may blind us to the
seriousness of her substance abuse problem because we are affected by her
attractiveness, our personal history, or our cultural lenses.
Fast Fact
The term YAVIS was coined in a 1964 book, Psychotherapy: The Purchase
of Friendship, by William Schofield to describe the type of client that
therapists prefer. YAVIS stands for Young, Attractive, Verbal, Intelligent,
and Successful. Schofield argued that counselors favor these clients because
physical attractiveness in others is appealing at an unconscious level. Humans
(including counselors) equate attractiveness with health, success, and
survival.
Counseling Controversy Should the

Counselor Be Directive or
Nondirective?
Background: In the early days of counseling, directive counseling could also
have been described as “test and tell,” meaning that the counselor
administered tests to the client and then revealed the results. This was the
typical scenario for career counseling. For example, the counselor would find
a match between the client’s personality and a career path and then made a
specific recommendation. Later, the term directive was applied to counseling
theories such as Rational Emotive Behavior Therapy (Ellis, David, & Lynn,
2010), which prescribes a healthy way of thinking. In strategic therapy, the
counselor gives clients specific directives or tasks to perform (Haley &
Richeport-Haley, 2007). For example, parents are directed to take
responsibility for the children on alternate days when shared responsibility is
not working.
Directive counseling contrasts with nondirective counseling, which

originated with Carl Rogers (1946). The nondirective counselor lets the client
take the lead and does not prescribe, give advice, or overtly guide the client.
The counselor believes that the answers to the client’s problems are within
the client, and answers will emerge that are coherent and genuine for the
client. A corollary of these ideas has emerged in the newer theories of
counseling such as solution-focused therapy and narrative therapy, which see
the counselor not as expert, but as facilitator.
COUNTERPOINT: THE
POINT: THE COUNSELOR SHOULD COUNSELOR’S Main
EMBRACE THE ROLE OF MENTAL Purpose Is to Empower
HEALTH EXPERT Clients to Find Their Own
Solutions
A client’s unique problem

cannot be easily solved by
The counselor has specific training and someone who does not
knows what facilitates change. The understand the
counselor should share this knowledge circumstances.
with clients.
The autonomy of the
People want someone to give them individual should be
expert knowledge. For example, a respected. It would be
client may want to know, “When does wrong for counselors to
substance abuse become dependence?” impose their beliefs on
clients.
The expert role does not force the
client to accept suggestions. The The role of expert sets up a
counselor is not manipulating the hierarchy between
client, but helping the client change in counselor and client. It
the agreed-upon direction. fosters dependency and
mistrust.
The weight of authority can encourage
clients to do what they have not done When the counselor falls
for themselves. back on prescribing for the
client, the client has not
learned anything.
argument.
Another kind of countertransference reaction is feeling sorry for the client.

Sometimes counselors feel their eyes filling up with tears at a client’s story.
Is this empathy, or are you identifying too much with the client’s situation?
Every counselor must sort this out personally. It turns out that about 20% of
counselors in training are somewhat to very worried about crying with clients
because they see it as unprofessional (Curtis et al., 2003). We have found that
some people are very likely to cry (even counselors) when they are nervous
or when they are exposed to something very sad, whether it be a movie or a
real story. If you are prone to tears, you will find a way to handle this
countertransference reaction, just as you learn to handle other emotional
reactions to clients, such as feeling angry. A helpful place to start is by not
admonishing yourself for these feelings and by later examining your personal
feelings in supervision. Jeffrey Kottler has written extensively on this topic in
his book, The Language of Tears (1996).
So how should the counselor handle countertransference or emotions towards

the client? The counselor tries to be aware of the immediate reaction,
recognizing that it is a prejudice. When you have a strong emotional reaction
to a client, ask yourself questions such as: Why does this client make me
angry? Why am I having such a strong reaction (positive or negative) to this
client? What is this about? Am I being fair? Am I objective? We hope this
leads you to take a second step and discuss every important reaction with a
supervisor, sharing these thoughts and feelings to consider how it might be
affecting the progress of the client. Getting supervision is one way to become
a more reflective practitioner.
A Roadmap of the Counseling
Process: The Shared Journey of
Counselor and Client
Now that we have looked inside the session from the viewpoint of both client
and counselor, we turn our attention to the process that they share. The
process of counseling differs slightly depending on the modality employed
(individual, group, couples, family), the setting in which the counseling
occurs (community, school, hospital), or the theoretical approaches used.
However, most counseling can be described as going through five stages. Of
course, these stages are often not distinct with discrete beginnings and
endings, but this is a general model that helps us see the bigger picture. The
“roadmap of counseling” (see Figure 8.1) is an analogy that helps counselors
conceptualize the steps in the process. In each stage, the counselor has a task
and the client has a task. Counseling is successful if both partners fulfill their
responsibilities.
Figure 8.1 The Roadmap of the

Helping Process
Stage I. Establishing the

Relationship
Roles of the Counselor and the Client: The counselor is empathic and
the client opens up.
Every relationship follows a zigzag course. It may start with extreme

closeness and then plummet, or it may build over time. The effective,
therapeutic counseling relationship may be intense, but it also might be
merely pleasant and respectful. We have already indicated that the counselor
must demonstrate warmth, empathy, unconditional positive regard, and
professionalism to help the client develop the trust needed for the therapeutic
endeavor. But the client also has a job. The client must first be able to show a
willingness to engage in counseling and second, must have the necessary
abilities to accomplish the basic tasks that the setting requires. Willingness
includes the idea that the client’s participation is voluntary and that clients
determine their own willingness to disclose to the counselor. Table 8.3 shows
a continuum of self-disclosure, which may help you see how the counseling
relationship is affected when the client is unwilling, or unable, to self-
disclose. The counseling relationship is thought to be most productive when
the depth of topics is greater, when the therapeutic relationship is
nonjudgmental and trusting, and when the topics are important. This is the
atmosphere that the counselor tries to establish.
Table 8.3 Continuum of Self-

Disclosure
Depth Relationship Things We Disclose
Menschen
waiting in
Superficial The weather, sports
the doctor’s
office
Business/Acquaintance Co-worker Our families, work
Worries, concerns, plans and
Trusting Friend
goals, religion and politics
Confidant Partner Dreams, shortcomings
Unethical or wrong actions,
Private Self sexual secrets, family
secrets, and substance abuse
What does this continuum tell us about the role of self-disclosure
in counseling?
Stage II Assessment
Role of the Counselor and the Client: The counselor asks the right
questions and the client provides information.
Before counseling begins, the client must answer the question, “Where does
it hurt?” Most counselors want to know something about the problem—its
intensity, frequency, and duration. The counselor wants to list all the
problems the client is experiencing so that in the treatment planning stage, the
counseling interventions can address the most critical issues. The counselor
also needs to know a little about the client’s background. Counselors might
ask questions about the client’s living situation, culture, previous counseling,
hospitalization, criminal background, mental status, family history, substance
use, and the client’s potential to harm self or others. Counselors will also
want to know about the client’s strengths and coping skills. In each of these
areas, counselors will need to understand the client’s perspectives and beliefs
about what is causing the problem and what needs to be done to help solve it.
Stage III Treatment Planning

Role of the Counselor and Client: The counselor proposes a schedule for
helping the client achieve the stated goals. The client collaborates in
identifying the goals and agrees to a plan.
Treatment planning is the process of taking all the gathered client information
and sorting it into piles as you might sort playing cards. Let us say that the
aces in the deck represent the most important problems that a client is facing.
This emergency pile might include issues such as finding a place to live,
getting a job, or abusing alcohol. In school counseling, the emergency pile
might include staying safe from bullying or developing coping strategies for
extreme shyness. Treatment planning is the process of determining what to
address first and what to focus on later. Perhaps the client has longer-term
goals such as becoming more independent, finding a partner, or overcoming
the fear of public speaking. These kinds of things go into a long-range pile
until the entire “deck” of the client’s problems and goals is sorted.
Treatment planning allows clients to get a handle on what is bothering them

in all areas of life. Surprisingly, treatment planning can be very healing. Just
having a To Do list makes the task seem less daunting and raises one’s spirits.
Treatment planning is a list of joint tasks that incorporates the client’s need to
get some pressing issues dealt with and the counselor’s expertise in knowing
which problems should be addressed first. Although it sounds like (and can
be) a very formalized and well-documented process, treatment planning can
be very informal, too, depending on setting or situation.
Stage IV Intervention and Action

Role of the Client and the Counselor: The counselor proposes methods
to treat the client’s problems, and the client puts them into practice.
Table 8.4 shows some techniques that a counselor might use to treat specific
problems. There are literally thousands of counseling techniques, but most
counseling programs expect you to master the basic listening skills first and
adopt advanced techniques later. The counselor should choose techniques
based on three questions:
1. Has research shown this approach to be effective with this problem?
2. Is this approach acceptable to and appropriate for the client?
3. Do I have the proper training and experience to administer the

technique?
Table 8.4 A Few Examples of

Counseling Techniques
Counselors Might Use During
Stage IV Interventions
Theoretical
Problem Intervention and Action Technique Origin (See
Chapter 6)
Countering and disputing self-
Feelings downing thoughts. The counselor
Cognitive
of helps the client identify thoughts that
therapy
depression are causing distress and learn to insert
more realistic and constructive ones.
Exposure. The counselor helps the
Fear of client develop a plan to slowly expose
Behavior
social him- or herself to more and more
therapy
situations difficult social situations until the
client gains confidence.
Encouragement. The counselor
Lack of
focuses on client efforts and interests Adlerian
motivation
and pushes with enthusiasm.
Unsure
Empathy. The counselor listens and
about a Rogerian/client-
allows the client to confront
course of centered
ambivalent feelings.
action
The client’s role in this stage is to use the counseling technique to bring about
change. For example, the counselor and client at this point may have
determined that the most pressing problem is the client’s difficulty in
expressing anger directly and appropriately. If the counselor proposes some
assertiveness training and techniques in Stage IV, then the client must agree
to learn these techniques and practice them.
SPOTLIGHT What a Counseling
Session in a School Might Look Like
School counselors recognize that in school settings, counseling can be less
formalized, shorter in duration, and less structured than in other settings.
School counselors might meet with their students for a few minutes during
lunch period to “check in” or have two or three 15- to 20-minute sessions to
help a student through a difficult time. It may be tempting to think that
because, on the surface, the logistics of the counseling sessions look so
different, none of the information about the format of counseling sessions in
this chapter applies to schools. However, that could not be further from the
truth. Whether a counselor sees a client in an agency setting for 20 weekly
hour-long individual appointments or for one quick session in a school, the
same format applies. Even in a single session, counselors must first establish
the relationship (Stage I), which may be done with some basic listening skills
and empathetic understanding. Counselors then try to understand the problem
(Stage II) that brought the client (student) into the counselor’s office and
move toward some goal or outcome that both counselor and client can agree
with (Stage III). A treatment plan need not be a formalized document, but can
simply be a verbal agreement between the counselor and student about what
needs to occur to help alleviate the student’s concerns. Once the goals are
agreed upon, the counselor uses counseling techniques or interventions to
help the student resolve the problem(s) (Stage IV), and then both agree to
either set up follow-up sessions, if needed, to talk with parents about
potential referrals to other resources, or to end the counseling with an
understanding that the counselor is available if the student needs more
assistance (Stage V).
For example, let’s say a high school student pokes her head into a school
counselor’s office to say that she needs to talk. The exchange might look
something like this.
Student: “Ms. Smith? Do you have a minute? I have a question.”
Counselor: “Sure, Susie, come on in. [student comes in, sits] What’s going
on?” (Stage I—relationship)
Student: “Well, um, I guess I’m a little worried about my brother. He’s in the
military—in the Middle East—and I heard my parents talking about it. I think
they are afraid for him. I guess I’m kinda scared, too. Um, you know, I heard
my friend say that when people come home from combat, they can be really
different, you know, they can just have totally different personalities—be all
scary and mean and stuff, because of what they saw in the war. He’s coming
home for leave in a few weeks, and I guess I’m kinda scared that he won’t be
the same guy that he used to be.”
Counselor: “Okay, so I’m hearing you say that you are thinking about how
things might be different between the two of you when he comes home.”
(Stage II—assessment of the problem)
Student: “Yeah, what if he’s all changed and everything, and he’s mean or
doesn’t want to talk to me or something? I mean, he’s my big brother, and I
really miss him (voice cracks).”
Counselor: “It sounds like he’s really important to you and you really love
him. You want to make sure that you do whatever you can to help him adjust
back to life here at home.” (Stage III—treatment planning or goal setting).
Student: “That’s the most important thing. I mean, I know he’s going to be
different after what he’s seen, but I want to help him. He was always there for
me when I was little—you know, standing up for me when others kids picked
on me and stuff. I want to have my big brother back, but you know, I also
want to help him if he needs it.”
Counselor: “That’s really important, Susie. I’m glad you want to help—it
sounds like the two of you have a really special relationship. I wonder what
you can do to help him transition back to his life here?” (Stage IV:
determining interventions)
Student: “Um, well, I don’t know. I guess I could write him an e-mail and tell
him that I’m looking forward to seeing him. I thought about that the other
day, but it seemed kinda weird—but maybe he’d like it. I also thought I
should ask my mom if she has any ideas. I don’t know, what do you think?”
Counselor: “It sounds like you already have some great ideas. Telling him
that you are excited to see him might help him feel more comfortable about
this transition. Is there anything else that you think you might tell him in your
e-mail? I also think it’s a great idea to talk with your mom. She might have
some ideas, too.”
Student: “I guess I kinda want to tell him that I want to help him adjust and
offer to help . . . do you think that’s okay?”
Counselor: “I think that would be really nice.”
Student: “Okay, I guess I just wanted to run that by someone before I talk
with my mom.”
Counselor: “Absolutely, Susie. That’s what I’m here for—and please let me
know if you want to talk more about this. I have some resources I can share
with you about how to help veterans who are returning from the war. Let me
know if you want those websites. You can look through them, and then let
me know if you have other questions or want to talk some more, okay?”
(Stage V: termination)
Student: “Okay, that sounds like a good plan. Thanks!”
Stage V Evaluation and Reflection

Role of the Client and the Counselor: Counselor and client jointly
review progress, plan further treatment, or terminate counseling.
Sometimes this stage is called termination, but that term does not accurately
reflect what counselor and client need to do at this stage. At regular points in
treatment, counselors need to call a halt, reflect on progress, and consider
new directions. The counselor and client need to look at what has changed
from beginning to end and either plan further treatment or halt the sessions.
Termination is not the only answer. It may be referral to another counselor or
another agency. Take, for example, the single mother who comes for help
with parenting issues. At the initial session, the counselor sees that, besides
her parenting, the mother needs some support and brainstorming to deal with
the multiple demands on her time. The counselor supplies this through
individual counseling until the client feels more stable. After three or four
sessions, client and counselor both agree that the crisis is past but that the
client still would benefit from parenting classes. So, a referral is made. The
individual counseling sessions are terminated and the client moves on to
another agency.
Counselors in all settings use the same basic counseling skills and engage in
the same basic format for counseling, although modifications might be
necessary to fit the setting or developmental level of the clients. In the
accompanying Spotlight, we discuss how the format of a counseling session
may be adapted to fit within the parameters of a school. Clearly, although the
big picture of counseling sessions can remain somewhat consistent across the
domains of counseling, there are important distinctions to make within each
setting.
The Skills of Counseling
In the final section of this chapter, we turn our attention to some of the
specific skills that you will use in a counseling session. Becoming a
counselor means that you must acquire the skills of the profession. Most
counseling programs have separate courses in counseling techniques or skills,
and these courses will help lay the foundation for your skill development. It
may seem artificial or strange as you first learn your counseling skills, and
many beginning counselors struggle when they start to practice them. We
encourage you to trust the process and know that the counseling skills you are
learning will start to feel more natural with time and practice.
The Skills of the Therapeutic

Relationship
The strength of a therapeutic alliance is defined as the degree of “trust, liking,
respect and caring” as well as the sense of being partners committed to
achieving therapy goals (Horvath & Bedi, 2002, p. 41). There are things that
the counselor and client can do to strengthen the relationship and things that
they can do to weaken it. Behaviors that strengthen the relationship include
collaborating with the client, being knowledgeable, offering specific
techniques to deal with problems, and being professional. Counselors can
weaken the relationship by being irresponsible, overly confrontational,
uncaring, and coldly professional (Horvath & Bedi, 2002).
Collaboration involves recognizing that the counselor and client are a team
and are committed to the therapeutic goals. Thus, both counselor and client
must agree on goals. Goals that are mutually agreed upon in counseling are
more likely to be achieved. In addition, the counselor and client must agree
on the methods for achieving those goals. If the technique goes against the
client’s religious, family, or cultural background, there is little likelihood of
success.
What clients find helpful in a
counselor
Clients tend to appreciate counselors for their skill and experience and they
are more willing to participate in counseling when they are treated with
respect, understanding, and as an intelligent person. Clients find that a
judgmental counselor who imposes a particular viewpoint or offers
interpretation too soon is not able to create a therapeutic alliance. The use of
too much confrontation and too much or too deep self-disclosures can
damage the bond. Certainly, not addressing client concerns about how
counseling is proceeding can lead to a rupture.
The good news for counseling students is that feeling accepted by the
counselor and the counselor/client bond is crucial to clients even when their
counselors are graduate students (Sackett & Lawson, 2016). Thus, although
you might be worried that your future clients in practicum or internship might
be disappointed to learn you are a counseling student, the research does not
bear that out. Clients want counselors (or counselors-in-training) who treat
them with the Rogerian principles of congruence, empathy, and unconditional
positive regard. Clients also value explanations or interpretations that provide
them with new ways of looking at their problems or situations. Finally,
clients say that they like being made to feel that they are competent, capable,
and insightful people, rather than being regarded as fragile, a failure, or
unable to cope (Manthei, 2007). Listed below are some traits and counseling
skills clients say they appreciate in their counselors:
1. Sensitive, gentle, honest (Lazarus, 1971)
2. Warm, attentive, interested, understanding, respectful (Strupp, Fox, &

Lessler, 1969)
3. Highly credible, skillful, empathic, affirming, attentive to emotions,

focused on client problems (Orlinsky, Graves, & Parks, 1994)
4. Warm and supportive (Elliott & Williams, 2003)

5. Empathetic, congruent, and demonstrating positive regard (Elliott,
Bohart, Watson, & Greenberg 2011; Elliott, Westmacot, Hunsley,
Rumstein-McKean, & Best, 2015; Greenberg, Elliott, & Lietaer, 1994;
Levitt, Pomerville, & Surace, 2016; Rogers, 1980).
6. Encouraging and reassuring, understanding, hopeful (Murphy, Cramer,

& Lillie, 1984)
7. Accepting and understanding (Lorr, 1965)
8. Dedicated to serving their welfare and developing a meaningful

relationship [clients of rehabilitation counselors] (McCarthy & Leierer,
2001)
Clients also appreciate counselors who:
1. Offer specific techniques to deal with problems.
2. Act professionally.
3. Make useful referrals.
4. Are knowledgeable about the client and the client’s problems.
Skills You Will Learn

Later in your training, you will be learning basic counseling skills. These are
generic building blocks of the relationship such as focusing on the client’s
feelings (see Table 8.5). They are skills that can help you improve your
relationship with anyone. Most parenting programs and virtually all
marriage/couples education programs focus on these helping behaviors.
Although they look simple, even basic skills take time to learn (Young,
2017).
Table 8.5 Basic Counseling

Skills
Skill Example
Open questions
(leaves options for “Tell me more about the blowup at the

the person to office.”
respond)
“Okay.” “Uh-huh.” “Yes.”

Encouragers
“Can you tell me more about that?”
Closed questions
(can be answered
with yes or no or “Did you get fired?”
with a brief
answer)
“So you had to go to another office for

Paraphrase several
(a rephrasing of weeks, and there is a strain between you

the facts) and
your supervisor.”
Reflection of
feeling “You’re really embarrassed about what has
(identifying the happened and a little afraid people don’t

client’s emotions) trust you to act professionally.”
Reflection of
meaning “Your identity has always been tied up with
(what the your job. Now it is hard to feel good about
problem means to yourself.”
the client)
Summary
“Though things have blown over and you
(a distilled version have smoothed things out with your
of the whole story, supervisor, there are several issues that
which might continue to worry you, including possible
include facts, promotions and how other people will view
feelings, and you.”
meanings)
Before you take a class on therapeutic communication (counseling skills),

there are some preliminary things you can do at this stage. You can begin to
observe the effects of your communication on others. In this chapter, we
make some suggestions about experiments you might attempt. Your friends
and family might think you are acting “shrinky,” but you will be able to act
more natural in time.
Second, you can practice some basic helping attitudes and helping behaviors
that will set the stage for your later practice. We will describe five things you
can work on early in your training. These are things that you can practice in
your everyday interactions with people when the other person has a problem.
We are also including three things to eliminate; habits you may have acquired
that you may want to become aware of and replace.
Skills to Work on Now

1. Pay attention. It is clear that human beings cannot multitask
(Rubenstein, Meyer, & Evans, 2001). Although many people believe
they can, it turns out that people are more effective when they do one
thing at a time. Yet, when someone starts a conversation, what
percentage of our attention do we give them? Do we continue watching
television or straighten some papers on our desk? Recently a client
related that she told a friend, over the phone, that she had been
diagnosed with cancer, and after a few minutes noticed that she could
hear the friend typing on the keyboard. In this age of electronic
distractions, it is difficult to get someone’s full attention. Yet attention is
a powerful commodity that human beings crave. If you want to gauge
the power of attention, the next time someone asks you, drop what you
are doing and make eye contact. Just being there with full attention can
transmit a very powerful message. It says, “You are important to me.”
As you begin your training as a counselor, learn to focus wholly and
solely on the person in front of you. Through practice, you can learn to
channel your full attention in one direction and give the other person the
benefit of your presence. Learn to ignore the chattering monkey of the
mind and instead pay close attention to what the client is saying. Later,
you will find that this will help you from being distracted by stage fright
as you practice your skills. Self-consciousness can be overcome by
“other-consciousness” if you can learn to shift your attention.
2. Check your understanding. Listening is like drawing a picture of the

client’s problem. Periodically, you hold up your sketch and say, “Is this
it?” The client’s response makes you draw new lines or erase some of
what you have previously drawn until you get it right. Initially,
counselors are trying to understand the client’s viewpoint, not get at the
absolute truth. What gets in our way is the judgments we make, such as,
“The client should make a commitment to his girlfriend and get
married.” Counselors listen for understanding. Counselors believe that
we need to understand why the client is dragging his feet, how he sees
commitment and marriage before we can make much headway in
addressing his reluctance. We should create an atmosphere where the
client does not feel judged. One way to do this is to provide
nonjudgmental feedback to the client regarding what you have heard so
far: “So you’ve been together for seven years and you have not decided
that this is the relationship for you?” One way to practice this skill is to
start using certain sentence stems that prompt you to check your
understanding, such as the following:
“In your mind . . .”
“What I am getting is . . .”
“All right, I am hearing . . .”
“So you are saying . . .”
These are far better than saying something like:
“What? Are you crazy, how could you let that woman slip away?”
“Some people never get married.”
“How long have you had this commitment problem?”
“There are a lot of fish in the sea!”
3. Use attentive silence. Attentive silence is not ignoring but rather just
accepting what the other person is saying with full attention. Silence can
prompt the other person to fill in the gaps, and all good counselors know
how to use it effectively. But silence is an art. Counselors use silence so
that they do not interrupt the flow of the other person’s story, but more
often to pressure the client to talk. Have you noticed that pressure to
speak when a conversation lags? When a person is telling a story,
silence can promote introspection. The counselor learns to live with that
silence, using it as a tool to urge the client to disclose. Silence
communicates that responsibility for the content of the session is up to
the client. The individual client is not obligated to answer the
counselor’s questions but to explore the issue aloud. Here we come to a
major fork in the road between therapeutic communication and
conversation. It is social to fill in silences and keep the conversation
light and breezy. It is asocial to use silence, contradict, or focus on
topics that are difficult or taboo. The counselor uses asocial
communication to let the client know that this is not a social situation
(Beier & Young, 1998).
4. Try to imagine what you would be feeling if this happened to you. The
ability to share another person’s feeling and way of seeing the world is
called empathy. Empathy is not sympathy or feeling sorry for someone.
It is the willingness to transcend one’s own situation and see through the
eyes of the other. There are many times when imagining how you might
feel in the client’s situation can help you get a handle on what is
bothering him or her. Perhaps it is not realistic to think we can truly
understand someone whose culture, family, and history are extremely
different from ours. But think about what happens when we try. If you
go to another country and try to learn the language of the locals, you
may stumble and you may be awkward, but it is generally appreciated
that you have tried. That effort builds a bridge in counseling too. If you
reach out and attempt to enter their world, it has been our experience
that clients will help you. One way you might practice this is to make a
list of behaviors of other people that you cannot understand. For
example,
I can’t understand:
Why it is so important to my roommate that the refrigerator is clean
Why some men cheat on their wives
Why people are against abortion but for capital punishment
Why people have different sexual orientations than me
The answers to these questions are locked up in the minds of the people
who do, feel, or believe these things. You will not be able to understand
them from your point of view. You must get into their perceptions,
feelings, and histories, and to do that you must imagine what you would
be experiencing in their situation.
Importantly, having empathy does not mean that you must have similar
stories or experiences as your clients. Sometimes beginning counselors
tell us that they worry that their clients will not want to work with them
if they haven’t had similar experiences. Counseling students without
children may worry that clients who are having parenting problems
won’t want to work with them. Students working with clients in
recovery may question their ability to understand the client’s situation.
Young counselors may be worried that older clients won’t trust them
because of their age. We remind our students that empathy is more of an
emotional response than a shared experience. In other words, we might
remind ourselves, “I don’t know what it is like to lose a parent to death,
but I know what it is to feel lost and lonely, and on that level, I can
connect to another human being.” Clients need to feel that connection,
and that is the core of empathy.
5. Remain neutral. Let’s say you are having a problem at work with the
boss. When you talk to your friend about it, you expect the friend to be
on your side, support you, and join you in seeing what an unreasonable
jerk the boss is being. But a counselor recognizes that there are two (or
more) sides to every story and that the client may be an accomplice in
the problem. It takes “two to tango” as the saying goes. Although the
counselor is working for the client, the counselor remains neutral as to
the cause of the problem and the solution to the problem. If you think
about it, the only person you have control over is yourself. You cannot
change other people. So, the counselor, much to the dismay of many
clients, seems to be implying, “Okay, your boss may be a jerk, but what
are you going to do about it?” Of course, there are times when
counselors must take sides, for instance, when someone is being abused.
However, most situations call for the counselor to convey to the client
that we are listening to the client’s version but not necessarily agreeing
with the client’s interpretation (asocial response). Here is an example:
Client: “My parents won’t let me go on Facebook unless they can read
what I am writing. It’s like the 1950s around them. None of my friends
have parents like them. They won’t let me go to the beach on prom night
with my boyfriend, either. It’s something we have been planning for
months. I can’t wait for two years when I can leave.”
Counselor: “So, in your mind, your parents don’t understand how
important this is to you. And you’re angry at them for being so
restrictive. To you, it doesn’t seem fair.”
In this response, the counselor is trying to understand what the client is

feeling, yet does not fall into the mistake of ganging up on the parents.
In the teenage client’s mind is the faint hope that the counselor will be
able to talk sense into the parents and advocate for her. Can you see that
the counselor makes no attempt to solve the problem for the client?
Does this fit with your idea of how a counselor talks to a client?
How can you practice this skill of being neutral in your life before you
work with clients? Even in our normal interactions, family members,
friends, and co-workers are often trying to recruit us to the side of the
argument. When it seems appropriate, find a way to remain neutral and
gauge the effect on the other person. Think about why they might be
trying to bring you around to their point of view.
In previous chapters of this text, you have seen Spotlights that give short
descriptions of counselors as advocates or counseling students from
different walks of life who have found success in graduate school. In the
final Spotlight of this chapter, we turn back to where the chapter started:
understanding the experiences of our clients. In this Spotlight, we focus
on the kinds of clients and client problems that counselors might face.
Things to Eliminate Now

1. Give up being a cheerleader. “That’s great!!” “I am so proud of you!”
Rah rah, rah. Enthusiastic praise may feel good, but in the world of
counselors, it is sometimes called “throwing a marshmallow” because,
like the unhealthy treat, it does not satisfy us emotionally. It is a
judgment that is simple to give and may seem superficial.
Think, instead, about encouragement. Encouragement recognizes the

person’s effort and offers support, interest, and enthusiasm but does not
make a judgment. For example, when your child brings you a hand-
drawn picture, instead of judging it as great art, instead, say what you
like about the use of color or some other aspect of the drawing, note the
effort expended, and encourage your child to keep working. Can you see
the difference in the relationship between one is giving praise and one
who is encouraging? Encouragement is the counseling relationship in a
nutshell. Practice encouragement with those around you. Do it in a
genuine way and see how it affects the other person.
2. Give up giving advice. Advice given to another is seldom useful. It can

reinforce a hierarchy in the relationship (one person has the “answer,”
which the other person seeks), but more importantly, advice sends a
message that the person is unable to come to answers without our
assistance. When we focus on giving advice and suggestions, we may
miss what is most important, such as the feelings the person is
experiencing. Advice-giving can create distance in a relationship. The
person on the receiving end often feels that important problems were
minimized or that the person giving the advice doesn’t understand the
situation. Either way, advice is seldom productive.
3. Stop practicing one-upmanship. Did you ever tell someone about a

problem and situation in your own life, only to have it countered with
something like, “You think you had a bad day? Let me tell you what
happened to me!” When we counter someone’s story with a story of our
own, we might think we are joining them in a common situation, but we
are creating distance. When our stories are more extreme, more severe,
more intense, our goal might be to help others feel less alone in their
trouble. Instead, they feel misunderstood and minimized, and the
emphasis in the counseling session moves away from the client and onto
the counselor. Counselors focus on the client and their stories, not on
our own.

Clients
The following brief descriptions are but a few examples of the many different
clients and client problems that counselors in different settings might
encounter.
Malik is a 20-year-old college junior who is experiencing extreme stress

because he is a student athlete and is also serious about his school work.
Every moment of his life is scheduled from required study periods to away
games. His scholarship depends on athletic involvement but he is not feeling
motivated to perform on the basketball court. He seeks counseling from the
college counseling center to try and understand why he has lost interest in
sports and his fears of losing his scholarship.
Armando is 22 and has been blind since birth. He finished a college degree
in literature on the Dean’s list but has no job prospects and is not sure what
he wants to do. He has been living with his parents and is very close to his
twin sister, who is not blind. He would like to live independently but is both
afraid and unsure how his family will take the fact that he wants to be on his
own. At the office of vocational rehabilitation, he sees a rehabilitation
counselor who is helping him with career counseling and the emotional issues
around being away from his family.
Maria and Charles are a married couple who have been separated for a year
after Charles had an affair with a co-worker. They say they want to repair
their marriage, but Maria’s anger is still fresh, and Charles is angry that
Maria can’t get past his infidelity. They have a three-year-old son, and living
separately has led to financial problems. Charles does not like the fact that
Maria has become very independent since their separation. They are seeing a
marriage, couples, and family counselor who is teaching them
communication skills and helping them form a new contract for their
partnership.
Dominique is a high school sophomore who is extremely shy and has trouble
with severe acne. Although she is never in trouble, neither is she present in
class discussions nor in extra-curricular activities. The school counselor has
been meeting with Dominique to encourage her to become more involved but
now realizes that many of her issues may stem from a stressful relationship
with her parents. The counselor invites Dominique to a group she is running
for students coping with anxiety. With the student’s permission, she
schedules a meeting with Dominique’s parents to see if they can seek medical
help for her acne and improve her diet.
Greta sought help from a mental health counselor in private practice because
of her depression, which seems to vary with the seasons, getting worse in
winter. Last Christmas, she was unable to get out of bed for two or three days
and when she did, she experienced periods of crying and suicidal thoughts.
With the help of medication, weekly counseling, and an overall wellness
regime with improved eating and exercise, recommended by her counselor,
she is back to work, and her crying has ceased.
As you think about the skills of counseling that you can begin to practice, or
eliminate, even in the early stage of your graduate program, we pull you back
to the big picture of why these skills are important. As always, this is about
clients. We learn these skills and eliminate unhelpful ways of interacting
because we know that ultimately, the ways that we improve our
communication skills will benefit the people we will counsel.
Summary
In this chapter, we discussed the counseling session and what counseling is
like for the counselor and the client. We talked about some of the basic
counseling skills that counselors use, recognizing that you will learn more
about these skills in your counseling techniques courses. These basic
listening skills have applicability to all relationships in your life, not just
those that occur in the counseling session. Finally, we noted that counselors
in all settings provide basic structure for the counseling session using
relationship building, assessment, goal setting, interventions, and closure.
Student Activities
2. What do you think makes self-disclosure so difficult for clients? What

makes it challenging for you? How can recognizing the difficulty that
most people have with self-disclosure make you a more empathic
counselor?
3. Many beginning counselors are discouraged to read about YAVIS and
how our clients’ appearance can unconsciously affect our counseling
relationship. What do you think about the concept that counselors prefer
to work with clients who are Young, Attractive, Verbal, Intelligent, and
Successful? Do you believe it is true? If not, why not? If so, what can
you do to help make sure all your clients receive fair and equitable
treatment in counseling?
Journal Question
1. Think back in your life to a time when you had a strong emotional
reaction to someone. It might have been positive or negative. You may
feel that there were good reasons for your reaction but rather than think
about these reasons, think about and list the characteristics that you liked
or did not like about the person. Can you relate this to someone else in
your past? How likely are you to have this same reaction to a client?

1. Why is it so important for counselors to remain neutral when they work
with their clients? What harm can be done by “siding” with the client?
2. In this chapter, we focused on the satisfactions and stresses of being a

counselor. As you look over the satisfactions, which ones do you think
are most appealing to you? As you look at the list of stresses, which of
these concerns you most? Because you are the expert on yourself, where
do you think you will have the most difficulty?
3. How can you incorporate some of your newfound basic listening skills
into your relationships with family and friends? How do you think your
relationships will change (for better or for worse) if you do?
Experiments
1. Most people who are new to the counseling field think of counselors as
advice givers, but counselors know the limitations of this technique. As
an experiment, try listening to a friend’s problem without trying to fix it.
But at the same time, stay involved. Make sure you fully understand all
aspects of the problem. How did you feel during the interchange? What
was the friend’s reaction? If you are normally prone to advice giving,
did your friend notice and feel let down?
2. Talk with counselors who work in different settings about the ways that
counseling sessions look for them. Are there common themes that you
can uncover? How do counselors maintain the essentials of the
counseling relationship when they must adhere to the parameters
imposed on them by their settings or clients?
Explore More
Books
Beier, E., & Young, D. M. (1998). The silent language of
psychotherapy. New York, NY: Transaction.
This classic in the field explores the critical role of covert

communication, persuasion, and social reinforcement that takes place
between counselor and client.
Choate, L. H. (2008). Girls’ and women’s wellness: Contemporary

counseling issues and interventions. Alexandria, VA: American
Counseling Association.
This clear, concise book provides a strength-based approach to helping

girls and women through the counseling process.
Jourard, S. M. (1971). The transparent self. New York, NY: Van

Nostrand Reinhold.
Jourard’s book, a foundational work in therapy, reminds all of us why

being open and forthcoming is an essential skill toward developing
wellness.
Powell, J. (1995). Why am I afraid to tell you who I am? Insights into
personal growth. Allen, TX: Thomas More Publishing.
This book, appropriate for clients as well as counselors, helps readers

become more emotionally open and more self-aware in interactions with
others.
Yalom, I. (2002). The gift of therapy: An open letter to a new generation

of therapists and their clients. New York, NY: HarperCollins.
Irvin Yalom is a well-known and well-respected therapist and writer

whose works are considered essential reading for many developing
counselors. This book reminds us all why we entered the field in the first
place and gives us strategies for making the most of our interactions
with clients.
Articles
Constantino, M. J., Arnkoff, D. B., Glass, C. R., Ametrano, R. M., &
Smith, J. Z. (2011). Expectations. Journal of Clinical Psychology: In
Session, 67(2), 184–192.
Fuertes, J. N., Brady-Amoon, P., Thind, N., & Chang, T. (2015). The
therapy relationship in multicultural psychotherapy. Psychotherapy
Bulletin, 50(1), 41–45.
Norcross, J., Strausser-Kirtland, D., & Missar, C. (1988). The processes

and outcomes of psychotherapists’ personal treatment experiences.
Psychotherapy, 25, 36–43.
More than 500 therapists were surveyed to determine their own

experiences in therapy, including the lessons they learned as clients that
are important for therapists to know.
Chapter 9 Where Do Counselors
Work?
Questions
The major counseling specialties and modalities and the benefits of each
for clients.
The usual elements of a typical counseling office.
The advantages and drawbacks of each major counseling setting

(inpatient, outpatient etc.).
Differentiate between the modalities of counseling, such as group,

family, couples, and individuals.
Make a preliminary decision about which modality of counseling a

client should receive (group, couples, family, individual, etc.).
Identify the common counseling specializations.
What settings and modalities of counseling seem most appealing to you?
Regardless of setting, how can you make my counseling office into a

place that facilitates the counseling relationship?
In this chapter, we discuss the settings where counselors work and the
different modalities or types of counseling practiced in each of those settings.
Counselors need to understand not just their own counseling setting, but all
the options that are available to clients. When we have this information, we
can match a client’s needs to the proper setting. To make this match, we must
answer three questions: 1) “What modality of counseling should we use?”
We need to know if the client should be seen as an individual, in a group, as a
couple, with family members present, in a multi-family group, or in
psychoeducation (classroom learning of an interpersonal skill). 2) “What
setting offers the best treatment or intervention for my client and for the
specific problem?” Some of the answers we might come up with include
treatment in outpatient, inpatient, partial hospitalization, in the client’s own
home or in a residential treatment facility. In schools, we might determine
that the client’s problem can best be addressed within the school building or
that we need additional resources and treatment from community providers.
3). “Once the decisions about overall modality and setting have been made,
then, is this specific modality, setting, and counselor the best available option
for the client?” For example, if the client needs assistance with substance
abuse, counselors ask if this is the right facility and the right counselor to
help that particular client. If not, a referral may be needed. Figure 9.1 might
help you envision how your answers to these questions might help you make
some initial decisions about counseling.
Figure 9.1 Three Questions to

Ask Before You Begin
Counseling
To help you learn to select the best treatment situation for a client, we first
introduce you to the major modalities of counseling, including the similarities
and differences between individual, group, couples, family, and multifamily
groups. We then move to a discussion about some of the most common
counseling specializations and consider how counselors with different
specialties use specific interventions to help their clients reach optimal
functioning. Finally, we discuss the various settings for treatment (physical
locations) from inpatient hospitalization to Internet counseling. This chapter
includes two Spotlights focusing on different counseling workplaces. These
are summaries of our visits to actual treatment centers that may help you get a
feel for what it might be like to work there. They include a center that helps
children and families, a substance abuse treatment center, and a center for
couples counseling and research. Finally, we include two Snapshots of
counselors who work in two very different types of settings: a college
counselor and a counselor who faces the realities and satisfactions of
counseling in a prison setting. It is a lot of information, and we have tried to
give you some organizational structures in the form of modalities,
specializations, and settings. But, just like everything else you have learned
about your new profession so far, the reality of counselors in practice is not
quite as structured as it might appear in this chapter.
Who is in the Room?
One of the first things a counselor does is determine who should come to the
counseling session. Some clients need couples counseling rather than
individual counseling. An adolescent client might benefit more if the entire
family discusses rules, roles, and communication. The client may have some
preference, but the counselor needs to weigh in on this decision and not
merely accept the client’s preference. Parents who bring in their 4-year-old
for therapy because they are going through a divorce may be better served by
helping them communicate with each other more productively rather than
simply treating the child. By the same token, the school counselor must
consider referring a student’s whole family to counseling if a school-based
intervention with the child is not sufficient. Consider the following common
scenarios:
Parents bring in a 12-year-old girl for counseling because her grades

have declined.
A man comes in to talk about the fact that he is not “in love” with his
wife of 20 years.
A man has difficulty in disclosing himself to others and says that his
relationships are shallow and that he is isolated and lonely.
A 9-year-old girl asks the school counselor how to stop being bullied.
A single parent wants family counseling because her two children fight
“constantly.”
Each of these scenarios requires a counselor to decide who should be in the

counseling session. To make a good decision, the counselor needs more
information. Frequently, it is too early to decide who should be in the session
when the first appointment is scheduled or when the initial contact is made in
a school. Therefore, the first session of counseling, much to the dismay of the
beginning counselor, usually has little to do with helping and more to do with
collecting data and sorting out who should attend later sessions. The
presenting problem (the client’s initial complaint) is the key to deciding
who should attend counseling. For example, if the presenting problem is poor
communication between child and parent, then both should attend a family
counseling session. If students are fighting with each other in the halls, it is
often productive to bring all of the students into the office to determine if a
resolution can be reached. The point is that some problems are best addressed
by an individual (even if other people are involved in the conflict), while
other situations benefit from a discussion with all those affected.
Differentiating between the two types is something that requires investigation
and understanding. For example, an adult client who is frustrated that her
mother is overly critical may benefit from a session that includes the client
and her parent. It might also be important to work with the client
independently, helping her disengage from her mother’s criticism and giving
her skills to enhance her sense of self-worth. Counselors first work to
understand the problem before they decide who will be in the room.
Even when the inclusion of others might benefit the client’s problem, this
might not be a realistic option. The client’s family may refuse to participate
in treatment or may live in another state. Further, just because a client’s
problems involve other people, that does not necessarily mean it is productive
(or appropriate) to include the others in counseling. A client who is having
difficulty working for an overbearing boss certainly cannot (typically) ask the
boss to accompany the client to counseling. A young woman who feels
pressured by her boyfriend to have sex even though she is not ready probably
would not benefit from having the counselor tell the boyfriend to back off. In
these instances, clients need to develop the necessary skills to help them
navigate difficult interpersonal relationships. Many clients come to
counseling and insist that other people need to change so that the client can
be happy. They say things like, “My partner nags me all the time,” “The other
kids won’t play with me,” or “My son drinks too much and it’s ruining his
marriage.” It seems we all think that our lives would be better if everyone
else changed. We remind clients that the only person they can control is
themselves. It’s a hard lesson, but one we all need to remember. In these
instances, counseling is often more about helping clients be proactive about
their choices rather than being reactive to the behaviors of others.
Of course, even if there are times when having certain individuals in
counseling might be beneficial, there are those who refuse to participate.
Involuntary clients are those who reject or decline counseling but who are
mandated to attend by an external authority and who face some type of
negative consequence if they refuse. Many counselors struggle to work with
these types of clients, but from a philosophical standpoint (these clients
challenge the concept of free will in counseling) as well as from a practical
one (involuntary clients can be particularly difficult to counsel).
Nevertheless, counselors in many different types of settings will encounter
involuntary (or, at the very least, very reluctant) clients. Consider these
scenarios. What are your reactions to working with these involuntary, or very
reluctant, participants in counseling?
Parents bring their 17-year-old in for counseling because the client is

failing his classes. What would you do if the adolescent client refused to
participate and sat mute?
College counselors are often faced with involuntary referrals from

Student Life or Student Judiciary. Do you think it is appropriate to
sentence college students to counseling? How would you handle a
student referred involuntarily for alcohol abuse or physical violence
against another student?
How do you feel about involuntarily hospitalizing a client who appears

to be dangerous to self or others? What sort of training do you think you
would need?
Words of Wisdom
[Advice for counselors running mandated groups for adolescents] “Be thick-
skinned: Know that some members are going to challenge you, ignore you
and accuse you of a variety of injustices. Be prepared to deal with members
who are resistant and defiant.”
Source: Schimmel & Jacobs, 2014

Counseling Modalities
Recall that the American Counseling Association (ACA) defines professional
counseling as the “application of mental health, psychological, or human
development principles, through cognitive, affective, behavioral or systematic
intervention strategies, that address wellness, personal growth, or career
development, as well as pathology” (American Counseling Association,
2011). That broad definition recognizes, however, that not all counseling
occurs in a one-on-one relationship. Many counselors engage in counseling
that has more than one client in the room at the same time, and these are
sometimes categorized as counseling modalities. For example, group
counseling, marriage, couples, and family therapy, and classroom lessons are
all counseling modalities that involve more than one client. Beyond the
special training required, practicing one of these counseling modalities means
making a perceptual shift. For instance, many counselors become
discouraged because they first learn individual counseling and then, when
confronted with a group, they attempt to work with each individual rather
than the whole group. Of course, this approach fails to take advantage of the
therapeutic conditions that only group counseling can provide. Another
example is the close relationship that forms between the counselor and client
in individual counseling, which seems less powerful in couples work. To
work with a couple, the counselor cannot side with one member or the other,
and this means that the relationship between counselor and clients can be
strained. In this context, the therapeutic relationship is qualitatively different
from individual counseling. Thus, counseling modalities are not just different
in terms of the knowledge that counselors must gain but also in terms of how
the counselor interacts with the clients. In Table 9.1, we summarize our
definitions and distinctions of some of the major counseling modalities. In
the following sections, we will discuss some of these counseling modalities,
although notably, we will not provide a narrative section on individual
counseling, as this has been covered in previous chapters (most notably in
Chapter 8).
Table 9.1 Counseling
Modalities
Best Reason for
Who Is Relationship
Modality Choosing This
Present? of Clients
Configuration
The client is
coping with
personal
decisions,
values,
motivation,
Individual One client, one
Not applicable career, school
Counseling counselor
problems,
disturbing issues
from the past, or
mental disorders
such as
depression.
None. Clients
Normally a
are usually
group procedure Clients do not
experiencing
with 5–12 have the skills
similar
individuals, it necessary to
problems such
Group may be tailored cope with a
as lack of
Psychoeducation to individual or problem and
assertiveness,
couples could benefit
marital
counseling from the support
problems,
sessions or with of a group.
parenting
larger groups.
issues, etc.
Clients have
interpersonal
issues such as a
Group 5–12 adults or wish to improve
Counseling children None themselves and
to form and
maintain
relationships.
None.
Normally
clients have
Clients have
different
Group 5–12 adults or serious problems
disorders but
Psychotherapy children or mental
may have a
disorders.
common
symptom such
as anxiety.
The couple
wishes to solve
relationship
Married, co- problems
Couples
habiting, affecting both
Counseling (also Two adult
considering people, or the
called marriage clients, one or
commitment, couple wants to
counseling when two counselors
or in a serious improve their
applicable)
relationship relationship, not
the individual
issues of each
person.
The problem
May be nuclear affects everyone
family, those in the family and
family members everyone can
currently living Related by help solve the
together, blood, problem. Typical
extended marriage problems include
Family family, or a through poor
Counseling client and adoption, or communication,
his/her family see rules and roles,
of origin. May themselves as adjusting to a
include children a family family member’s
and often two substance abuse
counselors recovery, death
(cotherapy). of a family
member, etc.
Families who
Members of Families are have common
several families unrelated issues such as
Multi-Family
(usually two or except that parenting
Group
three families) they may problems or
Counseling
and one or two share similar substance abuse
counselors issues. can learn from
each other.
Students in Efficient method
Classroom same class, to get important
Counselor and
Lessons typically at information and
classroom of K–
(classroom similar skills to students
12 students
guidance) developmental within the school
stage structure.
Group Work Including Group

Counseling, Group Psychotherapy,
and Psychoeducation
Group counseling is a format in which a collection of individuals who were
not previously connected meet with a counselor to overcome their problems.
Usually the members are carefully chosen to make sure that they can benefit
from this form of counseling and the group is an appropriate place for them.
Clients with interpersonal problems such as isolation, poor relationship
quality, or lack of assertiveness are best suited to group counseling. In school
settings, counselors use the power of groups to help children who face
interpersonal difficulties, (such as shyness or problems controlling anger), or
to help children connect with others who are facing similar challenges (such
as parents who are divorcing). Group counseling can be a powerful treatment
because it provides clients with a safe interpersonal laboratory in which to try
out a new way of interacting (Corey, Corey, & Corey, 2018; Gladding, 2016).
The Association for Specialists in Group Work (ASGW, 2009) divides,

groups into four types: (1) task and work group facilitation; (2) group
psychoeducation; (3) group psychotherapy; and (4) group counseling. Task
and work groups can be facilitated by a counselor who uses an
understanding of group dynamics to make work groups and committees
function more effectively. We have not included it in the chart because
counseling is not the primary focus of these groups. Group psychoeducation
involves a classroom-like setting where group members learn specific skills,
such as parenting, couples communication, or assertiveness training and then
process their learning with the other group members. Therefore, members of
psychoeducational groups usually share many of the same basic concerns or
challenges. Group psychotherapy, by contrast, is the use of a group setting
to help clients overcome serious problems such as depression or anxiety.
Clients may have different diagnoses or may all suffer from the same
problem, such as eating disorders. Finally, group counseling is a way of
describing a group experience for individuals without mental disorders who
want to make specific changes in their life.
Fast Facts
Many group counseling theorists believe that groups go through a series of
developmental stages, regardless of setting, population, or group structure.
These stages were first proposed by Tuckman in 1965, based on his review of
the empirical research. Tuckman’s model remains a foundational component
of group leadership training. Tuckman’s stages are as follows:
1. Forming (development of group culture and norms, introductions, etc.)
2. Storming (conflict emerges, with competing ideas, conflict, and struggle

for power and control)
3. Norming (as members work through conflict, they come to agreement
about their goals and purpose)
4. Performing (group members are interdependent, with high levels of

participation)
5. Adjourning (the group ends, and members emerge with new-found

knowledge or skills from the group experience)
Source: Tuckman (1965).
Couples Counseling
Couples counseling involves helping couples develop better relationships and
solve problems in their relationships. Couples are individuals who are
married, living together, or committed to a relationship. They may be of the
same or opposite sexes. Their problems frequently involve issues of
infidelity, poor communication, finances, dealing with children, and sexual
difficulties. For example, a couple comes to counseling because they are
fighting over money and they cannot agree who will be making financial
decisions. One wants to save and one wants to buy a new car. Although this
may seem like an easy problem to solve through compromise, in couples,
even the most prosaic problem has deep roots. Couples may deal with
conflict based on their own family histories and can stubbornly refuse to be
reasonable because it means relinquishing control. Many couples come to
counseling rather late in the game and with problems such as infidelity that
take a long time to overcome. Other couples show rapid improvement as they
learn methods for better communication and learn to be honest about their
needs (see Long & Young, 2007). Couples’ problems respond both to couples
counseling and to psychoeducational programs, sometimes called couples and
relationship education (CRE). In this chapter’s Spotlight on the Marriage and
Family Research Institute, we describe a CRE program that has treated
thousands of couples using a psychoeducational format.
SPOTLIGHT The Marriage &

Family Research Institute (MFRI)
The MFRI at the University of Central Florida has helped thousands of
couples since it first opened in 2003. The administrators, Dr. Sejal Barden
and Dr. Dalena Dillman Taylor, oversee the relationship educators, case
managers, and staff who provide services to low-income couples. The
relationship educators are counselors who teach the classes in Project
Harmony, a curriculum that provides couples weekly sessions on
communication and conflict resolution skills. Childcare is provided. In
addition, Project Harmony includes career counseling to improve the
couple’s financial situation.
The MFRI has published dozens of articles on its work. It is an example of a

research project that provides services to couples and training for counselors
and counseling students. Although the research demonstrates the
effectiveness of this kind of psychoeducational approach, the following
testimonials give you a sense of what couples appreciate:
Our experience at Project Harmony has changed our relationship in our

home completely. Married people are so quick to throw the word
divorce around. After these classes we feel that we have to make it work
no matter what because it is not just relying on love, now we have the
tools and feel responsible to use them and pass them on to the
generations to come in our family. We have a blended family and it is
not easy but having the tools makes you feel like you are going to get
through this and be successful.
Before we attended the UCF Project Harmony, my husband and I had

major issues. Some that we’ve tried to handle ourselves and others we
didn’t know how or where to begin. We’ve learned new ways to discuss
issues without the fighting. It’s brought us closer and we’re more in love
with each other now than ever before. The respect and understanding of
one another is at an all-time high.
Project Harmony is a research study that is funded by the U.S. Department of

Health and Human Services, Office of Family Assistance, Grant 90FM0039-
01-00, UCF IRB-00001138.
Family Counseling, Including

Multiple Family Groups
Family counseling means seeing members of a family to improve the overall
functioning of the family and its individual members. Families often come
for help because one member is causing a problem or because the unit is not
functioning well together. Communication and distributing responsibilities
are common problems. For example, family counseling might be needed
when a woman returns home after inpatient substance abuse treatment and
feels cut off from the life of the family or a divorced father with custody of
his children is considering remarriage and his children and fiancé are in
conflict.
Sometimes all family members are asked to attend and sometimes only
certain members. Frequently some members cannot or will not attend. That
can make it hard for the counselor who is trying to bring everyone together.
Family counseling is also challenging to the new counselor because it usually
requires the counselor to be more active and to direct the conversation in
constructive ways when several people are talking at once. Compared to
individual counseling, the counselor must be more direct in efforts to keep
the family on track. There is very little sitting back and saying, “Um hmm.”
Counselors who work with families get special training in theories of family
therapy and family therapy techniques and learn to recognize special ethical
issues associated with family work (see Wilcoxon, Remley & Gladding,
2013). In addition, some counselors, especially in addictions treatment, work
in multiple family groups. This is often a hybrid of family counseling and
group counseling, with some psychoeducational components. The counselor
may work with one family and then open up the discussion to the whole
group made up of observing families, who give feedback and support. At
times, the counselor might offer education on family development, coping
with addictions, and the stages of the family life cycle.
Fast Facts
Developing a classroom lesson is a five-step process:
1. Determining goals
2. Preassessing students’ current developmental levels related to the goals

(are they old enough to understand and relate to the issue?) For example,
is smoking the best discussion topic for kindergarten?
3. Creating concrete learning objectives
4. Designing instructional activities
5. Evaluating performance
Source: Fall (1994).
Classroom Lessons (Also Called

Classroom Guidance)
The American School Counselor Association (ASCA) National Model
includes classroom lessons, in the form of a classroom guidance curriculum,
as an important component of school counseling programs. Classroom
lessons are an efficient way for school counselors to provide all students with
developmentally appropriate knowledge and skills to help them achieve their
academic, career, and personal/social competencies (ASCA, 2012). School
counselors also use classroom lessons to give students information about
available services and resources as well as to learn more about important
transitions in their lives, such as preparing for middle school or
postsecondary opportunities. Here are some examples of classroom lesson
topics:
Test-taking skills
Getting organized
Understanding your learning style
Setting goals
Career possibilities
What to do about bullying
Friendships
Problem solving
Study skills
As you can see, classroom lessons are a proactive, psychoeducational, and

preventative approach. The ASCA Model (2012) recommends that
elementary school counselors spend 45% of their time in classroom lessons.
For high school counselors, the recommended allotment of time is 25%.
Counseling Specializations
Thus far, we have talked about counseling modalities, such as group or
family counseling. Just as with counseling modalities, counseling
specializations are areas of expertise that counselors can develop through
education and experience. What differentiates specializations is that they are
determined by specific interventions, client populations, or settings, rather
than by the number or people in the room.

One of the realizations we believe you will have when you read through the
many types of counseling specializations is how many of them are focused on
helping empower people who have been oppressed, disenfranchised, and
harmed by their life circumstances. Counselors who work with clients with
addictions, children who have been abused or traumatized, or people who are
in prison all recognize that they don’t just talk about social justice and
advocacy; they live these values every day. For example, you just read a
Spotlight about a large program that helps low income couples learn to
develop the skills they need to build strong and healthy families.
The Marriage and Family Research Institute (MFRI) offers assistance to

couples at no cost. In addition, free childcare and hot meals await the couples
and children who attend the sessions. In addition, as an added incentive,
participants are given Walmart gift cards. These benefits to the participating
couples represent a real and substantial cost to the program. Nevertheless, the
counselors at MFRI recognize that to attract the people who need the training
and skills the most—those who have no other options for participating in
programs to learn these skills—these costs are more than just an enticement
to attract couples into the services offered. They represent a very real
recognition that for many families, even services that are “free” are a luxury
that they cannot afford if attendance at them requires that the couple find or
pay for childcare or if the sessions run through dinnertime and would result in
missed meals or out-of-pocket expenses for fast food.
MFRI is certainly not the only program that attempts to meet the non-
counseling needs of its program participants. We highlight it here as an
important example of how counselors who work in all counseling
specializations need to be intentional about meeting the needs of their clients
in ways that can complement the counseling interventions used.
Counseling Specializations Based on

the Interventions Used
Some counseling specializations are based on specific types of interventions,
for example, biofeedback, psychodrama, or hypnosis. An example of this
kind of specialty is play therapy. Play therapy is the most commonly used
technique for working with young children. It involves using play materials
such as puppets and toys. As the child plays the counselor provides a
supportive environment, with as few limits as possible, to allow for the
expression of the child’s inner life. Although play therapy is primarily used
with kids, it is by no means confined to this population (O’Connor, Schaefer,
& Braverman, 2016). Many counselors use play techniques with adult
individuals, adolescents, couples, and families (Dillman Taylor, Pursewell,
Jayne, Lindo, & Fernando, 2011). For example, with adolescents, the
counselor may incorporate games as a way of establishing rapport or use
media such as drawing and writing to help clients express themselves. There
are also similar therapy techniques for couples such as asking a couple to
draw a picture together. The results can reveal important issues and add an
element of spontaneity and fun (see Landreth, 2002). In the accompanying
Spotlight, one of us (Mark) visits Kids House, a place where abused children
find refuge. You’ll read about how hard the staff works to provide an
environment that is safe and welcoming for the children as well as supportive
for the staff. Could you imagine what it would be like to work in a place like
this?
SPOTLIGHT The House Next Door
Since the 1970s The House Next Door has operated as a family resource
center in the small town of DeLand, Florida. A prevention-based agency
offering family counseling and other programs, it has provided help to more
than 50,000 families. Among its services are:
prevention of children entering foster care
assistance for low-income families to provide food in childcare facilities
early intervention programs for children and teens
counseling
Counselors who work at the House Next Door provide Parenting Classes,
Adult Anger Management, and Family Counseling. Right now, counselors
are offering support groups for those with bipolar disorder and anxiety
disorders. There is also a special program for victims of sexual abuse. The
agency has been identified as a trauma informed agency, allowing interns to
gain experience working in trauma. Because there are many Spanish-
speaking people in this part of Florida, the House Next Door offers programs
in English and Spanish.
Clients who come through the doors find more of a home than an institutional
setting. Counseling offices and group rooms are warm and inviting. Over the
years, the House Next Door has trained hundreds of counseling interns who
go on to careers in agency work or private practice. Compared to other
agencies, the House Next Door allows interns to see all aspects of family life
including parenting, couples’ issues, and family problems. Thus, it is an ideal
setting for marriage, couples, and family counselors to train and work.
Counseling specializations based on

client needs.
Other counseling specialties are based on client problems or needs, such as
rehabilitation counseling, career counseling, sports counseling, gerontological
counseling, or addictions counseling. Counselors who work in these
specialties recognize that additional training and experience is necessary due
to the complexities or specific concerns that their clients face. For example,
when beginning counselors work with clients who have addictions, they often
discover that their interventions cannot operate in isolation but must include
linking the client to support groups such as Alcoholics Anonymous (AA) or
Narcotics Anonymous (NA). Gerontological counselors must fully
understand the developmental stage of their clients and how aging interacts
with the mental health problems they present. Rehabilitation counselors
often not only help their clients (consumers) find jobs but help them adjust to
life with a disability. In the accompanying Spotlight, a counselor visits
Aspire, a setting where the staff focuses on the counseling specialty of
addictions. As you read the Spotlight, think about whether you can imagine
yourself as an Addictions Counselor in a setting such as this.
SPOTLIGHT Aspire Health

Partners
Tracy Hutchinson Tracy Hutchinson, Ph.D.,
Licensed Professional Counselor
Located in Orlando, Florida, Aspire offers a wide range of mental health

programs from early intervention for those struggling with drug and alcohol
dependence to higher levels of care such as residential treatment and
aftercare. I visited their downtown facility, which is housed in a renovated
1960s motel. The facility has a medication assisted treatment program
(formerly known as a methadone clinic) for those with an opiate dependency
as well as an outpatient counseling program called FOCUS. FOCUS provides
individual, group, and family counseling in the client’s home, in schools, and
at the downtown site.
As I arrive, I notice the busy waiting area crowded with clients. Many of
them are here to receive their methadone before going to work. I walk outside
to a courtyard where, on the second story, you can see the offices of six
counselors and three interns along the balcony. The center serves about 200
clients at this location. Jody Scott, the clinical director, explains that most of
the staff have master’s degrees and many of the counselors are in recovery
from some form of addiction themselves. There is no formal security here,
and counselors are not encouraged to be at the center alone.
The Center is located in a busy, sometimes noisy, urban environment.

Counselors are required to see 28 clients per week either in groups or
individually. Therefore, the daily goal of each counselor is to engage in six
direct service activities (client-contact hours) that include new intake
sessions, individual counseling, or case management services. Case
management is not counseling but includes assistance with a client’s health,
legal, job issues, or other practical problems that impede on treatment.
Counselors generally have a caseload of about 30 clients if they work in the
outpatient facility and about 50 clients if they work in the methadone clinic.
They are also required to facilitate 4 groups per week. Challenges for the
counselor include considerable paperwork and the fact that the Center does
not have separate case managers or social workers to advocate and locate
services for clients. Therefore, counselors are often faced with helping clients
find transportation, housing, and other basic needs. Jody explains that the
starting salary is low for beginning counselors, but an attractive bonus is that
the clinic offers supervision for those who are seeking licensure.
Another example of a counseling specialty based on client problems or needs

is career counseling. Career counselors help individuals or groups (for
example, in classroom lesson activities) explore career options, make career
plans, navigate career transitions, or work through career-related problems.
The profession of counseling has its roots in career (vocational) counseling,
and Frank Parsons, often called the Father of Vocational Guidance, helped
develop the idea of counseling as a mutual process, rather than something
done “to” the client. Career counseling has changed significantly from the
early days, when selecting a career was thought to be as easy as matching the
client to a particular work environment. Thanks to the work of Donald Super
(1910–1994) and others, career counseling is now seen as a lifetime
developmental process. Changes and transitions that occur over a person’s
lifetime, either planned or unanticipated, can greatly affect career choice.
Perhaps you have seen this in your own life or the journeys of some of your
classmates. People wait to go to graduate school until after the children are
grown, or marriages or separations result in geographical moves or changes
in finances. All these experiences can alter a career path. Career counseling
meets clients where they are in their developmental journey and helps them
make appropriate choices for the future. People who are unhappy in their jobs
or careers often find that the unhappiness bleeds into other parts of their lives.
Those who have conflicts at home or suffer from mental illness discover that
their personal problems can affect their careers too. In short, although career
counseling is a separate specialty within the profession, every counselor
needs to recognize its importance in the overall mental health of clients.
Counseling Specializations Based on

Setting
Finally, some specialties are based on setting, such as school counseling or
counselors who work in employee assistance programs (EAPs). These
counselors are housed in unique environments that, to some degree, shape the
clients and client problems that they face. Some of these environments are
highly specialized, such as the workplace of a forensic counselor, who
operates within the legal system, while others, such as counselors in
community mental health, have a much broader clientele. Regardless of
specialization, it is up to each individual counselor to make sure to have the
appropriate training and experience to practice a specialty.
An example of a counseling specialty based on setting is the role of the

college counselor. College counselors work in college- or university-based
counseling centers. In general, college counselors spend about two-thirds of
their time in direct services to students. The rest of their time is spent in
university-wide outreach programming, consultation with faculty and staff,
and crisis intervention. College counselors help students navigate both
academic and personal/social transitions that occur during college. Some of
these concerns are situational in nature, such as adjusting to living with
roommates or developing social relationships. In the following Snapshot, you
will read reflections about the life of a college counselor. As you read her
story, consider whether this might be a counseling setting that you would
enjoy.
SNAPSHOT Ximena Mejia, Ph.D.,

Licensed Mental Health Counselor
College Counselor
I was born in Quito, Ecuador and came to the United States to pursue my
college education. I graduated with a mental health counseling master’s
degree from Stetson University and completed my doctorate degree in
counselor education from University of Central Florida. I have worked for 15
years supporting college students through their adaptation and development
in their college careers in various student services roles, including an
admissions counselor, international student advisor, and as the director of a
Cross Cultural Center. My counseling experience also includes providing
individual, couples, and family therapy with sexual assault victims and
people suffering from chronic pain.
There is no average day as a college counselor because it is rewardingly

different every day. I provide individual and group counseling, manage cases
and crises, do outreach, consult, train, and supervise. I also perform various
other functions that support and contribute to the counseling center and
college’s mission statements. As a college counselor, I have to be prepared
for any and all clinical needs students might present. Because I work at a
small college counseling center trying to optimize services for all students, all
of the counselors in our office have to be generalists, working with a full
range of situations and problem areas. In a small office such as ours, it would
be logistically difficult to match every student who has a particular problem
with the counselor who has that kind of expertise. But the main reason is that
students’ situations are too complex and tangled to be neatly divided in
discrete categories. Students who might be abusing substances might also
have a diagnosis of depression and anxiety and present with suicidal ideation
and academic paralysis while simultaneously grieving the recent death of a
parent. It is important to understand the complexity of each case as a whole,
and helping and supporting students requires the perspective and skills of a
generalist.
I find it quite satisfying to watch students grow and develop throughout their
college journey and to see them navigate their college experiences. Given the
small residential campus where I work, I’m able to support students by
working together with various other support services on campus such as
health center, academic support, ADA office, residential life staff, etc. It is
rewarding to be able to refer students to the various offices on campus where
they can find support. The pace and volume of my job can be stressful at
times. It can also be very demanding in times of crisis and on-call
responsibilities. I have to be very intentional about self-care and stress relief
routines. In spite of the stressors, though, I absolutely love my job. It is a real
honor to be part of students’ lives and see them grow and blossom. Overall,
being a college counselor is really quite rewarding.
College counselors often address concerns that bring students into the
counseling center that are developmental in nature. For tradition-age college
students, challenges might include forming intimate romantic relationships or
navigating sexual identity concerns. For a significant portion of college
students, however, the issues that bring them into counseling are more deeply
entrenched. The last few decades have seen a dramatic increase in serious
mental health problems among college students. Nationally, about 20% of
students seen at college counseling centers have severe psychological
problems, and about 25% are on psychiatric medication (in contrast to about
9% in 1994) (American Psychological Association, 2013). Since 2007, the
suicide rate has steadily increased and suicide is the second leading cause of
death for college students (Centers for Disease Control and Prevention,
2016b). The good news is that college counselors can have a significant
effect on student mental health. When students receive help for their
psychological problems, the counseling they receive can improve not just
their overall well-being, but their academic success as well. Among college
students who receive counseling, 77% say they are more likely to stay in
school because of the counseling and their school performance would have
declined without it, and 90% say the counseling helped them meet their goals
and reduce stress that was interfering with their schoolwork. Retention rates
are 14% higher among students who received counseling (Kitzrow, 2003).
College counselors help students learn productive ways to manage their
mental health problems and to maintain their highest level of functioning. In
the accompanying Snapshot, you will read reflections about the life of a
college counselor. As you read her story, consider whether this might be a
counseling setting that you would enjoy.
Counseling Specializations and

Specific Training Requirements
Some specialties, such as those that are based on specific interventions, might
require additional courses or workshops, while others require the completion
of specific training programs. Still others, such as sex therapy or biofeedback,
might be regulated by your state licensure board. Clearly, there are a lot of
different counseling specializations for beginning counselors to explore. For
example, counselors can receive specialized training to use Dialectical
Behavior Therapy (DBT), Gestalt therapy, or Eye Movement Desensitization
and Reprocessing (EMDR®). They can go to workshops and trainings to be
Certified Grief Counselors or Certified Crisis Counselors. Counselors must
be careful to investigate the effectiveness of the different specializations
before they engage in advanced trainings or become certified in a specialty.
Not all specializations or certifications have empirical support to back their
claims. In Table 9.2, we briefly described some of the more common
counseling specializations we have discussed with links to websites with
more information.
Table 9.2 Some Common

Specializations Based on Interventions or Techniques
Client
Intervention and Population(s) Recommended Uses
Definition or Counseling or Applications
Einstellungen
Play Therapy Used when the child

is young or less
Primarily
A counselor uses play to verbal or talk therapy
children, but
communicate with a child is not working, when
can be used
in developmentally parenting help or
with clients of
appropriate ways. family counseling is
all ages in all
ot possible, when the
For more information: settings
child has
www.a4pt.org experienced a trauma
Art (Expressive) Therapy

Used with people of
A counselor uses the all ages and
creative process to improve problems (e.g.,
and enhance physical, Clients of all chronic health
mental, and emotional well- ages, in all conditions, anxiety,
being of clients of all ages. settings depression,
substance abuse,
For more information: domestic violence,
www.arttherapy.org/ trauma, loss)
Specializations Based on Client Population or Problem
Client
Specialization and Population(s) Recommended Uses
Definition or Counseling or Applications
Einstellungen
Many clients of all
Addictions Counselor ages in all settings
Clients who
have addictions.
A counselor who works have problems
Most counselors
with clients to help with alcohol,
believe that other
overcome addictions, as drugs,
mental health or
part of a larger intervention gambling, or
interpersonal
or as a focus of treatment. other addictions
problems cannot be
in all counseling
For more information: addressed if a client
settings
www.iaaoc.org/ is actively using
substances.
Students seeking
Career Counselor career direction and
Students in clients who are
A counselor who helps
schools and unhappy or
clients with career
universities or unfulfilled in their
exploration, career change,
adults in careers or who are
and personal career
community facing
development
agencies or unemployment or
For more information: private settings layoffs benefit from
www.ncda.org the services of career
counselors.
Gerontological Counselor Clients who need

Older adults in assistance with the
A counselor who provides all mental transition into older
services to clients who are health settings adulthood and the
older and their families as and in accompanying
they face developmental specialized lifestyle changes or
changes retirement or older clients with
assisted care mental health
For more information: facilities problems that can be
www.aadaweb.org/ exacerbated by aging
Clients with
disabilities of
Rehabilitation Counselor all ages who
receive services Clients with injuries
A counselor who works through or illness who need
with clients who have vocational assistance with job
disabilities to help them rehabilitation, or career transitions
maximize their potential, mental health or accommodations,
including their personal, programs, with adjustment to
social, and vocational goals employee life with a disability,
assistance or with developing
For more information: programs, independence
www.arcaweb.org/ insurance
companies, and
private practice
Specializations Based on Setting
Specialization and Client Recommended Uses
Definition Population(s) or Applications
College Counselor
College students
A counselor who provides have significant
direct services to students College and mental health
as well as outreach university problems. About 1 in
programming to the students (and in 3 report prolonged
university community, some cases, periods of
crisis prevention and their families) depression, 1 in 4
intervention, and and consultation has suicidal thoughts
consultation to university or feelings, and 30%
faculty and staff say they have trouble
For more information: functioning at school
www.collegecounseling.org due to mental health.
All ages and all
levels of
functioning, Community
many types of counselors help
Community Counselor settings, clients through life
including early transitions, through
A counselor who works
childhood times of crisis, and
with people in the
development, through many
community who have a
senior centers, different types of life
variety of mental health
homeless challenges, including
concerns and a wide range
shelters, trauma, depression,
of mental health
domestic anxiety, stress,
functioning.
violence interpersonal
For more information: shelters, crisis violence, social
www.amhca.org clinics, injustice, worksite
programs disruption, and
funded by career issues.
charitable
organizations
According to the
American School
Counselor
School Counselor Association, school
All K–12
counselors “help all
A counselor who works in students in
students in the areas
elementary, middle, or high traditional or
of academic
school to provide academic, online schools,
achievement,
career, and personal/social and their
personal/social
competencies to students parents/families,
development and
through comprehensive as appropriate.
career development,
school counseling programs Consultation
ensuring today’s
with teachers
For more information: students become the
and staff
www.schoolcounselor.org productive, well-
adjusted adults of
tomorrow” (ASCA,
2012).
College student
personnel provide
College Student Personnel outreach and
advocacy for
A counselor helps students
students to foster
adjust to campus life
college student
through offices of student
College and learning. Many
life and assists students to
university people who work in
develop a journey of
students college student
lifelong learning and
personnel are trained
discovery.
as counselors,
For more information: although they do not
www2.myacpa.org/ necessarily provide
direct counseling
services.
Counseling Settings: The
Environment Where Counseling
Takes Place
Much individual counseling does not take place in the counselor’s office,
although that is what we usually envision when we think about counseling.
Counselors also work in recreation centers, schools, treatment centers, and
other places where they may share an office or utilize a classroom or a corner
of the hallway for counseling sessions. The authors of this text have
conducted counseling sessions in agencies, hospitals, and schools, but also in
jails, prisons, hospital emergency rooms, domestic violence shelters, and
client homes.
Further, some counselors now work exclusively on the telephone (Kenny &
McEachern, 2004) or on the Internet. One of the most important advantages
of this type of technology-enhanced counseling is the ability to overcome the
barrier of physical distance. Counselors have a rule of thumb that if a client
lives more than 30 minutes a way, they will have trouble showing up for the
sessions. Without special reminders, clients do not show up in mental health
agencies more than 40% of the time (Swenson & Pekarik, 1988). Major
reasons for non-attendance are car problems, money for gas, and the time
needed to get there. Technology can instantly connect people in a counseling
relationship including those who may be unable or unwilling to travel to see
the counselor. There are still remote corners of the United States and even
more around the world where face-to-face counseling is simply not feasible.
There are, however, some specific ethical challenges, special skills, and
dangers associated with not-in-person counseling (Haberstroh, Parr, Bradley,
Morgan-Fleming, & Gee, 2008; Richards & Viganó, 2013). For example, you
may not be able to see nonverbal communications that are indicative of
serious problems. Further, no matter how good technology becomes and even
with high definition and 3-D pictures of the person we are talking to, most
counselors believe that it is not the same as being there. According to Woody
Allen, eighty percent of life is just showing up. At least one of the reasons
that counseling is valued is because both people have taken the time and
effort to make the meeting happen. Being there in person is more of a
commitment than turning on the computer. The counseling hour becomes
important because we have set it aside and excluded the rest of the world.
In spite of these limitations, there does seem to be some support for

counseling that includes technology such as telephone conversation and
therapeutic writing on the Internet (Day & Schneider, 2002). Studies
involving online counseling have not been large scale and few have used
random assignment and control groups (randomized control trial) (see Bee,
Bower, Lovell, Gilbody, Richards, Gask, & Roach, 2008), yet they have not
found a definite advantage for face-to-face counseling. In spite of limited
research on their effectiveness for clients with mental health problems,
online, email, and telephonic counseling are increasingly common.
In this chapter’s Counseling Controversy, we discuss the growing area of

online counseling. As you read through the controversy, consider what you
believe about this growing trend within the helping professions.

Counselors Practice Technology
Assisted Counseling (counseling
when the client is not physically
present)?
Background: As you read this, a counselor is conducting a group session via
the Internet. A client in a wheelchair in a remote part of New Mexico is using
Skype to talk to her counselor. Right now, a counselor on a hotline is talking
with a client who is thinking about suicide. At home, a client who wants to
improve his mood is using a smartphone app to identify things that are going
well. A client with bipolar disorder is searching for support groups online. In
an alternative school, a high school student does all her assignments online
and then consults a school counselor by email.
When the printing press was first invented, it met with equal parts excitement
and resistance (Einsten, 1983). Similarly, there is reason for caution and
optimism about the role of technology in counseling (Goss & Anthony,
2009). But like the printing press, technology in counseling cannot be
stopped, and counselors must be able to recognize good and bad uses.
POINT: TECHNOLOGY
COUNTERPOINT: TECHNOLOGY
ASSISTED COUNSELING IS
ASSISTED COUNSELING SHOULD
THE WAVE OF THE
NOT BE TAUGHT OR PRACTICED
FUTURE
Counselors have always

used technology. This is
just an extension of
Previously, technology was an adjunct
communication technology
to counseling, but conducting sessions
that offers advanced means
remotely will result in a counseling
for connecting client and
relationship that is less powerful. Will
counselor and does so
the counselor be able to assess suicide
when clients need help, not
online? The camera cannot smell
only at prearranged times.
alcohol on the client’s breath or touch
Technology allows us to do the client’s arm to provide
new types of counseling reassurance.
practices. We can alert the
Counseling will lose the special
client with electronic
quality and importance of having each
reminders, cue them to
member take the time to make the
practice and monitor
meeting happen.
progress online, and send
messages any time. Much of the online counseling is by
the minute (around $2.00 per minute =
Clients with disabilities,
$120 hour). That could be unethical if
financial problems, and
clients are not aware of the total
barriers caused by distance
amount of their charges before they
will still be able to obtain
receive counseling.
counseling, and costs can Counseling sessions that take place on
be greatly reduced if a cellular phones, e-mail, and Internet
counselor doesn’t have to may not be secure from hacking.
maintain an office. Clients might record sessions and
family members may overhear
Some ethical and legal conversations.
problems will be reduced
when a client does not
come to an office or is not
physically present.
As with most controversies, there probably is truth to both sides of this

argument.
We encourage you to be open and flexible at this stage of your counseling

career as you think about your future counseling setting. Many types of
counseling can be practiced in different settings. For example, you might
want to be a school counselor, but have you considered all of your options?
You could be a school counselor in an elementary, middle, or high school.
You could choose a public school, private school, or charter school. You
might be a school counselor in an on-line school, a bilingual school, a magnet
school, or an arts-intensive school. You may choose a religiously affiliated
school, a military school, or a boarding school. You might work in an all-
girls school, an all-boys school, or a specialized school for kids who identify
as transgender. Of course, there are urban schools, rural schools, and
suburban schools, too. We could go on, but we hope the point is clear. Even
once you have narrowed your setting within the field of counseling, there are
a multitude of options. One thing you may wish to consider (and research a
bit on your own) is the job satisfaction of counselors who work in these
different types of settings. In this chapter’s Informed by Research, we look at
a study of practicing rehabilitation counselors and their level of job
satisfaction, based on the physical setting of where they practice their
counseling.
Informed by Research How

Counseling Setting Influences Job
Satisfaction
Several research studies have measured job satisfaction of counselors based
on setting. One of these studies surveyed more than 1700 Certified
Rehabilitation Counselors (CRCs) using a measure of job satisfaction.
Respondents were asked to assess their satisfaction regarding daily work
activities, pay, opportunities for promotion, supervision, and relationships
with colleagues (Armstrong, Hawley, Lewis, Blankenship, & Pugsley, 2008).
A type of statistical test called a univariate logistic regression analysis was

used to calculate odds ratios (in other words, given particular characteristics
of the person or the position, what are the odds of a low or high level of
satisfaction compared to other CRCs?). In general, the researchers found that
the majority of participants were satisfied with their employment (mean score
= 48.02, SD = 11.83 out of potential high score of 54 on overall job
satisfaction). However, there were differences based on setting. CRCs who
worked in college or university settings had the highest level of overall job
satisfaction, and those who worked in state or federal vocational
rehabilitation settings had the lowest. In fact, the odds of a CRC in a college
setting being satisfied with the job were 1.93 times higher than those of a
CRC in a state or federal vocational rehabilitation job. In addition, there were
differences in level of satisfaction with components of the job based on
setting. More specifically, CRCs who were in mental health or substance
abuse treatment were the most satisfied with the type of work they do (94%
indicated high levels of satisfaction). More than 70% of individuals in private
rehabilitation (e.g., insurance companies, worker’s compensation, private
practice) were satisfied with pay (5 times more satisfied than those in
vocational rehabilitation). CRCs in mental health or substance abuse as well
as those in college and university settings were the most satisfied with
opportunities for supervision (82% highly satisfied in each of these settings).
Interestingly, regardless of setting, most CRCs were, in general, dissatisfied
with opportunities for promotion (more than 50% in all settings indicated
dissatisfaction). The study results found that CRCs in all settings tend to be
satisfied with their relationships with colleagues, ranging from 87% in private
rehabilitation to 92% in colleges and university settings.
The results of this study indicate that employment setting can influence job
satisfaction for CRCs. The majority of respondents across all settings
indicated general satisfaction with their jobs, but CRCs in college settings
were the most satisfied overall.
A Traditional Counseling Office

There is little to back up claims that a warm, inviting counseling office helps
clients get better (Pressley & Heesecker, 2001). Nevertheless, many
counselors believe that the environment can influence a client’s willingness
to disclose, reduce feelings of anxiety, and imbue a sense of safety. Clinical
wisdom and theory suggest that room color, lighting, the presence of plants,
art, and the spatial arrangement of furniture can affect the client and the
counselor.
We do know that clients want the counselor to sit (on average) between 48
and 60 inches away, although cultural background clearly has an influence on
this (Stone & Morden, 1976). In addition, privacy of the counseling session
certainly affects how much a client is willing to disclose (Holohan & Slaikeu,
1977). In general, warm, intimate settings are preferred by clients over cold,
institutional rooms (Chaikin, Derelega, & Miller, 1976). Theory and
experience tell us that clients like an orderly, not too homey setting that is
private, comfortable, and reflects the credibility of the counselor (Pressley &
Hessecker, 2001). For instance, clients seem to like seeing the counselor’s
credentials displayed but not the picture of the counselor at Disney World
with Mickey Mouse. As beginning counselors move into their first offices,
they often experiment with setting the appropriate professional tone by
bringing in artwork or knickknacks that match their own personal style. It is
always appropriate to check out the offices of other professionals in your
school or agency to see how they have (or have not) found a balance between
a professional and inviting tone (see Cook & Malloy, 2014 for suggestions
about making your school counseling office more welcoming).
Ordinarily, a counseling office should have three chairs: one for the client,
one for the counselor, and one for a significant other such as parent, spouse,
or partner. A small table with a lamp for soft lighting along with a carpet
gives the room a more intimate feel that can counteract institutional
furnishings such as tile floors and fluorescent lights. The table is also a place
to set some papers, clipboard, a glass of water, and the necessary box of
tissues. A key feature is the clock, because most counseling sessions must run
on time. The placement of the clock is important so that the counselor does
not have to look away from the client too much and disrupt the flow of the
session. It should also be visible to the client. A white noise machine can
preserve privacy by masking the voices of client and counselor from
passersby. Usually, the counselor’s chair is nearest to the door. In general, it
is an important safety precaution not to have obstacles (or clients) between
you and the door (Wilson, 2012).
Other Settings Where Counseling

Takes Place
Although we have described a generic counselor’s individual office, it is also
important to look at the larger setting in which the office might be located. In
Table 9.3 we describe the general categories where counseling most often
occurs. These range from hospitals to agencies to the client’s own home. We
believe that clients should be enrolled in the least restrictive treatment
environment in which they can participate. Inpatient hospitalization is the
most restrictive. Most are locked wards, and although clients have the right to
refuse treatment as inpatients, they may be discharged if they are not
compliant. At the other end of the continuum, in-home counseling, school-
based counseling, Internet, and phone counseling would be considered the
least restrictive because there are fewer guidelines enforced by the counselor.
Besides selecting the least restrictive environment, the counselor must
consider where the client is likely to make the fastest and most complete
recovery. Brief inpatient hospitalization might be the most restrictive, but it
may mean that the client will receive intensive daily treatment and
medication not available in other settings. For example, we once worked with
a woman experiencing a major depression. Despite outpatient counseling and
medication, she was unable to make a dent in her debilitating mood disorder
over a 3-month period. She was admitted to a hospital and within 7 days was
significantly improved because her medication could be administered
correctly and she could receive daily counseling. As counselors, we have
found that some clients cannot make progress when treating their addictions
in an outpatient setting. Some need a more controlled environment at first.
The selection of the environment also depends on the needs of the client
(proximity to support system), the amount of money the client has, the
insurance carrier of the client, and in the case of hospitalization, the potential
danger to the client or the community. Sadly, as in medical treatment, the
client who receives the best care is usually the client who can afford the best
treatment facility. In the accompanying Snapshot, we hear from a counselor
who works in a very specific specialization based on setting: a prison. As you
read her story, consider the unique challenges that she faces in her work with
clients.
In addition to the practical considerations, the ethical issue of client

autonomy arises when selecting a treatment location. Clients have the legal
and ethical right to refuse a specific treatment. But counselors have an ethical
duty to know what the best treatment is likely to be, based on current
literature, experience, and by consulting with experts. They deliver this
information to the client and allow the client to make the decision. In this
way, counselors are like all health care professionals. For example, let us say
you went to the doctor, who recommends surgery. You ask if there are
alternatives, and the doctor indicates that none of the alternatives to an
operation will solve the problem, that medication and diet will only ease the
pain for the time being. The doctor can do one of two things in this situation.
The doctor can give you the less effective treatment or refuse to go along
with half measures. The same dilemma applies to the counselor. If the client
wants a less restrictive, less intensive treatment, the counselor may agree
while letting the client know about the potential risks. But the counselor need
not accept the client’s treatment choice if the counselor feels that it is likely
to be harmful or if is likely to be ineffective. As you can see, these things are
a matter of judgment. Judgment means taking the time to consult and think
about the issue and not making a split-second decision on an important
problem. That is why all counselors should have supervisors and mentors.
In Table 9.3, we have described some of the major settings where counseling
occurs. Of course, the list is not all-inclusive, but we hope it gives you some
understanding of the physical settings where you might find yourself working
in the future.
Table 9.3 Typical Settings

Where Counseling Takes Place
Best Reason
Venue Treatment Description Disadvantages for Choosing
This Venue
A hospital
setting.
The client is
Clients remain
suicidal,
in the hospital
High cost. dangerous to
Treatment voluntarily,
Those who are others, or
normally includes but can be
Inpatient involuntarily needs
medication and committed
Hospitalization admitted may medication
individual and involuntarily
not want administered
group counseling. due to a
treatment. in a controlled
danger to self
medical
or others.
situation.
Ward is often
locked.
Most
programs are
voluntary.
Less
restrictive
than a Client needs
The usual
time away
treatment is group hospital, but
clients Costs vary from
counseling,
depending on addictions,
psychoeducational normally
Residential sessions, and agree to stay facility but family
Treatment individual for the entire may approach environment,
course of the costs of and needs
counseling.
treatment. inpatient intensive
Clients on
Commonly treatment. treatment and
medication are
used for daily
monitored.
treatment of monitoring.
addictions,
eating
disorders, and
adolescent
behavior
problems.
These two When clients
settings are need a
quite similar transition from
except that inpatient
partial treatment or to
hospitalization develop skills
Clients receive takes place in to help adjust
psychoeducational a hospital Higher cost to independent
Partial
and therapeutic setting. Day than outpatient living. Family
Hospitalization
groups along with treatment is counseling but therapy is
and Day
some individual open to the less than usually
Treatment
counseling and same kinds of hospitalization. available. Also
recreation. clients but is provides daily
generally less monitoring of
restrictive. client
About half the functioning
cost of and can
inpatient prevent
programs. hospitalization.
There is no formal Fellow
treatment; residents or
however, clients lack of
learn to live When clients
Adult oversight may
Congregate independently and A home-like make such
can live
environment independently
Living Facility deal effectively homes
with others. where several but need some
(ACLF) for antitherapeutic
clients reside minimal
people or the
together. May supervision
suffering from ACLFs usually environment
be public or and assistance
chronic mental provide some may be
additional private. to prevent
disorders dangerous.
services such as hospitalization.
Usually there
meals. is no on-site
treatment.
School School
School counselors counseling is counselors are
provide academic primarily to usually unable
and career help K–12 to treat family
counseling as well students systems that
as counseling for achieve may be
personal and academically contributing to When student
emotional and to help student issues. has academic
development. them plan for Also, school or career
School These services are future counselor issues or
Counseling provided in learning. responsibilities difficulties
individual, group, School may make it adjusting to
and counselors difficult to the school
psychoeducational also help fully address environment.
classroom clients with emotional and
sessions. They crises but interpersonal
also consult with generally do problems as
parents, teachers, not provide academic
and others. long-term issues are
counseling. foremost.
Nearly half of
first
appointments
do not show.
Counselors
have difficulty
recognizing Client is
Counseling signs of working,
takes place in deterioration,
raising
an agency, or suicidal or
Clients receive children, or
community homicidal
individual, group, going to
mental health intentions
couples, family, school; does
center, or because clients
or multifamily not have a
private are usually
Outpatient group counseling debilitating
practice. seen once
Counseling in the offices of mental
Clients make weekly. The
the agency or disorder and
their own counselor
private practice or can function
appointments hears only the
college independently
and usually client’s
counseling center. without daily
arrange for perspective monitoring; is
their own and may miss not a danger to
transportation. important
self or others.
information
about client’s
academic,
work, or
family life.
Transportation
can be a
problem.
The counselor
comes to
The The client
client’s home
environment would be
and conducts
Counselor can be unable to make
counseling
conducts distracting and regular
sessions.
assessments or privacy is counseling
In-home Home visits
individual, difficult to appointments
also supply
couples, or family the counselor maintain. unless the
counseling. with a wealth Counselor counselor
of information materials must came to the
about the be transported. home.
family.
The client is
Depending on physically
the type and disabled, lives
quality of the in a remote
Using Skype, connection, the area with
telephone or counselor may limited
Mainly
Online and email, not be able to counselor
individuals and
Phone counselors assess non- opportunities
groups
help clients verbals or or has a
remotely. accurately longstanding
assess a relationship
client’s mental with a
state. particular
counselor.
Some thoughts about private

practice.
Private practice is, for many, the holy grail of counseling work. In established
practices, counselors earn more than in any other setting. Some of the joys of
private practice include being your own boss, setting your own schedule, and
selecting the clients you are best at helping—being able to specialize. For
example, some school counselors get licensed as mental health counselors or
Licensed Professional Counselors and develop a practice working with
children and adolescents and running parenting groups. A marriage, couples,
and family counselor could focus on working with couples in groups using a
marriage education curriculum. A mental health counselor could develop a
niche practice for individuals who have experienced trauma or who want
cognitive behavioral therapy.
SNAPSHOT Bonnie Erickson,
Ph.D., Licensed Mental Health
Counselor
Counseling with Prisoners

I have worked for several years with men and women in county jails and state
prisons. Individuals in jail suffer long-term effects of substance abuse, mental
health issues, poor relationship skills, and faulty thinking. Most have
developed long-term patterns and find it difficult to believe in their potential
to change. Working in prisons, you don’t have much control over the place
and time when you can do counseling. While practicing art therapy,
sometimes the women in my groups had to be searched, coming and going,
because of the materials that we used. One of the challenges is creating and
maintaining good relationships with those who work in the facility.
Correctional staff can make it difficult to make treatment accessible to those
who need it or they can facilitate access to treatment. Despite the difficulties,
working in a jail setting can be gratifying. Although many inmates have
severe problems, every effort by the counselor is appreciated.
One male resident described his time in jail as a “pause.” He saw it as a time
to examine the state of his life and make choices for the future. He
participated in an intensive treatment program for substance abuse while in
prison, and he claimed that it had saved his life. With the help of treatment,
he changed his thinking and lifestyle. After his release, he returned to the
same neighborhood where he had been an addict and a drug dealer before
prison, but maintained his sobriety, and worked to establish his own small
business and rebuild his relationship with his daughter. Some of the women I
treated in art therapy have contacted me about the changes in their lives, how
they have restored family relationships and remained drug free.
You may have heard the story about the starfish on the beach. Something
similar happened to me as I was walking on the beach in Clearwater, Florida,
between training sessions at a conference in January. The beach was windy
and cold, so it was mostly deserted. As I walked, I realized that the beach was
covered with conchs. They were still alive but somehow stranded on the
sand. I started picking them up, throwing them back into the water to give
them a chance to survive. I could only throw them a little way but hoped that
it was far enough. For about a half a mile I threw the shells into the water
hoping that I could save a few. I was working at the jail at that time and
thought about the women in our program. They were a lot like the conchs.
They were struggling for life and needed help to get back on track. I was
overwhelmed by their numbers and realized that I could only help a few of
them and then only help them a little. I was also sure that many of them
would probably wash back up again, or were too weak to survive. This was
also true for my clients. Some repeatedly ended up in jail, but a few were able
to break the cycle and move on with their lives. As I turned to go back inside,
I recognized another counselor at the conference coming from the other
direction. We smiled as we realized that we were both trying to save them.
But private practice is not for everyone, and knowing oneself is a key to
deciding whether this is the route for you. Some counselors in private
practice find it isolating. Unless you pay for continuing supervision after
licensure, your work is entirely between you and the clients. You may not
have the opportunity to talk to anyone about your cases. Even in a practice
with other therapists, time is money, and talking about cases can only occur
when there are no clients or other duties to perform. You do not get paid for
staff meetings. People who do not have insurance or who are financially
strapped cannot afford private practice. Thus you will see a privileged
stratum. While some practitioners donate some time for those unable to pay,
most clients who come to private practices are likely to be white and middle
or upper middle class.
Is it too early for you to think about private practice? If it seems attractive,
there are some good reasons to begin thinking about it now. First, you need to
find out how your state regulates private practice. All 50 states have licensure
for counselors, but the ability to practice independently is different in each
state. What special training is required? Will you need to be supervised by
someone else and pay them for supervision? What business licenses do you
need? In addition, you should probably recognize that your university or
college is not really training you in business administration. You will require
additional training. At this stage, you might want to look at some magazines
and newsletters such as Psychotherapy Networker to get a feel for the current
issues facing private practitioners.
Unless you join a firmly established practice, the beginner in private practice
must consider 3–5 years as a minimum time to build a business. And that is
what you are: a small business owner. Unless you are successful enough to
hire a receptionist/administrator, you will also be interacting with insurance
companies, setting up and changing appointments, doing bookkeeping,
cleaning the bathroom, and vacuuming the waiting room. You will probably
pay 40% of your income for overhead such as office expenses. You must
figure out how to pay the rent for the first years when you are building a
reputation. The American Counseling Association provides guidance on its
website (www.counseling.org/knowledge-center/private-practice-pointers)
and in its magazine, Counseling Today, for members of the association.
Beyond money matters, the counselor in private practice must find ways of
getting referrals. This means joining insurance boards and professional
organizations and attending the meetings of fellow practitioners and
community members who might refer to you. Are you a good self-promoter?
Do you have an entrepreneurial spirit? If so, private practice can allow you to
build something for yourself free from the red tape and restrictions of agency
work (Centore, 2017). As we said, it’s not for everyone, but for some
counselors, private practice is the ultimate career success story.
Summary
This is a practical chapter designed to expose you to some settings where
counseling takes place. In addition, we hope that you have learned some rules
of thumb about selecting treatment settings. Rules of thumb suggest that they
are not exact or applicable to every setting. They are rough ideas gained from
experience. Here is a brief list of what we have suggested:
1. One of the first decisions a counselor has to make is who should come to
the counseling session. After doing a thorough assessment, the counselor
proposes that the client has an individual, couple, or family problem.
The next sessions will then include the key players.
2. There are different modalities of treatment including individual

counseling, family counseling, couples counseling, multiple family
counseling, psychoeducation, group counseling, and group
psychotherapy. Once the players have been chosen, the counselor offers
the most helpful modality.
3. There are many different types of specializations in counseling. Some

are based on specific interventions, while others are based on client
problems or setting. Requirements to practice each counseling
specialization vary, and counselors must know the educational and
experiential requirements before they engage in these specializations.
4. Counselors must ask themselves where it is most appropriate for the

client to receive counseling. If the client is dangerous to self or others, a
more restrictive environment is appropriate. If the clients are unable to
care for themselves, cannot be managed by their families, or are
homeless, outpatient counseling does not make sense. In addition, some
clients with severe mental disorders require more restrictive
environments to manage medication and achieve emotional stability as a
prelude to less restrictive treatment. There is also the question of client
autonomy to be considered. The client should be able to select the
preferred treatment setting, but the counselor as a mental health expert
must also make recommendations as to what will be most effective and
provide the least risk of failure. Associated with this issue is the knotty
problem of counseling people who do not want to be treated.
Involuntary clients can be particularly challenging for counselors. Here
at the end of this chapter, it should be quite clear to you that counselors
can work in diverse settings from schools to prisons to inpatient
hospitals and even online.
Student Activities
2. A counselor’s own beliefs and values about couples and families can
affect the choices made in the context of counseling. For example, if you
believe that infidelity means the end of a relationship, or that couples
should stay together for the sake of the children, or that blended families
can never really get along, you will find that your beliefs will influence
your counseling. Think about your own family background. What are
some of your inherited beliefs and values that may affect your work with
couples or families?
3. At the House Next Door, the program offers a Sexual Abuse Treatment
Program. Counselors are often faced with traumatic situations in such
settings. We encounter other people in their pain and sorrow, and that
can take a toll on the counselor’s own emotional health. This is even
more challenging for most people when children are involved. What are
your thoughts about working with people in pain? How can you take
steps to monitor your own reactions to working with people who have
survived trauma?
Journal Question
1.
A Counselor’s Professional Setting. Imagine that you’ve completed your

formal training in counseling and you’re in your ideal counseling job. In what
type of work setting do you see yourself? What kinds of counseling
interventions are you doing, for example, individual? Group? Family?
Rehabilitation? Adventure Therapy? Long-term or brief counseling? What
does your client population look like (e.g., age, diagnoses, etc.)? At this
point, when considering your future work setting, are there any clients or
populations that you would not consider working with or any setting that you
would rule out? Why? What is it about these clients/populations/settings that
you believe would make it difficult for you to be an effective counselor?

1. We have discussed couples, family, individual, and group counseling as
major modalities. Which of these appeal to you most? Many students are
reluctant at first to do group counseling. Yet, most workplaces want
counselors with this skill. Can you think of some ways that you might
become more comfortable with groups?
2. Think about your upcoming practicum and internship experiences. What

kind of setting should you select? In other words, where could you grow
the most? Share your ideas about the ideal field placement.
Experiments
1. Pretend for a moment that you are the parent of an adolescent who is
smoking marijuana and whose grades are slipping. As a parent, where
would you go for help in your own community? Choose a specific
counselor or treatment center. How did you make your decision?
2. Notice the visual settings of professional offices you enter or homes you
visit. What feelings does the setting evoke? Is the room contemporary or
traditional? Are the colors warm or bright? As you take particular notice
of these places, consider how the physical environment in your
counseling office can affect clients’ moods.
Explore More
chapter, we recommend the following articles.
Centore, A. (2017). How to thrive in counseling private practice.

Lynchburg, VA: Thriveworks.
Haberstroh, S., Parr, G., Bradley, L., Morgan- Fleming, B., & Gee, R.
(2008). Facilitating online counseling: Perspectives from counselors in
training. Journal of Counseling & Development, 86(4), 460–470.
Pressley, P. K., & Heesacker, M. (2001). The physical environment and

counseling: A review of theory and research. Journal of Counseling and
Development, 79, 148–161.
Promote Social Justice and Engage
in Culturally Competent
Counseling?
Questions
The effects of White privilege on counselors and the counseling

profession.
Some of the major categories of diversity in the United States and some
general ideas of what counselors need to know to work with diverse
clients.
The framework for the Multicultural and Social Justice Counseling

competencies.
Describe how your own cultural beliefs, values, and experiences might
affect your development as a counselor.
Discuss the role of social justice and advocacy in the counseling

profession.
List ideas you can use to intentionally seek out experiences that will
enhance your understanding of diversity, during graduate school and
beyond.
List strategies that you can use to become an advocate for social justice
who helps all members of society receive access to mental health
services.
What are your beliefs and assumptions about the role that culture and
other types of diversity play within your own life?
How can you continue to challenge your own cultural assumptions

during your graduate training and beyond?
e. advocacy processes needed to address institutional and social

barriers that impede access, equity, and success for clients
The world is a complex, exciting, vibrant, and ever-changing place. It is also
big, sometimes overwhelming, occasionally scary, and often chaotic. When
we venture out into the world and away from the relative comfort and safety
of our day-to-day lives, the challenge of making sense of it all can be
stressful. One of the strategies that human beings use to try to navigate the
complexity of the world is to categorize or label experiences, places, and
people. For example, when we turn on the television during an election
campaign and we hear an advertisement for a candidate, our brains instantly
tell us “This is a political ad.” And, based on that information, we make some
assumptions (“This person wants my vote,” or “We must be careful not to
accept all the information in this ad at face value,” or “I’m going to tune this
out of my consciousness because I already know who I will vote for”). As
another example, if a friend asks us to go with him or her to a jazz concert,
we might ask a few questions and then classify the type of experience that it
is likely to be and make assumptions about whether we will enjoy it based on
that information. (“The concert is a jazz concert by a nationally known group.
I like their music. I will probably like this concert.” Or “The concert is the
local middle school jazz quartet. I do not have a child or sibling in this event,
so I am not obligated to go. I will not enjoy a seventh-grade jazz concert.”)
In the examples of political ads or jazz concerts, categorizing and labeling is

an effective strategy that helps us navigate the world. Taking in all
information about everything in our environment and trying to make
decisions about each event independently would quickly overwhelm our
ability to function. However, that same strategy that helps us in so many
situations can harm us when we apply that process of categorizing or labeling
to people. This is where stereotypes are born. Consider the following
descriptions and think about your initial uncensored reactions to each of
them. Try not to think about whether your initial reactions are right or wrong;
just be open to your initial thoughts and feelings.
You are in a mall with a friend when around the corner you hear high-
pitched laughing and squeals of delight. As you turn the corner, you
encounter three young Caucasian girls (11 or 12 years old) looking at a
poster announcing that the latest young male heartthrob singer will be
putting on a concert in your town. They are dressed in brightly colored
clothes, have on lots of bright makeup, and are jumping up and down as
they squeal in delight about how cute they think the boy in the picture is
and how excited they are about the upcoming concert.
What are your immediate reactions? What “category” or “label”

would you use for these girls? (Consider your thoughts about their
maturity, what you think about the fact that they are wearing
makeup, whether you think that their loud voices are appropriate
for the mall, whether you have beliefs about the type of people they
are, etc.)
You are out with friends on a Friday night when you turn a corner and
find yourself on an unfamiliar street. It is quiet and dark, except for a
group of young African American males (ages 18–20) learning against
the wall of an abandoned building.

would you use for these young men? (Consider your thoughts about
their motivations for hanging out where they are, whether you have
immediate thoughts about your own safety, whether you have
beliefs about the type of people they are, etc.)
You are downtown on a Saturday night when an expensive car pulls up

in front of an upscale restaurant. The valet runs over to open the
passenger door and helps a middle-aged woman out of the car. She is
wearing a fur coat, and you can see the light from the lamppost in front
of the restaurant glimmer off her necklace in a way that makes you
believe that she is wearing diamonds. As she reaches her hand out to the
valet, you see the glint of a diamond tennis bracelet on her wrist. The
gentleman driving the car is wearing an expensively cut suit. As he
passes the valet, he hands him a tip. You see the valet glance at the bill
in his hand and look up with an appreciative smile.

would you use for this couple? (Consider your thoughts about their
motivations for driving an expensive car or wearing expensive
clothes or jewels, whether you think that their display of wealth is
appropriate, whether you have beliefs about the type of people they
are, etc.)
In each of these scenarios, most of us immediately begin to make

assumptions about the people involved. We may call the young girls “silly,”
the African American men “scary,” and the wealthy middle-aged couple
“pretentious.” When we do so, we are engaging in stereotypes. Stereotypes
are simplified and relatively fixed ways we have of making generalizations
about groups of people to help us label or classify them. Stereotypes can be
positive, but more often than not, they involve negative beliefs about others.
Stereotypes are so commonly held that they can become a fixed part of a
society’s messaging (for example, you may have heard of stereotypes such as
“dumb jock,” “pushy New Yorker,” “lazy Southerner,” “Muslim terrorist,” or
“frail old lady”). Stereotypes are not only harmful by themselves, but they are
particularly dangerous because they foster prejudice and discrimination.
Prejudice, as the word implies, is a prejudgment, or making decisions or
assumptions about individuals or groups without sufficient knowledge or
understanding. Racism is a specific category of prejudice, and involves the
belief that racial groups other than one’s own are intellectually,
psychologically, and/or physically inferior. Discrimination is the behaviors
that are rooted in prejudice and racism, and involves putting members of a
group at a disadvantage or treating them unfairly because of their group
membership (Casas, 2005).
Counselors live and work in a world where stereotypes, prejudice, racism,

and discrimination are remarkably common and persistent. And, because
counselors are first and foremost human beings, we are all susceptible to
learning and believing stereotypes and prejudices about others, particularly if
we grew up in an environment where these negative messages were dominant
and went unchallenged. What differentiates counselors from those who hold
onto these negative perceptions about others is that counselors make
deliberate and intentional decisions to understand and confront their own
beliefs and assumptions about others and work to eliminate stereotypes,
prejudices, racism, and discriminatory behaviors from their own lives.
Further, because of the deeply held beliefs counselors have about social
justice and advocacy, counselors work to challenge these assumptions and
behaviors whenever and wherever they exist in society.
In this chapter, we will discuss the challenges, and joys, that counselors face
as they live and work in an increasingly diverse society. We will introduce
you to some of the basic concepts of multicultural counseling and encourage
you to set out on a path of discovery—both of yourself, and of the richness of
diversity that exists all around you. Finally, we will encourage you to put into
action your beliefs about the inherent worth of all human beings by becoming
a social justice advocate in all aspects of your personal and professional life.
We recognize that this is a significant undertaking. The good news is that you
have a lifetime ahead of you to continue to work toward this goal.
In this text, we continually ask you to reflect on your beliefs and

assumptions, to engage in self-assessment and self-understanding, and then to
be intentional about your behaviors. Perhaps there is no part of your growth
as a counselor where this is more essential to your development.
Understanding your own beliefs, assumptions, and attitudes as well as the
early messages you received about diversity, tolerance, and the role of culture
in your life is essential to becoming a highly functioning counselor. It is for
this reason that we start this chapter with an exploration of you!
You: A Culture of One
As you learn to become a counselor who celebrates diversity and promotes
social justice, the first step is understanding yourself. You are unique. You
are a combination of many demographic and social factors, and
understanding these traits about you can help us uncover who you are. For
example, you might be female, White, 22 years old, Irish descent, Catholic,
heterosexual, only child of still-married parents, living in the northeast
United States, single, graduate student, middle class, and so on. But if we
were to find another person who matched you on every one of these
characteristics, we would find both similarities and differences between the
two of you. Understanding the categories a person falls into can only take us
so far. For instance, the “you” in this example might be very much in touch
with her Irish heritage or extremely connected to her religion—or she might
be these things in name only. When you think about your own life, what are
the beliefs you have about the importance of each of the “descriptors” about
you? Consider descriptors such as race, gender, ethnicity, generation, work
status, religion, disability, social class, geographic setting, sexual orientation,
mental health/illness status, veteran status, and so on.
Descriptors of me that I identify with strongly:
Descriptors of me that I identify with only somewhat:
Descriptors of me with which I do not identify:

If you were to go to a counselor, based on your appearance and demographic
information only, what assumptions might that person make about you? What
stereotypes exist about the groups with which you identify? Would the
counselor’s assumptions and stereotypes about you be accurate?
The most basic element of cultural competence is understanding one’s own

worldview and one’s own culture. Awareness of self as a cultural being is a
necessary precondition for emerging from ethnocentrism (the belief that
one’s own culture is the standard by which all other cultures are judged) and
becoming culturally competent (Sue, Arrendondo, & McDavis, 1992). Thus,
to be a culturally competent counselor, you must first understand who you
are.
Words of Wisdom
“Being aware of how I’m oppressed and how I’m privileged will be essential
as I move forward in this profession. I must understand larger systemic forces
at play in my own life in order to help diverse clients in the future.”
Source: Amanda P., First Year Counseling Student
Culturally competent counselors understand their own assumptions, values,

and biases. They engage in active self-assessment to increase their own
cultural awareness and to understand their worldview. Worldview is defined
as individual perceptions of relationship to the world, including relationships
with other people (Richardson & Molinaro, 1996). An individual’s
worldview is the framework from which the person operates. In the context
of counseling, the counselor’s worldview influences every interaction with
every client, from the formulation of a counselor’s theoretical stance to every
behavior, word, or nonverbal reaction in a counseling session. Counselors
who do not fully understand their own worldview cannot be intentional in
their counseling. To begin this process of understanding your own
worldview, you might want to work to:
Understand your values and beliefs about people and the world. Do you
believe people are basically good? That they can change? (See Chapter 6
of this text for some of the basic assumptions about people and the
process of change that you might wish to assess.) Consider where these
beliefs came from. Who (or what) helped formulate your ideas?
Understand, acknowledge, and value yourself as a cultural being. What

were the messages that you received about your cultural heritage when
you were growing up? Did your family embrace and support you as a
cultural being? Were there positive cultural role models?
Understand the influence of culture on your life. How did/does your

culture affect your experiences? What assumptions do others make
about you, based on your culture, and have you internalized these
messages? If you are White, or male, or middle or upper class, able-
bodied, or belong to any other privileged groups, have you reflected on
how that privilege has influenced your life?
Understand the role that defensiveness (including denial, projections,

anxieties, fears, guilt, and/or intellectualization) can play in cultural self-
awareness (Roysircar, 2003). How might defensiveness about your own
culture keep you from fully understanding and embracing the cultural
world of your client? What specific prejudices or biases do you have
(e.g., homophobia, racism, sexism, classism, ageism, beliefs about
exceptionality, language, dialect) that might play into the defensiveness?
Understand your own culture in relation to others. What do you see that
makes people from your culture different from others? What aspects of
your culture are similar to others’? How do you know?
Beginning counselors, particularly those whose experiences are congruent

with the dominant culture, are often challenged when asked to think about
their own culture. White Americans have traditionally not been asked to
consider themselves as cultural beings, and they may find it easier to
acknowledge others’ differences without exploring their own cultural value
characteristics (Richardson & Molinaro, 1996). Of course, this is exactly the
type of thinking that leads to unintentional ethnocentrism—focusing on
others and how they are different from me rather than understanding my
culture as just one of many that inhabit the world. The more you can adopt an
open, inquisitive stance to exploring your own culture and worldview, the
more effective your exploration will be. Think of yourself as a cultural
anthropologist, trying to investigate and understand you. As you do the hard
work of building your self-understanding and self-awareness, take heart that
this is a lifelong journey.
In the accompanying Spotlight, we explore the concept of White privilege, a

term used to describe the multiple societal privileges that benefit people who
are White in Western countries. As you read the accompanying Spotlight,
take a moment to notice your emotional and cognitive reactions to the
concept. Is this something that you have heard of/discussed before? Do you
think your own race affects how you react to this idea? After you read the
Spotlight, we will turn our attention to understanding some of the effects of
White privilege in counseling.
Fast Facts
The self-reported gender and racial/ethnic information about members of the
American Counseling Association appears in the list below. However, it is
important to interpret this information with caution. Of the 56,000 members,
only 22% have reported their gender and 26% have reported their ethnicity to
ACA. Therefore, we cannot make global generalizations about these data,
and in fact, it may be more interesting to ask ourselves, why do nearly three-
quarters (or even more, in the case of gender) of members decline to answer
this question on their membership form? Of the members of the American
Counseling Association for whom demographic information is available:
74% are female
and
84% are Caucasian
6% are African American

4% are Hispanic/Latino/a
2% are Asian American
<1% are Native American/American Indian
1% are Multiracial
Source: American Counseling Association (January 2017).
Regardless of our racial or ethnic heritage, we must all learn to think of

ourselves as cultural beings and take time to understand how our race or
ethnicity influences how we see the world, and how other people see us.
SPOTLIGHT White Privilege

According to McIntosh, privilege is “an invisible package of unearned assets”
that a person can “count on cashing in each day” (2001, p. 95). Whether we
are privileged because of our race, gender, sexuality, class, or ability status,
most of us are unaware of these privileges because we take them for granted.
As members of these groups, we don’t see them as privileges—we simply
experience them as normal, everyday experiences that everyone has.
However, members of minority groups who do not share this same set of
privileges recognize them as yet another example of oppression and
prejudice.
Countless studies have uncovered many different types of White privilege,

ranging from advantages in housing and employment to education and self-
image. For example, White and Black applicants for the same job with the
same set of skills and training consistently find more job offers go to the
White applicants. White applicants are far more likely than Black applicants
to have loan applications approved, even with identical credit records. In
schools, minority children are far less likely to be placed in honors classes,
even when such a placement is justified by test scores. In other words, White
privilege means that:
I can, if I wish, arrange to be in the company of people of my race most

of the time.
I can be pretty sure that my neighbors will be neutral or pleasant to me.
I can be sure that if I need legal or medical help, my race will not work
against me.
I can go shopping alone, pretty well assured that I will not be followed
or harassed.
Whether I use checks, credit cards, or cash, I can count on my skin color
not to work against the appearance of financial reliability.
If my day, week, or year is going badly, I need not ask whether each
negative situation had racial overtones.
I can worry about racism without being seen as self-interested or self-

seeking.
I will feel welcomed and "normal" in the usual walks of public life,
institutional and social. (McIntosh, 1990)
White counselors often respond to the concept of White privilege with

varying degrees of anger, guilt, and defensiveness, and these responses are
linked to resistance toward learning about racism or other types of oppression
(Hays, Chang, & Dean, 2004). Conversely, White counselors who are willing
to explore White privilege have higher levels of multicultural counseling
competence (Mindrup, Spray, & Lamberghini-West, 2011) and better actual
therapeutic outcomes with diverse clients (Miserocchi, 2014). In addition,
counselors who examine their own racial privilege are less likely to rely on
racial stereotypes, to impose their own ethnocentric values on the counseling
relationship, and more likely to view clients from minority groups from a
systemic perspective, rather than attributing problems to individual pathology
(Hays, Chang, & Havice, 2008).
Of course, it is not only White counselors who experience privilege. Most

counselors benefit from societal privilege in some way. What are some of the
privileges you may have received in your life because of your membership in
a privileged group? As you think about your own development as a
counselor, how might the privileges you have received affect your
interactions with others? What assumptions might you make about clients
and their experiences based on your own ideas of what is “normal” or
“typical”? How can you work to actively challenge these assumptions?
In the first of this chapter’s Snapshots, we hear from a White counselor

whose work has brought her into contact with clients who differ from her in
race, social class, sexual orientation, and health status. During her master’s
clinical counseling internship, she had to confront her own values and
assumptions not only about others, but about her own experience of being a
White, middle-class, heterosexual female in a society that values these traits.
The inclusion of her story in a chapter on diversity raised some eyebrows
when we discussed the text with colleagues. Several people asked us, “Why
would you put a story from a White counselor in a chapter on diversity?” One
even said, “If you don’t know any counselors of color to include, I’d be
happy to help you find some.” This is exactly the type of thinking that we are
encouraging you to avoid. The counselor in this story is no less a cultural
being than anyone else. Her inclusion in this chapter is to remind all of us
that we each are a product of complex, sometimes shared, and often unique
experiences that have led us to this place.
Counseling and Social Justice
Over the last decade, counselors have increasingly come to understand that to
be a counselor who celebrates diversity and encourages optimal human
development for all people means that we cannot sit idly by in the face of
systemic oppression and inequality. Counseling does not take place in a
social vacuum. In other words, when we focus on helping the individual but
ignore the larger social forces around us that limit the freedom and choices of
that individual, we miss the boat. Most people get into the profession of
counseling because they want to make a difference, but for many clients,
individual change is not enough. The social and environmental forces of
poverty, oppression, and discrimination shape people’s lives. Our clients may
live in neighborhoods that are unsafe, attend schools with substandard
resources, have limited access to the means to lift themselves out of poverty,
and have internalized society’s lowered expectations for them. They may be
in same-sex partnerships and not have access to the same rights and
opportunities as their heterosexual peers. Our clients might be migrant or
undocumented workers (or their children) who have limited (or no) access to
health care or education. They may have physical disabilities and face
discrimination in the workplace. In other words, we need only look around us
to see that many of the problems our clients face cannot be handled through
counseling alone. We cannot “counsel” someone out of hunger or inadequate
housing. Even if we are able to find resources to assist the individual in front
of us to survive another day, we still haven’t addressed the bigger societal
problems that allowed this type of inequality to exist in the first place.
When counselors speak of social justice, they speak of improving society by

challenging the systematic inequities that stifle the individual’s potential and
block opportunities (Lewis, Arnold, House, & Toporek, 2003). Social justice
involves “promoting access and equity to ensure full participation in the life
of a society, particularly for those who have been systematically excluded”
(Lee, 2007, p. 1). It is both a personal and professional approach to actively
participating in the struggle to eliminate social inequities. Counselors use a
social justice approach when they act as advocates in their schools, agencies,
or communities for people who are economically or socially disadvantaged.
School counselors act from a social justice perspective when they seek to
reduce or eliminate the barriers to academic achievement.
SNAPSHOT Alexis “Lexie” Rae,

Licensed Professional Counselor,
PhD Student
I am privileged. This is not a bad thing. I grew up in a middle-class suburb as

an only child, and I never wanted for anything. I went to private schools, I
got the best education, and it was never a doubt that I would get my master’s
degree. I’ve been spoiled and taken care of for most of my life. I like who I
am and what I do.
When I graduated from my master’s program in clinical mental health

counseling I was offered a job at the Columbus AIDS Task Force. My clients
were predominately middle-aged, self-identified gay men, who were HIV
positive. The majority of people who used the services were of low
socioeconomic status. I met with men who were prostitutes, in and out of jail,
homeless, substance abusers, and in violent relationships. Most of them
didn’t have any support at all. I worked with people who were in and out of
the hospital. When I was there, some of my clients died and others just
stopped coming. I worked with people who wished they were dead and a few
who had tried to take their lives.
Perhaps it goes without saying, but I worked with groups of people with
whom I had had very little previous interaction. Everything was new. I was
constantly on edge, double guessing every word that came out of my mouth.
That is one of the risks of being a counselor who is privileged: You can be so
concerned with what you shouldn’t say that you don’t always say the things
that need to be said. Sometimes I would avoid topics altogether because I
didn’t know how to approach them without being offensive.
I was lucky enough to have an amazing supervisor who gave me some

advice. The people you see in counseling are not protected from the evil in
this world and you are not doing them any favors by avoiding the difficult
conversations. Therapy is the place where clients should be able to talk about
their worries, concerns, and hurts without being stifled and where counselors
and clients are genuine in their interactions.
So, I started having the clients name or describe what it was that they were
going through. Sometimes just exploring the client’s world would be more
eye-opening for both of us than some specific intervention. I researched and
read as much as I could to help me understand the often confusing
information given to me by my clients. But all the books and/or journals in
the world could never be better than just getting clients to explain it
themselves. I often thought about it like taking a journey with a client,
sometimes asking for clarification and guidance but mostly just allowing the
individual to show me their world on their terms.
I found that I needed a lot of listening and a lot of imagination. I would try to
picture myself as the client, really thinking about it as if I had the same
background and life experiences. My clients grew up with different values,
different life lessons, and different needs. I repeatedly tried to learn as much
as I could about each client—not the diagnosis, not the presenting problem,
but the person. I think it helped that I am a curious individual. I just wanted
to know everything that I possibly could. Upon reflection I think that this
curiosity is what helped me to relate to different types of people, to be open
to the process as it unfolds, and to honor the dignity of each person I
encountered.
In this chapter’s Counseling Contro-versy, we address one of the challenges

that counselors face in becoming a social justice advocate. School counselors
might live in communities where local or state laws prohibit discussions of
sexual identity within school buildings, yet recognize that they have students
who need a safe place, and a safe person, with whom to have these
discussions. It is one of the challenges of adopting a social justice advocacy
stance: How much risk do counselors need to take to advocate for their
clients at the potential expense of their own careers? Of course, no one has an
answer to this question, but as you read the Counseling Controversy, consider
what you think you might do if faced with a similar situation.
Words of Wisdom
“Often the people that come in to see you have never felt cared about, have
never felt respected, doubt their own judgment, so that by your listening and
attentiveness, you begin the process of respecting them . . . you provide a
different way of seeing without blaming . . . and you help them to learn to
repair themselves through a relationship of respect.”
Source: Participant in a research study, Skovholt & Jennings, 2004, p. 63
Counselors in all settings can work with legislators, policy makers, school
administrators, agency leaders, or the media to become advocates for our
clients. We can become active in our local (and national) associations that
promote mental health for all members of society. Associations such as
NAMI (National Alliance on Mental Illness; http://nami.org), Mental Health
America (http://mentalhealthamerica.net), and Mental Health Advocacy
Coalition (http://mentalhealthadvocacy.org) actively work to reduce stigma
and increase access to mental health services for all. Counselors for Social
Justice (CSJ) is a division of the American Counseling Association
specifically dedicated to helping counselors advocate for systemic change
(http://counselorsforsocialjustice.com). Counselors can make a difference
when they team up with these associations and others to fight social
oppression.
Those who advocate for a social justice perspective in counseling remind us
that improving society by challenging systemic inequities has always been
part of the counseling profession. Historical figures in the profession, such as
Frank Parsons, Clifford Beers, and Carl Rogers, all recognized that social
changes were necessary in order for their clients to thrive. To adopt a social
justice perspective, counselors must first recognize that social injustice exists
and that it negatively contributes to the mental health of our clients (Crethar
& Ratts, n.d.). Once we all accept this reality, it is but a small step to
recognizing that we all have a personal and professional obligation to do
something. We remind our students that entering into the profession of
counseling means that you will have your eyes opened to the painful reality
of people who had previously been invisible to you. A social justice
perspective, however, gives us the tools to fight back against oppression,
racism, and poverty. Rather than throw up our hands and give up, social
justice pushes us to be advocates and fight for the dignity and respect of all
our clients. Social justice gives us hope.
Counseling Controversy Does Social

Justice Advocacy Require School
Counselors to Challenge their
School Administrators?
Background. More than a decade of research into the school experience of
LGBT students indicates that physical and verbal harassment and internalized
homophobia are significant barriers to emotional, social, and academic
development. LGBT students report higher levels of substance abuse, risky
sexual behavior, and dropping out of school. They also report higher levels of
trauma, depression, and low feelings of self-worth, and their educational
performance and aspirations are lower than the national average. School
counselors are ethically mandated to address the concerns of LGBT students
and advocate for their needs (ASCA, 2016; Lassiter & Sifford, 2015).
However, some school districts and school boards refuse to allow school
counselors to discuss LGBT issues and eight states have laws that either limit
how adults in the school building can talk about LGBT issues or forbid it
altogether. As you read the arguments favoring either of these positions,
consider where you stand on the question.
COUNTERPOINT: SCHOOL
POINT: SOCIAL JUSTICE
COUNSELORS CAN WORK
ADVOCACY REQUIRES
WITH LGBT STUDENTS, BUT
SCHOOL COUNSELORS TO
THEY ARE NOT OBLIGATED
ACTIVELY CHALLENGE ANTI-
TO CHALLENGE AN ANTI-
LGBT POLICIES
LGBT SYSTEM
• According to ASCA, school • Children exposed to LGBT identities

counselors promote awareness of may be indoctrinated into the belief
issues related to sexual orientation that these behaviors are acceptable or
and gender identity among students, normal, when some parents believe
teachers, administrators, parents, and they are unnatural and need to be
the community. corrected.
• 30% of LGBT youth have absences • Schools are not the place to
from school because they feel unsafe indoctrinate students into their
and more than one-third are bullied at sexuality; this should occur in the
school. This is a schoolwide, rather home, where it aligns with the
than an individual issue. religious and cultural beliefs of the
family.
• Choosing to remain silent is not an
option. School counselors witness the • Allowing students to be open about
effects of anti-LGBT environments their LGBT identities is a form of
on children. Finding other allies “disruptive speech” and offensive to
within the school and educating the First Amendment rights of parents
administrators so they can join in the and anti-LGBT students. School
fight for LGBT students is the only counselors who challenge these
ethical choice. restrictions are favoring one group of
students over another.
• Advocacy requires courage. It is
never without risk, but the • School counselors should not be put
willingness to stand up for LGBT in a position of challenging these
youth and create affirming policies at the risk of losing their jobs.
environments might not only be That is not a fight that school
personally transforming, but it might counselors can win, and the personal
save lives. cost is simply too high.

argument.
Courtland Lee, a leader in the field of counseling and a tireless advocate for
social justice, reminds us that each of us is responsible for adopting a
personal commitment to social justice. His action steps help each of us
commit to a life that actively seeks to make the world a better place (2007).
He uses these steps to help us adopt a self-reflective approach to challenging
ourselves to grow into the advocate we wish to be.
1. Explore Life Meaning and Commitment
What would a life committed to social justice mean to me? What am I

willing to do? Who am I willing to be? What do I believe about justice
and equity in the world? Am I truly committed to this cause?
2. Explore Personal Privilege
What unearned privileges have I enjoyed by virtue of my membership in

privileged groups? Can I acknowledge the role of privilege in my life
and recognize how this privilege has contributed to societal inequities?
Can I use my privilege in ways that will help promote equity and human
rights for others?
3. Explore the Nature of Oppression
Do I understand how oppression and inequity affect others? Have I been

a victim of oppression? Have I contributed to the perpetuation of
oppression of others?
4. Work to Become Multiculturally Literate
Do I have the knowledge, awareness, and skills to negotiate a diverse

society? Am I open to new cultural experiences and perspectives? Do I
work toward a celebration of diversity?
5. Establish a Personal Social Justice Compass
Can I establish a personal set of principles and ideals that will direct my
commitment to social justice? Can I work to embody the essence of
social justice in all of my personal and professional interactions?
Clearly, becoming a social justice advocate is a lifelong endeavor, and one

that requires changes to both our personal and professional world. Counselors
who understand the role that social forces play in the lives of their clients
recognize that the social and economic status quo is not sufficient. We can do
better. We have an ethical, and many would argue moral, obligation to be
agents of social change. Are you up for the challenge?
In Chapter 2, we discussed a social justice approach through “The Many

Faces of Advocacy.” In that Spotlight, we introduced you to many different
types of advocacy and encouraged you to think about ways you could be
proactive in changing the world in which you live and work. In the second
Snapshot of this chapter, you will read about a graduate student who used his
own experiences to help him find the strength to significantly improve the
lives of others. As you read Bowen’s story, we challenge you to consider how
you can channel your passion to help others into a social justice advocacy
approach to counseling.
SNAPSHOT Bowen Marshall,

Clinical Mental Health Counseling
MA Student
I never thought I would work in “multiculturalism.” I don’t know why. Being

a gay, partially adopted, half-Asian kid from Kansas, I guess I had “diversity”
stamped on the back of my head, but of course I couldn’t see it. Then I came
to my graduate program in clinical mental health counseling where I am a
Graduate Assistant for student outreach and engagement.
For most of my first year as a Graduate Assistant at the Multicultural Center

(MCC), I felt lost. I sat in on meetings and heard a lot of grandiloquent jargon
about communities affected by bias incidents, university-sponsored
educational responses and sanctions, and all of the university officials I
needed to consult with before making a move. This phase of acclimating to a
new position was at times disheartening because I felt lost, ineffective, and
afraid to make a move for fear of disrupting “the system” and being labeled
“the idiot.” To compensate, I poured my energy, abilities, and time into the
model of the position that others had created for me. While I didn’t make any
missteps my first year, I also didn’t do much of which I could be proud.
Looking back, becoming an advocate for my profession and my community

was easy. Everything was set up and in place to receive me. Becoming an
advocate for me, on the other hand, was one of the hardest things I have ever
had to do.
Growing up, I lived in a world that told me I wasn’t loved, I wasn’t accepted,
that I would forever be alone in my misery, and that I would go into an
afterlife of eternal damnation. That’s a pretty tough pill to swallow, so I
didn’t. I walled off those comments and the pain and hurt that came with
them. I went to the parades, went to the bars, wore my rainbows, and played
the part of an out and proud gay man, but I never addressed the ostracism and
anguish that was underneath it all. I even convinced myself that addressing
that underlying stuff was unimportant. As long as I could project the image
that everything was fine, what did it matter?
Then came practicum in spring of my first year when I worked with suicidal
adolescents whose pain and hurt were so powerful they couldn’t just push
them into a closet and ignore them. Being present with these children and
listening to their stories opened me. To grow as a counselor and as a human
being who is compassionate, accepting, and genuine, I was forced to look at
that backlog of baggage that I was carrying. Once I began to accept the ways
in which I had been mistreated and integrated those truths into my story, I
began to see the ways in which love rises up to combat those forces.
When the media shared the stories of the suicides of seven beautiful gay men
and boys because of hate and prejudice, I no longer felt undirected or
powerless. I had the training and Graduate Assistant position to step up and
begin to combat hate through counseling, educational engagement, and media
interviews. As a counselor, that is what multiculturalism and social justice
means to me. It is a way to show people they are loved and accepted no
matter their skin color, sexual orientation, religion, criminal history, or any
other reasons the world tries to tell them they don’t matter, they shouldn’t
exist, and that they aren’t worthy of love. Advocacy, like counseling, is my
love working for others.
The U.S. Population: A Testament
to Diversity
In today’s America, the idea of encouraging counselors to understand and
respect diversity or to develop culturally competent counseling seems so
obvious that it hardly needs justification. The United States is a nation of
diversity in many different characteristics, including race, ethnicity, religion,
sexual orientation, and disability status, to name just a few. Diversity is the
quality of being different or dissimilar. Thus, to state that the U.S. population
has a lot of diversity simply reports on the facts without commentary.
Multiculturalism, on the other hand, is the practice of acknowledging and
respecting the various cultures, religions, races, ethnicities, attitudes, and
opinions within an environment. Thus, the concept of multiculturalism carries
an inherent value whereas the concept of diversity does not. Social justice in
counseling is an outgrowth of multiculturalism. It moves multicultural
valuing and respect from words and beliefs into action. Counselors who
operate from a social justice perspective actively work to fight oppression
and discrimination in society.
Many counseling books and other texts help counselors understand the major
beliefs, values, and worldviews of people from diverse groups in society.
While this level of understanding can be useful, if the information is used
incorrectly, it can facilitate the development or maintenance of stereotypes.
There are at least three significant errors we can make if we do this.
First, we can make errors of deduction when we believe something to be true

in general and apply it to the specific. For example, although it may be
important to know that Hispanics typically place high value on the family or
that Asian Americans usually value a more restrained display of emotions, it
is important not to make assumptions about how (or whether) these values
are played out for the client sitting in front of you. This client may be an
exception to that general rule and not value these traits at all. Or the client
may still value these traits but express them in different ways. There is
always an inherent danger of false generalizations when we take broad-based
information and apply it to the individual. Can you think of an attribute that is
typically associated with your race or ethnicity that does not apply to you?
Second, we can make an error when we assume homogeneity. In other words,

when we use a classification such as Asian American, we are essentially
lumping together people from more than 70 countries and at least 15 different
ethnic groupings. Thus, any statements that we make about what Asian
Americans value or how Asian Americans perceive something are clearly
bound to be inaccurate for at least part of the population. Discussions about
racial groups often cause us to consider differences between groups of
people, but we must also remember that there is significant variability within
racial groupings as well. Can you think of an attribute that varies greatly
within your racial or ethnic group(s)?
A third error we can make is minimization or maximization. We do this when

we under- or overemphasize the significance of a person’s race or ethnicity.
Counselors do this when they make assumptions about the role that
race/ethnicity plays in the life of a client without checking for clarity.
Sometimes, beginning counselors talk about wanting to be racially color-
blind, or not to “see” the client’s race at all, in an attempt to minimize the
effects of race. They say things like, “I treat all my clients the same” or
“When I look at a client, I don’t see race—I just see a person.” These
attitudes, however, make counselors unaware of the effects of racial
dynamics and minimize the role of race in a client’s life. It is perhaps not
surprising, then, that counselors’ adoption of racial color-blind attitudes have
been correlated with low cultural competence for both mental health and
school counselors (e.g., Chao, 2013; Johnson & Williams, 2014). On the
opposite side of the spectrum, counselors can maximize the role that a
client’s race/ethnicity plays for that individual and believe race is the defining
characteristic of the client’s life. Ultimately, there is no way for a counselor
to understand the importance of a client’s race or ethnicity without asking.
Can you think of an attribute typically associated with your race or ethnicity
that you value very much? Can you think of one that you do not value at all?
Of course, each of these potential errors can occur for any of the categories of
diversity, including race, ethnicity, religion, sexual orientation, gender,
socioeconomic status, and so on. It is not difficult to see how these errors can
increase the likelihood of stereotyping and prejudice. However, that does not
mean that counselors do not need to learn about the different groups of
people they counsel. Just because this type of information can be used
incorrectly does not mean that it is not important. We encourage you to
develop your knowledge and understanding of the many different types of
diversity within the United States (or wherever you practice your counseling)
—and then use that information in responsible and appropriate ways to
enhance your counseling.
Counseling and Diversity

Counselors who attempt to understand client diversity often consider the
following categories to help them understand the client’s worldview. Of
course, there are many more ways to conceptualize clients, but these ideas
will help get you started.
Race and ethnicity

According to the definition used by the U.S. Census Bureau, race and
ethnicity are two distinct concepts. Race refers to a social definition (as
opposed to a biological or genetic test) that allows people to classify
themselves with the race(s) with which they most closely identify. Options
include White; Black; American Indian, Eskimo, or Aleut; Asian; Mixed; or
Other. Ethnicity in the United States is essentially divided into two
categories: Hispanic/Latino and Not Hispanic/Latino. Thus, in the United
States, there are five main racial/ethnic groups: African American/Black,
Asian American, Caucasian/White, Hispanic/Latino, and Native
American/American Indian/Eskimo. However, you need only look around
you to see that the reality of racial and ethnic diversity is far more complex.
In 2015, the U.S. Census Bureau reported that 77% of Americans self-
identified as White; 13% self-identified as Black; 6% self-identified as Asian,
3% as mixed race, and 1% as Native American/American Indian/Eskimo.
That same year, 18% self-identified as Hispanic or Latino ethnicity (any
race), and 13% of the U.S. population was foreign-born. For the first time in
our nation’s history, White, non-Hispanic Americans will be in the minority
by 2042. The number of Hispanic/Latino Americans will more than triple
over the next half century, and as a result, the percentage of Americans who
self-identify as Hispanic/Latino will nearly double, from 16% in 2010 to
more than 30% in 2050. Young children are the most diverse age cohort.
More than 50% of infants born in the United States in 2016 were members of
“minority” groups (a term that, as you can see, no longer applies!). We can
get rid of this sentence to make room for the couple of lines that get pushed
to the next page, after the feature on Demetra.
In the third Snapshot of this chapter, Demetra Taylor, a Licensed Professional

Counselor, talks about her experiences as an African American counselor
working in a setting designed to help clients navigate their mental health
problems through the lens of racial identity. As you read her story, think
about how her initial assumptions about race had to change in order to best
meet the needs of her clients.
Clients typically self-identify as members of race(s) and/or as Hispanic/ non-

Hispanic (ethnicity), and conceptualizing clients through this lens can help
counselors better understand them. Racial identity is the client’s psychosocial
orientation toward membership in specific race(s), and models of racial
identity development help us understand the client’s level of acceptance or
rejection of racial identity. There are many different such models that you
may learn about in your graduate program, but most share a common history
in a model developed by Helms (1995). Helms identified a six-stage model of
racial identity development: pre-encounter, encounter, immersion, emersion,
internalization, and integrative-awareness, and these stages have been used
to track both White Racial Identity Development and Racial Minority Identity
Development.
More recently, there is an understanding that racial (or any) identity

development cannot be understood in isolation. Rather, the interconnected
parts of human identity are intertwined, in a concept called Intersectionality.
Intersectionality recognizes that each of us has multiple intersecting
identities, and our complex individual conceptualizations of race, ethnicity,
gender, sexual orientation, economic status, religion, spirituality, disability
status, and other identities all collectively comprise our individual human
identity (Ratts, Singh, Nassar-McMillan, Butler, & McCullough, 2016).
Adding to this complexity, environmental influences on each of these
multiple identities change over time, emphasizing that each of us exists in a
complex and ever-changing interplay of person and environment.
Multiculturally competent counselors respect this complexity and do not limit
their understanding of clients to simple categorizations of race or ethnicity.
Gender
Gender is a social construct that emphasizes attitudes, behaviors, beliefs, and
relationships that are typically associated with being male or female. Gender
is often clearly linked to biological sex, but it is not the same thing. The
concept of gender varies across cultures, but also varies greatly by individual
within each culture. Each of us uses the information and feedback that we
receive from the outside world to create a self-image of who we are as
gendered beings and how we should behave. Of course, gender also
structures and shapes the expectations of those around us with whom we
interact, resulting in self-fulfilling behaviors that help shape our behavior to
meet the expectations that are important to others (Worell & Remer, 2002).
Within the field of counseling, gender plays an important role in client
conceptualization, assessment, goal setting, and treatment planning, as well
as intervention strategies. How counselors see gender issues operating within
their clients’ lives will have a significant impact on what goals and strategies
seem appropriate in counseling (Cook, 1993).
SNAPSHOT Demetra Taylor, MA

Counselor with Supervising
Credential
My internship (and ultimately my first counseling job) was at a place that
specialized in working with African American clients. I am African
American, so I believed that the clients there would have no trouble listening
to me and trusting me because we were of the same race. I thought my
biggest challenge would be getting the clients to become more self-aware.
But when it came time for me to have a caseload of my own, it turned out
that my own self-awareness would be the biggest challenge I would face.
I was confronted with the fact that within my own culture, there were many
different subcultures. Many of my clients lived in poverty, had broken
families, drug addictions, and legal problems. I was not familiar with these
issues in my personal life and it showed in my interactions with the clients.
Instead of the ease and trust that I expected because we were of the same
race, my clients put walls up. I heard comments like, “You don’t understand
because you never . . .” or “I want to talk to someone that didn’t learn this in
a book.” Occasionally, I faced a roadblock because of a male client’s feelings
regarding having an African American female in a perceived role of
authority. Needless to say, these were the times when I felt stuck and like I
would never be able to reach my clients.
During supervision and debriefings with my co-facilitators, I learned that

even though there were many different subcultures and beliefs within our
shared culture, there were several important similarities. On a broader level,
clients faced basic emotional needs not being met, feeling stigmatized by
their diagnoses, and feeling marginalized by society. Because of our shared
culture, I was able to relate to my clients when they spoke of being
marginalized, stigmatized, and feeling out of place because of our race and in
some cases, because of our gender. This was the foothold I needed to be able
to work successfully with my clients. As time went on, I also learned to meet
clients where they were. I learned to take a step back and instead of trying to
find commonalities in which to connect, I began to ask questions. I asked
about their experiences, about subcultures I didn’t understand, and I showed a
genuine interest in how and why my clients took the path that they did.
Ultimately, this proved to be the best way to connect, build a therapeutic
relationship, and get to the important work in front of us.
As I moved forward and became employed at this agency, I also had the
pleasure of completing some internship hours at a private practice. Here I was
working with counselors and clients of many different races and
backgrounds. I remained open to learning new things and just like within my
culture, I was able to understand that not all Caucasian people have the same
experiences, not all Hispanic people have the same experiences, and so on.
What I discovered along the way is that we all have basic human emotions
and needs that we want to have met. When this does not happen, and we do
not have appropriate coping skills to handle what comes our way, problems
arise. I learned to not assume anything about myself or my clients. We are all
unique. Learning to appreciate and value that uniqueness allowed me to find
the strengths within each person that set them on the path toward better
mental health.
Historically, gender has been presented as a binary construct (female or

male). However, more and more people are identifying as gender
nonconforming or gender variant individuals, and counselors must
understand and respect the complexities of the identities for these students
and clients (and for each other, as well!). Transgender (or Trans) is an
umbrella term used to describe those who challenge social gender norms,
including genderqueer people, gender-nonconforming people, gender-
questioning people, and transsexuals. People must self-identify as
transgender for the term to be appropriately used to describe them
(ALGBTIC Transgender Committee, 2010). Best estimates are that about
0.6% of the U.S. adult population identifies as transgender (Flores, Herman,
Gates, & Brown, 2016), or about 1.4 million adults.
As counselors, it is important that we do not make assumptions about our

client’s gender. One way to open the conversation about gender is to ask
clients their preferred name and preferred gender pronoun (called PGP). For
example, a counselor might ask “Do you have a preferred name? Do you
have a preferred pronoun?” These questions may elicit a conversation about
the person’s current gender identity and expression (Donatone & Rachlin,
2013). Other specific strategies to provide counseling with transgender
clients can be found within the American Counseling Association’s
Competencies for Counseling Transgender Clients (ALGBTIC Transgender
Committee, 2010).
Fast Facts
In the United States, more than 20 transgender people die each year due to
violence. Although many factors contribute to these deaths, it is clear that
fatal violence disproportionately affects transgender women of color, and that
the intersections of racism, sexism, homophobia, and transphobia conspire to
deprive them of employment, housing, and healthcare, which contribute to
their vulnerability.
Source: Human Rights Campaign (hrc.org). 2017
Sexual orientation
A person’s sexual orientation describes a pattern of romantic and physical
attraction to men, women, both genders, or neither gender. Generally, there
are thought to be four categories of orientation: heterosexuality,
homosexuality, bisexuality, and asexuality, although these simplified
categories do not accurately encompass the fluidity of sexuality that develops
over a person’s lifetime. Because these categories are not discrete and
because there are differences in people’s behaviors and self-labels, it is
impossible to place percentages of the U.S. population into the different
categories. In other words, people might consider themselves bisexual only if
they have equal attraction to males and females. Others might consider any
attraction to same-gendered individuals as bisexuality, even if most or all
sexual behaviors occur with those of opposite gender. The U.S. Census
Bureau (2010) found that 4.1% of the population (8.8 million adults)
identifies as lesbian, gay, or bisexual, although other estimates range as high
as 12%. Of course, part of the challenge of identification comes from the
stigma that continues to surround sexual minorities. Stigma is severe social
disapproval of people based on characteristics or beliefs that differ from the
norm, and homophobia is a specific type of stigma that involves irrational
fear or hatred of sexual minorities.
Individuals who are sexual minorities may self-identify as lesbian, gay, or

bisexual, and for historical reasons, these groups are often combined with the
transgender population and referred to as the LGBT population or
community. Other terms are adopted by segments of the community to help
clarify specific beliefs and practices, such as questioning (exploring one’s
gender, sexual identity, and/or sexual orientation), queer (a once negative
term that has been reappropriated by members of the LGBT community to
demonstrate pride), same-gender-loving (SGL; sometimes adopted by
African American males to distinguish themselves from White-dominated
LGBT communities), or men who have sex with men (MSM; adopted by men
who engage in sexual relationships with other men without identifying or
labeling their sexuality). The term homosexual is typically not used within
the counseling profession, as it harkens back to the time before 1973 when
homosexuality was included as a mental illness in the Diagnostic and
Statistical Manual of Mental Disorders. The important take-home message
here is that counselors must understand and use the labels and terms that
clients prefer rather than imposing their own language and terminology on
others.
Within the field of counseling, clients who are LGBT can present with a
multitude of concerns, many of which are related to social stigma and the
coming-out process. Counselors need to be sensitized to the ways in which
the lives of LGBT persons are affected by the stresses of living in a
homophobic society with people who believe them to be sick, immoral, or
criminal. Additionally, LGBT people are raised in the same homophobia and
heterosexist (assuming someone is heterosexual or assuming heterosexual is
the standard by which others are judged) society and can believe the
messages, resulting in internalized homophobia. For young people, bullying
and violence, isolation, substance abuse, eating disorders, suicide, depression,
and anxiety are all risks associated with coming out, particularly in the early
stages of sexual identity.
In addition to the unique needs that their status as sexual minorities can
present, LGBT clients also come to counseling for relationship, family, and
parenting issues (or any other mental health or career needs), just like their
heterosexual counterparts. The danger of maximization (discussed earlier)
means counselors may believe sexual orientation is the presenting issue
when, in fact, the orientation status of the individual or couple may be simply
one of many demographic characteristics that help provide context for
counseling. The Association for Lesbian, Gay, Bisexual, and Transgender
Issues in Counseling (ALGBTIC) was established in 1997 as a division of the
American Counseling Association to promote greater awareness and
understanding of gay, lesbian, bisexual, and transgender issues among
counselors, clients, and communities (www.algbtic.org).
Fast Facts
When compared to their heterosexual peers, LGBT teens are:
Bullied at more than three times the rate
Far more likely to feel unsafe at school (61% fear violence at school)
More likely to be homeless (20–50% of all homeless youth are LGBT)
More than twice as likely to drop out of high school
More than four times more likely to attempt suicide (35% of LGBT
youth attempt suicide)
Far more likely to experience harassment at school (87% of LGBT

students)
190% more likely to use drugs or alcohol
Source: http://www.thetrevorproject.org.
Religion/Spirituality
A 2014 poll of more than 35,000 adults by the Pew Forum on Religion and
Public Life concluded that “diverse and extremely fluid” was perhaps the best
way to describe the religious life of Americans. Just over 70% (70.6%)
classified themselves as Christians, down from 78.4% just seven years
earlier. There was a slight increase in the percentage of Americans who self-
identified as part of a religion other than Christianity (5.9% in 2014,
compared with 4.7% in 2007). The biggest change from 2007, however, was
in the percentage of Americans who did not identify with any organized
religion. That percentage increased by nearly 50%, from 16% in 2007, to
23% in 2014 (Pew Forum on Religion & Public Life, 2015).
One of the most important factors in the declining percentages of religiously

affiliated adults is generational replacement. More than 36% of the Millennial
generation (born between 1981 and 1996) are religiously unaffiliated,
compared with 17% of Baby Boomers (born from 1946 to 1964) and 11% of
the so-called Silent Generation (born between 1928 and 1945).
Many counselors help clients differentiate between religion and spirituality.

Religion is a formal, structured framework for organizing beliefs and refers to
adherence to a particular set of beliefs. Spirituality is a search for meaning
and purpose that is derived from inner wisdom, higher consciousness, and/or
connection to a Supreme Being or life force. For some people, religion and
spirituality are the same, but it is clear that spirituality can occur outside of an
organized religion.
Within the field of counseling, counselors can help clients integrate their
religious and/or spiritual beliefs into their treatment. Although care must be
taken not to impose the counselor’s religious beliefs on the client, it is also
important not to ignore what may be an integral part of the client’s life. Just
as with all aspects of diversity, the key is understanding the role that religion
or spirituality plays in the client’s life, the degree to which the client
identifies with that role, the client’s willingness to explore spiritual or
religious needs, and the degree to which religion and spirituality provide
comfort, strength, and meaning for the client. Of course, for some clients,
religion and spirituality have played a negative role in their identity
formation, and this must be acknowledged and (if appropriate) addressed as
well. The key is that just as with all aspects of diversity, the role that religion
and spirituality plays (or does not play) in counseling is at the discretion of
the client. The Association for Spiritual, Ethical, and Religious Values in
Counseling (ASERVIC) is a division of the American Counseling
Association comprised of counselors who “believe spiritual, ethical, and
religious values as essential to the overall development of the person and are
committed to integrating these values into the counseling process”
(ASERVIC mission statement). In 2009, ASERVIC adopted a list of spiritual
counseling competencies that have also been adopted by the American
Counseling Association. For more information and a description of the
competencies, visit their website (www.aservic.org).
Age/Generational status
You have undoubtedly heard of the terms associated with different
generations of Americans—Baby Boomers, Generation Xers, the Millennials,
and so on. These terms exist because there is a belief that people who are
born during particular periods in history tend to share some common cultural
reference points, beliefs, and perceptions about the world. In 2015, about
25% of the U.S. population were under age 18, and 15% were over age 65
(1.2% were 90 years or older). The median age in the United States is 38
(50% of people are younger, 50% are older). This compares with the world
median age of 29, meaning that the U.S. population is, on average, slightly
older than that of most other countries. Some countries have a very young
population, such as Uganda, with a median age of 15, meaning that half of
the population in the country is children. The country with the oldest median
age is Japan (47 years).
From a counseling perspective, age and generational status are important
developmental lenses with which to understand our clients and ourselves.
Lifespan development issues and life tasks can help provide the context for
understanding a client’s story. Age tends to have the most significant
influence on the counseling relationship when the client is very young or very
old, or when the counselor is significantly younger than the client. It is not
uncommon for counseling students to be significantly younger than their
clients, and many students worry that they will not be taken seriously by
clients who are old enough to be their parents or grandparents. Our students
sometimes ask, “What do I say if my client asks me how old I am?” We
remind students to focus on the underlying message of this question, which is
often not about the counselor’s chronological age and more about the client’s
underlying fears and trust (“Can I trust you with my problems?”). Addressing
the question at that level, rather than (or in addition to) the chronological
level can help allay concerns. Responses might sound something like, “When
I hear you ask that question, it occurs to me that what you are really
wondering is whether I have the experience or education to assist you, and I
think that’s an important discussion for us to have. . . .”
In addition, young counselors should remember that professional dress and a

professional demeanor will go a long way toward helping clients feel
comfortable entrusting you with their concerns.
Finally, we remind all counselors that it is important to have at least a basic

understanding of the life tasks facing people of different ages and the historic
milestones that people of their generation faced. For example, people
growing up in United States in the 1960s may have been influenced by the
civil rights movement; those in the 1960s and 1970s lived in the context of
the Vietnam War and Nixon’s resignation. These experiences helped shape
their lives. In the wake of the September 11, 2001, attacks, one of our
students expressed to an older client that this was the first time in anyone’s
memory that our country had been attacked by foreigners. Of course it was
not, as anyone alive during the attacks on Pearl Harbor would quickly attest.
The point is that understanding some historical context helps us understand
our clients. Alternatively, it is difficult to counsel those younger than you
without keeping up with current trends or social movements. A counselor of
today’s adolescents would want to know the role that Facebook or social
media plays in the lives of young people or perhaps even know something
about the recent pop icons, if conversations about them would help the
counselor and client connect. Just as we cannot be culturally encapsulated
and still understand clients of different races or ethnicities, we cannot be
trapped in our own generation and age and still expect to connect with older
or younger clients. The Association for Adult Development and Aging, a
division of the American Counseling Association, is designed to help
counselors address the needs of older adults in counseling (http://
www.aadaweb.org).
Dis/Ability status
The Americans with Disabilities Act (1990) defines disability as physical or
mental impairment that substantially limits a major life activity. About 19%
of the U.S. population self-identifies as a person with a physical and/or
cognitive disability, and for nearly 13% of Americans, that disability is
severe (U.S. Census, 2012). About 28% of people with disabilities live in
poverty (compared to the national average of 13%; Kraus, 2015). People with
mental illnesses are not necessarily captured in those disability statistics,
unless the illness is severe enough to be incapacitating (about 4–5% of the
population). In general, about 1 in 5 Americans (children and adults) suffers
from a diagnosable mental illness in any given year (NAMI, 2017), and as
many as two-thirds of people with mental illnesses never receive any mental
health care. More than one-quarter of adults in homeless shelters or prisons,
and more than 70% of youth in juvenile justice have a serious mental illness.
Individuals with disabilities often state that in addition to the hardships

imposed by their disability, they face a social stigma that challenges their
ability to connect with others in society. In fact, for many people, the
attitudes of society often represent a larger barrier than the disability itself
(Granello & Wheaton, 2001). In a landmark study on the debilitating effects
of stigma, Corrigan (1998) found that persons with severe schizophrenia
reported that the stigma associated with having the disease was harder to
manage than the disease itself. We find this to be a truly stunning statement.
Think about it—people who are living with severe and debilitating psychosis
say that the illness is not as bad as the way they are treated by others!
People with disabilities face social stigma, discrimination, and prejudice, and
counselors help give them tools to challenge assumptions made about them.
Just as with homophobia, persons with disabilities often internalize the
stigma, and helping them challenge their own prejudicial assumptions is a
critical role for counselors. Rehabilitation counselors help people with
disabilities obtain their highest level of functioning and quality of life. Find
more information about the American Rehabilitation Counseling Association,
a division of the American Counseling Association, at their website (http://
www.arcaweb.org).
Informed by Research The Power of

Language and Labels
The term “the mentally ill” is everywhere, and it is used interchangeably with
“people with mental illness” in nearly every venue. Even within the
counseling profession, the term is commonplace and considered acceptable to
publishers, educators, and counselors.
In the 1990s, there was an effort to encourage the use of “person first
language,” but many people dismissed this as simply an example of political
correctness. As it turns out, no one had investigated whether the use of
person-first language actually made a difference in people’s beliefs and
attitudes.
In 2016, researchers conducted a series of studies to investigate the effects of

person-first language on attitudes toward people with mental illnesses. The
research involved three groups: 221 undergraduate students, 211 non-student
adults, and 269 professional counselors and counselors-in-training who were
attending a meeting of the American Counseling Association (Granello &
Gibbs, 2016).
The design of the study was very simple. All participants completed a
standard, often-used survey instrument, the Community Attitudes Toward the
Mentally Ill (Dear & Taylor, 1979). The surveys given out were identical in
all ways except one: Half the people received a survey that used the term “the
mentally ill” and half received a survey that used the term “people with
mental illnesses.”
The questionnaires had four subscales looking at different aspects of how

people view those with mental illnesses. The four subscales (and sample
questions) are:
Authoritarianism: “The mentally ill / People with mental illness need the
same kind of control and discipline as a young child.”
Benevolence: “The mentally ill / People with mental illness have for too
long been the subject of ridicule.”
Social restrictiveness: “The mentally ill / People with mental illness

should be isolated from the rest of the community.”
Community mental health ideology: “Having the mentally ill / People

with mental illness living within residential neighborhoods might be
good therapy, but the risks to residents are too great.”
Results showed that participants in each of the three groups (college students,
other adults, counselors) showed less tolerance when their surveys referred to
“the mentally ill,” rather than “people with mental illnesses.”
Overall, when people in the study saw the term “the mentally ill,” they were
more likely to believe the people described by the label are dangerous,
violent, and need coercive handling. They were also more likely to perceive
them as inferior and to treat them like children, or to try to distance
themselves and their communities from interactions with the people
described, and less likely to want to spend tax dollars to help them.
One surprising finding was that although counselors had the highest level of
tolerance overall, they also showed the largest difference in tolerance levels
depending on the language they read. In other words, counselors and
counselors-in-training were the group that was most affected by language.
This study has significant implications for the counseling profession.

Counselors who work with people with mental illnesses every day can have
our perceptions altered by language, and we all need to be aware of how
language might influence our decision-making when we work with clients.
Whether we are consciously aware of it or not, all of us are affected by
language that dehumanizes others and defines people only by their labels.
In this chapter’s Informed by Research, which appears on the previous page,

you read about a study that emphasizes the importance of language and labels
that counselors use in their efforts to lower the stigma that surrounds mental
illness. As you read this research, we hope you will consider the language
you use—in your professional as well as your personal life—and make an
effort to use language that enhances the dignity of all people.
Language
English is the de facto language of the United States, and according to the
U.S. Census Bureau (2016), 92% of the population claim to speak it very
well. The other 8% are considered to be Limited English Proficient (LEP).
However, that statistic does not adequately represent the vast number of
spoken and signed languages within the U.S. borders. For more than 21% of
Americans, English is not the primary language spoken in the home. Spanish
is the second most common language (spoken by 12% of the population), but
this clearly differs by region. Of the 39 million people in the United States
who speak Spanish in their homes, 10 million (26%) speak English not well
or not at all. Of the top 10 most common languages in the United States, nine
are spoken by more than a million people each (in order: English, Spanish,
Chinese (mostly Cantonese), American Sign Language, French, Tagalog,
Vietnamese, Korean, and German). Each of the top 20 most common
languages is spoken by more than 250,000 Americans. Overall, there are
more than 350 different languages spoken by Americans.
In counseling, shared language creates a common bond and allows for the
development of trust. Counseling is, after all, a primarily spoken endeavor,
and lack of a shared language can significantly, and often negatively, affect
outcomes. When counselor and client speak different languages, the services
of an interpreter (sometimes a professional, but often a family member of the
client) must be used, often with a corresponding decline in the therapeutic
relationship. Language has been identified as a significant barrier in
preventing counselors from establishing quality relationships with Spanish-
speaking clients and students in schools, and when schools provide
counseling services in Spanish, Hispanic/Latino students and their families
are more likely to seek help (Smith-Adcock, Daniels, Lee, Villalba, &
Indelicato, 2006).
Socioeconomic status
The concept of socioeconomic status (SES) is an economic and sociological
construction that is a combined index of a person’s income, education, and
occupation. Typically, individuals in the United States are classified into
three major SES categories: upper (wealthy), middle (middle class), and low
(poor). Others have conceptualized essentially a six-tiered system of SES:
upper class (rich and powerful), upper-middle class (highly educated and
wealthy), middle class (college educated and employed in white-collar
industries), lower-middle class (working class and employed in clerical and
blue-collar positions), working poor, and unemployed.
In counseling, SES is correlated with many factors that are often linked to
psychological health and wellness. For example, countless studies have found
an extremely strong correlation between poverty and mental illness, although
determining whether either causes the other is more difficult to ascertain. For
example, it may be that being poor renders a person more susceptible to
mental illness, or that mental illness pulls a person into poverty. In fact, it
may be both. The relationship between poverty and mental health has long
been assumed to be interactive. Children in poor families have higher levels
of aggression than their more economically advantaged peers and are
instigators and recipients of higher levels of childhood antisocial behavior
(bullying, peer violence) than higher income peers. Counselors who
understand their clients in the context of their socioeconomic status recognize
the powerful effect that the environment plays on the individual.
A large-scale, multi-decade effort to understand the interaction between

living environment and mental and physical illnesses has resulted in a
national conversation about Adverse Childhood Experiences, or ACEs. ACEs
are adverse experiences that harm children’s developing brains so profoundly
that the effects show up decades later, most often in the form of chronic
diseases, mental illnesses, and violence. In other words, the toxic stress of
growing up in adverse conditions changes the actual structure and
functioning of children’s brains (ACEstoohigh.com).
The ten experiences measured by ACEs are as follows: (1) physical abuse,
(2) sexual abuse, (3) verbal abuse, (4) emotional neglect, (5) physical neglect,
(6) family member with mental illness, (7) family member with
alcoholism/substance abuse, (8) family member in prison, (9) witnessing
abuse of mother, and (10) loss of parent to divorce or death. ACEs scores
range from 0 (no adverse events) to 10. Most Americans (about two thirds)
had exposure to at least one of these adverse events during their childhood,
but for a significant proportion of people, childhood exposure to multiple
adverse events has had devastating effects. Those who have ACEs scores of 4
or higher are 7 times more likely to have alcoholism as adults, 2 times as
likely to be diagnosed with cancer, 4 times more likely to have emphysema,
and nearly 20 times more likely to have learning or behavioral problems in
school. People with ACEs scores of 6 or higher are 30 times more likely to
have attempted suicide than those with low ACEs scores, and the lifespan of
those with ACEs scores of 6 or higher is 20 years shorter than the general
population. In short, ACEs scores have become shorthand for understanding
the role of complex trauma in a person’s life.
There are literally hundreds of research studies measuring the effects of

ACEs, and more importantly, ways that counselors and other helping
professionals can help boost resiliency in those who have high ACEs scores.
If you are not familiar with ACEs, if you would like to learn your own ACEs
score, or if you would like to learn what counselors can do to help clients and
students with high ACEs scores, we encourage you to visit this website:
acestoohigh.com
Words of Wisdom
The reality of poverty is that it is more like a caste system than a class
system. People born into poverty often cannot escape it, which is the
definition of a caste—you are born into it and there is nothing you can do.
Calling poverty an issue of social class ends up blaming people for the
circumstances into which they were born.
Source: Kaira B., Practicing Counselor, after attending a training on ACEs
Other diversity categories

There are, of course, many different ways to classify people into groups. We
could make distinctions based on educational level, military status,
relationship status, or legal involvement. We classify people by their
occupation, hobbies, health care practices, and recreational activities. For
example, if we say someone is a Vietnam-era veteran, you may form some
immediate assumptions, just as if we said someone was a NASCAR fan,
attended polo matches, practiced meditation, worked on Wall Street, or was a
juvenile offender. Many people argue that the behaviors or values between
Southerners and Northerners, or between those who live on the East Coast
and those who live in the Midwest differentiate us. The classification of
urban versus rural also highlights differences. Each of these characteristics
(and many more!) helps us classify the many different types of diversity in
the United States. Each category helps us better understand the worldview of
the client, but only if we are open to learning what it means to the client to be
a part of the group.
Diversity and Oppression in the

Lives of our Clients
As we consider the many different types of diversity within the United States,
it inevitably causes us to think about how each of the diversity categories is
fraught with both privilege and oppression. Oppression exists for each type of
diversity (consider racism, sexism, heterosexism, classism, ageism, ableism,
and religious oppression, just to name a few). At the individual level,
oppression can occur with countless dehumanizing interactions that people
from marginalized groups often experience. Pierce (1970) coined the term
microaggressions to describe these experiences, and they can be experienced
as words or behaviors. At the larger systems level, oppression can manifest as
rules, policies, laws, or institutions that create inequities for marginalized
groups. Whether intentional or unintentional, oppression has a devastating
influence on the mental health of historically marginalized individuals and
communities (Ratts et al., 2016).
Earlier in the chapter, you read about a social justice approach to counseling,
a strategy that counselors have developed to help historically marginalized
groups cope with, and fight back against, individual and institutional
oppression. In the next section, you will learn more about how counselors
balance an approach to counseling that focuses on the internal problems of
individual clients with the social justice approach that addresses the larger-
scale, structural, and societal inequities that harm our clients in their day-to-
day lives. All counselors struggle with finding this balance. How, for
example, do we help an adolescent at a drop-in homeless shelter cope with
suicidal thoughts when we know that stable housing and a supportive family
is really what the child needs? Although many of the problems that our
clients face are the result of (or exacerbated by) the environment in which
they live, we cannot wait for large-scale social changes to occur before we
help our clients. We must meet our clients where they are, providing
multiculturally competent counseling for them now, while simultaneously
advocating for social transformation.
Multicultural and Social Justice
Counseling
Today’s counseling profession celebrates diversity, but this was not always
the case. The counseling profession, like all the helping professions, entered
the 1960s firmly entrenched in a White, heterosexual male value system.
Gilbert Wrenn coined the term “culturally encapsulated counselor” in 1962 to
describe White counselors who were ill-equipped to address the needs of
minority clients (p. 444). The turmoil of the 1960s and the lessons from the
civil rights movement, however, changed the course of the counseling
profession. At the national conference in 1969, the governing body of the
American Personnel and Guidance Association (APGA, now the American
Counseling Association) approved a petition calling for the organization to
become more responsive to the needs of clients of color. Within a few years,
the Association for Non-White Concerns (now the Association for
Multicultural Counseling and Development; http://www.amcdaca.org) and
the Journal of Non-White Concerns (now the Journal of Multicultural
Counseling and Development) were established in 1972.
It wasn’t until the 1980s, however, that multicultural counseling started to

become more than just the concerns of one of the divisions of the association.
A 1982 position paper outlined specific multicultural counseling
competencies that remain the foundation for culturally competent counseling
decades later (Sue et al., 1982). A 1992 article in the Journal of Counseling
and Development called upon the profession of counseling to adopt the
standards laid out in the 1982 position paper. Within the next decade, the
American Counseling Association and six of its divisions endorsed the
Multicultural Counseling Competencies. Counselors take pride in the fact
that counseling was the first of the helping professions to formally adopt
specific guidelines for multicultural competence, and that leadership and
vision continues to be an important aspect of the counseling profession’s
identity.
More recently, increasing awareness of the impact of social conditions that

affect our clients caused the profession to take a deeper look at the
Multicultural Counseling Competencies and make some important changes.
In 2015, the American Counseling Association endorsed the updated
competencies, now called the Multicultural and Social Justice Counseling
Competencies (MSJCC). The MSJCC highlights the importance of (a)
understanding the complexities of diversity within the counseling
relationship; (b) recognizing the powerful influence of oppression on mental
health and well-being; (c) understanding people within the context of their
social environment; and (d) integrating a social justice advocacy approach
into counseling (Ratts et al., 2016). As counselors and counselors-in-training,
we must always remember that these competencies are aspirational. No one is
“done” when it comes to cultural competence in counseling. All counselors
are in a constant state of “being-in-becoming” (Ratts, D’Andrea, &
Arrendondo, 2004, p. 29), and the development of multicultural and social
justice competence is a lifelong process that requires commitment and
understanding, and cultural humility.
The accompanying Spotlight provides an overview of the Multicultural and

Social Justice Counseling Competencies for your exploration. Although the
competencies appear to be rather straightforward, they actually require a lot
of effort, education, and self-awareness to implement. Therefore, rest assured
that although this may be your first exposure to the Multicultural and Social
Justice Counseling Competencies, it certainly won’t be your last.
SPOTLIGHT The Multicultural

and Social Justice Counseling
Competencies
The Multicultural and Social Justice Counseling Competencies (MSJCC)
were developed to help guide the interpersonal interactions of counselors
engaging in cross-cultural counseling. Originally presented as a position
paper in 1982, by 1992 the competencies had been published as a call to the
profession (Sue, Arrendondo, & McDavis, 1992). The competencies were
originally conceptualized as involving three distinct counselor characteristics
and three specific dimensions of cultural competency, with a fourth
dimension, Action, added in 2015 to reflect the reframing of the
competencies to include Social Justice.
The Counselor Characteristics

1. Counselor Self-Awareness: Is aware of his/her own assumptions, values,
and biases.
2. Client Worldview: Actively attempts to understand the worldview of

culturally different clients.
3. Counseling Relationship: Understands how client’s and counselor’s

statuses influence the counseling relationship.
The Dimensions
The counselor develops competence in:
1. Attitudes and beliefs (also called awareness)
2. Knowledge
3. Skills
4. Action (added in the 2015 update)
In 2015, a new section of the competencies, called Counseling and Advocacy

Interventions, was included to help counselors understand how they could
intervene with, and on behalf of clients at the intrapersonal, interpersonal,
institutional, community, public policy, and international/global levels.
A visual representation of the Multicultural and Social Justice Counseling

Competencies helps highlight the interconnectedness of these various
domains and dimensions. This socioecological model provides counselors a
multilevel framework for individual counseling and social justice advocacy.
Figure 10.1
Copyright 2015 by M. J. Ratts, A. A. Singh, S. Nassar-McMillan,
S. K. Butler, & J. R. McCullough.
In its 2014 revision of the Code of Ethics and Standards of Practice, the
American Counseling Association stressed the importance of multicultural
counseling competence, and every division of ACA has included
multicultural competence in its mission or vision statement, standards, and/or
by-laws. In fact, multiculturalism has been called the Fourth Force of the
counseling profession (following psychodynamic, behavioral, and humanistic
approaches), and some have argued that social justice should be considered
the Fifth Force in counseling (e.g., Ratts & Pedersen, 2014). Social and
cultural diversity is one of the eight core areas of the counseling curriculum
as outlined by CACREP, and nearly every counseling program includes both
classroom and experiential activities to enhance counselor cultural
competence. Graduate programs in counseling use one of three strategies to
help students become culturally competent: (1) infusion throughout the entire
graduate program; (2) a separate course in multicultural counseling; and (3) a
combination of #1 and #2. None of these strategies has been demonstrated to
be more effective than the others, but many counselor educators would argue
that it would be difficult to teach any class in the counseling curriculum
without significant attention to multicultural factors.
Fast Facts
In spite of a higher prevalence of psychiatric disorders, African Americans
and Americans of Hispanic/Latino ethnicity receive approximately half the
amount of outpatient mental health services as non-Hispanic White
Americans. These differences persist even after controlling for
socioeconomic status and insurance coverage.
Source: Substance Abuse Mental Health Services Administration, 2015.
Strategies to Enhance Your Own

Multicultural and Social Justice
Competence
Counselors recognize that cultural competence is both something learned
during graduate school and something that must be attended to throughout a
person’s personal and professional life. Most professional conferences and
journals include information and research on culturally competent
counseling, and seeking out opportunities for ongoing learning is essential to
your growth in this area. In this section, we highlight five strategies you can
use to help enhance your multicultural and social justice competence.
1. Attend workshops and trainings There are many different opportunities

available—in person, on the Internet, at your university, and through
local and national counseling associations. For example, a quick look at
a recent American Counseling Association conference program list
(which includes over 500 different educational sessions) reveals that
many, if not most, of the sessions have a strong multicultural
component. In the following list, we provide just a few examples of
some education sessions from a recent conference that have a clear
multicultural or social justice component in addition to their focus on a
specific aspect or type of counseling.
Addictions Counseling: Best Practices in Counseling Gay Male

Youth with Substance Use Disorders
Career Counseling: Providing Career Support to Ex-Offenders: A

Systemic, Social Justice Perspective
Child & Adolescent Counseling: Play Therapy Training for Mental

Health Professionals in the Border Region
Clinical Mental Health Counseling: Behavioral Activation:

Effective Treatment Approach for Latinas/os with Depression
College Counseling: Intergenerational Trauma and College

Student Success
Couples and Family Counseling: Fortifying Resilience in Pre- and

Post-Deployment Military Families
Creativity in Counseling: Reauthoring Stories: Using Narrative

Therapy to Assist Recent Young Adult Immigrants
Gerontological Counseling: The Long and Winding Road: A

Critical Evaluation of Aging and Intersectionality
Rehabilitation Counseling: Facilitating Groups That Include

Persons With Disabilities
School Counseling: Conceptualizing the Mental Health Needs of

Gifted/High-Ability Children and Teens
Spirituality and Religion: Reconciling Gender and Spiritual

Identity in LGBTQ+ Individuals
2. Seek exposure to other cultures Go to festivals or celebrations of

different countries, attend services in other languages or visit churches,
synagogues, or mosques that expose you to new ideas. Go to a music
festival that celebrates the music of a different culture. While you are
there, seek opportunities to interact with others. At your own college or
university, talk with classmates and colleagues who represent different
perspectives from your own. Initiate conversations. Notice if you are
spending time with people who “look just like you” and make
intentional efforts to broaden your circle of acquaintances.
3. Read books or scholarly articles Read a first-person narrative by a

person of color with a mental illness or the life of a person with a
disability. Seek out scholarly journal articles on diversity, social justice,
advocacy, or multicultural counseling. As you read, consider how you
can apply what you are learning to your own growing sense of cultural
competence.
4. Take a class Use the resources at your university to take a class in

culture, religion, disability, gender studies, or military history. Challenge
yourself to seek new perspectives in your academic work and work to
incorporate your new learning into your development as a counselor.
5. Volunteer Offer your services at a homeless shelter or other place where

you will come in contact with people in poverty. Challenge your
preconceived ideas and push yourself to grow.
SNAPSHOT International Students
Becoming Counselors Ursula Lau,
Diego Lopez-Calleja, Jenny Sheng-
Hsin Cheng, and Chieh Hsu
Every year, millions of students make the decision to study abroad in search
of a learning experience that extends to the world beyond the classroom
walls. Through this endeavor, students immerse themselves in a new culture,
master the challenges of learning in a new and different academic
environment, and live through the many highs and lows of being a
“foreigner.” It is a life-transforming decision that results in increased self-
confidence and a feeling of achievement.
Preparation in the field of counseling, in and of itself, entails change.

Students don’t simply learn how to be counselors—they become counselors.
It is through this process that many of them discover who they are and form a
professional identity. In the case of international students, however, there is
an additional layer of complexity that presents numerous challenges both
academically and personally. In this snapshot, Ursula Lau, Diego Lopez-
Calleja, Jenny Sheng-Hsin Cheng, and Chieh Hsu, graduate students in the
Counselor Education Program at The Ohio State University, share some of
their experiences as international students.
“Being an international student in a distant land has reawakened within

me the questions related to my own social location and identity. My
experiences of both belonging and exclusion within my own country
have fostered my own social positioning as a ‘politically black’ South
African Asian woman. In so doing, I feel I am gravitated toward
postmodernism as a philosophical approach that not only embraces the
tensions of identity and the contradictions of ordinary experience, but
also nurtures subjective voices and multiple truths of the clients I would
serve in the future.”
Ursula Lau
“I have learned that to be an efficient counselor is to know who you are.

I was born in Taiwan, immigrated to Canada when I was 13 and am now
studying counseling in the U.S. I have started to examine the role my
dual nationalities play in my identity by asking, ‘Where do I say I am
from?’ and ‘Do I identify with an English or a Chinese name?’ and
‘How do my cultural perspectives align with different social issues?’ It
will be some time before I can answer the big questions about my
identity, but with every small question I answer about myself, I come
one step closer to finding out who I am.”
Jenny Sheng-Hsin Cheng
“At internship, my name badge says ‘Diego.’ However, most people

assume that I was born in the U.S., given that I have no accent, and that
I physically do not look Hispanic. What happens when I reveal that I am
from Costa Rica? Will it be an unimportant detail or will it be a critical
piece of information that will instill doubt in my clients about my ability
to help them? This is only one of many different challenges I face as an
international student every day.”
Diego Lopez-Calleja
“Study abroad is like taking an endless ride on a roller coaster where

you experience all the ups and downs without knowing the destination. I
am from Taiwan, and I embarked on a journey far from home to become
a counselor. I have been adjusting to this new country and program,
which is a slow but enjoyable process. The language barrier is the
primary issue, but the peers in my program are really helpful and
supportive. I just have to remember to be open to their support—and to
be kind and gentle with myself as I learn about my new profession in
this new culture.”
Chieh Hsu
“These are only some of the many situations that we face in our personal
journeys in becoming counselors abroad. However, the learning
involved in overcoming any obstacles is an invaluable experience. Each
of us brings to the table a diverse set of skills and values, and a unique
cultural background that molds our identities as counselors. The
challenge then lies in how we capitalize on these contributions to
become the best counselors we can be.”
The point is that there are many, many opportunities to enhance your cultural
competence right now as you learn to be a counselor as well as throughout
your counseling career. You need only to seek these opportunities and push
yourself to learn. We all know that we are not “supposed” to have reactions
to interacting with people who are different from ourselves, but we also know
that each of us has some level of cultural encapsulation that needs to be
challenged. Challenge yourself.
In the last Snapshot in this chapter, four international graduate students in

counseling talk about their experiences studying in the United States. As you
read through this Snapshot, consider ways in which their perspectives might
differ from your own (whether you are a native-born American or
international student), and what values and goals you share with these
students. How can interacting with students from different countries or
cultures enhance your own growth as a multiculturally competent counselor?
Summary
In this chapter, we challenged you to think about yourself as a cultural being,
living and working in an extremely diverse and complex society. Through an
exploration of your own beliefs and understandings about the world, you can
start to make sense of who you will be as a culturally competent counselor.
The Multicultural and Social Justice Counseling Competencies will help
guide you in that direction, but you must make a concerted and intentional
effort to become a counselor who understands and celebrates diversity in all
its forms and becomes a social justice advocate to help our clients live in an
environment that promotes their optimal health and wellness.
Student Activities
2. Most people have fairly strong reactions to the idea of privilege and how
unearned privileges, by virtue of race, gender, SES, education, and so
on, have affected their lives. What are your reactions to the concept and
its application to you? What privileges have you enjoyed by virtue of
your membership in privileged groups?
3. You had an opportunity to read Snapshots from the perspectives of
members of both majority and minority cultures. As you think about
your own cultural identity and your emerging identity of yourself as a
counselor, jot down any ideas you might have about how your own
understanding of yourself as a cultural being might affect your
development as a counselor.
Journal Question
Think about your gender, race, ethnicity, sexual orientation, family
background, religion, SES, disability status, and other characteristics of you.
How do you think you fit with other students in your program? In your
college or university? With your faculty? Future clients? How will you
capitalize on the similarities and differences between you and others around
you to get the most from your program? As an experiment, find a student in
your program who is very different from you in at least one of these areas and
discuss how your differences and similarities could affect your experiences as
counselors-in-training. Reflect on what you learned from this exercise.
1. We all are products of social, environmental, and familial messaging. As
a result, we have heard, and possibly internalized, many different
stereotypes about other groups. How can we acknowledge and then
challenge our own internalized prejudice?
2. What do you think about counselors as advocates for social justice?

What parts of that role do you embrace? What parts do you think move
us away from our individual work with clients?
3. What unique cultural groups exist in your community that will require
specific education and training for you and your classmates? For
example, some communities host specific refugee groups, have large
populations of particular immigrant groups, or are located near Native
American reservations. How will you learn the necessary skills and
information to promote the mental health needs of the populations you
will serve?
Experiments
1. Think of yourself as a cultural anthropologist exploring the “Culture of
You.” Develop a PowerPoint® or other type of presentation, as though
you had just come back from an anthropological expedition to the
“Culture of You,” and now you need to describe what you learned to a
group of people who have never met “You” and have no cultural
reference points to understand who you are.
2. Look ahead to your counseling curriculum to discover how

multiculturalism and social justice will be addressed in your graduate
training. Are there separate course(s)? Does your program use an
infusion model? How will you be trained to be a culturally competent
counselor? Is there anything you need to do to be proactive and take
control of this important component of your graduate training?
3. Find out what legislative, policy, or political agendas exist in your state
or community that will affect mental health services. Are funding issues
being discussed for school services or mental health agencies? Are there
legislative initiatives in your state that will affect the delivery of mental
health services? What can you do to help influence these discussions and
make your voice heard?
Explore More
Books
Ahmed, S. (2012). On being included: Racism and diversity in
institutional life. London, UK: Duke University Press.
Alexander, M. (2012). The new Jim Crow: Mass incarceration in the

age of colorblindness (rev. ed.). New York, NY: The New Press.
Banaji, M. R., & Greenwald, A. G. (2013). Blind spot: Hidden biases of

good people. New York, NY: Delecorte.
hooks, b. (1994). Teaching to transgress: Education as the practice of

freedom. New York, NY: Routledge.
McWhirter, J. J., McWhirter, B. T., McWhirter, E. H., & McWhirter, R.

J. (2012). At-risk youth: A comprehensive response for counselors,
teachers, psychologists, and human service professionals (5th ed.).
Belmont, CA: Thomson.
Ratts, M. J., & Pedersen, P. B. (2014). Counseling for multiculturalism

and social justice. Alexandria, VA: American Counseling Association.
Ratts, M. J., Toporek, R. L., & Lewis, J. A. (2010). ACA advocacy

competencies: A social justice framework for counselors. Alexandria,
VA: American Counseling Association.
Shields, C. M. (2013). Transformative leadership in education:

Equitable change in an uncertain and complex world. New York, NY:
Routledge.
Sue, D. W. (2010). Microaggressions in everyday life: Race, gender,

and sexual orientation. Hoboken, NJ: John Wiley & Sons. ISBN: 978-0-
470-49140-9
Articles
McIntosh, P. (1990, Winter). White privilege: Unpacking the invisible
knapsack. Independent School, 31–36.
Websites
The American Counseling Association has multiple lists of
competencies for working with diverse clients (e.g., Advocacy
competencies, ALGBTIC competencies, Spiritual and Religious
competencies, Multiracial competencies, and of course, the Multicultural
and Social Justice Counseling Competencies), all of which can be found
at their website:
https://www.counseling.org/knowledge-center/competencies
The American School Counselor Association has developed position

papers on a variety of subjects, including many related to diversity and
social justice (e.g., Cultural Diversity, Equity for All Students, Gender
Equity, Gifted & Talented Programs, LGBTQ Youth, and Students with
Disabilities, just to name a few), all of which can be found at their
website:
http://www.schoolcounselor.org/school-counselors-members/about-
asca-(1)/position-statements
Collect and Use Assessment
Information?
Questions
How counselors in various settings use assessment to plan treatment.
Why counselors spend so much time in assessment.
Some diversity considerations in the field of assessment.
The general categories of assessment, including interviewing and

testing.
A general way of assessing suicide potential.
The importance of assessing strengths and problems as part of a

counselor’s plans for assessment.
Identify the major ethical issues that arise when a counselor uses
assessment.
Differentiate between the process of assessment, which is an integral

part of the counseling process, and testing, which is only one means of
assessment.
Recognize important considerations in test selection.
How might your own beliefs and experiences with assessment might
influence when and how you conduct assessments with clients.
What role might the culture of the counselor and the client play in the
assessment process.
“Testing is boring.” That’s what one of our students said. And we must agree.
Giving tests to clients can be boring (test administration). But assessment
(collecting information about your client) is more than interesting. In fact, it
is one of the most fascinating aspects of being a counselor. It is the
investigative aspect that allows you to channel Sherlock Holmes in the
service of the client. Assessment may include giving paper-and-pencil tests to
clients or individually administering tests question-by-question, but
assessment is the larger enterprise of trying to understand the other person. It
involves collecting and analyzing information from at least seven different
sources:
Results of tests given to the client, including tests of achievement,

personality,
intelligence, brain functioning, and career development
Client reports of their problems, background, history of the problem,

family issues, and so on
Reports of family members
Medical data, including medications and physical problems
Information from courts, previous counseling services, and agencies,

including response to previous counseling, criminal behavior, reports
from probation officers, and so on
Behaviors and things the client says during the session
Data from schools and teachers, including achievement testing and

behavioral information
Counselors use the information they collect to guide their counseling.

Without accurate assessment, the entire counseling process is destined to
failure. Accurate assessment takes time and patience, and counselors must
take care not to assume that the very first thing a client reports is really the
problem. Consider this example. Imagine you walk in the door after a long
day at school and you are confronted by your roommate (or partner) who
says, “You didn’t take out the trash last night after supper, even though you
said you would. I tripped on it and it spilled in the kitchen, and I had to clean
it up.” You could respond to the statement, making some promise about
being sure to take out the trash in the future, but chances are, that’s not really
the issue. Seeking to understand the underlying problem will make for a
much more productive discussion. Perhaps your roommate or partner feels
taken for granted or lonely. Maybe that person is angry about something else,
and the whole story about the trash is just a symptom of an entirely different
problem. The point is, accurate assessment helps us determine what
intervention is necessary. Maybe you need to take out the trash more often or
to spend more time with that person.
What Kinds of Assessments Do
Counselors Use?
Assessment is an extremely complex endeavor that requires much education
and experience. For this reason, some counselors specialize in assessment.
Nevertheless, counselors in all settings use assessments, primarily in the
areas of achievement, career, intelligence, personality/psychopathology, and
counseling outcomes (indicators of client improvement). In Table 11.1, we
highlight some of the tests most commonly used by counselors.
Table 11.1 Types of Tests in

Common Use by Counselors
Where
What Do They Are They
Type Example Controversy?
Assess? Primarily
Used?
Woodcock-
Johnson Test When
of teachers are
Achievement evaluated
and various based on their
What has been
Achievement Schools state students’
learned?
achievement improvement,
tests they teach
including only to the
high stakes test.
testing
Mental Such tests are
health time
Minnesota
Tests of Deficits in clinics, Multiphasic consuming
Psychopathology emotional agencies, Personality and may not
adjustment hospitals, Inventory help with
and (MMPI) diagnosis. No
private strengths are
practices assessed.
The best
intelligence
tests are
Various areas of individually
intellectual ability administered
Wechsler
and predictions of and time
Intelligence
academic consuming.
Intelligence Schools Scale for
achievement. Imaginative
Children
Usually part of a thinking is not
(WISC)
neuropsychological assessed.
assessment. Limited
usefulness in
assessing
minorities.
May not
Mental
address the
health
client’s
Measures of clinics, Outcome
Change because of specific goals
Counseling agencies, Questionnaire
counseling but instead
Progress hospitals, 45.2 (OQ45)
looks at
privat
overall
practices
functioning.
Impairment in a While
Halstead-
psychological dysfunction
Hospitals, Reitan
function such as can be
Neuropsychological agencies, Battery and
memory due to identified,
Assessment private tests for more
problems in the results may
practices specific
central nervous not specify
problems
system treatment.
Personality
Mental
health California does not
The client’s clinics, Personality reliably
personality traits agencies, Inventory predict
Personality Tests such as private (CPI) and behavior.
introversion vs. practices, Myers-Briggs Thus, an
extroversion and in Type individual
business Inventory may be an
and (MBTI) introvert but
industry enjoy working
on teams.
Similarity between
the client’s Many tests do
Strong
interests, not predict
Interest
personality, and satisfaction
Inventory
values and various and may
(SII) and
Career Tests career pigeonhole
Career
environments, or women by
Thoughts
assesses client’s accepting
Inventory
preferences and their interests
(CTI)
thoughts about at face value.
careers
In the following sections, we discuss some of the assessment strategies most

used by counselors to gather information and improve their understanding of
clients and programs. Typically, they fall into the following categories:
interviews, questionnaires and surveys, standardized or non-standardized
tests and measures, and measures of program effectiveness or accountability.
Interviewing
When we began this chapter, we said that assessment is not just testing. In
fact, testing is only a part of the process and not something that every
counselor will use with every client. Interviewing, on the other hand, is the
most common assessment method among all helping professionals and
involves asking questions and listening. Here a client provides information
about specific concerns and specific goals. The initial session may be an
intake session, during which the counselor elicits background information
from the client, unless this has already been gathered on the telephone or by a
designated intake specialist. At intake, many counselors ask the client to fill
out a form and then review the answers with the client. Other counselors
prefer an unstructured interview where the counselor gathers information on
important topics.
Counselors engaging in interviews recognize that this type of assessment

helps build rapport, can be tailored to the needs of the client, and can provide
a lot of in-depth information that would be hard to assess in other ways.
Conversely, interviews have inherent weaknesses, most notably in that they
are subject to the biases of the counselor because they are typically not
standardized and therefore rely heavily on the judgment of the counselor
about which topics to explore in more depth.
Jones (2010) identified the major categories most commonly included in the
initial interview:
1. General data about the client, including ethnicity, age, referral source,
and so on
2. Information about the problem that brought the client to counseling (i.e.,
symptoms)
3. A history of the problem, including the duration, severity, and frequency
4. Family history, including information about who the client is living with
and history with parents and siblings (family of origin)
5. Relationship history, including close friends, intimate relationships,

history of violence in relationships
6. Developmental history, including school problems, diagnostic labels

applied, child abuse, and so on
7. Educational history that encompasses success or failure in school, higher

education, and other training
8. Work history, which involves present employment, length of
employment, and a sketch of the client’s successes and failures at work
9. Medical history, including present health, medications, important

accidents and illnesses in the past, and chronic conditions
10. Substance abuse history
11. Legal history
12. Previous experiences in counseling
Even counselors who work in settings that do not have formal intake sessions
must still elicit information from their clients about what caused them to seek
assistance. Initial interviews, whether in-depth and comprehensive, or a few
well-articulated questions asked by a school counselor to understand why a
student was crying in the stairwell, help counselors focus their interventions.
Words of Wisdom
“The common element underlying both evaluation/assessment and
intervention/helping is sensitive and effective listening.”
Source: Sommers-Flanagan & Sommers-Flanagan (2009, p. 21).
Diagnostic interviewing is a specialized type of interview that helps

counselors arrive at a client’s diagnosis. Counselors who seek to form a
diagnosis through this process will help the client describe the history of
problems, associated symptoms, personal experiences relevant to the
problem, current situation, and mental status. Counselors engaging in
diagnostic interviews use the DSM 5 as a guide to help ask clarifying
questions about specific symptoms or problems. Accurate assessment can
facilitate accurate diagnosis, which is essential for appropriate treatment
planning. A couple of weeks ago, one of our students in internship class
talked about a client who had previously been seen at a college counseling
center following the accidental death of his best friend. The previous
counselor saw the client for several sessions and marked in the file that he
had made good progress. Now, a year later, the client was back in counseling
because of recurrent nightmares about his friend, intrusive thoughts about his
friend’s death, diminished interest in his studies, and blunted affect. Clearly,
the student was suffering from Post-Traumatic Stress Disorder (PTSD).
Because the college counseling center does not require a diagnosis for
students to receive counseling, the original counselor had never diagnosed
this student and never understood the real problems that the student faced.
Consequently, the student’s problems were never sufficiently or accurately
addressed. To quote the internship student, “I enjoyed my assessment and
diagnosis classes, but now I get it. I get why assessment and diagnosis matter.
Avoiding a diagnosis because you don’t believe in labeling or because it is
not a requirement of the site completely misses the point. If the lack of proper
assessment means clients do not receive the treatment they need and deserve,
then we have the potential to cause great harm.”
Questionnaires, Surveys, and Rating

Scales
Counselors use surveys to gather information about clients, programs, and
needs of a community or school. They can be simple questionnaires that the
counselor develops or published surveys that are commercially available. For
example, school counselors often use the results of the Youth Risk Behavior
Survey (YRBS; http://cdc.gov) to help inform programming in their schools.
Or they might use a simple questionnaire that assesses students’ learning or
understanding of material after a group counseling or classroom lesson.
Counselors might also use simple questionnaires, such as a client satisfaction
survey, to measure the quality of their programming. In general, we give
surveys or questionnaires to our students and clients to help us make sure our
programming meets their needs.
When counselors use questionnaires, surveys, and rating scales, they

typically appreciate that these types of assessments are quick, efficient, and
typically inexpensive. However, these types of assessments often do not have
strong psychometric properties (validity, reliability) and can have rater bias.
Standardized Tests or Instruments
When most people think of assessment, they think of specific tests that are
given to individuals or groups to identify problems, assess functioning,
measure progress, or determine qualifications for entry into programs or
professions. Standardized tests are structured instruments that have been
developed against rigorous criteria and allow comparisons to be made across
individuals. Most tests that are available for purchase in the field of
counseling are standardized. If you took the GRE to get into graduate school
or have taken the Myers-Briggs or Strong Interest Inventory, you have taken
standardized tests. School counselors are very familiar with standardized
tests, especially the achievement tests that are commonly used in schools.
Counselors who use standardized assessments recognize that they often have
good evidence for validity and reliability and allow counselors to compare
their clients to how other people score on the assessment. However,
standardized tests can be costly or require specialized training, and many
standardized tests have been challenged because of their potential cultural
bias.
Nonstandardized instruments do not have the same rigorous test development

and do not allow for comparisons across individuals. Intake questionnaires or
client drawings are examples of nonstandardized tests. For example, suppose
a client consults you because she is experiencing increased stress. You could
ask the client to draw a pie chart showing a typical day. If work and
maintenance activities are leaving little room for sleep or recreation, then this
assessment technique, even though it is subjective and nonstandardized,
might help the client recognize that she needs a better balance.
Nonstandardized assessments often allow for more in-depth understanding of
the client and are typically time and cost efficient. However, they suffer from
subjectivity in scoring and interpretation and do not allow for comparisons
across clients. They are also affected by the relationship between the
counselor and client and typically require a strong therapeutic relationship
before they can be appropriately used. Both standardized and
nonstandardized tests can be incredibly useful for counselor to better
understand their clients, and both types can be integral components of the
assessment process.
Measures of Program
Accountability or Counseling
Effectiveness
Assessment is also crucial when it comes to determining if a program is
successful. School counselors use assessment strategies to demonstrate that
their comprehensive school counseling programs are effective. Mental health
counselors might measure whether the partial hospitalization program in
which they work reduces the likelihood that clients will need additional
hospital stays. Counselors who oversee large-scale projects, such as alcohol
and drug outreach programs at universities or antiviolence campaigns for
communities, use assessment strategies to track their effectiveness. In fact,
the assessment of program effectiveness is a critical component of many
grant-funded projects and programs. Because this type of assessment is so
critical to counseling programs, we give it specialized attention in the chapter
on the use of research in counseling (Chapter 7).
Why Should Counselors Spend So
Much Time on Assessment?
When counseling students begin seeing clients in their practicum or
internship experiences, they are often surprised and dismayed at the amount
of time and paperwork required before the client can even talk about their
problems in any depth. But practicing counselors know that accurate
assessment is worth the time. The following are some reasons that counselors
spend so much time interviewing, assessing, and thinking about accumulated
data prior to counseling.
Thorough assessment:
Provides information to plan realistic goals.
Allows clients to discover events related to the presenting problem.
Lets us understand what is unique about our client.
Helps us decide if suicide or violence is likely.
Tells us about the client’s strengths as well as weaknesses.
Makes clients aware of problems that they have ignored.
Allows us to understand the whole story, not just what the client tells us.
Allows us to track the changes that the client is making.
Assembles data to make a diagnosis.
Although these (and more!) are reasonable and useful reasons to engage in
assessment, there are even more important reasons to spend time on and
becoming skillful at assessment. Beginning counselors are particularly
vulnerable to the Three Big Mistakes. We make the Three Big Mistakes when
we ignore (or forget to assess):
1. Evidence of a severe mental disorder such as schizophrenia or bipolar

disorder that affects all aspects of the client’s functioning
2. Evidence that the client is abusing alcohol or drugs
3. Evidence that the client is dangerous to self or others, including failure

to assess bullying, suicide, child abuse, and interpersonal violence
Ruling out the Big Mistakes is not only clinically prudent, but it is ethically
sound. We must ensure that we have done our best to safeguard the client,
and we will not waste our time solving minor problems when larger issues
are looming in the background. Let us give you an example. Early in my
career (Mark), a client came to counseling, presumably to deal with feelings
of tension and stress. I failed to recognize the symptoms of bipolar disorder
and saw him for five or six sessions before a manic episode prompted his
hospitalization. He withdrew all his considerable savings from the bank and
was about to invest it in a questionable scheme when his wife recognized the
symptoms of his disorder and got him to agree to get inpatient treatment. I
made one of the Big Mistakes, which I might have avoided had I sought more
supervision or done more research on my own. By focusing on the problems
that the client presented rather than doing an accurate assessment, I missed
the opportunity to help.
Fast Facts
Signs vs. symptoms: These are two categories of clinical information that the
counselor uses when trying to understand a client’s problem.
Signs are things the counselor observes, such as “disheveled

appearance.”
Symptoms are things the client complains about, such as “feelings of

sadness.”
Let’s Start with a Case Study:
What’s Wrong with Raymond?
As we consider why we conduct assessments in the first place, let us look at a
case study that may illustrate how the counselor uses assessment techniques
to gather information to make a treatment plan. The assessment process may
include tests, but important data are also garnered from interviews and
observations.
Raymond was a 15-year-old white male who was brought to the session by
his adoptive mother after he had been suspended from school following an
incident in art class. Raymond had lit a smoke bomb in the trash container,
which set off the fire alarm and led to a school evacuation. Raymond was
brought to the private practice of a counselor as part of the requirement for
him to reenter school. His mother, a social worker, was in favor of counseling
and provided information about his past. Raymond had been adjudicated at
age 12 for sexual battery when he fondled a neighbor’s child. Raymond
himself had been sexually abused by his stepfather, which led to his removal
from his family of origin and eventually to his adoption by his foster parents.
On one occasion Raymond took the family car for a ride without permission
or a driver’s license. The adoptive parents have one natural child who became
fearful of Raymond as he can be physically aggressive. On the other hand,
they recognize that, until now, these incidents had not resulted in any real
injury. Instead, his mother saw them as symptoms of the child’s impulsive
personality.
Raymond was given tests and was interviewed to arrive at a diagnosis and
treatment plan. To establish rapport, the counselor began with some drawing
because, despite his behavior in art class, Raymond had shown some talent.
His self-portrait was, instead, a caricature of the counselor. Raymond and his
mother filled out the Achenbach Child Behavior Checklist (CBCL) (see
Achenbach & Ruffle, 2000). The counselor also gave an individually
administered intelligence test and a self-esteem scale. The brief self-esteem
instrument was not useable because Raymond checked all the answers to all
the items on the test and wrote notes in the margins such as, “Do you think I
am crazy?” and “Wouldn’t you like to know.”
The intelligence test indicated that Raymond was capable of academic

success. His scores were in the average range and there were no indications
of potential learning disabilities. He was considered artistically talented. In
contrast, Raymond’s grades were poor and he was consistently in danger of
failing, which he would usually avert by sporadic efforts just before grades
came out. There appeared to be a consistent pattern of Rule-Breaking
Behavior and Aggressive Behavior on the CBCL, and his teachers noted a
tendency to speak out of turn in class and small skirmishes with fellow
students.
1. If you were Raymond’s counselor, what would be the primary issue that
you would focus upon? Make a list of the most important problems and
put them in priority order.
2. Aside from what has already been done, what other kinds of assessment
methods would you want to conduct before or during counseling?
3. What are Raymond’s strengths? Were they systematically assessed?

How could they help Raymond?
4. What would be the major roadblocks to understanding and

communicating with Raymond? Is forming a relationship the first order
of business?
What Should Counselors Assess?
Strengths and Positive Psychology
We have cautioned against the Three Big Mistakes in assessment, but there is
another error we might commit. We can forget to assess the client’s strengths
and abilities. Notice that the previous section is entitled, “What’s Wrong with
Raymond?” That is the usual way of stating the problem. We try to find out
what is wrong and fix it. “Where does it hurt?” is the first thing the doctor
asks. We always ask about the problem but we often fail to identify what the
client is doing well, what is going right, and what resources the client can call
upon. Most clients find it far easier to identify their weaknesses than their
strengths. They may find it challenging to identify 10 good things about
themselves but can easily list 10 negative qualities. We have been trained to
look for our faults and what is wrong in the world instead of looking at what
we do well and what (and who) is supporting us. Solution-focused counselors
balk at the idea of spending too much time talking about the origin of a
problem, because it steeps the client in the problem-saturated story. They
believe that we must shift our focus to what is going well and what works.
This dichotomy between strengths and disorders underscores an area of

controversy and discussion in counseling and in the broader field of mental
health. Clinical psychology, psychiatry, and to some extent counseling have
focused on defining several hundred mental disorders and finding fixes for
those problems. At the same time, there is a burgeoning interest in a “positive
psychology” (Seligman, 2012), which seeks to study the efficacy of
treatments such as hope, forgiveness, gratitude, optimism and happiness, self-
efficacy, love, and many others. The third edition of Positive Psychology
(Lopez, Pedrotti, & Snyder, 2015) documents the research on these virtues.
But the controversy over the dichotomy between strengths and problems is
not new. It has raged ever since the humanistic existential theory was first
propounded. Abraham Maslow, in his 1954 book, Motivation and
Personality, named the last chapter of that text “Positive Psychology.” Now
research seems to be suggesting that positive human traits can become a focal
point for counseling, providing clients with a preventive approach and a
range of new tools for helping including optimism, hope, gratitude,
forgiveness, and meditation.
Many counselors are naturally drawn to the focus on their clients’ strengths
and successes. Counseling has its roots in the humanistic tradition, believing
in the resilience and untapped potential of people to heal themselves. In fact,
it could be argued that counseling has always been positive psychology in the
Maslovian definition. Instead of the phrase “positive psychology,” the term
wellness has become part of the counseling lexicon, and instruments
developed by counselors, such as the WEL Inventory, and its successor, the
5F WEL, measure wellness instead of pathology (see Myers, Sweeney, &
Witmer, 2000). The WEL Inventory originally identified 17 aspects of
wellness that can be used to assess strengths, including Realistic Thinking,
Positive Humor, Exercise, Nutrition, Spirituality, Cultural Identity,
Friendship, Self-Worth, and others. Earlier, when talking about Raymond, we
asked you to think about what resources and competencies he has to draw
upon. Although he has tended to be impulsive, he has a number of cognitive
resources and family supports that might be brought to bear on the challenges
he faces. Focusing on these strengths, in addition to recognizing his
significant challenges, is how counselors can interact with clients from a
wellness perspective. Chapter 13 of this text discusses how counselors can
incorporate wellness into their counseling practice and into their own lives.
For now, it is important to note that although counselors cannot ignore the
debilitating effects of mental disorders, they must also be aware that utilizing
the client’s strengths may be one of the best ways to help the client overcome
difficulties. Counselors must assess client problems while simultaneously
searching for solutions. An exclusive focus on problems leads to
demoralization of both the counselor and the client. Integration of strengths
into counseling can lead to hope, and outgrowth of the belief that human
beings (including the client sitting in front of you) are strong, resilient, and
capable.
What Is Assessed Varies by Client

Problem, Population, and Setting
Although all counselors might assess for suicide, substance abuse, and
serious and debilitating mental disorders, frequently the client’s needs and
special problems point to specific assessment methods (see Balkin & Juhnke,
2014; Drummond, Sheperis, & Jones, 2016; Hays, 2014; Watson & Flamez,
2015). In the following sections, we will consider three counseling
specialties: mental health, school counseling, and marriage, family, and
couples counseling. Because counselors in these specialties and environments
see clients with many of the same problems, they frequently select similar
assessment techniques to get at the usual challenges of their clients.
Assessment in School Counseling

School counseling is an assessment-rich environment. School counselors can
easily see from school records that their clients have special abilities and
deficits, interpersonally, physically, and intellectually. School counselors
must also be able to assess for suicide and substance abuse, looking for the
signs and conducting assessment interviews with students. They must be alert
to family problems that might be affecting achievement and aware of the
signs of mental health concerns, such as depression and anxiety, because
some of these disorders first manifest in the late teens. Counselors must be
alert to the signs of child abuse and able to assess and then report to
authorities, because they are legally required to do so in most states.
School counselors conduct, evaluate, and interpret assessment information

every day to parents, teachers, and students. Grades are indicators of
academic success and give information about the student’s overall
functioning. In addition, counselors help students, teachers, and parents
understand standardized tests, such as those given by state departments of
education. In this chapter’s Snapshot, you will read about Jason Durell, a
Professional School Counselor who works in a program with a RAMP
designation (Recognized ASCA Model Program). Recognition as a RAMP is
difficult to obtain, and school counselors who work in programs with the
RAMP designation must pay particular attention to the role of assessment in
all of the decisions they make. As you read the Snapshot, notice how Jason
does not see this as a tradeoff between obtaining data and assessment or
meeting the needs of the students in the building, but uses assessments and
data to provide the highest quality of services to the students who need it
most.
SNAPSHOT Jason Durell,

Professional School Counselor in a
Recognized ASCA Model Program
The word “data” has seemingly been a curse word among school counselors,
mainly because it gives the impression that school counselors must abandon
the grey area we work in for the black and white world of quantitative data.
In addition, school counselors have to substantiate the data they collect:
“What can you prove and what will you change now that you have the data?”
As I learned more about using data and how to effectively analyze it, I have
been able to come up with some consistent measures that help me improve
school-wide programming and classroom lessons.
In my first year as a middle school counselor, I conducted a needs assessment

of our entire school. This was not an easy task since I did not know the pulse
or climate of the school so I did not know what to really assess. I didn’t know
what was working and not working, so I simply made the needs assessment
informational for me and asked questions related to areas within my control
as a school counselor. I did not worry about collecting data on attendance,
grade point averages, and even discipline because this was historical data and
was already available. With the needs assessment, I wanted information that
was not written down already, and the source for this “hidden information”
was in our students, their parents, and our teachers.
This first needs assessment not only provided me with purpose in the
direction of my school counseling programming, but it also gave me
confidence in the usefulness of assessments to help substantiate what I do as
a school counselor. As I processed the results, I saw that all of our
constituents (students, parents, teachers) wanted more information about high
school planning, time management, and anxiety management. I took this
information to my fellow counselor and administrators and planned school-
wide programming to address each of these topics. We saw success with
these school-wide topics through post-test surveys, but we also saw
deficiencies, which was also great feedback since we hadn’t evaluated
school-wide programming before. We adjusted several areas and continued to
assess the outcomes. As data collection from assessments became more
natural, I decided to start using data collection in the classroom lessons I
taught and also saw the advantages of planning a lesson using data as a guide.
Today, I continue to use assessments and data collection collectively in

planning the objectives of my lessons and school-wide programming. I think
about the objectives that I want students to comprehend at the end of the
lesson or school-wide event and my next immediate thought is, “How am I
going to assess their learning?” The objective outcome and the data go hand-
in-hand: What do I want students to know as a result of this lesson or event
AND how will I be able to prove they know it?
Overall, my road to using data was bumpy at first as I was already using most
of my brain-power on being a better school counselor. But years later, I
continue to use assessments and data and work with others in the school to
make decisions that give our students the best opportunities to succeed.
In the last 10 years, school counselors have been called upon to prevent
bullying (Espelage, 2016). Recent news headlines point out that bullied
students suffer from ostracism and alienation, and in some cases die by
suicide. The assessment issue here is that counselors should attempt to detect
and prevent bullying (see Hazler & Denham, 2002; Juhnke, Granello, &
Granello, 2011) not just treat those who have been bullied. Crothers and
Levinson (2004) identified methods for assessing the potential for physical,
verbal, and emotional aggression. They include observations, interviews, peer
and teacher ratings, sociometric methods, and even use of standardized tests,
such as the Bullying-Behavior Scale (Austin & Joseph, 1996).
One of the most important issues for school counselors to be able to

recognize is the learning disabilities and special needs of students, which may
interfere with their academic and social functioning as well as their transition
to higher education (Milsom & Hartley, 2005). School counselors sit on
committees where individualized education plans (IEPs) are formulated based
on assessment data from school psychologists, teachers, and behavior reports.
School counselors must understand the common mental disorders of
childhood as well as the disabilities related to learning, such as those that lead
to difficulty in understanding language, reading, and math, those associated
with poor attention span, and those that manifest as social and emotional
issues.
Assessment in Mental Health

Counseling
Mental health counselors working in clinics, hospitals, and private practice
screen their clients for substance abuse, suicide, and the existence of severe
disorders. They also look at specific symptoms to evaluate the client’s
improvement. For example, a mental health counselor might use the Beck
Depression Inventory every week with a client to track the client’s depressive
symptoms. The counselor might also assess clients’ progress on their
identified counseling goals. For example, if a shy client has set a goal to
improve social relationships, the client can report weekly in writing about the
number and quality of social contracts, which helps client and counselor see
if treatment is working.
One way of helping clients see the changes they are making is to use charts
and graphs. Early in my career I (Mark) was working with a woman named
Martha with severe anxiety (panic disorder) and treated her for eight sessions
using progressive muscle relaxation, a technique where the counselor
instructs the client to systematically tense and then relax the major muscle
groups in the body. I kept track of her fingertip temperature, muscle tension
in the forehead, the time it took to reduce her tension, and her subjective units
of discomfort (SUD) on a 100-point scale, with 100 being the tensest and 0
being completely relaxed. Overall, she was quite effective in increasing her
finger temperature (measure of relaxation) and decreasing muscle tension,
while reducing the time it took to achieve a state of relaxation. Yet, as Figure
11.1 shows, her SUD or perceived anxiety at the beginning of each session
(before) did not change at the end of the session (after), nor did it decrease
significantly over the 8 sessions. When I saw no improvement, I began other
treatments, including in vivo desensitization, which involved teaching the
client to face real-life situations. Thus, assessment helped me realize what
was not working and we tried another method that was much more effective.
Figure 11.1 Martha’s Progress

in Subjective Units of
Discomfort over Eight Sessions
Assessment in Marriage, Couples,

and Family Counseling
Assessment in marriage, couple, family counseling can reveal how the family
is functioning, the couple’s happiness, whether divorce is likely, and how the
family is structured. Yet, few marriage, couple, and family therapists use
formal or systematic assessments (Huff, Anderson, & Edwards, 2014).
Instead they rely on family histories and informal methods. One of the most
commonly used methods of assessment is the genogram (Young, 2017). The
genogram is a pictorial family tree that graphically shows the family
arrangement through several (usually three) generations. We see the family,
individual, or couple within their historical and extended family context. For
example, we can see that the client’s father had a history of alcoholism as did
his paternal grandfather. The client and counselor can both track family
influences on the client’s drinking, which may help the client understand the
potential consequences and causes of his own problem.
For a couple, assessment can be part of the treatment when couples learn
about each other’s personality and feelings. For example, in David Olson’s
PREPARE/ENRICH Programs (Olson & Olson-Sigg, 1999), couples who are
married, partnered, or considering a permanent relationship take tests to
identify areas of compatibility and incompatibility. Some marriage, family,
and couples counselors also use a general measure of marital satisfaction,
such as the Locke-Wallace (1959) (Marital Adjustment Scale). The scale
shows the satisfaction of each person and identifies the areas of conflict that
can be explored in counseling.
One of the key issues in couples and family counseling is the detection of
domestic violence, now commonly called interpersonal violence (IPV)
because it includes all kinds of violence, including violence between couples
who are dating and not cohabiting and the maltreatment of children. All
couples should be screened for interpersonal violence, because the National
Coalition Against Domestic Violence (2017) reports that one in three women
and one in four men have been physically abused by an intimate partner.
Counseling couples when one member is assaulting the other is not
considered to be ethical or effective (Long & Young, 2007). Many clinics
and hospitals screen only the female member of the couple so as not to alert a
potentially violent husband that the assessment is going on, as this could put
the woman at risk. The usual method for assessment is an interview with the
victim, who is then given information about how to safely receive help.
In the accompanying Spotlight, you will read about some of the ways that
counselors in all different settings use assessment to further their work with
clients. As you read through the Spotlight, consider how assessments help the
counselors make the most use of their time in counseling because assessment
allows them to identify, and more quickly focus on, the important concerns.
Steps in the Assessment Process
Although there are many sources of assessment data, we will focus mainly on
the interview and test data to simplify the description of the steps in the
process. We use the metaphor of a funnel to describe the method of gathering
information that is wide-ranging and then narrowing down the focus when we
arrive at a problem statement. At the beginning, counselors collect data from
a wide variety of sources, like the wide end of the funnel. But eventually,
they narrow the focus to work on a few specific issues, just as a funnel
narrows as liquid goes through. This is certainly an oversimplification,
because assessment is not just conducted in the beginning of the counseling
relationship; assessment continues as we try to determine if we are making
progress. Still, this metaphor might help you understand the initial steps in
assessment when we are first trying to understand the client. We start with an
open mind and information assembled from many avenues. Then we make
some decisions about what is important.
Selecting Good, Developmentally

and Culturally Appropriate, and
Comprehensive Methods
The first step in the process of putting information in the funnel is to make
sure you have access to all the sources of information. For some clients, this
means contacting their parole officer, asking their father and mother to come
in, or having the doctor fax over the list of the client’s medications. For
others, it means selecting the appropriate assessment instruments based on
the client’s age, culture, and background. It also means making sure that your
instruments are reliable (consistent, free from errors of measurement) and
reasonably valid (truly measure what they say they do).
Assessment in Counseling
In the chart below, you will find examples of how counselors in a variety of
settings use assessment in their practices. In each of the settings, the choice of
assessment is based on what you want to know about the client.
Counselor
Sue Elementary
[email protected] School
Jerry Juhnke Mental

Health
https://www.counseling.org/resources/library/ERIC%20Digests/95-03.pdf Counseling
Marriage,
Vincent Poon Couple, &
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2426998/pdf/0540858.pdf Family
Counseling
Gloria Lee Rehabilitation

http://cirrie.buffalo.edu/culture/curriculum/casestudies/assessment.php Counseling
Career
Mark Savickas Counseling
http://www.uwex.edu/ics/stream/admin/files/case_study.doc with a High

School Senior
42-year-old
client who
Angeline Hernandez has come for
Counseling Student in Practicum counseling
concerning
her divorce
When a client has been referred by a third party for assessment, the next step
is to identify what the referring source wants to know about the client. Is the
school trying to determine if a teenager is depressed and that is why she is
failing? Are the parents of a 6-year-old trying to find out if their child is
adjusting to their divorce? These kinds of questions determine which types of
assessment methods you will use.
But assessment is not just testing; it also means selecting the kind of
questions and interviewing strategy you are going to adopt. We believe your
approach should be dictated by the characteristics of the client. For example,
interviewing young children is completely different from interviewing adults
and in fact, it has been called a form of cross-cultural counseling (Sommers-
Flanagan & Sommers-Flanagan, 2015) because it means crossing a
generational divide. Unfortunately, we tend to think of kids as either just like
us (miniature grownups) or just like us when we were children. Imagining
adult-to-child counseling as a form of cross-cultural communication reminds
us that we need to try to understand the world from their perspective. In
short, for the interview to be relevant, it must be modified to fit the
developmental level of the client.
Counselors also understand the role of culture and diversity when selecting
appropriate assessments and methods. In order to make sure instruments are
the most appropriate for the individual being assessed, counselors understand
the client’s background and culture and actively investigate any implicit
cultural assumptions and biases in the assessments selected. For example,
counselors choose instruments that have appropriate norming groups (people
for whom the test is intended and against whom the client’s scores will be
compared) and language and concepts that are free of bias. For example, an
earlier version of the Wechsler Intelligence Test for Children, a commonly
used measure of IQ, was criticized for including questions about the sport of
tennis, a sport that many inner-city children or children from disadvantaged
homes may never have seen or played. Counselors make every effort to
choose appropriate assessments that have limited cultural bias.
In the accompanying Spotlight, we look at a case of culturally inappropriate

use of tests and the Supreme Court case that challenged it. We encourage you
to think about how tests might be used inappropriately and what you can do
as a counselor-in-training to help encourage culturally appropriate test use.
Fast Facts: Multicultural

Assessment
The Association for Assessment and Research in Counseling (AARC) is the
division of the American Counseling Association promoting research and
assessment for counselors. Membership is open to students and professionals.
AARC publishes the journal Measurement and Evaluation in Counseling and
Development. AARC has developed standards for multicultural assessment.
In the standards, counselors are reminded to select instruments appropriate
for culturally diverse clients, use appropriate norming groups for comparison,
make reasonable accommodations in testing for persons with disabilities, and
interpret test results within the context of clients’ lives. For a full listing of
the competencies, visit the AARC website at: http://www.aarc-counseling.org
SPOTLIGHT Testing Abuse: A
Multicultural Reminder
Duke Power, an energy company, historically segregated their workers, and
nonwhites were only allowed to work in more menial jobs. After the Civil
Rights Act, Duke Power used IQ tests as a way of determining promotion.
Griggs v. Duke Power was a 1971 Supreme Court case charging that 13
African American employees of the power company were denied promotion
due to their IQ scores. But of course, IQ itself is a not a single number and
contains error. IQ is different from intelligence as there are many different
types of abilities besides those measured by these tests. Many skilled jobs,
like professional hockey, do not require verbal intelligence. Never mind the
fact that IQ tests themselves are affected by culture. The Supreme Court ruled
that criteria for advancement had to be reasonably related to job performance,
putting an end to this misuse of testing.
The importance of the Griggs case is not merely that companies must now
make certain that tests are not used in discriminatory ways. It also reminds
counselors test results are often more highly valued by individuals without a
background in assessment, such as the people who work in human resource
departments. Therefore, test results should not be released to those who might
misunderstand or misuse them. Additionally, individuals with diverse
backgrounds may score poorly on tests for a multitude of reasons. For
example, students from foreign countries are typically required to take the
Graduate Record Examination, and their scores are compared with scores of
native English speakers. To expect foreign students to achieve the same GRE
scores on the verbal aspects of the test is not defensible because it compares
their scores with those highly proficient in the English language.
Establishing a Relationship
The relationship between counselor and client during the assessment period is
just as crucial as it is in later counseling sessions (Young, 2017). A client
who does not trust the counselor will not be honest and open in the
assessment process (Gregory, 2010). For example, research has demonstrated
that one of the most significant factors in assessing suicide risk is the quality
of the therapeutic relationship (Bongar, 2002; Rogers & Oney, 2005).
Sometimes counselors see assessment as a laborious process. When that is
attitude, the counselor may be tempted to hand the client the requisite forms
and disappear. But the best approach is to preview and explain the assessment
materials to clients so that they recognize their importance and to emphasize,
from the very beginning, that the counselor is trying to help, not just put the
client under a microscope.
Administering the Assessment

Whether it is an interview, a test, or filling out an intake form, assessment
takes time. For this reason, many counselors try to hurry their clients through
the onerous paperwork. Instead of seeing it as a mere formality, the counselor
can utilize the administration time to observe the client’s reaction to the
assessment. Does the assessment reveal reading or writing problems? Is the
client’s memory intact? What is the client’s reaction to being asked a lot of
questions? Does the client answer openly or guardedly? As Yogi Berra said,
“You can observe a lot just by watching.” We sometimes fail to appreciate
that an individual’s response to any task tells us something about the client,
and we need to watch. For example, in the earlier case study, Raymond wrote
angry notes in the margins during the testing process, which was another
example of the behavior that got him into trouble at school. His
impulsiveness, artistic ability, and resentment of authority issues all came out
in his test-taking behavior.
Words of Wisdom
“Assessment is treatment. Even the process of assessment itself can begin the
healing and start clients on the path of change.”
Source: Granello (2010, p. 367).

Interpreting Assessment Data
The most important concern when interpreting test data is to make sure that
the interpretations reflect the context of the person’s life. By this we mean
that one piece of evidence on a test is not enough to validate an insight about
a client. Every piece of data must be compared to what we know about the
client. For example, we once administered an IQ test to a 10-year-old boy
from rural Appalachia. His response to the question, “What are the four
seasons of the year?” was, “Squirrel, Deer, Rabbit, and Fishing.” In his
world, this was technically correct, but according to the scoring sheet, it was
not one of the right answers.
Just as the selection of appropriate assessments is affected by culture, the

interpretation of the assessment must be done in a cultural context as well.
What if English is not the client’s first language? What does the client think
will happen with the test results? How do the client’s responses make sense
in the world in which the client lives? These questions should make us
recognize that how the scores are interpreted is based on several assumptions
about the client. The most important one is that we are basing our evaluation
on a comparison with a group of people (norming group) whom we believe to
be like the client. Even when we interview clients, we are essentially
comparing our client to someone who is “normal.” Thus, the counselor must
have multiple sources of data before making bold assertions about the client’s
personality, family, or problems and be aware that the norming group may
not be appropriate to this specific person.
Writing Up Assessment Results and

Generating Suggestions for
Intervention
The final step in assessment is summarizing the findings of interview and test
data. It is this step that can potentially do the most harm to the client, and
therefore the counselor must choose words carefully. Many clients have told
us about teachers and counselors who discouraged them from certain careers
based on their test scores. Assessment can help or it can limit. How sure are
you about your conclusions? Summarizing your findings is an art because it
must be a balance between what the assessment shows and recognizing that
this is only a part of the client’s unique makeup. There are many manuals and
templates that you can utilize to help you organize your reports.
Assessment must also be practical. It should yield treatment suggestions. In

other words, if we find that a middle school student has an attention problem
that is affecting her school performance, besides test data, we need a plan to
help the student, parents, and teachers address this obstacle to academic
success. As opposed to assessment technicians, counselors must be aware of
treatment options. They are not just presenting what is wrong but also how to
overcome the problem.
A Social Justice Approach to the

Process of Assessment
Because of the inherent power differential in the assessment process, it is
important for counselors to learn to help make the assessment process
become one of empowerment for clients, rather than an experience where
professionals make decisions about clients. We all have stories where people
engaged in assessment and then were told what their problem was or what
they needed to do next to address it. Proper assessment should be
empowering for clients. It is a way to learn information about clients and then
form a collaborative understanding with our clients about what should
happen next.
Arthur Kleinman is a psychiatrist and medical anthropologist who has studied

the role that culture plays in understanding illness. He developed a list of
questions that can be used to help clients communicate their understanding of
the problem (Kleinman, 1981). Although the questions were developed for
medical illness, they could be used within the counseling profession to help
assess the role that culture plays in an individual’s understanding of the
experience of mental illness. The questions remind counselors not to impose
their biases on the assessment of clients’ problems and that clients must “buy
into” the assessment results for treatment to work. For example, counselors
might ask the client:
What do you think the problem is? What is the name you have given it?
Why and when did it start?
What does the illness other problem do? How severe is it? How long do
you think it will last?
What should be done (if anything) to treat the problem?
How important is it for you to overcome this problem?
When we enter the world of our clients, we make them collaborators in their
own treatment. Clients are experts about their own lives, and they often have
ideas or have already tried things to help solve their problems before they
enter the counselor’s office. A collaborative approach to treatment and
intervention increases chances for successful outcomes.
What Do You Do After You Have

Collected Information?
Section E of the American Counseling Association’s Ethical Guidelines
identifies some crucial issues regarding letting clients know about the results
of their assessment. Clients must understand the reasons and types of
assessment they are receiving, but the guidelines are a little less clear about
what we should tell clients about the tests or assessment procedures they have
taken. That is because these are complex questions that must be considered in
the context of each client and cannot be easily addressed in standardized
guidelines. Nevertheless, here are some suggestions to consider:
Not being told about the results of an assessment procedure can be

dehumanizing and make the client feel less a part of the treatment
process. Therefore, clients should almost always be fully informed about
what the test says in ways that they can make sense of the information.
Some tests and assessment methods produce ambiguous or easily

misunderstood information. For example, people frequently believe that
IQ test scores are very accurate measures of a person’s intelligence and
that a person with a tested IQ of 105 is smarter than a person with an IQ
of 100. This is a complex problem, but counselors should strive to
explain that test results contain error. By giving results but informing
them about testing error, we are respecting their clients’ right to know
about their own performance and the limitations of the test.
When clients are given a diagnosis, the counselor should help the client
understand just what that means. For example, the diagnosis of cancer
might make many people believe that they are terminally ill. Similarly, a
diagnosis of a mental disorder may precipitate fear, shame, and the
feeling that the diagnosis suggests a lifelong struggle. Thus, all
counselors need to have information that explains common diagnoses in
lay terms and the prognosis (expected recovery). In addition, counselors
engender hope by describing the treatments available. School counselors
should have handouts or information to share with students and parents
about common learning and behavioral problems in the schools and how
they can best be addressed.
Counselors always consider the cultural context when explaining

assessment results. It may be crucial to have an explanation in the
client’s native language so that there is no confusion or to have a family
member translate when assessment results are explained.
Giving clients at least some information about their assessment results may
seem obvious, but many clients share stories of participating in extensive
testing without ever knowing the results. Helping clients see the connection
between assessment and intervention can be a meaningful approach to
improving clients’ buy-in into the counseling process.
Assessment of Personality
In this section, we take some time to discuss the assessment of personality
and describe some of the current and historical ways that human nature has
been mapped. We do this for three reasons. First, personality is an interesting
way to introduce the topic of assessment. We could just as easily have
described neuropsychological assessment (measuring the degree of
impairment of a psychological function such as memory and identifying a
location in the brain from which it stems), but we thought personality would
be more fun. Second, we address personality assessment because it is all
around us in the media and on the Internet. Using some of these examples
illustrates the difference between good assessment and bad. Third, counselors
frequently use personality testing to help people choose careers, evaluate
their relationships, and assess their preferences. Personality assessment can
help people understand themselves and be more tolerant of others as they
recognize the differences.
Personality Assessment Theories

Personality is the unique blend of psychological traits that make up a human
being. During the 1950s and 1960s theories of personality were of great
interest to all helping professionals, and counselors were also enthusiastic
about understanding a client’s personality as a way of formulating a treatment
plan. Myriads of personality tests were developed to help counselors identify
personality traits. Chief among them were the Minnesota Multiphasic
Personality Inventory (MMPI), the California Personality Inventory (CPI),
and the Cattell 16 Personality Factors (16 PF). Yet, scads of other tests
sprang up in the enthusiasm to map the intricacies of the human mind. For
example, the Adorno F-Scale attempted to determine if a person had a fascist
personality (Adorno, Frenkel-Brunswik, Levinson, & Sanford, 1950).
Personality testing was especially popular in industry and was often misused
as part of selection procedures for hiring (see Gibbey & Zickar, 2008).
Counselors have basic training in psychological testing but philosophically

place more emphasis on understanding the client in the process of counseling
rather than the assessment of an individual based on paper-and-pencil tests.
Nevertheless, personality is a branch of psychology that has relevance for us
whether or not we place much emphasis on the major personality tests.
Counselors frequently utilize, read the results of, and refer to some of these
tests to understand couple relationships, identify career preferences, and to
help an individual gain self-knowledge and accept differences in others. For
example, knowing that you are an introvert may help you realize why you
prefer periods of quiet while your partner does not. Personality tests also
remind us to look deeper than the presenting problems or symptoms that
clients discuss. A client may not be aware of the persistent need to control
others. Understanding one’s personality can help us gain insight into
unproductive patterns of behavior. Finally, personality theories are one way
of understanding other people. Even without the major theories of
personality, human beings seem to develop their own homemade theories
about what they believe (for example, extroversion is good, introversion is
bad). The theories that you hold about life and about people undoubtedly
affect your evaluation of them.
What Are Personality Theories?

Personality theories are theories of human nature. Type theories say that
people can be divided into somewhat distinct categories like “thinkers” or
“feelers.” Trait theories, by contrast, propose that all people have the same
set of characteristics or traits, such as flexibility or rebelliousness, but to a
greater or lesser degree. What makes people unique is the personal
combination of these qualities.
Personality theories also relate to human motivation, because these internal

traits are believed to direct behavior (Hall & Lindzey, 1978). For example, a
sympathetic person is motivated to listen, and an outgoing person is
interested in people and things. To understand personality theories a little
better, let’s start with an ancient Greek type theory: Galen’s Four
Temperaments. Although mental health professionals rarely talk about these
types, the basic principles have made their way into our language, and they
are still oddly appealing.
Galen’s Four Temperaments
(Example of a Type Theory)
Galen’s four psychological types (about A.D. 100) were based on Greek
medical theories about bodily fluids. The physicians of that time attempted to
restore physical and mental health by keeping a balance between four
“humors” (a type theory). Balance was achieved by reducing the amount of
the fluid in some humors by cathartics, emetics, purgatives, and bloodletting
or by eating substances that would increase other fluids. It is said that
bloodletting, based on this theory, was the cause of George Washington’s
death. Although the medical theory has been discredited, the personality side
of the theory has been the subject of study and research for centuries and still
inspires interest, probably because the types are intuitively compelling. To
illustrate, we have put the names of some U.S. presidents next to these types
as examples:
Choleric (yellow bile): excitable, emotional, confrontational (Teddy

Roosevelt; Donald Trump)
Melancholic (black bile): sad and inhibited (Abraham Lincoln, Richard

Nixon)
Sanguine (blood): active and enthusiastic but changeable (Ronald

Reagan, Bill Clinton)
Phlegmatic (phlegm): inactive, calm (Woodrow Wilson, Calvin

Coolidge, Barack Obama)
Now let’s turn to other similarly discredited trait theories, phrenology and
body types, to contrast these early attempts to understand human nature.
Phrenology
Phrenology is the study of personality traits based on bumps on the head. It
began in the 1700s and was initially championed by the Viennese physician
Joseph Gall (1758–1828), who reasoned that because human personality
traits were distinct, there must be distinct places in the brain that housed these
traits. The size and shape of the brain (as evidenced on the skull) could be
measured to assess the amount of each trait in an individual. In general, the
larger the bump on the head, the more of the specific trait was thought to be
present. Phrenology was eventually discredited and now remains something
of an embarrassment. Yet, in its time, there were many scholars and lay
people who firmly believed in its ability to predict human behavior. One
American writer, Ambrose Bierce, is said to have described it as “the science
of picking one’s pocket through the scalp.”
Offshoots of this theory included attempts by Lombroso (1876) and others to

investigate the criminal mind based on head and facial features, such as shifty
eyes. Lombroso believed that people were born criminals and genetics made
them so. It was not a far leap to conclude that certain races were more highly
developed than others and that the White race particularly was more highly
developed. Although this may seem ridiculous today, this theory was used to
support Nazi dogma regarding racial superiority.
Sheldon’s Body Types: Type Based

on Body Shape
Psychologist William Sheldon proposed that physique is associated with
personality. During his life, he tried to show that different body types
correlated with behavior— especially delinquency (Sheldon, 1942). Sheldon
identified the following “somatotypes” or physiques: Endomorphs have soft
rounded bodies and love comfort, sociability, food, affection, and people.
Mesomorphs are strong, tough, and muscled and love adventure, risk taking,
and physical activity. Ectomorphs are thin and lightly muscled and are
restrained, secretive, self-conscious, and prefer solitude. To be fair, Sheldon’s
theory is more complex than we have presented it, and a person is described
as having some traits from all three physiques rather than being one specific
type. Research has found some confirmation of a link between constitution
and personality, if not wholly confirming Sheldon’s specific theory (Rees,
1973).
Counselors today do not rely on bumps on the head or bloodletting, but we

still use personality theories to classify ourselves and others. In Chapter 4, we
discussed the Myers-Briggs Type Indicator (MBTI), which, The Myers-
Briggs Type Indicator (MBTI), though flawed, is a commonly used
personality inventory that is still widely used in individual and marriage
counseling and in career and business consulting. The inventory looks at
introversion versus extroversion, thinking versus feeling, sensing versus
intuiting, and perception versus judgment. Based on these traits, 16 potential
personality types emerge. One lesson from the MBTI is that by looking at
one’s own personality and understanding the styles and preferences of others,
people can learn to appreciate and tolerate differences and even see them as
complementary strengths. For example, can such differences lead you to new
solutions and strategies in a work group or in your intimate relationship? Can
that help you appreciate rather than clash with colleagues? Could it help you
recognize your own preferences and see them as strengths rather than
weaknesses? In the next section, we turn from the older and discredited ideas
of personality to several personality tests that are commonly used by
counselors today: the NEO Personality Inventory and John Holland’s Self-
Directed Search (SDS).
The “Big Five” Theory of

Personality and NEO Personality
Inventory
The Big Five personality traits are shown in Table 11.2. They are often
assessed using the NEO Personality Inventory (Costa & McRae, 1995).
These five factors are thought to encompass most of the myriad personality
traits that have been proposed by personality tests. The Big Five were
identified using a statistical technique called factor analysis, which looks at
the degree to which the various measures overlap. Factor analysis allows
many factors to be grouped together if it looks as if they are measuring the
same thing. For example, intelligence has been measured in a variety of ways
and with a variety of tests. Factor analysis has shown that many tests seem to
be measuring a factor that the researchers named verbal intelligence or the
ability to understand and use words. The Big Five was the result of this kind
of analysis.
Table 11.2 Self-Rating

Inventory of the Big Five
Personality Characteristics.
Self-
Name of rating
Characteristics
Dimension (1–
10)
Responsible and dependable, you are a
Conscientiousness planner, organized and productive, with
a high need for achievement.
Talkative and sociable, you are
Extraversion &
ambitious, assertive, and active—
Sociability
generally a positive person.
You are cooperative, trusting,
Agreeableness sympathetic, good-natured, and
empathic.
Your mood fluctuates a lot; you often
Neuroticism feel fed up. You frequently find that you
are irritable, guilty, or self-conscious.
Openness to You are imaginative, artistic,
Experience, aesthetically interested, curious, and
Intellectance, & have a need for variety. You are
Culture intellectual and feel deeply.
Read over the characteristics of each of the five dimensions in Table 11.2 and
rate yourself on a 10-point scale. A self-rating of 1 would indicate that you
believe you possess very little of that characteristic; 10 would mean you see
yourself as very similar to the characteristics of that dimension. For
simplicity’s sake we have not included the opposite poles of each dimension.
In other words, if you score low on one of these scales, it may be that you
would score high on the opposite dimension. Of course, most people fall in
the middle of the two polar descriptors, for example, somewhere between
Agreeable and Disagreeable. Our inventory is unscientific because it has not
been tested, but its purpose is to help you to get a feel for the Big Five.
Now let’s look at Table 11.2 and your own rating of yourself on the Big Five
Personality Characteristics. The purpose of this activity was for you to
become familiar with the concepts by thinking about your own personality.
But is it not risky to publish this as a test? Could you administer this
personality test to your friends and family and analyze them based on their
scores? Yes! And it would be a misuse of the test. How do we know that it is
really measuring personality? As you answer the following questions about
personality tests, think about Table 11.2 as an example:
1. To determine how much oil is in your car, you can use the dipstick, but
you could also drain the oil and test the instrument to see if your dipstick
is bent or was designed for a different engine. If you wanted to be sure
you were measuring a personality trait such as Extraversion, what
method could you use to validate your test? In other words, what other
instruments or measures could you use to be sure your test is measuring
extraversion instead of something else?
2. Our instrument has only one question per personality trait. Do you think
one item is enough? Why? Would we get a better measurement if we
increased the number of questions?
3. Because personality is supposed to be “a relatively stable and distinctive
pattern of behavior that characterizes an individual and his or her
reactions to the environment” (Kaplan & Saccuzzo, 2001, p. 405), do
you think it would be important for our test to get the same or very
similar results next year? In other words, is reliability an important
characteristic of all tests?
Figure 11.2 shows a possible profile of Abraham Lincoln on the NEO

Personality Inventory. It is an estimate by experts of how he might have
answered. Below his profile, a dotted line shows an estimate of the average of
all U.S. presidents through the year 2000. Many consider Lincoln our greatest
president. The profile shows him as rather neurotic (depressed) but
intellectually brilliant and creative. Scores above 65 or below 35 are
considered exceptionally high or low. Looking at averages is another way of
understanding test scores. Thus, compared to the average U.S. president,
Lincoln was much more agreeable. This trait was described in Team of Rivals
(Goodwin, 2005), which documents his ability and willingness to make use
of the talents of his archenemies by using humor and willingness to share
credit. One of the possible implications of looking at these kinds of profiles is
that seemingly negative traits such as depression do not necessarily handicap
a person and that many traits have a secret strength (Flach, 2002).
Figure 11.2 Lincoln Analyzed

Using the Revised NEO
Personality Inventory
Source: From Rubenzer, S. J., Faschingbauer, T. R., & Ones, D.
(2000). Assessing the U.S. presidents using the Revised NEO
Personality Inventory. Assessment, 7(4), 403–20 (p. 410).
John Holland’s Self-Directed Search

(SDS): Personality in Career Choice
The SDS is a self-administered, self-scoring, self-interpreting career interest
test. Holland theorized that there are six personality types. When you study
career counseling, you will certainly learn more about the RIASEC types of
John Holland. They are briefly described below.
Realistic
Likes using tools and machines, is physical, is practical, values

common sense
Investigative
Scientific, analytical, likes solving problems, values independence,

and inventiveness
Artistic
Creative, independent, disorganized, values beauty and self-

expression
Social
Supportive, helpful, nurturing
Enterprising
Competitive, persuading, achievement oriented
Conventional
Organized, detail oriented, precise, values accuracy and order
Holland’s theory, in simple terms, says that first we should know our
personality, and then we should choose a career that matches. It follows that
we will be more satisfied in a career if our personality type matches the work
environment. Thus, a conventional person is going to be happier working in
an accounting firm than in a social environment, such as a day care center
where things might get messy. Holland developed the Self-Directed Search
(SDS) that matches a person’s type with potential work environment.
Everyone who takes this test gets scores on each of the six types, and the top
three usually guide one to consider a range of work environments. The
authors of this text have taken the Self-Directed Search and both possess a
combination of Artistic, Social, and Investigative types. We agree that we
could easily have worked as detective novelists or forensic investigators.
Earlier, we proposed that no one set of traits or types is the ideal for
counselors. These types do not predict every possible combination of people
and environments. For example, a counselor in private practice would
probably benefit from Enterprising tendencies. A school counselor should
probably be Social above all and may be happier with record keeping if the
highest trait is Conventional. Thus, Holland’s theory is flexible enough to
recognize that specific work situations call for certain types and not all
counseling environments call for the same types of counselors. We encourage
you to take the SDS. It is available online. It may help you understand
yourself better and perhaps consider what area of the profession might
interest you the most.
Implicit Theories
The term implicit theory refers to the fact that we all have ideas about what
makes people tick. These personality theories are not formed in our schooling
but from our life experience. For example, we frequently hear people
described as “down to earth” or “a people person.” Yet we often do not
recognize that these are assumptions about others and they affect how we
interact with them. Perhaps it is because these theories are integral parts of
our way of looking at the world. Allen Greenbaum, a sociologist, believes
that he can identify liberalism or conservatism based on how people keep
their front lawns (Walker, 2000). Manicured lawns are more likely to be kept
by conservatives while more natural lawns with native plants more often
belong to “left-leaners.” In this same tradition, one of the authors of this text
(Mark) has developed a personality assessment tool, the Corn-On-The-Cob
Personality Test (COCPT), based on the way people eat sweet corn. Do you
randomly attack the defenseless ear of corn or compulsively eat each kernel
separately? Do you cautiously cut the kernels off with a knife? Or do you
obsessively eat from left to right? Right now, the theory is in its infancy, but
you see where we are going. People tend to behave in patterns, and we as
observers tend to hypothesize about their tendencies to repeat these actions. It
seems that human beings have an innate desire to organize what they see to
understand and predict the future. Personality theorizing is something we all
do.
George Kelly (1963), a well-known personality theorist, believed that
everyone is a scientist. We are all constantly theorizing about the world,
including other people. Because these implicit theories affect how we see and
react to other people, we think it might be useful to become aware of your
own implicit theories and assumptions that could affect your counseling
relationships—not to mention relationships with family, friends, and co-
workers.
The dark side to the notion of implicit personality theories is that they are
developed without peer review! Thus, we develop a private theory that may
be influenced by our prejudices. One objection to personality in general is
that it is based on European and American psychologies. The typologies are
specific to our culture and our shared language. For example, the notion of
conscientiousness is an important principle among White Anglo-Saxon
Protestants as it relates to an historic love affair with the work ethic. In Indian
personality theory, the notion of the three gunas is connected to Hinduism.
The three states of life are Raja, Sattwa, and Tamas. Raja is an active state
like the sanguine personality. Sattwa is a serene, pure, enlightened state, and
Tamas is a state of inertia and darkness. Even foods can be divided into
Rajasic (spicy), Satvic (vegetables, grains, etc.), and Tamsic (dead foods).
Since these states are even mentioned in the Bhagavad Gita, the Hindu
scripture, they pervade Indian society and consciousness. The point is that
our ideas about personality do not arise merely from our scientific data but
from our culture and from our own experiences. We need to recognize that
the lenses through which we view our clients are not pristine and objective
but built from our histories, our families, our biases, and our good and bad
experiences with people in our lives.
Ethics in Assessment
In the final section of this chapter, we turn to some of the overarching ethical
issues in counseling assessment. There are a variety of complex ethical
problems in testing and assessment, and you will learn about these during
your graduate program and beyond.
Ethical Issues to Practice Now

We thought it best to discuss the ethical issues in assessment that you are apt
to run into early in your training, perhaps even before you take your testing or
ethics class. In those classes, you will identify ethical issues that are relevant
for many different types of assessment situations, and you will learn about all
the trouble that counselors can get into if they fail to understand ethics and
the law. Rather than scare you with that kind of data, we thought it would be
useful to identify some of the issues you may face before you start seeing
clients. Right now, you may encounter some ethical pitfalls, including the
temptation to assess your friends and family; believing the results of one test,
one sign, or one symptom; using photocopies of tests; believing online tests;
and using a test or assessment instrument without any training or supervision.
Ethical issue #1: Confidentiality, the

prime directive.
In your introductory classes, testing, and career classes, you will have the
opportunity to give and take tests. You will probably interview fellow
students. All of this is assessment data, and you should keep what you learn
to yourself. That means that you do not discuss it with your spouse or partner,
friends, or other students. You are officially a keeper of secrets and it begins
now.
Ethical issue #2: Evaluating or
testing your friends.
Is it all right to use assessment instruments with family and friends? It is
something like the dilemma of a doctor whose family members want medical
help. It is almost always better for the patient to see someone who is quite
objective and not emotionally attached. Of course, as a doctor, you would
treat a friend or family member on an emergency basis, just as the counselor
should recognize suicidal ideation and assist a friend or relation in getting
help.
When you analyze your friends with tests or other assessment devices, you
are uncovering areas that may hitherto have been unavailable to you (or
sometimes even to them!). This may influence the way that you look at them
in the future and potentially affect your relationship. Has your friend
consented to all of this? Can you keep the results of your assessment secret?
What if you find your friend has a substance abuse problem? Would that
change things between you? Would you be able to insist that your friend
receive treatment? These are only a few of the dilemmas that we face when
we open this can of worms. Therefore, counselors avoid diagnosing,
evaluating, and testing their friends and relatives.
Consider this example. One of us (Darcy) teaches a personality testing class

where graduate students learn to give comprehensive psychological
evaluations. Students are asked to practice on volunteers, with the warning
that testing family members and close friends can be dangerous to healthy
relationships. Nevertheless, a few years ago, one of my students decided to
test her mother. She came into my office a few days later, incredibly shaken,
because the results of the tests revealed that her mother was having an affair,
which was confirmed in the interview she conducted. The student’s mother
told her, “I’m so glad to be talking to a professional about this—it’s really
been on my mind, and I feel so guilty. I’m glad to get it off my chest!” Of
course, the student did not want to know this about her mother, did not see
herself as a professional in this mother-daughter relationship, and was
incredibly upset with having this information. The lesson is an important one.
Clear professional and personal boundaries are essential. Saying “No” to
boundary violations protects the other person too.
Ethical issue #3: Believing the

results of one test, one sign, or one
symptom.
One of the problems that school counselors have identified with the concept
of high stakes testing is the overreliance of a single data point on the lives of
students. Students who successfully pass all of their classes can have their
progress stopped by the results of a single exam. About 15 states have
required tests with severe consequences for failure, including not graduating
or not being promoted (National Center for Fair and Open Testing, 2017)
down from a peak of 25 states just a few years ago. Although parents can
now apply to allow their children to drop out of these required tests, schools
are required to test 95% of students. Many states continue to have their own
state tests (Kamenetz, 2016). Frequently, counselors are asked to prepare
students for these “high-stakes tests” and even administer them. In addition,
college-bound students face the pressures of standardized testing such as the
ACT and the SAT. Their scores determine where they might be accepted, and
counselors are needed to interpret the scores, help with test anxiety, and find
the appropriate college fit. In our Counseling Controversy in this chapter, we
look at whether counselors should support high stakes testing and its reliance
on these single measures of student success.

Counselors Support High Stakes
Testing in Schools?
Background: The term high stakes testing refers to achievement testing
conducted by states and districts with consequences for those who fail. In
some states students cannot graduate or progress to the next grade level if
they do not pass these exams. Other consequences include sanctions for
teachers and administrators, reduced funding for schools, and negative
publicity. Positive results lead to awards, positive publicity, promotion, and
monetary incentives for administrators and teachers. School counselors are
often charged with psychological preparation of students for the tests and
under the ASCA National Model, they should help interpret achievement
tests like these but not coordinate the testing program.
COUNTERPOINT:
POINT: COUNSELORS SHOULD
COUNSELORS SHOULD NOT
SUPPORT HIGH STAKES
SUPPORT HIGH STAKES
TESTING
TESTING
The first sentence in the ASCA If student achievement is the

national model is, “School goal of school counseling, then
counselors design and deliver counselors, like teachers,
comprehensive school counseling should be held accountable for
programs that promote student student success. This does not
achievement.” Thus, supporting make sense as the counselor’s
high stakes testing is part of the role is to help students
counselor’s prime responsibility overcome social and emotional
to promote achievement. barriers to achievement.
In the ACA code of ethics (D.1.g.) High stakes testing becomes a
it says, “The acceptance of problem for the school
employment in an agency or counselor because the
institution implies that counselors atmosphere of the school
are in agreement with its general becomes infused with stress.
policies and principles” (p. 10). If Testing creates a fearful
high stakes testing is the policy of atmosphere.
the school system, the counselor
should support it. Students with test anxiety now
have more to worry about when
Testing can motivate student the consequences of failure are
achievement by providing high. School counselors have
incentives and consequences. It less time to interact with
motivates teachers, students, and students if they are asked to
administrators and provides data coordinate or monitor testing.
on the effectiveness of instruction.
Emotional well-being of
By setting standards, everyone students, college selection, and
now knows what students are career development receive less
expected to accomplish and emphasis because they are not
instruction can be designed to tied to test preparation.
accomplish these goals
Data shows that high stakes
Achievement testing helps school testing widens the achievement
counselors identify low achieving gap between students. Minority
students who can then be or poor children are more likely
contacted to see how the school to fail and be penalized.
counselor can help.

argument.
In my counseling practice, I (Mark) recognized that many of the clients

diagnosed with Histrionic Personality Disorder (extreme attention seeking
and excessively dramatic behavior) often wore five or six rings. So, I began
using that as a sign of the disorder. Although many individuals suffering from
Histrionic Personality Disorder do dress dramatically and wear a lot of rings,
the converse is not necessarily true. Wearing rings does not mean you have
this mental disorder. The Diagnostic and Statistical Manual (DSM) uses a
list of the symptoms that a client must have, and does not allow a diagnosis
on a single sign or symptom.
Fast Facts
Because of high stakes testing, test sales have grown from $270 million
dollars in 1997 to $700 million in 2016.
Source: Supovitz (2017).
Any client sign or symptom that you identify and the results of any tests must
be taken in context and compared with all the other knowledge you have
about the client. Thus, it is a mistake to give a client a personality test and
consider its results in isolation. Before we can take the results of the test
seriously, we should consider them within the overall picture of the client.
Thus, most counselors and other test givers like to give a full range of tests
and see if similar results appear from multiple sources.
What relevance does this have for you as a counseling student? Have you
ever heard of medical students starting to believe that they have every disease
that they study? Similarly, counseling students, as they learn about various
pathologies, start to think that they have every mental disorder. Unless you
recognize that one symptom does not equal a disorder, you can erroneously
assign yourself to a category to which you do not belong. Similarly, as you
take tests in your testing or assessment class, you need to keep in mind that
they are a single source of information, and your fellow students cannot be
diagnosed from one piece of data.
Ethical issue #4: Using photocopies

of tests.
Many tests are expensive, and it is tempting to photocopy them. Some tests
can be copied with the permission of the authors or publishers (see Measures
for Clinical Practice and Research by Corcoran & Fischer, 2006). So, it is
not always necessary to purchase them; however, those that are copyright-
protected are like songs. They are the creations of their authors, who deserve
to be remunerated just as popular singers deserve credit for their music.
Making photocopies of these tests is unethical and illegal.
Ethical issue #5: Believing online

tests and tests in magazines.
There are online and magazine tests of personality, depression and anxiety,
alcoholism, personality disorders, and the list goes on and on. But how do we
know that these tests measure what they claim to measure? If you take it
today, will you get the same results next week? If you cannot answer these
questions, a test in a magazine should be considered a fun way to pass a plane
ride, not something that you can rely on. In the accompanying Informed by
Research feature, we consider how these popular surveys can mislead
members of the general population.
Informed by Research The Effects

of Popularized Tests
Surveys have long been a feature of women’s magazines and now appear in
the new wave of men’s magazines such as Maxim and Men’s Health and on
many popular websites. You may have taken such online tests, for example,
“What’s your party personality? What fitness routine is best for you? What
study environment do you do well in? These tests will show you what works
best with your personality, for everything from shoes to bras!” A recent issue
of a popular women’s magazine had the following survey: “What’s His
Intimacy IQ?” Can you really analyze the men you are dating based on your
opinion of his behavior and find out which one has the best potential for an
intimate relationship? No. But maybe we are taking this too seriously. These
tests are primarily for entertainment, right? Even so, is it possible that they
mislead readers about what is important in a relationship? Are these tests
feeding on the mistaken belief that all test results are true? Do you think that
there is potential damage in disseminating information about health and
relationships through surveys that do not really measure what they say they
are measuring?
Consider the article entitled “Health Advice in Women’s Magazines: Up in

Smoke?” by Dr. Elizabeth Whelan (1996), an epidemiologist. Dr. Whelan
complained that surveys in women’s magazines failed to identify cigarette
smoking as the major health risk for women (the leading cause of premature
death) in their health “tests” while overemphasizing other issues. In other
words, the content of the test did not include the right questions (this is the
problem of test validity). This means that your score on the test is unlikely to
relate to longevity, as the articles suggest. Unfortunately, people tend to
believe test results even when they come from unreliable sources. Numbers
have the power to persuade us even if they are misused. Mark Twain’s said,
“There are lies, damned lies, and statistics.” Part of being a counselor today is
wading through the statistics and being able to identify the good and the bad
information that is coming our way. Counselors, as purveyors of mental
health information, must understand research, separating the good from the
bad, or risk endangering their clients.
Ethical issue #6: Using a test

without any training or supervision.
You may become fascinated with a test and be tempted to administer it to
others. All published tests have specific qualifications that are required to
purchase or use them. Typically, Level A tests are surveys and questionnaires
that anyone can use. Level B tests usually require a college-level course in
tests and measurements. Level C tests are the most stringent, requiring an
advanced degree, membership in the appropriate professional association,
licensure, or certification, and training in both the specific test and the testing
domain. Of course, there are ways that people access tests inappropriately. A
few years ago, for example, a retiring professional was selling his collection
of Level C tests on eBay®. Anyone could have purchased the tests,
constituting a serious breach in test security. Although you may be able to get
access to highly specialized tests, you should never administer them without
proper training and supervision.
Ethical issue #7: Thinking you can

learn to assess suicide later.
As soon as you become a student of counseling, your friends, co-workers,
family members, and even your fellow students may begin to seek you out
for help. You may be flattered at first, but soon you will realize that you are
not entirely prepared. One of the areas new counseling students are often
least ready to handle is the unexpected admission by one of these significant
others that the person is considering suicide. You should develop a plan now
to deal with that eventuality.
SPOTLIGHT Assessing Suicide

Risk Through IS PATH WARM?
All clients should be screened for suicide. Some wonder if asking about
suicide puts the idea into the client’s mind, but there is clear and convincing
research that says that is not the case. Getting clients to talk about their
thoughts will help you determine if some intervention is needed. IS PATH
WARM is a mnemonic device that reminds you of the major issues to assess
regarding suicidal potential. Remember, suicide risk is a complicated type of
assessment, and beginning counselors should never try to assess suicide
without training and supervision.
Ideation: Does the client think about, write about, or talk about suicide?
This is the most important criterion, and anyone who meets this criterion
should be seen by a mental health professional. While the other criteria
do increase the chances of suicide, this suggests acute risk.
Substance abuse: Excessive or increased usage of alcohol or drugs.
Purposelessness: Client sees little or no meaning in life or reason to go

on.
Anxiety: Client is restless, anxious, sleepless, or sleeping all the time.
Trapped: Client feels that there are few alternatives and no way out.
Hopelessness: Client has no hope for self or the future.
Withdrawal: Client withdraws from usual activities, family, and friends.
Anger: Client feels vengeful because of being wronged or has periods of

rage.
Recklessness: Client acts without regard to consequences and may be

involved in dangerous behavior. Does not care what happens.
Mood changes: Client experiences extreme mood changes.
Source: Granello & Granello (2007); Juhnke, Granello, & Lebrón-Striker

(2007).
You may wish to keep the person’s confidence, but you do not have an
ethical responsibility nor a legal right to maintain confidentiality. In fact, you
must intervene. You must tell the appropriate people. There is a special
Spotlight on suicide risk assessment in this chapter to help get you started.
We are not suggesting that after reading this chapter you’ll be able to conduct
a suicide risk assessment. Rather, we suggest that starting now, you learn to
become more comfortable with the topic of suicide risk and risk assessment
and start learning all you can to develop appropriate expertise in this
important type of assessment.
Now, use the information you have learned in this chapter to consider the
case outlined in the accompanying Spotlight. Consider how a letter sent to a
teacher includes many clues to understanding the student. Also, think about
what was left out of the letter—what you would like to ask the student if she
were sitting in front of you.
SPOTLIGHT Jennifer’s Letter
Jennifer, a college student, sent this letter to her professor:
What do I feel? A restlessness. A loneliness. A hurt. Who do I give my

love to? Who will love me in return? When I was younger, the
loneliness was almost unbearable. It would come at times and be totally
engulfing. Sometimes listening to songs does it. Sometimes it doesn’t
have to be triggered. It just happens. When I was younger the feelings
would be worse than being yelled at or getting in trouble. I felt so alone.
So desolate. It’s hard to put into words. To explain it is really beyond
words.
Through the years, I’ve been able to ward it off. I don’t let myself get
too close to it. I can feel it coming on. Sometimes it does come and it’s
just as bad as when I was younger. What’s wrong with me? Why am I
this way? I want to yell or scream. I want to let it out but I can’t. My
mind screams with the feelings inside. I scream and scream but no one
hears. Everyone thinks I am calm and happy-go-lucky. I want to cry but
I can’t let anyone see. They’ll think I’m crazy because I can’t explain.
They don’t understand. Do they have a feeling like it? It’s not good to
talk about it.
Why am I so alone? Why is it that when I feel that I have found

someone who would understand, things get messed up? Why do I
withdraw from people when I get close and they do something I don’t
like? Why does terror settle in the pit of my stomach? Does anyone
care? Can’t they listen? Can’t they hear? I feel like my insides will
explode. I want to let it all out so maybe I will be okay. But will I? Am I
normal? I can’t be. Nobody else is like this. This can’t be. I must be
crazy. I need to be locked away. This can’t be how others feel.
Who can I talk to? Will they really care? How can they? Please help me.
I hurt so bad. The loneliness is unbearable. Tell me I’m not crazy. Tell
me I can be loved too. Hear me. See my hurt. I know you can if you’ll
just look. What does it matter? Nobody would care. All they would say
is, “Bad thing that it happened.” “She was so young and had her whole
life in front of her.” It’s not much of a life if nobody will reach out to
me.
1. Despite the fact that you do not have much information about Jennifer, if
she were your friend, would you consider this a serious problem
requiring counseling?
2. Using the Spotlight feature entitled IS PATH WARM, try to get an idea
of Jennifer’s risk for suicide.
3. Besides being a cry for help, does the note tell us something about
Jennifer’s thinking that we might use to help her in counseling? What
ideas are expressed that give clues to her view of the world, self, and
others?
4. What ideas does Jennifer have that might be modified or challenged as

part of counseling?
Summary
In this chapter, we discussed the critical role that assessment plays in the
counseling process for counselors in every setting and for every client
population. When counseling students think that assessment means only the
giving of standardized tests, they miss the essential goal of assessment.
Assessment means adopting an investigative role in understanding your
client. It means taking in information by whatever means available and using
that information to develop a full understanding of the client that leads to
appropriate and successful interventions. All counselors are investigators, and
assessment gives us the tools for this important part of our job.
In addition to an investigative attitude, counselors must have double vision,

that is, the ability to see both the strengths and the weaknesses in their clients.
They cannot ignore the debilitating effects of mental disorders, but they must
also be aware that utilizing the client’s strengths may be one of the best ways
to help the client overcome them. Unlike physical illness, the best approach is
not always to focus on eliminating the problem. Sometimes, it is best to boost
the individual’s psychological immunity. But before we can use our
strengths, we need to identify them for ourselves and for the client. Focusing
solely on problems and disorders leads to demoralization of counselor and
client alike. Counselors have hope because they believe that human beings
are also strong, resilient, and capable.
Student Activities
2. Review the seven ethical guidelines for assessment presented in this

chapter. What would you do if you believed a classmate was considering
suicide? Because you are not the person’s counselor, whom would you
tell?
3. Think about the types of mistakes that counselors might make in
assessment (ignoring or not detecting a mental illness, substance abuse,
or potential for violence). Why do you think beginning counselors might
miss these? Most of us have a natural desire to see the good in people.
Do you think that keeps us from realistically assessing their problems?
Journal Question
1.
Think about all the tests that you have taken during your school years,
including an IQ test, the SAT, and perhaps the GRE or MAT. Your life may
have been drastically affected by these tests. How crucial is it for you as a
counselor to know about the reliability and validity of tests like these?

1. Much of assessment takes place at the beginning of the counseling
relationship, but few counselors use measurements along the way to
assess client progress by keeping records, charts, and other information.
Should counselors spend more time learning about methods of tracking
client progress? What tools are available?
2. Most standardized assessments measure weaknesses, flaws, pathology,

and maladjustment. What are your personal strengths that have never
been measured in school?
Experiments
1. Try making a genogram or pictorial family tree for yourself. Samples
and instructions are available from several sources, including
McGoldrick, Gerson, and Shellenberger (1999) and Young (2017).
There is even free genogram software available online. Looking and
reflecting on your own genogram is relatively safe; however, if you feel
disturbed by thinking about your family history, consider talking to a
professional about what you discover.
2. Go to your university career or counseling center and take a career

inventory. Discuss the results with a professional. What does it say
about you and the possible career of counselor? What other issues
besides test results will be useful in making this decision?
Explore More
Books
Balkin, R. S., & Juhnke, G. A. (2014). The theory and practice of
assessment in counseling. Upper Saddle, River, NJ: Pearson.
Drummond, R. J., Sheperis, C. J., & Jones, K. D. (2016). Assessment
procedures for counselors and helping professionals (8th ed.). Upper
Saddle River, NJ: Pearson.
Lukas, S. (1993). Where to start and what to ask. New York, NY:
Norton.
Sommers -Flanagan, J., & Sommers-Flanagan, R. (2015). Clinical

interviewing. Hoboken, NJ: Wiley.
Suzuki, L. A., Ponterotto, J. G., & Meller, P. J. (2008). Handbook of

multicultural assessment.
Articles
Granello, D. H. (2010). The process of suicide risk assessment: Twelve
core principles. Journal of Counseling and Development, 88, 363–71.
This article discusses the overarching assessment principles involved in

suicide risk assessment, a critical issue for counselors in all settings.
Hays, D., & Emelianchik, K. (2009). A content analysis of intimate

partner violence assessments. Measurement & Evaluation in Counseling
& Development, 42(3), 9–153.
Intimate partner violence is something that every counselor should know

about and any counselor working with couples and families will find
essential.
Willow, R., Tobin, D., & Toner, S. (2009). Assessment of the use of
spiritual genograms in counselor education. Counseling and Values,
53(3), 214.
The article highlights assessment issues in assessing religious and

spiritual issues in counseling and gives insight into how genograms can
be used.
Make Legal and Ethical Decisions?
Questions
The major ethical guidelines of the counseling profession.
The major legal decisions that impact counseling in a variety of settings.
The resources that are available for counselors to help them make
appropriate ethical decisions.
Discuss the role of a counselor’s personal values and ethics in the

counseling process.
Apply ethical decision-making models to counseling.
Understand how to determine when you need assistance in making

ethical choices during your graduate program and in your counseling
practice.
What impact might your own personal values and beliefs have on your
counseling practice?
How can you be intentional in your decision to practice counseling in a

legally and ethically appropriate manner?
1. ethical standards of professional counseling organizations and

credentialing bodies, and applications of ethical and legal
considerations in professional counseling
As you enter the counseling profession, you may find it both comforting and
a bit intimidating to realize that you will have a code of ethics as well as a
multitude of laws and rules to help guide your practice. Most professions
have ethical codes and legal requirements that provide expectations for
behavior. The profession of counseling is no exception. Counselors follow
the appropriate ethical codes, state-level rules and regulations, relevant state
and national statutes, and case law. These legal and ethical requirements exist
to help counselors provide the highest quality of care possible to the clients
they serve. When you first enter the profession, you may be tempted to think
of all of these codes and regulations as restrictions or worry that they will get
in the way of your counseling practice. You might even be already starting to
worry that you will make a mistake, get sued, or lose your license. Those are
common fears among beginning counselors. But the good news is that with
education, practice, and supervision, you will come to see that the legal
requirements and ethical codes are there to protect you and your clients, not
to limit what you do.
Over your counselor training, you will realize that the details of the
profession’s legal and ethical mandates are complex. In addition, ethical
codes and laws are constantly evolving to meet the changing needs of the
society in which we live. As a result, many beginning counselors find
themselves feeling overwhelmed and eager to find quick and definitive
answers to their legal and ethical questions. Unfortunately, we cannot provide
all of these answers in just one chapter. What we can do in this chapter is to
help you start your journey as a counselor armed with what you need to begin
to develop a personal, positive, and practical approach toward becoming an
ethical professional counselor.
In this chapter, we take a proactive stance to legal and ethical decision-

making in counseling. Ethical counselors recognize that they have a personal
responsibility to self-monitor and take full responsibility for all of their
professional actions. They internalize the values and beliefs of the profession
and strive to develop the “habits of character” they need to realize the
profession’s goals (Welfel, 2005, p. 122). This contrasts with a punitive
approach that focuses on the repercussions of violations. In the punitive
approach, a counselor might say, “I won’t commit an ethical violation
because I might lose my license.” In a proactive approach, a counselor might
say “I want to operate as a highly ethical counselor so that I can provide the
highest level of service for my clients.” This proactive approach aligns with
the stance of the American Counseling Association’s Code of Ethics (2014a),
which focuses on developing an ethical approach to practice that benefits
clients and fosters professional values that are derived from personal
dedication, rather than imposed by an outside force. In other words, the best
ethical practice is one that is an outgrowth of the personhood of the counselor
and is an integral part of the counselor’s personal and professional identity.
This type of ethical practice empowers counselors to help their clients grow
and develop. Counselors who operate ethically recognize that their primarily
responsibility is to their clients, and this responsibility guides all of their
professional decisions.
American Counseling Association Code of Ethics
“A.1.a. Primary Responsibility The primary responsibility of

counselors is to respect the dignity and to promote the welfare of
clients.”
American School Counselor Association Code of Ethics
“A.1.a. Professional school counselors have a primary obligation to the

students, who are to be treated with dignity and respect as unique
individuals.”
The primary responsibility of counselors, as outlined in the first section of the

American Counseling Association Code of Ethics (2014) and the American
School Counselor Association Code of Ethics (2016).
A proactive approach to ethics aligns well with the idea of aspirational ethics,
an approach that calls upon counselors to uphold the highest ethical standards
of the profession. In the accompanying Spotlight, we introduce you to the
idea of aspirational ethics. As you read the Spotlight, you may want to
consider how you can begin to adhere to aspirational ethics in counseling,
even during your graduate training.
SPOTLIGHT Minimal vs.
Aspirational Ethics
Ethical codes provide only the minimal acceptable standard to which
professionals must adhere. If a counselor uses the laws and ethical codes in a
strict prescriptive manner, then what is required is adherence to the minimum
guidelines outlined in the ethical codes. This practice will generally protect a
counselor from legal repercussions. This “letter of the law” approach has
been called “mandatory ethics,” and it is all that is legally required of
professionals. The focus of mandatory ethics is discouraging inappropriate
practice and protecting clients (Dougherty, 2008). A second approach is a
higher level of ethical decision-making, called “aspirational ethics.”
Aspirational ethics refers to “the attempt to accomplish the maximum in
moral and ethical outcomes” (Newman, Gray, & Fuqua, 1996, p. 231). In this
approach, counselors do more than simply comply with the codes of ethics or
laws. Rather, counselors who use this approach continually scan their
interventions and approaches to make sure that they are always aware of the
effects of their actions on their clients. Aspirational ethics are less
prescriptive and more general than mandatory ethics, which are rooted in
specific ethical codes or rules. Examples of aspirational ethics include social
justice, integrity, and respect. Maintaining this type of ethical behavior is a
continuous active process that involves self-awareness and self-monitoring.
Thus, highly ethical counselors follow the minimum guidelines of the
mandatory ethics and they always work toward the highest levels of
aspirational ethics.
The Purpose of Ethics in the
Practice of Counseling
Ethics is the systematic study of value concepts, such as right and wrong, and
the principles that are derived from such a study. Professional ethics are the
standards of good practice, as agreed upon by experts and professionals in a
given occupation. Ethics are linked to moral behavior, but professional ethics
are not the same as morals. Professionals develop ethical codes to describe
the standards and rules of good practice, and these standards are based on
professional agreement regarding what is good or right or acceptable, or how
professionals “ought” to behave in various situations.
The primary purpose of ethical standards in the field of counseling is to

protect clients and consumers of counseling services. Clients know that if
they go to counselors who are members in good standing of the profession,
they will receive treatment that meets the minimum acceptable standard of
the profession. Clients have the right to enter into the counseling relationship
with specific expectations regarding the counselor’s professionalism and
practice.
A secondary purpose of the ethical standards is to protect the members of the

profession. Professional counselors have ethical codes to guide their practice,
and they understand that their colleagues meet these minimal standards of
conduct. In this way, counselors are protected, rather universally, from
unethical practices of colleagues that would serve to lessen the credibility of
the profession in general. Additionally, professionals know that if they adhere
to the professional ethics, they are offered some protection from the public
against spurious lawsuits.
A third purpose of the ethical standards is to limit government interference in

the regulation of the profession. Of course, the government is involved with
regulating all the mental health professions, but by drafting their own
standards of conduct, professional counselors take a proactive stance in
determining the acceptable behaviors for counselors. Thus, members of the
profession, who have the most knowledge and insight about the profession,
take the lead in drafting the rules of responsible and ethical behavior.
Professional Codes of Ethics

All of the helping professions have established codes of ethics to guide
clinical practice. The ethical codes developed by the various counseling
associations provide general guidelines for practice and typically represent
the minimal standards of conduct. Additionally, the codes tend to be based on
past occurrences and therefore cannot anticipate all ethical dilemmas that
may occur. For example, all ethical codes address the use of technology in
counseling, but it is impossible for the codes to keep up to date with all the
recent electronic platforms that may impact a counselor’s practice. As a
result, counselors in all settings are struggling to keep up with the best ethical
and legal practices surrounding technology (Wheeler & Bertram, 2015). The
challenges surrounding ethically sound use of technology highlight this
important point: Counselors use the ethical codes to guide practice, but they
recognize that the codes cannot be blueprint for practice. Adhering to the
ethical codes of the profession does not negate the need for sound clinical
judgment, professional integrity, consultation with other professionals, and
ethical reasoning.
We encourage you to become familiar with the ethical code(s) for the
counseling specialization(s) you plan to pursue. Typically, these codes are
available on the organizations’ websites. Although specifics of the ethical
codes differ, several common themes have been identified (Koocher & Keith-
Spiegel, 2008). These include the following:
Promoting client welfare
Practicing within the scope of one’s competence
Doing no harm
Protecting client confidentiality and privacy

Acting ethically and responsibly
Avoiding exploitation of clients
Upholding the integrity of the profession
In addition to outlining the ethical principles in the document, some of the

professional codes of ethics within the counseling specializations explicitly
state the values upon which the code is built. For example, the Code of
Professional Ethics for Rehabilitation Counselors (2009) outlines the
following foundational values to which all rehabilitation counselors should
commit:
Respecting human rights and dignity;
Ensuring the integrity of all professional relationships;
Acting to alleviate personal distress and suffering;
Enhancing the quality of professional knowledge and its application to

increase professional and personal effectiveness;
Appreciating the diversity of human experience and culture; and,
Advocating for the fair and adequate provision of services.

The Role of Personal Ethics and
Values
Counselors can look to the professional ethical codes to help make sure they
are following minimum standards, but the codes cannot provide answers to
all ethical dilemmas. There are situations in which the ethical codes are silent.
In other situations, the counselor might understand the imperatives within the
codes but be less certain as to how to actually carry them out. (For example,
you know that as a counselor, you cannot accept an invitation to date your
client, but what do you actually say to a client who asks your counselor out to
dinner?) In these situations, the counselor’s personal characteristics are
critical additions to professional expertise and identity.
You may find that many of the positive personality traits that already will
help you be a good counselor will also help you be an ethical counselor. For
example, counselors who are open, honest, and willing to take risks are more
likely to reach out for help when they need it. Reaching out to colleagues
and/or supervisors for advice, support, or feedback is an essential component
of ethical decision-making. Counselors who are honest with themselves
recognize that they don’t have to be perfect. Counselors who try to be
perfectionists run the risk of feeling the need to go to great lengths to cover
up mistakes or to make sure that they look like an expert in all situations.
The Role of the Counselor’s

Personal Values
As you seek to integrate your personal and professional identities as a
counselor, one of the most difficult situations to manage can be in the area of
values. Because our values are intrinsic to who we are, we often cannot see
when they affect our decision-making or influence our work with clients. It is
clear that clients are affected by the values of the counselor. Clients who have
counselors who try to impose their personal values can feel coerced into
actions that do not align with their own values, unsupported in their own
decision-making, or guilty for not meeting the counselor’s expectations. They
may even adopt some of the counselor’s values as their own (Richards,
Rector, & Tjelveit, 1999). As a result, counselors must be very aware of their
own values and beliefs.
Consider these examples.
A high school counselor working with a bright and capable young

woman might be dismayed to learn that she has decided not to accept a
scholarship to attend college but to instead move in with her boyfriend
and become a waitress. It may be tempting for the counselor to use
subtle (or even obvious) means of persuasion to help guide that young
person into making a different choice.
A mental health counselor working with a client with schizophrenia may

be frustrated to learn that the client has decided to go off his medication
because he misses the voices he was hearing and now finds he is lonely
for much of the day. It may be difficult to resist convincing the client to
stay on his medication.
A couples counselor learns that a couple has decided to drop out of

counseling in which they were learning how to integrate healthy
communication styles into their marriage, deciding that their marital
problems are caused by a lack of time devoted to their religious faith.
Instead of counseling, they have decided to join a more fundamental
branch of their religion and spend more time praying for a resolution of
their problems. It may be frustrating for the counselor to discover that
the couple has given up on learning a strategy for improved
communication in their relationship.
Counselors are faced with countless scenarios like these, and it is often
difficult to know when we cross a line between helping clients come to the
best decisions they can make and using our power and position to impose our
values. There is no clear line here, and ethical counselors recognize the
complexity of many of life’s dilemmas. Most counselors would argue that in
all of these scenarios, the counselor has an obligation to help the client(s) see
the potential consequences of their decisions. The question becomes, “Where
is the line between presenting options and imposing values?”
In order to sidestep these concerns, beginning counselors sometimes talk

about the need to conduct “values-free” counseling. They argue that they will
simply be neutral and allow their clients to make their own choices. But even
these choices— allowing clients to explore their options and make their own
choices—are based on the values of autonomy and freedom. In fact, every
choice a counselor makes is laden with values, from attending to certain parts
of a client’s story to the selection of certain counseling techniques, to the
decision to become a counselor in the first place. In fact, the “myth” of
values-free counseling can actually be dangerous. Counselors who think they
are values-free are, in reality, unaware of the effect their own values have on
their counseling. One of the most important steps beginning counselors can
take is to become keenly aware of their own values and how these values
might impact their work as counselors.
Rather than a values-free or even values-neutral approach to counseling,

which is impossible, most counselors believe in a “values-aware” approach.
Counselors should be keenly aware of their own values, understand where
those values come from, and recognize how their values might affect the
counseling relationship. Although the need for a values-aware approach is
often mentioned within the context of multiculturalism and diversity in
counseling, the reality is that we must be aware of our values and how they
affect our counseling relationships with all of our clients. A consistent theme
of this text is the importance of self-awareness and self-discovery for the
beginning counselor, and this is clearly an important approach when it comes
to counselor values. Counselors impose their values on clients when they
attempt to influence or define a client’s beliefs, attitudes, or actions. This can
be done either actively (such as making overt statements that support one
particular value or belief over another), or passively (such as paying attention
and responding to only those goals or choices articulated by the client that
align with the counselor’s values). Importantly, the imposition of values by
the counselor can be an intentional choice by the counselor or an
unintentional one outside the counselor’s awareness. Either way, the results
are the same.
American Counseling Association Code of Ethics
A.11.b Counselors refrain from referring prospective and current clients

based solely on the counselor’s personally held values, attitudes, beliefs
and behaviors. Counselors respect the diversity of clients and seek
training in areas in which they are at risk of imposing their values onto
clients, especially when the counselor’s values are inconsistent with the
client’s goals or are discriminatory in nature.
Most counselors can easily think of times when their work with clients
put them into discussions where the goals for counseling were in conflict
with their own values. For example, one of us (Darcy) still remembers a
time when I was working in a clinic in Appalachia. I saw a young
woman who was in counseling for Panic Disorder with Agoraphobia (a
mental disorder in which people are fearful of leaving the house or
going out into crowds for fear they might have a panic attack). The
woman came to the first counseling session with her husband, which
made sense because her illness made it impossible for her to drive
herself. However, within the first few minutes of the session, it became
clear that her husband intended to stay in the counseling session with
her, and he answered most of the questions that I directed to her. From
where I sat, it appeared that their relationship was one in which he
exercised the power and control, and she meekly agreed to whatever he
said. My initial reaction was to become angry with the husband, to
diagnose the woman with Dependent Personality Disorder (a disorder in
which people rely on others to meet their emotional and physical needs),
and to set up a counseling goal for her to be more independent and
assertive in her relationship. Luckily, I did a quick values-check and was
able to stop myself before I said anything. Whose values was I
supporting here? Was I expecting this woman to live my values? She
hadn’t complained about the relationship, and marital equality was not
the goal of the counseling. Just because her relationship did not match
the type of spousal relationship that I value in my own life did not mean
that it needed to be changed. Instead, I recognized that I was about to
impose my values onto her without her blessing or permission, and I
backed away from my own reaction to pay more attention to her story
and her perspective and to focus on her goals for the counseling session.
I made sure to check in with her independently from her husband
(always a good idea, to assess for potential domestic violence), but when
I got to know the couple, I saw that they were simply operating from a
more traditional framework than my own. As always, when counselors
take a moment to ask themselves, “Whose needs are being met?”, they
can help focus on the values and beliefs of the client, instead of their
own.
When Personal and Professional

Values Collide
The intersection of personal and professional values can be particularly
difficult for counselors who hold strong personal beliefs or values that are in
conflict with the stated values of the counseling profession. Professional
ethics guide professional behavior. However, a behavior can be
professionally ethical, but not morally acceptable to an individual therapist
(say, for example, counseling a woman who is getting an abortion). However,
personal morals cannot negate professional ethics. For example, if an
individual counselor’s personal morals support keeping the confidentiality of
a person who molests children (perhaps based on the belief that the counselor
can help the client more than involvement in the legal system), that does not
free the counselor from the legal and ethical obligation of disclosure. The
ethical mandates of the profession must be upheld regardless of the personal
values and beliefs of the counselor. In this chapter’s Counseling Controversy,
we highlight the challenges that can arise when a counselor’s personal values
collide with the ethical mandates of the profession. As you read through the
Controversy, you may want to think about areas where your own values
might cause you to have difficulty when working with certain clients or with
specific behaviors. Now is a good time to start thinking about steps you can
take to get assistance when your personal and professional values are in
conflict.
Understanding Ethical Practice

from a Social Justice Perspective
As you continue to think about the role that your own values will play in your
quest to become an ethical counselor, this is an important time to remind you
about the role of diversity, multiculturalism, and social justice in counseling
practice. The ethics of our profession are grounded in deep and meaningful
values (e.g., dignity, respect, altruism, justice, and caring), and the goal of
ethical practice is to engage in behaviors that promote these values in our
interactions with our clients. It is quite clear that if counselors engage in
practices that do not promote these values, they can cause harm to their
clients. For clients who have been oppressed or marginalized, engaging in
counseling can become part of yet another system that devalues or disregards
their experiences.
The ethical codes of all of the helping professions have been challenged for
their lack of non-White, non-Western perspectives (Frame & Williams, 2005;
Pack-Brown, Thomas, & Seymour, 2008). As the codes are updated, there
has been a conscious effort to make them less prescriptive about specific
behaviors that are considered ethical or unethical, and more tied to universal
themes of helping clients. For example, previous versions of the ACA ethical
codes prohibited receiving gifts from clients. The most recent version (2014)
recognizes that when culturally appropriate, receiving a very small token of
appreciation from a client can be extremely important to the therapeutic
relationship. However, it is important to remember that even as the codes of
ethics are continually updated to be more inclusive, the core values remain
the same.
As you begin to implement the ethical codes in your own counseling practice,
we encourage you to continually explore how your work is valuing the
worldviews of the clients with whom you work. As you read through the
categories of the ethical issues in counseling in the next section, consider
what values underlie the ethical practices being discussed and how these
values can be supported with diverse clients. After all, it is when you work to
merge multicultural understanding with ethical practice that you move toward
becoming a counselor who truly makes a difference in all clients’ lives.
Ultimately, when you engage in practice that enhances the dignity and worth
of every client, you become a living advocate for your clients in every
interaction you have.
Counseling Controversy Do
Counselors have the Right to Refuse
to Work with Certain Clients?
Background: One of the ethical mandates within the American Counseling
Association Code of Ethics is that counselors not condone or engage in
discrimination based on sexual orientation of clients, students, employees, or
research participants. It is within this context that a series of recent court
cases have challenged whether students in counseling programs can be forced
to work with gay, lesbian, bisexual, or transgender clients, or whether this
mandate infringes upon their First Amendment rights.
COUNTERPOINT:
POINT: COUNSELORS HAVE AN COUNSELORS DO NOT HAVE
ETHICAL MANDATE TO WORK TO WORK WITH CLIENTS
WITH ALL CLIENTS WHO EXHIBIT BEHAVIORS
THEY DO NOT CONDONE
The ethical codes are wrong to

force counselors to work with
clients who behave in ways the
A fundamental premise of the counselor sees as morally
ethical codes is to respect the wrong.
dignity and worth of all clients.
A person’s choice of profession
Counseling is about helping should not be allowed to limit
clients find their own way, not that person’s free speech or
about forcing the counselor’s demand that they engage in
values onto the client. Prejudice behaviors that are contrary to
against clients has no place in the the person’s belief system.
counseling relationship.
Where personal and professional Counselors with strong religious
values are in conflict, beliefs cannot, and should not,
professional duty takes turn off their beliefs in their
precedence. professional practice.
Professional conduct is not the Counselors have First

same as individual free speech. Amendment rights, which
Adherence to ethics is a legal and include the freedom to take a
legitimate requirement for state- strong public stand against a
licensed counselors. lifestyle to which they are
opposed.
Simply referring clients to
another counselor has practical Clients deserve services by
implications. In many settings, counselors who can support and
other counselors are simply respect their choices.
unavailable or overbooked, and Counselors cannot just pretend
referrals are often logically to support clients—that would
difficult. mean counseling was based on a
lie.
Clients who are referred to
another counselor because of For counselors to be one person
their sexual orientation can feel at the office and another at
judged or emotionally harmed. home violates many of the
profession’s core beliefs of
integrity, genuineness, and
congruence.

Major Ethical Issues in Counseling
Ethical codes are used to help guide decision-making, and they are intended
to help you (with consultation and supervision) make the best choices for
your work with clients. As a counselor in training, it is important for you to
read and understand the ethical guidelines of your new profession. As a
counselor, you will be expected to monitor and take responsibility for your
own professional actions. To help you learn the basics of the ethical codes of
the counseling profession, we have organized them into several major
categories, which can help you learn to navigate the complex world of ethics
in counseling.
Rules Related to Professional

Responsibility
First and foremost, professional counselors have an ethical duty to maintain
high levels of integrity in their practice. In other words, as a counselor, you
have an ethical responsibility to use your professional knowledge and the
power of the counseling relationship to help your clients in responsible ways.
This responsibility rests with the individual counselor, who must uphold
ethical practice, even in the face of pressure to engage in unethical practice
that may come from clients, employers, insurance companies, or others.
To insure that the client’s needs are being met, counselors are aware of their
own personal issues and unresolved conflicts, often called unfinished
business, and do not allow personal problems to interfere with the counseling
they provide. Counselors should continually engage in self-reflection and be
self-aware in order to recognize and correct any countertransference or
symptoms of burnout. Impaired professionals should not work with clients
unless they are receiving assistance and supervision.
The ethical imperative of professional responsibility applies in all of a

counselor’s many roles. Counselors who engage in research adhere to strict
rules in their work with human subjects and try to eliminate bias from
research. Counselors who teach take care not to allow their opinions to color
the presentation of course material. Counselors who supervise beginning
professionals understand that their primary responsibility is always to the
client, but they also have an ethical responsibility to their supervisees, using
supervision to enhance the trainee’s development and growth.
Words of Wisdom
“Primum non nocere” (Above all, do no harm)
—Hippocrates
Rules Related to Competence

Counselors must know and act within their own competence and work to
continually maintain and expand their competence. This means that even
after graduate school, you must keep current with the latest research in the
field, particularly as it relates to your clients and/or specialization. Most
licensure laws and certifications carry a legal responsibility for continuing
education, but there also is an ethical obligation that counselors have to keep
abreast of the latest developments in the field. Counselors must know and
recognize their professional limitations and refer clients who have problems
that are beyond the scope of their knowledge.
Counselors have an ethical responsibility (as well as a legal one) to inform

clients of all of the aspects of their educational background’s licensure,
specialization, training, and competence. Counselors who misrepresent
themselves or their competence violate the ethical codes and can also be sued
for fraud. Although working within your area of competence is both an
ethical and legal requirement, the definition of competence is based on a legal
standard. The legal standard for competence is whether the counselor’s skills
match an average practitioner in good standing. Thus, you do not need be a
leading expert in a particular intervention or with a particular type of client,
but you must be able to prove training and knowledge, and for some
specialized interventions, supervised experience. When counselors use
interventions that are not considered the professional standard, they must
inform clients that they are using experimental techniques and give the client
the option of more conventional interventions.
Rules Related to the Counselor’s

Own Moral Standards and Values
Counselors are human and have their own personal ethical and moral stances
on issues. As mentioned earlier, however, a personal moral stance cannot be
used as a defense to violate the profession’s ethical standards. As a counselor
you may believe what you wish, but you must behave in ways that are
consistent with the law and the professional ethical codes. For example,
counselors may not engage in discriminatory behaviors, even if they hold
discriminatory beliefs. Counselors are strongly cautioned to monitor their
own biases and beliefs for discriminatory or stereotyping thoughts, as these
can (even inadvertently) affect behaviors.
The ethical codes also remind professional counselors that they are
representatives of counseling profession in the community at large. They
caution that personal choices and behaviors that reflect negatively on the
individual also reflect poorly on the profession as a whole.
Rules Related to Confidentiality

Confidentiality is a professional agreement to respect the privacy of their
clients and to refrain from disclosing any information about them to others,
except under certain agreed-upon conditions, such as during supervision. The
issue of confidentiality is both an ethical and legal concept and will be
discussed in greater detail as a legal issue later in this chapter. Confidentiality
is the cornerstone of the counseling relationship, but as you will learn later in
this chapter, confidentiality is not absolute.
Rules Related to the Welfare of the

Client
Counselors do what is best for their clients. The ethical codes in counseling
include rules about promoting the welfare and autonomy of clients and the
integrity of the counseling relationship. As a counselor, you will put the
needs of your clients ahead of your own, consistently asking yourself,
“Whose needs are being met?” To help counselors focus on the needs of their
clients, the ethical codes include sections on topics such as multicultural
competence, advocacy, client dependency, informed consent, termination and
referral, dual relationships, and sexual relationships.
Multicultural competence
Counselors have an ethical responsibility to engage in culturally and
developmentally appropriate interventions. They recognize and value
diversity in cultures and beliefs, and they demonstrate commitment to
multicultural counseling competence.
Counselors for Social Justice Code of Ethics
A. 2. [counselors] work collaboratively with clients/students to develop

goals and strategies for counseling and advocacy efforts that are
culturally sensitive and relevant.
Advocacy
When appropriate, counselors advocate for their clients at the individual,
institutional, and societal levels. School counselors are advocates for all
students and strive to develop school environments that promote tolerance
and respect. They take leadership roles in schools and work to close
achievement and opportunity gaps that disadvantage groups of students and
deny all students the chance to pursue their educational goals.
Client dependency
Counselors advance the welfare of their clients, whether they are individuals,
families, or groups. As a counselor, you will use your power to empower
others. Fostering client dependency—whether intentionally or unintentionally
—is not consistent with ethical treatment. Counselors assist clients in making
decisions, but clients ultimately have the freedom—and the responsibility—
to make their own choices.
Informed consent
Informed consent is both an ethical and legal concept and will be discussed in
greater detail later in this chapter. Ethically, clients must be empowered to
make informed choices about their treatment, and they cannot do so unless
they have all the necessary information. Informed consent about the
purposes, goals, and techniques used in counseling, as well as the education
and licensure of the counselor, and the fees and financial commitments,
allows clients to make better choices.
Termination and referral

Because of the potential for clients to be abandoned or neglected by
counselors, there are sections of the ethical codes that specifically address
issues that can occur at the end of counseling. Counselors ensure that clients
have appropriate referrals and emergency information in case interventions
are required when the counselor is unavailable. When referrals are made to
others or counseling is terminated, counselors keep lines of communication
open with their former clients in case they require additional assistance.
Dual Relationships
A dual relationship occurs whenever a counselor and client have an
additional personal or professional relationship, either prior to or during
counseling, or in some cases, after its termination. Dual relationships are
inappropriate if they exploit the client financially, sexually, or personally. For
example, two people who are friends or business associates should never
enter the counselor/client relationship. Likewise, counselors never engage in
therapy with members of their families. Professors won’t counsel their
students. The list goes on and on. Friends, relatives, employees, students,
supervisees, research participants, and colleagues can all be inappropriate
“clients” for a counselor. It is not difficult to understand why dual
relationships can be a problem. If you have been asked to practice counseling
with one of your classmates in a techniques class, you know that it is
important not to delve too deeply into that person’s problems. When you visit
with family members at holiday get-togethers, you understand that it is
inappropriate to practice your new counseling skills with family members as
your clients. We cannot be truly objective with our clients if we have multiple
relationships with them. Further, the power from the counseling relationship
can transfer over into the second relationship, exploiting the non-therapeutic
relationship. (Imagine a case where a classmate has disclosed too much to
you, and now feels uncomfortable around you in the classroom.) When it is
impossible to avoid dual relationships (such as in small communities where a
counselor and client may be neighbors or belong to the same religious
community), counselors openly discuss the dual relationship with the client,
make every attempt to make sure that the dual relationship does not cause the
client harm, and seek supervision and consultation to help manage the dual
relationship, as appropriate.
Sexual Relationships
Because of the extreme exploitive nature of sexual relationships, they deserve
some extra attention here. Whereas other types of dual relationships are
dangerous and should be avoided (or at least managed in cases where it is
impossible to avoid them), sexual relationships between counselors and their
clients are specifically forbidden in all the ethical codes of the helping
professions. Nevertheless, sexual or romantic relationships between
counselors and clients accounted for 40% of all the liability claims paid by
HPSO (ACA’s malpractice insurance network) from 2003–2012 (HPSO,
2013). In spite of very clear prohibitions against this type of relationship,
research shows that about 3–5% of all mental health professionals
(psychologists, psychiatrists, and social workers—counselors have not
specifically been included in these studies) admit to engaging in sexual
relations with at least one client (Bernsen, Tabachnick, & Pope, 1994; Borys
& Pope, 1989; Lamb, Catanzaro, & Moorman, 2003). Offenders are about 4
times more likely to be male (9.4%) than female (2.5%) (Pope, Tabachnick,
& Keith-Spiegel, 1987). Perhaps the numbers are even higher, as some
therapists may not admit to this behavior in self-report surveys.
It is important to note that more than 90% of therapists admit having a sexual
attraction to at least one of their clients (Fisher, 2004). Counselors are
human, and they have natural human reactions to others. Nevertheless, this is
a boundary that cannot be crossed. Most therapists who reported having
sexual attraction to a client said that they felt guilty, anxious, and confused by
their feelings, and more than half said that they had received no guidance or
training about how to handle feelings of sexual attraction. Almost 40% said
they had no professional with whom they could consult (Rodgers, 2011).
Clearly, counselors must have an outlet, for example, their own counseling or
peer supervision or consultation with a colleague, to discuss the sexual
feelings that can arise during the counseling relationship. If it is impossible to
keep sexual feelings in check or to resist responding to a client’s seductive
behaviors (or perceived seductive behaviors), then the counselor must refer
the client. Sexual relationships with clients are an ethical violation, and they
can be the basis for malpractice suits (or in some states, felony convictions)
as well. Laws vary from state to state regarding how long after termination
from therapy before counselors and their clients can engage in sexual
relationships.
Fast Fact
More than 90% of clients who become sexually involved with their therapist
suffer negative consequences due to the sexual contact, according to a study
of 559 clients who had sex with their therapists. The most common problems
reported were difficulties in personal relationships, hesitation about seeking
further help from mental health professionals, depression, and in 11% of the
cases, hospitalization or suicide attempts.
Source: Bouhoutsos, Holroyd, Lerman, Forer, & Greenberg (1983).
Rules Related to Professional

Relationships
Professional counselors recognize that their professional relationships with
others in the field of mental health can have significant impact on their clients
as well as on the public perception of the counseling profession. As a
counselor, it is important for you to work to develop positive working
relationships in the professional community and to respect other professionals
and their work, even if the counseling approaches employed by your
colleagues differ from your own (as long as they are legally permissible).
Clients should never enter into a relationship with more than one counselor
simultaneously, and professionals are entrusted to help make sure this does
not happen. If a counselor knows that a client is currently seeing another
therapist, then the first relationship must be terminated before a new
therapeutic relationship can begin.
Counselors who serve as consultants or supervisors have the same

requirements for confidentiality, client privacy, and adherence to the ethical
codes as counselors who are in direct service with clients. Clients have the
same right to informed consent if consultants, or supervisors, will be
reviewing their cases. Counselors seek peer consultation on difficult cases,
when they plan to deviate from standard practice, or when they face
challenging ethical dilemmas.
Just as dual relationships between counselors and clients are ethically

problematic, so too are dual relationships among supervisors and supervisees
or students and instructors. This area of ethics, however, is less clear than the
rules surrounding the counselor/client relationship. Many argue that
supervisors and supervisees should not mix personal and professional
relationships, although there are certainly many real-life examples where
these boundaries are blurred. Likewise, there are those who say that
professors should not have dual relationships with their students (friendships,
dating), but this is not universally agreed upon. High profile legal cases aside
(and there are plenty of these in the news!), there is little empirical data
available on the prevalence of sexual relationships between students and
faculty or supervisors. Two national surveys of graduate students in
psychology found comparable results. One study found 13% stated that they
had sexual contact with either a professor or a clinical supervisor (or both)
during their graduate programs (Pope, Levenson, & Schover, 1979). When
only females were included in the analysis, 25% (21% in a 1986 study by
Glaser & Thorpe) said they had sexual contact with a professor or clinical
supervisor. In the study by Pope and his colleagues, only 2% of respondents
who had engaged in sexual contact with professors or supervisors reported
that they believed such relationships could be beneficial to both trainees and
educators.
Finally, the ethical codes underscore the importance of counselors policing

our own profession. First and foremost, all professional counselors and
counseling students have a responsibility to know and understand the ethical
and legal guidelines of the profession. Ignorance of the ethical codes is not a
sufficient reason for noncompliance. Welfel (2005) reminds all of us as
counselors and counseling students to consistently self-monitor our own
professional actions and to take responsibility for any misconduct.
F.8.a. Standards for Students
Students have the same obligations to clients as those required of

professional counselors.
ACA Code of Ethics, 2014
Further, as counselors, we have an ethical obligation to act if we know that

other counselors are acting unethically or if they are impaired in any way.
Professional counselors monitor the work of their colleagues and step in if
there is reason to believe there are ethical or legal violations. Likewise,
professors serve as gatekeepers to the counseling profession and do not allow
students to practice counseling if they are not sufficiently qualified or if they
are impaired.
When counselors suspect that a colleague is behaving unethically, the first

step is typically an informal face-to-face meeting. It is possible (and
sometimes probable) that the offending professional does not realize that the
action is unethical. Many counselors can recall a time when they took a
colleague aside for a quick “heads-up” about a potential ethics violation. For
example, one of us saw a professional brochure by a colleague and noticed
that the counselor had Ph.D. after her name. The counselor did indeed have a
Ph.D., but it was in a field unrelated to counseling. The counselor wasn’t
aware that the ACA ethical code specifically forbids the use of an educational
degree for the purposes of advertising if the degree is not in counseling or a
related field. Sure enough, the counselor was unaware of this clause in the
code of ethics, the brochure was changed, and there was no reason to go any
further. However, if the informal discussion does not result in adherence to
the laws and ethics of the profession, it may be necessary to file an official
complaint with the offending counselor’s professional organization or state
licensing board, or when appropriate, a law enforcement agency. Of course,
none of us likes to be in the role of “turning in” a professional colleague, but
policing the profession is an important aspect of our professional
responsibility.
Informed by Research Practicing

Counselors’ Perceptions of Ethical
Behaviors
Making good ethical choices requires complex decision-making that typically
comes from education, supervision, experience, and consultation. Even with
all of these factors in place, however, counselors can still struggle to
determine the best ethical decisions. In a 2011 study of over 500 licensed
counselors who are members of the American Counseling Association,
Neukrug and Milliken presented 77 different short scenarios and asked
respondents to identify each scenario as ethical or unethical as well as rate
how strongly they felt about their responses. Participants in the study ranged
in age from 21 to 60, and no overall differences in responses emerged based
on age, gender, race, or counseling specialty.
Although most respondents were in agreement about their ratings for the
majority of scenarios, there was significant disagreement (25–50% of
respondents disagreed) on 31 (40%) of the items. Some of these items
represented complex scenarios with competing legal and ethical demands,
such as counseling minors and whether to inform parents, and refraining from
making a diagnosis to protect a client from a third party, such as an employer.
Other items represent areas that do not have clear ethical or legal guidelines
for decision-making, such as attending a client’s graduation or other formal
ceremony, or using the title “Ph.D. candidate” in clinical practice while
completing one’s dissertation. There were several items among the 31 with
significant professional disagreement, however, that represent a very clear
misunderstanding of legal and ethical requirements by counselors in the
survey. For example, allowing clients to see their case notes, guaranteeing
confidentiality in group counseling, or pressuring a client to receive certain
services are all specifically addressed within the ACA and ASCA code of
ethics. Results from this survey demonstrate the importance of ongoing
education and consultation in professional ethics for practicing counselors.
As you think about becoming an ethical professional counselor, we hope you

take a moment to recognize the complexity of the ethics of our profession.
Even counselors who have been in practice for years can struggle to make
good ethical decisions, at times because of the competing ethical demands of
a situation, and at other times because of a fundamental lack of awareness of
the requirements included within the ethical codes. As you read through this
chapter’s Informed by Research, notice how some counselors simply are
unaware of the specific demands that our ethics make of us. We hope you
will be inspired to engage in ongoing professional learning to make sure you
always stay abreast of the changing ethical codes within the counseling
profession.
Ethics and the Law
Ethical codes are not the final authority for counselors; counselors must
adhere to both the ethical codes and the legal standards of practice. The law
and professional ethics clearly overlap, although there are differences
between the two. Activities can be legal, for example, but not ethical. An
example might be providing counseling to a close personal friend, which
although not specifically prohibited by any law, clearly violates ethical
boundaries. In other situations, activities might be ethical, but not legal. For
example, a parent may ask a school counselor to share a student’s records
with a college athletic recruiter, but unless very specific paperwork and legal
requirements are met, this is illegal. In many instances, however, decisions
have both legal and ethical ramifications, and related principles within the
law and ethics complement each other. For example, earlier in this chapter,
you learned about the ethical imperative of confidentiality, and in this
section, you will learn about the corresponding legal principle of privileged
communication. These two concepts are clearly interrelated, but they are not
the same thing. Ethical codes exist to clarify and define legal standards or to
fill in and offer guidance where the law is silent. However, in all situations,
the law takes precedence over any ethical mandates, and counselors must first
and foremost follow the legal requirements.
Legal issues in counseling are determined through state and federal statutes
and case law. Federal and state statutes are determined by governments. In
mental health, these laws are often established by legislatures in order to
protect client welfare. Examples are state statutes that determine scope of
practice or reporting of child abuse. Case law is determined by precedent.
Judges and juries make legal decisions, which are then codified into case law
and are referenced to help determine the legal standing of a particular issue
before the courts. Examples of case law include the counselor’s duty to warn
or duty to protect.
At least part of the difficulty in understanding the legal mandates for

counselors is that most of the laws that directly affect counselors are passed
at the state (or sometimes local) level. For example, in 2013, California was
the first state to pass a law making it illegal for any therapist to work with
minors to change their sexual orientation (called reparative or conversion
therapy). Since then, Illinois, New Jersey, Oregon, Vermont, and the District
of Columbia, as well as several major cities, have passed similar bans. In this
case, the law aligns with the ethical stance taken by the American Counseling
Association against conversion therapy in 1999. In other instances, however,
the laws of a state and the ethics of the profession do not align. For example,
in 2016 Tennessee passed a law that specifically allows mental health
counselors the right to refuse to treat clients based on “goals, outcomes or
behaviors that conflict with the sincerely held principles of the counselor.”
The law is in direct violation of the ACA Code of Ethics. In response to the
controversial law, the ACA Governing Council made the decision to move
the 2017 ACA Conference out of Nashville and relocate it to San Francisco.
From these examples, it is easy to see why counselors in practice must pay
attention to the ever-changing legal landscape in their state and in the nation.
In addition to the legal mandates that differ by jurisdiction, there are legal
(and ethical) requirements for the differing counseling specialties. Although
in general these principles align across specialty, there are certain legal
principles that are more salient for each of the differing types of counselors.
In one study, for example, school counselors cited the following as their top
legal and ethical concerns (with the percentage who say they’ve encountered
the situation within the last year): determining whether a student was suicidal
(90%); determining whether to report suspected child abuse (89%);
determining whether a student posed a danger to others (73%); being
pressured to verbally reveal confidential information (51%); being asked to
turn over confidential records (19%); and being subpoenaed to appear as a
witness in a legal proceeding (18%). In the specialty of addiction counseling,
common legal and ethical issues include working with involuntary clients,
counselor impairment (when the counselor is in recovery for his/her own
addiction), and mandated reporting (National Institute on Alcohol Abuse and
Alcoholism, 2017b). For counselors specializing in career counseling, some
of the most commonly identified ethical and legal considerations surround
the role of values and culture in counseling and career choice, as well as
electronic or Internet-based counseling interventions (Ajagbawa, 2014).
Fast Fact
Counselors should always carry their own professional liability insurance,
which helps protect them against legal action and covers financial risk. Many
social service agencies and schools cover their employees through the
institution’s insurance policies, but those are designed to protect the
institution, not the individual employee. The American Counseling
Association and the American School Counseling Association both offer
insurance to their members at greatly reduced prices, and as of this writing,
eligible student members of ACA and ASCA have this insurance provided
free as a benefit of membership.
Sources: www.counseling.org; www.schoolcounselor.org
We know that all of this discussion about the ethical and legal requirements
can be very intimidating, particularly to beginning counselors. Our goal is not
to frighten you or to overwhelm you with details. In this introductory text, the
goal is for you to be exposed to the major legal and ethical requirements for
counselors and to start to learn how to make appropriate decisions in practice.
But this chapter is not the final word on the topic during your graduate
program. You will have lots of time and opportunities to learn about the
nuances of these requirements and to practice their application. You will also
have your counseling supervised by more experienced practitioners who can
help you navigate the profession’s legal and ethical requirements. Remember,
counselors are required to have a basic knowledge of their own state statutes
and the case law related to their profession, but they are not required to have
advanced legal knowledge. Any time there is a legal question, counselors are
strongly urged to get legal counsel. This is particularly important because
statutes and case laws vary from jurisdiction to jurisdiction and change over
time.
Major Legal Issues in Counseling
In this section, we will overview some of the major legal requirements that
counselors must follow. In an introductory text such as this, it is impossible
to list every legal principle that applies to the counseling profession. Thus,
our goal here is to introduce you to the topic and to get you thinking about
how to set yourself up to be a legally competent professional counselor both
during graduate school and beyond.
Legal Principle: Counselor

Competency
The legal requirements that regulate the practice of counseling differ from
state to state, although all 50 states (and the District of Columbia) have
passed legislation that determines who can practice mental health counseling
and the scope of practice for counselors in that state. The determination of
who can practice school counseling also varies from state to state, and these
requirements are determined by the state’s Department of Education.
State laws that regulate mental health counseling determine who can conduct
counseling (called a practice act) or call themselves a counselor (called a title
act). These laws are supported by a body of rules that interpret and clarify the
law. The laws also determine the scope of practice for the profession, which
outlines the general areas of competency for counselors, gained through
appropriate education and experience. An individual counselor’s scope of
practice, however, is typically narrower than the scope of practice outlined by
law. For example, although a legal scope of practice in a particular state may
include psychological testing, if the counselor has not had adequate training
and/or practice in testing, then it would be unethical for the counselor to
engage in such testing. The law broadly defines the practice, and then the
counselor determines individualized limits, within the boundaries of the law.
A counselor’s professional disclosure statement is used to inform clients of
that individual’s scope of practice. In most states, mental health counselors
are required to provide clients with a copy of this statement and to display a
copy of it in a conspicuous location.
State departments of education determine who can practice school

counseling. Most (but not all) states require a graduate degree in counseling
and a licensure exam. However, in most states, the practice of school
counseling is less tightly regulated than the practice of mental health
counseling. In many states, school personnel who are not trained as school
counselors can engage in the practice of school counseling, particularly as
temporary assignments. As a result, the American School Counselor
Association (ASCA) and its state divisions have become heavily involved in
setting standards for school counselors to insure the highest levels of
professionalism among those who practice.
In general, all counselors must operate within the standards of care of the
profession. Standards of care can be defined as professional conduct as
practiced by “reasonable and prudent practitioners who have special
knowledge and ability” (Granello & Witmer, 1998, p. 372). These standards
are “professional practices followed by others in the same discipline and
either considered standard practice or at least accepted by a significant
minority of other professionals” (Meyer, Landis, & Hays, 1988, p. 15). Not
meeting the professional standards of care is considered negligence, which is
a major criterion for determining malpractice. Thus, when a client is harmed
because a counselor fails to follow accepted procedures, it is malpractice.
Failure to operate within the generally accepted standards of care of the
profession accounted for nearly 16% of all closed claims by HPSO (the ACA
provider for malpractice insurance) from 2003–2012 (HPSO, 2013).
Ways to Help Protect Yourself from

Legal Involvement Regarding
Counselor Competency:
Know the license/certification laws in your state that determine who can
practice counseling (practice act) and who can use the term professional
counselor (or whatever terms are protected) (title act). Many states have
both a practice and title act for mental health counselors.
Operate within your scope of practice. Know what limits the state
license or certification places on you and what limits you need to place
on yourself. Do not engage in interventions that are new—or new to you
—without proper training and supervision.
Keep up to date regarding counseling interventions for the clientele with

whom you work. Just because something is (or was) a widely heralded
intervention does not mean it is effective. Read journals and professional
publications and attend professional conferences and workshops that
update you on the effectiveness of different interventions and the latest
thinking in the field. One good way to help you do this is to join your
national (and state) professional organizations.
Graduate Students and Counselor

Competency:
The legal concept of counselor competency applies to graduate students
as well as practicing counselors. Of course, it is unrealistic to think you
will be completely ready to practice counseling during your graduate
practicum and internship, and no one expects that of you. This is why
there are strict standards in place for supervision of your counseling
during your graduate school training.
To help protect yourself from legal involvement during graduate school,

we encourage you to:
Make the most of your supervision. Be forthcoming with your

supervisor about your clients and cases so that you can receive
proper assistance with meeting the standards of care of the
profession.
If you are interested in a particular type of counseling or in working
with a specific population, seek out opportunities to engage in this
work during your graduate training, with proper education and
supervision, of course.
Legal Principle: Client Rights and

Informed Consent
Clients have the right to make informed choices about counseling before they
enter into the counseling relationship. Informed consent is both a legal and
ethical issue. Clients must fully understand what they can expect from
counseling, including potential risks, benefits, and alternatives to counseling.
In school settings (or in any counseling situation with minor clients), school
counselors engage in informed consent with parents or guardians. In some
school districts, counselors must obtain parental permission before beginning
counseling with students, although other districts require such permission
only if ongoing counseling is sought. Remley and Herlihy (2010) argue that
unless there is a specific school policy or state law to the contrary, school
counselors do not need parental permission before they provide counseling to
students. However, this stance is controversial, and not everyone agrees. The
American School Counselor Association has a website dedicated to helping
school counselors navigate challenging legal and ethical issues, and you may
wish to explore this topic in more depth (see:
https://www.schoolcounselor.org/school-counselors-members/legal-ethical).
When making decisions surrounding informed consent, it is important for any
school counselor to check with the school administration to determine how
the legal mandate of informed consent is enforced within each particular
school. Regardless of the policy on parental consent, minor students cannot
give informed consent. Nevertheless, although not a legal responsibility,
many school counselors argue that it is important to obtain assent from their
student clients, meaning that students understand the counseling relationship
before they enter into it.
Informed consent is based on three legal requirements. In order for clients (or
parents) to enter info counseling as an informed participant, they must have:
1. Capacity to make rational decisions. When capacity is lacking (either

because the client is a minor or because the client lacks the cognitive
ability to have capacity) typically a parent or guardian must give consent
for the counseling relationship to begin.
2. Comprehension of the information that is presented by the counselor.

That means the information must be presented by the counselor in a
clear and unambiguous manner, using common language (not clinical
language or psychological terms).
3. Voluntariness or the freedom to enter into counseling without coercion

or under duress.
Counselors want to give clients the information they need to make informed
decisions, yet they must be careful not to overwhelm clients with irrelevant
details. Putting information in writing (and having clients or parents sign a
copy stating that they have received and read the information, as well as
providing a copy for clients to keep) is one way to assist with informed
consent. However, it is not sufficient to simply provide a written informed
consent form. Clients and counselors must also engage in a verbal discussion
of informed consent—one that is checked by the counselor for
comprehension by the client.
Areas that are typically included in informed consent are:
Qualifications, credentials, affiliation, and education of the counselor
Specific areas of counselor competence
General procedures and goals of counseling
Costs associated with counseling, if any
Whether the counselor is being supervised or engages in consultation

with colleagues, including expectation to share case notes, recordings, or
transcripts of the session
Limits of confidentiality
Use of diagnostic labeling and/or reporting to insurance companies or

other third parties
Emergency procedures
Informed consent is a process, not something that is “gotten out of the way”
in the first session and never addressed again. Although there is no one
absolutely right way to present informed consent information, care should be
taken to make sure that it is presented in a variety of formats (written, verbal),
at a language and literacy level that clients can understand, and presented in a
manner that empowers (rather than intimidates) the client. Counselors will
want to consider the intellectual capacity and emotional state of their clients
when they present informed consent issues to them.

Informed Consent:
Make sure that all counseling relationships include a discussion of
informed consent at the beginning. Check the client for capacity,
comprehension, and voluntariness. With involuntary clients, be sure the
client understands the legal right to refuse treatment and the
consequences for that choice.
Use language that clients understand. One study of informed consent

documents found that the majority were written in a language equivalent
to upper-level college reading level (Paasche-Orlow et al., 2013).
Be sure to discuss types of interventions that will be used, particularly if

the intervention is not standard practice.
Re-visit informed consent issues during treatment, particularly at

“choice-points” in counseling (when considering sending clients to a
psychiatrist for medication, when considering termination, etc.).
Pay attention to cultural issues in informed consent. Clients from some

cultures may be inclined to defer to the counselor, rather than consider
their own participation or rights in counseling, while others may wish
to include community elders or family members in their decisions
regarding informed consent.
Graduate Students and Client

Rights and Informed Consent:
It is an essential legal (and ethical) requirement for graduate students to
inform their clients of their graduate student status. Graduate students in
counseling practicum or internship cannot introduce themselves or
present themselves as counselors, when, in fact, they are counselors-in-
training.
To help protect yourself from legal involvement during your graduate

training, we encourage you to:
Develop protocols and strategies (with help from your supervisors

and instructors) to inform your clients that you are a student and
that you will be discussing their case in supervision
Seek supervision when you are uncertain about a client’s legal

ability (capacity, comprehension, or voluntariness) to give
informed consent.
Legal Principle: Privileged

Communication and Confidentiality
Confidentiality is the counselors’ ethical duty to keep client information
private, and in most states, is a legal as well as ethical requirement. Privileged
communication is a related legal concept that insures that whatever is
discussed in the therapeutic relationship cannot be revealed in a legal
proceeding, unless certain criteria are met. Counselors who have their notes
subpoenaed should always consult with an attorney. At a minimum,
counselors will want to get written consent from their clients authorizing the
release of information or a court order from a judge before they release their
records (Kennedy, 2008). Counselors are most commonly served with
subpoenas in cases related to divorce or parental custody. Only 20 states have
granted privilege to school counselors (Stone, 2015). Thus, a school
counselor’s notes are subject to subpoena. Therefore, only essential data
should be contained in these notes, and they should be written in specific,
objective, and behavioral terms.
The legal protection of confidentiality cannot be extended to minors, as

parents or guardians have the legal right to know what occurs within a
counseling session. In general, however, counselors rely upon their
professional expertise to determine what information should be shared with
parents. The developmental level of the student often plays into this
determination, as in general, “the more mature the minor, the greater the
measure of confidentiality that young person is given in counseling” (Welfel,
2016, p. 152). However, counselors cannot use the protection of
confidentiality to keep information from the parents of any minor child if that
information is specifically requested by the parents. Just as with informed
consent, school counselors making determinations about student
confidentiality should understand their state laws and school policies and
consult with more experienced colleagues and supervisors when they have
questions.
Even when working with adults, confidentiality is not an absolute guarantee.

There are certain situations when counselors are both ethically and legally
required to break confidentiality. The three major legal exceptions to
confidentiality that are present in all states are:
1. Danger to self—if clients are suicidal or pose a danger to themselves,

there is no privileged communication or confidentiality. The counselor
must place client safety over clients’ rights to confidentiality.
2. Danger to others/society (and in some states, danger to property)—this
limit on confidentiality arose from the Tarasoff case (Tarasoff v. Regents
of the University of California, 1976), in which the court held that a
mental health professional must warn a potential victim of a dangerous
client, overriding the client’s right to confidentiality. In cases where a
counselor reasonably believed or should have believed that the client
posed a serious danger to an identifiable potential victim, the counselor
must warn the potential victim. This is called the duty to warn. A more
recent case expanded the duty to warn to include any persons who could
be foreseeable victims, not just those specifically identified by the client.
An extension of the Tarasoff case ruled that counselors also have a duty
to protect—that is, counselors must do everything in their power to
protect potential victims, such as hospitalizing dangerous clients, having
physicians increase medication, etc. The duty to warn and the duty to
protect laws are broad, and it is sometimes confusing to understand the
specific requirements placed on individual counselors. Because of this,
29 states have passed laws that further define these duties (National
Conference of State Legislators, 2015).
3. Abuse (and in some states, neglect) of children or elder abuse (required

in some states). In all instances, child abuse must be reported. This is a
legal responsibility. Counselors need only the suspicion of child abuse to
make a report. It is not the counselor’s responsibility to investigate or
substantiate the suspicion, which is the role of child protective services.
Mandated reporting of child neglect and elder abuse varies by
jurisdiction.
SPOTLIGHT The Special Case of

Confidentiality in Group or Family
Counseling
When the counselor and client are the only two people in a room, it is fairly
easy for the counselor to ensure confidentiality. However, in group, family,
or couples counseling, confidentiality becomes a shared responsibility, rather
than the sole domain of the counselor. Counselors who work with more than
one client simultaneously help educate clients or group members about
confidentiality and its role in establishing a trusting and therapeutic
environment. Group norms that reinforce confidentiality are important, and
counselors can emphasize the need for everyone to respect the privacy of all
members of the group. Counselors can ensure their own commitment to
confidentiality, but they cannot ensure that other members of the group will
honor this commitment. Ultimately, it is up to the group (or family) members
to maintain confidentiality.
There are other exceptions to confidentiality that apply in certain legal

settings or situations. For example, confidentiality (and privilege
communication) can be waived by the client. In these instances, clients agree
to have information shared with other professionals (e.g., psychiatrists, social
workers), with the court system (e.g., in custody cases), or when suing the
counselor. The other exception that applies most directly to counseling
students occurs when a counseling student (or new professional) is receiving
clinical supervision, and the client is aware that an authorized supervisor will
be reviewing case notes or recordings or transcripts of sessions. In all
instances, it is important that clients understand the limits of confidentiality
before treatment begins (with periodic reminders during treatment).
Because confidentiality is more complex than it may first appear, it is

important for counselors to continually seek supervision and consultation
when questions about confidentiality arise in practice. Inappropriate sharing
of client confidential information accounted for nearly 13% of all closed
claims from HPSO (the malpractice insurance provider for ACA) from 2003
to 2012 (HPSO, 2013).
In the accompanying Spotlight earlier on this page, you read about a very
special concern that arises regarding confidentiality in counseling—that
which occurs when there is more than one client in the room. As you read
through the Spotlight, we hope you will see how complicated this legal
principle can be in practice.

Confidentiality and Privileged
Communication:
Make sure clients fully understand confidentiality—and its limits—
before beginning counseling. Although most counselors agree that this is
important, there is some evidence (admittedly old, but this research is
hard to do!) that fewer than half of counselors actually do so (Simon,
1988).
Try to involve the client in the process when confidentiality must be

broken. Most ethical codes recommend informing clients, and to the
extent possible, involving clients in the disclosure.
Contact a lawyer immediately if you are subpoenaed. Try to maintain

client privacy.
If a client waives privileged communication, make sure the client fully

understands the risk of such a move, including any negative evaluations
that could be disclosed about that client.
Graduate Students and

Confidentiality:
In the previous section, you learned that you must inform your clients
that you are a student and that you are seeking supervision about your
cases. This same rule applies here. Clients must know that you are in
supervision and how this affects the limits of confidentiality.

Take extreme care when discussing anything about your counseling
experiences with anyone other than your supervisor! You may be
used to coming home in the evening and talking about your day
with other people in your life, but you cannot do this when it comes
to counseling. Legally, we cannot discuss our clients with anyone,
outside of the context of professional consultation and supervision.
Legal Principle: Documentation and

Records
Documentation, record-keeping, and the handling of client and student
records are all components of counseling that have very stringent legal
requirements. Some problems with documentation, such as insurance fraud or
falsification of records, are very clearly wrong and are legal violations that
are obvious to even the most novice counselor. Other legal violations,
however, are more nuanced, and require a greater understanding of the law.
Documentation is a critical component of the counselor’s role. Good case

notes allow counselors to be thoughtful and intentional in their interventions
because it forces us to stop and think about what has already occurred in
counseling, how the session aligned with the client’s goals, and where
treatment should go next. State requirements differ regarding what should be
included in a client’s records, but at a minimum, mental health counselors
should document the presenting problem, diagnosis, treatment plan, treatment
progress, results, and follow-up plan. When working with potentially
dangerous or difficult clients, it is important to document abuse and threats to
self or others, including actions (such as consultations or reporting to
authorities) taken by the counselor (Kennedy, 2008). Documentation by
school counselors varies greatly by school district, and school counselors
should consult local experts, including colleagues and supervisors, for
guidelines.
Words of Wisdom
“If it isn’t documented, it didn’t happen.”
Source: Common adage related to documentation in mental health care.
Legally, counselors must follow the requirements of the Health Insurance

Port-ability and Accountability Act (HIPAA) of 1996. The key requirement
of this Act is that clients have a reasonable expectation that all health records
will be kept private and confidential. This is the same Act that regulates all
medical professionals. Perhaps you have been to a doctor’s office lately and
signed legal documents that allow your doctor to submit a bill to an insurance
company or to share records with another medical provider. If so, then you
have been affected by HIPAA requirements. Counselors, just like all medical
professionals, must carefully safeguard clients’ Protected Health Information
(PHI). All records, both hard copy and electronic, must be carefully secured.
Hard copy information should be double-locked, meaning that a person
would have to break through two different locks (for example, the door
locking the room and the lock on the file cabinet) to access the information.
Electronic records can be particularly challenging for HIPAA compliance. In
general, encryption of all client data is required when transmitting data, and
all counselor records should be password protected. Most agencies keep
separate computers that do not link to the Internet or e-mail services to store
client records. HIPAA requires counselors to make a conscious effort to keep
client records secure.
An additional federal requirement for documentation by educators, including

school counselors, is the Family Educational Rights and Privacy Act
(FERPA) enacted by Congress in 1974. Also called the Buckley
Amendments, this law states that federal funds can be withheld from any
educational institution that (a) fails to provide parents access to their child’s
educational records or (b) disseminates any information from a student’s
educational records (with a few exceptions) to any third party without the
parent’s permission. In accordance with FERPA, school counselors cannot
share student records with any third party, unless there is an emergency
situation where it is necessary to share this information in order to protect the
health or safety of other students or individuals (Kennedy, 2008). Letters of
recommendation written by school counselors are an expected, normal, and
integral part of the duties of a school counselor, and letters sent to a third
party (such as a college admissions office) are clearly permissible.
Counselors should be reminded, however, that students (or parents) have
access to these letters. Therefore, letters of recommendation should be sent
only at the request of students (or parents), and should be factual and free of
malice.
When it comes to case notes written about students by school counselors,

there is less clarity in FERPA. School counselors in general do not keep
prolific notes about their counseling sessions. Case notes might include the
student’s name, date, and a few hasty words to help jog the counselor’s
memory, except in situations of suspected abuse, suicidal or non-suicidal
self-inflicted injury (NSSI) behaviors, or other instances where information is
likely to be subpoenaed in legal proceedings (Gearhart, 2005). In general, a
school counselor’s handwritten notes about a student are not considered to be
an education record under FERPA and are therefore “not subject to access or
disclosure rules” (Cheung, Clements, & Pechman, 1997, p. 16). However,
once the notes are shared with anyone else, they become part of the record
and are subject to FERPA. In addition, the counselor’s private notes are
always subject to subpoena in legal proceedings. It is for this reason that the
American School Counselor Association (2016) recommends that counselors
periodically review information obtained from students as well as any
handwritten private notes about students and retain only what is currently
relevant. The legal requirements surrounding student records and the role of
the school counselor has led to confusion for many school counselors and has
led some in the field to call for more clear guidelines for school counselors
and student records (Merlone, 2005).

Legal Involvement
RegardingRecordkeeping:
In order to promote accurate record-keeping, counselors may wish to follow
these guidelines:
Maintain the security of paper files at all times. Files cannot be left
where they can be accessed by unauthorized persons. All trash of a
confidential nature must be shredded. If files are stacked on a desktop,
they should be kept face-down. Keep protected health information
separate from other files and locked in a secure cabinet.
Maintain the security of electronic records. Files on computer must be

password protected. Sign off or lock your workstation when you leave
your desk. Set up your computer so the screen faces away from other
people.
Exercise caution when communicating with clients electronically.

Counselors and clients alike must understand the limits of
confidentiality when communicating electronically (e.g., email, text
messaging). Counselors should take care to maintain appropriate
professional boundaries when communicating in these media. Finally,
counselors must consider the treatment issues that may arise using this
format. For example, if a client emails a counselor after hours or on the
weekend about an emergency situation, what if those emails remain
unread? Clearly, electronic communication with clients represents a
challenging aspect of counselor-client relationships (Bradley, Hendricks,
Lock, Whiting, & Parr, 2011).
Write notes that are clear, objective, and behaviorally based. Include
only relevant information. Use nontechnical language. If subjective or
opinion statements are made, separate them from the facts and clearly
mark them as opinion or professional judgment. Remember: All clients’
files may someday be seen by the client or the courts. Be very clear
about what is written in them.
In the case of client emergencies or other critical incidents, maintain

very detailed notes of all that was done in order to assist the client,
particularly in cases where the client is a danger to self or others or
when the client refuses treatment. Document extensively.
Graduate Students and

Recordkeeping:
In practicum and internship classes, graduate students are often required
to bring client notes to supervision, but this can represent a potential
violation of confidentiality if documentation with identifying
information is removed from the site where the counseling occurs.

Never put information about clients in email or other electronic

formats that are not encrypted. We often see on the national student
listserv for graduate students in counseling (COUNSGRADS) an
appeal for assistance for work with a specific client. It is never
okay to put this information in an email format.
Develop a very secure system for protecting any client records that
you take off site (with permission of your site supervisor, of
course).
Continue to seek supervision on writing case notes that meet the

standards of your site and align with the legal and ethical
requirements of the profession.
Other Legal Requirements for

Counselors
There are, of course, many laws and legal precedents that have relevance to
counselors and the counseling profession, and there are several key factors
that make understanding the legal mandates for counselors particularly
challenging. First, many of the laws vary from state to state. For example,
involuntary commitment of persons who are considered a danger to self or
others is regulated by each state. In some states (Florida, for example),
mental health counselors are among the list of professionals who have this
legal power. Second, the laws related to the practice of counseling are
constantly evolving. For instance, in some states, mental health counselors
are seeking legal rights for mental health holds, which would allow
counselors to have a person considered dangerous to self or others taken into
custody and immediately transported to a hospital for a risk assessment. In
other states, school counselors are supporting legislation that would put more
money—and more accountability—into career planning for middle school
students. If the legislation passes, school counselors would be among those
required to complete additional paperwork in exchange for more funding.
Third, legislation is not the only type of legal mandate counselors must
follow. Case law and legal interpretations of the rules to implement
legislation at the state and national level also influence counseling. For
example, recent suicides by students who were bullied in schools may result
in case law that changes how schools respond to reports of bullying in their
buildings or on-line. In other states, courts are scrambling to determine how
professionals will be affected by legislation regarding reporting of
undocumented immigrants. The point is that laws and legal requirements
differ by jurisdiction and are constantly changing. Counselors must keep up-
to-date to insure their practice follows the latest professional and legal
standards. Membership in state and national counseling associations is one of
the best ways to stay abreast of, and help advocate for, changes and updates
to the laws that regulate the profession.
The following are several national laws that are of particular importance to
counselors:
Health Insurance Portability and Accountability Act (HIPAA, 1996)

establishes national standards for the protection of medical records and
other personal information, including behavioral health information. The
law also gives individuals the right to access their healthcare
information.
Family Education Rights and Privacy Act (FERPA, 1974) protects the
privacy of student education records, and gives parents certain rights to
these records.
The Americans with Disabilities Act (ADA, 1990) prohibits

discrimination on the basis of disability and improves accessibility for
persons with disabilities in everyday life. Counselors who engage in
testing must use tests that are appropriate for persons with a disability or
modify or seek alternative assessments, as appropriate.
IDEA (Public Law 94-142) (1975) guarantees the rights of all children,
regardless of severity of disability, to free and appropriate education.
The law establishes the use of annual individualized educational plans
(IEPs) that allow children with physical, emotional, or intellectual
disabilities and their parents to participate in the educational process. In
2004, IDEA was re-authorized with updated requirements. School
counselors are typically very involved with the provisions of IDEA,
particularly in the development IEPs as well as participation in meetings
with students and their families.
Title IX (1972) requires that schools with federal funding provide equal
access to students of both sexes. School counselors adhere to these
requirements by using gender-neutral, nonstereotypical materials in their
counseling and classroom guidance instruction and promoting equality
between the sexes in their schools.
No Child Left Behind Act (NCLB, 2001) was designed to make schools
accountable for student learning and to make sure at-risk students were
not left behind academically. School counselors have been greatly
affected by NCLB, with both positive and negative consequences.
Accountability efforts as mandated by NCLB resulted in more data
about the effectiveness of school counseling programs, and that data can
be use to demonstrate how school counseling programs support and
enhance academic progress for all students. However, NCLB also led
school counselors to become more involved with paperwork and test
administration, with less time available for interactions with students
(Dollarhide & Lemberger, 2006).
Every Student Succeeds Act (ESSA) was passed in 2015 to replace

NCLB. The major purpose of ESSA was to pull back the involvement of
the federal government in education. The American School Counselor
Association was directly involved with the passage of ESSA and helped
to write requirements within the new law that would lessen the burden
of paperwork and test administration for school counselors.
When Counselors Violate Ethical
and Legal Requirements
In this chapter, we have taken the stance that counselors want to engage in
highly ethical and legally sound practice. We believe that no one enters the
profession of counseling with the intention of behaving unethically. In fact,
most people enter the profession because they have a deep and heartfelt
desire to help others, and the idea of behaving unethically is something they
would never consider. Nevertheless, ethical and legal violations among
counselors continue to be a major concern in all counseling specializations
and in all jurisdictions across the United States. Although there are no
national statistics on the number of ethical violations by counselors, the data
from one state can help underscore the magnitude of the problem of ethical
violations in the helping professions. In just one state (Texas) each year, the
licensure board’s investigation unit typically opens up to 40 new cases of
alleged ethical violations committed by counselors
(https://www.dshs.texas.gov/counselor/default.shtm).
Counselors who fail to follow the profession’s ethical mandates and legal
requirements can face serious professional and personal ramifications. When
counselors engage in legal and ethical violations, it can have devastating
effects on the counselor, the client, and the entire counseling profession.
Because of the potential for significant harm that violations can cause, there
are structures in place to help address both legal and ethical concerns.
Overall, standards of practice in counseling are enforced through four
mechanisms: (1) professional ethics committees, (2) state licensure boards or
Departments of Education, (3) civil courts, and (4) criminal courts.
Professional Ethics Committees

These committees are established by counseling associations at the state or
national level. Decisions of ethics committees are binding only to members
of the association. If a person is a member of a particular association (e.g.,
ACA, AMHCA, ASCA) or holds a credential (e.g., from NBCC) and violates
an applicable code of ethics, then the professional ethics committee of that
association can deliver some sort of punishment or sanction, ranging from a
letter of warning, to expulsion from the organization, to a referral for possible
legal action. Counselors who do not belong to professional associations
cannot be sanctioned by them, but the association can notify law enforcement
for legal action, when necessary.
State Licensure Boards or State

Departments of Education
State licensure boards regulate the practice of professional counselors in each
state, and professional school counselors are regulated by their state’s
department of education. If an ethical or legal violation is reported to the
state, the state licensing board or administrative arm of the state’s department
of education will assess the seriousness of the violation and determine the
punishment, which can range from a reprimand, to a period of probation, to a
sanction for additional supervision or coursework, to revocation of a license
or credential. Persons who do not hold a license or certification in the state
cannot be sanctioned by a state licensure board, but they can be referred to
law enforcement for legal action, when necessary.
Words of Wisdom
“Each time I get my copy of the newsletter [from our state licensure board],
the first thing I do is look at the listing of the disciplinary actions taken
against licensees. It’s amazing. There is always a bunch of names of my
fellow counselors, what they did, and what punishment was given to them. I
find myself holding my breath as I read through the list—I’m always hoping
and praying that I won’t read the name of someone I know. I think it would
be terrible to be ‘called out’ that way in front of your colleagues. I guess it’s
one more reason to stay on the straight and narrow!”
Source: Shari W., practicing counselor
State licensure boards publicize the names of counseling professionals who

have been found guilty and have been sanctioned by the board. The names of
these professionals and the sanctions that have been imposed are typically
listed in board newsletters that go out to members of the profession in that
state and/or are posted on the website. Information regarding violations is a
matter of public record, and the posting of this information serves to inform
the public (and other professionals) about violations and whether or not a
specific professional has been sanctioned by the board.
In this chapter’s Snapshot, we introduce you to a lawyer who investigates

legal and ethical violations that are brought to the state’s counseling licensure
board in Ohio. As you read through the Snapshot, notice how Mr. Hegarty
emphasizes the importance of keeping up to date with changing laws and
ethics in the profession counseling.
Regardless of whether or not the professional association or state boards have

taken action on a specific complaint, counselors who engage in legal
violations can find themselves involved in the legal system, through either
criminal or civil courts. In general, civil law involves an offense to an
individual for which there must be compensation to the victim. In counseling,
malpractice is the most common cause of civil liability. Malpractice is
professional conduct that falls below the standard of practice of similar
professionals in similar circumstances. Thus, a counselor can be sued for
malpractice if the practice or intervention is outside of what reasonable
professionals would do in similar circumstances. You may recall reading
about this earlier in the chapter, under the legal principle of counselor
competency. The remedy for civil violations, such as malpractice, is typically
monetary compensation.
Malpractice requires the following three elements:
The counselor must have duty to the client (that is, there must be a
contract, or implied contract, of a professional relationship between the
counselor and client)
The counselor must have acted in a negligent or improper manner (that

is, acted outside of what is the professional standard of practice)
There must be a causal relationship between negligence and damage

claimed by client (the counselor’s action—or inaction—caused harm to
the client).
The final type of enforcement is through the criminal courts. Criminal law for
counselors involves conduct that is prohibited by all citizens. The most
frequent criminal misconduct by counselors is fraud related to third-party
billing. In some states, engaging in sexual contact with clients is considered
criminal misconduct. In some instances, such as failure to report suspected
child abuse, legal violations can be prosecuted both civilly and criminally,
which can have both civil and criminal legal ramifications. Criminal
misconduct requires punishment by the government, including imprisonment
and/or fines.
Ethical Decision-Making in Practice
Learning to counsel at the highest level of legal and ethical practice is an
advanced skill. Beginning counselors, who are more black and white in their
thinking than more advanced counselors, are often eager to have “answers”
about what they “should” do. Some ethical mandates lend themselves to that
kind of approach. For example, it is never okay to have sex with a client. It is
always the right thing to do to report suspected child abuse. But other
counseling situations are more nuanced and do not have easy answers. For
this reason, several models help counselors make decisions that follow the
best ethical practice when confronted with difficult and challenging ethical
dilemmas. These models are intended to supplement, not replace, the codes
of ethics, and it is always important for counselors to seek consultation and
supervision when they encounter ethical challenges, no matter how many
years they have been in practice or how advanced their clinical decision-
making has become.
SNAPSHOT William (Bill) Hegarty

I have been the Deputy Director and in charge of the investigations of alleged
ethical infractions by licensed mental health professionals for the Ohio
Counselor, Social Worker, and Marriage and Family Therapist Board for
over 18 years. I am an attorney by profession and try to bring that skill set
into investigation situations. Over this time period I have seen the full range
of ethical violations—from the more minor types (being late for session on
occasion), to the more serious (client record problems), to the most severe
(having a sexual relationship with a client).
One of the most important things about entering into the mental health
profession is the need to be aware there are codes of ethics and, more
importantly, laws and rules a licensee must follow. No matter what state you
end up practicing in, there are laws and rules that govern the profession. And
they change! It is important as a licensed professional that you take a pro-
active role in your profession by keeping up to date on the state laws and
rules and by being active in your state or local counseling association. One of
the more amazing things I find when I talk to someone under investigation is
the total lack of awareness that a set of laws and rules exists—and that they
may have changed over the last ten years!
An equally important part of entering into a new profession or even

remaining an integral part of a profession is the understanding that you do not
know everything. That is why it is so important that a licensed professional
seek supervision and peer review. This should not be considered a formality
or something you “have to do,” but really it is an opportunity for professional
growth and development. Seeking out quality continuing education
opportunities is another important means of learning new things and keeping
up with the changes taking place. We all make mistakes, which is why we all
need to understand our limitations and abilities and then to seek out
supervision and peer review when a question arises. The last thing a license
professional wants to do is inadvertently harm their clients.
As a licensed counseling professional, you must be aware of your scope of

practice. This may differ from state to state, so it is incumbent upon you as a
professional to know what your scope of practice is and to work within it. If
you have a question about whether an action may be outside of your scope of
practice, seek supervision and peer review.
What I have seen with new counselors entering the profession is that some
may be overconfident in their abilities, which prevents them from seeking
needed supervision. Others are not organized or cannot manage time
effectively, which inevitably leads to problems with client records. Another
problem is that some new counselors put so much pressure on themselves to
succeed that they lose the ability to empathize with their clients. This can
make you less effective as a professional.
In short, counseling can be an exciting stimulating profession. It also takes

hard work every day not to lose sight of your client’s best interests. In order
to be an effective professional counselor, you must know your limitations,
always seek supervision and peer review, keep abreast of the changes taking
place not only in the profession but in the laws and rules as well. Your
counseling education is the first step of your professional journey.
Fast Facts
In ethical decision-making, consider these three simple tests to determine
whether your course of action is appropriate.
1. Test of Justice. Does your decision fit with your own sense of fairness?
2. Test of Publicity. Would you be willing to have your behavior reported

to the press? Would you stand up in class (or at a professional
conference) and proudly announce what you have done?
3. Test of Universality. Would you recommend the same course of action

to another counselor in the same situation?
Source: Stadler (1986).
One model for ethical decision-making (Forester-Miller & Davis, 1996),

reminds counselors to first seek a resolution through the relevant ethical
codes. If the problem is more complex than can be answered by the ethical
codes, the next step is a review of the professional literature and/or
consultation with more experienced colleagues or state or national
professional associations. Based on these activities, the counselor should
generate possible alternatives, carefully considering the potential
consequences of each option, seeking additional consultation as appropriate.
Once a decision has been made and implemented, the counselor should assess
whether the actions had the intended effect and consequences.
In difficult ethical situations in counseling, Kitchener’s (1984) seminal work

is often used to determine the highest standards of ethical practice. Kitchener
believed that five ethical principles can serve to help counselors adhere to the
highest level of aspirational ethics.
Autonomy is the right of clients to make their own choices. Unless there
is a compelling reason to the contrary (e.g., danger to self or others),
clients should be free to act as they desire.
Nonmaleficence can be summed up as “above all, do no harm.” It means

counselors refrain from intentionally inflicting harm on their clients and
refrain from any action that may cause harm.
Beneficence is when counselors act in a way that contributes to the well-

being of their clients. It is an obligation to provide aid and assistance, to
be proactive, and to help clients.
Justice involves fairness. It means clients have equal access to services

and resources, and counselors ensure that they do not discriminate. If
counselors treat clients differently, then there must be a therapeutic
rationale for doing so.
Fidelity means keeping promises and commitments and being loyal to

clients. Fidelity is based on a bond of trust in the counseling
relationship. Counselors know that their primary responsibility is to their
clients.
There are other models for ethical decision-making in practice. For example,
a model based on feminist theory gives the client as much power as possible
in the ethical decision-making process (Hill, Glaser, & Harden, 1995). This is
similar to models of ethical decision-making based on a multicultural
perspective (Frame & Williams, 2005). Another model uses cognitive
counseling theory to develop decision-analysis, or a step-by-step procedure to
break down an ethical decision into its component parts, testing the logic and
rationality of each step (Rest, 1994). Still another model uses a social
contructivist approach whereby ethical decision-making is a social process
that involves an interactive process of negotiating, arbitrating, and reaching
consensus (Cottone, 2001). The STEPS (Solutions to Ethical Problems in
Schools) model by Stone incorporates the developmental and chronological
age of the student into the ethical decision-making process (2007). The point
is not about which model is correct, but about the importance of using a set of
procedures to help guide ethical decision-making in counseling. Counselors
use these types of models to begin to disentangle the complicated ethical
scenarios that are often part of their professional lives.
Summary
Professional counselors must be ever vigilant of their behaviors to ensure that
they are conducting themselves in a way that is both legally and ethically
appropriate. Aspirational ethics, or striving to achieve the highest level of
ethical functioning, is one effective way to minimize risks of engaging in
unethical or illegal behaviors. Awareness of the relevant law (both state
statutes and case law) in the counselor’s jurisdiction as well as the ethical
codes of the relevant professional organizations is essential to maintaining
legal and ethical practice.
Attention to ethical and legal issues in counseling is an ongoing concern for

counselors, not something to be completed and checked off a “to-do” list.
Counselors should continually monitor their practice, consult with
colleagues, attend workshops, and read the professional journals to keep
abreast of changes in practice as well as changes in pertinent laws and rules.
Counseling students can begin the practice of adhering to professional ethics
and the legal mandates of the counseling profession during graduate school.
Ethical practice is a way of being, and a strong self-awareness, along with an
understanding of the laws and rules, is a critical component of ethical
behavior.
Student Activities
2. As you read about all of the legal and ethical requirements for
counselors, what are your reactions? Do you find yourself feeling
overwhelmed or anxious? How do you think counselors manage to keep
up with all the legal and ethical responsibilities for practice?
3. Some ethical codes, such as that for the Code of Professional Ethics for
Rehabilitation Counselors (2009), include foundational values to which
all members of the profession are expected to commit. What do you
think of this idea? Is it the place of a professional association to require
adherence to personal values from members of the profession? Can
personal and professional values be separated?
Journal Question
1. Counseling ethics. In any area of your life, have you encountered a
professional (e.g., auto mechanic, realtor, doctor, lawyer, landlord,
teacher, supervisor) who acted unethically? Think of a specific situation
in which you were the recipient of what you believed to be unethical
behavior. As you think of that situation, can you recall many of the
details and specifics of how you were wronged? Consider for a moment
the experiences of the person who committed the unethical act.
Typically, the person who was unethical does not remember the
situation with the same clarity as the person against whom the act was
committed. In many situations, in fact, the unethical behavior may seem
like “no big deal” to the person who committed it, but remains a
lingering and painful memory to the person who was the recipient. How
can you relate your experience of receiving unethical treatment to the
importance of maintaining ethical behavior as a counselor?

1. Take a moment to think about strong values that you hold and how these
may affect your counseling. Is there a particular type of client (or
presenting issue) that would be difficult for you to counsel? For
example, some counselors struggle with clients who have strong
religious beliefs, are having an affair, or choose to have an abortion.
Other counselors might have more difficulty working with clients who
have sexually abused children, harm animals, or use drugs. What are
your “hot buttons”—the places where you may have particular difficulty
maintaining your clients’ rights to pursue their own choices? Remember,
this is not about being “values-free,” but about being aware of your own
values in these challenging areas so you can avoid imposing your values
on your clients.
2. As you consider the differences between minimal and aspirational

ethics, think about what might make aspirational ethics so much more
challenging for counselors in practice?
3. Dual relationships are a particularly challenging component of the

ethical codes for most counselors to navigate. What are some of the
reasons why counselors might give to engage in dual relationships? Can
you think of a time when dual relationships are okay? Why do you think
the ethical codes include so many cautions against these types of
relationships?
Experiments
1. Counselors must post their professional disclosure statements for their
clients, and many counselors post their disclosure statements online.
Collect some examples of professional disclosure statements and
consider how the information contained in them might (or might not) be
useful for clients to know before they begin counseling.
2. Think about a typical ethical challenge that a counselor might face and
consider how Kitchener’s model might apply to the scenario. How can a
careful consideration of these five ethical principles help counselors
make ethical decisions?
3. Go to your state licensure board website and find the listing of

counselors who have engaged in ethical or legal wrongdoing. What are
the most common types of violations that counselors in your state are
committing, and what can you learn from this experiment?
Explore More
1.
Books
Barnett, J. E., & Johnson, W. B. (2014). Ethics desk reference for
counselors (2nd ed.). Alexandria, VA: American Counseling
Association.
A clear and concise reference to help counselors prevent ethical conflicts

and to find appropriate responses to ethical situations when they arise.
Remley, T. R., Hermann, M. A., & Huey, W. C. (2010). Ethical and

legal issues in school counseling (2nd ed.). Alexandria, VA: American
School Counselor Association.
Topics include confidentiality, managing suicidal or potentially violent

students, child abuse and neglect, supervision, and navigating the
complex legal arena of schools.
Wheeler, A. M., & Bertram, B. (2015). The counselor and the law (7th
ed.). Alexandria, VA: American Counseling Association.
Topics include civil malpractice liability, confidentiality, HIPAA, duty

to warn, threats of harm to self or others, professional boundaries,
records, and documentation.
Articles
Granello, P. F., & Witmer, J. M. (1998). Standards of care: Potential
implications for the counseling profession. Journal of Counseling and
This article provides counselors with an overview of the important legal
requirement of standards of care, including case studies to assist with
application of the principle to counseling practice.
Kitchener, K. S. (1984). Intuition, critical evaluation and ethical

principles: The foundation for ethical decisions in counseling
psychology. Counseling Psychologist, 12, 43–55.
This foundational article describes Kitchener’s model, which has now

become a standard in the counseling profession.
Welfel, E. R. (2005). Accepting fallibility: A model for personal

responsibility for nonegregious ethics infractions. Counseling and
Values, 49, 120–131.
Welfel encourages counselors to adopt a self-reflective stance regarding

ethics and to monitor their own interactions with a goal toward
aspirational ethics.
Websites
Explore the ethical codes of the various counseling specializations,
which are available on their websites. They differ in scope, content, and
“feel.” Some are direct and concise while others are more general,
providing overall guidelines rather than specific dictates.
The American School Counselor Association has issued position

statements on a wide variety of counseling topics, many of which are
related to values, ethics, and the law. These can be found at: http://
www.schoolcounselor.org/school-counselors-members/legal-ethical
Support Wellness in Themselves
and Their Clients?
Questions
That a wellness philosophy is part of counseling’s foundation.
Some history of wellness in the counseling profession.
The definition of counselor impairment and ways to prevent impairment.
The specific challenges to wellness that exist in the work of counseling.
The importance of identifying sources of strength in ourselves and our

clients.
Construct a Personal Wellness Plan for yourself.
Identify potential sources of burnout for the counselor.
Identify strength-based assessment and intervention strategies for a

client.
What strategies will you use to help maintain your own wellness as a
counselor?
12. self-care strategies appropriate to the counselor role

Wellness is a positive and active approach to mental and physical health. It is
not disease oriented but strength based. Counselors believe that fostering a
person’s strengths can help the person cope, but also help them thrive. But
clients must also take responsibility for their own wellness. We cannot just go
to the doctor; we must also take the medicine. In this case, the medicine is a
set of positive attitudes and skills such as physical exercise, good diet,
positive thinking, and social support that a counselor recommends. In this
chapter, we look at how counselors take care of their clients by teaching and
supporting them in some of the basic tools of wellness and asking them to
engage in a program of positive self-change. As we adopt this perspective
with clients, we begin to recognize that as counselors, we need our own
wellness because of the psychological stresses of the job. Thus, a wellness
philosophy applies to clients and is also the basis for self-care in the
counselor. In the first section of this chapter, we begin with some definitions
and a little history to describe how wellness has become a foundation of the
profession.
A Brief Historical Sketch of
Wellness in Counseling
The spark that lit the wellness fire in the health care community was the 1947
World Health Organization’s definition of health as “a state of complete
physical, mental, and social well-being, not merely the absence of disease or
infirmity” (World Health Organization, 1958). At the time, there was no term
for this positive state. In the early 1970s, the only label for wellness was
“preventive medicine,” which focused mainly on staving off epidemics,
providing safety tips, and advocating for good nutrition. At that time,
physicians did not study healthy people; they were mainly interested in
diseases. In psychology, George Albee lobbied for the separation of
psychology from psychiatry and wanted the profession to focus more on
prevention of psychopathology. He was interested in primary prevention,
which focuses on strategies to avoid the development of pathology, rather
than responding to problems after they arise. He believed that psychologists
should work at the institutional and governmental level to address
inequalities and social conditions that produce or contribute to people’s
mental problems.
Words of Wisdom
The counseling profession shall promote optimum health and wellness for
those served as the ultimate goal for counseling interventions.
Source: Principles for Unifying and Strengthening the Counseling

Profession, the delegates of 20/20: A Vision for the Future of Counseling,
American Counseling Association.
But it wasn’t until the 1980s, as stress became a household word, that mental
health professionals realized that psychological factors play a role in physical
health. Stress workshops became common in workplaces and agencies, and a
new term entered the counseling lexicon: coping. Richard Lazarus and
colleagues (Lazarus & Folkman, 1984) found that coping strategies for
coping with stress differ and that people can be taught better ways of dealing
with the burgeoning “hurry sickness.” This was a major step in the wellness
movement because, for the first time, we were not looking at a problem, but a
solution.
One of the pioneers of the wellness movement in counseling was Donald B.

Ardell (1976, 1988) at the University of Central Florida (UCF). He created
one of the first campus wellness programs for students and it is still in
operation today. About this same time, J. Melvin Witmer, professor of
counselor education at The Ohio University, was teaching a class on
wellness, which was initially entitled “Stress, Biofeedback and Self-Control.”
Witmer also wrote about the implications of a wellness philosophy in one of
the first books on wellness counseling, Pathways to Personal Growth (1985).
He linked wellness in counseling to the humanistic movement and Adlerian
philosophy because of their emphases on growth and wholeness (holism)
(Witmer, 1985). Based on this early work, Myers, Witmer, and Sweeney
(1996) developed the WEL Inventory, a multidimensional evaluation of
wellness that evaluates the following areas of wellness:
Spirituality (meaning in life, derived from inner wisdom, higher

consciousness, and/or a Supreme Being)
Sense of Worth (self-acceptance, self-esteem)
Sense of Control (sense of competence, perceived ability to cope)
Realistic Beliefs (logical, rational understanding of the world)
Emotional Responsiveness (willingness to experience and share

emotions)
Intellectual Stimulation (being mentally active, challenging your

thinking, engaging in new learning)
Sense of Humor (ability to laugh appropriately at oneself and the world,

to use humor to cope with life’s difficulties)
Nutrition (healthy, balanced eating that maintains one’s ideal weight)
Exercise (engaging in an active, healthy lifestyle)
Self-Care (limiting exposure to danger by not using substances, by

wearing seatbelts or helmets, by seeking preventive health care)
Stress Management (ongoing assessment of one’s coping resources,

using methods for stress reduction as appropriate)
Gender Identity (satisfaction with one’s own gender, as expressed by the

individual)
Cultural Identity (satisfaction with one’s cultural identity)
Work and Leisure (activities that contribute to financial resources,

feeling satisfaction with work and leisure, ability to engage in work and
leisure with high levels of competence)
Friendship and Love (connectedness to others in both platonic and

romantic relationships)
J. Melvin Witmer, Wellness Counseling professor and pioneer.
After the development of the original WEL, Myers and Sweeney (2005a),
using factor analysis, produced another research instrument, the Five Factor
Wellness Inventory. They identified five major aspects of wellness that
encompass the 17 subscales as follows:
Creative Self: Thinking, Emotions, Control, Positive Humor, Work
Coping Self: Realistic Beliefs, Stress Management, Self-Worth, Leisure
Social Self: Friendship, Love
Essential Self: Spirituality, Self-Care, Gender Identity, Cultural Identity
Physical Self: Exercise, Nutrition
The WEL Inventory and the Five Factor WEL allows counselors and clients
to see how they are doing on each of the dimensions of wellness and develop
a wellness plan. These instruments also provide tools for those who want to
study wellness (see Myers & Sweeney, 2005b, 2008). Both tests are available
online at http://www.mindgarden.com.
Words of Wisdom
The universal striving for wholeness is as old as mankind.
Source: J. Melvin Witmer

Definitions and Dimensions of
Wellness
Frequently, wellness has been confused with physical health. For example,
the former Surgeon General, David Satcher (2009), wrote an article on
“taking charge of wellness programs in schools,” but discussed only nutrition
and exercise. The medical community has tended to utilize the concept of
wellness as a synonym for physical illness prevention. On the other hand,
some fitness experts and other health practitioners are focused on a “peak
health” concept, which suggests that wellness means the pinnacle of total
health that we can all attain. The premise is that everyone can become disease
free and extremely healthy, which is evidently not true.
What is needed is a definition that focuses on people who have developed an

intentional plan to be “all that they can be.” In other words, wellness is
exemplified by the individual who is persistently working on developing a
sense of well-being and quality of life in all spheres, even when suffering
from acute or chronic mental or physical problems. In this vein, the National
Wellness Institute (2017) defines wellness as “an active process through
which people become aware of, and make choices toward, a more successful
existence” (para. 1). Further, the institute expands this definition by
identifying three aspects of wellness:
1. Wellness is a conscious, self-directed, and evolving process of achieving

full potential.
2. Wellness is multidimensional and holistic, encompassing lifestyle,

mental and spiritual well-being, and the environment.
3. Wellness is positive and affirming. (para. 1)
Below we look at these three aspects in a little more depth.
1. Wellness is self-directed: It involves responsibility and self-actualization

The first aspect of the definition emphasizes a sense of personal
responsibility for one’s own wellness. Previously, we saw science and
medicine as the only route to better health. Responsibility suggests that
our own habits and choices are vitally important. In addition, it also
indicates that our goal, connected to the humanistic paradigm, is to
achieve self-actualization, exploring our own potential. To do so, we
must be intentional. When we are intentional about our own wellness,
we make choices about who we want to be, how we want to react, and
what actions we want to take to enhance our own lives. In their book,
Choosing Brilliant Health (2008), Foster and Hicks suggest that rather
than respond reflexively to life’s stressors and problems, we ask
ourselves three questions to make wellness intentional:
What is my attitude or behavior right now?
Is this the most beneficial attitude or behavior?
Is there a more beneficial attitude or behavior I can choose?
Fast Facts
Genes account for only about 25% of an individual’s health and
longevity, while our environment and personal behaviors account for the
rest.
Source: Butler (2010).
Counselors know and understand the power of helping clients make

intentional choices for optimal living. Still, we must realize that some
things, like genetics and some life events, are outside of our control. In
addiction counseling, clients learn this through the Serenity Prayer. The
prayer is: “God grant me the serenity to accept the things I cannot
change; courage to change the things I can; and wisdom to know the
difference.” The message of the prayer is that we need to recognize we
cannot control everything, yet we must continue to seek self-
improvement. When we take responsibility for our lives and also accept
what fortune bestows, we move toward wellness.
2. Wellness is multidimensional: Holism is an important aspect of the

wellness philosophy Wellness is a holistic phenomenon. That means that
the separate parts of human functioning in body, mind, and spirit are
interrelated, each affecting the other. In this way, wellness is like a web
(Witmer, 2011). Each strand or dimension may be separate, but a
vibration in one affects all the others. Let’s take the example of sinusitis,
a very common physical disorder, which arises when the lining of the
sinuses swells. We can identify many causes of sinusitis: viruses,
bacteria, fungus, nose blowing (pressure makes the sinuses swell), scuba
diving, certain medications, allergies, asthma (preexisting conditions),
temperature and humidity, narrow sinus passages (genetic), mucous
membranes not functioning properly, dehydration, poor air quality,
hormonal imbalance, stress, polyps, tumors, and even sexual activity
(Monteseirin, Camacho, Bonilla, Sanchez-Hernandez, Hernandez, &
Conde, 2001). Therefore, the causes or ends of the web originate from
interpersonal, physiological problems such as hormone imbalance, from
the environment, from our genetic history and diet, and from habits and
behaviors.
The same holistic concept of sinusitis also applies to mental disorders

and everyday problems in living. For example, it is likely that
depression has many causes, and can be treated from physical, mental,
emotional, and/or spiritual perspectives. We often approach treatment in
a “shotgun” manner, as the specific causes can be elusive. So, let us say
that a person’s depression seems to be associated with irrational
thoughts and beliefs about the world, including the depressive triad
(negative view of self, the world, and the future) (Beck, 1975). With a
holistic view in mind, we might engage the client in cognitive
behavioral therapy, but we would also try to get the client to increase
physical activity, possibly refer the client for antidepressant medication,
get the person to activate social supports, and encourage a balanced diet.
In other words, because most problems involve many different aspects
of a person’s life, the solution may also come from multiple directions.
As you consider the concept of holism in wellness, think about your own
life. When you are feeling stressed or overwhelmed, do you use one
strategy or many to address the problem? You might organize your work
space to eliminate clutter, try to eat better, take a walk, and talk with a
friend. The point is, many of us naturally understand the need for
multiple inroads into a problem, and a wellness approach asks us to
bring this same holistic model to our work with clients.
3. Wellness is positive: It is strength-based Wellness approaches

emphasize optimal functioning by discovering and promoting the factors
that allow individuals to thrive (Seligman & Csikszentmihalyi, 2000).
The counselor with a holistic wellness philosophy tries to identify the
client’s strengths and utilize them in the service of the client’s goals. A
book on this topic, Strength-Centered Counseling (Ward & Reuter,
2011), ties together the philosophy of wellness with postmodern
theories, such as solution-focused and narrative therapies. The
connecting thread is that the client’s existing abilities and strengths can
be activated when we identify times when the client has met with
success and then encourage the client to adapt those strengths to a
current problem. The approach empowers clients to be experts in their
own treatment, reminding them that they have many strengths and
positive qualities that they can bring to the current situation. In this
chapter’s Counseling Controversy, we consider the dialectic between
strengths-based and disorder-based counseling. As you read the
controversy, consider if there is a side of this debate toward which you
naturally gravitate.
Dimensions of Wellness
The dimensions of wellness we present here are the major aspects of life that
affect our overall wellness. Even though we think of a wellness approach as a
holistic one, we discuss these dimensions as separate entities. This approach
allows us to evaluate the client’s (or our own) current strengths and develop a
personal wellness plan to maintain optimal functioning. Roscoe (2009)
looked at nine different theories of wellness and identified eight common
components. We have identified six dimensions that these theories share.
Social Wellness: Social wellness refers to the amount of support one

gives and receives. Having a good social support network is the best
buffer against stress. Social support combats loneliness and isolation.
There is a large body of research to support the finding that low levels of
social support increase the risk for different types of mental disorders,
especially depression (Adams et al., 2016; Turner & Brown, 2010).
Adler was among the first to think about the need for social
connectedness in clients. He considered “social interest” to be a prime
indicator of mental health and a key motivator. It means being interested
and committed to others. For example, he asked clients to do a good
deed every day. So, social wellness is not just receiving support but
being interested in others and engaging in acts of altruism. Social
interest is not extraversion. It is a healthy curiosity and feeling for one’s
community. Do you give in relationships as well as take? Are your
relationships intact and of high quality? An ongoing discussion in the
field is the influence of electronic social support on social wellness.
How do you think “Facebook friends” factor into this definition of social
wellness?
Emotional Wellness: Emotional wellness is related to Goleman’s 1990

concept of Emotional Intelligence (Goleman, 1990). Goleman believed
that this specific ability means being aware of your own emotions and
those of others. In addition, it means knowing how to handle the
emotions of others and express your own emotions productively.
Similarly, emotional wellness refers to the ability to be aware of
feelings, manage overwhelming negative feelings, and express feelings.
Most definitions of emotional wellness emphasize the ability to control
negative emotions, but emotional wellness also means the ability to
experience positive emotions, which can improve mental health
(Patnaik, 2013). Through optimism, hope, gratitude, and even
meditation, positive emotions are produced that increase happiness and
well-being (Lambert, Fincham, & Stillman, 2012; Zeng, Chiu, Wang,
Oei, & Leung, 2015). There is evidence to support the claim that
negative emotions (e.g., anger, anxiety, depression) can suppress the
immune system or raise blood pressure. Conversely, the ability to
express positive emotions has been linked to a strengthened immune
system (Kllay, Tincas, & Benga, 2009).
Counseling Controversy
Strengths-Based vs. Disorder-
Based Counseling
Background: Abraham Maslow (1966) said, “It is tempting, if the only
tool you have is a hammer, to treat everything as if it were a nail” (p.
16). He may have borrowed this quote from Mark Twain. In short, we
tend to use familiar tools. Maslow was highlighting the importance of
the “law of the instrument,” which suggests that if we look through a
particular lens, the instrument itself changes our perspective. There is
also an Indian saying that the “pickpocket in the crowd only sees
pockets.” In short, we tend to see what we expect to see, what we have
been trained to see, and what we want to see.
The law of the instrument is particularly important in the controversy

concerning whether we should primarily focus on diagnosis and mental
disorders or whether we should focus on clients’ strengths. If we focus
on illness, will we begin to see only people’s problems and not their
strengths? If we fail to recognize diagnoses, will we miss something
crucial in our clients’ makeup that could affect their treatment? In short,
this controversy surrounds how much training and emphasis we should
give to psychopathology and how much time and effort we should spend
in finding and getting clients to utilize their strengths. Is there a middle
ground?
POINT: MENTAL COUNTERPOINT: FOCUSING

DISORDERS EXIST, AND ON ILLNESS KEEPS US MIRED
THEY SHOULD BE THE IN THE MEDICAL MODEL AND
PRIMARY FOCUS OF OBSCURES OUR VISION OF
COUNSELING STRENGTHS AND WELLNESS
Identifying a mental
disorder in an individual
provides the basis for
treatment planning. Clients with similar labels are
Without diagnosis, we will quite likely to have different
not select the best treatments.
treatments for a particular
disorder. People are not merely the sum of
their problems, and these labels
In addition, research needs override client strengths.
these categories so that we
can study what works best A wellness philosophy does not
and identify evidence- preclude treating mental
based treatments. disorders, but it suggests that
utilizing existing strengths and
Merely focusing on a improving overall wellness will
client’s strengths instead of be more effective than focusing
the major mental disorder only on the disorder.
may be disastrous if the
client’s symptoms are not When all we learn to look for is
brought under control first. illness, we will find it. Just as
students who learn
Counselors need to know psychopathology see symptoms
how to speak the language in themselves, they also start
of the mental health seeing them in others.
professions if we are to
communicate about clients.
Physical Wellness: Physical wellness involves regular physical activity

to maintain cardiovascular health, flexibility, and strength (Hettler,
1980). In addition, physical wellness includes eating a healthy diet,
engaging in good nutritional practices, maintaining regular doctor’s
appointments, and adhering to medical treatments. In short, physical
wellness is not just going to the gym and going on a diet. It means
making healthy lifestyle choices such as walking up the stairs rather than
taking the elevator and changing eating habits to eat more fresh
vegetables and fruits. It involves an attitude of taking charge of our own
physical condition and actively engaging with health care providers.
Making healthy choices is not just for the young and able-bodied. Even
those who have significant chronic illnesses or disabilities can take
charge of at least a portion of their own physical wellness. Although
taking the steps may not be an option for a person with a disability,
working to keep (or strengthen) whatever mobility is available to you is
important. In short, physical wellness is an approach to taking control
over whatever part of your physical health you can manage.
Intellectual Wellness: We frequently hear that as we age, we need to

keep mentally active, do crosswords, keep learning, and generally
stimulate the mind. Stimulating the mind means actively and creatively
using the mind to solve problems, acquiring new knowledge, and
generally developing an identity as a lifelong learner. Watching
television is a passive way of interacting with media, and as we grow
older, it is easier for both mind and body to become a couch potato.
Intellectual wellness means refusing to accept that you cannot learn,
create, or grow because of your circumstances and making a determined
effort to stay intellectually fit. Graduate students sometimes tell us that
their school work forces them into intellectual wellness and there is no
need for more growth. We remind them that intellectual wellness is far
more than learning a field of study. It involves approaching life in an
inquisitive and curious manner, seeking new information and
experiences. Do you read the news every day? Do you try to learn
something that is outside of your “comfort” zone? Do you engage in
lively debates about (non-counseling) topics with people who challenge
you to grow? Do you read (or write) fiction or poetry or talk to people
from other countries or cultures? Intellectual wellness means
challenging your mind.
Spiritual Wellness: Spirituality is a broader concept than religion.
Spirituality means a personal relationship with God, a higher power, or a
higher purpose. Others see spirituality as a deep sense of connectedness.
Religion, on the other hand, is a group activity involving beliefs, rites,
scriptures, and rituals. The Dalai Lama (2001) teaches that religion is
just one type of spirituality, and spirituality is expressed by basic
spiritual values, such as qualities of goodness, kindness, love,
compassion, tolerance, forgiveness, human warmth, and caring. The
greatest mental health benefits seemed to accrue from spiritual rather
than religious activities. Being engaged in religious and spiritual
practices such as meditation, prayer, and worship have been shown to
positively affect physical and emotional health (Brown, Carney, Parrish,
& Klem, 2013; Cashwell, Bentley, & Bigbee, 2007; Roach & Young,
2011).
Most models of wellness include purpose in life as a core aspect of

spiritual wellness (Young, 2011). Purpose in life suggests that you
believe your life has meaning is coherent, and is significant (Martela &
Steger, 2016). Clients (and counselors) who do not have a religious
tradition may at first struggle with the idea of spirituality being part of
wellness, so understanding spirituality in this broad sense can be
extremely helpful. Having a sense of meaning in life can have an impact
on your health (e.g., Agardh, Ahlbom, Andersson, Efendic, Grill,
Hallqvist, Norman, & Östenson, 2003). There are a variety of activities
that can lead to a sense of meaning, purpose, and coherence in life.
These activities may involve a higher purpose, such as working to end
poverty or homelessness, creating beauty, caring for animals, and so on.
Because these activities connect us to others in meaningful ways, they
can be spiritual. But it is also quite possible to have a sense of meaning
in life without a religious or spiritual practice. Thus, it appears that
meaning and spirituality may be separate entities (Young, 2011).
In the accompanying Spotlight, Loving-Kindness Meditation is

presented as a technique to help people connect to others and develop
their sense of spirituality. As you read through the description, consider
how such an approach might be used with clients as they work to
incorporate a sense of meaning and purpose into their lives.
Occupational Wellness: Counselors recognize the important role that
work plays in our lives. Occupational wellness involves the degree of
satisfaction people derive from work. At the same time, being
occupationally well means being able to strike a healthy balance
between your job and personal relationships and other life demands
(Gatchel, 2012). For example, work/home spillover is the tendency to let
aspects of the job bleed into home life. The restorative qualities of home
are then eroded by the requirements of work. With more people working
from home, many complain that there is no clear stopping point at the
end of the day. Work takes over physical space as well as the emotional
space that is intended for family and friends. Some people are infected
with the obsessive need to stay in contact with their work via cellular
phone, e-mail, and texts at all hours. Thus, the time they use to recover
is diminished by a technology that never sleeps. Coupled with
demanding or stressful jobs, the result can be diminished physical
health.
SPOTLIGHT Loving-Kindness
Meditation
Monica Leppma, Ph.D., Counselor
Loving-kindness meditation combines mindfulness (i.e., nonjudgmental

awareness of the present moment) with the cultivation of warm,
compassionate emotions. It is similar to guided imagery, although the
practice involves mindfully focusing on feelings more than visualizations
(Fredrickson, 2009). Meditation can be used to improve awareness, self-
regulation, well-being, and spiritual development (Walsh & Shapiro, 2006;
Young, de Armas DeLorenzi, & Cunningham, 2011). However, loving-
kindness meditation is aimed at training the mind to generate feelings of
warmth, kindness, and compassion toward ourselves and others (Fredrickson,
2009). This practice seems to be particularly suited to counselors, because
our profession requires a great deal of giving and caring on the part of the
counselor. Thus, we need ways to replenish ourselves and then joyfully
reconnect with others.
The process of loving-kindness meditation begins by sitting in quiet
contemplation and focusing on your breath and then your heart. Once you
feel centered, you access feelings of loving-kindness by bringing to mind a
person or pet that you love a great deal. Visualizing what it feels like to be
with this loved one, allow warm, tender feelings to arise. Once you are in
touch with these emotions, gently allow the image of your loved one to fade
and take ownership of those warm feelings, and then attempt to direct those
feelings toward yourself. You are the source of these feelings, and they can
be directed wherever you choose. This can be quite challenging at first but
becomes easier with practice (Fredrickson, 2009; Salzberg, 2005; Weibel,
2007).
The next part of the meditation involves slowly expanding those loving, kind,
compassionate feelings outward. Typically you begin with people you love
and have a connection with, then slowly and gently radiate toward neutral
people, possibly people you have had difficulty with, and then your entire
community. Ultimately, you extend these feelings to all people, all beings,
and eventually the whole planet. As you imagine radiating these feelings in
an ever-widening circle, it is customary to silently repeat positive intentions
such as, “May my friend be happy” or “May my colleagues be happy.”
Alternately, you may wish health, safety, or the ability to live with ease. You
may repeat positive intentions for yourself, others, and eventually all beings.
As you end the meditation, you can remind yourself that you have the ability
to generate these positive feelings any time you wish (Fredrickson, 2009;
Salzberg, 2005; Weibel, 2007). In a major research study, loving-kindness
meditation was been shown to be an effective method for increasing positive
emotions, increasing feelings of life satisfaction and social support, and
decreasing physical symptoms and symptoms of depression (Frederickson,
Cohn, Coffey, Pek, & Finkel, 2008).
Occupational wellness reminds us that getting the most satisfaction from our
job helps us feel better in all aspects of our lives. We need not be in high-
power or high-status occupations to have a happy work life. Did you ever
notice that some people work hard to make their jobs more fun or more
fulfilling, no matter what they do? For example, one of us (Darcy) makes an
extra effort to go through the checkout line of a particular grocery clerk, even
if the line is a little longer than the others. The clerk is friendly, talkative, and
has a great sense of humor. He really enjoys his job, and his positive
approach to life is infectious. Occupational wellness for the counselor is
particularly important because your job satisfaction will affect the clients you
serve. Finding the right job, the right agency, the right school, the right boss,
and so on, are all helpful but you must also find a way to maintain wellness in
the other aspects of your life so that you can bring your best to counseling.
Wellness in Counseling
Counselors who want to incorporate a wellness approach in their counseling
describe the wellness concept to clients and collaboratively evaluate them on
each of the dimensions. Clients can then make goals to enhance their
wellness. We caution our clients not to try to change everything all at once,
and counselors help clients identify two or three areas to work on and set
reasonable goals. As with all counseling goals, small changes that improve
wellness in one area of our lives often have ripple effects on the other
dimensions of wellness (see Do One Thing Different by Bill O’Hanlon,
1999). Counselors who help clients enhance their wellness through this
approach do not ignore other problems or concerns that a client may have;
they simply recognize that a wellness plan can serve as an important
complement to more traditional counseling approaches. Using wellness as a
guiding principle, counselors help clients identify their optimal selves,
finding the strengths and skills they already possess. In this chapter’s
Snapshot, Dr. Paul Granello, a Licensed Professional Clinical Counselor,
discusses how he incorporates a wellness perspective into his counseling
practice. As you read through the Snapshot, you might want to consider how
you could incorporate aspects of wellness into your work with clients.
Strengths-Based Counseling
Wellness counseling begins by assessing the dimensions of wellness and
developing a plan to improve those areas. Another way of thinking about a
positive approach to counseling is finding a person’s strengths and using
them to overcome problems and lead a full life (Rashid, 2015). Counselors
who adopt a strengths-based approach focus on what the client does well.
Counselors and clients work together to identify past and present successes,
and then build on those successes to face current problems or challenges.
Strengths-based assessment
The first step in strengths-based counseling is identifying the client’s
strengths so that they can be activated. The Values in Action Inventory of
Strengths (VIA-IS; Peterson & Seligman, 2004) is a 240-item inventory that
can be taken at viacharacter.org without cost.
SNAPSHOT Wellness Counseling

Paul F. Granello, Ph.D., LPCC, Certified Wellness Counselor
I have been interested in wellness and its role in counseling and mental health
for over 20 years. Paradigm change in health care can be a very slow process,
but I have seen steady growth in attention to wellness in health care and in
counseling. In my practice, I provide Wellness Counseling and train Certified
Wellness Counselors, who are already licensed counselors seeking additional
training and experience in applying wellness in their counseling practice. The
Wellness Counseling that I provide to clients can be characterized by several
important tenets. First, clients are multidimensional. They have many
interrelated and important domains, including social, emotional, physical,
cognitive, and spiritual. My assessment encompasses the totality of the client
and focuses on abilities and strengths, not just the identification of
pathological symptoms. Second, all clients are capable of personal growth in
some area of their lives, and improvement in one area will positively impact
other areas. Toward that end, the entire lifestyle of the client is a potential
target for therapeutic interventions. As a result, treatment planning that comes
from a wellness perspective may be a bit broader than it is for counseling that
focuses exclusively on the mental and emotional domains. I may also play a
role that includes a bit more emphasis on treatment coordination for the
client, particularly if other health professionals are brought in as consultants
on the case. For example, when I work with clients with depression, I may
encourage them to pursue a nutritional consultation or develop a walking
program in consultation with their primary care provider. Third, when
working with clients from a wellness orientation, I am willing to draw from
multiple theoretical approaches, apply models for behavior change, use
motivational interviewing techniques, and recognize the value of working
with professionals in other health care professions. I am open to my clients
working with complementary and alternative medicine (CAM) providers,
such as massage therapists or acupuncture therapists. I try to provide my
clients with quality advice about which CAM procedures have some research
behind them and steer them toward quality providers. Fourth, I realize that
making any significant change in life is difficult, and I seek to have a very
supportive therapeutic relationship with all my clients. Encouragement,
support, self- and social accountability, and positive feedback are all
important elements of counseling from a wellness philosophy. Finally, I
believe that everyone can benefit from this type of intervention. Clients who
need help changing a lifestyle habit or those who have a chronic physical
disease and are looking to optimize their health are appropriate for services.
Additionally, I have found that even clients with severe and diagnosable
mental and emotional disorders can benefit from a wellness perspective. It
might be easy when a client has so many pathological symptoms to adopt a
problem-based focus. But counseling from a wellness perspective reminds us
that all clients, even those with significant obstacles to overcome, are far
more than just the sum of their problems.
We often encourage our counseling students to complete this strength-based

assessment, not only to learn about a strength-based approach, but also to
identify their own strengths from which they can work as they build their
counseling practice. The VIA-IS identifies 24 character strengths:
Spirituality
Appreciation of beauty and excellence
Gratitude
Creativity, ingenuity, and originality
Love of learning
Perspective (wisdom)
Fairness, equity, and justice
Bravery and valor
Capacity to love and be loved
Judgment, critical thinking, and open-mindedness
Kindness and generosity
Curiosity and interest in the world
Self-control and self-regulation
Hope, optimism, and future mindedness
Humor and playfulness
Leadership
Modesty and humility
Social intelligence
Citizenship, teamwork, and loyalty
Forgiveness and mercy

Industry, diligence, and perseverance
Honesty, authenticity, and genuineness
Zest, enthusiasm, and energy
Caution, prudence, and discretion
There are other strengths inventories, including the StrengthsFinder

associated with the book Strengthsfinder 2.0 (Rath, 2007). The instrument is
available online, and you can also gain access by purchasing the book (used
books will not give you access to the test). The test assesses knowledge,
skills, and talents primarily focused around 34 themes aimed at business and
work settings. Thus, it is easy to see which of your strengths will work best in
a team, committee, or group project setting.
Strengths-based assessment and

counseling
Rashid and Ostermann (2009) make observations and suggestions for
implementing strengths-based assessment in clinical practice. Among these
are the following:
1. Utilize assessments of positive emotions and strengths. For example,

assess strengths with the VIA-IS or other positive psychology
instruments online or consult The Oxford Handbook of Methods in
Positive Psychology (Ong & van Dulmen, 2006), which has instruments
you can copy with permission. Some of the areas that are very important
to assess are the client’s level of hope and meaning and purpose in life.
2. Use the intake interview to assess strengths as well as problems. For

example, include questions like the following:
What are you good at?
What brings meaning and purpose to life?

What holds you together?
Who supports you?
3. Help clients identify their own strengths:
Discuss examples of famous people who used their special

strengths to overcome obstacles, such as Thomas Edison (struggled
in school and with speech and became a famous inventor); Richard
Branson (has dyslexia, founded Virgin Atlantic); Steven Hawking
(has ALS, is well-known physicist); Helen Keller (deaf and blind,
became political activist); Sudha Chandran (lost leg to amputation,
became most acclaimed and influential dancer in India).
Think about books and films that tell stories that clients admire
(positive film list in Snyder & Lopez, 2007, pp. 19–22) to allow
clients to compare their ideals with their present reality and identify
what strengths they wish to use more often.
Positivepsychologynews.com creates an annual awards list for the
best positive psychology movies of the year.
Consider a technique called “Positive Introduction” in which

clients introduce themselves in a positive way. The story is about
300 words and it has a beginning, a middle, and a positive ending.
It should be about a time when the client was functioning well. The
client is asked to discuss particular strengths employed during this
incident.
4. Ask family and friends to validate a client’s self-assessment of strengths.

The client may not be the only one with information about positive traits
that can be used in counseling.
5. Assess how a client has historically handled the most important

challenges of life as well as the daily stressors. Sometimes setbacks
provide us with the most important growth experiences, especially if we
can identify what resources we employed to overcome them.
6. Assess strengths early in counseling. If you start with deficits, the client
believes that this is what you want to discuss and will expect to always
talk about problems.
7. Look for signs of flourishing. These are times when the client is
operating at a high level of functioning.
8. Develop a plan that suggests that clients use strengths when faced with
particular common difficulties. For example, “When I feel anxious, I
will utilize my spiritual resources and meditate or pray.”
Fast Facts
Even clients with the most severe and debilitating presenting problems can
benefit from a strengths-based assessment in addition to traditional
assessment techniques. For example, Marsha Linehan and her colleagues
developed the Reasons for Living Inventory to help suicidal individuals and
their counselors recognize the important reasons clients have for staying
alive, despite the internal pressure they might feel to take their own lives.
When used in conjunction with other assessment techniques that measure
suicide risk, it can be a powerful tool that helps instill hope while
simultaneously assessing risk.
Source: Linehan, Goodstein, Nielsen, & Chiles (1983).
Strengths-based interventions
Counselors who use a strengths-based approach use a variety of intervention
techniques that complement more traditional approaches. For example,
counselors might focus on positive emotions to help negate the harmful
effects that negative emotions can have on the body, called the Undoing
Effect. Counselors might also use a concept called Broaden and Build, where
positive emotions are used to help broaden a person’s thought-action
repertoire, thereby encouraging a person to pursue a wider range of interest,
thoughts, and actions. In this way, counselors encourage clients to fully
experience their positive emotions, not just concentrate on the negative ones.
Other strengths-based interventions include mindfulness (a state of
nonjudging, open curiosity), flow (a state of intense absorption in work as
intrinsically rewarding), and learned optimism (the ability to cultivate a talent
for joy and happiness). Counselors teach clients to use daily gratitude
journals, which have been demonstrated to improve positive affect (Emmons
& McCullough, 2003). (For more ideas about strengths-based interventions,
see Gander, Proyer, Ruch, & Wyss, 2013.)
The Stress of Counseling and
Potential for Burnout
Counselors live in a world of wounds. Like physicians, counselors see the
effects of horrible accidents and psychological scars inflicted by others. So,
every counselor must find a way to cope with two particularly challenging
aspects of the job: (1) vicarious trauma, and (2) burnout. Vicarious trauma
occurs when a counselor is significantly affected by the experiences of the
client. Vicarious trauma is the cumulative effect of seeing others in mental
anguish. All counselors have heard client stories that deeply affected them,
both positively and negatively. Although we take great joy when clients
overcome adversity, we are often wounded by the stories our clients tell us
about their lives. It is impossible to listen to someone’s story of abuse,
betrayal, or grief and not have it touch you. Recognizing and attending to the
pain that we can feel when we hear these stories is essential to maintaining
our own wellness. Help comes in the form of supervision and our own
personal counseling.
Words of Wisdom
“Empathy is a double-edged sword; it is simultaneously your greatest asset
and a point of real vulnerability.”
Source: Larson (1993, p. 30).
Fast Facts
School Counseling Caseloads Increase, and So Does Counselor Stress
The American Counseling Association (2013) found that the national average
ratio of students to school counselors increased from 460:1 to 470:1 between
2012 and 2013. California’s ratio was the highest at 815:1 and Wyoming was
the lowest at 181:1. ACA recommends a ratio of 250:1.
Source: American Counseling Association. (2013). Counselor to student ratio

chart. Retrieved from: https://www.counseling.org/docs/default-
source/public-policy-faqs-and-documents/2013-counselor-to-student-ratio-
chart.pdf?sfvrsn=2
Burnout is the term used for long-term exhaustion, resulting in diminished

interest, low energy, and reduced sense of personal accomplishment.
Counselors are vulnerable to burnout as they manage the pressures and
stressors of heavy caseloads, clients with significant pathology, and
organizational systems and constraints (e.g., school policies, paperwork,
tightening budgets) while trying to maintain a sense of emotional stability for
clients. Burnout can have negative effects on a counselor’s life, both
professionally and personally.
Informed by Research A National

Survey of Counselor Wellness and
Impairment
Gerard Lawson, surveyed 500 counselors in the Lawson (2007). He started
with 1,000 names and had a return rate of about 50%, which is considered
very good. First, he asked participants to complete the Career Sustaining
Behaviors Questionnaire (CSB; Stevanovic & Rupert, 2004), which assesses
strategies that help a counselor keep a positive attitude and work effectively.
The top 12 strategies the counselors identified were the following:
1. Maintain a sense of humor.
2. Spend time with partner/family.
3. Maintain a balance between professional and personal lives.

4. Maintain self-awareness.
5. Maintain a sense of control over work responsibilities.
6. Reflect on positive experiences.
7. Try to maintain objectivity about clients.
8. Engage in quiet leisure activities.
9. Maintain professional identity.
10. Participate in continuing education.
11. Engage in physical activities.
12. Spend time with friends. (Lawson, 2007, p. 28)
Next, Lawson assessed their quality of life using the Professional Quality of
Life Scale (ProQOS; Stamm, 2005). The inventory has three scales:
Compassion Satisfaction (the degree to which they are deriving satisfaction
from their work), Burnout and Compassion Fatigue (the degree to which they
are unable to show compassion), and Vicarious Traumatization (the degree to
which they are stressed by their clients’ problems). He found:
1. About 14% of the counselors were not deriving satisfaction from their
work.
2. More than 5% were said to be experiencing burnout.
3. About 11% were showing compassion fatigue or evidence of vicarious

traumatization.
In this chapter’s Informed by Research, we consider results of a large

national survey about how practicing counselors perceive their own wellness
and strategies they use to help cope with the stressors of the job. The same
survey also asked counselors to assess their own levels of burnout. As you
read the feature, consider strategies you might use to attend to your own
wellness as a counselor and counseling student. The topic of maintaining
your own wellness as a counselor is one we will return to later in this chapter.
Consider the following story from a counselor, Robert, age 25, who has been
working for about two years in a public mental health agency:
Although I was right out of my master’s program, my first job was to

see all kinds of clients including children, adolescents, and adults. I ran
two groups per week. One of my first clients was a 16-year-old girl who
was cutting herself nearly every day. Another client was a grieving 58-
year-old man who had run over his 2-year-old granddaughter. My third
client was very difficult because she had a long history of abuse. She
called nearly every day and frequently threatened to complete suicide. I
realized that I was under a great deal of stress. I was having trouble
sleeping, was thinking about my clients all the time, was irritable with
my family, and was angry with my supervisors, who didn’t seem to have
any answers. I eventually realized from my friend, who was also a
counselor, that I was faced with some pretty severe situations and that
perhaps I was suffering from a case of the “myth of omnipotence.” I was
expecting myself to have all the answers for these long-term and serious
problems in just a few short weeks. I had not really accepted the fact that
I was a beginner and that I had entered a profession that takes years to
learn and where sometimes even vast experience is not enough. One of
the things I did was make sure the intake staff knew I had some difficult
cases and to let me have some less severe clients in the next few months.
I increased my supervision time and made a concentrated effort not to
worry about my clients when I was not at work. Perhaps the biggest
change took place when I stopped expecting myself to be a master
counselor in my first years.
The case of Robert reminds us that intense pressure can be part of counseling
right from the start. Burnout is a response to that pressure. It is a state of
depletion, fatigue, and hostility—a sort of numbing that provides a defense
against overwhelming stress. Yet the most important symptom is an
interpersonal one: The burned-out individual starts seeing people as objects.
You have probably seen this syndrome in retail salespeople and in doctors
and nurses. The recognition of burnout in the helping professions began in
the late 1970s (Edelwich & Brodsky, 1980; Pines & Maslach, 1978). It was
originally conceptualized as a condition of fatigue involving a negative self-
concept, a negative view of the job, and a loss of empathy for clients.
In the accompanying Spotlight, we discuss some of the special challenges

that are part of the life of a school counselor and provide some tips and
suggestions to help prevent burnout as a counselor in the fast-paced and
challenging world of K–12 education.

Preventing Burnout
Counselors are beginning to recognize that social justice and advocacy can be
important tools for burnout prevention. Knowing that client problems must be
understood within an environmental context can remove some of the self-
imposed pressure that beginning counselors feel to fix everything the client is
facing. It also can keep us from feeling as frustrated as we might otherwise
become when clients don’t make the changes we are looking for at the pace
we might hope. Changing the way we perceive the behaviors of others, from
intentional individual choices to reactions to living with toxic stress and
trauma in uncaring environments, can increase our empathy and
understanding. Many people who engage in advocacy and activism find that
it recharges them, connects them to a larger purpose, and gives them hope
(Gorski, 2015). In fact, one study of individuals engaged in advocacy and
activism noted the similarities between this type of work and the practice of
mindfulness (Hick & Furlotte, 2009). The researchers found that social
justice advocacy, like mindfulness, carries with it a deep awareness of social
relations, a recognition of interconnectedness, a focus on consciousness-
raising, and a desire for critical self-reflection.
Fast Facts
Stress in a nutshell:
Percentage of adults who suffer harm to their health from stress: 43%
Percentage of all doctor’s visits for stress-related complaints: 75 to 90%
Conditions exacerbated by stress: headaches, high blood pressure, heart

problems, diabetes, skin conditions, asthma, depression, anxiety, and
many others
Source: Retrieved from http://www.webmd.com/balance/stress-management/

effects-of-stress-on-your-body.
SPOTLIGHT Being Well as a

School Counselor
Challenges for the School Counselor
The professional school counselor is pulled between responsibilities to
students, teachers, and administrators, and role conflict is a major challenge
of the job (Burnham & Jackson, 2000; Lambie, 2007). For example, consider
a high school student who reveals to the school counselor that she has been
binging (overeating) and purging (vomiting) at school every day with two of
her friends because they believe it will help them lose weight. The counselor
will want to (a) help the student, (b) intervene with the other students
involved, (c) recognize that the behavior is dangerous and potentially life-
threatening, (d) find ways to prevent the spread of misinformation in the
school, (e) give staff and faculty accurate information about this dangerous
practice, (f) involve the school administration; and (g) notify the parents.
Clearly the duty to the client competes with larger responsibilities to the other
students and the institution.
In addition, a school counselor must manage crises and unexpected situations

including suicide (Juhnke, Granello, & Granello, 2011) and other mental
health emergencies and developmental crises. In spite of all of the pressure,
most professional school counselors believe that they have an exciting job
where every day brings different challenges and successes. Yet, at times, this
excitement speeds up the pace of life so much that school counselors may
feel that they are on a merry-go-round that cannot be stopped.
Suggestions for Fighting Stress and

Burnout as a School Counselor
Like everybody else, school counselors can make a number of personal
changes to promote their own wellness outside of the job, but stressors of the
job itself must also be addressed. So, the suggestions here are aimed at
helping you, the school-counselor-to-be, think about how you can go into a
job and manage the environmental and interpersonal challenges right from
the beginning. Young and Lambie (2007) identified some of the things a
school counselor can do to stay vital and prevent burnout:
1. Collaborate with the school administration to reduce role ambiguity, role

overload, and role conflict. When the school counselor knows what the
counselor’s role should be, it is easier to advocate for it. A strong
professional identity provides a basis for saying “Yes” and for saying
“No.”
2. Advocate for a district-wide school counseling manual that outlines the

duties and responsibilities of a school counselor. The ASCA Model
(2012) provides a framework for a more consistent professional role.
But principals will not be reading the ASCA document. Instead, an
internal document is needed to get everyone on the same page.
3. Educate administrators, teachers, students, and parents about what a

school counselor does. This is a daily task of the school counselor and
should be part of the job so that constituents are not disappointed or
expect school counselors to perform functions outside their expertise or
role.
4. Insist on supervision. One of the things that can help a counselor

manage the stress of difficult problems, emergencies, and dilemmas is
supervision by an experienced counselor. School counselors often have
a difficult time getting supervision from other counselors. School
counselors must become self-advocates and ask for clinical supervision.
5. Engage in professional development. This means developing your own

learning plan as well as attending conferences and seminars. It also
means taking courses to enhance your knowledge and reading the
professional literature.
Insulating Yourself Against Stress

and Burnout
Consider this metaphor about self-care. Every time we get on an airplane, the
flight attendants give us great advice about helping others: “In the unlikely
event that we experience a loss of cabin pressure, oxygen masks will fall
from the compartment above. Secure your own mask and breathe normally. If
you are traveling with another person who needs your assistance, please put
on your own mask before helping others.”
As counseling students, when you experience stress, you need to make sure
your mask is in place before entering a potentially stressful profession. Do
not forget to breathe normally. Your mask in this case is all the things that
you do to maintain your personal wellness and, as the famous therapist
Virginia Satir put it, “to keep your own pot full.” Satir’s idea of one’s “pot”
was that it represented personal resources that one could call on when
depleted. She believed that self-confidence and self-esteem flowed from this
kettle that needs constant replenishing (Banmen, 2008). It is a bank account
into which you must keep depositing to avoid depletion.
The ACA Code of Ethics (American Counseling Association, 2014a)

identifies the concept of impairment as an ethical issue for counselors in
training (that is you) and also for established counselors. The following
paragraphs describe the responsibilities of students, teachers, and supervisors
and practicing counselors. An important issue here is that counselors are
considered impaired when their physical, mental, or emotional issues seem
likely to harm a client or others. Such a determination is often difficult to
make for oneself, and we are often reluctant to report a fellow student or
counselor. But ACA ethics make it clear that we have a responsibility to
clients that supersedes our own possible embarrassment or fear of
confrontation.
ACA Code of Ethics (2014): F.5.b Impairment in Supervision,

Training and Teaching.
Students and supervisees monitor themselves for signs of impairment

from their own physical, mental, or emotional problems and refrain from
offering or providing professional services when such impairment is
likely to harm a client or others. They notify their faculty and/or
supervisors and seek assistance for problems that reach the level of
professional impairment, and, if necessary, they limit, suspend, or
terminate their professional responsibilities until it is determined that
they may safely resume their work.
ACA Code of Ethics (2014): C.2.g. Professional Responsibility:

Impairment
Counselors monitor themselves for signs of impairment from their own

physical, mental, or emotional problems and refrain from offering or
providing professional services when impaired. They seek assistance for
problems that reach the level of professional impairment, and, if
necessary, they limit, suspend, or terminate their professional
responsibilities until it is determined that they may safely resume their
work. Counselors assist colleagues or supervisors in recognizing their
own professional impairment and provide consultation and assistance
when warranted with colleagues or supervisors showing signs of
impairment and intervene as appropriate to prevent imminent harm to
clients.
ASCA Code of Ethics (2016): B.3.f. Responsibilities to Self
[School counselors] monitor their emotional and physical health and

practice wellness to ensure optimal professional effectiveness. School
counselors seek physical or mental health support when needed to
ensure professional competence.
Maintaining Your Wellness as a
Counseling Student
In addition to the ethical responsibility to monitor one’s stress we have a
responsibility to prevent it by keeping tabs on our own lifestyle. In this
section, we offer strategies, advice, and tips for keeping balance in your life
during your graduate program in counseling. The ideas offered in the
following paragraphs come from counseling students, counselors, and
faculty, and can help you in graduate school as well as later in your role as a
Physical Wellness
When students are under stress, they often start to ignore their physical
wellness. It may be tempting to “save time” by skipping meals, eating junk
food, giving up time at the gym, or skimping on sleep. Of course, these are
the very strategies that tend to make us work with reduced efficiency, get us
sick, or cause us to be so exhausted that we lose interest in what we are
doing. Maintaining your physical wellness is essential to optimal functioning
as a graduate student.
Maintain your fitness

Physical activity rather than exercise should be the focus for most working
adults. In other words, find a fun and regular way to keep moving, whether it
be disc golf, walking with a friend, or a daily run. Going to the gym may not
always be the best use of time when taking a walk or playing tennis with your
significant other can serve two purposes.
Eat well
It is tempting when you have regular appointments or evening classes to skip
lunch, wolf down a microwaved meal at dinner, or eat a snack in the car.
Eating should be a priority for a counselor because you need regular
nutritious fuel to keep your energy up during sessions, and it may be hours
before you get to eat again. Here are six suggestions for keeping your energy
up when you are working as a counselor.
1. Drink water or juice rather than soda or sports drinks.
2. Eat whole grains rather than white rice and pasta.
3. Eat fruits and nuts for snacks rather than crackers, or eat an energy bar.
4. Pack a lunch with healthy leftovers rather than eating fast food.
5. Make lunch your biggest meal and do not eat late at night.
6. Drink tea rather than coffee in the afternoon as tea has lower levels of
caffeine and is less likely to cause stomach upset.
Emotional Wellness
Counselors must be prepared to handle the strong emotions of their clients,
and to do so, they must maintain their own emotional wellness. Counseling
students can become overwhelmed with the intensity of their clients’
emotions. You might have a natural (although unhelpful) reaction, which is
the desire to squash your feelings to protect yourself from the pain around
you. Emotional numbing, as you read earlier in this chapter, is one of the
signals of counselor burnout. Taking time to care for yourself emotionally
will help give you the skills you need to have a long and happy career in the
counseling profession. Following are some suggestions.
Reduce emotional arousal
This might mean finding a way to take a five-minute walk during your lunch
break or between classes. Find a minute to meditate or pray.
Get counseling for yourself

Until 2005, the British Association for Counselling and Psychotherapy
required that members receive 40 hours of therapy as part of their
requirements for certification. Now they allow other options for personal
development, which can include therapy (Grimmer, 2015). Today, there seem
to be fewer counseling programs requiring the student to engage in personal
counseling, yet more than 80% of counselors receive personal counseling on
their own (Bike, Norcross, & Schatz, 2009). One of the reasons that personal
counseling is no longer required in many programs is that requiring a
therapeutic relationship goes against a basic idea in counseling: that it is most
effective and ethical when it is voluntary (see Grimmer, 2015). Still, there are
good reasons to consider personal counseling as a part of training even if it is
not required. Grimmer and Tribe (2001) listed five important reasons why
you should consider personal counseling as a student/trainee.
1. To experience being in the role of the client There is no other way to

really understand the experience of a client than to sit in the other chair.
Early in my own training, I (Mark) went to see a counselor and had to
wait for about 20 minutes. I learned a lot from just that one appointment.
As I watched the clock, I started wondering if the fee would be reduced
or my session would be lengthened, or even if I had showed up at the
wrong time and place. I started to consider whether the counselor could
really help me if he couldn’t even be on time. I became annoyed at the
fact that I had to sit in the waiting room with the other clients, like a
public admission that I couldn’t handle my problems. Because of that
experience, I try never to let my clients languish in the waiting room. I
try to finish my sessions promptly and began the next session on time.
When I have an emergency, I tell the waiting client.
There is also a sort of humiliation that comes from being in the role of
the client. There is often a part of us that believes that help is for
everyone else—that it is okay for the weak, but I am one of the strong. It
seems self-indulgent, and you feel needy. If you are the kind of person
(and we suspect that you are) that others seek out when they need help,
then asking or needing help yourself is uncomfortable and unfamiliar.
2. To feel the impact of counseling interventions and techniques As a

client, you can really experience the power of certain interventions that
seemed benign when you were using them as a counselor. For example,
I (Mark) might chide my clients, in the way of Albert Ellis, about their
“nutty ideas.” Although I want it to be a joke with a message, some
people feel that they have just been called a “nut” by a mental health
professional. By becoming a client, you become more conscious about
making such jokes and giving off-the-cuff advice.
More importantly, you can feel it internally when your counselor hits the
“nail on the head” and accurately summarizes what you have been
saying and thinking and feeling. Everyone wants to be understood, to
explain their rationale for their actions and have their intentions
recognized. They do not merely want to justify themselves or have
someone feel sorry for them. When someone truly understands you, it is
a tremendous relief. The problem may not be gone, but someone gets it,
and they get you. That is an important part of any intimate relationship.
3. To increase your personal growth and emotional and mental health

Counseling stimulates personal growth. When counselors go to
counseling, they can explore their own self-defeating patterns and
negative ways of interacting with others, and they begin to see that their
life can be more than they imagined. The counselor who goes to
counseling may be open to trying new things and perhaps may want
more out of life when counseling is over.
4. To recognize that personal counseling might help you reduce stress

when you are in practice When you experience counseling for yourself,
you recognize the benefits of having a neutral party to explain yourself
to. You experience the reduction in anxiety and tension, and you see the
need for a different perspective to help you cope with pressure from
inside and from without.
5. To address mental health problems that might be affecting your ability

to provide support for the client, whether you are in your internship or in
a counseling job When you have an anxiety disorder, substance abuse
disorder, are depressed, or are suffering from an episode associated with
bipolar disorder, you may be impaired. When one of us (Darcy) faced a
physical health diagnosis, a trip to a counselor for a few visits helped
manage the complex emotions that accompanied the illness. Processing
through the feelings with a counselor allowed me to minimize the
possibility that my negative emotions would interfere inappropriately in
my work with clients. Remember, most colleges and universities offer (a
limited number of) free counseling sessions for students. That might be
a good place to start.
Intellectual Wellness
Staying sharp and cognitively engaged is an important part of wellness.
Counseling students might argue that they are already intellectually
challenged because of their role as students, but intellectual wellness is more
about adopting an inquisitive stance to the world around you than it is about
meeting the requirements of a class assignment.
Stay on the cutting edge

Read the ACA journals. Listen to audiobooks if you have a long commute.
Attend conferences and in-service training. Some of the biggest boosts come
from your fellow counselors, who know what you are going through and have
some ideas to help with that difficult client or a way to adjust your attitude.
We are both inspired by a colleague who, despite being in the profession for
more than 50 years, attends counseling conferences and stays current in the
latest research and ideas. He attends workshops by student presenters, goes to
sessions on topics that are new to him, and reads journals and books that
challenge his thinking. By all accounts, he is an expert in the field, but he is
quick to point out, “I always have something new to learn.”
Spiritual Wellness
Engage in meditation or prayer
Counselors with a strong sense of meaning and purpose in their lives can find
the strength and courage to do the hard work that the profession requires. A
sense of spirituality, whether through organized religion, meditation, or
prayer, or a connection to nature, can provide a private retreat in times of
stress. Take 10 minutes during the day to sit in silence. Just that amount can
have a stress-reducing effect for graduate students (Gutierrez, Conley, &
Young, 2016).
Experience nature
When you are not counseling, find ways to commune with nature. Like
meditation and prayer, it can give you a peace that you need when you
engage others who are not peaceful.
Be ethical
It simplifies your life if you tell the truth, and don’t talk about your clients,
colleagues, or fellow students behind their backs. The students in your classes
are your professional colleagues. If you gossip, they will see you as
unprofessional.
Relationship Wellness
In Chapter 5, we discussed the importance of preparing your family and
friends for your life as a graduate student. In this chapter on wellness, we
remind you that doing so is important not just because it will help you in your
studies, but because you will need the love and support of others to be an
effective counselor. Counselors know and understand the importance of other
people in their lives, and they work to maintain healthy, strong, and
supportive relationships.
Maintain your relationships

Three studies have looked at what problems therapists discuss when they go
for personal counseling (Bike, Norcross, & Schatz, 2009; Norcross,
Strausser-Kirtland, & Missar, 1988; Pope & Tabachnick, 1994). All three
identify marital or couples distress as the most common presenting problem.
Like everyone else, counselors have a difficult time maintaining a primary
relationship. Yet it is our personal relationships that provide the biggest
buffer against stress at work (Andersson-Arntén, Rosén, Jansson, & Archer,
2010). In essence, the reason many counselors go to therapy and the potential
source of relief both stem from their couple relationships. How can we make
sense of this paradox and make some recommendations for beginning
counselors? Like all the recommendations for better wellness in this chapter,
this one requires time and effort. Yet, perhaps for romantic reasons, we do
not see that our made-in-heaven relationships need maintenance here on
earth. Based on research, we would be much better off in terms of stress if we
spent as much time mending and sustaining our relationships as we do in the
gym. Here are some quick suggestions for relationship wellness that can help
you maintain your relationship and improve your overall wellness by
decreasing work-related stress.
Suggestion 1: Spend 10 minutes a day, starting now, checking in with

your significant other. In the PAIRS program, an educational
relationship enhancement curriculum (see http://pairs.org), they have a
tool called the Daily Temperature Reading, adapted from the work of
Virginia Satir. It involves noticing and appreciating the partner,
discussing new information, sharing puzzles and requests for change, as
well as going over wishes, hopes, and dreams. Although it may seem
overly structured, it is surprising how much couples benefit immediately
from even the smallest time spent on talking about what is good in the
relationship and how they want it to be. Sharing problems should not be
the only interaction that you have with your significant other, nor should
a discussion of shared responsibilities take precedence over what you
like about him or her.
Suggestion 2: Go ahead and talk about your work but focus on your own
feelings, not the problems of your clients or your fellow students. Your
clients’ problems can be discussed with your supervisor, but do not
breach confidentiality.
Suggestion 3: Seek couples counseling if you need to work on your

relationship, not individual counseling. People who seek an individual
counselor for their couple problems are more likely to break up than
those who seek conjoint couples counseling. Find an experienced
counselor who has special training and interest in working with couples
or go to a relationship or marriage education class. Research is now
confirming that relationship psychoeducation can be effective in
improving relationships (Navarra, Gottman, & Gottman, 2016).
Developing Your Own Personal

Wellness Plan
In this chapter, we discussed many different aspects of personal wellness and
encouraged you to consider working with your clients to develop
individualized wellness plans for them. Now it’s time to turn that attention to
ourselves. Figure 13.1 is a chart you can use to sketch out a personal wellness
plan. Take another look at the six dimensions of wellness described
previously. The general themes of wellness are important, but now you need
to get specific. Identify which areas you need to work on to improve your
wellness in that area and what obstacles are likely to arise. I (Mark) have
filled out an example of the physical dimension on the chart to give you an
idea of how it might be used. Although you may have something in each of
the dimensions you want to work on, choose one or two goals. Too many
goals can be overwhelming. Simply having a personal wellness plan is not
enough. You must find a regular time to review your progress. One way to
keep yourself honest and on track is to ask a significant person in your life to
remind you or check in with you on your goal. Put a note on your calendar,
computer calendar, or smart phone and assess how you are doing every 30
days.
Figure 13.1 Your Own

Wellness Plan
One
Obstacles Why do I By what
Things I specific
to really want date do I
do goal I
making to expect to
regularly have for
Dimension of this a accomplish make
to improving
Wellness regular this goal at noticeable
strengthen this
part of all? What is progress
this dimension
my my on this
dimension of
lifestyle motivation? goal?
wellness
Walk It’s hot in I need to
10,000 the reduce my
I swim 3
EXAMPLE steps summer cholesterol
mornings Nov. 1
(PHYSICAL) daily, 3 and I feel and get
per week
days per tired at more fit so I
week night feel better
Physical
Emotional
Spiritual
Intellectual
Social
Occupational
&
Environmental
Summary
In this chapter, we discussed how counselors use models of wellness and a
positive, strength-based approach to counseling to help guide practice.
Counselors in all practice settings can find ways to integrate these positive
approaches into their work. We also discussed the importance of maintaining
a healthy, balanced life, both now, as a counseling student, and later, as a
practicing counselor. Counselors use a wellness approach to help clients
achieve their highest level of functioning, but we cannot help clients if we are
not willing to work toward wellness ourselves. Because of the potential for
burnout and emotional exhaustion, inherent in the work that we do,
counselors must take extra care to maintain their physical, emotional,
intellectual, social, and spiritual wellness.
Student Activities
2. Wellness approaches to counseling encourage clients to take

responsibility for their own choices. Clearly, counselors are human, and
none of us has attained complete and perfect wellness in our lives.
Consider your own assessment of your wellness and the goals that you
set for yourself. How can you balance the statement that each of us must
take responsibility for our own wellness with the reality that few of us
actually do? How can your own striving for wellness help you
empathize with your clients?
3. Many counseling students have had contact with mental health
professionals who are experiencing burnout. Have you met a counselor
(or other mental health professional) who demonstrates signs of
burnout? If so, how did you know? How did it feel to interact with that
person? What lessons can you take for your own professional life from
this experience?
Journal Question
1. Think about times as a student or employee when you were
overwhelmed with work. What did you do to regain your equilibrium
when you experienced symptoms of stress? As a counselor, you may
find a parallel situation when you feel incapable of handling the
responsibilities and pressures of clients and their needs. You may be
pulled by paperwork and by rules and regulations that make your job
harder. What strengths do you have and what resources can you call on
when that happens?

1. Counselors in training have an ethical responsibility to monitor
themselves and refrain from offering services when they are impaired by
substance abuse, burnout, or any other condition that would potentially
cause harm to a client. If you felt that you were suffering from
depression, what steps would you take as a student to comply with the
ACA ethical guidelines?
2. As you look at the guidelines for keeping yourself well as a counselor,

which do you think will be the hardest to implement in your counseling
setting? Consider the following: eat well, engage in regular physical
activity, maintain your spiritual wellness, develop positive self-talk, go
to conferences that refresh you, stay in supervision, get a hobby, and get
counseling for yourself.
Experiments
1. Go online and use a fitness program or a smart phone application to
track your diet or exercise over a five-day period. Many of these
programs are quite sophisticated and can give you nutritional
information and charts of daily exercise. Keeping track of what you eat
and how you exercise increases your awareness and brings about
change. What kinds of clients might benefit most from this kind of
monitoring? Could keeping track of calories also be a symptom, in some
cases, of an eating disorder? Is food monitoring always to be
encouraged?
2. Go to the National Institutes of Health Complementary and Alternative

Medicine (CAM) website to discover interventions and approaches that
have been supported by research (http://nccam.nih.gov). What approach
will you take if clients want to engage in CAM activities (e.g., massage,
acupuncture, magnet therapy, light therapy, reiki) in addition to the work
that you are doing with them?
Explore More
1.
Books
Choate, L. H. (2009). Girls and women’s wellness: Contemporary
counseling issues and interventions. Alexandria, VA: American
Granello, P. (Ed.). (2011). Wellness counseling. Upper Saddle River,

NJ: Pearson.
Ward, C. C., & Reuter, T. (2010). Strength-centered counseling.

Thousand Oaks, CA: Sage.
Articles
Lambie, G. W. (2006). Burnout prevention: A humanistic perspective
and structured group supervision activity. Journal of Humanistic
Counseling, Education and Development, 45, 32–44.
Myers, J. E., & Sweeney, T. J. (2008). Wellness counseling: The

evidence base for practice. Journal of Counseling & Development, 86,
482–93.
Roscoe, L. (2009). Wellness: A review of theory and measurement for

counselors. Journal of Counseling & Development, 87, 216–26.
Chapter 14 Counseling Tomorrow
Questions
The global and societal trends that are likely to affect counseling
practice.
Fourteen characteristics of the Experimental Prototype of the Counselor

of Tomorrow.
How an increase in technology is affecting counseling practice and

preparation.
Develop a plan for lifelong learning.
Recognize the need for continuing training in diversity.
Identify your own development towards professional identity.
How do you think technology will change the way that counseling is
delivered?
How will you keep up with changing trends that will affect your
counseling practice?
How can you continue to stay professionally involved and enhance your
professional identity?
10. technology’s impact on the counseling profession

Counseling is a young and dynamic profession. Like any adolescent, it is still
developing and there are growing pains. We are struggling to achieve
universal, portable licensure. We face a lack of recognition in other countries
and challenges by competing professions who seek to reduce the scope of
counseling practice. We are always working to better define the practice of
counseling in ways that promote social justice and diversity. There is so
much to do. The counseling profession is changing, and you will be part of,
and perhaps take a leadership role, in what happens next. What do you
envision for the future? How can counselors and the counseling profession
meet the needs of a world that is moving at a break-neck speed? Where do we
go from here?
It may seem a bit silly to ask you what you think counseling will look like in
the future when you are just beginning to learn what it looks like in the
present. But the fresh perspective that you bring to the counseling profession
makes your input and ideas extremely valuable. You are not entrenched in the
“this is the way we’ve always done it” syndrome, and in many ways, you are
more open to possibilities for the future than counselors who have been in the
profession for years. As you read this chapter, consider what trends and ideas
you see that will change the counseling profession—for better or for worse—
and think about how counselors can situate themselves to best respond to
these trends.
Global and Societal Trends
We have identified three trends in the United States that are certain to change
our profession. For each trend, we will try to make some guesses about how
this will affect counseling, counselors, and clients.
Speeding Up: Technology, More

Work, and Stress
The future will be too much for us. There will be too much change, too many
choices, too much technology, and too much work. In the future, the speed of
communication will increase. For example, a few years ago, a textbook like
this took a year to produce after the authors finished it. Now, that has been
cut to less than half that time because the authors’ pages go electronically to
the printer and everyone else communicates faster without mailing big, fat
manuscripts back and forth.
Faster communication means that pace of life increases, which can result in
greater stress for counselors and clients. Expectations become higher. Now
co-workers seem to demand that you return their emails or text messages
immediately, regardless of the time of day. Because we can leave text
messages, instant messages, phone messages, and posts on social networking
sites, there is more pressure to respond.
The counselor of tomorrow, in order to rapidly connect with their clients, will
need to be conversant with social networking, instant messaging, and
whatever communication applications emerge. Future counselors must cope
with pressure from students, clients, teachers, and administrators who want
instant answers. One of the benefits to counselors and counseling students is
that online communication allows us access to people worldwide. We can see
what other people are doing and our cultural horizons are expanded (Bhat &
McMahon, 2016).
Technophilia
There is a saying, “Every solution creates new problems.” This is certainly
true for technology. Technophilia is the unhealthy belief that all technology is
good for you. You may know a technophile who spends too much time on the
computer away from family and friends, or who answers every call, returns
every text message, and cannot separate work, family, and leisure. Some
researchers consider this to be an addiction (Billieux et al., 2015).
Fast Fact
More data was created between 2013 and 2015 than in the entire history
of the human race.
300 minutes of video are uploaded to YouTube every minute.
By 2020, there will be more than 50 billion smart connected devices in

use.
Source: Marr, B. (2015). Big data: 20 mind-boggling facts everyone must

read. Retrieved from: http://www.forbes.com/sites/bernardmarr/2015/09/30/
big-data-20-mind-boggling-facts-everyone-must-read/#1b5bea9f6c1d
Social networking sites allow us to track old flames and manage relationships
with hundreds of people simultaneously. The Internet is currently creating
problems in committed relationships (Mao & Raguram, 2009; Peluso, 2007)
just as it has created millions of hours of lost time at work. Although there
are many positive aspects of technology, counselors are likely to see many of
the negative aspects as well. Clients come to us after their lives and
relationships have been harmed by overuse of (or addiction to) electronic
devices and the Internet. We must learn to have a balance in our life between
work and home and teach this skill to clients.
It is not just technology that is the problem. It is the fact that we can gain
access to work wherever we are, day or night. The problem is that we have
become overloaded, stressed, and fatigued with this new responsibility (Lee,
Son, & Kim, 2016). Right now, Americans work more than people in almost
any other country. A corollary is the over-scheduling of children who now
need an online calendar to keep track of their afterschool lives and play dates.
It is said that Americans trade the money gained by extra productivity for
things that allow us to work more (for example, eating out or having someone
clean the house). Europeans, on the other hand, trade their work for leisure
(for example, having less money but more time for leisure). Without leisure
and time off, there can be an increasing spiral of stress and a feeling that we
are not enjoying life. In the future, counselors will have to help people design
ways to stop work and technology from taking over their lives.
Connected to the net but technically

alone
Recently, on our college campus, we saw a couple holding hands while both
talked to other people on their cell phones. Were they together? Technology
can separate people as well as bring them together. Certainly, one person’s
love of technology can disrupt a relationship. But technology can also replace
relationships of the face-to-face variety. It is estimated that at any given
moment, there are more than 2 million people in the United States playing a
fantasy war game online. In such games, the creation of a pseudo-identity is
de rigueur. Do we know what the effect of living a “second life” will be on
adolescents or young adults who are not connected to other people in real-
time relationships? We do know that there is a growing subculture of
individuals who cannot find love relationships or face-to-face friendships and
so substitute them with online worlds. Robotics may become a way in which
people fulfill their social and sexual needs.
Overchoice
Increasing choice will also be a problem (Haynes, 2009). In his book, The
Paradox of Choice (2004), Barry Schwartz told how he went shopping for
gadgets at a local electronic store. He found 45 different car stereos, 42
different computers, 27 different printers, 110 different televisions, 50
different DVD players, 20 video cameras, and 85 telephones. Since his
writing, the number of choices has drastically increased. Consider the
problem of jeans. There are at least three kinds of fabric, raw, washed, and
natural, and many different types of “cuts” from skinny to boot cut. To top it
off, there are about 110 different kinds of pockets! How can we be happy
when we feel we may have made the wrong choice? Buying a television and
the associated buyer’s remorse may not be very distressing, but increasing
choices in other areas can make us even more stressed when it involves
changing our health care coverage, our retirement, or buying a house.
Even relationships have more choices. It is not just getting engaged or getting
married, it involves deciding when to get married. Should we wait until we
finish our degrees, get established in our careers, or save enough money to
buy a house? Should we live together first? Should we merge our finances?
When it comes to career, whose career should suffer if I get a job here and
you get a job there? When should we have children? Should we have
children? Counselors in the future will be more involved in helping people
make romantic and unromantic relationship choices.
We have named only a couple of areas where increased choice due to

technological and society changes are confronting us. But it is not just the
stress of choosing that is a potential problem. The way people cope with
overchoice may also become an issue. In his book, Fear of Freedom, Erich
Fromm (1942), predicted that increasing choice and freedom leads to anxiety,
and people seek to escape this personal freedom by accepting simple
solutions, conformity, and authoritarian rule. Freedom and choice can create
feelings of alienation and dehumanization. Thus, increasing choice and
freedom can lead to the increasing allure of simple-minded solutions,
harkening to the good old days, and wanting Big Brother to take over. Can
we help clients embrace the complexity of modern life without pretending
that there are simple solutions to complex problems or worse, escaping into
unhealthy ways of life such as substance abuse or black and white
philosophies?
One trend that counselors should be aware of is a movement to adopt simple

ways of living. Unlike people, such as the Amish, who use their religious
beliefs to develop closed communities based on rules of simplicity, there is a
small but growing group of people who merely live with less (Alexander &
Ussher, 2012; Blumenthal & Mosteller, 2008; Foster, 2008). The voluntary
simplicity movement embraces self-sufficiency, reduced technology, and
freedom from things. Even diet can be simplified, leading to less stress and
happier lives. Whether such trends will continue is not certain, but simplicity
probably works to reduce stress. For example, it seems that the Amish are
happier than most of us (Biswas-Diener, Vitterso, & Diener, 2005).
Health, Healthcare, and Aging

There is a growing interest in health and wellness in the U.S. population. The
counselor of tomorrow will need special training in physical health and
wellness because clients will likely want to work on physical health through
counseling (Barden, Conley, & Young, 2015). For example, counselors must
understand the symptoms of multiple sclerosis so that they can help clients
deal with the psychological issues associated with chronic illness. They will
need to be able to help individuals with obesity and type II diabetes. They
must understand the needs of veterans who present with traumatic brain
injury.
Fast Fact
The typical teenager now sends and receives about 128 text messages per
day. Teenagers prefer this form of communication to face-to-face or phone
conversations. One of the reasons is that it helps them avoid questions and
arguments with their parents.
Source: Burke, 2016
The specialized training a counselor has in helping clients identify and

maintain goals will be essential to helping clients achieve healthcare goals
such as losing weight or quitting smoking. Counselors must gain an
understanding of medications, exercise, and treatment adherence protocols if
counselors are to keep up with other professions, like psychologists, who
consider themselves healthcare professionals. Counselors will need to take
care not to operate outside their scope of practice, but they will want to assist
clients in taking greater control of their own health-related issues. For
example, a counselor cannot (and should not) tell clients to stop taking
medication, but counselors can help clients develop the necessary skills and
assertiveness to speak with their medical doctor about concerns they might
have regarding a medication’s side effects. The counselor can help a client
develop methods to improve medication compliance.
The professional school counselor of tomorrow will need to help students

manage chronic illnesses within the school setting. About 20% of all children
have a chronic illness, and about one-third of them experience consequences
that are severe enough to interfere with school functioning and performance
(Kaffenberger, 2006). Because the goal is to have children return to their
normal routine as much as possible, children with chronic illnesses are
increasingly coping with the challenges of their illness and with the demands
of a typical school day (Hamlet, Gergar, & Schaefer, 2011). The school
counselor remains the professional in the building who is best equipped to
help students, and their families, manage these complexities.
The counselor of tomorrow will need to be comfortable working with older

people. They will need to understand and devise interventions for a graying
clientele. Older people were about 10% of the population in 2000, but by
2030 they will be about 20% as baby boomers live longer and fewer children
are born (Williams, 2014).
Counselors should be trained to help with special issues such as cognitive

impairment, grief, and loss and the interaction between physical and mental
problems. The American Counseling Association’s Division, Association for
Adult Development and Aging is the counseling organization that looks at
counseling issues in the adult lifespan. Since 1986, they have published the
journal AdultSpan. Counseling older adults will become a more common
specialty, and counselor education programs will include more training about
the concerns of older adults.
Increasingly Diverse Society
Not only are we getting older, but the United States is becoming more
racially diverse. Between now and 2030, the percentage of White Americans
will decrease, the percentage of African Americans will increase about 1%
while the percentage of Hispanics will likely grow from about 12.5% to 24%,
and the percentage of Asian Americans of all nationalities will increase by
about 200% to 8% of the population. There will also be an increase in the
percentage of individuals who identify themselves as multiracial (Pew
Research Center, 2016). Thus, it is incumbent on the counselor of tomorrow
not just to be aware of cultural differences but to be comfortable and familiar
with cross-cultural communication. Because counseling involves appreciation
of nuances in communication, it is best to receive counseling in your own
language. Therefore, it is expected that as more Spanish-speaking and Hindi-
speaking students become counselors, clients will increasingly want
counseling in their native tongues.
It would be useful for the counselor of tomorrow to learn Spanish to connect

with that growing population; however, a little Spanish will not solve all the
difficulties that can arise in cross-cultural communication. Cultural
understanding and openness to differences are required, and that necessitates
cultural awareness, experiences that promote cultural understanding, and
specific counseling skills that help reach across cultures. Counselors in the
future need to have diverse cultural experiences built into their training.
Changing families and couples

American families are changing with smaller family size, more dads staying
at home, and one in ten kids living with a grandparent (Pew Research Center,
2013). Families are chosen, blended, adopted, or childless. As far as the
couples are concerned, more are living together before marriage and there is a
growing realization that the married heterosexual couple is not the only way
to be paired. Couples are much more likely now to be from different
backgrounds, and these must be addressed in counseling (Blount & Young,
2015). In addition, the age at which couples are marrying and having children
and older people having children late in life are changes that will affect
counselors. Older parents may have different views about childrearing, and
the ongoing challenge of helping aging parents will “sandwich” those who
are still raising their young children.
Religious/spiritual changes
Although there is no apparent upsurge in religious sentiment (Gallup, 2016),
the importance of religions and spirituality in counseling is expected to
increase as counselors and their clients become more comfortable with the
discussion. Americans represent the full spectrum of religions, but there is a
growing group of individuals worldwide who consider themselves spiritual
but not religious. Membership in an organized religion may be at an all-time
low according to U.S. News (March 13, 2013). In a poll conducted by
Newsweek, 24% of respondents saw themselves this way—believing in a
higher power but not in a church or organized religion (Newsweek/Beliefnet
Poll, 2005). At the same time, 57% felt that spirituality was very important in
their life, and 27% felt it was somewhat important. With this kind of response
to spirituality, the counselor of tomorrow should know more than a person’s
religion (Robertson & Young, 2011). Counselors will need to investigate the
importance of spirituality in the client’s life and be open to the fact that their
client may be a Buddhist Catholic. Pew Forum (2009) research reveals that
Americans’ religious beliefs no longer fit into neat and traditional categories.
Many Americans are involved in several different religious practices, with
28% of respondents indicating that they attend services outside their own
faith.
The Experimental Prototype
Counselor of Tomorrow (EPCOT)
Walt Disney imagined a futuristic community, which has since become a
theme park in Orlando, Florida. He called it EPCOT, experimental prototype
community of tomorrow. He tried to imagine what new technologies and
innovations might shape human living. The first conference of the
Association for Counselor Education and Supervision (counseling professors
and supervisors) was held at EPCOT in 1983, and they took up this theme
later chronicled in a publication on the counselor of tomorrow. The
individuals who contributed to the book Shaping Counselor Education
Programs in the Next Five Years: An Experimental Prototype for the
Counselor of Tomorrow (Walz & Benjamin, 1983) were among the most
innovative scholars and teachers in the field including Robert Nejedlo,
Thomas Elmore, Nicholas Vacc, Larry Loesch, Gary Seiler, Glenda Isenhour,
Stephen Southern, Patricia Arrendondo, and Barry Weinhold, among others.
Their vision about where counseling would go was in many ways prophetic,
and most of the needs they identified are still relevant:
a need for creative leadership
a need for more holistic developmental approach
the emergence of health concerns in counseling
the need for more research skills so that counselors can help the
profession stay independent
the need for a sixty-hour master’s program for mental health counselors
the transformation of behavioral approaches into more cognitive

behavioral approaches
the emerging role of meditation and religion in counseling

the importance of recognizing the impact of culture on the profession
the trend towards theoretical integration
the role of technology
the importance of lifelong learning to combat professional obsolescence
The predictions of these counseling visionaries were made a couple of

decades ago. What has changed since then? What, if any, new trends should
you be thinking about as you become that future professional? What skills
should you possess?
In recent years, the American Counseling Association has undertaken a

project to look to the future and consider what the profession of counseling
might look like in the decades ahead. In the following Spotlight, the 20/20
Vision for the Future of Counseling outlines the latest thinking about how the
profession can adapt to the challenges and opportunities that lie ahead.
Although 20/20 codifies our underlying assumptions and sets some important
goals, it is not specific about the training of prospective counselors. The
future counselor we envision has 14 qualities needed to adapt to a new age
and develop professional identity (see Figure 14.1). That may seem to be a lot
of areas of skills and knowledge but, as a beginning counseling student, you
are not expected to master them now. In fact, they represent areas of
professional and personal development that you will work on throughout
your career and form an outline for your portfolio of lifelong learning.
Figure 14.1 The Counselor of

Tomorrow
Eclectic or Integrative
We think that the counselor of tomorrow must be open to discovery as
research confirms new techniques and fails to support some older, more
traditional approaches. Only an eclectic or integrative approach that can
accommodate new thinking is compatible with a scientific perspective and
sensitivity to cultural and personal differences. That does not mean that you
cannot adopt a major theoretical position but you, the counselor of tomorrow,
will find that even your specific counseling theory will continue to evolve
over time, and you must integrate new findings with basic tenets of the
theory. Theoretical purity seems to be outdated as we recognize effective new
methods and the needs of our diverse clientele. Let us say you are a person-
centered counselor working with anxiety in adolescents. You find that
biofeedback-assisted relaxation might help. As a counselor of tomorrow, you
must be able to get additional training and add it to your professional skills
without abandoning your person-centered theory.
SPOTLIGHT The 20/20 Project

Between 2005 and 2013, the American Counseling Association developed a
plan for what counseling would be in the year 2020 (Rollins, 2010). Dr.
Samuel T. Gladding, a past president of ACA, led a consensus-building
process that yielded a 21-word definition of counseling: “Counseling is a
professional relationship that empowers diverse individuals, families, and
groups to accomplish mental health, wellness, education, and career goals.”
The definition and a set of unifying principles were endorsed by 29 of the 31

participating counseling organizations, including many of the ACA divisions,
the American Association of State Counseling Boards, National Board for
Certified Counselors, Chi Sigma Iota, and CACREP. Each organization
signed the unifying principles:
20/20: A Vision for the Future of Counseling Principles for Unifying

and Strengthening the Profession
Preamble
As one of the organizations in the counseling profession, our

organization supports the premise that strengthening our profession is
essential. Our organization participated in 20/20: A Vision for the
Future of Counseling.
Rationale
Professional counseling is approaching its 100th anniversary of the

founding of the first counseling association. Since this time, we have
become an established profession and made significant progress. As the
profession expands and develops, continued attention to a unified
counselor identity is important. The opportunity to establish a cohesive
counseling identity leads to multiple benefits for professional
counselors, including the presentation of a clearer image of professional
counseling to clients, students, and the public; and the promotion of
legislative efforts that are in the best interest of the counseling
profession and the people we serve. We believe that the seven principles
identified in this document constitute a beginning for developing a
unifying vision and creating a long-term dialogue regarding these
principles. Such a dialogue is important to identify the many approaches
toward professionalism that can vary and, at the same time, are common
to our profession. The following seven principles provide a foundation
for unity and advancing the counseling profession as we progress toward
the year 2020.
The delegates of 20/20: A Vision for the Future of Counseling

identified these principles as important in moving the profession
forward.
Principles
1. Sharing a common professional identity is critical for counselors.
2. Presenting ourselves as a unified profession has multiple benefits.
3. Working together to improve the public perception of counseling

and to advocate for professional issues will strengthen the
profession.
4. Creating a portability system for licensure will benefit counselors

and strengthen the counseling profession.
5. Expanding and promoting our research base is essential to the

efficacy of professional counselors and to the public perception of
the profession.
6. Focusing on students and prospective students is necessary to

ensure the ongoing health of the counseling profession.
7. Promoting client welfare and advocating for the populations we

serve is a primary focus of the counseling profession.
Source: Reprinted with permission of the American Counseling Association.
In the next few decades, there will be an increase in accountability. You must
be able to document that you are effective. You might recall that in Chapter
7, you learned that there are essentially two ways to do this. One is to show
that the practice you are using has been proven in other settings or through
research. This is called evidence-based practice. Evidence-based practice is
not yet an article of faith in the counseling field. It is an area of controversy,
as you also learned in Chapter 7. Not every counselor agrees that evidence-
based approaches are the best, and certainly not the only, choice. On the other
hand, the profession of psychology has taken a strong stand in favor of their
practitioners relying on evidence-based treatments. For example, Raymond
Fowler, Past President of the American Psychological Association said, “Our
scientific base is what sets us apart from the social workers, the counselors,
and the Gypsies” (quoted in Dawes, 1994, p. 21). A couple of decades later,
we believe that Fowler would have a hard time making this accusation stick.
Counseling is conducting more research, and the future counselor must stay
in touch with it, learning about what works and what does not work. One
prediction is that counseling and evidence-based treatments will separate in
the future. Insurance companies will pay for evidence-based treatments but
not for counseling for “normal” people with “normal” problems.
Reading research studies conducted by others, however, is not the only way
to validate what you do. Besides relying on evidence-based treatments,
another way is to prove you are effective is to document the effects of your
own interventions. You can conduct your own outcome research on your
clients. This could be called “practice-based evidence.” The professional
school counselor of tomorrow must be able to show that the programs within
a school, a classroom, for a single student or a group of students, improve
their lives (Zyromski & Mariani, 2016). The counselor working in an agency
or private practice setting who sets up a program or treatment regime for a
client must collect data on client change to verify that the intervention is
effective. Counselors should be prepared to account for their cost efficiency
and their treatment effectiveness (Thomason, 2010). That means counselors
ought to be better prepared to work with client data and present it in an
understandable fashion.
Culturally Aware and Competent

We have suggested that counselors should have appropriate skills,
knowledge, and attitudes that increase our ability to work with clients from a
variety of cultures. The demographics of the counseling profession itself will
change, with more counselors coming from different racial and ethnic groups
or representing more than one racial or ethnic background. Our clients will be
more diverse, too. In tomorrow’s world, counselors must be willing to cross
social/class boundaries and recognize the needs of those who are
economically disadvantaged.
But it is often difficult for counselors to cross these cultural fences and get
the knowledge and skills that they need to function in a competent way.
Although we may have good intentions, it is unlikely that we will find the
time to have cross-cultural and immersion experiences unless we make it a
priority. A counselor’s best source of training is working with clients who are
culturally or socially different than themselves, taking a tutorial stance and
learning from them. That is why you owe it to yourself to insist on seeing a
wide variety of clients in your practicum and internship experience. Seeking
an experience where everyone is culturally or religiously similar may seem
more comfortable, but a more diverse experience will simply make you a
more competent counselor. Attending conferences where cultural aspects of
counseling are addressed is an easy way to gain information and skills, but
you also need contact with those who are different from you.
Understanding and Accepting of
Differences
Clients can be different in so many other ways besides culture, including
personality, religion, family background, and so many more. Here are three
tips to keep you aware of the importance of recognizing and accepting
differences: (1) Take personality tests and compare your results with people
you know. You will begin to appreciate the diversity of psychological traits
and types that affect how people see the world. (2) Record your own history
of your life within your family of origin. Trace the rules and roles you grew
up with. Now look at the same data from someone you know. Can you see
how the family messages affected each of you? (3) Learn about other
religions and about denominations under your own faith. Religion and
spirituality affect a client’s world view, and finding a sensitive way to
understand a client’s spiritual background and yearnings is critical to
understanding the whole person (Richards & Bergin, 2014).
A Leader at Work
Counselors have special training in the right thing to do (ethics) and what is
most effective (interventions or techniques). Therefore, we have a duty to
stand up for what is right and for what we know in the workplace. That is one
form of leadership. Maybe you have not thought of yourself as a leader, but
there are many avenues for leadership. Leadership sometimes means going
against the grain of what is popular or easy and instead advocating for what is
ethical and legal. Sometimes it is persuading the powers-that-be to adopt
more effective counseling programs. For a counselor, leadership at work
means knowing what is best because of training and research, not just
following the rules. The school counselor of the past was a quasi-
administrator who perhaps took ideas about what the job should be from the
principal. They often did jobs that an untrained clerk could handle even
though they possessed master’s degrees. In many situations, following the
directives of the principal may still seem like a good way to enhance a
counselor’s career. Today, however, professional school counselors see
themselves as highly trained professionals who create new systems rather
than react to the job as other people see it. They set the mental health agendas
for the schools, lead efforts to prevent problems like bullying, demand
supervision by seasoned counselors, have special training in crisis
intervention and suicide, and understand emotional barriers to school
achievement. Standing up for spending your time doing what you were
trained to do rather than allowing your role to be defined by others is a
leadership function.
All counselors who work in agency settings such as mental health counselors,
marriage, couples, and family counselors, and rehabilitation counselors must
similarly become proactive in identifying unhealthy work situations, such as
too many clients, too little time to deal with emergencies, and inadequate
supervision (Young & Lambie, 2007). Leadership for the counselor working
in an agency means making sure that the way counseling is practiced is in
accordance with ethical and legal standards. For example, some new
professionals have reported that they see questionable billing practices at
their sites, and others have found therapists who make clients dependent upon
them or who use clients sexually. The professional counselor must sometimes
be an “army of one” who must speak up, regardless of consequences,
especially when clients are being harmed.
Words of Wisdom
“We have to move ourselves from seeing a problem and thinking someone
should do something to recognizing that we can step up—to a sense that I
should do something. That is leadership.”
Source: Adam C, student in Counselor Education practicum class
A Lifelong Learner
One of the things you face as a counselor at all phases of your career is the
fact that you cannot know everything you need to know. The diversity of
client problems and their myriad background issues make it impossible to be
completely conversant with the full range of client backgrounds and
disorders, from eating disorders in children to counseling low-income
couples. Lifelong learning is the only answer because, although it would be
nice to be able to choose your specialty, sometimes your specialty is
determined by the clients that you see. For example, even if you choose to be
a career counselor, you need to recognize (and refer) clients who have
significant pathology that is interfering with their ability to hold down a job.
Receiving advanced training beyond your formal degree is a good way to

improve your skills, especially if you are in a specialized setting such as a
substance abuse treatment center. Of course, you can still take university
classes in areas you want to explore. Another way people do this is to get
certified by some organization. A few of these credentials are recognized as
requiring lengthy and exacting training such as AAMFT (American
Association for Marriage & Family Therapy) Approved Supervisor. Some
certifications, however, are money-making ventures for a private institute that
require little training beyond sending a check. For example, online you can
find individuals who hold themselves out as a “Nationally Certified
Body/Mind Therapist.” The home study certification costs $295.00. Although
it is legal to put this somewhat bogus title after your name, it may not be
ethical. The ACA code of ethics prohibits us from misleading others about
our credentials.
One of the best ways to get advanced training is to attend conferences in an

area where you are considering getting training. Different conferences are for
different counselors and for different stages of life. There is a convention for
spirituality in counseling, play therapy, biofeedback, psychodrama, brief
therapy, and even a creativity conference. The people you meet at
conferences can be sources of information and learning for you. At the
American Counseling Association Conference & Expo, attend a Learning
Institute for a day or half-day to get a handle on how to work with couples,
help clients with grief, conduct play therapy, assess domestic violence,
develop a private practice, use mindfulness, or increase your diagnostic skills
using the DSM. These initial experiences are relatively inexpensive, give you
sense of something new, and can lead you to more intensive training once
you find out what resources are available and which ones are legitimate. Here
are some other ways we think will keep you on the forefront:
1. Check the bookstores. Many of the most important trends in counseling

start first in other professions. Trade books are indicators of where the
profession is moving. What trends are people responding to? What types
of problems on a local or national level will require counseling
interventions?
2. Apprentice yourself to another counselor. Find a counselor who is

constantly learning and growing.
3. Develop a lifelong learning community. Some counselors, especially

those who were in cohorts during their formal training, get together on a
regular basis for support and to share where they are going.
4. Make sure you have access to the counseling literature. There is no need
to “reinvent the wheel” each time you begin a new project. Beginning a
group for children with anxiety disorders? Articles and curricula are
already available.
5. Stay connected with a professional counseling organization, the

American Counseling Association (http://counseling.org) and/or the
American School Counselor Association (http://schoolcounselor.org).
They will send you newsletters, publication catalogs, and online updates
about what is happening in the profession.
Whatever strategies you use, we want to remind you that becoming a lifelong
learner doesn’t just happen. You need to make make an intentional effort to
engage in lifelong learning and to become the professional counselor that you
wish to be. In this chapter’s informed by research, you’ll read about how
several researchers have conceptualized the process of growing your own
professional identity as a counselor.
Technologically Competent
Counselors need familiarity with the latest technology to help with
communication (emails, text messages, instant messaging), access to
information (library searches online), and technological methods to manage
the counseling program (calendars, spreadsheets, apps, programs that let you
organize and analyze data and make charts and graphs).
Since the turn of the 21st century, counselor education programs have been
increasing their use of distance-based education. Wantz et al. (2003) found
that 42% of CACREP programs incorporated online learning. Although no
data is available, it is safe to say that the majority of counseling programs
now have some online courses. Podcasts, video conferencing, and hybrid
instruction with some typical classroom blended with online assignments are
increasingly popular. The ability to learn online and master the associated
technologies will be important in continuing education.
Besides technology that assists counselors in their jobs and in their

continuing education, more client-oriented applications are becoming
popular. Right now, computer programs and home biofeedback devices are
available that help clients monitor stress. Self-help programs have also been
developed for coping with psychological problems such as fear of public
speaking, agoraphobia, and loneliness. Clients who have trouble attending
counseling sessions because of distance or fear can go online daily to chart
their symptoms or thoughts and share them with their counselors or doctors.
These technologies allow clients to become more responsible, but some
technologies can lead clients to wrongly believe that assistance from a
counselor is no longer necessary. Helping clients navigate the newest
technologies will be an important skill for counselors of tomorrow.
Informed by Research How Your

Professional Identity Grows:
Qualitative Research
Remley and Herlihy (2007) identified six elements that they believed are the
core set of knowledge and beliefs that comprise a counselor’s professional
identity. They include (1) knowledge of the history of counseling, (2) the
philosophical underpinnings of the profession, (3) the roles, jobs, and
functions of counselors, (4) professional ethics, (5) professional pride, and (6)
professional engagement. Can you see that knowledge is part of professional
identity, but so is feeling that you are a part of the profession? But how does
one acquire these qualities? Does it begin during their training?
A series of qualitative studies have attempted to understand how counseling

students and professionals take on the identity of professional counselor.
In 2010, Gibson, Dollarhide, and Moss conducted seven focus groups of

counseling students. (A focus group is a recorded discussion of interested
individuals on a topic.) They found that counseling students go through three
important developmental tasks in order to transform their professional
identity. Counseling students have to (1) move to an internalized
understanding of the definition of counseling; (2) become self-directed
learners who are responsible for their own professional growth; and (3)
develop a relationship with a community of professionals and begin to see
themselves as part of that community.
A follow-up study with six focus groups of practicing counselors (Moss,

Gibson, & Dollarhide, 2014) found that professional identity development
continues after the completion of graduate training. Again, three
transformational tasks emerged for practicing counselors to work toward the
development of a lifelong professional identity. Professional counselors have
to (1) adjust their expectations from idealism to realism, which gives them a
deeper understanding of the joys, and limitations, of the counselor role; (2)
move from frustration and insecurity to an increase in confidence and
freedom, which leads to rejuvenation; and (3) develop an integrated and
congruent sense of self that includes both personal and professional identity,
rather than compartmentalizing and separating the different parts of the
counselor’s life.
In summary, the authors of these studies confirmed their hypothesis that the
development of a professional identity as a counselor is a long and complex
process. During graduate training, students acquire specialized knowledge
and skills, and start to find a professional fit within the community of
counselors. As they do so, they move from a reliance on external authorities
and experts to a more internally focused locus of authority. This
transformation continues throughout the entire career of professional
counselors. Moving from idealism to realism, from frustration and exhaustion
to rejuvenation, from a compartmentalized sense of self to an integrated
congruent self, and from the need for external validation to self-validation all
become part of the journey of the counseling professional.
Hand-held devices
Hand-held computers such as tablets or smartphones have the most potential
for helping both clients and counselors and increasing our ability to provide
evidence of our effectiveness (Cucciare & Weingardt, 2010; Parmar &
Sharma 2016). A hand-held device can deliver reminders and monitor
exercise and diet or track mood symptoms with great efficiency. Hand-held
devices have been found to be helpful with clients trying to overcome obesity
(McDonielab, Wolskeeb, & Shenb, 2010) and with social skill development
for adolescents on the autism spectrum (Campbell, Morgan, Barnett, &
Spreat, 2015); some apps appear to be effective in treating depression
(Roepke et al., 2015). A smartphone allows access to the Internet from
anywhere, giving you information that you or the client may need. Imagine
being able to give the client an entrée into a support group that they can
access from their own pocket. Smartphones can help clients track homework,
moods, and even act as a pedometer or other health monitor. What if we
could record a person’s social interactions via their smartphones and help
socially isolated clients increase the quantity and quality of their
relationships? There are clearly many exciting uses for this technology on the
horizon.
Video
Another technology relevant to counselors and clients is the improved quality
and availability of video. Video can, of course, be used in training and
supervision, and it is now cheap enough for most counseling clinics and even
private offices to record and store video. Although having accurate records of
counseling sessions might help with legal issues, it could also help counselors
keep on top of their game by being a source of self-supervision. If the
counselor reviews only a small portion of last week’s video as preparation, it
may allow for better preparation for this week. Live video using smartphones
is now a reality, and it becomes possible for a supervisor to look in on a
counselor’s session whenever they wish.
But the use of video goes far beyond supervision or self-evaluation. Video
will soon be used to help clients learn skills and evaluate their performance.
Filmmaking, for example, may be a new form of therapy (Cohen, Johnson, &
Orr, 2015). Video games will be developed with therapeutic themes, and
counselors and clients will interact with each other and with the counselor
(Ceranoglu, 2010). Video will be used to help clients learn materials for
psychoeducational purposes and it will be delivered over the Internet. For
example, video can be utilized to present models of successful behaviors for
children and adolescents (see Carr & Fox, 2009; Steadman, Boska, Lee, Lim
& Nichols, 2014).
Counselors may be required to learn how to use video in their counseling

sessions as video feedback for clients (Polfai, 2007). Video allows us to get
very specific feedback on our performance, just as group counseling can
provide feedback on social interactions. Couples can see exactly how they
fight unproductively, and clients with social anxiety can learn to interact
better and with less fear (Parr & Cartwright-Hatton, 2009).
Words of Wisdom
“It is true that we have made great scientific progress. We have already
reached the moon and we are trying to reach other planets. But we have failed
to reach the heart of our neighbor.”
Source: Sant Darshan Singh
Planful and Intentional in

Maintaining Personal Wellness
Counseling can be stressful, and the threat of burnout and vicarious
traumatization is real. Burnout is a syndrome that makes you see clients as
objects and is characterized by hostility and fatigue (Wardle & Mayorga,
2016). Vicarious traumatization, on the other hand, can occur to any
counselor but especially those who work with physically and sexually abused
people. It is not always easy to shake off the stories you hear. To be fully
present for the next client, the counselor of tomorrow must have a good life
on the outside, one that provides positive emotions, emotional security,
peace, and fun. However, this good life doesn’t just happen. We must
develop a plan for exercise, fun, time with significant others for social
support, relaxation, and spiritual renewal (Meany-Walen, Davis-Gage, &
Lindo, 2016). If you were living with an Olympic athlete, you would expect
him or her to have a rather rigid schedule of self-care. Perhaps we need to
educate our significant others about our own limits? Just like an athlete
facing an upcoming marathon, we must also have a schedule of self-care that
involves taking the time for emotional and physical self-care. Lack of sleep,
junk food, and emotional emergencies can affect your work. Self-neglect is
not a long-term option for the counselor of tomorrow.
There are many ways to develop a wellness plan, including the one we
included in Chapter 13 of this text [see Granello (2011) for a more
comprehensive strategy for counselor wellness]. You may want to simply list
the categories of wellness and develop a short-term plan to improve in one of
the categories. The major categories include intellectual (keeping yourself
mentally sharp), physical (diet and physical activity), emotional (keeping
negative feelings at bay, increasing positive ones), social (keeping your
support system alive and enhancing your primary relationship), spiritual
(developing happiness and serenity from prayer and meditation or a sense of
connectedness), and occupational (making sure your work is safe, interesting,
and in a supportive environment).
In addition to a plan, a counselor needs a bag of tricks to use at work to brush

off the negative feelings from the last client and move on to the next. Among
these tricks is taking the time to go to lunch with colleagues, meditating, or
just going outside for five minutes. Small breaks like these slow down the
pace of life. Learning to enjoy what is happening in the present rather than
focusing on mistakes and worries is something we try to teach clients, and we
need to focus on it in our work life, too.
Able to Read and Evaluate

Forschung
The counselor of tomorrow must have a strong understanding of research
(there is more about how to read and evaluate research in Chapter 7 of this
text). When you read a research study that promises to help you in your work,
ask yourself the following questions:
“Was the study properly designed and carried out?” To be a good

consumer of research, you should be able to identify a bad study. For
example, we saw the published results of a survey that was sent out to
supervisors in mental health agencies. They were to copy the survey and
administer it to their supervisees. Some of the supervisors sent back
surveys, others did not. The researcher did not know who had and who
had not responded. It was unclear at the end where the 50 participants
came from. In fact, they may have come from a single agency.
“How many people participated in the study” The answer about how
many subjects make a good study depends on what kind of research you
are doing. In general, for quantitative research studies, the more the
better, although this is not always the case. Researchers use a formula to
identify how many subjects they need before they can boast that their
treatment is effective. Qualitative studies may utilize only a few subjects
but examine their responses in detail. As we will see below, even when
you have a lot of subjects, it cannot overcome the problem of where you
got them.
“Who were the subjects?” An article in Self Magazine (Pawlik-Kielen,

2008) has drawn fire because more than 4,000 respondents were readers
of the magazine not sampled from the U.S. population. About 75% of
the respondents reported eating patterns that could be considered eating
disorders (like bulimia). Although the researchers tried to explain that
these results did not necessarily reflect the view of all Americans, the
article is written in such a way that makes it seem that most women have
these problems. We can be sure that the people who read a magazine
that focuses on beauty were more concerned with dieting and losing
weight.
“Who conducted the research and who paid for it?” This is the problem
with online and social networking site research because the studies may
be paid for by advertisers. Yet, we recently saw a published journal
article about a counseling organization that was sponsored by the
organization itself. Guess what? It found that the organization made a
difference in people’s lives. The companies and individuals who
conduct these surveys have something they want to sell or may not
allow the publication of findings if they are not flattering.
“Where was the research published? Was it Self Magazine or the

Journal of Mental Health Counseling? Before you believe Internet blogs
about the next great counseling technique, look at an article from a
respected journal to see whether there is any research behind it and
whether the article has been subject to rigorous peer review. If the article
contains a review of previous research or if the article presents no
original research, even if it comes from a worthy source, it may be
biased or represent the authors’ viewpoints rather than a scientific look
at the effectiveness of a technique.
Active in Professional Organizations

As a student, you might begin to find the benefits of professional groups
through Chi Sigma Iota, the counseling professional honor society, or other
student organizations. Leadership and involvement in groups like these
prepare you for later work at the local, state, or national level. Why get
involved in these groups? Your job may depend upon it. The fact that
counselors are now licensed in every state is due to the grassroots work of
counselors who knew that opportunities were being denied by legislatures,
school systems, and other professional groups. When licensure laws were
passed and amended, the real heroes were counselors who went to the state
capitol, year after year, to testify and lobby for access. It is because of them
that counselors are gaining access to the Veterans Administration, Medicare,
Tri-Care, and other sources of funding that have been jealously guarded by
other professions. Counselors, through their professional organizations,
sponsor days on Capitol Hill or the state capitol to meet with legislatures.
Through these events, the ability to use psychological testing instruments, to
fund rehabilitation counseling, to get reimbursed by third-party payers, and to
increase the financial ability of school systems to hire more counselors have
all been achieved.
Besides advocating for counselors, professional groups can provide you two
other crucial benefits. First, conferences, both small and large, keep you on
the cutting-edge and can protect you from burnout. Second, professional
groups also have the power to support you. Going to a conference and seeing
the universal things we all face helps us recognize that we are not alone, and
there are solutions and strategies that others have discovered.
Able to Work with Couples,

Families, Individuals, and Groups
Some beginning counselors reject working with groups, couples, or families,
feeling sure that they will only see individuals. Then, the first day on the job,
they ask you to run a group with families. That is why being broadly trained
is critical. We cannot be sure what we are going to run into on the job or what
we are going to love. We frequently hear beginning counselors say, “I don’t
think I would like working with middle schoolers,” and later hear the exact
opposite when they have the experience to interact with that age group.
One area receiving increasing emphasis is working with couples and families,
even in the school system. CACREP training programs do not currently
require students to take courses in marriage couples and family counseling
unless your degree is in that specialty. Yet, in the future, counselors in all
settings will need to know more about how to do this type of counseling
because couples and family work is now expanding to many different
settings, including prisons, the military, college counseling settings, and
hospice (Doherty & McDaniel, 2010). The school counselor will be
interacting with parents and may even run groups for parenting skills. The
rehabilitation counselor should know how a family can support a client with a
disability. Without a doubt, substance abuse counselors will help their
clients’ recovery if they know how to conduct family counseling sessions.
Even if you are a college counselor and you think you will only be working
with individuals, many college students have significant problems that
revolve around their relationships, including with their families of origin.
A Social Justice Advocate for

Clients and the Profession
Counseling’s history began in the repressive conditions of the industrial
revolution. It was built on a foundation of societal change, and a thread of
that reformer’s spirit has remained. Today, there is a movement within the
profession to have counselors become more trained in social justice advocacy
(Meyers, 2014; Ratts, Toporek, & Lewis, 2010). Advocacy for the counselor
means trying to influence political, economic, and social institutions to
become more just and more accessible to the needs of all people (Cohen,
Vega, & Watson, 2001). Articles on social justice and advocacy appear in all
of the counseling journals from employment counseling (Marzucco &
Hansez, 2016) to school counseling (Feldwisch, 2016). Many believe that
advocacy is a crucial skill needed to combat oppression (Holcomb-McCoy &
Bryan, 2010) and to help recognize the effects that the environment have on
the lives of our clients (http://ACEstoohigh.com). Advocacy can be as simple
as helping a client obtain health care reimbursement when unfairly denied or
supporting a high school student who has been unfairly victimized by other
students.
Advocacy also means being proud of the profession and becoming involved
in local, state, and national issues and organizations that represent and
support counseling. That may mean trying to persuade school administration
to offer supervision for school counselors at the system or county level. It
may mean going to the state capitol to speak in favor of legislation, visiting a
legislator, or writing a letter. Professional advocacy opportunities become
available when you join list serves or get newsletters from your professional
organization.
A Reflective Practitioner
A reflective practitioner is one who consciously thinks about and evaluates
professional actions, beliefs, values, and theories and improves individual
practice based on this reflection (Schön, 1987). The reflective practitioner
concept sees the learner as an active and engaged participant, not a passive
receiver of knowledge (Nelson & Neufeldt, 1998). This means speaking up in
class and reacting honestly to what you hear.
One of the simplest and most effective ways to begin becoming reflective is
to keep a journal in which you respond to what you have learned and your
reaction to it is based on previous learning, your conscience, prejudices, and
feelings (Collins, Arthur, & Wong-Wylie, 2010; Wright, 2005). In this text,
we have asked you to journal about your reactions to the material, but every
course may not be structured in that way. We hope you will decide to
continue your journal in other classes, keeping track of your major learning
points and chronicling your growth and your reactions to the material. If you
do, it will help you analyze your resistance to and acceptance of the material
you are exposed to. It may help you understand yourself better and help you
apply what you are learning when you encounter real-life situations with your
first clients in practicum and internship.
Ethically Aware
The problem with relying on a course in ethics is that students tend to
memorize ethical standards but may not be able to use them as guidelines
rather than rules. Ethical guidelines are tools that you use to judge potential
courses of action. They are not commandments. A professional is not a rule-
follower but must respond as a reflective practitioner during ethical
dilemmas. The thorniest issues in counseling involve problems too complex
to be instantly solved by rules (Lambie, Hagedorn, & Ieva, 2007; Tennyson
& Strom, 1986). Guidelines are there to help the professional make difficult
decisions, not make the right decisions, because there may not be one right
decision, only a best decision. So, beyond learning the ethical guidelines, the
counselor of the future must be able to do two other things: reflect and
consult.
Both reflection and gaining knowledge help you grow as a counselor. These
activities help you become more cognitively complex in your thinking as you
struggle with ethical dilemmas, real-life situations, and implementing the
ethical guidelines (Lambie et al., 2007). That means that you do not just
repeat simple responses that reflect a right/wrong mentality. You begin to see
ethical dilemmas in their full complexity, and you are able to construct
solutions that take into account the many different perspectives in each
situation.
In addition, being ethically aware means that you do not have to react
immediately and make snap decisions. You can take the time to formulate a
plan by consulting with someone about possible alternatives. We call this
kind of reflection supervision. Supervision is the counselor’s secret weapon
against clinical, ethical, and legal mistakes. As we point out this ongoing
need for supervision, we are also aware that ethical issues arise more for
school counselors than for those who work in other settings (Remley &
Herlihy, 2007), and yet it is the environment in which supervision by a fellow
professional is the hardest to obtain (Walker, 2015).
Able to Use Assessment Data to

Plan Intervention and Treatment
At this point in history, many counselors are not trained at the master’s level
to conduct psychological assessment batteries. We are taking the point of
view that counselors—now and in the future—must be more involved in
assessment, especially in the area of risk for suicide and violence (Granello,
2010b; Moran, Sweda, Fragala, & Sasscer-Burgos, 2001) and for monitoring
client progress (Young, 2017).
We have advocated for counselors to utilize assessment methods, both formal

and informal, to prove to themselves and to others that counseling is working.
For both children and adult, brief measures such as the OQ.45 and the YOQ
can be given throughout treatment to gauge overall psychological distress in
adults and children. Other measures such as the Beck Depression Inventory
can be used to identify specific symptoms. In addition, counselors need to
keep track of improvement in grades, or behavior changes as measured by
parent and teacher observations. Marriage, couple, and family counselors
should be able to use observation techniques to identify healthy and
unhealthy communication patterns. In short, the future will probably involve
more use and more training in assessment if individual counselors and the
profession seek to justify its effectiveness.
In the Crystal Ball
While focusing on proven and promising practices, it is also useful to keep
our eyes on the horizon. It is time to go out on a limb and suggest some areas
that may possibly emerge in the counselor education program of the future.
These are areas for you to explore.
The Rise of Ecotherapy

Eco-counseling is a term that has been used to talk about family ecology or
the relationship between components of a family system (Huber, 1994) and
quite differently by others who want to use counseling expertise to solve
environmental problems (Howard, 1993). But ecotherapy is something else.
In the future, nature will be used, to a much greater degree, as an adjunct to
counseling (Hasbach, 2012; Wolsko & Hoyt, 2012). Many of us are familiar
with Outward Bound and other adventure-based counseling programs or
wilderness therapy that pose physical and interpersonal challenges in a
natural setting as a therapeutic process (Hill, 2007; Swank & Daire, 2010).
That trend will almost certainly continue and expand. The next phase will
involve utilizing the wonder, awe, and natural healing qualities of nature
rather than just physical/emotional challenge and the development of team
work skills (Chalquist, 2009; Prade & Saroglou, 2016; Schneider, 2015).
People will spend extended periods in natural locations as a form of therapy.
One of the first articles on ecotherapy in the counseling literature appeared in
2004 (Davis & Atkins, 2004, 2009). For more information, see Sackett
(2010) who discusses its potential salutary effects on young people.
The Mainstreaming of Japanese

Therapies, Meditation, Yoga, and
Eastern Perspectives
Japanese therapies are old news in counseling. Morita therapy has been
around for some time but was introduced in the United States in the 1950s
(see Kondo, 1953). Other therapies such as seiza, shadan, and naikan therapy
share a similar contemplative approach. They have been labeled the “Quiet
Therapies” (Reynolds, 1982) because most involve periods of isolation and
reflection, but their primary goal is to spur client action in the face of
inaction. Despite having become more aware of these therapies, they have
proven difficult to adapt to the western audience. In the future, adaptations
for a western audience will arise when current research studies confirm their
effectiveness (Zhang, Yuan, Ren, & Lu, 2014).
The prevalence of hatha yoga (the yoga of physical exercises) and an upsurge
in meditation are likely to influence counselor practice and theory (Schure,
Christopher, & Christopher, 2008; Young, de Armas DeLorenzi, &
Cunningham, 2011). For example, mindfulness has become a buzzword in
new approaches to counseling. Mindfulness is a form of meditation in which
one keeps attention focused on here and now actions and thoughts. Jon
Kabat-Zinn pioneered medical uses of mindfulness in his system,
Mindfulness Based Stress Reduction (which integrates hatha yoga) (Kabat-
Zinn, 2003). There are many other forms of meditation yet to be researched
(Gutierrez, Conley, & Young, 2016). In the future, therapies that include
meditation and mindfulness will increase (Bingaman, 2016).
Increasing Problems with Process

Addictions
One in six Americans uses marijuana, and more and more states are
legalizing its use for adults. The literature of the past 20 years shows that
marijuana use creates dependence in 10% of its users, increases car accidents,
and leads to mental health and social issues in adulthood. About 35% of
twelfth graders report using marijuana within the last year (National Institute
on Drug Abuse, 2017). Particularly for children and adolescents, there appear
to be detrimental effects of marijuana use on the developing brain (Hall,
2015). Opioid use and overdose is an area of increasing concern as more and
more people struggle with this addiction and the rates of death from opioid
overdose tripled between 1999–2014, and deaths from one particular type of
synthetic opioid, fentanyl, increased 72% from 2014–2015. (Centers for
Disease Control and Prevention, 2016a). These kinds of statistics are
alarming, but alcohol remains our most significant drug problem, with
millions of Americans in need of treatment and more than 88,000 alcohol-
related deaths each year (National Institute on Alcohol Abuse and
Alcoholism, 2017a). Clearly, the counselor of tomorrow must be able to work
with clients who have substance use and abuse.
There are many treatment options available and self-help groups for
substance addictions. But treatment is not widely available for all kinds of
addictive behaviors. We have become more aware of process addictions that
do not involve a substance but are the result of repetitively engaging in a
process, such as watching Internet pornography, playing video games,
gambling, spending money, and even working too much (see Smith, 2015).
They become addictions when they cause disruption in the person’s career,
finances, and relationships (the same kinds of things that happen with
substance addictions). Counselors will need more training in this aspect of
addiction.
The Death of Counseling Theories

Beginning in the 1980s counselors and therapists of every ilk showed less
allegiance to a particular school of thought compared to earlier decades. An
array of studies has shown that more than 75% of counselors are eclectic or
integrative because they do not subscribe to a single theory (Young & Feiler,
1994). John Norcross has followed trends among psychologists and found
that integration has grown over time (Norcross, Hedges, & Prochaska, 2002;
Norcross & Rogan, 2013), so the number of counselors who consider
themselves to be eclectic or integrative will likely increase.
Because counselors will want to utilize therapies that have been proven,
trainees and experienced counselors will be less likely to accept the premise
that one technique or one school of thought is the best for everything. There
are new data suggesting that although cognitive behavior therapy has
traditionally had the most research and evidence to support its use, it may not
be the magic bullet that it was once considered to be. There are emerging
therapies with good research to which we should pay attention. For example,
research is confirming the effectiveness of a wide variety of neglected
techniques in positive psychology including gratitude, hope, and forgiveness
(see Lopez, Pedrotti, & Snyder, 2015). We predict counselors will find ways
to organize their treatments using the best of what is available while
considering the individual personality, culture, and preferences of the client.
Counseling will become more individualized and less driven by theory.
A Focus on Health, Wellness,

Prevention, Complementary and
Alternative Medicine, and Using
Discoveries in Neuroscience
The use of complementary and alternative medicines (CAMs) has increased
in all areas of medicine, and clients who want to improve their mental health
will utilize more of these treatments (Lake & Spiegel, 2007; Lavretsky,
Sajatovic, & Reynolds, 2016; Micozzi, 2011). Evidence of its growing
popularity includes the fact that the federal government has increased its
budget to the National Center for Complementary and Alternative Medicine
(http://nccam.nih.gov) and Medicare now has codes for preventive health
interventions. We can expect that treatments such as acupuncture,
homeopathy, osteopathy, chiropractic medicine, yoga, meditation, massage,
and others will gain status as evidence-based treatments for mental disorders
(Barnett, Shale, Elkins, and Fisher, 2014).
For good or ill, pharmaceuticals for mental health problems will become
more popular. Drugs will become more specific. Counselors need to
understand the medications that are used to treat their clients so that they can
alert the supervising physician about good and bad effects they see.
Counselors need to obtain training in basic psychopharmacology if they are
to be ready for the next set of biomedical interventions.
Just as counselors now use biofeedback devices to identify times when clients
are emotionally aroused and when they relax, in the future, feedback from
non-invasive scanning technology may allow us to see into clients’ brains.
Right now, biological bases of behavior are largely ignored in counselor
education (Barden, Conley, & Young, 2015). The counselor of the future
must find a way to get training to stay current with medications, CAMs, and
health and wellness promotion innovations.
Advances in Neuroscience
Neuroscience has been producing data that helps inform counseling (Barlow,
2014; Goss, 2016). Many of these findings do not have immediate application
but are intriguing nonetheless. For example, it turns out the brain changes as
it adapts to new experiences and the associated emotions. Further, the brain
adapts to its environment throughout life, not just in childhood. This is
sometimes called neuroplasticity (Grawe, 2007). Neuroplasticity is merely a
buzz word today, but in the future it may be important as we see the ways
that the brain changes due to psychotherapy or stressful experiences. We
already are beginning to understand the impact of toxic stress on the physical
structure of the brain (Boyce, Sokolowski, & Robinson, 2012). In the future,
we may be able to track brain changes as they react to therapeutic
interventions. We may be able to determine how effective a method is by its
neurological effects and we may be able to strengthen weak areas of brain
function with psychotherapeutic techniques.
Fast Fact
About one-third of American adults engage in complementary and alternative
medicines (CAMs), at a cost of more than $34 billion. Some of the most
common types of CAMs include vitamins, chiropractic care, yoga,
homeopathy, meditation, acupuncture, and massage therapy.
Source: Clark, Black, Stussman, & Barnes (2015). CDC National Health
Statistics Report #79. Trends in the use of complementary and alternative
medicine use among adults: United States, 2002–2012. Retrieved from: http:/
/www.cdc.gov/nchs/data/nhsr/nhsr079.pdf
Findings in neuroscience are also expected to affect counseling because of an

understanding of “high road” and “low road”—two pathways in which the
brain is activated. High road responses are thoughtful while the low road
(limbic response) is quicker, more intuitive, and probably built to protect us
from danger. With a low road response, we can react quickly to a snake in the
woods, but it may not be helpful in human relationships if we react
emotionally and irrationally (Fishbane, 2007). Understanding the
neurobiological effects of trauma has led to new treatments (Siegel &
Gottman, 2015).
Within marriage, couple, and family counseling, John Gottman (1999) has
discovered that many couple communication problems are caused when one
member is flooded with negative emotions (such as anger) that keep him or
her from connecting verbally. Couples are now being taught to self-soothe
and not to activate the other person’s emotions so that communication can
take place on the high road. There is now a field of study called interpersonal
neurobiology (Fishbane, 2015).
Virtual Reality Will Be Used to

Train Counselors and Help Clients
Practice
There is a concept called transfer of learning. It suggests that if you are in a
learning environment that is similar to the actual situation you will face, you
will transfer your training to the real situation more easily and completely.
Right now, computer programs are being developed that allow clients to
slowly approach feared objects, such as exposure therapy through virtual
reality glasses (North & North, 2016). Thus, the client who is afraid of
spiders will be able to hear someone say “spider” until they are comfortable.
Later they will put on special goggles and encounter virtual spiders before
trying to face them in life. Virtual reality has applications for body-image
distortion, treatment of post-traumatic stress disorder, testing, rehabilitation,
and pain control (Riva, 2005). Virtual reality will be enhanced by full-
immersion headsets and glove interfaces that allow for manipulation of
virtual objects (see Goss & Anthony, 2009).
A group of researchers in Spain have recently developed something called

“EMMA’s world” (Baños, Botella, Guillen, García-Palacios, Quero, Bretón-
López, & Alcañiz, 2009). It is a virtual world that can be adapted to treat a
wide variety of stress-related disorders including post-traumatic stress
disorder, adjustment disorder, and pathological grief. The client selects
environments and tools that help freely express emotions and review
important people and moments. Initial trials seemed to decrease negative
emotions and increase positive emotions. Other virtual reality interventions
also have been found to work particularly well with anxiety and stress-related
disorders (see Botella, Serrano, Baños, & Garcia-Palacios, 2015, for a
review).
In the final Snapshot of this text, Dr. Marty Jencius, an Associate Professor
of Counselor Education at Kent University, discusses his lifelong fascination
with technology and his application of the latest technological breakthroughs
to the world of counseling and counselor training. Dr. Jencius is an
internationally known scholar in the field of technological applications to
counseling, and his story can help spark your creative ideas about where
technology might take the profession of counseling in the future.
SNAPSHOT Marty Jencius,

Associate Professor, Kent State
University
a.k.a. Kimbo Scribe, Dr. Jencius’ avatar in the virtual world of Second Life
I am grateful to be in a profession where I can mix work with play.
Technology is the form of play that I get passionate about. Once I am
passionate about an idea, it ceases to be work and becomes play for me. My
play (and work) is in the deciphering of how technology works and then
discovering how it can be applied to counseling and counselor education.
My career in counseling started as a volunteer on a crisis line, communicating

care and offering assistance using telephone “technology.” In 1990 I
convinced my spouse that I needed a personal computer to complete my
doctoral program. I became fascinated with the computer’s information and
productivity capabilities, but also with email and live chat rooms that were
developing as means of communicating and forming relationships.
In 1994, I attended a regional counseling conference where healthy academic

discussion raised questions of how we might continue these conversations. I
offered to create a listserv for counseling faculty and supervisors, CESNET-
L, which still exists and now has more than 3400 members. I have always
been excited about the “next new thing” and have managed to apply
technology trends to counseling as my scholarship. In 1995 the next new
thing was the World Wide Web. I was involved in creating websites for
several counseling associations, and as a new counseling professor I
produced course content on CD-ROM. I believe that much of what we do in
classrooms can be done using technology and that face-to-face classroom
instruction should be for personal interactive experiences. I helped create The
Journal of Technology in Counseling, the first online, peer-reviewed journal
in the counseling profession. It was the beginning of a current trend to get
content from producers (authors) directly to consumers (counselors and
counseling students). I believe that content should be free or at little cost to
consumers, so all my projects are publicly available and free of charge
through the efforts and generosity of contributing colleagues.
In 2000 I moved to my current position at Kent State University where my

interest and opportunities with technology grew. When I started listening to
podcasts in 2005 (to occupy my mind on long international flights), I got the
idea of creating an audio podcast interview program for counselors called
CounselorAudioSource.Net. In 2008 a doctoral student introduced me to the
virtual world of Second Life. Later that year we created Counselor Education
in Second Life (http://SL.CounselorEducation.org), which serves as a training
site for professional conferences and workshops. These training experiences
can be held without the cost of travel, hotels, and conference centers. I am
now passionate about the idea of virtual presence; the visceral connected
experience people have when using technology in the counseling field sets a
foundation for therapeutic change.
Teaching has always been a great place for me to experiment with

technology. For my Advanced Theories class we took a dimensional view of
theories, unlike the traditional categorical approach, and rated theories on
fourteen dimensions. We were able to run that data through a 3-D printer and
make physical models that represented counseling theories.
What does the future hold for technology and the counseling profession? The
“real” presence of a counselor will never be eliminated by the virtual
presence of an avatar. Humans have far too complex a personal narrative to
be replicated or replaced by a computer program. Technology, however, is
another way by which people can teach and create a psychological contact
that can lead to change.
Based on the speed of technological innovation, the creation of a “virtual

client” does not seem too far away. Imagine putting on 3-D glasses and
seeing a client, a group, or a couple sitting in front of you. Maybe it will just
be a holographic image created by multiple projectors. In this method of
training, the client responds as you ask questions or reflect feelings. Right
now, simulations are being used to help teachers learn classroom
management and for a myriad of other training scenarios, especially by the
armed services. The virtual client will probably be first used to help train
counselors in basic counseling skills and in diagnosis.
Concluding Comments: Where’s
My Jet Pack?
Yogi Berra once said, “The future ain’t what it used to be.” It is true. In our
childhoods, we were promised flying cars, underwater cities, moving
sidewalks, and a 3–4-hour workday. So, I ask, “Where’s my jet pack?” They
said it would attach to our backs and allow us to zoom to work. It turns out
change is a lot slower than we thought it would be. The bold claims of
science have not always materialized. Is life today much different than 50
years ago? People wake up, get in their cars, and go to work, sending their
kids to school where they learn from books and teachers. Their problems are
mostly with other people. They cut the grass and watch TV at night. In other
words, we need not see the future as a frightening place that is completely
different from the world of today. Rather than envisioning the world as a
train that will run us down, it is more likely that the future will probably just
creep up on us.
That means that we can take a different attitude towards the future. It is
something we can prepare for because it will be a lot like now. A better
metaphor than apocalyptic change is the idea that the counselor must stay in
touch with the most important and likely changes rather than worrying about
the improbable things. The other conclusion we can draw is that there may be
great truths about counseling and about human nature that are relatively
unchangeable, and we should focus on this fundamental understanding of
people, not only on what is new.
Counselors, like technology buffs, are on a constant search for the latest and
greatest; the technique or theory that will cure everything. In the past 80 or so
years since Freud died, there have been enduring contributions and flashes in
the pan. Among the enduring contributions, we should consider person-
centered counseling and cognitive therapy, while flashes in the pan are
exemplified by primal scream, thought field therapy, or the use of
psychedelics.
So, what can you take from this chapter on the future of counseling? First, we
hope you see that counseling is a growing and expanding profession with
challenges, opportunities, and an exciting and promising future. We hope a
second take-home is a simple attitude about learning. It is important to be
prepared, but it is even better to become a lifelong learner so that you are
aware of the changes as they crawl down the pike. It is, after all, quite
unlikely that one method, one human invention, or one counseling technique
will be discovered that will solve everything. It is more likely that we will
rediscover basic truths about helping people, and the next big craze will be
old wine in new skins. In short, do not expect the kind of rapid change that
we have been promised. Rather than merely learn what is newest and most
promising, learn from the wisdom of the ages too. In your papers for class, do
not just look at the last five years of literature, go back and read Freud and
something by Carl Rogers. Despite technological change, societal upheaval,
and economic downturns, the profession of counseling will probably remain a
meaningful conversation between two or more people about how to change
and how to adapt. No technology is required.
Student Activities
2. What are your own beliefs about working with clients who represent
some of the demographic trends that were discussed in this chapter (for
example, clients from different religions or faiths than yours, clients
who are older, clients who have English as a second language, clients
who have non-traditional families)? Consider how your beliefs about
these individuals might affect your work with them.
3. In the Informed by Research section we discussed the characteristics and
stages of professional identity development. Based on their definitions,
where do you stand now?
Journal Question
1. As you look at the fourteen characteristics of the Counselor of
Tomorrow, write down a list of those that you feel describe you right
now and those that are on your growing edge. Think about one of those
that you think you need to work on. Devise a rough plan for your first
steps towards lifelong learning. For example, you might write, “I am just
learning how to be a reflective practitioner. I will start a notebook of my
reflections on counseling techniques that I learn thoughout my training
program, describing my reaction and thoughts about when and with
whom this technique might be useful.”

1. In this chapter, we discussed some of the trends that we see that might
influence the profession of counseling. What trends do you see that we
have missed?
2. As you read the 14 characteristics of the counselor of tomorrow, which

of these excite or energize you? Which ones do you think will challenge
you? Are there any characteristics that counselors of tomorrow will need
to have that you think we have missed?
3. There is increasing concern that today’s young people may grow up

without mastering the skills necessary for face-to-face communication.
Do you agree? If so, do you think this is a problem, or is virtual
communication simply a new and different (neither better nor worse)
way of interacting?
Experiments
1. Find someone who is from a faith you know little about. For example, if
you know little about Islam, write a paragraph or two about Islamic
ideas about mental health and then talk to a practicing Muslim. If you
are amazed at your ignorance, it may help to know that you are not
alone. Only about half of the people in the United States know that the
Dalai Lama is Buddhist (Pew Forum on Religion and Public Life, 2010).
2. Search your cell phone or the Internet for free applications that can be
used to chart progress with an issue such as wellness diaries, blood
alcohol content, depression, moods, medication compliance, etc. Search
for programs such as mypsychtracker.com that allow users to track
psychological symptoms and behaviors.
3. Explore the technological applications that are available for counselors

to learn more about counseling, such as those suggested by Dr. Marty
Jencius, or others. What do you think about the role of these types of
technologies in counseling or counselor training?
Explore More
1.
We have tried to cite some of the most useful articles in each section of this
chapter. If you find a topic of interest, go back to that section, and look up
some of the articles. If you are interested in exploring more about the ideas
presented in this chapter, we also recommend the following books:
Books
Maheu, M., Pulier, M., Wilhelm, F., Menamin, J. & Brown-Conolly, N.
E. (2017). The mental health professional and the new technologies: A
handbook for practice today (2nd ed.).
This book has not been released, but its previous edition was widely
praised for its coverage of legal and ethical issues and practical
applications of technology in practice.
McGeeney, A. (2016). With nature in mind: The ecotherapy manual for

mental health professionals. London, UK: Jessica Kingsley.
The book describes how to conduct ecotherapy, the evidence for its
effectiveness, and activities to use.
Montgomery, A. (2013). Neurobiology essentials for clinicians: What

every therapist needs to know. New York, NY: Norton.
This book provides an overview of neuroscience concepts and then

applies them to the settings in which counselors work: adolescents,
groups, and supervision.
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Name Index
A
Achenbach, T., 351
Ackerman, P. L., 157
Adams, M., 177
Adams, T. R., 422
Addams, J., 18, 33
Adler, A., 8, 26, 130, 191–193, 209, 422
Adorno, T., 363
Agardh, E. E., 425
Ahlbom, A., 425
Akos, P., 49
Albee, G., 418
Alcañiz, M., 467
Alexander, S., 447
Allport, G., 20
Altschuld, J. W., 238
Alves, S., 2, 63
Amatea, E. S., 139
American Counseling Association (ACA), 284

American Psychological Association (APA), 227, 240–241, 295
American School Counselors Association (ASCA), 62
Anderson, S. R., 356
Andersson, T., 425
Andersson-Arntén, A. C., 440
Anthony, K., 298, 466–467
Archer, T., 440
Ardell, D. B., 418
Arjune, B., 120
Arjune, K., 120
Armstrong, A. J., 236, 299
Arnkoff, D. B., 203
Arnold, M. S., 71–72, 316
Arrendondo, P., 87, 313, 335, 450
Arthur, N., 462
Association for Specialists in Group Work (ASGW), 91
Atkins, S., 464
Aubrey, R. F., 30
Austin, S., 355
Authier, J., 204

Axelson, S. L., 67
Axline, V., 206

B
Baillargeon, R. S., 30
Baker, C., 157
Balkin, R., 237, 262, 353
Bandura, A., 198
Bankart, C. P., 183
Banks, B. P., 239
Banmen, J., 435
Baños, R., 467
Baran, B., 157
Barden, S., 32, 447, 466
Barden, S., 287
Bardhoshi, G., 235
Barley, D. E., 194
Barlow, D. H., 466
Barnett, J. E., 466
Barnett, V., 458
Barsness, Z. I., 71
Barterian, J. A., 24
Bass, B., 255
Baucom, D. H., 200
Bauman, S., 224, 242
Baumann, E. C., 254
Bayne, R., 123, 125
Beamish, P. M., 138, 221
Beck, A., 8, 199–200, 201, 421
Bedi, R. P., 270
Bee, P. E., 297
Beers, C. W., 27–28, 318
Belaire, C., 208
Bellack, A. S., 197
Bem, D. J., 227
Benga, O., 424
Benjamin, L., 450
Bentley, D. P., 425
Berano, K. C., 254–255
Berg, I. K., 187
Bergin, A. E., 454
Bergmann, L., 62
Bernard, J. M., 65
Berne, E., 8
Bernsen, A., 393
Berra, Y., 361, 469
Bertram, B., 384
Best, M., 271
Beutler, L. E., 203
Bezyak, J. L., 217, 224
Bhat, C. S., 445
Bierce, A., 365
Bigbee, A., 425
Bike, D., 195, 437–439
Billieux, J., 445
Binet, A., 22
Bingaman, K. A., 464
Bion, W. R., 259
Bishop, K. K., 234
Biswas-Diener, R., 447
Blacher, J. H., 94
Blanchard, M., 254

Blankenship, C., 299
Blocher, D. H., 18, 22, 33
Bloom, M. L., 52, 62
Bloomfield, M., 33
Blount, A. J., 449
Blumenthal, R., 447
Boer, P. M., 91
Boggs, S., 40–51
Bohart, A. C., 271
Bohecker, L., 239
Bonasse, F., 206
Bongar, B., 360
Bonilla, I., 421
Bonner, M. W., 55
Booth, C. S., 125
Borders, L. D., 245
Boska, C., 458
Botella, C., 467
Bower, P., 297
Boyce, W. T., 466

Boysen, G. A., 252
Bradley, L. J., 224, 297, 407
Brady-Amoon, P., 252
Braithwaite, V. A., 251
Brannon, L. A., 235
Branson, R., 430
Braverman, L. D., 290
Bretón-López, J., 467
Brett, J., 71
Briggs, C. A., 245
Brodsky. A., 433
Brookfield, S. D., 136, 148, 172
Brown, D. R., 72, 425
Brown, L. S., 189
Brown, N. W., 91
Brown, R. L., 422
Brown, T., 326
Brubaker, M. D., 189
Bruno, E., 74
Bruno, M., 246

Bruss, K. V., 134
Bryan, J., 462
Bryanova, T., 204
Buchholz, C. E., 173
Burge, P., 258
Burnham, J. J., 434
Buser, J. K., 224, 242–243
Butler, A. C., 200, 420
Butler, S. K., 88, 189, 324
Byrne, J. S., 175

C
Calderwood, C., 157
Camacho, M. J., 421
Campbell, J. E., 458
Caperton, W., 52, 62
Capobianco, J. A., 254–255
Capuzzi, D., 5
Carducci, B. J., 193
Carkhuff, R., 125, 128, 204
Carlson, J., 254
Carlson, J. S., 24
Carney, J. S., 425
Carr, J., 458
Carroll, N., 46, 48–49
Carter, J. A., 203
Cartwright-Hatton, S., 458
Casas, J. M., 311
Cashwell, C. S., 425
Cass, V. C., 89
Catell, J. M., 22
Cavanagh, S., 90
Centore, A., 305
Ceranoglu, T., 458
Chaikin, A. L., 300
Chalquist, C., 464
Chamodraka, M., 253
Champney, T. F., 205–206
Chan, T., 27
Chandran, S., 430
Chang, C. Y., 315
Chang, T., 252
Chapman, J. E., 200
Cheavens, J. S., 253
Cheever, N. A., 157
Chemtob, H. J., 255
Cheng, Y-J, 234
Cheung, O., 406
Chi, M. T. H., 136
Chiesa, R., 234

Childs, R. A., 93
Chiu, C. P. K., 424
Christopher, J. C., 140, 464
Christopher, S., 464
Claiborn, C. D., 136–137
Clance, P. R., 135
Clark, E., 75
Clements, B., 406
Clinton, B., 365
Coats, K., 173
Cockman, C. R., 49
Coffey, K. A., 426
Cohen, D., 462
Cohen, J. L., 458
Cohn, M. A., 426
Coker, J. K., 62
Cokley, K., 135
Collins, S., 462
Comas-Díaz, L., 189
Conde, J., 421

Conklin, E., 157
Conley, A., 32, 439, 447, 466
Consoli, A. J., 203
Constantino, M. J., 252–253
Conyers, L. M., 236
Cook, A. L., 87–88
Cook, E. P., 326
Cook, J. M., 204
Cook, K., 300
Cooley, E. L., 135
Coolidge, C., 365
Cooper, M., 205–206
Corcoran, K., 374
Corey, G., 284
Corey, M. S., 284
Corey, S., 284
Cormier, L. S., 125
Corrigan, P. W., 330
Corsini, R. J., 21, 184
Costa, P. T., 366

Cottone, R., 255, 414
Cottraux, J., 206

Programs (CACREP), 65
Coursol, D., 91
Coyne, J. C., 204
Cramer, D., 271
Cramer, K. M., 251
Crethar, H. C., 72, 318
Crites, J. O., 90
Crockett, D. S., 67
Cross, W. E., Jr., 89
Crothers, L., 355
Csikszentmihalyi, M., 422
Cucciare, M., 457
Cunningham, L., 426
Curtis, R., 260–262

D
Dagg-Murry, D. R., 186
D’Agostino, J. V., 93
Dahl, H., 236
Daire, A., 464
Dalai Lama, 425
Dalgard, K. A., 138
Dana, R. H., 93
D’Andrea, M., 335
Daniels, M. H., 332
Davis, Jesse B., 18, 33
Davis, K., 464
Davis, M. P., 72
Davis, P., 72
Davis, T., 413
Davis, T. E., 138
Davis-Gage, D., 459
Daw, B., 175
Day, D. D., 173

Day, J. M., 121
Day, S. X., 297
Dayan, S., 173
Dean, J. K., 315
Deane & Chamberlin, 251
de Armas DeLorenzi, A., 426, 464
Dee, C., 234
Defero, K., 235
Dejulio, S. J., 206
Delworth, U., 134
de Mey-Guillard, C., 206
Denham, S., 355
Denitzio, K., 87–88
Derelaga, V., 300
de Shazer, Steve, 187
Dewey, John, 18
DiClemente, Carlo, 203
Diener, E., 447
Dillman-Taylor, D., 290
Dillman Taylor, D., 287, 290

Ding, Y., 129
Disney, Walt, 449
Dobmeier, R. A., 2, 73, 112
Dobson, K. S., 200
Doherty, W. J., 461
Dollarhide, C., 2, 87, 134, 134, 457
Donatone, B., 326
Donovan, D., 200
Dougherty, A. M., 56
Doumas, D. M., 239
Dovidio, J. F., 251
Drake Wallace, M. J., 127
Drummond, R. J., 353
Dummett, B., 235
Duncan, K., 223, 235
Dunn, R., 74
Durell, J., 353
Duys, D., 123

E
Echterling, L. G., 63, 67, 206
Edelwich, J., 433
Edey, W., 253
Edison, T., 22, 430
Edwards, L. L., 356
Efendic, S., 425
Ehrenwald, J., 183
Einstein, E., 298
Ekstrom, R. B., 55, 94
Elder, A., 208
Elison, Z. M., 237
Elkins, G. R., 466
Elliott, K. P., 271
Elliott, M., 271
Elliott, M., 231
Elliott, R., 204, 271
Elliott, R. K., 206
Ellis, A., 11, 190–191, 199–200, 201, 438

Elmore, P. B., 55, 94
Elmore, T., 450
Emery, G., 200
Emmerling, D., 32
Emmons, R. A., 431
Epstein, N., 200
Erford, B. T., 235
Erickson, B., 304
Erickson, M., 8
Erikson, E., 29, 89
Espelage, D. L., 353
Etringer, B. D., 136–137
Evans, J. E., 272
Ewing, K. M., 135
Ey, S., 135
Eyde, L. D., 93
Eysenck, H., 201

F
Falco, M., 235
Fall, M., 288
Farber, B., 254–255, 256, 259
Feiler, F., 21, 193, 195, 465
Feldstein, J. C., 134
Feldwisch, R. P., 462
Feltovich, P. J., 136
Fernando, D., 290
Fincham, F. D., 424
Finkel, S. M., 426
Fisch, R., 192–193
Fischer, J., 374
Fish, J., 2
Fishbane, M. D., 467
Fisher, W. I., 466
Fitzpatrick, M. R., 253
Flach, F., 368
Flamez, B., 353

Flanagan, D. P., 23
Fleming, M., 231
Flores, A. R., 326
Folkman, S., 31, 418
Forester-Miller, H., 413
Forman, E. M., 200
Foster, J., 447
Foster, R., 420
Fowler, R., 29, 453
Fox, E., 458
Fox, R. E., 271
Fragala, M., 463
Frame, M. W., 388, 413
Frank, J. B., 183
Frank, J. D., 183, 253
Frank, J., 8, 203
Frederickson, B. L., 426
Freeman, A., 198
Freeman, M., 195
Freire, E., 204

Frenkel-Brunswik, E., 363
Fretz, B. R., 56
Freud, S., 5, 8, 26, 29–30, 89, 183–185, 190, 193, 210, 216
Fromm, E., 447
Fuertes, J. N., 252
Fullen, M. C., 229
Fulton, C., 90
Furlotte, C., 435

G
Galen, 365
Gall, J., 365
Gallo, M., 239
Gander, F., 431
Gask, L., 297
Gatchel, R. L., 425
Gates, G. J., 326
Gazzolan, N., 2, 63
Gearhart, J. A., 406
Gee, R., 297
Gelso, C. J., 56, 203
Gendlin, E. T., 206
Genshaft, J., 23
Gergar, P. G., 448
Geyer, P., 122
Giavannucci, E. L., 27
Gibbey, R. E., 363
Gibbons, M. M., 239

Gibbs, T. A., 28, 331
Gibson, D. M., 2, 134, 457
Gibson, W., 89
Gilbert, W., 5
Gilbody, S., 297
Gill, C., 125
Gilligan, C., 30
Ginter, E. J., 68
Gladding, S. T., 63, 127, 284, 288, 451
Glaser, K., 413
Glaser, R., 136
Glass, C. R., 203
Glass, G. V., 215
Glass, J. S., 260–262
Glasser, W., 8, 193, 209
Glauser & Bozarth, 205–206
Gnilka, P. B., 139
Goforth, A. N., 24
Gold, J. R., 203
Goldberg, C., 254

Goldberg, S. B., 71
Goldfried, M., 203
Goleman, D., 422–424
Gonzalez, L., 90
Goodwin, D. K., 368
Goodyear, R. K., 65
Gordon, V., 67
Gorski, P. C., 435
Goss, S., 298, 466–467
Gottman, John & Siegel, 467
Gracia, R., 87–88
Granello, D. H., 28, 60, 62, 96, 137–139, 148, 161, 219, 231, 233, 234,
240, 255, 330–331, 355, 361, 376, 434, 463
Granello, Paul F., 60, 62, 218–219, 231, 233–234, 255, 355, 376, 399,
427–428, 459
Grave, K., 271
Grawe, K., 466
Gredler, M. E., 238
Greenbaum, A., 370
Greenberg, L. S., 206, 271
Greenberg, S. A., 68
Greenhill, L. L., 27
Gregory, R. J., 360
Grill, V., 425
Grimmer, A., 437
Groetzinger, N. J., 57
Gross, D. R., 5
Guglielmi, D., 234
Guillen, V., 467
Gulliver, P. H., 70
Gunther, C., 235
Gutierrez, Conley, & Young, 464
Gutierrez, D., 235, 439
Guttman, J., 133
Guy, J. D., 175
Gysbers, N., 30–31, 49

H
Haas, J. S., 27
Haberstroh, S., 297
Habley, W. R., 67
Hackney, H., 125
Hadley, R. G., 238
Hadwin, A. F., 160
Hagedorne, W., 462–463
Halgin, R. P., 229
Halibur, D. A., 209
Hall, B. S., 173
Hall, C. S., 365
Hall, G. S., 33
Hall, J., 235
Hall, S. B., 224, 242–243
Hall, W., 465
Hallqvist, J., 425
Ham, M. D., 134
Hamed, S. B., 67
Hamer, A. M., 27
Hamlet, H. S., 448
Han, S. S., 206
Hansen, N. D., 127
Hansez, I., 462
Harden, J., 413
Harrison, P. L., 23
Hartley, M. T., 355
Harvey, J. C., 135
Hasbach, P. H., 464
Havice, P., 315
Hawking, S., 430
Hawley, C. E., 299
Hayden, L. A., 87–88
Hayden, S. W., 239
Hayes, B., 195
Hayes, D., 231
Hayes, J. R., 218
Hayes, R. L., 72
Haynes, G. A., 446

Hays, D. G., 2, 55, 236–237, 315, 353
Hays, J. R., 399
Hazler, R. J., 125, 138, 148, 154, 168, 355
Healey, A. C., 2
Healy, C. C., 122
Hedges, M., 465
Heesacker, M., 299–300
Hegarty, W. (Bill), 411–412
Heifetz, L., 256, 259
Heitzmann, D. E., 57
Helms, J. E., 89, 324
Henderson, P., 49
Henderson, V., 205
Hendricks, B., 407
Henning, K., 135
Herink, R., 21, 184
Herlihy, B., 400–401, 457, 463
Herman, J. L., 326
Hernandez, A., 358
Hernández, M., 421

Hernández, T. J., 2, 73, 112
Herr, E. L., 57
Herrera, M., 164
Hersen, M., 197
Hershenson, D. B., 56
Hettler, B., 424
Hick, S. F., 140, 435
Hicks, G., 420
Hill, C. E., 88, 254
Hill, M., 413
Hill, N. R., 205, 464
Hillerbrand, E., 136–137
Hinkelman, J. M., 90
Hippocrates, 390
Hjelle, L. A., 190, 193, 197–198
Hoadley, C., 173
Hohenshil, T. H., 258
Holcomb-McCoy, C., 462
Holland, J., 366, 368–370
Hollis-Peel, M. E., 221

Holloway, E. L., 96
Holohan, C. J., 300
Horney, K., 8
Horvath, A. O., 270
House, R., 71–72, 316
Houser, R., 225
Howard, G., 205
Hoyt, K., 464
Hsu, C., 339
Huber, C., 464
Huff, S. C., 356
Hughes, H., 237
Hunsley, J., 271
Hunt, B., 2
Hurt, K. M., 2
Hussin, F. B., 67
Hutcherson, P., 141
Hutchinson, T., 291

I
Ieva, K., 462–463
Imel, Z., 5, 200, 202, 206
Indelicato, N. A., 332
Ingraham, L. J., 255
Isenhour, G., 450
Ivey, A. G., 64, 204

J
Jackson, C. M., 434
Jackson, S. W., 5
Jacobs, E., 283
Jam, S. B., 67
James-Myers, L., 135
Jansson, B., 440
Janzen, J. L., 253
Jayne, K., 290
Jencius, M., 467–469
Jennings, L., 63, 137–139, 318
Jeter, W. K., 235
Johnson, J. L., 458
Johnson, M., 112
Jones, C., 258
Jones, D., 173
Jones, K. D., 55, 347, 353
Jorgensen, M. F., 223
Joseph, S., 175, 355

Juhnke, G. A. (Jerry), 74, 354, 355, 358, 376, 434
Jung, Carl, 26
K
Kabat-Zinn, Jon, 464
Kaffenberger, C., 224, 448
Kakhnovets, R., 251–252
Kalb, C., 27
Kamenetz, A., 372
Kantor, E. E., 27
Kaplan, R. M., 368
Karpinski, A. C., 139
Kassoy, F., 178
Ke, F., 173
Keith-Spiegel, P., 384, 393
Keller, H., 430
Keller-Dupree, E., 173
Kellogg, S. H., 199, 203
Kelly, A. E., 255
Kelly, G., 370
Kennedy, A., 403, 405–406
Kiesler, D. J., 206

Kim, K. K., 446
King, J. E., 135
Kirby, J. R., 160
Kirk-Jenkins, A., 236
Kirschenbaum, H., 204–205
Kiselica, M. S., 68, 72, 74, 189
Kitchener, K. S., 413
Kitzrow, M. A., 296
Klarich, C., 173
Kleinman, A., 362
Klem, J. L., 425
Kline, W. B., 90, 129, 236
Kllay, V., 424
Knox, S., 254
Kohlberg, L., 29
Kohn, A., 23
Kolb, D. M., 70
Koltz, R. L., 32
Kondo, A., 464
Koocher, G. P., 384

Kopala, M., 134
Kottler, J. A., 154, 168, 254, 262–263
Kozelka, S., 129
Kraft, J., 235
Kramen-Kahn, B., 127
Kraus, L., 330
Kreiser, J. S., 134
Krell, M. M., 87–88
Kubota, C., 217, 224
Kuch, T., 195
Kulis, S., 222
Kuther, T. L., 156, 168

L
Lafleur, L. B., 112
Lake, J., 467
Lamberghini-West, A., 315
Lambert, M., 194
Lambert, M. L., 194, 206, 253, 424
Lambie, G., 462–463
Lambie, G. W., 237, 454
Landis, E. R., 218, 399
Landreth, G., 290
Lane, G., 203
Langford, J., 135
Langman, M. C., 125
Lara, T. M., 90
Larsen, D., 253
Lassiter, P. S., 319
Lau, U., 339
Laux, J., 129
Lavenberg, J. G., 221

Lavretsky, J., 467
Lawson, G., 270, 431
Lawson, G., 125, 432
Lazar, A., 133
Lazarus, A. A., 271
Lazarus, A., 11, 133, 202
Lazarus, R., 31, 418, 418
Leafgren, F., 32
Lee, A. R., 446
Lee, C. C., 73, 458
Lee, C., 316, 320
Lee, F., 234
Lee, Gloria, 358
Lee, S. M., 332
Leierer, S. J., 271
Leiter, M. P., 139
Lemay, L., 253
Lenes, E., 237
Lent, J., 125
Lenz, A. S., 235

Leppma, M., 55, 140, 426
Lessler, K., 271
Leung, F. Y. K., 424
Levenson, H., 395
Levinson, D. J., 363
Levinson, E., 355
Levitt, H. M., 271
Levy, S., 171
Lewin, Kurt, 182
Lewis, A. N., 299
Lewis, J., 71–72, 91, 316, 461
Lichtenberg, J. W., 188
Liles, Keith, 75
Lillie, F. J., 271
Lim, X., 458
Lincoln, A., 365, 368–369
Lindo, N. A., 290, 459
Lindzey, G., 365
Linehan, M., 430
Litaer, G., 206, 271

Lock, R., 407
Locke, H. J., 357
Loesch, Larry, L., 450
Loesch, L. C., 238
Loevinger, J., 30
Lomas, G. I., 55
Lombardi, A., 75
Lombroso, C., 366
Long, L. L., 203, 286, 357
Look, C. T., 68
Lopez, R. J., 430
Lopez, S. J., 352, 465
Lopez-Calleja, D., 339
Lorr, M., 271
Lovell, K., 297
Lu, Y., 464
Luzzo, D. A., 90
Lynah, S., 75
M
Macaskill, A., 175
Macaskill, N., 175
Mahaffey, B., 75
Mahoney, M., 200
Mahoney, M. J., 133
Malinoski, A., 127
Mallinckrodt, B., 188
Malloy, L., 300
Mannis, J., 255
Manthei, R. J., 254, 271
Mao, A., 445
Mariani, M. A., 453
Maris, J. A., 140
Mark C. L., 157
Markus, H., 255
Marlatt, G. A., 200
Marotta, S. A., 94
Marshall, B., 321

Marsiglia, F. F., 222
Martela, F., 425
Marzucco, L., 462
Maslach, C., 139, 433
Maslow, A., 192, 352, 422
Massei, F., 234
Matise, M., 260–262
Matthews, C. R., 69
Mayorga, M. G., 459
McCarthy, H., 271
McCaulley, M. H., 122
McCrae, E. R., 366
McCullough, J. R., 88, 189, 324
McCullough, M. E., 431
McCurdy, K., 255
McDaniel, S. H., 461
McDaniels, C., 18
McDavis, J., 87, 313
McDonielab, S. O., 458
McIntosh, P., 315

McKee, J. E., 67, 206
McLeod, J., 205–206
McMahon, M., 445
McMinn, M. R., 208
Meany-Walen, K. K., 459
Meichenbaum, D., 11
Mejia, X., 295
Mellin, E. A., 2
Merlone, L., 407
Meyer, A., 28
Meyer, D. E., 272
Meyer, G. M., 218, 399
Meyers, L., 461
Michael, S. T., 253
Micozzi, M., 467
Middleton, W., 127
Midgett, A., 239
Miller, S., 200
Miller, S. J., 300
Miller, T. L., 215

Miller, W. R., 206–207
Milsom, A., 355
Mindrup, R. M., 315
Minich, C. J., 127
Minton, C. A. B., 125
Miserocchi, K. M., 315
Missar, C. D., 439
Mitchell, L. K., 238
Mitte, K., 200
Mobley, J., 72
Mobley, K., 125
Molinaro, K. L., 313–314
Monroe-DeVita, M., 139
Monteseirin, J., 421
Montessori, M., 18
Moorhead, H. J. H., 125
Moran, M., 463
Morden, C. J., 299
Morgan, M., 458
Morgan-Fleming, B., 297

Morse, G., 139
Moss, J. M., 2, 134, 457
Mosteller, R., 447
Mueller, P. A., 160
Muench, J., 27
Mullen, P. R., 235
Mullenbach, M., 63
Murdock, J., 173
Murphy, D., 175
Murphy, P. M., 271
Murray, K., 255
Murray-Ward, M., 94
Myers, I. B., 122
Myers, J. E., 32, 71, 125, 352, 418–419
Myrick, R., 30–31

N
Nash, S., 237
Nassar-McMillan, S., 88, 189, 324
National Center for Fair and Open Testing, 372
National Prevention Council, 69
National Survey of Children’s Health, 67
Nejedlo, R., 450
Nelson, J. R., 173
Neukrug, E. S., 55, 175
Newman, C. F., 202
Nichols, L. M., 2
Nichols, N., 458
Nielsen, R. C., 173
Nieri, T., 222
Nixon, R., 365
Norcross, J., 175, 195, 200–202, 206, 437, 439, 465
Norman, A., 425
Norris, F. H., 66
North, M. M., 467

North, S. M., 467
Note, I., 206
Nugent, F. A., 94
Nurius, P., 255

O
Obama, B., 365
O’Brien, D. K., 138
O’Connor, K. J., 290
Oei, T. P. S., 424
Ogles, B. M., 194
O’Hanlon, B., 427
Okiishi, J. C., 206
Olson, D. & Olson-Sigg, 356
Oney, K. M., 360
Ong, A. D., 429
Oppenheimer, D. M., 160
Orlinsky, D. F., 271
Orr, P. P., 458
Osborn, D. S., 239
Osman, B. B., 27
Östenson, C., 425
Ostermann, 429
P
Paasche-Orlow, M. K., 402
Pack-Brown, S. P., 388
Palloff, R. M., 173
Palmer, F., 142
Parkman, A., 135
Parks, B. K., 271
Parloff, M. B., 21, 184
Parmar, A., 457
Parr, C., 458
Parr, G., 297, 407
Parrish, M. S., 425
Parsons, F., 18–19, 27, 89, 294, 318
Patnaik, G., 424
Patterson, C. H., 5, 205
Paulson, D., 90
Pawlik-Kielen, L., 460
Pechman, F., 406
Pedrotti, J. T., 352, 465

Pehrsson, D. E., 245
Pek, J., 426
Pekarik, G., 297
Peluso, P., 445
Perez-Arce, P., 255
Perls, F., 8
Perry, W., 29, 136
Peterson, C., 427
Peterson, C. E., 55, 224, 242–243
Peterson, G. W., 239
Petrosino, A., 221
Pew Research Center, 208, 448–449
Pfahler, C., 139
Piaget, J., 29–30
Pierce, C., 334
Pines, A. M., 433
Polfai, F., 458
Pomerville, A., 271
Poon, V., 358
Popadiuk, N. E., 195

Pope, K. S., 129, 260, 393, 395, 439
Pope, V. T., 129
Powell, J., 254
Power, P. W., 56
Prade, C., 464
Pratt, K., 173
Prediger, D. J., 93
Presbury, J., 206
Presbury, J. H., 67
Preskill, S., 172
Pressley, P. K., 299–300
Prochaska, J., 200–202, 465
Prosek, E. A., 2
Proyer, R. T., 431
Puglia, B., 2
Pugsley, R. A., 299
Puig, A., 189
Purswell, K., 290
Pyne, J. R., 257

Q
Quero, S., 467
Quimby, J., 255

R
Rachlin, K., 326
Radeke, J. T., 133
Raguram, A., 445
Rank, O., 8
Rashid, G. J., 123
Rashid, T., 427, 429
Raskin, N. J., 125
Raspica, C., 62
Rath, T., 429
Ratts, M. J., 71–72, 88, 189, 318, 324, 334–335, 461
Rayman, J. R., 57
Reagan, R., 365
Rector, J., 385
Rees, L., 366
Reese, R. F., 189
Rehabilitation Counseling Consortium, 111
Rehm, C. D., 27
Reicherts, M., 206

Reinecke, M. A., 198
Reiner, S., 2, 73, 112
Remer, P., 326
Remley, T. P., 73, 288, 400–401, 457, 463
Remsing, L., 221
Ren, Q., 464
Renfro, J., 74
Rest, J. R., 414
Reuter, T., 422
Reynolds, C. I., 467
Reynolds, D. K., 464
Rice, L. N., 206
Richards, D., 297
Richards, P. S., 385, 454
Richardson, T. Q., 135, 313–314
Rickwood, D. J., 251
Rieckmann, T., 62
Riessman, F., 133
Ritchie, M. H., 238
Roach, L. F., 125, 425

Roach, P., 297
Robinson, G. E., 466
Rodgers, N. M., 394
Roepke, A. M., 458
Rogan, J. D., 465
Rogers, C. R., 11, 20–23, 124–125, 128, 190, 204–207, 271, 318
Rogers, J. R., 360
Rollins, A. L., 139
Rollnick, S., 206
Rønnestad, M. H., 63, 137, 139, 175
Roosevelt, T., 365
Rosen, L. D., 157
Rosén, S., 440
Rosenbaum, L., 235
Rosenthal, D., 217, 224
Ross, M., 235
Rovai, A., 173
Rubenstein, J. S., 272
Ruch, W., 431
Ruffle, T. M., 351

Rumstein-McKein, O., 271
Rupert, P. A., 432
Rush, A. J., 200
Russell, R. K., 135

S
Saccuzzo, D. P., 368
Sackett, C. R., 270, 464
Sajatovic, M., 467
Salyers, K., 129
Salyers, M. P., 139
Salzberg, S., 426
Sampson, J. P., 239
Sánchez-Hernández, C., 421
Sanford, R. N., 363
Saroglu, V., 464
Sasscer-Burgos, J., 463
Satcher, D., 420
Satir, V., 435, 440
Savickas, M., 358
Savitz-Romer, M., 68
Schaefer, B. A., 448
Schaefer, C. E., 290
Schatz, D., 195, 437, 439

Schimmel, C., 283
Schneider, K. J., 464
Schneider, P. L., 297
Schofield, W., 262
Schottenbauer, M. A., 203
Schover, L. R., 395
Schroeder, G., 58–60
Schulz, E. M., 205–206
Schure, M., 464
Schwartz, B., 446
Schwartz, R. C., 125
Schwartz, S. J., 89
Seegobin, W., 208
Segool, N. K., 24
Seiler, G., 450
Seligman, M. E. P., 352, 422, 427
Selye, H., 31–32
Serrano, B., 467
Sexton, T. L., 224
Seymour, J. M., 388

Shafer, W. D., 55, 94
Shale, A., 466
Shallcross, L., 125
Shamburger-Rousseau, A. E., 236
Shapiro, S. L., 426
Sharf, R. S., 199
Sharma, P., 457
Shaw, B. F., 200
Shaw, D., 135
Sheldon, W., 366
Shemwell, D., 237
Shenb, J., 458
Sheng-Hsin, C. J., 339
Sheperis, C. J., 353
Sheperis, D., 235
Sherrell, R. S., 237
Shufelt, B., 175
Shuman, D. W., 68
Sibicky, M., 251
Sifford, A. M., 319

Simon, Théodore, 22
Simpson, D. E., 138
Singh, A. A., 88, 189, 324
Singh, N. (Nimo), 155
Singh, S. D., 458
Skinner, B. F., 11, 24–25, 125, 191, 197, 198
Skovholt, T. M., 63, 119, 137, 139, 175, 318
Skowron, E. A., 69
Slaikeu, K. A., 300
Slaten, C. D., 237
Slone, L. B., 66
Smith, A., 32
Smith, D., 204
Smith, H. B., 224
Smith, H. J., 139
Smith, L. B., 235
Smith, M. L., 215
Smith, R. L., 465
Smith 2003, 260
Smith-Adcock, S., 332

Sneed, J. R., 89
Snyder, C. R., 253, 352, 465
Snyder, R. C., 430
Sokolowski, M. B., 466
Sommers-Flanagan, J., 347
Sommers-Flanagan, R., 347
Son, S., 446
Southern, S., 450
Spiegel, D., 467
Spray, B. J., 315
Spreat, S., 458
Staley, R. C., 208
Stamm, B. H., 432
Steadman, J., 458
Steger, M. F., 425
Stein, D. M., 206
Steiner, H., 221
Stevanovic, P., 432
Stevens, B., 124
Stillman, T. F., 424

Stoltenberg, C. D., 134
Stone, C., 403, 414
Stone, G. L., 299
Strausser-Kirtland, D., 439
Stricker, G., 203
Strickland, C. A., 49
Strom, S., 463
Stromwell, L. K., 222
Strong, E. K., 22
Strupp, H. H., 271
Sue, D., 87, 313, 335
Sullivan, T. A., 57, 60, 174
Sultanoff, S. M., 127
Super, D., 294
Supovitz, J., 374
Surace, F. I., 271
Swank, J. M., 237, 464
Sweda, M., 463
Sweeney, T. J., 32, 71, 130, 352, 418–419
Swenson, T. R., 297

T
Tabachnick, B. G., 260, 393, 439
Taillade, J. L., 200
Tassara, M. H., 52, 62
Tate, K. A., 52, 62
Taub, G., 195
Taylor, D., 324–325
Tennyson, W., 463
Thind, N., 252
Thomas, Dave, 70
Thomas, T. L., 388, 453
Thompson, E. S., 139
Thompson, I. A., 139
Thorne, B., 204
Tinkas, I., 424
Tjeltveit, A., 385
Toporek, R., 71–72, 316, 461
Travis, J. W., 32
Trepal, H., 125

Trotter, T. V., 94
Truax, C. B., 125, 204, 206
Trump, D., 365
Trusty, J., 72
Tubesing, D. A., 31
Tuckman, B., 286
Turner, N., 74–75
Turner, R. J., 422
Turpin-Petrosino, C., 221
Twain, M., 18
U
Uellendahl, G., 94
Ulloa, E. C., 164
Underfer-Babalis, J., 76–77
Ussher, S., 447

V
Vacc, N., 450
van Dulmen, M., 429
Vanpelt-Tess, P., 123
Vega, R., 462
Venable, M., 90
Vereent, L. G., 239
Vess, H. K., 209
Viganó, N., 297
Villalba, J. A., 332
Vitterso, J., 447
Vogel, D. L., 252
von der Embse, N., 24
Von, H. C., 175

W
Wachtel, P., 203
Waldo, M., 56
Walker, K., 370
Walker, R., 463
Wallace, M., 357
Walsh, R., 426
Walz, G. R., 450
Wampold, B. E., 5, 200, 202, 206
Wang, R., 424
Wantz, R. A., 456
Ward, C. C., 422
Ward, J., 173
Wardle, E. A., 459
Washington, A. R., 229
Washington, G., 365
Wathen, C. C., 239
Watson, G., 462
Watson, J. B., 195

Watson, J. C., 271, 353
Watts, G., 18
Watts, R. E., 94
Watzlawick, P., 192–193
Weakland, J. H., 192–193
Weaver, K. M., 125
Webb, K. C., 208
Webster, B., 55, 94
Wei, M., 252
Weibel, D., 426
Weingardt, K., 457
Weinhold, B., 450
Weiss, B., 206
Weisz, J. R., 206
Welfel, E. R., 395, 403
Wells, P. C., 239
West, S., 222
Westcott, J., 173
Wester, K., 125
Wester, S. R., 252

Westmacot, R., 271
Wettersten, K. B., 188
Wheaton, J. E., 330
Wheeler, A. M., 384
Whelan, E. (Dr.), 375
Whiston, S. C., 55, 62
White, V. E., 71
Whiting, P. P., 407
Wiggers, T. T., 134
Wilcoxon, A., 288
Wilkins, P., 127
Wilks, D., 190
Williams, A., 173
Williams, C. B., 388, 413
Williams, D., 271
Williams, G. T., 175
Williams, J. M., 242
Williams, S. C., 125
Williams, T., 448
Wills, T. A., 251

Wilson, R. M., 300
Wilson, W., 18, 365
Winer, J., 229
Witkin, B. R., 238
Witmer, J. M., 32, 125, 130, 218, 352, 399, 418–419, 421
Wolpe, J., 198
Wolskeeb, P., 458
Wolsko, C., 464
Wong-Wylie, G., 462
Wood, A. M., 242
Wood, C., 93, 236
Woodhouse, R. A., 160
Worell, J., 326
Wrenn, G., 5, 335
Wright, J., 462
Wright, T. L., 255
Wundt, W., 22–23
Wyss, T., 431

Y
Yabiku, S., 222
Yalom, I., 8, 21, 92, 262
Yao, S. N., 206
Yough, M., 237
Young, A., 224
Young, A., 74
Young, D., 173
Young, J., 189
Young, J. E., 199, 203
Young, J. S., 208
Young, M. E., 21, 32, 64, 67, 125, 140, 193, 195, 202, 203, 205, 271,
286, 356, 357, 360, 425–426, 439, 447, 449, 454, 463–466
Yuan, K.-H., 255
Yuan, Y., 464

Z
Zeng, X., 424
Zhang, Q., 464
Zickar, M. J., 363
Ziegler, D. J., 190, 193, 197–198
Zyromski, B., 453

Subject Index
A
abuse, confidentiality issues with, 405
ACA Code of Ethics and Standards of Practice, 55–57, 62–63, 65,

103–104
assessment and, 362–363
impairment concept, 435–436
multicultural counseling and, 338, 340
personal values and, 387
primary responsibilities in, 382
state laws and, 397–398
academic sources, research, 226–227
acceptance, counselors’ capacity for, 129
accountability
assessment of, 349
counseling research on, 217–225
accreditation for counseling, 83–85
Achenbach Child Behavior Checklist (CBCL), 351
achievement testing, 23–24
action, as counseling stage, 267

action research, counseling effectiveness, 216
addictions counseling, 291
process addictions, 464–465
administrator, counselor as, 57–60
Adorno F-Scale, 363
adult development models, counselor training, 135–136
adult learners, counselors as, 135–136
Adultspan, 106
Adverse Childhood Experiences (ACEs), 333–334
advice, avoidance of giving, 275–276
advisor, counselor as, 67–68
advocacy
counseling and, 71–72, 74, 128–129, 316–320
ethics in counseling and, 392
future trends in, 461–462
mental illness and, 28
professional associations and, 73
affiliative humor, 127
Affordable Care Act, 32–33
African Americans
as counselors, 257–258, 324
multicultural assessment in counseling for, 359–360
age/generational status, cultural competency concerning, 329–330
aging, wellness and, 447–448
alternative medicine, 466–467
ambiguity, in counseling, 130
American Association for Marriage and Family Therapy (AAMFT),

9–10, 13, 110
American Association of Christian Counselors (AACC), 208
American Association of Pastoral Counselors (AAPC), 110, 208
American Association of State Counseling Boards, 99–100
American College Counseling Association (ACCA), 107
American College Personnel Association (ACPA), 33
American Counseling Association (ACA), 10, 12
advocacy and, 71–72
assessment competencies, 93
career counseling and, 20
counseling definition, 45
demographic data, 82–85
divisions of, 105–110
founding of, 103–104

history of, 33–35
information resources, 15–16
membership in, 73
multicultural competencies, 87
Practice Research Network, 62
structure and mission of, 102–114
American Medical Association, psychiatric training and, 8
American Mental Health Counselors Association (AMHCA), 33, 104,

108
American Psychiatric Association, 8, 12
American Psychological Association (APA), 10, 12
health psychology and, 31–32
American Red Cross, 66
American Rehabilitation Counseling Association (ARCA), 108
American School Counselors Association (ASCA), 5, 41–42
counseling definition, 45
documentation and records guidelines, 407
establishment of, 104, 108
membership in, 73
Standards, 90
Americans with Disabilities Act (ADA), 330–331, 409

anecdotal reports, 239–240
animal models, behavior therapy, 198
antidepressants, 27
antivirus software, 156
anxiety disorders, cognitive therpy, 200
APA style guide, 160
Army Alpha and Beta Tests, 22
ASCA National Model, 44–45, 217–225
classroom lessons (classroom guidance), 288
counselors’ satisfaction with, 257–258
ASCA National Standards, 47
Aspire Health Partners, 291
assessment
acceptance of results, 372, 374
administration protocols, 360–361
components of, 352–357
confidentiality in, 371–372
in counseling, 52–56, 265–266, 344–377
of counseling effectiveness, 349
data interpretation, 361

ethical guidelines for, 362–363, 371–377
importance of, 350–351
intervention and treatment planning and, 463–464
interviewing, 345–347
marriage and family counseling, 356–357
mental health counseling, 355, 356
of personality, 363–371
population characteristics, 353
problem variations, 353
process, 357–371
of program accountability, 349
questionnaires, surveys and rating scales, 348
results reporting and analysis, 361–363
in school counseling, 353–355
selection of methods for, 357–360
setting variations, 353
social justice approach to, 362
standardized tests and instruments, 348–349
of strengths, 352
suicide risk, 375–377

therapeutic relationship and, 360–361
Three Big Mistakes in, 350
training and education in, 92–94
types of test used in, 345–349
Association for Adult Development and Aging (AADA), 106, 448
Association for Assessment and Research in Counseling (AARC), 56,

106, 360
Association for Assessment in Counseling, 56
Association for Child and Adolescent Counseling (ACAC), 106
Association for Clinical Pastoral Education (ACPE), 208
Association for Counseling and Development, 31
Association for Counselor Education and Supervision (ACES), 107,

449–450
Association for Creativity in Counseling (ACC), 106
Association for Humanistic Counseling (AHC), 20, 107
Association for Lesbian, Gay, Bisexual and Transgender Issues in

Counseling (ALGBTIC), 107, 326–328
Association for Multicultural Counseling and Development (AMCD),

107–108, 335
Association for Specialists in Group Work (ASGW), 21, 109, 285–286
Association for Spiritual, Ethical, and Religious Values in Counseling

(ASERVIC), 108–109, 329
attendance problems in counseling, 297–305
attention skills, 272–273
attitude about counseling education, 153

B
balance, in life, counselor’s management of, 139
Beck Depression Inventory, 355, 463
behavioral/cognitive theories, 185
behaviorism, 24–25
behavior therapy
contributors to, 198
effectiveness, 197
human nature and, 197–198
problems with, 196–197
theories in, 195–198
beneficence, 413
Beutler’s Systematic Treatment Selection and Prescriptive

Psychotherapy, 203
Biblical counseling, 208
Big Five Personality Theory, 366–368
biological treatments, 26
biology, psychology and, 26–27
“blue chip growth selection” hypothesis, 200

Bobo doll experiments, 198
brain stimulation research, 26
British Association for Counselling and Psychotherapy, 437
bullying, assessment for, 353–355
Bullying Behavior Scale, 355
burnout in counseling, 139, 258–259, 431–436, 458–459
business, counseling and, 69–70

C
California Personality Inventory (CPI), 363
Career Advising (Gordon), 67
career counseling, 18–20, 67–68
specialization in, 294
testing technology and, 22–23
career development, counselor education in, 89–90
Career Development Quarterly, 110
Career Sustaining Behaviors (CSB) Questionnaire, 432
case law, legal issues in counseling and, 397
catharsis, 5
Cattell 16 Personality Factors (16 PF), 363
Centers for Disease Control and Prevention (CDC), 296
certification in counseling, 100–102
competency obligations and, 391
Certified Rehabilitation Counselors (CRCs), 299
change
in behavior, 196
counselors’ belief in, 128

changeability, vs. unchangeability, 192–193, 198, 201, 207
cheerleading, avoidance of, 275
Chi Sigma Iota (CSI), 113–114, 162, 174
choice theory, 209
Choosing a Vocation (Parsons), 18
Choosing Brilliant Health (Foster & Hicks), 420
Christian Association for Psychological Studies (CAPS), 208
Christian counseling, 208
chronic illness, counseling and, 447–448
classroom lessons (classroom guidance), 288
classroom performance, graduate programs in counseling and, 172
Client-Centered Therapy (Rogers), 21
clients
acceptance of counselor by, 270–271
advocacy for, 18–20
autonomy of, 413
belief in counseling process of, 253–254
counselor’s experience as, 437–438
decision to seek counseling by, 251–252
dependency of, 392

differences in, 276
diversity and oppression in, 334
expectations from counseling, 252–253
hope for counseling in, 253–254
informed consent issues, 392, 400–402
involuntary clients, 283
refusal to work with, counselors’ rights concerning, 388
rights of, 400–401
secrets and lies of, 254–256
session experience for, 251–256
settings for counseling, 280–305
sexual relationship with, 393–394
welfare of, ethics concerning, 392
clinical experience, counselor training and, 95–96
clinical psychology, 10
cloud storage, 156
Code of Professional Ethics for Rehabilitation Counselors, 384–385
cognitive behavioral therapy (CBT), efficacy studies, 233
cognitive behaviorism, 25, 196, 199
cognitive development, stage model of, 30

cognitive distortion, 199
cognitive therapy, 198–201
applications, 200
basic principles, 199
contributors to, 201
effectiveness of, 200
human nature and, 200–201
cognitive triad, 201
collaborative approach
counseling consultations, 56
in therapeutic relationship, 270
college counseling, 67–68, 294–296
standardized testing and, 374
colleges and universities, counseling programs at, 83–85
college student development models, 136
Commission on Accreditation for Marriage and Family Therapy

Education (COAMFTE), 9–10
Commission on Rehabilitation Education (CORE), 83–85
common core curriculum, counselor training, 7
community counseling services
mental health specialization, 294

reactive research on, 217–225
community mapping, 238
Community Mental Health Center Act, 29
comorbidity, 233
compassion fatigue, 67
competence
ethics rules for, 391
legal issues involving, 399–400
complementary medicine, 466–467
computer, backups, 156
confidentiality
in assessment, 371–372
family counseling, 404
group counseling, 404
legal issues concerning, 397, 402–405
congruence, 124–125
constructivist theories, 187–188
consultant, counselor as, 56–57
context evaluation, 238

contingency management, 197
continuing education for counselors, 138–142
lifelong learning and, 455–456
conversion disorder, 26
core counseling curriculum, 83–97
Corn-On-The-Cob Personality Test (COCPT), 370
cost-benefit analysis of counseling, reactive research on, 217–225

Programs (CACREP), 7, 20, 22
educational requirements for counselors, 83–86
multicultural counseling and, 337–340
online learning programs, 456–457
counseling
assessment and testing training in, 92–94
associations and organizations, 102–114
bad habits in, 275–277
certification, 100–102
client expectations concerning, 252
client’s belief in process of, 253–254
comparison of professions, 11–13

controversies in, 14
core values of, 17
for counselors, 437–438
counselor’s experience with, 256–264
decision to seek, 251–252
defined, 4–7, 45
demographics, 5, 82–85
effectiveness research and assessment, 194, 215–246, 349
evaluation and reflection stage, 269
global and social trends in, 445–449
history of, 15–33
intervention and action phase, 267
job projections, 82–85
licensure and certification, 97–102
modalities, 284–288
as multiple professions, 105
psychotherapy and, 4–5
roadmap of process in, 265–269
roles of counselors in, 39–65

skills needed for, 270–277
specializations, 289–296
stages of, 265–269
strengths-based vs. disorder-based, 422
terminology, 6
theories in, 21–22, 182–211
therapies, 21–22
timeline of, 16–17
training for, 7
treatment planning stage of, 266–267
values in, 18–20
wellness approach in, 427–431
Counseling and Psychotherapy (Rogers), 20–21
Counseling and Values, 109
Counseling Association for Humanistic Education and Development (C-

AHEAD), 20
Counseling Outcome Research and Evaluation (CORE), 106
counseling psychologists, 11
counseling sessions, 250–277
selection of participants in, 282–283
counseling students
characteristics of, 117–119
inner thoughts of, 260–261
minority students, 164
wellness in, 436–441
Counselor Education and Supervision, 107
counselors
as administrator or program planner, 57–60
as advisor, 67–68
as advocate, 71–72
assessments by, 52–56, 344–377
as businessperson or entrepreneur, 69–70
characteristics of, 125–126, 127–131
as consultant, 56–57
counseling experience for, 256–264
countertransference in, 262, 264
crisis intervention and, 66–67
development models for, 135–138
as diagnosticians, 52
dissatisfaction with job, 258–259
documentation and records management by, 60–61

educational requirements, 83–97
effective characteristics of, 121, 124
effectiveness and accountability assessment, 349
experiential education, 96–97
Experimental Prototype Counselor of Tomorrow, 449–463
as expert witness, 68
fears expressed by, 259–260
as group leader, 46–47
as learning, 63
as mediator, 70–71
motivation of, 121
personality types of, 121, 126
personal journey of, 133–138
practicums and internships, 95–96
as prevention specialist, 68–69
professional memberships, 73
refusal to work with clients, rights concerning, 388
research by, 242–246
resistance to research by, 224–225
responsibility ethic in, 264

satisfactions for, 256–257
scientific research by, 62–63
settings for, 280–305
as supervisor or supervisee, 65
as teacher/educator, 64
as therapist, 46
wellness and impairment in, 432–436
Counselors for Social Justice, Code of Ethics, 392
Counselors for Social Justice (CSJ), 71–72, 109
COUNSGRADS listserv, 119, 170, 408
countertransference, in counselors, 262, 264
couples and relationship education (CRE), 286
couples counseling. See marriage and couples counseling
criminal law, counseling violations and, 411
crisis intervention, counseling and, 66–67
Critical Incident Stress Debriefing (CISD), 222
cultural competence
diversity and, 322–334
future demands for, 453–454

self-identity and, 312–316
culturally encapsulated counselor, 335
culture
in graduate programs in counseling, 174
mental health and, 251–252
professional identity and, 312–316
testing and, 23
curative factors, 92, 206
curiosity, in counselors, 127

D
D.A.R.E. (Drug Abuse Resistance Education) Program, 222
data analysis
assessment and, 361
technology and data generation, 445–446
deinstitutionalization, 29
delusions, 27
determinism, freedom vs., 190, 197, 200, 206
development models for counselors, 135–138
Diagnostic and Statistical Manual (DSM), 8, 159
Diagnostic and Statistical Manual of Mental Disorders, 5th edition

(DSM-5), 52, 327, 348
diagnostician, counselor as, 52
diagnostic interviewing, 347–348
diagnostic treatment planning model, 5
diet, physical wellness and, 436–437
directive counseling, 263
direct service, counseling as, 46
disabilities
counseling students with, 161
cultural competency concerning, 330–331
Disaster Mental Health Responders, 66
discrimination, 311
disorder-based counseling, 422
Distance Education and Training Council (DETC), 173
distractions, limiting of, 156
diversity
cultural competency and, 322–334
education and training about, 87–88
in graduate counseling programs, 164
oppression and, 334
doctor of psychology, 10
documentation
assessment results, 361–362
by counselors, 60–61
Do One Thing Different (O’Hanlon), 427

dualistic thinking, 136
dual relationships, ethics in counseling, 393–396
Duped: Lies and Deception in Psychotherapy (Kottler and Carlson), 254
duty to protect, confidentiality and, 403–405
duty to warn, confidentiality and, 403–405
dysfunctional belief systems, 199

E
eclectic/integrative theories, 185, 201–203, 450–453
ecotherapy, 464
ectomorph body type, 366
education programs for counselors, 83–97, 117–119
continuing education, 138–142
counselor development models, 135–138
graduate programs, 146–179
novice-to-expert models, 136–138
professional identity development, 134–138
skills acquisition, 271–272
effectiveness studies, 234
effect size, quantitative research, 232
efficacy studies, quantitative research, 232–233
electroconvulsive therapy (ECT), 26
electronic storage, guidelines for using, 156
e-mail, management of, 156
EMMA’s world virtual reality system, 467

emotional arousal, 437
emotional health, 438
Emotional Intelligence, 422–424
emotional stability, in counselors, 127–128, 262
emotional wellness, 422–424, 437–438
empathy
as counseling skill, 125, 273–274
person-centered therapy and, 205
employee assistance programs (EAPs), 294
encouragement, as counseling skill, 275
endomorph body type, 366
English as a Second Language (ESL), counseling students, 161
entrepreneurship, counseling and, 69–70
Epictetus, 200
equality, value of, 18–20
ethics in counseling
advocacy and, 392
in assessment, 362–363, 371–377
building awareness for, 462–463
client dependency, 392

client welfare and, 392
competency and, 391
confidentiality, 391
in core curriculum, 86–87
decision-making in practice and, 411, 413–414
dual relationships, 393
informed consent, 392
legal issues and, 396–409
minimal vs. aspirational ethics, 383
moral standards and, 391
overview, 381–383
personal ethics and values, 385–388, 391
in practice of counseling, 383–385
professional ethics, 383
professional relationships, 394–396
professional responsibility, rules of, 390–391
research on, 62–63
sexual relationships with clients, 393–394
social justice perspective, 388–390
termination and referral, 392

violations of, 409–411
ethnicity, cultural competence and, 322–324
ethnocentrism, 313
evaluation, as counseling stage, 267, 269
Every Student Succeeds Act (ESSA), 409
Evidence Based Practice (EBP), 219–229, 452–453
experiential education, 96–97
Experimental Prototype Counselor of Tomorrow (EPCOT), 449–463
expert witness, counselor as, 68
exposure, behavior therapy, 197
external validity, efficacy studies, 233

F
factor analysis, 367
faculty relationships, graduate programs in counseling, 165–169
family counseling, 287–288, 461
assessment, 356–357
confidentiality, 405
future trends in, 449
Family Educational Rights and Privacy Act (FERPA), 406, 409
family systems, 187
mental health and, 251–252
family therapy, 9–10
The Family Journal, 110
Fear of Freedom (Fromm), 447
federal statutes, legal issues in counseling and, 397, 408–409
feedback, in graduate programs in counseling, 166–167
feminist approaches to counseling
ethics and, 413–414
social counseling theory, 189
fidelity in counseling, 413

field experiences, 95–96
firewall software, 156
fitness, physical wellness and, 436
Five Factor WEL inventory (5F WEL), 352–353, 419
flexibility, of counselors, 130
FOCUS counseling porgram, 291
forensic counseling, 294
foundational theory of mediation, 70–71
Foundations of Counseling class, 173
freedom, determinism vs., 190, 197, 200, 206
functional analysis, 195–196

G
Galen’s Four Temperaments, 365
gender
counselor development and, 134–138
cultural competence and, 326
gerontological counseling, 291
Gestalt Therapy, 186
global trends in counseling, 445–449
graduate programs in counseling, 117–119
attitude about, 153
career preparation after, 176–179
classroom success in, 172
confidentiality and, 405
counselor competency and, 400
counselor interactions during, 169–171
culture of, 174–175
department politics and, 169
diversity in, 164
documentation and records management and, 407–408

faculty relationships, 165–169
focus in, 147–148
intensity of coursework in, 147
maximization of results in, 146–179
meaning of courses in, 148
mental health maintenance during, 175–176
networking in, 169–171
online education, 173–174
peer relationships in, 148–149, 163–168
PhD programs, 176
preparation for, 152–163
professional associations and, 169–171
social media and, 171
student authorship of research, 231
student responsibilities in, 148
success in, 149–152, 163–176
top 10 list of priorities in, 162
Griggs v. Duke Power, 359
group leader, counselor as, 46–47
group psychotherapy, 284–286

group therapy
confidentiality and, 405
counselor education for, 91–92, 461
movement for, 21–22
group work, 284–286
guidance counseling, 5
H
hallucinations, 27
Handbook of Integrative Psychotherapy, 203
hand-held devices, counseling using, 457–458
hatha yoga, 464
Health Insurance Portability and Accountability Act (HIPAA), 406, 408
health psychology, 26–27, 31–32
helper therapy principle, 133
helping relationships
counselor training in, 91
defined, 4
road map of, 265–269
heterostasis, homeostasis vs., 192, 198, 207
high stakes testing, school counselors’ debate over, 372–374
holism, wellness and, 421
homelessness, mental illness and, 29
homeostasis, heterostasis vs., 192, 198, 207
homophobia, 327
House Next Door, 290

HPSO malpractice insurance, 393, 399
human development
counselor education on, 88–89
psychology and, 26–27, 29–30
humanistic/existential theories, psychology and, 185, 352–353
humanity in counseling, 131
human nature
behavior therapy, 197–198
person-centered therapy and, 206–207
humor, in counselors, 127
hydrotherapy, 26
I
IDEA (Public Law 94-142), 409
identity development, models of, 89
impairment, 435–436
implicit personality theory, 370–371
imposter phenomenon, 135
inappropriate feelings, in counselors, 262
India, personality theory in, 371
Individualized Education Plans (IEPs), 355
informed consent, 400–402
input evaluation, 238
insuling shock therapy, 26
insurance coverage, counseling and, 32–33
integrity, of counselors, 127
intellectual wellness, 424, 439
intentionality, counseling education and, 149, 161
inter-agency consultation, 56
internalized homophobia, 327

International Association of Addictions and Offender Counselors
(IAAOC), 109
International Association of Marriage and Family Counselors (IAMFC),

10, 109–110
International Coaching Federation, 13
international counseling students, learning skills for, 161
International Journal of Psychotherapy Integration, 202
Internet
academic research on, 228–229
societal impacts of, 445–446
internships, 95–96
interorganizational consultation, 56
interpersonal violence (IPV), 357
intersectionality
client identities, 89
race and ethnicity and, 323–324
interventions
assessment and suggestions for, 361–362, 463
counseling specializations and, 289–290, 292
as counseling stage, 267
counselor’s experience of, 438

interviewing
client assessment and, 345–347
diagnostic interviewing, 347–348
invernal validity, efficacy studies, 232–233
in vivo exposure, behavior therapy, 197
involuntary clients, 283
IQ tests, 22–23
ethical issues with, 363
multicultural assessment and, 359–360
irrationality
rationality vs., 190–191, 197, 200, 207
IS PATH WARM assessment, 376–377

J
Japanese therapies, 464
job satisfaction for counselors, 256–257
Journal for Creativity in Mental Health, 106
Journal for Humanistic Counseling, 107
Journal for Social Action in Counseling and Psychology, 109
Journal for Specialists in Group Work, 109
journaling, by counselors, 140
Journal of Addictions and Offender Counseling, 109
Journal of Clinical Psychology, 254
The Journal of College Counseling, 107
Journal of Counseling and Development, 31, 32, 236, 335
Journal of Counseling Psychology, 11
Journal of Employment Counseling, 110
Journal of LGBT Issues in Counseling, 107
Journal of Mental Health Counseling, 108
The Journal of Military and Government Counseling, 110
Journal of Multicultural Counseling and Development, 108
Journal of Psychology & Christianity, 208

Jung, Carl, 89
justice, ethics and, 413

K
K-12 guidance curriculum expert, school counselor as, 47–49
Kaiser Family Foundation, 32–33
Kids House, 290

L
language, cultural competence and, 332
The Language of Tears (Kottler), 264
leadership development, future trends in, 454–455
learning disabilities, assessment, 355
learning skills
behavior therapy and, 196
in counseling, 63
graduate school education, 158–160
lifelong learning and, 455–456
legal issues in counseling, 396–409
competency issues, 399–400
confidentiality, 402–405
documentation and records, 405–408
informed consent, 400–402
privileged communication, 402–405
violations and, 409–411
LGBT clients
cultural competence concerning, 327–328

social justice and advocacy for, 319
licensing requirements, 63, 97–102
competency in counseling and, 391
counselors, 9–10
mental health counseling, 97–98
portability of license, 101
school counseling, 99–100
state licensure boards, 410
lies by clients, 254–256
life coaching, 13–14
lifelong learning, 455–456
limitations of counseling, 130
Limited English Proficient (LEP) population, 332
literature reviews/position papers, 227, 230
reading guidelines, 240–241
Little Albert experiments, 198
Locke-Wallace Marital Adjustment Scale, 357
Love’s Executioner (Yalom), 262
Loving-Kindness Meditation, 425–426

M
magazine tests, 374–375
magnification, 199
malpractice cases, 411
sexual relationships in counseling and, 393
marathon group therapy, 21
marijuana, addiction problems with, 464–465
marriage and couples counseling, 9–10, 286–287, 461
assessment, 356–357
neuroscience and, 466–467
Marriage & Family Research Institute (MFRI), 287, 289
Master Therapists (Skovholt & Jennings), 137
Measurement and Evaluation in Counseling and Development (MECD),

106
Measures for Clinical Practice and Research (Corcoran & Fischer), 374
mediator, counselor as, 70–71
medical model, 5
medication, psychology and, 27
meditation, 464
Mental Health America, 28
mental health counseling
assessment, 355, 356
cognitive therapy and, 199
community mental health, 294
competency laws concerning, 399
for counselors’ health, 130, 175–176, 438
graduate training and maintenance of, 175–176
holistic concepts in, 421–422
language and labels in, 331
license for counseling in, 97–98
movement to improve, 27–29
reactive research on, 217–225
stigma about, 251–252
training for counselors in, 304
mental imagery task, 151–152
mental testing, 22
mentorship, in counselor education, 245–246
mesomorph body type, 366
meta-analyses, 234–235
metacognitive strategies, study skills and, 161
microaggressions, 334
Military and Government Counseling Association (MGCA), 110
A Mind That Found Itself (Beers), 27–28
mindfulness, 464
counselors’ practice of, 140
Minnesota Multiphasic Personality Inventory (MMPI), 363
minority counseling students, 164
mixed methods research, 237–238
modalities of counseling, 284–288
classroom issues (classroom guidance), 288
couples counseling, 286
family counseling, 287–288
group work, 284–286
moral standards and values, ethics in counseling and, 391
Morita therapy, 464
motivation, personality theory and, 365
motivational interviewing, 206
Motivation and Personality (Maslow), 352
multicultural counseling, 20–22, 87–88

assessment in, 359–360
cultural competence and, 322, 335–340
ethics and, 388–390, 392
increased diversity and, 448–449
social justice and, 388–390
theories, 189
Multicultural Counseling and Social Justice Counseling Competencies

(MSJCC), 335–340
Multicultural Counseling Competencies, 87, 335–340
multimodal therapy, 202–203
multiple family groups, family counseling and, 287–288
multiplistic thinking, 136
multi-tasking, 157
Murphy v. A. A. Mathews, 68
Myers-Briggs Type Indicator (MBTI), 121–123, 366

N
National Aeronautics and Space Administration (NASA), 26
National Alliance on Mental Illness (NAMI), 28
National Association for College Admissions Counselors (NACAC),

110
National Association for Mental Health, 28
National Association of Alcohol and Drug Abuse Counselors

(NAADAC), 110
National Association of Social Workers, 12–13
National Board for Certified Counselors (NBCC), 100–102
National Career Development Association (NCDA), 20, 110
National Certified Counselor (NCC), 100–102
National Coalition Against Domestic Violence, 357
National Coalition for the Homeless, 29
National Defense Education Act (NDEA), 25–26
National Employment Counseling Association (NECA), 20, 110
National Institute of Mental Health, 26
National Panel for School Counseling Evidence-Based Practice, 62–63
National Society for the Promotion of Industrial Education (NSPIE), 33
National Vocational Guidance Association (NVGA), 33

National Wellness Institute, 420
“The Necessary and Sufficient Conditions of Therapeutic Personality

Change” (Rogers), 204
needs assessment, 238
NEO Personality Inventory, 366, 368–369
networking, graduate counseling programs and, 170–171
neuroscience, 466–467
neutrality, as counseling skill, 274–275
“New Methods for the Diagnosis of the Intellectual Level of

Subnormals,” 22
No Child Left Behind Act, 409
nondirective counseling, 263
person-centered therapy as, 205
nonexperimental quantitative research, 235–236
nonmaleficence, 413
non-native speakers, as counseling students, 161
nonstandardized instruments, as assessment tool, 349
not-in-person counseling, 297–305
nouthetic counseling, 208
novice-to-expert development models, 136–138

O
Occupational Outlook Handbook, 6
occupational wellness, 425–427
Omnibus Budget Reconciliation Act, 29
On Becoming a Person (Rogers), 21, 124
one-upmanship, avoidance of, 276–277
online counseling, 297–305
online education, graduate programs in counseling and, 173–174
online testing, 374
Oppositional Defiant Disorder (ODD), 221–222
oppression, diversity and, 334
optimism, in counselors, 128
outcome studies, counseling effectiveness, 216
overchoice, 446–447
The Oxford Handbook of Methods in Positive Psychology (Ong & van

Dulmen), 429
P
pain, counselors’ engagement with, 128
PAIRS program, 440
The Paradox of Choice (Schwartz), 446
participants in counseling sessions, guidelines for selecting, 282–283
pastoral counseling, 208
Pathways to Personal Growth (Witmer), 418
patience, in counseling, 130
peer relationships, in graduate counseling programs, 148–149, 163–167
personal coaching, 13–14
personal growth potential, 20–22, 438
personality theories
changeability vs. unchangeability, 192–193, 198, 201
counseling and, 189–190
freedom vs. determinism, 190, 197
homeostasis vs. heterostasis, 192, 198
implicit theories, 370–371
in India, 371
proactivity vs. reactivity, 191–192, 198, 200

rationality vs. irrationality, 190–191, 197
personality traits
assessment of, 363–371
in counselors, 121
measurement of, 22
personal values, ethics in counseling and, 385–388, 391
personal well plans, 440–441
person-centered therapy, human nature and, 206–207
person-centered (client-centered) therapy, 22–23, 204–207
effectiveness of, 206
problems and settings for, 205–206
personhood, 119
“Persons or Science?” (Rogers), 22
Persuasion and Healing (Frank), 253
Pew Forum on Religion & Public Life, 328
PhD programs in counseling, 176
phrenology, 365–366
physical space, counseling students’ preparation of, 154–155
physical wellness, 424, 436–437, 447–448
play therapy, 289–290

Play Therapy, 206
population characteristics, assessment and, 353–357
positive psychology, 429–431
assessment and, 352
Positive Psychology (Lopez, Pedrotti, & Snyder), 352
post-traumatic stress disorders (PTSD), proactive research on, 222
power, of counselors, 129
practice act, 399
practice of counseling
ethics and, 383–385, 411, 413–414
reflective skills in, 462
research and, 226–227
stress reduction in, 438
virtual reality and, 467–469
practicums, 95–96
practitioner-scientist counseling model, 225–226
preferred future, constructivist theories and, 187–188
preferred gender pronoun (PGP), 326
prejudice, 311
Premack Principle, 197

PREPARE/ENRICH Programs, 356–357
presenting problem, 282–283
prevention
counseling and, 68–69, 290
wellness and, 418, 466–467
primary prevention, 418
prisoners, counseling for, 304
private practice, counselors in, 69–70, 301, 305
privileged communication, 402–405
proactive counseling research, 221–222
proactivity, reactivity vs., 191–192, 198, 200, 207
problem identification, assessment and, 353–357
problem-solving skills, counselor’s use of, 139
process addictions, 464–465
process evaluation, 238–239
product evaluation, 239
professional associations
codes of ethics in, 384–385
counseling and, 73
graduate programs in counseling and, 169–171

involvement in, 460–461
as research resource, 225
professional counseling, 1
professional disclosure statement, 399
professional ethics, 383–385, 410
professional identity, 2, 111
counseling education and, 117–120
culture and, 312–316
development of, 134–138
personal fit with counseling, 132–133
research and development of, 223
professional liability insurance, 398
professional organization in counseling, 7–8
professional orientation in counseling, 86–87
Professional Quality of Life Scale, 432
professional relationships, 394–396
Professional School Counseling journal, 108
professional school counselors, 99–100

roles of, 41–45
program evaluation research, 238–239
program planning
counselor role in, 57–60
education and training for, 94–95
Progressive Muscle Relaxation (PMR), 221–222
progressivism, 18–23
project deadlines, management of, 156
Protected Health Information (PHI), 406
pseudo-identity creation, 446
psychiatry, counseling and, 8
psychodynamic theories, 184–185
psychoeducational groups, 91–92, 284–286
psychological reports, 23
psychological test, 23
psychology, counseling and, 10–11
psychotherapy, 4–5
terminology, 6
theoretical orientations, 184

Psychotherapy Relationships That Work (Norcross), 206
Publication Manual of the American Psychological Association, 160
public image, of counseling students, 171
Purdue Online Writing Lab, 161
purpose in life, wellness and, 425

Q
qualitative research, 236–237
quantitative research, 230–236
effectiveness studies, 234
efficacy studies, 232–234
meta-analyses, 234–235
nonexperimental, 235
questionnaires, as assessment tool, 348
“Quiet Therapies,” 464

R
race, cultural competence and, 322–324
racial identity, 324
racism, 311
Rae, Alexis “Lexie,” 317
rating scales, as assessment tool, 348
Rational Emotive Behavior Therapy (REBT), 190–191, 199–201
rationality, irrationality vs., 190–191, 197, 200, 207
reactivity, proactivity vs., 191–192, 198, 200, 207
reality therapy, 193, 195
Recognized ASCA Model Program (RAMP), 353
records management
by counselors, 60–61
references, guidelines for seeking, 179
referrals, ethics involving, 392
reflection
as counseling stage, 267, 269
professional identity and, 2–3

reflective practitioners, 264
rehabilitation counseling, 291
Rehabilitation Counseling Bulletin, 108
relationship wellness, 439–441
relativistic thinking, 136
religion
REPLAN model, 64
research
accountability in counseling and, 217–225
anecdotal reports, 239–240
classifications, 227–240
counseling applications for, 215, 225–246
counseling theories in, 183, 194
on counselor development, 137
by counselors, 62–63, 242–246
counselors’ resistance to, 224–225
on counselor stress and burnout, 432
education and training for, 94–95

evaluation of, 459–460
graduate student authorship of, 231
Internet sources, 228–229k
job satisfaction in counseling, 299
literature reviews/position papers, 227, 230
mixed methods research, 237–238
practice and, 226–227
proactive approach in, 221–222
program evaluation, 238–239
qualitative research, 236–237
quantitative, 230–236
reactive approach in, 217–220
reading guidelines, 240–241, 459–460
single case studies, 239
as social justice, 222–224
The Resilient Practitioner (Skovholt), 137
respect for client, counselors’ belief in, 128
responsibility, counselor’s feelings of, 265
resume preparation, 176
RIASEC personality types, 369–370

Rights and Responsibilities of Users of Standardized Tests (RUST
Statement), 106
risk assessment, suicide risk, 375–377
risk-taking, by counselors, 127
Ritalin, 27
S
Sain v. Cedar Rapids Community School District, 67–68
scheduling, for counseling students, 156–158
schemas, cognitive therapy, 199
school counseling
as academic advisors, 67–68
achievement testing and, 24
advocacy and, 72
assessment in, 353–355
chronically students and, 447–448
curriculum guidance and, 47–49
documentation and records guidelines, 405–408
high stakes testing and, 372–374
informed consent in, 400–402
job satisfaction in, 257–258
licensure for, 99–100
relations with students in, 395–396
secrets and lies of clients in, 254–255
session example, 268–269

social justice and advocacy in, 319
surveys used in, 348
science
behaviorism and, 24–25
counseling and, 22–23, 62–63
Science and Human Behavior (Skinner), 24–25
scope of practice in counseling law, 98–99
secrets of clients, 254–256
self-actualization, 420
self-awareness
of counselors, 127
cultural competency and, 312–316
self-care, 435–436
self-control, behavior therapy, 197
self-denial, counselors’ capacity for, 129
Self-Directed Search (SDS), 366, 368–370
self-disclosure
client difficulties with, 254–256
continuum of, 265–266
self-reflection, in counselors, 127, 140

Serenity Prayer, 421
settings for counseling, 280–305
environmental factors, 296, 297–305
specializations and, 293, 294–296
traditional counseling office, 299–300
sexual orientation, 326–328
sexual relationships with clients, 393–394
sexual relationships with professional colleagues, 394–396
Shaping Counselor Education Programs in the Next Five Years: An

Experimental Prototype for the Counselor of Tomorrow (Walz &
Benjamin), 450
Sheldon’s body types, 366
silence, as counseling skill, 273
simplicity movement, 447
single case studies, 239
smart phones, 457–458
social diversity, education and training in, 87–88
social justice, 18–21
assessment based on, 362
burnout prevention in counseling for, 433, 435

client expectations and, 252–253
counseling and, 71–72, 128–129, 189, 316–320, 335–340
defined, 316, 318
diversity and, 322
ethics in counseling and, 388–390
mental illness and, 28
research as, 222–224
social media
graduate programs in counseling and, 171
technophilia and, 445–446
social wellness, 422
social work, 9
societal trends in counseling, 445–449
Society for the Exploration of Psychotherapy Integration, 202
socioeconomic status (SES), cultural competence and, 332–334
Solution Focused Brief Therapy (SFBT), 187–188, 209
somatotype theory, 366
specializations in counseling, 289–296
assessment protocols and, 353–357

client needs and, 290–291
special needs of students, assessment for, 355
spirituality
wellness and, 425–426, 439
Sputnik launch, 25–26
stage model of cognitive development, 30
stages of counseling, 265–269
The Stages of Life (Jung), 89
stage theory of human development, 29–31
standardized tests/instruments, as assessment tool, 348–349
Standards for Multicultural Assessment, 106
standards of care
counseling accountability and, 218
laws involving, 399–400
state counseling associations, 113
state departments of education, 410
state laws, counseling regulation and, 397–409
statistical power, meta-analyses, 235

statistical significance, quantitative research, 230–236
statistics
in counseling research, 216
quantitative research, 230–236
STEPS (Solutions to Ethical Problems in Schools) model, 414
stereotypes, 311
stigma
of disability, 330–332
of mental illness, 251–252
sexual orientation and, 327
Strength-Centered Counseling (Ward & Reuter), 422
strength-focused assessment, 352–353, 427–430
strengths-based counseling, 422, 427–431
strengths-based interventions, 431
StrengthsFinder, 429
stress
in counseling, 258–259, 431–436
management techniques for, 139
technology-assisted counseling and, 445–449
wellness and, 31–32

Strong Interest Inventory, 22
study skills, for graduate school, 158–160
subjective meaning, behavior and, 191
subjective units of discomfort (SUD), 355, 356
Substance Abuse Mental Health Services Administration (SAMHSA),

66
suicide
assessment of risk, 375–377
by clients, counselors’ feeling of responsibility for, 259–260
in college students, 295–296
supervision of counselors, 65
ethics concerning, 394–396
supervisors, counselors as, 65
support networks
during graduate school, 153–154
survey, as assessment tool, 348
systematic desensitization, 198
systematic eclecticism, 202
systematic integration, 202
systems theory, 187

T
Tarasoff v. Regents of the University of California, 403
teachers, counselors as, 64
Team of Rivals (Goodwin), 368
technical eclecticism, 202
technology-assisted counseling, 297–305
competence in, 456–458
technophilia, 445–446
termination of counseling, ethics involving, 392
testing
abuse in, 359
achievement testing, 23–24
goals and purposes of, 344–345
magazine tests, 374–375
multicultural assessment, 359–360
online tests, 374
photocopies of tests, 374
popularized tests, 375

in schools, 372–374
standardized tests/instruments, 348–349
supervision of, 375
technology of, 22–23
training and education in, 92–94, 375
types of tests, 345–349
theories in counseling, 21–22, 182–211
behavior therapy, 195–198
branding of, 204
change theories, 183–195
common factors, 194
death of, 465–466
eclectic/integrative counseling, 201–203
focused search for, 193–195
personality theory and, 189–193
selection of, 207–211
single vs. multiple theories controversy, 210
social justice approach, 189
therapeutic relationship
establishment of, 265–266
in person-centered therapy, 206
skills of, 270
therapist, counselor as, 46
time management, scheduling and, 156–158
title act, 399
Title IX, 409
tolerance, counselors’ capacity for, 129
training for counselors
continuing education, 138–142
counselor development models, 135–138
novice-to-expert models, 136–138
professional identity development, 134–138
specializations and specific requirements, 296
virtual reality and, 467–469
trait theories of personality, 363–364

transgender, 326
transtheoretical counseling model, 203
treatment planning process, 266–267
20/20: A vision for the future of counseling, 104, 245, 450–451
type theories of personality, 363–364

U
uncensored reactions, 310
unchangeability, vs. changeability, 192–193, 198, 201, 207
unconditional positive regard, 124–125, 204–205
understanding skills, 273
unfinished business
for counselors, 140
universality concept, 92
U.S. Census Bureau, 87
U.S. Department of Labor Bureau of Labor Statistics, 82

V
values-aware counseling approach, 386–388
values-free counseling, myth of, 386–388
Values in Action Inventory of Strengths (VIA-S), 427–429
verbal intelligence, 367
vicarious trauma, 431, 459
video, in counseling sessions, 458
virtual reality, counselor training and practice and, 467–469
Vocation Bureau, 18, 27

W
Walden II (Skinner), 24
warmth, in person-centered therapy, 205
Watson, J. B., 198
Wechsler Intelligence Test for Children, 360
WEL Inventory, 352–353, 418–419
wellness
as assessment focus, 352–353
in counseling, 427–431, 432
in counseling students, 436–441
definitions and dimensions of, 420–427
dimensions of, 422–427
future trends in, 447–448, 466–467
history in counseling of, 418
maintenance of, 458–459
philosophy of, 417
stress and, 31–32
Why Am I Afraid to Tell You Who I Am? (Powell), 254
World Health Organization (WHO), 418

worldview, 313
Wounded Healer concept, 131
writing skills, APA style in, 160–161

Y
YAVIS clients, 262
yoga, 464
Youth Risk Behavior Survey, 348

Inhalt
1. Counseling Today Foundations of Professional Identity
2. About the Authors
3. To Our Students
4. Preface
1. New to the Second Edition
2. Organization of This Book
3. Special Features
4. Instructor’s Supplements
5. 2016 CACREP Standards
5. Brief Contents
6. Contents
7. Chapter 1 Who Are Counselors?
1. Advance Organizers and Reflective Questions
2. Professional Counseling and Professional Identity
1. What Is a Professional Identity?
2. Reflecting on What You Are Learning
3. This Text Is a Field Guide to Counseling
3. What is Counseling?
4. The Helping Professions Today
1. What Is a Counselor?
1. A counselor has specific training.
2. Common core curricular experiences.
3. A counselor belongs to professional organizations.
2. Psychiatry
3. Social Work
4. Marriage and Family Therapy
5. Psychology
1. The training of a psychologist.
6. Comparing the Helping Professions
5. Counseling Yesterday: The History of the Counseling Profession
1. The Big Ideas of Counseling
1. The values of equality, social justice, and client
advocacy, and the importance of career.
1. Progressivism Today.
2. The potential for personal growth.
1. The Legacy of Rogers.
2. The Group Therapy Movement and The
Proliferation of Counseling Theories.
3. The belief in science.
1. The Technology of Testing.
2. Achievement Testing.
3. Behaviorism.
4. Sputnik and the National Defense Education Act.
4. The influence of health, human development, and
biology: Is biology destiny?
1. Biological Treatments.
2. The Mental Health Movement.
3. The Importance of Human Development.
4. Stress and Wellness.
6. Brief History of the American Counseling Association
7. Summary
8. End-of-Chapter Activities
1. Student Activities
2. Journal Question
3. Topics for Discussion
4. Experiments
5. Explore More
1. Books
8. Chapter 2 What Do Counselors Do?
2. Counseling: A Multi-Faceted Profession
1. Counselor as Therapist (Direct Service Provider)
2. Counselor as Group Leader
3. Counselor as K–12 Guidance Curriculum Expert
4. Counselor as Diagnostician
5. Counselor as Assessor
6. Counselor as Consultant
7. Counselor as Administrator or Program Planner
8. Counselor as Documenter or Record Keeper
9. Counselor as Researcher or Scientist
10. Counselor as Learner
11. Counselor as Teacher or Educator
12. Counselor as Supervisor or Supervisee
13. Counselor as Crisis Interventionist
14. Counselor as Advisor
15. Counselor as Expert Witness
16. Counselor as Prevention Specialist
17. Counselor as Businessperson or Entrepreneur
18. Counselor as Mediator
19. Counselor as Advocate or Agent of Social Change
20. Counselor as Member of Professional Associations
3. Summary
2. Journal Question
4. Experiments
5. Explore More
1. Books
9. Chapter 3 How Are Counselors Trained and Regulated?
2. How Many Counselors are There?
3. The Education of Counselors
1. Educational Requirements
2. Core Curriculum
1. Professional orientation and ethical practice.
2. Social and cultural diversity.
3. Human growth and development.
4. Career development.
5. Helping relationships.
6. Group work.
7. Assessment.
8. Research and program evaluation.
9. Clinical experiences (practicum and internship).
10. Other program courses and experiences.
3. Beyond Graduate School
4. Counseling Licensure and Certification
1. Mental Health Counseling Licensure
2. School Counselor Licensure
3. Certification
5. Counseling Associations and Organizations
1. The American Counseling Association
1. The 20/20 definition of counseling.
2. The Divisions of ACA
1. Other counseling organizations.
2. State counseling associations.
3. Chi Sigma Iota
6. Summary
2. Journal Question
4. Experiments
5. Explore More
Identity?
2. Who are Counseling Students?
3. Why Do People Become Counselors?
4. What Types of People Become Counselors?
5. What are the Characteristics of Effective Counselors?
6. How Do People Determine Their Personal and Professional Fit
with the Counseling Profession?
7. What is the Personal Journey Toward Becoming a Counselor?
1. Counselor Professional Identity Development
2. Models of Counselor Development
1. Adult developmental models.
2. College student developmental models.
3. Novice-to-expert models.
8. How Do You Make Sure You Continue to Develop?
1. Self-Reflection
9. Summary
2. Journal Question
4. Experiments
5. Explore More
Graduate Programs?
2. Preparing for Success in your Graduate Program
1. Notes to myself:
3. Getting Ready to Start
1. Prepare Your Attitude
2. Prepare Your Support Network
3. Prepare Your Physical Space
4. Prepare Your Schedule
5. Prepare Your Mind
4. The Successful Graduate Student
1. Successful Peer Relationships
2. Successful Relationships with Faculty
3. Successful Interactions with Counselors and the Professional
Gemeinschaft
4. Success in the Classroom
5. Success in Online Education
6. Success in Navigating the Program Culture
7. Success in Maintaining Your Own Mental Health
5. Next Steps: Life After Graduate School
1. Preparing Your Resume
2. Getting a Ph.D.
3. Seeking References
6. Summary
2. Journal Question
4. Experiments
5. Explore More
12. Chapter 6 How Do Counselors Use Theories?
2. Theories of Change: Counseling Theories
1. What Are the Major Theoretical Positions?
2. Psychodynamic Theories
3. Behavioral/Cognitive Theories
4. Humanistic/Existential Theories
5. Eclectic/Integrative Theories
6. Other Approaches
1. Systems theory or family systems.
2. Constructivist theories.
3. Multicultural theories.
7. A Social Justice Approach to Counseling Theory
8. Dimensions of Personality Applied to Counseling Theories
9. Focusing Your Search for a Theory
3. Behavioral, Cognitive, Eclectic/Integrative, and Rogerian/Person-
Centered Theories
1. Behavior Therapy
1. Basic tenets of behavior therapy.
2. Problems and settings where behavior theory is used.
3. Is behavior therapy effective?
4. Common dimensions of human nature applied to
behavior therapy.
5. Important contributors to behavior counseling.
2. Cognitive Therapy
1. Basic tenets of cognitive therapy.
2. Problems and settings where cognitive therapy is used.
3. Is cognitive therapy effective?
cognitive therapy.
5. Important contributors to cognitive counseling.
3. Eclectic/Integrative Counseling
1. Problems and settings where integrative/eclectic
counseling is used.
2. Is eclectic/integrative counseling effective?
eclectic/integrative therapy.
4. Important contributors to eclectic/integrative counseling.
4. Rogerian/Person-Centered Theory
1. Basic tenets of Rogerian person-centered theory.
2. Problems and settings where person-centered therapy is
used.
3. Is person-centered therapy effective?
4. Common dimensions of human nature applied to person-
centered therapy.
5. Important contributors to person-centered counseling.
4. How do Counselors Choose a Counseling Theory?
1. On What Basis Should I Choose a Counseling Theory?
5. Summary
2. Journal Question
4. Experiments
5. Explore More
1. Books
2. Articles
3. Films
13. Chapter 7 How Do Counselors Use Research?
2. Why Counselors Use Research
1. The Reactive Approach: Responding to External Pressures
2. The Proactive Approach—Responding to Internal Pressures
3. Research as Form of Social Justice
4. Resistance to Research: Why Counselors Don’t Engage in
Forschung
3. How Counselors Use Research
1. Using Existing Research and Scholarship to Inform Practice
4. Understanding the Major Classifications of Scholarly Research
1. Literature Reviews or Position Papers
2. Quantitative Research
1. Efficacy studies.
2. Effectiveness studies.
3. Meta-analyses.
4. Nonexperimental quantitative research.
3. Qualitative Research
4. Program Evaluation
5. Other Types of Articles and Research
5. Engaging in Your Own Research as a Counselor
6. Summary
2. Journal Question
4. Experiments
5. Explore More
14. Chapter 8 What Happens in a Counseling Session?
2. What Counseling Is Like for the Client
1. Before Counseling Begins: The Decision to Seek Counseling
2. What Clients Expect from Counseling
3. Using a Social Justice Approach to Understanding Client
Expectations
4. Hopes and Dreams: The Client’s Belief in the Process of
Counseling
5. Secrets and Lies: The Client’s Struggle to Open Up
3. What Counseling Is Like for the Counselor
1. The Joys and Satisfactions of Being a Counselor
2. Some of the Dissatisfactions of the Counselor Role
1. Counselor fears
2. Countering the fear of client suicide
3. Responsibility
4. Countertransference
4. A Roadmap of the Counseling Process: The Shared Journey of
Counselor and Client
1. Stage I. Establishing the Relationship
2. Stage II Assessment
3. Stage III Treatment Planning
4. Stage IV Intervention and Action
5. Stage V Evaluation and Reflection
5. The Skills of Counseling
1. The Skills of the Therapeutic Relationship
1. What clients find helpful in a counselor
2. Skills You Will Learn
3. Skills to Work on Now
4. Things to Eliminate Now
6. Summary
2. Journal Question
4. Experiments
5. Explore More
1. Books
2. Articles
15. Chapter 9 Where Do Counselors Work?
2. Who is in the Room?
3. Counseling Modalities
1. Group Work Including Group Counseling, Group
Psychotherapy, and Psychoeducation
2. Couples Counseling
3. Family Counseling, Including Multiple Family Groups
4. Classroom Lessons (Also Called Classroom Guidance)
4. Counseling Specializations
1. A Social Justice Approach to Counseling Specializations
2. Counseling Specializations Based on the Interventions Used
1. Counseling specializations based on client needs.
3. Counseling Specializations Based on Setting
4. Counseling Specializations and Specific Training
Requirements
5. Counseling Settings: The Environment Where Counseling Takes
Place
1. A Traditional Counseling Office
2. Other Settings Where Counseling Takes Place
1. Some thoughts about private practice.
6. Summary
2. Journal Question
4. Experiments
5. Explore More
Culturally Competent Counseling?
2. You: A Culture of One
3. Counseling and Social Justice
4. The U.S. Population: A Testament to Diversity
1. Counseling and Diversity
1. Race and ethnicity
2. Gender
3. Sexual orientation
4. Religion/Spirituality
5. Age/Generational status
6. Dis/Ability status
7. Language
8. Socioeconomic status
9. Other diversity categories
2. Diversity and Oppression in the Lives of our Clients
5. Multicultural and Social Justice Counseling
1. Strategies to Enhance Your Own Multicultural and Social
Justice Competence
6. Summary
2. Journal Question
4. Experiments
5. Explore More
1. Books
2. Articles
3. Websites
Information?
2. What Kinds of Assessments Do Counselors Use?
1. Interviewing
2. Questionnaires, Surveys, and Rating Scales
3. Standardized Tests or Instruments
4. Measures of Program Accountability or Counseling
Effectiveness
3. Why Should Counselors Spend So Much Time on Assessment?
1. Let’s Start with a Case Study: What’s Wrong with Raymond?
1. Questions to Consider
4. What Should Counselors Assess?
1. Strengths and Positive Psychology
2. What Is Assessed Varies by Client Problem, Population, and
Setting
3. Assessment in School Counseling
4. Assessment in Mental Health Counseling
5. Assessment in Marriage, Couples, and Family Counseling
5. Steps in the Assessment Process
1. Selecting Good, Developmentally and Culturally Appropriate,
and Comprehensive Methods
2. Establishing a Relationship
3. Administering the Assessment
4. Interpreting Assessment Data
5. Writing Up Assessment Results and Generating Suggestions
for Intervention
6. A Social Justice Approach to the Process of Assessment
7. What Do You Do After You Have Collected Information?
8. Assessment of Personality
9. Personality Assessment Theories
10. What Are Personality Theories?
11. Galen’s Four Temperaments (Example of a Type Theory)
12. Phrenology
13. Sheldon’s Body Types: Type Based on Body Shape
14. The “Big Five” Theory of Personality and NEO Personality
Inventory
15. John Holland’s Self-Directed Search (SDS): Personality in
Career Choice
16. Implicit Theories
6. Ethics in Assessment
1. Ethical Issues to Practice Now
1. Ethical issue #1: Confidentiality, the prime directive.
2. Ethical issue #2: Evaluating or testing your friends.
3. Ethical issue #3: Believing the results of one test, one
sign, or one symptom.
4. Ethical issue #4: Using photocopies of tests.
5. Ethical issue #5: Believing online tests and tests in
magazines.
6. Ethical issue #6: Using a test without any training or
supervision.
7. Ethical issue #7: Thinking you can learn to assess suicide
later.
7. Summary
2. Journal Question
4. Experiments
5. Explore More
1. Books
2. Articles
18. Chapter 12 How Do Counselors Make Legal and Ethical Decisions?
2. The Purpose of Ethics in the Practice of Counseling
1. Professional Codes of Ethics
3. The Role of Personal Ethics and Values
1. The Role of the Counselor’s Personal Values
2. When Personal and Professional Values Collide
3. Understanding Ethical Practice from a Social Justice
Perspective
4. Major Ethical Issues in Counseling
1. Rules Related to Professional Responsibility
2. Rules Related to Competence
3. Rules Related to the Counselor’s Own Moral Standards and
Values
4. Rules Related to Confidentiality
5. Rules Related to the Welfare of the Client
1. Multicultural competence
2. Advocacy
3. Client dependency
4. Informed consent
5. Termination and referral
6. Dual Relationships
7. Sexual Relationships
6. Rules Related to Professional Relationships
5. Ethics and the Law
6. Major Legal Issues in Counseling
1. Legal Principle: Counselor Competency
2. Legal Principle: Client Rights and Informed Consent
3. Legal Principle: Privileged Communication and
Confidentiality
4. Legal Principle: Documentation and Records
5. Other Legal Requirements for Counselors
7. When Counselors Violate Ethical and Legal Requirements
8. Ethical Decision-Making in Practice
9. Summary
2. Journal Question
4. Experiments
5. Explore More
1. Books
2. Articles
3. Websites
Their Clients?
2. A Brief Historical Sketch of Wellness in Counseling
3. Definitions and Dimensions of Wellness
1. Dimensions of Wellness
4. Wellness in Counseling
1. Strengths-Based Counseling
1. Strengths-based assessment
2. Strengths-based assessment and counseling
3. Strengths-based interventions
5. The Stress of Counseling and Potential for Burnout
1. A Social Justice Approach to Preventing Burnout
2. Insulating Yourself Against Stress and Burnout
6. Maintaining Your Wellness as a Counseling Student
1. Physical Wellness
1. Maintain your fitness
2. Eat well
2. Emotional Wellness
1. Reduce emotional arousal
2. Get counseling for yourself
3. Intellectual Wellness
1. Stay on the cutting edge
4. Spiritual Wellness
1. Engage in meditation or prayer
2. Experience nature
3. Be ethical
5. Relationship Wellness
1. Maintain your relationships
6. Developing Your Own Personal Wellness Plan
7. Summary
2. Journal Question
4. Experiments
5. Explore More
1. Books
2. Articles
20. Chapter 14 Counseling Tomorrow
2. Global and Societal Trends
1. Speeding Up: Technology, More Work, and Stress
1. Technophilia
2. Connected to the net but technically alone
3. Overchoice
2. Health, Healthcare, and Aging
3. Increasingly Diverse Society
1. Changing families and couples
2. Religious/spiritual changes
3. The Experimental Prototype Counselor of Tomorrow (EPCOT)
1. Eclectic or Integrative
2. Culturally Aware and Competent
3. Understanding and Accepting of Differences
4. A Leader at Work
5. A Lifelong Learner
6. Technologically Competent
1. Hand-held devices
2. Video
7. Planful and Intentional in Maintaining Personal Wellness
8. Able to Read and Evaluate Research
9. Active in Professional Organizations
10. Able to Work with Couples, Families, Individuals, and Groups
11. A Social Justice Advocate for Clients and the Profession
12. A Reflective Practitioner
13. Ethically Aware
14. Able to Use Assessment Data to Plan Intervention and
Treatment
4. In the Crystal Ball
1. The Rise of Ecotherapy
2. The Mainstreaming of Japanese Therapies, Meditation, Yoga,
and Eastern Perspectives
3. Increasing Problems with Process Addictions
4. The Death of Counseling Theories
5. A Focus on Health, Wellness, Prevention, Complementary and
Alternative Medicine, and Using Discoveries in Neuroscience
1. Advances in Neuroscience
6. Virtual Reality Will Be Used to Train Counselors and Help
Clients Practice
5. Concluding Comments: Where’s My Jet Pack?
2. Journal Question
4. Experiments
5. Explore More
1. Books
21. References
22. Name Index
1. A
2. B
3. C
4. D
5. E
6. F
7. G
8. H
9. I
10. J
11. K
12. L
13. M
14. N
15. O
16. P
17. Q
18. R
19. S
20. T
21. U
22. V
23. W
24. Y
25. Z
23. Subject Index
1. A
2. B
3. C
4. D
5. E
6. F
7. G
8. H
9. I
10. J
11. K
12. L
13. M
14. N
15. O
16. P
17. Q
18. R
19. S
20. T
21. U
22. V
23. W
24. Y
List of Illustrations
1. Figure 1.1 The Big Ideas of Counseling
2. Figure 1.3 Sputnik
3. Figure 7.1 Sample Graph of Average Fights at Baseline and
Intervention.
4. Figure 7.2 Sample Graph of Client Distress on a Measure of
Symptomatology at Pre-Test, Post-Test, and 6-Month Follow-up.
5. Figure 8.1 The Roadmap of the Helping Process
6. Figure 9.1 Three Questions to Ask Before You Begin Counseling
7. Figure 10.1
8. Figure 11.1 Martha’s Progress in Subjective Units of Discomfort over
Eight Sessions
9. Figure 11.2 Lincoln Analyzed Using the Revised NEO Personality
Inventory
10. Figure 14.1 The Counselor of Tomorrow
List of Tables
1. Table 2.1 The Many Roles of the Counselor
2. Table 2.2 Counselors and Diagnosis: A Breakdown by State (updated
10/16)
3. Table 6.1 Theoretical Orientations of Psychotherapists in the United
States
4. Table 8.1 What Counselors Say They Like (and Don’t Like) About
Their Jobs
5. Table 8.2 What Counselors Say Causes the Most (and Least) Stress in
Their Jobs
6. Table 8.3 Continuum of Self-Disclosure
7. Table 8.4 A Few Examples of Counseling Techniques Counselors Might
Use During Stage IV Interventions
8. Table 8.5 Basic Counseling Skills
9. Table 9.1 Counseling Modalities
10. Table 9.2 Some Common Counseling Specializations
11. Table 9.3 Typical Settings Where Counseling Takes Place
12. Table 11.1 Types of Tests in Common Use by Counselors
13. Table 11.2 Self-Rating Inventory of the Big Five Personality
Characteristics.
Landmarks
1. Brief Contents
2. Frontmatter
3. Start of Content
4. backmatter
5. List of Illustrations
6. List of Tables
1. i
2. ii
3. iii
4. iv
5. v
6. vi
7. vii
8. viii
9. ix
10. x
11. xi
12. xii
13. xiii
14. xiv
15. xv
16. xvi
17. xvii
18. xviii
19. xix
20. xx
21. 1
22. 2
23. 3
24. 4
25. 5
26. 6
27. 7
28. 8
29. 9
30. 10
31. 11
32. 12
33. 13
34. 14
35. 15
36. 16
37. 17
38. 18
39. 19
40. 20
41. 21
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Long description
The four big ideas and their subcategories are as follows:
Biology, Health, and Development
Developmental Stage Theories
Mental Hygiene
Stress and Wellness
The Importance of Science
Evidence Based Counseling
Technology of Testing
The Values of Equality, Client Advocacy, and the Importance of Career
Vocational Guidance in the Schools
Progressivist Ideas about the Value of Work and Equality
The Potential for Personal Growth
Personal Growth through Group Therapy
The Theories of Carl Rogers

Long description
The breakdown is as follows:
Counselor as Therapist, 10%
Counselor as Group Leader, 10%
Counselor as Assessor, 5%
Counselor as Consultant, 1%
Counselor as Administrator or Program Planner, 7%
Counselor as Documenter or Record Keeper, 23%
Counselor as Researcher or Scientist, 3%
Counselor as Learner, 3%
Counselor as Educator or Trainer, 10%
Counselor as Supervisor or Supervisee, 6%
Counselor as Advisor, 1%
Counselor as Businessperson or Entrepreneur, 20%
Counselor as Member of Professional Organization, 1%.

Long description
Counselor as Advisor, 15%
Counselor as Crisis Interventionist, 15%
Counselor as Group Leader, 10%
Counselor as K–12 Guidance Curriculum Expert, 10%
Counselor as Documenter or Record Keeper, 25%.

Long description
A double-headed arrow shows the two sides of arguments as follows:
On the left, diagnosis is necessary and important and SHOULD be done.
On the right, diagnosis undermines the dignity of the client and

SHOULD NOT be done.
Text at the bottom reads: On the continuum, place an "X" where you
think you stand on this issue.
Long description
Counselor as Supervisor, 5%
Counselor as Businessperson or Entrepreneur, 5%.

Long description
Counselor as Diagnostician, 5%
Counselor as Assessor, 10%
Counselor as Researcher or Scientist, 3%
Counselor as Supervisor, 3%
Counselor as Crisis Interventionist, 2%
Counselor as Advocate or Agent of Social Change, 5%
Counselor as Expert Witness, 2%
Counselor as Businessperson or Entrepreneur, 3%
Counselor as Member of Professional Organization, 20%

Long description
The labels are as follows:
Left: “There is just one profession, and all counselors are part of it.”
Right: “The specialties in counseling are so distinct, they represent truly

unique professions.”
Long description
The labels are as follows: Left: “Art; Counselors are Born.” Right: “Science;
Counselors are Made.”
Long description
The row is labeled “Determinism: External forces and unconscious drives” at
left and “Freedom: Human beings are free to choose and are responsible for
actions” at right. The first box is labeled Freud; the second and third boxes
are blank; and the fourth and fifth boxes are labeled Adler and Rogers,
respectively.
Long description
The row is labeled “Rational: Humans are basically rational and scientifically
try to understand the world” at left and “Irrational: Human beings are mostly
irrational and more affected by biology and emotion” at right. The first box is
labeled Ellis (cognitive); the second box is labeled Rogers; the third and fifth
boxes are blank; the fourth box is labeled Freud.
Long description
The row is labeled “Humans are reactive: External forces such as rewards and
punishments change behavior” at the left end and “Humans are proactive:
Change occurs from within” at the right end. The first box is labeled Skinner
(Behaviorism); the second, third, and fourth boxes are blank; the fifth box is
labeled Adler.
Long description
The row is labeled “Homeostasis: People seek to fulfill their needs, leading to
a state of quietude and balance” at the left end and “Heterostasis: People are
questing to be all that they can be” at the right end. The first box is labeled
Systems theory; the second box is labeled Freud (psychodynamic); the third
and fourth boxes are blank; the fifth box is labeled Existential/humanistic.
Long description
The row is labeled “Unchangeability (Better to adapt): People do not have the
capacity to change” at the left end; “People must adapt to life” at the center;
and “Changeability: People are constantly changing and growing” at the right
end. The first two boxes are blank; the third box is labeled Freud; the fourth
and fifth boxes are labeled Adler and Rogers, respectively.
Long description
The arrow is labeled “Choosing One Theory Is Best” at the left end and
“Learning Multiple Theories Is Better” at the right end.
Long description
The arrow is labeled “Evidence-based” at the left end and “Clinical wisdom”
at the right end.
Long description
The vertical axis ranges from 0 to 10. The horizontal axis is labeled Baseline
at the left end and Intervention toward the right, with eight bars indicating the
number of average fights. The bars on the left extend to 8, 7, 9, and 9 from
left to right; they decline to 6, 7, 4, and 3 on the right.
Long description
The vertical axis is labeled Mean and ranges from 40.00 to 80.00. The
horizontal axis has tick marks labeled Admission, Discharge, and Follow up
from left to right. The graph line starts at 80.00 at Admission, declines to
40.00 at Discharge, and rises to 50.00 at Follow up.
Long description
The arrow is labeled Evidence-based at the left end and Nondirective at the
right end.
Long description
The first segment of the road is labeled Relationship Building. The second,
third, fourth, and fifth curves of the roadway are labeled Assessment,
Treatment Planning, Intervention & Action, and Evaluation & Reflection,
respectively.
Long description
Question 1: Based on the client's problem, which modality is best?
Family
Individual
Couple
Group
Multi Family
School Class
Question 2: What is the best setting for this client or these clients to
overcome the problem?
Inpatient
Outpatient
Residential
In-Home
Partial Hospitalization
Within the School Setting
Question 3: Do you have the optimal modality available? Is this the right
setting for this client or these clients?
If yes: Begin Counseling
If no: Make a Referral

Long description
The arrow is labeled “Technology–Assisted Counseling – Counseling is the
wave of the future” at the left end and “Technology–Assisted – Should not be
taught or practiced” at the right end.
Long description
The label at the left end of the continuum reads “Yes, our ethics and social
justice approach require this” and the label at the right end reads “No, school
counselors should not have to risk their jobs.” The caption reads “On the
continuum, place an ‘X’ where you think you stand on this issue.”
Long description
The diagram is a circle divided into four quadrants; each quadrant consists of
labeled concentric rings. At the top of the circle is the label Privileged
Counselor; at the right is the label Marginalized Client; at the bottom is the
label Marginalized Counselor; and at the left is the label Privileged Client.
Each quadrant is labeled Attitudes and Beliefs – Knowledge – Skills –
Action. The center of the circle is labeled Multicultural and Social Justice
Praxis. The rings extending outward from the center are labeled Counselor
Self-Aware, Client Worldview, Counseling Relationship, and Counseling and
Advocacy Interventions, respectively, in each of the four quadrants.
Long description
The vertical axis ranges from 0 to 90 in subjective units of discomfort. The
horizontal axis is broken into eight units representing sessions. A graph line
labeled S U D Before has the following discomfort values: session 1, 50;
session 2, 80; session 3, 65; session 4, 70; session 5, 70; session 6, 85;
session 7, 60; session 8, 50. A graph line labeled S U D After has the
following discomfort values: session 1, 10; session 2, 60; session 3, 50;
session 4, 55; session 5, 60; session 6, 65; session 7, 40; session 8, 30. The
Before graph line is higher than the After graph line at each session.
Long description
The vertical axis is labeled U.S. T Score and ranges from 30 to 70. The
horizontal axis shows five aspects of personality. A pair of graph lines show
readings for Lincoln and for the average president for each aspect. The
approximate readings are as follows:
Neuroticism: Lincoln 59, average president 52
Extraversion: Lincoln 57, average president 55
Openness: Lincoln 66, average president 45
Agreeableness: Lincoln 57, average president 42
Conscientiousness: Lincoln 57, average president 57

Long description
A label at the left end of the arrow reads “Counselors should not support high
stakes testing”; a label at the right end reads “Counselors should support high
stakes testing.” A caption reads “On the continuum, place an ‘X’ where you
think you stand on this issue.”
Long description
The arrow is labeled “Counselors should be able to work with all clients” on
the left end and “Counselors should be free to choose their clients” at the
right end.
Long description
The arrow is labeled “Treat mental disorders” at the left end and “Focus on
strengths and enhance wellness” at the right end.
Long description
Clockwise from top, the skills are as follows:
Has a plan for maintaining wellness
Is a leader at work
Lifelong learner
Stays active in professional organizations
Eclectic or integrative
Uses evidence to make decisions
Open to promising practices
Technologically savvy
Social justice advocate for clients and the profession
Reflective practitioner
Ethically aware
Able to read and evaluate research
Able to work with couples, families, individuals, and groups
Culturally aware and competent
Understands and accepts differences
Uses assessment data to plan treatment

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Foundations of Professional Identity

Darcy Haag Granello

The Ohio State University

University of Central Florida

330 Hudson Street, NY, NY 10013

Portfolio Manager: Rebecca Fox-Gieg

Content Producer: Pamela D. Bennett

Portfolio Management Assistant: Casey Coriell

Executive Field Marketing Manager: Krista Clark

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Media Project Manager: Lauren Carlson

Procurement Specialist: Deidra Smith

Cover Designer: Melissa Welch, Studio Montage

Cover Photo: Frank Chen/Moment/Getty Images

Full-Service Project Management: Sudip Sinha, iEnergizer Aptara®, Ltd.

Composition: iEnergizer Aptara®, Ltd.

Cover Printer: LSC/Crawfordsville

Text Font: PalatinoLTPro

Copyright © 2019, 2012 by Pearson Education, Inc. or its affiliates. All

Unless otherwise indicated herein, any third-party trademarks that may

Library of Congress Cataloging-in-Publication Data

Names: Granello, Darcy Haag, author. | Young, Mark E., author.

Title: Counseling today : foundations of professional identity / Darcy Haag

Description: Second edition. | Boston : Pearson, 2019. | Includes

Identifiers: LCCN 2017042453| ISBN 9780134816425 | ISBN 0134816420

Subjects: LCSH: Counseling—Vocational guidance—United States. |

Classification: LCC BF636.64 .G73 2019 | DDC 158.3023—dc23 LC record

ISBN 10: 0-13-481642-0

To J. Melvin Witmer, Professor Emeritus, Ohio University, with deep

Darcy Haag Granello is Professor of Counselor Education at The Ohio State

Mark E. Young, PhD

Mark Young is Professor of Counselor Education at the University of Central

As you begin your professional journey, we encourage you to strive to

Darcy Haag Granello

In this book, we use a developmental perspective that encourages students to

New to the Second Edition

2016 CACREP Professional Orientation and Ethical Practice Standards

The latest information about state licensure requirements, updates to the

Chapter 4, now entitled How Do Counselors Integrate Personal and

Chapter 5 includes a section on success in online education for

Chapter 10, now entitled How Do Counselors Promote Social Justice

Chapter 13, How Do Counselors Support Wellness in Themselves and

Chapter 6 includes an updated Spotlight on Pastoral, Biblical, and

Chapter 14 includes updated connections to the role of technology in

New Counseling Controversies, including Coaching vs. Counseling,

Organization of This Book

Chapter 1 provides a brief historical overview of the profession of

Chapter 2 highlights the many roles of the counselor. This chapter

Chapter 3 moves to a discussion of professional identity through an

Chapter 4 introduces students to the developmental journey of

Chapter 6 gives students a framework to understand how counseling

Chapter 7 introduces students to the connection between research and

Chapter 9 introduces students to the many different settings where

Chapter 10 challenges students to think about the diverse world in which

Chapter 11 helps students understand the important role that assessment

Chapter 12 encourages students to understand the important role of

Chapter 14 is a glimpse into the future of counseling. Students reading

Words of Wisdom provide advice and guidance from experienced

Spotlights highlight current trends and important viewpoints that help

Snapshots are first-person stories by real counselors who work in the

Fast Facts offer interesting snippets of data about counseling and

Counseling Controversies feature two sides of an issue that is currently