A two-part survey was conducted, where respondents reported ethically challenging incidents encountered in the previous two years and actions taken to address them. 132 certified counseling psychologists participated and reported 136 ethical dilemmas. The top categories of dilemmas pertained to breaking confidentiality between respondents and clients, including mandatory reporting, collaborating with education associates, and interjecting by the authority. 82% of the respondents took actions to address the dilemmas. These actions ranged from steering a middle course, upholding professional ethical standards, (...) seeking consultation to taking no actions. Potential environmental contributors to the dilemmas and actions taken to address them were explored. (shrink)

The comprehensive guide to ethics "An excellent blend of case law, research evidence, down-to-earth principles, and practical examples from two authors with outstanding expertise. Promotes valuable understanding through case illustrations, self-directed exercises, and thoughtful discussion of such issues as cultural diversity."--Dick Suinn, president-elect 1998, American Psychological Association "The scenarios and accompanying questions will prove especially helpful to those who offer courses and workshops concerned with ethics in psychology."--Charles D. Spielberger, former president, American Psychological Association; distinguished research professor of psychology, University (...) of South Florida The authors draw on their professional experience, empirical studies, and case examples to examine the ethical responsibilities that confront psychotherapists and counselors in their day-to-day practice. They offer insights into contending with the sometimes competing demands of clients' needs, formal ethical principles, personal values, and evolving legal standards in a range of areas--including fees, informed consent, sexual concerns, confidentiality, documentation, and supervision. (shrink)

Psychotherapy holds out the promise of help for people who are hurting and in need. It can save lives and change lives. In therapy, clients can find their strengths and sense of hope. They can change course toward a more meaningful and healthy life. They can confront loss, tragedy, hopelessness, and the end of life in ways that do not leave them numb or paralyzed. They can discover what brings them joy and what sustains them through hard times. They can (...) begin to trust, or to trust more wisely. They can learn new behaviors in therapy and how to teach themselves new behaviors after therapy ends. They can question what they always believed was a given. They can find out what matters most to them, and how to stop wasting time. They can become happier, or at least less miserable. They can become better able, as Freud noted, to love and to work. They can learn how to accept and love themselves just as they are and accept others who are different from them. Our ethics acknowledge and affirm our profession's responsibilities. This book was written to help strengthen, deepen, and inform ethical awareness and the sense of personal ethical responsibility. Its job is to help you hold onto the ideals-including ethical ideals-that called you into the profession to begin with, to help you develop and fulfill those ideals. There will be so much-trust us on this-that tends to dull ethical awareness, to make ethics drift out of focus, to create barriers between you and your ideals, to replace ethics with pseudo-ethics and ethics placebos. Fatigue, endless paperwork, unrealistic expectations, illness, family crises, not being able to make ends meet, burn out, threats of job loss, insurance coverage that doesn't come close to meeting the needs of our clients, biases that have not been addressed, and so many other forces can pressure us into cutting ethical corners. This book is intended to help you develop a strong and healthy resistance to such forces, to help you weather them without losing your ethical awareness and ideals. (shrink)

The current state of Ukrainian society is characterized by socio-economic instability, there are dynamic, unique processes in which each person is involved. In this connection, there are increasing demands on the professionalism of specialists in the field of practical psychology, their philosophical counseling in the context of postmodernism, aimed at helping people become the subject of their life, work, social and value relationships, to teach them to find meanings and maximize self-actualization. This is represented in the change of priorities (...) in the professional development of practical psychologists, its focus on the development of specialists' subjectivity, their ability to independently solve professional and life tasks. An important role in enhancing the development of professionalism is the understanding of the essential characteristics of existential professional activity, expressed most often in professional meanings and values. The basis of a meaningful professional and personal life is the key ability of the practical psychologist to see and accept the needs of the profession and life and to find the most correct explanations for them. The purpose of the article is to investigate the importance and necessity of the activity of a practical psychologist, its peculiarities, the study of types of psychological aid: counseling, psychological rehabilitation, correction, psychotherapy, training, education and prevention; as well as the need to identify the main areas of professional activity of practical psychologists in the context of postmodernism. (shrink)

The aim of this study is to investigate the necessity of revising the Ethics Code of the Psychology and Counseling Organization of the Islamic Republic of Iran with respect to people’s rights and dignity and to avoid unfair discriminations toward sexual orientation and gender identity. It is said that confused diagnoses; wrong decision making; unethical practice; and the subsequent harm caused to lesbian, gay, bisexual, and transgender clients result from the lack of a clear code and relevant guidelines. In (...) addition, certain conditions in Iran lead professional psychologists and researchers to avoid researching sexual minorities and gender identity, which negatively impacts the Ethics Code of the PCOIRI. Iranian and Western researchers have identified four primary sources to which psychologists and counselors can refer when faced with ethical dilemmas: developmental psychology, professional ethics codes, philosophy of psychology literature, and available researches and compilations on professional ethics. Finally it is suggested that, when dealing with homosexual clients and the related ethical dilemmas, Iranian psychologists and counselors need clear and specific guidelines and a professional ethics code developed from more appropriate reference points than legal and religious sources. (shrink)

Counseling Ethics for the 21st Century prepares students to address ethical issues arising in contemporary counseling practice. Drawing on their own clinical and practical experiences, authors Elliot D. Cohen and Gale Spieler Cohen present detailed, realistic, and engaging clinical case studies along with a comprehensive five-step model that can be used to manage the complex ethical problems raised throughout the book. Each chapter focuses on particular virtues in the context of examining a particular counseling issue, including online (...) counseling, digital record keeping, and social media. Students will be empowered to define problems, identify relevant facts, conduct ethical analyses, and make the best decisions for their clients. (shrink)

This article investigates whether there are differences in religious and spiritual (R/S) beliefs, attitudes, practices, training, and self-assessed competence between counselors and psychologists in Canada. Researchers surveyed 307 mental health professionals in Canada with two standardized measures (the Assessment of Spirituality and Religious Sentiments Scale and the Duke University Religion Index) and various other questions corresponding to variables investigated or alluded to in past research. We hypothesized that, compared with psychologists, counselors would (a) have stronger personal R/S beliefs, (b) demonstrate (...) more positive attitudes about the appropriateness of using R/S techniques with clients, (c) utilize R/S techniques more in sessions, (d) possess more positive attitudes toward training in this area, and (e) have higher self-assessed competence for working with R/S clients. These hypotheses were generally supported except for the last one: there were no significant differences found between counselors and psychologists in self-assessed competence in working with R/S clients. We compare our findings to those of extant research, particularly the study by Plumb who examined counselors in Canada. On the basis of our findings, we advocate for more systematic cultivation of R/S competence in programs for both counselors and psychologists in Canada. (shrink)

Whether one's interests lie in psychological practice, counseling, research, or the classroom, psychologists today must deal with a broad range of ethical issues--from charging fees to maintaining a client's confidentiality, and from conducting research to respecting clients, colleagues, and students. Now in a new edition, Ethics in Psychology, the most widely read and cited ethics textbook in psychology, considers many of the ethical questions and dilemmas that psychologists encounter in their everyday practice, research, and teaching. The book has (...) been completely updated in response to evolving trends in psychological research and practice, as well as extensive changes in the American Psychological Association's ethics code. Taking a practical, common sense approach to ethics in modern-day psychological practice, this useful book offers constructive means for both preventing problems and resolving ethical predicaments. This new edition retains the key features which have contributed to its popularity, including extensive case studies that provide illustrative guidance on a wide variety of topics, such as fee setting, advertising for clients, research ethics, sexual attraction, classroom ethics, managed care issues, confidentiality, and much more. Highly readable, the book unites an accessible style with humorous anecdotes that highlight the human side of ethics and make the book a pleasure to read. Ethics in Psychology will be an indispensable guide to ethical decision-making for all psychologists and students in psychology. (shrink)

Psychologists today must deal with a broad range of ethical issues--from charging fees to maintaining a client's confidentiality, and from conducting research to respecting clients, colleagues, and students. As the field of psychology has grown in size and scope, the role of ethics has become more important and complex whether the psychologist is involved in teaching, counseling, research, or practice. Now this most widely read and cited ethics text in psychology has been revised to reflect the ethics (...) questions and dilemmas that psychologists encounter in their everyday work. Ethics in Psychology has been completely updated in response to evolving trends in psychological research and practice, as well as extensive changes in the American Psychological Association's ethics code. Gerald P. Koocher and Patricia Keith-Spiegel take a practical, commonsense approach to ethics in modern-day psychological practice, and offer constructive suggestions for both preventing problems and resolving ethical predicaments. In this book, their main intent is to present the full range of contemporary ethical issues in psychology as not only relevant and intriguing, but also as integral and unavoidable aspects of the profession. The authors make extensive use of actual case studies in order to illustrate how the APA guidelines apply to specific situations, such as fee setting, advertising for clients, research ethics, sexual attraction, classroom ethics, managed care issues, confidentiality, and much more. The most recent ethics code of the American Psychological Association (1992) is used here only as a starting point. The authors go well beyond the APA code and incorporate the input of many experts. In addition to the analysis of a wide variety of general situations, new problematic areas are identified and explored. The book includes two appendixes - Ethical Principles of Psychologists and Code of Conduct, adopted by American Psychological Association, Rules and Procedures of the Ethics Committee of the American Psychological Association - both in an easy-to-use format. In addition, each chapter lists summary guidelines along with current and valuable references. Highly readable, the book unites a straightforward, lively writing style with humorous anecdotes that highlight the human side of ethics and make the book a pleasure to read. Ethics in Psychology will be an indispensable guide to ethical decision-making for all psychologists and students in psychology. (shrink)

The mapping of therapeutic collaboration throughout counseling deepens our understanding of how the helping relationship fosters client change. To better understand the process of career construction counseling, we analyzed the therapeutic collaboration on six successful face-to-face cases. The participants were six Portuguese adults, five women and one man, real clients of a career counseling service, and four psychologists, three female and one male trained in the career intervention model. The participants completed demographic questions and measures of (...) career certainty, vocational identity, career indecision, and psychological functioning. The Therapeutic Collaboration Coding System was used to track collaboration throughout all interactive episodes. The clinical significance of the intervention was calculated by analyzing pre-post-test statistical differences for each case, with the Reliable Change Index and Z score. The findings evidenced a pattern of therapeutic collaboration evolution for good outcome cases. Based on this pattern, we propose a model of process-outcome evolution for the three phases of CCC. (shrink)

State statutes, case law, and professional codes of ethics in the mental health professions typically stress either a duty or the permissibility of disclosing confidential information in order to prevent clients from seriously harming themselves. These sources are intended to address cases where clients are deemed to be suffering from cognitive dysfunction for which paternalistic intervention, including involuntary hospitalization, is considered necessary to prevent self-destructive behavior.The counselor’s moral and legal responsibility is less apparent when mentally competent clients desire suicide as (...) release from irremediable suffering due to severe physical illness, and this desire is defensible within these clients’ value systems. This paper will explore moral and legal dimensions of a counselor’s decision not to intervene in such cases. The concept of permitted suicide will be introduced and defined, and guidelines for its application developed. (shrink)

Philosophical counselling, Ran Lahav and others claim, helps clients deepen their philosophical self‐understanding. The counsellor's role is the minimalist one of providing the client with the philosophical tools needed for reflective self‐evaluation. Respect for the client's autonomy entails refraining from intervening with substantive moral criticism, theories, and methods; the client's ways of working out fundamental questions like ‘Who am I and what do I really want?’cannot be assessed by the counsellor in terms of their truth‐value, but only (...) in terms of whether they reflect the client's autonomous choice to express him/herself in a certain way. I argue that this view, which is informed by an anti‐realist account of self and life‐history, undermines the distinction between self‐knowledge and self‐deception. Once interpretive and criteriological free rein is given to the client, and once personal, pragmatic and aesthetic considerations take precedence over truth‐value, then the way is left open to clients to generate the most morally convenient self‐interpretation to suit their current needs. I defend the view that truth matters in philosophical counselling; more specifically, that there is a basic distinction between true and false forms of self‐understanding. To do this, I offer a broadly realist account of self and reflective self‐evaluation. If this is right, then philosophical counsellors shoulder a significant burden of responsibility in helping their clients achieve an accurate, defensible, action‐guiding and truth‐oriented self‐understanding. (shrink)

Though there has been interest in philosophical counselling in South Africa since at least the 1990s little has been accomplished by way of formalizing and developing the practice into a profession. We ask what would be required for it to become a fully-fledged profession? We argue that in order to count as a profession, a practice must meet certain normative, cognitive, and organizational criteria, but that philosophical counselling in South Africa falls short both cognitively and organizationally. This has implications for (...) individual philosophical practitioners, it would seem, who cannot any longer consider themselves professionals. We argue that being a professional is not contingent on belonging to an established profession, but rather that to claim to be a professional is to claim that one can be trusted because one has the client’s good at heart. Exploring the idea of trust highlights again, though this time from an ethical rather than from a sociological perspective, that there is an urgent need to fill the cognitive and organizational gap that exists in South Africa. We propose that in order to facilitate the professionalization of philosophical counselling in South Africa, we should adopt an approach that focuses on the training of philosophical counsellors in the hopes that an organizational component will grow out of this rather than following previous attempts to put organizations first. (shrink)

Standards and Ethics for Counselling in Action is the highly acclaimed guide to the major responsibilities which trainees and counselors in practice must be aware of before working with clients. Author Tim Bond outlines the values and ethical principles inherent in counselling and points out that the counselor is at the center of a series of responsibilities: to the client, to him/herself as a counselor and to the wider community. Now fully revised and updated, the second edition examines issues (...) fundamental to the process of counselling. A wide range of ethical problems is discussed and advice is given for resolving these dilemmas. Topics covered include: confidentiality, legal aspects of counselling, working with suicidal clients, false or recovered memory, record keeping, and the importance of adequate supervision. Full of practical information and guidance, the second edition of Standards and Ethics for Counselling in Action will be essential reading and a continuing source of reference for all those involved in counselling training and practice. (shrink)

Professor katie harster has considered the phenomenon of psychological trauma, bringing philosophical understandings into play. She provides an informed account of observed “symptoms,” and associated treatments. I comment as a counseling psychologist, although I do not specialize in the evidence-based treatments that she describes. Usually, in my work with clients, we are trying to make sense of what has happened, with a concern for what might happen in the future. I am grateful therefore to colleagues who have the (...) expertise that I lack. I recall a discussion with one of these colleagues, who suggested that, “If a house is on fire, your priority should be to put out the flames and you can worry about how it caught... (shrink)

: The accelerated discovery of gene mutations that lead to increased risk of disease has led to the rapid development of predictive genetic tests. These tests improve the accuracy of assigning risk, but at a time when intervention or prevention strategies are largely unproved. In coming years, however, data will become increasingly available to guide treatment of genetic diseases. Eventually genetic testing will be performed for common diseases as well as for rare genetic conditions. This will challenge genetic counseling (...) practice. The ethical principles that now guide this practice take into account the personal nature of test decision making, the need to respect individual self-determination, and the importance of client confidentiality. Certain of these principles may have to be modified as genetic testing becomes more widespread in order to meet the changing needs of clients and society. This paper offers recommendations to ensure that genetic counselors will take a leading role in the future delivery of ethical genetic services. (shrink)

This article examines the issue of nonsexual relationships between psychologists and their former therapy clients. What little research is available concerning nonsexual relationships with former clients suggests that psychologists have clear reservations about some of these relationships, especially personal ones and intentional social interactions. Relationships immediately following termination are seen as particularly suspect. Drawing on the literature dealing with multiple relationships in general, and sexual relationships with former clients in particular, a number of arguments are made outlining why psychologists should (...) avoid significant nonsexual relationships with former clients for at least some period of time following termination. (shrink)

A survey form sent to psychologists (Pope, Keith-Spiegel, & Tabachnick, 1986) was adapted and sent to 1,000 clinical social workers (return rate = 45%). Most participants reported sexual attraction to a client, causing (for most) guilt, anxiety, or confusion. Some reported having sexual fantasies about a client while engaging in sex with someone other than a client. Relatively few (3.6% men; 0.5% women) reported sex with a client; training was related to likelihood of offending, though the (...) effect is small and complex. An analysis of eight national studies (data from 5,148 therapists) found significant effects for gender (more male offenders) and year of study (about 10% annual decrease in reported offenses since 1977) but not profession (i.e., no difference among psychiatrists, psychologists, and social workers). Most social workers reported no graduate training whatsoever about sexual attraction; only 10% reported adequate training. (shrink)

Modal responses to items from a recent survey of independent practitioners regarding the impact of managed care on their practices and ethics were presented to participants as the responses of a hypothetical independent practitioner. Participants were asked to consider seeing this hypothetical practitioner both before and after being informed of the practitioner's responses to the managed care survey. Results indicate that when participants were informed of the practitioner's views toward managed care, their own attitudes toward therapy changed significantly. Specifically, compared (...) to uninformed participants, informed participants were significantly more likely to believe that managed care would have a negative impact on treatment and significantly less likely to see an independent practitioner, use insurance benefits, expect to benefit from treatment, expect to form a strong working relationship, and trust that the practitioner would work in their best interest. Implications regarding ethics and informed consent are discussed. (shrink)

Reviews the book, Culture, psychotherapy and counseling: Critical and integrative perspectives edited by Lisa Hoshmand. Lisa Tsoi Hoshmand points out in a new book she has edited, Culture, psychotherapy and counseling: Critical and integrative perspectives, framing the culture concept in this way trivializes and distorts the significance of "the cultural," both for psychotherapists and for psychologists more generally. In this volume, Hoshmand and her contributors both explicate and perform a much broader understanding of what culture is, and of (...) the ways in which it inescapably does influence psychotherapeutic and counseling theory and practice. Most notably, she highlights the ways that personal history, sociopolitical context, social change, and globalization all influence an individual's cultural identity; as a corollary of this, she asserts, "the internalized culture and identity of a given individual cannot be presumed on the basis of ethnic origin and cultural tradition". In spite of the limitation, virtually all of the chapters blend personal history, theoretical reflection and clinical material in interesting ways that enhance the reader's appreciation of the many contexts that surround and infuse the therapeutic encounter. 2012 APA, all rights reserved). (shrink)

The present study investigated whether individual differences between psychologists in thinking styles are associated with accuracy in diagnostic classification. We asked novice and experienced clinicians to classify two clinical cases of clients with two co-occurring psychological disorders. No significant difference in diagnostic accuracy was found between the two groups, but when combining the data from novices and experienced psychologists accuracy was found to be negatively associated with certain decision making strategies and with a higher self-assessed ability and preference for a (...) rational thinking style. Our results underscore the idea that it might be fruitful to look for explanations of differences in the accuracy of diagnostic judgments in individual differences between psychologists (such as in thinking styles or decision making strategies used), rather than in experience level. (shrink)

An introduction to vision counseling - the principles, method, and strategies of helping clients develop their rational and supra-rational tendencies.

Independent on Sunday October 2nd One of the country's lead­ing philosophical counsellers, and chairman of the Society for Philosophy in Practice (SPP), Tim LeBon, said it typically took around six 50 ­minute sessions for a client to move from confusion to resolution. Mr LeBon, who has 'published a book on the subject, Wise Therapy, said philoso­phy was perfectly suited to this type of therapy, dealing as it does with timeless human issues such as love, purpose, happiness and emo­tional challenges. (...) `Wise Therapy, is part of a series aimed at promoting an integrative attitude as its ethos. Among all the many perspectives of psychotherapists and counselors, philosophy needs to take its place and needs to find its voice. Tim LeBon has provided an effective means by which counselors can bring philosophy into their work with clients' - APPA journal `Tim Le Bon's Wise Therapy is a comprehensible and well argued book dealing with the practical therapeutic applications of philosophical research that may well be of interest to philosophers but -- as the author himself intends -- will be of most obvious benefit to therapists and counselors, both by informing their dialogue with clients in new ways and by helping them become more informed about ways to resolve the ethical dilemmas arising within the context of their own work' - Metapsychology `A fascinating workshop for therapists and clients, backed up a thorough degree if philosophical acuity' - Journal of the Society for Existential Analysis `I strongly recommend the book for philosophers as well as practitioners, teachers, students and supervisors in counselling and psychotherapy' - Self and Society `Provides some additional and valuable arrows for the therapist's quiver' - Irvin Yalom, author of Love's Executioner `Like Aristotle, Tim LeBon examines what is said and extracts what is best from it…. There are many fascinating exercises designed to bring out and enlighten the client's values, conception of the good life, well-being, happiness, pleasure, and the proper place of reason in life…. Wise Therapy is well written and engaging. The case histories are illuminating examples of therapeutic techniques at work, the thought experiments are well designed, and the philosophical position adapted from the internal debates of the philosophers is level headed…. I recommend it highly to philosophers with an interest in counselling, and psychological counsellors with an interest in philosophy' - Jeff Mason, The Philosophers' Magazine `Tim LeBon has… authored a text which should become a staple on the philosophical counsellor's bookshelf…. Wise Therapy is a concise, well-written book…. His ability to relate philosophical concepts to counselling concerns is admirable and attests to the skill and knowledge he possesses as a working counsellor. But, by far the most important part of Tim LeBon's book to PC is the last chapter, "The Counsellor's Philosophical Toolbox"' - Craig Munns in The Examined Life ` Tim LeBon has done a good job of offering practical approaches to some of the most important and vexing issues that arise in counselling…. Tim LeBon's book contains helpful suggestions, practical information, and useful examples, and would make a good addition to the library of any counsellors willing to allow philosophy to turn mere client sessions into wise therapy' - Peter Raabe, Practical Philosophy Wise Therapy is an original and practical guide to how philosophy can benefit counselling and psychotherapy. Tim LeBon argues that therapy, informed by philosophy, can help clients make better decision and achieve emotional wisdom. He uses philosophical approaches to explore issues of right and wrong, the emotions and reasons, well-being and the meaning of life, and develops a 'counsellor's toolbox' of techniques that can help practitioners apply the wisdom of philosophy to good therapeutic practice. For counsellors who may find philosophical approaches to therapy useful, this work addresses key philosophical topics - the emotions, free will, the meaning of life and ethics. It is jargon-free where possible and assumes no previous philosophical training. From The Independent, 16th November 2004 Plato is my agony aunt It was the end of a love affair that broke her heart. Could the wisdom of the great philosophers show her how to be happy again? Claire Smith tries a novel form of therapy "The unexamined life is not worth living," Socrates said. Nor is the life you're left with after your boyfriend has left you for another woman - at least, that's how it felt in October last year when mine broke rank and went off with an art student from Cleveland, Ohio. We were over there for the opening of his new art exhibition. He'd flown over four days before me and had met her at a party. Supposedly, they "connected". The five months that followed were a roller-coaster of confusion, vitriol and despair. I knew there'd been problems in our relationship. We saw the world very differently; he delighted in the charm of the ordinary, I wanted maximum divinity. He walked; I galloped. He drank tea; I loathed the stuff. But, along the banks of the Thames, we'd made a promise to always stick together. Our love was something unique: "transcendental", I called it. And besides, we recycled. Surely a commitment to save the world would save our relationship? Alas, no. So there I was, a woman scorned. Hell truly hath no greater fury. And what made it worse was that I still believed in our transcendental love. If I wanted to change the way I was feeling, I needed to alter the way I was thinking. But how? A few bottles of wine and a sharp blow to the head might have done the trick. Fortunately, there's an older, more trusted way of turning your head on its head that counsellors are starting to use: philosophy. The idea of employing Plato as an agony aunt was begun in 1981 by the German philosopher Gerd Achenbach. Although philosophy spends a lot of its time asking real-life questions that affect real-life people - What is happiness? And is it always wrong to lie? - most of the debate goes on in ivory towers. What Achenbach and subsequent philosophers including Tim LeBon, the chairman of the UK's Society for Philosophy in Practice, wanted to do was "give practical application" to this gigantic library of great thoughts. So how does it work? Like most types of therapy, you sign up for a set of sessions. "Two would give you a new perspective on one issue; six would help you to make a major life-decision, like a career change; with 12 you can start to rethink your entire life philosophy," explains LeBon. Each session lasts 50 minutes and costs £50 - and, no, you don't have to have any previous knowledge of philosophy. "If you think of Friends, it would suit Ross and Chandler more than Joey," LeBon says. "It's for anyone who wants to make their emotions more intelligent. Or for those who have tried other kinds of therapy, and want something more cerebral." The first session begins with the patient venting off about whatever's troubling them. The rant over, the counsellor then picks out some key concepts that are crucial to the problem - in the case of heartbreak, it is love and happiness that come hurtling to the fore - and then gets the patient to define what they mean. So, what is love? What is happiness? To kick-start the patient's thinking, LeBon describes what a great philosopher had to say about it. In my case, he tells me what Plato wrote about love in his Symposium: that to stop man fighting the gods, Zeus decided to cut each human in two, so they would lose their strength. "This, then, is the source of our desire to love each other," Plato said. "Each of us is a 'matching half' of a human whole, because each was sliced like a flatfish, two out of one, and each of us is always seeking the half that matches him." This method of probing what we might think are "obvious" ideas, such as love and happiness, was devised by Socrates in the squares of Athens. "The only I thing I know is that I know nothing at all," he boasted. What Socrates showed was that although many of the thinkers of his time thought they knew what justice, happiness and goodness meant, their understanding was tied in to their personal agenda and world view, and, what's more, when pushed, their ideas often contradicted themselves. A bit like me on love. Whereas part of my understanding of love was something that gave life meaning, made it worth living and bound us together, I also believed that true love was "transcendental": that it was out of this world, and it didn't matter if the two people who loved each other couldn't get along in the day-to-day. Love was bigger than the mundane. But when it came to the next stage of the therapy, critical thinking - "to check out whether your assumptions stand up to examination" - I walked head first into a contradiction. If I think love's purpose is to make life worth living, but then say it's irrelevant to daily life, surely my two ideas of love are not compatible? As the cogs in my brain start to creak into motion, I feel myself taking a step back from my predicament: thinking about how I've been thinking. This idea I had of transcendental love might have started off as a romantic dream. But when the relationship stopped working, and I found myself feeling trapped and frustrated, I used it to justify the mechanics of a relationship that just didn't work in the daily grind. I used it to lie to myself. In the final stage, LeBon gets me to start thinking about how to go forward. "You can't change what has happened," he says. "You can't change that he's left you, or how you behaved in the relationship. So, as the Stoics did, let's work on controlling the controllables: the things that you can change." To work out what can be changed, he gets me to try out a thought experiment, a method often used in philosophy to imagine other worlds where people can have different codes of behaviour. Thought experiments shatter your preconceived ideas of how the world should be and let your imagination run wild to how the world could be. "I find Viktor Frankl very useful here, the Austrian psychiatrist and concentration-camp survivor who actually believed that everything in life happens for a purpose," LeBon says. "Suppose this break-up did happen for a reason that will work to your benefit," he suggests. "What might that be? The answer might be that you can now focus on something important that was denied in the relationship. Or - the Hollywood version - so you'll meet someone who is really right for you." Temporarily freed of any sense of responsibility for the relationship that was, and its sorry demise, the list came fast. I could now travel more; he didn't like me travelling on my own, but too often he didn't want to go anywhere, preferring to stay in his studio and make art. I'd love to meet someone with a similar sense of adventure to mine. For the first time in two years, I was being honest with myself about what I really wanted - listening to those voices that we all have inside our heads, and too often try to muzzle. So did philosophy save me? Well, I'm now dating a travel writer I have to run to keep up with. I still haven't got over the fact that my replacement came from Cleveland, Ohio. But I guess I never will. Tim LeBon can be reached by e-mail at [email protected] A FEW WORDS FROM THE WISE Compiled by Ed Caesar · "At the touch of love, everyone becomes a poet" - Plato · "There is always some madness in love. But there is also always some reason in madness" - Friedrich Nietzsche · "That man shall live as his own master and in happiness who can say each day 'I have lived'" - Horace · "The good of man is the active exercise of his soul's faculties in conformity with excellence or virtue... Moreover this activity must occupy a complete lifetime; for one swallow does not make spring, nor does one fine day; and similarly one day or a brief period of happiness does not make a man supremely blessed and happy" - Aristotle · "There is nothing on this earth more to be prized than friendship" - Thomas Aquinas · "Whatever you do... love those who love you" - Voltaire · "Happiness is not an ideal of reason but of imagination" - Immanuel Kant · "Happiness is a state of which you are unconscious. The moment you are aware that you are happy, you cease to be happy" - Jiddu Krishnamurti · "Love is an ideal thing. Marriage is a real thing" - Johann Wolfgang von Goethe I shrink, therefore I am Therapy has many answers, but some questions require the help of a philosopher, says Clint Witchalls Sunday November 21, 2004 The Observer Danny had worked in the City of London for 10 years. As a research analyst, stockbroker and fund manager, he'd made a lot of valuable contacts, earnt a lot of cash, and learnt some important business skills. However, as he approached his mid-thirties, he no longer felt good about himself or what he did for a living, and he found his colleagues cold and unfriendly. A chronic illness made him realise his mortality, and he began to reassess his priorities. Danny had been struggling with his career conundrum for nearly five years when he met David Arnaud, a philosophical counsellor. After a few soul-searching sessions, Danny arrived at a decision. Today, he teaches economics to sixth-formers, and he loves it. 'It's a much better lifestyle,' he says. Many people are turning to philosophical counsellors to get answers to questions such as: 'How do I make sense of myself?' 'What is important to me?' 'Where am I going?' These are perhaps not the sort of questions that require psychiatric intervention, but Arnaud, who recently completed the first empirical study of philosophical counselling in the UK, has found that within just five sessions the majority of clients, with important decisions to make, tend to move from a state of concern and confusion to a resolution. Modern philosophical counselling can be traced back to 1981, when the philosopher Gerd Achenbach opened the first practice near Cologne. Achenbach referred to the new discipline as 'therapy for the sane.' Today, there are hundreds of philosophical counsellors around the world, with the movement particularly strong in the US, Britain and the Netherlands. 'The dilemmas people face aren't always primarily psychological,' says Alex Howard, a philosophical counsellor from Newcastle. 'If people face problems that are social or economic, it doesn't make sense to define their problems in purely psychological terms.' Tim LeBon, a founder member of the Society for Philosophy in Practice (SPP) and author of Wise Therapy, adds: 'We are faced with far more life choices than our grandparents, yet have far fewer resources to deal with them. Our grandparents may have gone to a priest or to other family members for advice; most people don't trust these solutions any more and so want to make their own well-informed, well thought-out choices. Philosophical counselling can help these people - people in mid-life crises who are wondering how to make the most of the rest of their life. People who want to take stock of their values.' Where stressed executives might once have been prescribed a course of tranquillisers or antidepressants, they can now get a dose of Bertrand Russell instead: 'Success is too dearly purchased if all the other ingredients have been sacrificed to obtain it.' While some philosophical counsellors do recommend books for their clients to read, most sessions are about helping the client identify faulty thoughts. For example, a briefing in Aristotelian logic might show a client why their beliefs are erroneous. The person might infer that they're a screw-up because they've screwed up. The counsellor could point out that they're making an error called 'fallacy of composition' - that is, what's true of the part isn't necessarily true of the whole. In philosophical counselling, problems aren't pathologised as they are by the psychiatric profession, and the dialogue between client and counsellor is more like a meeting of equals, compared to many therapies where the client is treated like a patient and seen as someone who is, in some way, inadequate. 'Anybody can benefit from philosophical counselling,' says Howard. 'But it does require someone who is willing to take stock.' Lou Marinoff, author of international bestseller Plato Not Prozac! has done much to promote philosophical counselling. 'Some people who have stabilised their neurochemistry and validated their emotions now wish to examine or re-examine the criteria of their beliefs, the principles of their conduct, or the meaning of their lives,' he says. 'With whom shall they do this? Psychologists and psychiatrists can shed light on such issues - as can rabbis, priests, imams and gurus. Philosophers are now rejoining the ranks of helpers.' LeBon believes certain therapies (such as cognitive behavioural therapy) don't go far enough in helping their clients. 'For instance, if you are anxious about your relationship, a cognitive therapist would try to dispute your catastrophising and jump to conclusions to make you feel less anxious,' says LeBon. 'A philosophical counsellor would do this, but would also look for existential meaning in your anxiety - perhaps you really don't want to be in the relationship and that is what your anxiety is telling you.' LeBon also gives short shrift to psychoanalysts. 'There's very little evidence for the Freudian unconscious, and it's time to move on to more intellectually satisfying and helpful therapies,' he says. However, Alain de Botton, the man who popularised philosophy as self-help, isn't ready to bury psychologists and their ilk just yet. 'The truth is that psychoanalysis grew out of philosophy - it's not some completely new idea, and in fact, done properly, psychoanalysis is philosophical anyway. It may even be dangerous to the mental health of some people to suggest a philosopher rather than a properly trained analyst. The knowledge of analysts when it comes to many emotional problems is now much greater than that of most philosophers.' Guardian Unlimited © Guardian Newspapers Limited 2004. (shrink)

BackgroundWhile most studies on HIV/AIDS often identify stigmatization and patients’ unwillingness to access health care as critical problems in the control of the pandemic, very few studies have focused on the possible consequences of accessing health care by sero-positives. This paper examines the socio-psychological trauma patients experience in their desire to access health care in two health facilities in the Ashanti Region of Ghana.MethodsThrough participant observation, informal conversation and in-depth interviews, data were collected from health workers and clients of the (...) voluntary counselling and antiretroviral therapy units in the two hospitals.The data gathered were analysed and categorized into themes and supported with illustrative quotes obtained from health workers and clients.ResultsThe study found that the mere presence of a person at the HIV counselling centre or clinic is enough for the person to be labelled as or suspected to be HIV patient. It demonstrates that stigmatization may occur not only in the community but also overtly or covertly, in the health facility itself. Consequently, for many HIV/AIDS patients, access to antiretroviral therapy and treatment of related nosocomial infections are problematic. Besides, the study found that many clients and potential users of services were uncomfortable with the quality of care given by some health workers, especially as they overtly and covertly breached confidentiality about their clients’ health status. This has compelled many patients and potential users of the services to adopt a modus vivendi that provides them access to some care services while protecting their identity.ConclusionThe paper argues that by examining issues relating to privacy and confidentiality in the provision of care for and use of services by seropositives, more light will be shed on the whys of the limited uptake of HIV-related health care services in Ghana. (shrink)

The World Health Organisation recently listed air pollution as the most significant threat to human health. Air pollution comprises particulate matter (PM), metals, black carbon and gases such as ozone (O3), nitrogen dioxide (NO2) and carbon monoxide (CO). In addition to respiratory and cardiovascular disease, PM exposure is linked with increased risk of neurodegeneration as well as neurodevelopmental impairments. Critically, studies suggest that PM crosses the placenta, making direct in utero exposure a reality. Rodent models reveal that neuroinflammation, neurotransmitter imbalance (...) and oxidative stress are triggered following gestational/early life exposure to PM, and may be exacerbated by concomitant mitochondrial dysfunction. Gestational PM exposure (potentiated by mitochondrial impairment in the metabolically active neonatal brain) not only impacts neurodevelopment but may sensitise the brain to subsequent cognitive impairment. Having reviewed this field, we conclude that strategies are urgently required to reduce exposure to PM during this sensitive developmental period. (shrink)

Multicultural Counseling: Responding With Cultural Humility, Empathy, and Advocacy is divided up into three sections. The first section is comprised of four chapters and explores the counselors' worldview. The second section is made up of 19 chapters that encapsulate the clients' worldview. The third section includes four chapters that demonstrate the application of multicultural counseling by broaching race and culture; providing culturally responsive assessment, diagnosing, and treatment planning; finding a supervisor who prepares advocates; and designing a culturally sensitive (...) workplace. Each chapter opens with questions designed to have counselors consider their beliefs, attitudes, and judgments and how they might show up in their work with diverse clients. Chapters include clinical case scenarios where students can conceptualize cases using empathy, humility, and advocacy. A distinguishing feature of this book is that it includes cultures that may have been overlooked elsewhere. The authors also sought to include various faiths in this text-such as agnosticism, atheism, and indigenous spiritual practices-with hopes that counselors' first experience with such would be in this book rather than on their couches with clients. Another chapter is dedicated specifically to transgender people. The goal of this book is to give learners the framework to begin to understand who the people are that they will be serving. (shrink)

To what extent does payment method (managed care vs. out of pocket) influence the likelihood that an independent practitioner will assign a Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 1994) diagnosis to a client? When a practitioner does diagnose, how does payment method influence the specific choice of a diagnostic category? Independent practitioners responded to a vignette describing a fictitious client with symptoms of depression or anxiety. In half of the vignettes, the fictitious client (...) intended to pay via managed care; in the other half, the fictitious client intended to pay out of pocket. Payment method had a very significant impact on diagnosis such that relative to out-of-pocket clients, managed care clients were much more likely to receive diagnoses and more likely to receive adjustment disorder diagnoses in particular. We discuss implications involving informed consent and other ethical issues. (shrink)

This paper recounts experience from the author’s philosophical counseling supervision experience. The paper then gives an overview of the narrative turn in bioethics, showing how the bioethical narrative turn disputes the assumption that client case notes can provide reliable empirical information about what happens in philosophical counseling sessions. The paper concludes that interpretation by philosophical peer reviewers is an in-eliminable aspect of peer review. Accountability for our counseling practices and improvement in them requires that we avoid (...) a solipsistic stance and submit in some way to the interpretive interventions of other philosophical counselors. (shrink)

This edited volume comprehensively examines the critical ethical challenges that arise in the practice of counselling and psychotherapy. It translates philosophical positions and professional ethical guidelines in a way that can be applied to practice. The various chapters focus on specific ethical issues that emerge in working with a range of different client groups; for example, children, couples and families. While some ethical imperatives are common across the board, others could be more closely associated with certain client groups. (...) Practitioners might experience uncertainty in working with vulnerable client groups; for example, lesbian/gay/transgender/intersex (LGBT) clients, or persons who report intimate partner violence. Several chapters raise questions, provide information and additional resources to enhance ethically informed practice. Chapter contributions also highlight the ethical dilemmas that might be unique to certain contexts; for example, private practice, schools and consultation-liaison settings. This volume also addresses contemporary and relatively less understood playing fields like 'digital ethics' related to therapist-client interface in the internet space and the navigation of ethical dilemmas in the newly emerging field of employee assistance programmes which address mental health needs in the corporate sector. Written by experienced practitioners of psychotherapy, and culturally contextualized, this is a valuable resource for academics and practitioners interested in psychotherapy and counselling. (shrink)

Pre‐abortion counselling may play a key role in abortion seekers’ understanding of their decision to terminate a pregnancy and the subsequent emotions that they feel. In this paper, we report on a study conducted in the Eastern Cape province of South Africa concerning womxn's experiences of the pre‐abortion counselling offered as part of the implementation of the Choice of Termination Act that governs the provision of legal abortion in the country. Using a narrative‐discursive lens, the analysis revealed four micro‐narratives in (...) which participants appreciated non‐directive and empathic counselling, as well as being provided with information. They also indicated that the counselling was upsetting and hurtful, particularly when providers drew on the awfulisation of abortion discourse to suggest that abortion leads to terrible consequences, and foetal personhood discourse to intimate that terminating the pregnancy is wrong and other alternatives (adoption, parenting) are better. The connection between these broadly positive and negative responses may lie in the dominance of anti‐abortion discourses coupled with the powerful positioning of healthcare providers as experts. The attendant disempowerment of clients within the health clinic setting may constrain pregnant people's ability to question such ‘expert’ information. The implications for feminist client‐centred pre‐abortion counselling are discussed. (shrink)

Much of the research on the delivery of advice by professionals such as physicians, health workers and counsellors, both on the telephone and in face-to-face interaction more generally, has focused on the theme of client resistance and the consequent need for professionals to adopt particular formats to assist in the uptake of the advice. In this article we consider one setting, Kid’s Helpline, the national Australian counselling service for children and young people, where there is an institutional mandate not (...) to give explicit advice in accordance with the values of self-direction and empowerment. The article examines one practice, the use of script proposals by counsellors, which appears to offer a way of providing support which is consistent with these values. Script proposals entail the counsellors packaging their advice as something that the caller might say — at some future time — to a third party such as a friend, teacher, parent or partner, and involve the counsellor adopting the speaking position of the caller in what appears as a rehearsal of a forthcoming strip of interaction. Although the core feature of a script proposal is the counsellor’s use of direct reported speech, they appear to be delivered not so much as exact words to be followed, but as the type of conversation that the client needs to have with the third party. Script proposals, in short, provide models of what to say as well as alluding to how these could be emulated by the client. In their design, script proposals invariably incorporate one or more of the most common rhetorical formats for maximizing the persuasive force of an utterance such as a three-part list or a contrastive pair. Script proposals, moreover, stand in a complex relation to the prior talk and one of their functions appears to be to summarize, respecify or expand upon the client’s own ideas or suggestions for problem solving that have emerged in these preceding sequences. (shrink)

Why do counsellors and psychotherapists practice? What is the purpose? What real benefit does the client gain and what benefit accrues to society as a whole? Do liberal and postmodern values leave counselling and psycho-therapy vulnerable to being devalued by consumerism, individualism and relativism? This unique text subjects counselling and psychotherapy to a proper and thorough moral and ethical analysis. Using radical new theories, the author opens up the field of counselling to rational debate, giving it a thorough analysis (...) that is political, sociological and philosophical in outlook. Drawing on the communicative ethics of Habermas, he provides a new basis for understanding the purpose of counselling and psychotherapy. Using an argument that is both challenging and stimulating, the liberal and postmodern approaches are decisively investigated and rejected. Of interest to specialists and non-specialists alike, this work offers a new vision for counselling, which is both appealing and soundly argued. (shrink)

This book offers numerous questions and answers about ethics in counselling and therapy, training, counselling supervision, research and other important issues. The authors bring psychodynamic, person-centred, integrative or eclectic approaches to their selection of questions and answers. They also bring a variety of experience from independent practice, institutional and voluntary agency settings. Between them they have experience as counsellors, psychotherapists, trainers, counselling supervisors and authors. The questions cover a range of issues that practitioners need to consider including: confidentiality, constraints and (...) the management of confidentiality; boundaries, dual and multiple relationships, relationships with former clients; non-discriminatory practice, issues for individuals and agencies; competence and the proper conduct of counsellors and therapists and the profession's responsibilities to deliver non-exploitative and non-abusive help to clients. Questions of Ethics in Counselling and Therapy also contains three appendices offering useful information. It is written in a clear, accessible style and is aimed at a wide readership in counselling and therapy, ranging from trainees to more experienced practitioners. (shrink)

Various approaches and methods are used in philosophical counselling. Two main trends can be observed: the first is the use of contemplative methods and the second constitutes approaches based on dialogical critical thinking. The author defends the idea that developing philosophical counselling on the basis of critical thinking presupposes that it is possible for counsellor and client to hold a philosophical dialogue where the relationship is one of expert/lay person. J. Šulavík has described this relationship in greater detail. In (...) the Socratic model, the philosopher and the lay person hold a dialogue whereby they ascertain opinions via inductive comparison and by defining things, creating a shared concept. While the Platonic and Enlightenment models were grounded in the authority of the expert philosopher, in the Socratic and postmodern models, the expert philosopher loses the power to manipulate those who know “less”. Lay people are not passive consumers of a particular “optimal” philosophy but through their own “philosophising” create philosophy and tailor it for themselves. While philosophising, therefore, the philosopher does not take on the role of “producer” of philosophy but of “adviser” (consultant). It is therefore supposed that people have a general need for philosophy and that ultimately they should create and reflect upon their own philosophy. (shrink)

Are dual relationships always detrimental? Speaking the Unspeakable provides an in-depth exploration of client-practitioner dual relationships, offering critical discussion and sustained narrative on thinking about and being in dual relationships. Lynne Gabriel draws on the experiences of both practitioners and clients to provide a clear summary of the complex and multidimensional nature of dual relationships. The beneficial as well as detrimental potential of such relationships is discussed and illustrated with personal accounts. Subjects covered include: · Roles and boundaries in (...) dual and multiple role relationships · Client experiences and perceptions of being in dual and multiple role relationships · Developing a relational ethic for complex relationships This book offers an insightful and challenging portrayal of dual relationships that will be welcomed by therapists, trainers, trainees and supervisors. (shrink)

During an Australian qualitative and empirical study looking at lesbian, gay, bisexual, and transgender client's experiences of counseling, and counselor's experiences of working with minority clients, a large body of unsolicited data emerged related to experiences of religious-based homophobia. Analysis of the data suggests that a lifelong process of posttraumatic recovery for many lesbian, gay, bisexual, and transgender people follows prior experiences of religious-based homophobia. This paper discusses the sociological debate related to how counselors find themselves at the (...) crossroad between a healthy lifestyle model of homosexuality based in well established contemporary professional ethics versus long standing religious-based attitudes and constraints toward homosexuality. This intersection of conflicting beliefs generates a controversial social and political environment in which counselors must make a basic decision to either support minority clients according to ethical guidelines or to side with socially conservative constructs that, rightly or wrongly, rely largely on Western religious traditions. (shrink)

This book provides an elaboration and evaluation of the dominant conceptions of genetic counseling as they are accounted for in three different models: the teaching model; the psychotherapeutic model; and the responsibility model. The elaboration of these models involves an identification of the larger traditions, visions and theories of communication that underwrite them; the evaluation entails an assessment of each model’s theses and ultimately a comparison of their adequacy in response to two important concerns in genetic counseling: the (...) contested values of non-directiveness and the recognition of differences across perspectives, with special focus on how religious and spiritual beliefs of patients are coordinated with the networks of meaning in genetics. Several insights are made explicit in this project through the work of Robert Brandom. Brandom’s deontic scorekeeping model demonstrates how dialogue is at the root of grasping a conceptual content. Against this backdrop, professional communications such as genetic counseling can be seen as late developments in linguistic practices that have structural challenges. Brandom’s model reminds us that the professional needs the client’s understanding to grasp conceptual content in a particular context. (shrink)

This study is an analysis of 186 psychologists' attitudes on what constitutes ethical practice when counseling clients who present with a range of concerns related to their experience of same-sex attraction and behavior. Three different groups of psychologists were surveyed: generalists, specialists in gay and lesbian issues, and religiously affiliated psychologists. Participants also rated the effectiveness of several professional experiences in providing education, direction, sanctions, or support to regulate the practice of counseling nonheterosexual clients. Significant group differences were (...) found regarding what is considered best, acceptable, and unacceptable practice with clients presenting with same-sex attraction issues. Significant differences were also found among the three groups in what respondents rated as effective elements of their clinical experience. Keywords: gay, lesbian, religion, survey. (shrink)

The purpose of this paper is to examine what heals and harms the client in the psychotherapeutic encounter, from the client's perspective. The experience of eight clients was explicated using a model based on Giorgi and Schweitzer. The counselling experienced as healing by clients has at its core a vibrantly warm and honest relationship where the client feels held in the safety of the good heart space of the counsellor. The counsellor is experienced as providing an intense (...) beingness for the client that embraces the client's suffering and provides solid ground created out of the crucible of the counsellor's own encounter with his or her shadow. The counsellor is emptied out of his/her own agenda and provides space for the client's experience. The counsellor can evoke the higher resources of the client. The counselling is experienced as renewing and reconnecting the clients to his/her sense of self, of other and the lifeworld. The counselling relationship experienced as harming is described as being drained of human presence and transforming power. There is no alive human connection. The counsellor is experienced as insubstantial, and has no ability to hold traumatic experience. The counsellor's cold reception to the client's vulnerabilities has the power to shatter, fragment and splinter the client. The counsellor is full of self. This fullness may be ego that manifests as dry intellectualising or playing manipulative games as a substitute for human presence. This may lead the client to terror, sickness and anxiety. The counsellor may be full of their own fears and are experienced by the client as chaotic, avoidant and overwhelmed. Their unavailability leads clients to experience emotional depletion, exhaustion and frustration. The counsellor's self-righteousness, judgement and critical disengagement are experienced by clients as being belittled, condemned and diminished. The therapeutic encounter results in a weakening of the human potential for recovery. Both client and counsellor emerge as lesser human beings, with weakened relationships to self, others and the world. Indo-Pacific Journal of Phenomenology , Volume 1, Edition 2 September 2001. (shrink)

Wittgenstein conceived of philosophy as an activity rather than a subject. Thus, his work is highly relevant to the contemporary philosophical counseling movement. This paper explores the ways in which his views on how to do philosophy shed light on how we can approach philosophical counseling. First, Witgenstein's anti-theoretical approach to conceptual analysis highlights the dangers of interpreting clients? symptoms in light of theory. Second, his notion that "pictures hold us captive" underscores the need to help clients recognize (...) unfounded assumptions underlying their apparent dilemmas. Finally, Wittgenstein's Socratic conception of philosophy as a means to lead an authentic life shows the value of philosophizing beyond the confines of the academy. (shrink)

Can philosophy help ordinary people confront their personal or interpersonal problems of living? Can it help a couple whose marriage is on the rocks, or someone going through a midlife crisis, or someone depressed over the death of a significant other, or who suffers from anxiety about making a life change? These and many other behavioral and emotional problems are ordinarily referred to psychologists, psychiatrists, clinical social workers, or other mental health specialists. Less mainstream is the possibility of consulting a (...) philosophical counselor or practitioner. Yet, there is presently a steadily increasing, world-wide movement among individuals with postgraduate credentials in philosophy to harness their philosophical training and skills in helping others to address their life problems. But is this channeling of philosophy outside the classroom into the arena of life a good idea? Are philosophers, as such, competent to handle all or any of the myriad emotional and behavioral problems that arise in the context of life; or should these matters best be left to those trained in psychological counseling or psychotherapy? Through a diverse and contrasting set of readings authored by prominent philosophers, philosophical counselors, and psychologists, this volume carefully explores the nature of philosophical counseling or practice and its relationship to psychological counseling and psychotherapy. Digging deeply into this relational question, this volume aims to spark more rational reflection, and greater sensitivity and openness to the potential contributions of philosophical practice. It is, accordingly, intended for students, teachers, scholars, and practitioners of philosophy, counseling, or psychotherapy; as well as those interested in knowing more about philosophical counseling or practice. (shrink)

Genetic counseling is viewed as a therapeutic interrelationship between genetic counselors and their clients. In a previous relational ethics research project, various themes were identified as key components of relational ethics practice grounded in everyday health situations. In this article the relational ethics approach is further explored in the context of genetic counseling to enhance our understanding of how the counselor-client relationship is contextually developed and maintained. Qualitative interviews were conducted with six adult clients undergoing genetic (...) class='Hi'>counseling for predictive testing. Engagement, dialogue and presence were revealed as relevant to genetic counselor-client relationships. A relational ethics approach in genetic counseling challenges the concept of nondirectiveness and may enhance the outcome of counseling for both counselor and client. (shrink)

Although therapists often work with clients with whom they share a great many beliefs, there remain many cases where the therapist and client have very little in common. Spirituality is, especially in the latter kind of case, one specific area in which clashes and similarities may be important. However, recent evidence suggests spirituality is to a surprising extent ignored in therapy when exploring it would be therapeutically relevant and, even more, that counsellors often struggle when training to more effectively (...) engage with client spirituality. These results are problematic, especially when taken together. In this paper, I attempt to address this vexing issue in a way that brings together work on counselling and spirituality with recent discussions of intellectual virtue in contemporary epistemology. In particular, I show why it is important for the therapist to cultivate and maintain the virtue of intellectual humility with respect to spirituality in a counselling context. To this end, I explore, with reference to a particularly promising model of intellectual humility, how the therapist can be attentive to—and own—their limitations in a productive way when dealing with a wide range of spiritual backgrounds. (shrink)

BackgroundMany genetic counseling studies have focused on anxiety status because clients of GC often feel anxious during their visits. Metacognition is known to be one of the causes of having an inappropriate thinking style. In this study, we examined the relationship between anxiety and the metacognitive status of GC clients according to their characteristics.MethodsThe participants were 106 clients who attended their first GC session in our hospital from November 2018 to March 2021. The survey items were the clients’ characteristics, (...) anxiety status at the time of the visit, and metacognitive status.ResultsHigh state anxiety and high trait anxiety were observed in 34.9 and 11.3% of clients, respectively. Clients who were a relative or had a family history were significantly more likely to have high state anxiety. As for metacognitive status, only negative beliefs about thoughts concerning uncontrollability and danger were associated with having an anxiety status. Furthermore, multivariate analysis showed that negative beliefs about thoughts concerning uncontrollability and danger were an independent determinant of higher state anxiety, but not being a relative or having a family history. Metacognitive status scores were significantly lower in clients than in the control group.ConclusionState anxiety was shown to be more dependent on negative beliefs about thoughts concerning uncontrollability and danger of GC clients than their characteristics such as being a relative or having a family history. The results of this study will contribute to the development of new GC psychosocial support measures to address the anxiety of GC clients. (shrink)

Navigating limits to confidentiality with adolescent clients can be ethically and professionally challenging. This study follows on from a previous quantitative survey of psychologists about confidentiality dilemmas with adolescents. The current study used qualitative methods to explore such dilemmas in greater depth. Twenty Australian psychologists were interviewed and asked to describe an ethically challenging past case. Cases were then used to facilitate discussion about the decision-making process and outcomes. Interviews were transcribed and analyzed using interpretive content and thematic analysis. Three (...) key findings are discussed. First, it is of little use to perceive confidentiality dilemmas as binary choices because psychologists described 5 distinct options. These can be conceptualized on a spectrum of varying degrees of client autonomy, ranging from “no disclosure” to “disclosure without the client’s knowledge or consent”. Second, confidentiality dilemmas often involve balancing multiple and conflicting risks regarding both immediate and future harm. Third, a range of strategies are employed by psychologists to minimize potential harms when disclosing information. These are primarily aimed at maintaining the therapeutic relationship and empowering clients. These findings and the case studies described provide a valuable resource for teaching and professional development. (shrink)