Foundations of MHC Final Flashcards

Making Ethical Decisions:

Beneficence Nonmaleficence Autonomy
Justice Fidelity Veracity


Doing good Choosing the best practice


Do no harm Don�t cross boundaries No dual
relationship (it can cause client harm)


Respect client�s independence, values, moral systems, etc.
If she�s in a domestic violence relationship & wants to
go back, you can�t stand in her way


Quality Treating everybody equally Someone
having cash rather than paying through insurance


Trust, keeping promise, etc. Can tell client you�re
going to do research for resources for them


Your credentials Not lying, not over-exaggerating


Interacts with processing of data Worldview
Culture What one counselor may see as
ethical, another may not


The extent to which an instrument accurately measures what it
says it measures You can be confident in the results of a
test only if there is a high degree of agreement between the
test scores and the quality being measured


The degree to which scores obtained on tests are consistent,
dependable, and repeatable Reliability of a test increases
as the sources of random error are controlled

Weakest form of reliability?


Weakest form of validity?


The major purpose of achievement tests are to?

Designed to assess present levels of
developed abilities Current functioning and basic academic
skills are relevant to planning for educational/training

IQ tests are achievement tests� T or F?

False, they are intelligence tests

Three ways to understand:

Authority Experience Reasoning

Two types of research people conduct:

Quantitative Qualitative


Numerically-driven Larger sample population
Researcher removed More objective Statistical


Phenomenological-driven Smaller sample population
Researcher is not removed Open to interpretation
Thematic patterns

Research wants to:

Describe Explain Predict

There are five steps to scientific method. T or F?

False, there are six. Identify problem/topic
Create hypothesis Collect data Researcher
carries out plan Analyze data Discussion and
conclusion that either confirms or disconfirms hypothesis

Four major movements in counseling:

Psychoanalysis Behaviorism Humanistic

Confirmatory Bias

Human tendency to search for information that confirms one�s
preexisting conceptions See what want Search for
what confirms belief

Five stages of racial development:

Conformity Dissonance
Resistance/Immersion Introspection Integrative


Tend to show strong preference for the value of the dominant


Stems from an increased awareness that one�s minority culture
has strengths and is not as bad as previously believed


Occurs as minority persons move toward and endorse the values
and lifestyles of their minority group


Minority members are more comfortable with self and their own

Integrative Awareness

Minority persons experience greater flexibility and inner


How well a person is adjusted to the dominant culture
The gradual physical, biological, cultural, and psychological
changes that take place in individuals and groups when contact
between two cultural groups takes place

Five dimensions ethics encompasses:

Counselors should ethically: Possess adequate
knowledge, skills, and judgment to produce effective
interventions Respect dignity, freedom, and rights of
clients Use power inherent in the counselor�s role
judiciously and responsibly Conduct oneself in such a
way that promotes confidence in the profession
Maintaining the client�s welfare (highest priority)

Significance of Ethics

Ethics involves everything a counselor does Acting
ethically promotes professionals Ethical
codes-organizations regulate behavior for members Legal
codes enforced Attempts to protect clients
and sets parameters Puts into place safeguards
Shield consumers from counselors operating without a sound
rationale Ethical codes sets guides into
place Attempts to protect practitioners against malpractice
suits Ethical codes cannot prevent against this

Relationship between Ethics and Law:

Ethics help in: Protecting consumers (clients) from
counselors behaving unethically Includes competence
�I did not know� is not an excuse
Different processes set into place promote ethics
and law criminal law civil law
proceedings federal regulations peer

Gray Areas:

Court and counseling Need to understand the nature of
the case Who is asking for what information What
to give them

Codes of Ethics

According to the text ethical codes fulfill these primary
objectives Educate people on what is considered ethical
(professional conduct) Identify set of standards that
people can be held accountable for Improve professional
services Operate according to �best practices�
Keep practitioners safe

Nine areas covered by ethics:

The counseling relationship Confidentiality,
privileged communication, and privacy Professional
responsibility Relationship with other professionals
Evaluation, assessment, and interpretation Supervision,
training, and teaching Research and publication
Technology Resolving ethical issues

Ethics Committees

If behavior is found to be questionable, ethics committees can:
Mandate remedial requirements Place a person on
probation Suspend a person Expel

Informed consent

Right to know Specific types of information must be
provided Given at the beginning of treatment
Client gives consent Understand �who� is the
client Client makes a voluntary decision


Focuses on the need to respect the privacy of clients and
clinical records Includes: Research and
training Consultation Working with:
Groups Families Minors

Circumstances under which confidentiality can be breached:

Threat to oneself Plan How detailed?
Threat to others
Tarasoff Law Person has to be identified
Child abuse Elder abuse When
the client requests their information

Categories of Multiple relationships:

Structures multiple professional relationships Shifts
in professional roles Personal and professional role
conflicts Predatory professionals Happenstance
multiple relationships

MHC Model Review

Three dimensions: Mental health/Wellness
Mental illness/Dysfunction Ecological context

Contemporary trends

Transition from individual to ecological Holistic
Focus on strength-based/wellness as opposed to
deficits/pathology Emphasis on subjective realities
Culture Increased reliance on prevention
and education Less reliance on remediation

Five primary stages of helping:

Establishing the relationship Assessing or defining
the presenting problem Identifying and setting goals
Choosing and initiating interventions Planning and
introducing termination and follow-up

Relationship building

According to the book, many counselors see therapeutic relationship
as being the primary curative factor in the treatment
process Therapeutic relationship (alliance) is critical
Warmth, empathy, acceptance Recall Rogers six
necessary & sufficient factors
Text describes client can be a unit Not
solely an individual The therapeutic relationship
(alliance) established a mutual commitment to the collaborative process
and goals of counseling

Clients need to know:

Who does what More likely to commit to work of getting
things done Know what is expected from them
Therapeutic relationship grows as clients feel as part of
the process Client buy-in

Items of Importance in therapeutic relationships

Treatment modalities & theoretical perspective
What exactly ARE you going to do
Timeframes How long is it going to take?
Payment How the client will pay, what forms
accepted, insurance Confidentiality
Risks and side effects Tell them the potential
drawbacks of counseling Informed consent
Qualifications of counselor Veracity
Additional issues Assessment,
supervision/treatment team meetings
Therapeutic relationship is established when the client
perceives they are significant and valued

Problem Identification:

Need clear focus on the client�s problem Occurs
through counselor intuition Occurs through:
Embracing the process Risk taking
Reflective practitioner Counselor
intuition guides next stage Assessment More


Understand DSM & Assessment are: Tools for use in
the toolkit of the counselor NOT what base entire case
conceptualization on or treatment

Remember counseling focuses on four concepts:

Personal wellness Strength based
Holistic Multidisciplinary

Initial Interviews

Social workers Build a social history
Clinical Psychologists/Psychiatrists Use as a
diagnostic tool Counselors Use as a
�helping interview� Build self-understanding with
clients, alternative actions Culturally competent

Conducting Intake Interview

Remember Rogers Aware of client and self Use
humor Use of micro skills: Minimal encouragers
Paraphrasing Reflection Summarizing

Parts of Intake Interview

Identifying and demographic information Presenting
problems How do you ask? Current life
setting and level of functioning Bio-psychosocial history
Medical history Family
history/constellation FOO Behavioral
observations POO Related to counselor

Mental Status Examination (MSE)

For clients who may be impaired Used with clients with
moderate to severe problems Used in
hospitals & jails MSE are more focused Current
level of functioning at this moment Different than
psychosocial Components of MSE include:
Appearance Motor activity Attitude
Speech State of consciousness Affect
Perception Thinking process Content of
thought Judgement Memory
Intelligence Concentration and attention span
Orientation x 3

Diagnosis and Case Conceptualization

Understand emotional and mental problems See how they
relate Connect to client Lead to see how you
conceptualize client Another
tool in the tool belt of the counselor Three areas of the
client�s life have to be negative impacted: Mental
Social Physical


Diagnostic and Statistical Manual of Mental Disorders Text
Revision IV (Five) Descriptive not prescriptive
Similar to medical model Places people into
categories Is atheoretical� Does not give you a
theory behind diagnosis

Mental disorder in DSM IV-TR is characterized by:

A clinically significant behavioral or psychological syndrome
occurring in an individual Experienced distress or
impairment in adaptive functioning in one or more major life
areas The syndrome exceeds expected or culturally approved
responses to specific events Deviant behaviors or conflicts
between and individual and society, in themselves, are not
considered mental illness unless such behaviors are functions of a
mental illness

Axis I

Clinical disorders and other conditions Encompasses
all mental disorders Exceptions- personality disorders
and mental retardation (cognitive impairment)
Early childhood disorders Substance Abuse
Schizophrenia Other Psychotic Disorders Mood
Disorders Anxiety Disorders Eating
Disorders Sexual & Gender Identity Disorders
Impulse-Control Disorders Adjustment Disorders

Axis II

Personality disorders Cognitive impairment
More chronic Includes a variety of
pervasive and long-standing patterns of inflexible maladaptive
behaviors that interfere with the client�s social and/or
occupational functioning

Axis III

General medical conditions Diagnosed physical
conditions Diabetes

Axis IV

Psychosocial and Environmental Job Money
Relationships with others
Any psychosocial or environmental factors that might
influence the course of the mental disorder, its treatment, and its
prognosis Both negative and positive stressors require
clients to adjust to the demands placed on them and are considered
on this axis

Axis V

Global Assessment of Functioning (GAF) Goes from
0-100 Lower is worse If there are contradictions
GAF represents lower
Report client�s general level of psychosocial, social,
and occupational functioning, using the GAF Scale Scale
provides a system for rating the client�s level of general
functioning on a hypothetical continuum of mental illness�mental
health that ranges from 0 to 100 (APA)


Combines the first three DSM IV-TR axes One list that
contains all mental disorders Includes personality
disorders Intellectual disability Other
medical diagnoses Axis IV & V no
longer part of DSM 5 Axis IV now has separate notations
for psychosocial stressors Axis V (GAF)
Related to disability Similar to the former
axis four Now is a separate notation

Critiques of DSM 5:

Places people into categories Does not take into
consideration multiculturalism Clear line that separates
normal and clinical problems (discontinuity assumption)
Managed care problems Too early to create a new
classification of psychiatric diseases

Goal Setting

Recalls steps of the transtheoretical model Counselor
needs to be collaborative Treatment plans answer the
following: Who What When
Degree�what level/practical Where
Conditions, locations How (much)
Directions Needs to
be: Systematic Deal with SPECIFIC
behaviors Understand difference between goals and
objectives Be able to convey this to a client
Meeting the client �where they are� Is

Six Components of Goal Setting:

Who: who
specifically will be performing the behavior
does the goal involve an increase, decrease, or
maintenance of a specific behavior?
Behavior, thought, or affect: what is the observable
activity that the identified person is to do?
Conditions: What
is the specific setting(s) in which the observable activity is
to be performed?
what is the level of performance desired?

Time frame:
what is the estimated length of time expected for the goal
to be attained, assuming the client works in treatment
according to the plan?

The �Y� Question

Never ask the �Y� question Two basic assumptions are
made: The client knows the answer Knowing why will
be helpful Most adults respond to why
question with Rationalization and intellectualization
Beginning counselors use it when: With a
difficult client Feel stuck

Intervention and Action

Do a client map!!! Beginning stages of intervention
and action phase Diagnosis Objective of
treatment Assessment Clinician
characteristics Location Interventions
Emphasis of treatment (style) Numbers


Involves: Problem solving Triadic
Indirect Is egalitarian and
collaborative Very important Different roles
consultant can have: Advocate Expert
Trainer Trainings at work
Collaborator Work within timeframe May
work independently Fact finder
Process specialist Focuses on a specific


Another term is social justice Social justice deals
with: Disenfranchised and marginalized populations
Encompasses multiculturalism Social
justice is more broad Socio-economic status
Assist those who do not have a voice

Three types of advocacy stated by text:

Individual counselors represent the interest of the
clients they serve
Group of people counselors represent the interests
and rights of an entire group
Advocate for your field Professional identity
Public awareness

Validity and Reliability

A test CAN be reliable but not valid A test CANNOT be
valid but not reliable

Forms of Validity

Weakest of the forms of validity
Degree to which a test measures a content, or variable
(e.g., verbal aggression)
Measure outcomes of test to an outside criterion

How well it measures a broad construct (i.e.

Forms of Reliability

Same test given twice Weakest of the forms of
Equivalent versions of the same test Equivalence
and stability Multiple times to insure scores are
stable Example: taking a test on a �bad� day

consistency Items on same test Similar
in what they are asking
Inter-rater reliability

Aptitude Tests (ASVAB)

Measure specific skills of the ability to acquire a certain
skill Intended to predict how well an
individual may perform on a job or in an educational and/or training
program- (most criticism received) They indicate an
individual�s cognitive strengths and weaknesses SAT

Intelligence Tests

Used to measure intelligence Wechler Scales
Originated by Alfred Binet in 1905 Place
children in school programs Identify mental
retardation Controversial

Achievement Test

Designed to assess present levels of
developed abilities Developed by George Fisher in 1864
Current functioning and basic academic skills are relevant to
planning for educational/training programs

Interest Inventories (SDS
(self-directed survey), SII (self-interest inventory)

Interests are primarily designated by responses to complied
lists of occupations and lists of activities associated with
them Two common methods of reporting results are direct
comparison (likes/dislikes) and comparisons with themes or clusters
of occupation Six types on personality theories for
realistic investigative artistic
social enterprising conventional

Personal Inventory (16 PF)

Individual personality patterns assist in the task of
identifying and clarifying each individual�s needs�provides a
stimulus for career exploration Myers-Briggs Type
Indicator Assesses four characteristics:
traits relatively enduring tendencies to act,
think,and feel in a certain manner in any given
situation Personality states
emotional reactions that vary from situation to
situation Personality types
general descriptions of personal styles, such as
high social interest, high activity levels, and subjective
styles of personal decision making
the person's view of self

Values Inventories

Classified as two types: Inventories that primarily
measure work values Inventories that measure values
associated with aspects of lifestyle

Myers-Briggs Type Indicator (MBTI)

Personality Inventory

Wechler Intelligence Scale
for Children (WISC)

Intelligence Tests

Counselor Preparation
Comprehensive Examination (CPCE)


Ethics in Assessment

SAIR!!! Test Selection Test
Administration Test Interpretation Test
Reporting Consider Regional
differences SES Family systems/values
Country of origin differences

Types of Quantitative Research:

Five types (categories) of quantitative research
Survey Correlation Causal-comparative
Experimental Single Subject

Survey (Quantitative Research)

Questionnaires, presidential polls, census data

Correlation (Quantitative Research)

Relationship between two or more variables Example-
smoking and cancer

(Quantitative Research)

Pre-existing conditions Example- working parents and
rate of parental involvement in school

Experimental (Quantitative Research)

More control over situation Independent and dependent
variables Experimental and control group Example-
developing a new counseling technique, randomly placing people
into different groups and reporting results

Single Subject (Quantitative Research)

Tests a group of participants Within-Subject
designs Administer a treatment or intervention Tests
the group again Example- anger management group

Qualitative Research:

Numerous methods of qualitative research: Case
Studies Narrative Research Ethnography

Case studies (Qualitative Research)

Example- Freud�s work in psychoanalysis

Narrative research
(Qualitative Research)

Example- having veterans write about their experiences and
transitioning back to life

Ethnography (Qualitative Research)

The scientific description of the customs of individual
peoples and cultures Example- isolated
Mormon society in Utah


Informed consent Deception
Confidentiality Disclosure Freedom from harm
Physical Mental Social

Four major movements of Multiculturalism in counseling:

Psychoanalysis Behaviorism Humanistic


A biologically based classification system of people groups based on
visible physical appearances


A group of persons who identify with one another by virtue of sharing
common ancestry, religion, language, skin color, and/or culture


A way of living that encompasses the customs, traditions, attitudes,
and overall socialization in which a group of people engage that are
unique to their cultural upbringing


An attitude, judgement or feeling about a person that is generalized
from attitudes or beliefs held about the group to which the person belongs


The use of power and position, overtly or covertly and intentionally
or unintentionally, to treat others differently on the basis of
perceived racial differences between them and oneself


Biased treatment of a person based on the view one holds of the group
to which that person belongs
Part of schemata Unconscious

Cultural Encapsulation

The tendency of counselors to: (a) define and
dogmatically cling to viewing reality according to their own
sets of cultural assumptions to the exclusion of alternative
interpretations (b) demonstrate insensitivity to persons
of other cultural backgrounds who hold alternative
perspectives (c) resist or simple not recognize the
necessity of testing the validity of one�s underlying
assumptions and therefore, (d) become trapped in what
may be described as a cultural tunnel vision
See people�s behavior as part of them

Microaggressions (mistrust):

Ways minority mistrust receives reinforcement in contemporary
society Microinvalidations Microinsults


Tend to be more highly valued, trusted, and favored
those in our

Within-group vs. between group differences:

A difference between groups on a given characteristic is judged
as being statistically significant when the difference (or variance)
between groups is greater than the difference within each group

Within group variations

Individual differences in clients' racial/cultural identity development

Five different stages a person can be in: (Acculturation)

Traditional Transitional Marginalized
Bi-cultural Assimilated

Working with persons of multiple heritage:

Henrikson and Paladino (2009) present a multiple heritage
identify development model (MHID) to assist counselors in
understanding, being sensitive to, and working with persons of
multiple heritage Six stages are: Recognition identification with
multiple heritages Transition inner search for
identity Experimentation seeking a group with
which to identify Awareness awareness of multiple
identities Acceptance recognize and accept
basic differences between people
lack of difference

�Mental Health Care Revolution�

Managed care changed methods of counselors Used to
provide structure Reduce costs Some forced to
change approaches

Treatment plan

Set goals Objectives Timeframe

Financial risk and rise of insurance companies

Managed care is new 1990s and
United States first attempt in 1904 Socialist
President Woodrow Wilson proposed a national health plan
in 1920
Plan failed Great Depression in 1929 renewed interest in
national health care plans Predecessor of Blue Cross/Blue
Shield occurred in 1929 Led to Health
Service Plan Commission in 1937 Blue Shield
created in 1939 Community
mental health act of 1963

First nation to legislate national health insurance


Push towards managed care:

In 1970s two underlying assumptions: Doctors know
best Must spend money whatever is necessary Led
to excessive spending Misrepresentation
forced managed care

What is managed care?

A constellation of businesses, organizations, and practices
that arrange for the financing and delivery of mental health
services Managed Care Organizations (MCOs) Health
maintenance organizations Clients assigned primary care
provider Can be looked at as gatekeeper Primary
purpose: Containment of costs!!! Total
costs = utilization x cost per unit Value = desired outcomes � adverse

Procedures for reducing utilization:

Pretreatment authorization
of treatment

Familiar term: �medically necessary and
appropriate� Some agents do not have
counseling background Firm understanding of how treatment
plan works Systematically putting together interventions
based on empirical evidence

Procedures for reducing utilization:

Concurrent utilization reviews

If a client needs services beyond what was originally
authorized Agent can authorize additional service
Can increase efficiency and effectiveness

Procedures for reducing utilization:

Incentives for efficient providers

Meet company standards Placed on panel
Meet standards of care (empirically-based interventions)
Services are brief and goal-oriented (action)

Procedures for reducing utilization:

Sharing of costs

Employees and clients pay more

Procedures for controlling price per unit:


Mental health care provider paid a contracted rate for each
member assigned �per-member-per-month� rate
Regardless of the number or nature of services provided
Contractual rates are adjusted for age, gender, illness,
regional differences

Procedures for controlling price per unit:

Less expensive but
comparable (equal)

Cheaper providers (Masters as compared to doctoral-level)
Group work Medication

Procedures for controlling price per unit:

Retrospective claims reviews

Suspicion of fraud Independent agent Done
after a client is no longer receiving services

Impact on practice of mental health counseling:

Managed care has caused "an upheaval in the practice
community" Changes have occurred in the nature of
treatment, its delivery, and the management of the business of
mental health service Beier and Young stated counselors
respond in three things to managed care: Move away
Bypass managed care clients Move
towards Working within the system AMHCA
Move against Political
movements/advocacy Global impact

Case Study

Form a treatment plan Make a diagnosis
Develop: Goals Objectives
What interventions will use Rationale behind it
Answers the: Who What When
Where How

Mental Health & Chronically Mentally Ill:

Cases of mental health Treatment delivery takes place
in: Residential homes Inpatient
Outpatient Partial hospitalization Sometimes
all at the same location Services include:
Assessment & diagnosis Supportive and
clinical counseling for psychiatric and substance abuse
problems Medication management services

Mental Health & Correctional Facilities:

Five groups (levels)

Individuals with misdemeanors Condition
may influence incarceration Nuisance
(1) Survival
Individuals with dual diagnosis Drugs/Substance Abuse or
Dependence and mental health issues (3)
History of severe
problems (4) Disturbing the peace
Psychopathic Antisocial personality disorder
Have high rates of substance abuse Severe
mental health issues
Individuals out of control Stereotypical �raging
madman� (5) Criminal/violent acts
Driven by psychotic symptomatology to commit violent
acts Smallest group of the five

Mental Health & Correctional Facilities:

Five groups (levels): Nuisance Survival
Drugs/Substance Abuse or Dependence and Mental Health
Issues History of Severe Problems Stereotypical

Mental Health & Dual Diagnosis:

diagnosis/co-morbidity: presence of both substance-related
and psychiatric conditions in clients Traditional
approaches to treatment tend to take the linear approach by first
moving the person toward recovery from substance
abuse/dependence Then, as progress is noted, referral or
transfer is made to mental health agency Problems can feed
off one another Become worse Goals are:
To withdraw clients safely from substances
Establish physical and emotional stability Identify
and threat the coexisting disorders

Individuals encountering disasters:

Tend to move through three overlapping phases
Impact Recoil Post-trauma

Intervention for individuals encountering disasters:

Three-phase model developed by Herman (1992) Safety
and stabilization Remembrance and mourning-

Contradicting pictures of mental health:

May change perspective Continuum of mental health
Placing diagnosable emotional/subjective distress and mental
illness on the same continuum as mental health is an artifact of
the medical model Can have severe mental
illness Some may see themselves as �sick� or �ill�
Other people may not see them that way

Grant Work:

Six step process Cover letter (two-three sentence
summary) Executive summary (Two-three paragraph
description organization) Statement of existing problem
(rationale) Working goals and plans Measurable
outcomes and impact Budget Other sources of
funding If have (or had) other grants (Best
fitted) Supplementary materials
Will depend on grant

Mental Health Delivery Systems:

Assessing needs and wants of clients What is the
mission Population want to service
Goals What want to do Programs
What are the specialties Working
skills/ability Technology/staff Program evaluation
How you know program is working

Inductive Reasoning

A logical process in which multiple premises, all believed true
or found true most of the time, are combined to obtain a specific
conclusion Often used in applications that involve
prediction, forecasting, or behavior.

Deductive Reasoning

A logical process in which a conclusion is based on the
concordance of multiple premises that are generally assumed to be
true Sometimes referred to as top-down logic

Case Example:

A new counselor-in-training (student) understands the ideas
behind counseling terms yet does not fully grasp how they connect to
a real client. The counselor does not think this is necessary now as
he/ she will learn eventually.

Possess adequate knowledge, skills and judgment
Application-ensure some degree of minimum quality

Case Example:

A counselor refuses to support a student for a scholarship.
The counselor believes another student (whom the counselor
identifies better with due to similar demographics/characteristics),
is more deserving.

Respecting dignity, freedom, and rights of others

Case Example:

A counselor does not like a particular supervisor. Although
other counselors perceive the supervisor as okay, this counselor
thinks the supervisor is too hard, demanding, and inflexible. The
counselor tries to influence her younger colleagues to sign a
petition and complain against the supervisor.

Using power in the counselor�s role Knowledge of
being a reflective practitioner

Case Example:

A counselor has had three jobs and lost each one due to poor
performance. On each job there was a problem with others: people
were not giving enough respect, too inflexible, or demanding. The
counselor has been told that he/she has some issues that need to be
worked out. The counselor acknowledges there are issues but thinks
most of the issues are with others. He/she continues to see clients
and remains limited in his/her ability to assist others clinically.

Conducting oneself that promotes public�s confidence
Reflective practitioner/professional identity

Case Example:

A counselor has had a client for two months now. The
therapeutic relationship started off rocky, with the client coming
in late repeatedly, with the therapist insulting the client by
insinuating that the client was late due to being resistant. The
client revealed that he/she is taking care of sick family members,
working two jobs, and barely gets sleep, but still tries to make it
into counseling. After this incident, the relationship began to get
better. However, yesterday the client disclosed that he/she abused
drugs in the past, and due to that, they just found out they have
HIV. The counselor responds that there are always consequences for

Maintaining client�s welfare Lack of empathy

Criminal Law

Embodies what the federal and state governments regard as illegal behavior

Civil Law

Covers controversies between two or more people.
The focus is not the violation of a statute but the
possible harm one person has caused another

Federal Regulations

Requires that practitioners who transfer client records
electronically comply with procedures regulating the informed-consent process

Peer Mechanisms

Implemented by professional groups that seek to monitor the
activities of their group members.

Mary, a counselor, has a friend whose recent ex-boyfriend is
taking counseling at the local clinic. The friend asks Mary to find
out some information about what the ex-boyfriend�s counseling deals
with. Mary goes into a computer system on three separate occasions
to access information in the ex-boyfriend�s files.

Peer Mechanisms

Beth needs client hours as a beginning counselor. However, she
is very busy and cannot make all the hours she needs. She decides to
forge her supervisor�s signature on her forms so that she looks like
she has worked hours she really has not.

Criminal Law

Meg has had multiple (at least two confirmed) sexual
relationships with consenting adults that happen to be a client and
the father of one of her clients. She has been called in to sit in
front of a committee to state her case, and to petition to not have
her license revoked and be expelled from the profession.

Civil Law

A client is stressed out from his new job and sees the work
place environment as not fitting his personal beliefs of what an
ideal occupation should be. He moved to a different city for this
job and is unmarried. He knows few people and is separated from his
family and friends. He is starting to feel anxious, forgetful and
his work is beginning to suffer because of these issues.

Axis IV
Psychosocial and Environmental Job
Money Relationships with others

AJ has no regard for right and wrong in his life. He
persistently lies, and uses deceit to get his way with others.
When that does not work, he uses charm or wit to manipulate.
Although very handsome and charismatic, he has had recurring
difficulties with the law. Throughout his life, he has repeatedly
violated the rights of others, has used Intimidation, or
aggressive/violent behavior to get what he wants. When he does
this, he has a lack of remorse about harming others. At times, he
has Impulsive behavior, is agitated. He does have relationships
with others, but they are very poor and abusive.

Axis II
Personality disorders Cognitive impairment
More chronic
Includes a variety of pervasive and long-standing patterns of
inflexible maladaptive behaviors that interfere with the client�s
social and/or occupational functioning

Where does this person most likely work?

Counsels individuals and families referred by six school
districts, where most of the families and individuals were
multi-stressed, with complicating issues including substance abuse,
mental illness, family violence, sexual abuse, and lack of financial
resources. Counseling caseload of approximately 60 adolescent age
students. This person collaborates with the Student Assistance Team,
Special Education Department, and Test Coordinator.

University health services

Where does this person most likely work?

Provides individual, couples, and family counseling to
adolescents and adults suffering from depression, anxiety,
interpersonal difficulties, poor self-esteem, and stress-related
disorders. This person also serves as an adjunct professor and
primarily teaches Ethics and Human Sexuality.

Small college counseling centers

Where does this person most likely work?

Provides direct therapy through a variety of modalities
including individual, group, and family counseling. Teaches problem
solving-skills, behavior strategies and normalization in a
behaviorally-based school setting. Provides on-going
assessment/feedback regarding clients� progress toward treatment
goals, as well as problems and needs . Teaches family and child
behavior management techniques and basic life skills. Provides
intensive in-home mental health support services. Maintains accurate
and confidential documentation of counseling services administered
to clients through treatment notes and organizational service forms.
Maintains caseload of 10-15 clients, seen on a weekly basis.

Private practice

Where does this person most likely work?

Provides individual, family, and group counseling to adults
suffering from chemical dependency and dual diagnosis disorders.
Fulfills all administrative duties required by an intensive
outpatient (IOP) setting (e.g. intakes, medication consults,
treatment planning, managed care coordination, discharges, etc).

Substance abuse treatment programs

Which type of assessment is it?

Bobbi just finished taking an assessment that contains
numerous questions. It asked her about her feelings of anger and how
she reacts when she gets mad. She remembers the assessment asked her
reactions to annoying or frustrating situations as well. It seemed
as if the assessment also wanted to know how her behavior fluctuates
in intensity and over time.

Personality assessment

Internal Validity

The extent to which the results of a study can be interpreted accurately

External Validity

The extent that the results of a study can be generalized to other
populations and conditions

Internal Reliability

The extent to which the methods of data collection and the analysis
and interpretation of the results are consistent with the study

External Reliability

The extent to which independent researchers using the same methods
can obtain the same or similar results

Forms of Validity:


Weakest of the forms of validity

Forms of Validity:


Degree to which a test measures a content, or variable (e.g., verbal aggression)
extent to which a test
measures the skills or subject matter that it is supposed to

Forms of Validity:


Measure outcomes of test to an outside criterion
correlation between a
test score and some performance measure

Forms of Validity:


How well it measures a broad construct (i.e. aggression)
the extent to which a
test accurately measures a specific theoretical concept

Forms of Reliability:


Same test given twice Weakest of the forms of

Forms of Reliability:


Equivalent versions of the same test Equivalence and
stability Multiple times to insure scores are stable
Example: taking a test on a �bad� day

Forms of Reliability:

Internal Consistency

Items on same test Similar in what they are

Forms of Reliability:


Inter-rater reliability The degree of agreement among
raters Gives a score of how much homogeneity, or
consensus, there is in the ratings given by judges

What does CACREP stand for?

Council for Accreditation of Counseling & Related Educational
Programs (getting licensed after graduating)

How many different divisions are there of ACA?

19 different divisions in ACA

What do the following acronyms stand for?

LMHC: Licensed
Mental Health Counselor
LPCC: Licensed
Professional Clinical Counselor
NCC: National
Certified Counselor
MAC: Master
Addiction Counselor
LPC: Licensed
Professional Counselor
CCMHC: Certified
Clinical Mental Health Counselor
NCSC: National
Certified School Counselor

Who was Frank Parsons?

Very important figure in the field of vocational (career)
counseling Wanted to match interests/aptitudes of people with
occupations Set groundwork for what is now modern counseling
process Looked at �normal�
youth facing developmental issues Was preventative in
nature More holistic

Who is Carl Rogers?

Developed person-centered therapy theory
Humanistic Goal of person-centered therapy is to provide
clients with an opportunity to develop a sense of self wherein they
can realize how their attitudes, feelings, and behavior are being
negatively affected and make an effort to find their true positive

How are the deficit & medical model alike?

Both are models that conceptualize the patient as defective or
deficient in some way

CACREP was established in:


What did APGA stand for?

American Personnel and Guidance Association
was the predecessor of ACA

The five stages of the transtheorectical model are:

Precontemplation -
no intention to change, often unaware of the problem
Contemplation -
aware the problem exists and serious evaluation of options but not
committed to take action
Preparation -
intends to take action and makes small changes; needs to set goals
and priorities
Action - dedicates
considerable times and energy; make over and viable changes;
develops strategies to deal with barriers
Maintenance - works
to adapt and adjust to facilitate maintenance of change

What are the six factors for therapy stated by Rogers?

A psychologically close, warm relationship exists A
person (client) is experiencing incongruency and vulnerability
A person (counselor) is experiencing congruency and
genuiness A person (counselor) displays unconditional
positive regard for the other A person (counselor) displays
empathetic understanding for the other A person (client)
perceives and understands the other has unconditional positive
regard and empathetic understanding

8 core areas of CACREP:

Research Assessment Group
Career Helping relationship Human
growth/development Professional orientation
(identity)/ethics Diversity

American Psychological Association formed in:


Mental Health Act of 1963:

Set standards for mental health care Inpatient
treatment for short-term care Outpatient treatment
Partial hospitalization Crisis intervention
Consultation and education services Amended in 1968
and 1970

Ecological Perspective

Understand the person through contextual situations Do
you act the same at: School? Work? A
party? Environment has an effect
Urie Bronfenbrenner

Case Conceptualization

Predict Map Challenge Describe
Collect Contemplate Compare and Contrast

Areas accredited by CACREP:

Clinical Mental Health School Counseling
Student Affairs and College Counseling Addictions
Counseling Marriage and Family Therapy Career
Counseling Counselor Education and Supervision