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 vii
Preface    

In Chapter 2, “Professional Counseling Organizations, Licensure, Certification, and

Accreditation,” by Joshua C. Watson, Bradley T. Erford, and Grafton T. Eliason, students are
introduced to the American Counseling Association (ACA) and its divisions, branches, and
professional partners so that students can become familiar with the wide array of professional
associations advocating for counselors and clients. This chapter offers a glimpse of the many
credentials that professional counselors can earn. An overview of state licensure, national
certification, and counselor education program accreditation processes (e.g., CACREP and
CORE) is provided to answer student questions early and to make students aware of the
choices that exist for future professional credentialing. Various accountability mechanisms
found at the state level for educational systems and mental health agencies are also reviewed.
Section One ends with Chapter 3, “Ethical and Legal Issues in Counseling,” by Lynn
E. Linde and Bradley T. Erford. The chapter is a comprehensive introduction to ethical and
legal issues in counseling practice, covering new editions of the ACA and ASCA ethical
codes, confidentiality, privilege, subpoenas, malpractice, records and personal notes, child
abuse, suicide, HIPAA, FERPA, minor consent, and ethical decision making. A profes-
sional counselor must always remember that how one conducts oneself personally and
professionally reflects not only on oneself, but also on one’s colleagues.
Section Two, “Counseling Processes and Approaches,” provides an in-depth review of
counseling theories, process, and skills. Chapter 4, “Theories of Counseling,” by Bradley T.
Erford and Ann Vernon, portrays the nature and quality of the counseling relationship as more
significant than any other factor in counseling. Regardless of the setting, and whether they are
working with individuals, families, or groups, counselors have a professional responsibility to
develop a foundation and clear rationale for their theoretical orientation to serve clients best.
Professional counselors operate out of theories that best fit their personal philosophies of
human change and the counseling process. Chapter 4 highlights the significance of theory to
counseling practice and provides a brief overview of the major theoretical paradigms. Students
will also explore their own beginning preferences for theoretical orientation with the intent of
continuing their personal and professional exploration to discover their personal style.
Chapter 5, “The Counseling Process,” by Donna S. Sheperis, orients students to
counseling processes and approaches, providing a brief overview of the stages of the
counseling process and approaches to helping clients. The counseling process embodies
the art and science of helping. Professional counselors bring their training, experience,
and personalities into the process. Once initiated, counseling occurs over a series of stages
that includes information gathering and the application of theory to generate relevant
goals, treatment, assessment, and termination. In Chapter 5, students beginning the path
to becoming professional counselors are encouraged to consider their fit with the process
and profession of counseling.
Chapter 6, “Counseling Microskills,” by Joseph B. Cooper, provides an overview of
the fundamental skills that constitute the key elements of effective helping relationships.
The skills in this chapter focus on Ivey, Ivey, and Zalaquett’s’s (2013) microskills hierarchy.
At the heart of this hierarchy is the basic listening sequence, an interrelated set of skills that
not only fosters the development of rapport with clients, but also aids in the identification
of interventions to help achieve a successful resolution to the clients’ presenting concerns.
Examples of the skills in use, along with practice exercises to foster individual skill devel-
opment, are provided.
Section Three, “Client Issues and Advocacy,” explores the knowledge, skills, and atti-
tudes required of the counselor when working with clients across the life span and with
viii    
Preface

common presenting problems (e.g., substance use, eating disorders, behavioral difficulties,
crisis intervention), as well as multicultural competence, consultation, and supervision.
Chapter 7, “Crisis Prevention and Intervention,” by Judith Harrington and Charlotte Daugh-
hetee, recognizes that crises, suicide and homicide continue to play increasingly important
roles in American society and on the world stage. Suicide and homicide affect us personally
as we, family members, friends, and those in extended social networks struggle with the
ever-increasing challenges of modern life. The effectiveness of the care given by professional
emergency first responders, as well as the effectiveness of ordinary people in responding to
their own crises and the crises of those about whom they care, is improved by background
knowledge involving current trends in and treatments for suicidal and homicidal impulses.
Chapter 8, “Mental Health and Rehabilitation Counseling,” by Catherine Y. Chang,
Amy L. McLeod, and Nadine E. Garner, provides a broad overview of the general mental
health settings and client issues (i.e., drug and alcohol counseling, mental health counseling,
career counseling, and rehabilitation counseling). The field of counseling is becoming increas-
ingly specialized, with certifications and licensures available for addictions counselors
(National Certified Addictions Counselor [NCAC]; Master Addiction Counselor [MAC]),
mental health counselors (Licensed Professional Counselor [LPC]—term may vary depend-
ing on the state), career counselors, and rehabilitation counselors (Certified Rehabilitation
Counselor [CRC]). Although these areas are not distinct, and clients may enter counseling
with a mental health, substance use, career, or rehabilitation issue, or any combination of the
four, it is important for professional counselors to have a basic understanding of each area.
Chapter 9, “School, College, and Career Counseling,” by Nadine E. Garner, Jason
Baker, and Molly E. Jones, describes the unique characteristics of working as a professional
counselor in the increasingly multicultural settings of elementary and secondary schools;
college and university campuses; and career counseling.
Chapter 10 “Human Development Throughout the Life Span,” by Bradley T. Erford
briefly describes developmental characteristics of infancy and toddlerhood (birth to age
3 years); early childhood (ages 4 to 6 years); middle childhood (ages 6 to 11 years); early
adolescence, midadolescence, and later adolescence (ages 11 to 24 years); young adulthood
(ages 24 to 40 years); middle adulthood (ages 40 to 60 years); and later adulthood (ages 60
years and older). The information in these approximate age categories serves as a basis for
examples of interventions that helping professionals can use to facilitate development at
several of these stages.
In Chapter 11, “Multicultural Counseling,” by Geneva M. Gray, multicultural coun-
seling applications are reviewed to help students integrate principles of cultural diversity
into the counseling process from the beginning of their training. This chapter features
multicultural applications of identity development and counselor competency (multicul-
tural implications are highlighted throughout the other chapters of the text too). Cultural
identity developmental processes and culturally specific information and intervention
strategies are presented across the cultural dimensions of socioeconomic status, race,
­ethnicity, gender, sexual orientation, spirituality, ability level, and age.
Chapter 12, “Assessment, Case Conceptualization, Diagnosis, and Treatment
­Planning,” by Bradley T. Erford, reviews each of these major counseling tenets. Assessment
is the systematic gathering of information to address a client’s presenting concerns effec-
tively. A case conceptualization reflects how the professional counselor understands the
nature of the presenting problems and includes a diagnostic formulation. Treatment plans
outline counseling outcome expectations and interventions to meet these expectations.
 ix
Preface    

In Chapter 13, “Supervision and Consultation,” by Mark A. Young and Alan Basham,
an introduction to supervision and consultation is provided to help students understand
the theory and practical applications of these two essential counselor roles. In particular, the
chapter helps counselors in training understand how to get the most out of their relation-
ships with supervisors and understand what will be expected of them as future supervisors
to the next generation of counselors in training. Models, techniques, types of activities, and
important skills used to fulfill the role of consultant or supervisor are presented.
An innovative facet of this text is the integration of advocacy counseling and the
introduction of professional advocacy strategies. Chapter 14, “Advocating for the Coun-
seling Profession,” by Amy Milsom, answers important questions about advocacy coun-
seling, including: “What does it mean to advocate for the counseling profession?” “Why is
professional advocacy important?” “In what ways can professional counselors advocate
for the profession?” Counselors can best serve their clients by advocating for a strong pro-
fessional presence in the public and legislative venues. A positive view of the counseling
profession by citizens and legislators helps remove barriers for clients and promotes the
worth and dignity of diverse individuals.
In addition, obtaining social justice for clients demands that professional counselors
understand and practice advocacy counseling according to the standards developed by
the ACA. Chapter 15, “Advocacy Counseling: Being an Effective Agent of Change for
­Clients,” by Donna M. Gibson, proposes that the core purpose of advocacy counseling is to
address external barriers that interfere with human development. Although this purpose
can be met by advocating for the profession of counseling, it is often met by advocating at
the individual client level. Through an examination of the advocacy competency domains
(Ratts et al., 2015), specific guidelines are provided on how to increase clients’ empower-
ment and how to be a successful advocacy counselor.
Section Four, “The Effectiveness of Counseling,” addresses the crucial issues of
accountability and outcome in counseling. The future of the counseling profession lies in
the ability of counselors to show that counseling practices are effective in helping clients
reach their stated goals. Counselors in training need to learn to conduct needs assessments,
outcome studies, and program evaluation to determine what services are needed, and the
effects of those services. Chapter 16, “Accountability in Counseling,” by Bradley T. Erford,
proposes that accountability is a central responsibility of all professional counselors. At its
core, accountability shows the effect that a professional counselor has in producing changes
in clients and program stakeholders. The process of outcome studies is approached from
traditional research methods perspectives and contemporary perspectives, including
action research and single-subject research designs.
Counselors also need to realize that a great wealth of extant literature exists to inform
their daily counseling practice with clients. This literature is reviewed in Chapter 17,
“­Outcome Research in Counseling,” by Bradley T. Erford, to bolster the students’ knowl-
edge of what does and does not work in counseling, and so counselors can use effective
counseling interventions. Professional counselors have an ethical responsibility to use
counseling methods grounded in theory and empirically validated through research. It is
now known that counseling is effective in many forms and for many client conditions.
Chapter 17 reviews research on the effectiveness of counseling in several areas: client–
counselor characteristics, individual approaches, group approaches, career intervention,
and school-based student interventions. This body of information should be used by pro-
fessional counselors to inform their practice and increase treatment efficacy.
x    
Preface

Orientation to the Counseling Profession: Advocacy, Ethics, and Essential Professional

Foundations provides a wealth of information on the most foundational and emerging
issues of the counseling profession. It was specifically designed to orient counselors in
training, regardless of specialty area, to the profession of counseling that we have all dedi-
cated our careers and lives to improving. Enjoy!

Supplemental Instructional Features

Supplemental to this text are pedagogical tools helpful to counselor educators choosing to
use this text as a course text. The companion Instructor’s Resource Manual with Test Bank
contains at least 50 multiple choice questions and 20 essay questions per chapter. Numer-
ous case studies and activities included in the text can stimulate lively classroom discus-
sions. PowerPoint® lecture outlines are also available. Instructor supplements can be
downloaded from the Instructor Resource Center at www.pearsonhighered.com.

Also available with MyCounselingLab®

This title is also available with MyCounselingLab—an online homework, tutorial, and
assessment program designed to work with the text to engage students and improve
results. Within its structured environment, students see key concepts demonstrated
through video clips, practice what they learn, test their understanding, and receive feed-
back to guide their learning and ensure they master key learning outcomes.
• Learning Outcomes and Standards measure student results.
MyCounselingLab organizes all assignments around essential learning outcomes and
national standards for counselors.
• Video- and Case-Based Exercises develop decision-making skills.
Video- and Case-based Exercises introduce students to a broader range of clients, and
therefore a broader range of presenting problems, than they will encounter in their own
pre-professional clinical experiences. Students watch videos of actual client-therapist
sessions or high-quality role-play scenarios featuring expert counselors. They are then
guided in their analysis of the videos through a series of short-answer questions. These
exercises help students develop the techniques and decision-making skills they need to
be effective counselors before they are in a critical situation with a real client.
• Licensure Quizzes help students prepare for certification.
Automatically graded, multiple-choice Licensure Quizzes help students prepare for
their certification examinations, master foundational course content, and improve their
performance in the course.
• Video Library offers a wealth of observation opportunities.
The Video Library provides more than 400 video clips of actual client-therapist sessions
and high-quality role plays in a database organized by topic and searchable by key-
word. The Video Library includes every video clip from the MyCounselingLab courses
plus additional videos from Pearson’s extensive library of footage. Instructors can create
additional assignments around the videos or use them for in-class activities. Students
can expand their observation experiences to include other course areas and increase the
amount of time they spend watching expert counselors in action.
 Acknowledgments

All of the contributing authors are to be commended for lending their expertise in the various
topical areas. As always, Kevin Davis of Pearson has been wonderfully responsive and sup-
portive. At Aptara, thanks go to the production team (Sudip Sinha, Production Project
Manager; Ramesh Rawat, Production Lead). Finally, special thanks go to the outside reviewers
whose comments helped to provide substantive improvement to the original manuscript:
Maria D. Avalos, University of Texas of the Permian Basin; Laura Choate, Louisiana State
University; Pit Kolodinsky, Northern Arizona University; Kara P. Ieva, Rowan University; and
Waganesh Zeleke, Duquesne University.

xi
 Brief Contents

Section One Foundations of Professional Counselor Identity 1

Chapter 1 Becoming a Professional Counselor: Philosophical,
Historical, and Future Considerations ■ Bradley T. Erford
and Gerta Bardhoshi 3
Chapter 2 Professional Counseling Organizations, Licensure,
Certification, and Accreditation ■ Joshua C. Watson,
Bradley T. Erford, and Grafton T. Eliason 35
Chapter 3 Ethical and Legal Issues in Counseling ■ Lynn E. Linde
and Bradley T. Erford 70

Section Two Counseling Processes and Approaches 113

Chapter 4 Theories of Counseling ■ Bradley T. Erford and Ann
Vernon 115
Chapter 5 The Counseling Process ■ Donna S. Sheperis 160
Chapter 6 Counseling Microskills ■ Joseph B. Cooper 192

Section Three Client Issues and Advocacy 217

Chapter 7 Crisis Prevention and Intervention ■ Judith Harrington
and Charlotte Daughhetee 219
Chapter 8 Mental Health and Rehabilitation Counseling ■ Catherine
Y. Chang, Amy L. McLeod, and Nadine E. Garner 249
Chapter 9 School, College, and Career Counseling ■ Nadine E.
Garner, Jason Baker, and Molly E. Jones 280
Chapter 10 Human Development Throughout the Life Span ■ Bradley
T. Erford 311
Chapter 11 Multicultural Counseling ■ Geneva M. Gray 337
Chapter 12 Assessment, Case Conceptualization, Diagnosis, and
Treatment Planning ■ Bradley T. Erford 373
Chapter 13 Supervision and Consultation ■ Mark A. Young and Alan
Basham 406
Chapter 14 Advocating for the Counseling Profession ■ Amy
Milsom 435
Chapter 15 Advocacy Counseling: Being an Effective Agent of Change
for Clients ■ Donna M. Gibson 458

Section Four The Effectiveness of Counseling 487

Chapter 16 Accountability in Counseling ■ Bradley T. Erford 489
Chapter 17 Outcome Research in Counseling ■ Bradley T. Erford 520

xii
 Contents

About the Editor xxvi

About the Authors xxviii

Section One Foundations of Professional Counselor Identity 1

Chapter 1 Becoming a Professional Counselor: Philosophical, Historical,
and Future Considerations
■ Bradley T. Erford and Gerta Bardhoshi 3
Preview 3
Counseling and Professional Counselors: Where We Are 3
How Do Counselors Differ from Psychologists and Social
Workers? 6
The Philosophical Underpinnings of Counseling 7
How We Got Here: People, Issues, and Societal Forces That Have
Shaped the Counseling Profession 9
1900–1920 9
1921–1940 15
1941–1960 17
1961–1980 18
1981–2000 19
2001–Present 20
Where We Are Going 22
Evidence-Based Practices, Research-Based Practices, and Outcomes
Research 22
Managed Care 23
Multiculturalism, Diversity, and Social Justice Counseling 24
Technology 25
Gatekeeping 26
Professional Advocacy and Social Advocacy Counseling 26
Mentoring and Leadership Training 29
Bonding and Splintering of Facets of the Counseling Profession 29
Developing a Commitment to Career-long Wellness 30
Summary 34
Chapter 2 Professional Counseling Organizations, Licensure, Certification,
and Accreditation
■ Joshua C. Watson, Bradley T. Erford, and Grafton T. Eliason 35

xiii
xiv    
Contents

Preview 35
Professional Counseling Organizations 35
American Counseling Association 36
American Counseling Association Divisions 39
American College Counseling Association 40
American Mental Health Counselors Association 41
American Rehabilitation Counseling Association 41
American School Counselor Association 41
Association for Adult Development and Aging 41
Association for Assessment and Research in Counseling 42
Association for Child and Adolescent Counseling 42
Association for Counselor Education and Supervision 42
Association for Creativity in Counseling 43
Association for Humanistic Counseling 43
Association for Lesbian, Gay, Bisexual, and Transgender Issues
in Counseling 43

Association for Multicultural Counseling and Development 44

Association for Specialists in Group Work 44
Association for Spiritual, Ethical, and Religious Values
in Counseling 44

Counselors for Social Justice 45

International Association of Addictions and Offender
Counselors 45
International Association of Marriage and Family Counselors 45
Military and Government Counseling Association 45
National Career Development Association 46
National Employment Counseling Association 46
American Counseling Association Regions and Branches 48
Other Essential Professional Counseling Organizations 50
American Counseling Association Foundation 50
Chi Sigma Iota 50
Council for Accreditation of Counseling and Related Educational
Programs 51
Council on Rehabilitation Education 51
National Board for Certified Counselors 51
Professional Development 51
Benefits of Joining Professional Counseling Organizations 52
Additional Benefits for Professional Counselor Members 52
The American Counseling Association Member Services Committee 53
 xv
Contents    

Additional Benefits for Student Members 53

Ethical Standards 54
Legislative Advocacy 54
Supporting the Mission of the Profession 54
Relationship Between the American Counseling Association and the
American Psychological Association 56
Some Key Challenges That Need to be Addressed by Counseling
Professionals 56
National Accreditation 58
International Efforts at Program Registry 60
State Accreditation 60
State Professional Certification and Other Credentials 60
State Licensure 61
Education 62
Supervised Experience 62
Examination 63
American Association of State Counseling Boards 63
License Portability 64
Certification/Licensure for Professional School Counselors 64
Benefits and Drawbacks of Counseling Licensure 65
National Certification 65
Commission on Rehabilitation Counselor Certification 66
Summary 68
Chapter 3 Ethical and Legal Issues in Counseling
■ Lynn E. Linde and Bradley T. Erford 70
Preview 70
Ethical Standards and Laws 70
American Counseling Association Code of Ethics 72
The Practice of Internet or Technology-Assisted Distance
Counseling 83
American School Counselor Association Ethical Standards
for School Counselors 83
Decision Making Using Ethical Standards 85
Additional Sources of Information and Guidance: Courts, Laws,
and Regulations 91
Court System 91
Statutory Law 92
State and Local Agencies: Regulations and Policies 92
Making Decisions 93
Additional Legal Considerations 95
xvi    
Contents

Professional Competence 95
“Can I Be Sued?” and “What Is Malpractice?” 96
Subpoenas 98
Confidentiality 100
Limits to Confidentiality 101
Confidentiality and Privileged Communication 102
Minor-Consent Laws 103
Records and Personal Notes 104
Educational Records 104
Personal Notes 108
The Health Insurance Portability and Accountability Act (HIPAA)
of 1996 109
Child Abuse 109
Suicide 110
Summary 112

Section Two Counseling Processes and Approaches 113

Chapter 4 Theories of Counseling
■ Bradley T. Erford and Ann Vernon 115
Preview 115
The Significance of Theory 115
Ethics of Applying Counseling Theory 116
What Makes a Good Theory? 117
Theoretical Paradigms 117
Psychodynamic Paradigm 121
Humanistic/Existential Paradigm 125
Behavioral/Cognitive-Behavioral Paradigm 127
Family Systems Paradigm 136
Emergent Theories 142
Applying Theory to Practice 151
View of Human Nature 152
Goals of Counseling 153
Role of the Professional Counselor 153
Techniques and Approaches 153
Flexibility 154
Theoretical Integration 155
Integrative versus Eclectic Counseling 155
Why an Integrative Approach? 156
Summary 159
 Contents    xvii

Chapter 5 The Counseling Process

■ Donna S. Sheperis 160
Preview 160
The Professional Counselor 160
Counselor Characteristics 161
Common Issues for the Beginning Counselor 162
Client Characteristics 164
Cross-Cultural Counseling Competence 165
Basic Counseling Paradigm 166
The Counseling Process and Stages of Change 166
The Helping Process—The Helping Relationship 168
The Art of Helping 168
Helping as a Science 169
Common Factors in Helping 170
What Brings Clients to Counseling? 171
Initiating Counseling 174
Counseling Environment 174
Helping Relationship 175
Role of Theory 177
Structure of Counseling 178
Informed Consent 178
Information Gathering 179
Exploring and Working Together 180
Goal Setting and Positive Counseling Outcomes 182
What Happens When Change Does Not Happen? 183
Integration and Termination 185
Becoming a Professional Counselor 188
Personal Strengths and Challenges 188
Summary 191
Chapter 6 Counseling Microskills
■ Joseph B. Cooper 192
Preview 192
Essential Counseling Microskills 192
Attending Skills 193
Eye Contact 193
Body Position 194
Vocal Tone 195
Basic Listening Sequence 196
Open and Closed Questions 197
xviii    
Contents

Reflecting Skills 201

How to Reflect Meaning 210
Summary 216

Section Three Client Issues and Advocacy 217

Chapter 7 Crisis Prevention and Intervention
■ Judith Harrington and Charlotte Daughhetee 219
Preview 219
Crisis Theory 219
Concepts 222
Resilience and Post-Traumatic Growth 224
Counselor Safeguards: Professional Burnout, Compassion Fatigue,
Secondary Traumatic Stress, Vicarious Trauma, and Transcrisis 227
Crisis Counseling 232
How Does Crisis Counseling Differ from Traditional
Counseling? 232
Ethical Considerations 232
Risk Assessment: Suicide and Homicide 234
Significance of the Problem 234
Principles of Assessment 236
Suicide Risk Assessment 237
Clinical Interview Modality 237
Homicide Assessment 238
Intimate Partner Violence 243
Child and Elder Abuse 243
Special Topics in Crisis Intervention and Prevention 244
Community Disasters 244
School System Adaptions 245
Safety Concerns 247
Summary 248
Chapter 8 Mental Health and Rehabilitation Counseling
■ Catherine Y. Chang, Amy L. McLeod, and Nadine E. Garner 249
Preview 249
Counseling Career Choices 249
Counseling in Mental Health Settings 250
Background 250
Community/Agency Setting 251
Hospitals 252
Corrections 254
 xix
Contents    

Private Practice 255

Marriage and Family Counselors 257
Pastoral Counseling 257
Wilderness Therapy 258
Mental Health Counseling Issues 259
Depression 259
Anxiety 261
Eating Disorders 262
Addictions 263
Drug and Alcohol Treatment Approaches 264
Alcohol and Drug Use Issues in Special Populations 266
Rehabilitation Counseling 269
Summary of Rehabilitation Laws 270
Disability Eligibility and Demographics 272
Adaptation to Disability 274
Rehabilitation Counseling and Technology 274
Vocational Rehabilitation Counseling 275
Multicultural and Social Justice Issues in Rehabilitation
Counseling 276
Summary 278
Chapter 9 School, College, and Career Counseling
■ Nadine E. Garner, Jason Baker, and Molly E. Jones 280
Preview 280
Counseling in the Schools 280
Background 280
Elementary Counseling 281
Middle School/Junior High Counseling 282
High School Counseling 283
Current Issues Affecting All School Counseling Settings 283
Multicultural and Social Justice Issues in Schools 286
College/University Counseling and Student-Life Services 289
Background 289
College and University Counseling 290
Student-Life Services 293
Counseling College and University Students Who Have
a Disability 296

Multicultural and Social Justice Issues in College Counseling

and Student-Life Services 297
xx    
Contents

Career Counseling Issues 298

Major Theories of Career Development 299
Technology Use and Career Resources 308
Social Justice Issues in Career Counseling 309
Summary 310
Chapter 10 Human Development Throughout the Life Span
■ Bradley T. Erford 311
Preview 311
Counseling and Human Development: A life span perspective 311
Infancy and Toddlerhood 314
Motor Development in Infancy and Toddlerhood 314
Emotional Development in Infancy and Toddlerhood 315
Cognitive/Language Development in Infancy and Toddlerhood 315
Early Childhood 316
Social Development in Early Childhood 316
Emotional Development in Early Childhood 316
Cognitive Development in Early Childhood 317
Developmental Interventions in Early Childhood 318
Middle Childhood 319
Social Development in Middle Childhood 319
Emotional Development in Middle Childhood 319
Cognitive Development in Middle Childhood 320
Developmental Interventions in Middle Childhood 321
Adolescence 321
Early Adolescence 321
Developmental Interventions in Early Adolescence 323
Midadolescence 324
Developmental Interventions in Midadolescence 325
Late Adolescence (Emerging Adulthood) 326
Developmental Interventions in Late Adolescence
(Emerging Adulthood) 327
Early Adulthood 328
The Worker in Early Adulthood 328
The Partner in Early Adulthood 328
The Parent in Early Adulthood 329
Developmental Interventions in Early Adulthood 329
Middle Adulthood 330
Physical Changes in Middle Adulthood 330
Cognitive Changes in Middle Adulthood 330
 xxi
Contents    

Key Developmental Tasks in Middle Adulthood 331

Developmental Interventions in Middle Adulthood 332
Later Adulthood 332
Accepting Life in Later Adulthood 333
Redirecting Energy to New Roles and Activities in Later
Adulthood 333
Physical Changes in Later Adulthood 333
Cognitive Changes in Later Adulthood 334
Dealing with Loss in Later Adulthood 334
Developmental Interventions in Later Adulthood 334
Summary 336
Chapter 11 Multicultural Counseling
■ Geneva M. Gray 337
Preview 337
Multiculturally Competent Counseling 337
Key Issues in Multicultural Counseling 340
Etic versus Emic Debate 340
How Much of Counseling Is Multicultural? 340
Assessment and Treatment 341
Evidence-Based Practices in Multicultural Counseling 342
Cultural Identity Development and Multicultural Counseling 342
Cultural Identity Development Models 344
Racial and Ethnic Identity Development 345
Feminist Identity Development 348
Sexual Identity Development 348
Spiritual Identity Development 349
Counseling Culturally Diverse Individuals 350
Socioeconomic Status and Poverty 350
Racial and Ethnic Diversity 352
Gender 358
Sexual Minorities 361
Spirituality 363
Counseling Individuals with Disabilities 367
Counseling the Elderly 368
Social Justice in Counseling 368
Multicultural Organizational Development: Creating a Culturally
Sensitive Environment 369
Summary 371
xxii    
Contents

Chapter 12 Assessment, Case Conceptualization, Diagnosis, and Treatment

Planning
■ Bradley T. Erford 373
Preview 373
A Comprehensive Approach to Understanding Client Issues
and Designing Plans to Help 373
Assessment 374
Testing and the Counseling Profession 375
Why Should Professional Counselors Know About Testing? 376
Categories of Tests 376
Types of Tests 377
Qualities to Consider When Evaluating Tests 379
Cultural Fairness 381
Technology and Testing 381
Ethical Considerations 381
Testing Resources 382
Intake Interviews 382
What Is a Mental Status Examination? 383
What Are the Elements of a Suicide Assessment and an Exploration
of Intent to Harm Others? 384

Behavioral Observation 386

Environmental Assessment 386
Developmental Considerations 387
Case Conceptualization 390
Diagnosis 394
Social Justice Counseling and Assessment, Diagnosis,
and Treatment 396

Benefits of Diagnosis 397

Drawbacks of Diagnosis 398
Treatment Planning 398
Treatment Plans 399
Comprehensive Models of Assessment and Treatment Planning 402
Summary 404
Chapter 13 Supervision and Consultation
■ Mark A. Young and Alan Basham 406
Preview 406
Use of Supervision and Consultation in Counseling 406
Supervision 409
Models of Supervision 410
 xxiii
Contents    

Supervision Formats 412

Supervision Interventions 414
Supervisory Relationship 418
Consultation 423
Models of Consultation 424
Consultant Roles 426
Consultation Skills 428
Consultation Settings 429
Summary 432

Chapter 14 Advocating for the Counseling Profession

■ Amy Milsom 435
Preview 435
Defining Advocacy 435
Brief History of Counselors Advocating for the Profession 436
Current Counseling Advocacy Agendas 437
Why Advocate? 439
Prerequisites to Effective Advocacy 444
Process of Advocacy 446
Identify the Problem 447
Assess the Availability of Resources 447
Engage in Strategic Planning Activities 448
Train Professional Counselors to Advocate 449
Implement a Plan of Action 450
Celebrate Accomplishments 451
Ways to Advocate 451
Identifying Yourself as a Professional Counselor 451
Serve Your Community 452
Use the Media 454
Technology 454
Target Policy Makers 456
Summary 456

Chapter 15 Advocacy Counseling: Being an Effective Agent of Change

for Clients
■ Donna M. Gibson 458
Preview 458
Advocacy Counseling 458
When to Advocate 459
Advocacy Counseling and Intervention Competencies 461
xxiv    
Contents

Counseling and Advocacy Intervention Competencies:

Community 469
Counseling and Advocacy Interventions Competencies:
Public Policy 477
Counseling and Advocacy Intervention Competencies:
International and Global Affairs 483
Summary 485

Section Four The Effectiveness of Counseling 487

Chapter 16 Accountability in Counseling
■ Bradley T. Erford 489
Preview 489
Accountability 489
Using a Counseling Program Advisory Committee 491
Conducting a Needs Assessment 492
Data-Driven Needs Assessment 492
Perceptions-Based Needs Assessment 497
Evaluating Programs 504
Service Assessment 505
Outcome or Results Evaluation 506
Important Assessment Terms 507
Practical Program Evaluation Considerations 508
Aggregated Outcomes 508
Designing Outcome Studies 510
Single-Subject Research Design 513
Action Research 516
Reporting Results 516
Accountability and Social Justice Counseling 518
Accountability and Technology 518
Summary 518
Chapter 17 Outcome Research in Counseling
■ Bradley T. Erford 520
Preview 520
How Research Assists Counselors: The Importance of and Barriers
to Conducting Outcome Research 520
How Effective is Counseling? 527
Facets of Counseling that Contribute to Outcomes 528
Which Client and Professional Counselor Factors Contribute
to Successful Outcomes? 531
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minutes; or, if at hand, substitute weak veal broth for the water. Lift
them out, place them on a drainer, and leave them until they are
perfectly cold; then cut them into half-inch slices, and either flour and
fry them lightly in butter, or put them, without this, into as much
curried gravy as will just cover them; stew them in it very gently, from
twenty to thirty minutes; add as much lemon-juice or chili vinegar as
will acidulate the sauce agreeably,[97] and serve the currie very hot.
As we have already stated in two or three previous receipts, an
ounce or more of sweet freshly-grated cocoa-nut, stewed tender in
the gravy, and strained from it, before the sweetbreads are added,
will give a peculiarly pleasant flavour to all curries.
97. We find that a small portion of Indian pickled mango, or of its liquor, is an
agreeable addition to a currie as well as to mullagatawny soup.

Blanched 10 minutes; sliced (fried or not); stewed 20 to 30

minutes.
 CURRIED OYSTERS.

“Let a hundred of large sea-oysters be opened into a basin without

losing one drop of their liquor. Put a lump of fresh butter into a good-
sized saucepan, and when it boils, add a large onion, cut into thin
slices, and let it fry in the uncovered stewpan until it is of a rich
brown: now add a bit more butter, and two or three tablespoonsful of
currie-powder. When these ingredients are well mixed over the fire
with a wooden spoon, add gradually either hot water, or broth from
the stock-pot; cover the stewpan, and let the whole boil up.
Meanwhile, have ready the meat of a cocoa-nut, grated or rasped
fine, put this into the stewpan with a few sour tamarinds (if they are
to be obtained, if not, a sour apple, chopped). Let the whole simmer
over the fire until the apple is dissolved, and the cocoa-nut very
tender; then add a cupful of strong thickening made of flour and
water, and sufficient salt, as a currie will not bear being salted at
table. Let this boil up for five minutes. Have ready also, a vegetable
marrow, or part of one, cut into bits, and sufficiently boiled to require
little or no further cooking. Put this in with a tomata or two; either of
these vegetables may be omitted. Now put into the stewpan the
oysters with their liquor, and the milk of the cocoa-nut, if it be
perfectly sweet; stir them well with the former ingredients; let the
currie stew gently for a few minutes, then throw in the strained juice
of half a lemon. Stir the currie from time to time with a wooden
spoon, and as soon as the oysters are done enough serve it up with
a corresponding dish of rice on the opposite side of the table. The
dish is considered at Madras the ne plus ultra of Indian cookery.”[98]
98. Native oysters, prepared as for sauce, may be curried by the receipt for eggs
or sweetbreads, with the addition of their liquor.

We have extracted this receipt, as it stands, from the Magazine of

Domestic Economy, the season in which we have met with it not
permitting us to have it tested. Such of our readers as may have
partaken of the true Oriental preparation, will be able to judge of its
correctness; and others may consider it worthy of a trial. We should
suppose it necessary to beard the oysters.
 CURRIED GRAVY.

The quantity of onion, eschalot, or garlic used for a currie should

be regulated by the taste of the persons for whom it is prepared; the
very large proportions of them which are acceptable to some eaters,
preventing others altogether from partaking of the dish. Slice, and fry
gently in a little good butter, from two to six large onions (with a bit of
garlic, and four or five eschalots, or none of either), when they are
coloured equally of a fine yellow-brown, lift them on to a sieve
reversed to drain; put them into a clean saucepan, add a pint and a
half of good gravy, with a couple of ounces of rasped cocoa-nut, or
of any of the other condiments we have already specified, which may
require as much stewing as the onions (an apple or two, for
instance), and simmer them softly from half to three quarters of an
hour, or until the onion is sufficiently tender to be pressed through a
strainer. We would recommend that for a delicate currie this should
always be done; for a common one it is not necessary; and many
persons prefer to have the whole of it left in this last. After the gravy
has been worked through the strainer, and again boils, add to it from
three to four dessertspoonsful of currie-powder, and one of flour, with
as much salt as the gravy may require, the whole mixed to a smooth
batter with a small cupful of good cream.[99] Simmer it from fifteen
to twenty minutes, and it will be ready for use. Lobster, prawns,
shrimps, maccaroni, hard-boiled eggs, cold calf’s head, and various
other meats may be heated and served in it with advantage. For all
of these, and indeed for every kind of currie, acid of some sort
should be added. Chili vinegar answers well when no fresh lemon-
juice is at hand.
99. This must be added only just before the currie is dished, when any acid fruit
has been boiled in the gravy: it may then be first blended with a small portion
of arrow-root, or flour.

Onions, 2 to 6 (garlic, 1 clove, or eschalots, 4 to 5, or neither);

fried a light brown. Gravy, 1-1/2 pint; cocoa-nut, 2 oz. (3, if very
young): 1/2 to 3/4 hour. Currie-powder, 3 to 4 dessertspoonsful; flour,
1 dessertspoonful; salt, as needed; cream, 1 small cupful: 15 to 20
minutes.
Obs.-In India, curds are frequently added to curries, but that may
possibly be from their abounding much more than sweet cream in so
hot a climate.
 POTTED MEATS.

Any tender and well-roasted meat, taken free of fat, skin, and
gristle, as well as from the dry outsides, will answer for potting
admirably, better indeed than that which is generally baked for the
purpose, and which is usually quite deprived of its juices by the
process. Spiced or corned beef also is excellent when thus
prepared; and any of these will remain good a long time if mixed with
cold fresh butter, instead of that which is clarified; but no addition
that can be made to it will render the meat eatable, unless it be
thoroughly pounded; reduced, in fact, to the smoothest possible
paste, free from a single lump or a morsel of unbroken fibre. If rent
into fragments, instead of being quite cut through the grain in being
minced, before it is put into the mortar, no beating will bring it to the
proper state. Unless it be very dry, it is better to pound it for some
time before any butter is added, and it must be long and patiently
beaten after all the ingredients are mixed, that the whole may be
equally blended and well mellowed in flavour.
The quantity of butter required will depend upon the nature of the
meat; ham and salted beef will need a larger proportion than roast
meat, or than the breasts of poultry and game; white fish, from being
less dry, will require comparatively little. Salmon, lobsters, prawns,
and shrimps are all extremely good, prepared in this way. They
should, however, be perfectly fresh when they are pounded, and be
set immediately afterwards into a very cool place. For these, and for
white meats in general, mace, nutmeg, and cayenne or white
pepper, are the appropriate spices. A small quantity of cloves may
be added to hare and other brown meat, but allspice we would not
recommend unless the taste is known to be in favour of it. The
following receipt for pounding ham will serve as a general one for the
particular manner of proceeding.
 POTTED HAM.[100]

100. See Baked Ham, Chapter XIII., page 258.

(An excellent Receipt.)

To be eaten in perfection this should be made with a freshly cured
ham, which, after having been soaked for twelve hours, should be
wiped dry, nicely trimmed, closely wrapped in coarse paste, and
baked very tender. When it comes from the oven, remove the crust
and rind, and when the ham is perfectly cold, take for each pound of
the lean, which should be weighed after every morsel of skin and
fibre has been carefully removed, six ounces of cold roast veal,
prepared with equal nicety. Mince these quite fine with an
exceedingly sharp knife, taking care to cut through the meat, and not
to tear the fibre, as on this much of the excellence of the preparation
depends. Next put it into a large stone or marble mortar, and pound it
to the smoothest paste with eight ounces of fresh butter, which must
be added by degrees. When three parts beaten, strew over it a
teaspoonful of freshly-pounded mace, half a large, or the whole of a
small nutmeg grated, and the third of a teaspoonful of cayenne well
mixed together. It is better to limit the spice to this quantity in the first
instance, and to increase afterwards either of the three kinds to the
taste of the parties to whom the meat is to be served.[101] We do
not find half a teaspoonful of cayenne, and nearly two teaspoonsful
of mace, more than is generally approved. After the spice is added,
keep the meat often turned from the sides to the middle of the
mortar, that it may be seasoned equally in every part. When perfectly
pounded, press it into small potting-pans, and pour clarified
butter[102] over the top. If kept in a cool and dry place, this meat will
remain good for a fortnight, or more.
101. Spice, it must be observed, varies so very greatly in its quality that discretion
is always necessary in using it.

102. This should never be poured hot on the meat: it should be less than milk-
warm when added to it.
 Lean of ham, 1 lb.; lean of roast veal, 6 oz.; fresh butter, 8 oz.;
mace, from 1 to 2 teaspoonsful; 1/2 large nutmeg; cayenne, 1/4 to
1/2 teaspoonful.
Obs.—The roast veal is ordered in this receipt because the ham
alone is generally too salt; for the same reason butter, fresh taken
from the churn, or that which is but slightly salted and quite new,
should be used for it in preference to its own fat. When there is no
ready-dressed veal in the house, the best part of the neck, roasted
or stewed, will supply the requisite quantity. The remains of a cold
boiled ham will answer quite well for potting, even when a little dry.
 POTTED CHICKEN, PARTRIDGE, OR PHEASANT.

Roast the birds as for table, but let them be thoroughly done, for if
the gravy be left in, the meat will not keep half so well. Raise the
flesh of the breast, wings, and merrythought, quite clear from the
bones, take off the skin, mince, and then pound it very smoothly with
about one third of its weight of fresh butter, or something less, if the
meat should appear of a proper consistence without the full quantity;
season it with salt, mace, and cayenne only, and add these in small
portions until the meat is rather highly flavoured with both the last;
proceed with it as with other potted meats.
 POTTED OX-TONGUE.

Boil tender an unsmoked tongue of good flavour, and the following

day cut from it the quantity desired for potting, or take for this
purpose the remains of one which has already been served at table.
Trim off the skin and rind, weigh the meat, mince it very small, then
pound it as fine as possible with four ounces of butter to each pound
of tongue, a small teaspoonful of mace, half as much of nutmeg and
cloves, and a tolerably high seasoning of cayenne. After the spices
are well beaten with the meat, taste it, and add more if required. A
few ounces of any well-roasted meat mixed with the tongue will give
it firmness, in which it is apt to be deficient. The breasts of turkeys,
fowls, partridges, or pheasants, may be used for the purpose with
good effect.
Tongue, 1 lb.; butter, 4 oz.; mace, 1 teaspoonful; nutmeg and
cloves each, 1/2 teaspoonful; cayenne, 5 to 10 grains.
 POTTED ANCHOVIES.

Scrape the anchovies very clean, raise the flesh from the bones,
and pound it to a perfect paste in a Wedgwood or marble mortar;
then with the back of a wooden spoon press it through a hair-sieve
reversed. Next, weigh the anchovies, and pound them again with
double their weight of the freshest butter that can be procured, a
high seasoning of mace and cayenne, and a small quantity of finely-
grated nutmeg; set the mixture by in a cool place for three or four
hours to harden it before it is put into the potting pans. If butter be
poured over, it must be only lukewarm; but the anchovies will keep
well for two or three weeks without. A very small portion of rose-pink
may be added to improve the colour, but unless it be sparingly used,
it will impart a bitter flavour to the preparation. The quantity of butter
can be increased or diminished in proportion as it is wished that the
flavour of the anchovies should prevail.
Anchovies pounded, 3 oz.; butter, 6 oz.; mace, third of
teaspoonful; half as much cayenne; little nutmeg.
 LOBSTER BUTTER.

(For this see page 138, Chapter VI.)

 POTTED SHRIMPS, OR PRAWNS.

(Delicious.)
Let the fish be quite freshly boiled, shell them quickly, and just
before they are put into the mortar, chop them a little with a very
sharp knife; pound them perfectly with a small quantity of fresh
butter, mace, and cayenne. (See also page 92.)
Shrimps (unshelled), 2 quarts; butter, 2 to 4 oz.; mace, 1 small
saltspoonful; cayenne, 1/3 as much.
 POTTED MUSHROOMS.

The receipt for these, which we can recommend to the reader, will
be found in the next Chapter.
 MOULDED POTTED MEAT OR FISH.

(For the second course.)

Press very closely and smoothly into a pan or mould the potted
ham, or any other meat, of the present chapter, pour a thin layer of
clarified butter on the top, and let it become quite cold. When wanted
for table, wind round it for a moment a cloth which has been dipped
into hot water, loosen the meat gently from it with a thin knife, turn it
on to a dish, and glaze it lightly; lay a border of small salad round it,
with or without a decoration of hard eggs, or surround it instead with
clear savoury jelly cut in dice. The meat, for variety, may be equally
sliced, and laid regularly round a pile of small salad. A very elegant
second course dish may be made with potted lobsters in this way,
the centre being ornamented with a small shape of lobster butter.
(See page 138.)
 POTTED HARE.

The back of a well-roasted hare,

and such other parts of the flesh as
are not sinewy, if potted by the
directions already given for ham and
other meat, will be found superior to
the game prepared as it usually is by
baking it tender either with a large
quantity of butter, or with barely
sufficient water or gravy to cover it;
but when the old-fashioned mode of
potting is preferred, it must be Wedgwood Pestle and
cleansed as for roasting, wiped dry, Mortar.
cut into joints, which, after being
seasoned with salt, cayenne (or
pepper), and pounded cloves and mace or nutmeg well mingled,
should be closely packed in a jar or deep pan, and slowly baked until
very tender, with the addition of from half to a whole pound of fresh
butter laid equally over it, in small bits, or with only so much water or
other liquid as will prevent its becoming hard: the jar must be well
covered with at least two separate folds of thick brown paper tied
closely over it. It should then be left to become perfectly cold; and
the butter (when it has been used) should be taken off and scraped
free from moisture, that it may be added to the hare in pounding it.
All skin and sinew must be carefully removed, and the flesh minced
before it is put into the mortar. Additional seasoning must be added if
necessary; but the cook must remember that all should be well
blended, and no particular spice should be allowed to predominate in
the flavour of the preparation When water or gravy has been added
to the hare, firm fresh butter should be used in potting it: it will not
require a very large proportion, as the flesh will be far less dry and
firm than when it is roasted, though more of its juices will have been
withdrawn from it; and it will not remain good so long. The bones,
gravy, head, and ribs, will make a small tureen of excellent soup.
Thick slices of lean ham are sometimes baked with the hare, and
pounded with it.
 CHAPTER XVII.

Vegetables.

The quality of vegetables depends much both on the soil in which

they are grown, and on the degree of care bestowed upon their
culture; but if produced in ever so great perfection, their excellence
will be entirely destroyed if they be badly cooked.
With the exception of artichokes, which are said to be improved by
two or three days’ keeping, all the summer varieties should be
dressed before their first freshness has in any degree passed off (for
their flavour is never so fine as within a few hours of their being cut
or gathered); but when this cannot be done, precaution should be
taken to prevent their withering. The stalk-ends of asparagus,
cucumbers, and vegetable-marrow, should be placed in from one to
two inches of cold water; and all other kinds should be spread on a
cool brick floor. When this has been neglected, they must be thrown
into cold water for some time before they are boiled to recover them,
though they will prove even then but very inferior eating.
Vegetables when not sufficiently cooked are known to be so
exceedingly unwholesome and indigestible, that the custom of
serving them crisp, which means, in reality, only half-boiled, should
be altogether disregarded when health is considered of more
importance than fashion; but they should not be allowed to remain in
the water after they are quite done, or both their nutritive properties
and their flavour will be lost, and their good appearance destroyed.
Care should be taken to drain them thoroughly in a warm strainer,
and to serve them very hot, with well-made sauces, if with any.
Only dried peas or beans, Jerusalem artichokes, and potatoes, are
put at first into cold water. All others require plenty of fast-boiling
water, which should be ready salted and skimmed before they are
thrown into it.