Counseling Special Populations Counseling The Older Adult As society ages, more counselors will be...

Counseling Special PopulationsCounseling Special Populations

Counseling The Older Adult

As society ages, more counselors will be needed to work with those 65 years or older.

It is estimated that by the year 2020, this population will encompass 50 million of the American population.

Older adults will vary according to: age, sex, marital status, geographic distribution, race and ethnicity, retirement, employment and income status as well as physical and mental health.

“Copyright © Allyn & Bacon 2004”


Problems and Concerns of the Older Adult

Loss of work role identity.

Increased amount of leisure time.

Decreased financial support.

Loss of significant other(s).

Increased loneliness and separation.

Geographic relocation.

Peer and family restructuring.

Increased physiologic disorders.

Increased amount of dependence.“Copyright © Allyn & Bacon 2004”


Counseling Principles for the Older Adult

Enhancement of dignity and worth.

Counselors need to “sell” the positive benefits of counseling.

Counselors need to attend to the physical environment.

The counselor is often an advocate of the client.

Goals should be short-term and clear-cut.



Counseling Principles for the Older Adult (continued)

Counselors need to attend to dependence/independence issues.

Counselors need to attend to the age differential.

Counselors need to attend to the client's place in history.

Counselors need to diagnosis carefully with this population.



Goals For Counseling for the Older Adult

To decrease anxiety and depression.

To reduce confusion and loss of contact with reality.

To increase socialization and improve interpersonal relationships.

To improve behavior within institutions.

To cope with crisis and transitional stress.

To become more accepting of self and the aging process.

“Copyright © Allyn & Bacon 2004”“


Counseling Gay, Lesbian and Bisexual Clients

There are at least 20 – 25 million gay, lesbian and bisexual individuals in the United States, or 10% - 15% of the adult population.

There is no typical gay, lesbian or bisexual person. Individuals come from different races, ethnicities, religious backgrounds, socioeconomic statuses, and cultures.

There are seven variables of sexual orientation: sexual attraction, sexual behavior, sexual fantasies, emotional preference, social preference, lifestyle, and self-identification.



Problems Faced by Gay, Lesbian and Bisexual Clients

Cultural Homophobia

Cultural Heterosexism

Internalized Homophobia

Homophobia and Heterosexism in Counselors



Identity Development of Gay, Lesbian and Bisexual Clients

Identity confusion

Identity conflict

Identity denial

Community identity

Coming out or not



Special Situations in Counseling for Gay, Lesbian and Bisexual Clients

Violence in Lesbian and Gay Male Couples

Gay and Lesbian Families

Religious Issues

Drug and Alcohol Abuse

AIDS



Special Situations in Counseling for Gay, Lesbian and Bisexual Clients (continued)

Loneliness

Guilt

Depression

Suicide



Counseling Ethnic Minority Clients

Ethnic minority clients are members of cultural groups who have been marginalized by society.

There is no typical member of any one group. There is diversity within groups also.

Worldview, culture, and acculturation are important considerations.



Models of Racial and Ethnic Identity Development

Cross’s Model of Nigresence.

Minority Identity Development Model

Helm’s White Identity Development Model

Common stages within each: pre-exposure, dissonance, immersion, internalization and cultural awareness, and acceptance.



Counselor Training for Counseling Ethnic Minorities

Multicultural competencies are now expected.

Facilitation of growth and awareness of cultural differences.

Facilitation of growth and awareness of counselor bias.

Adoption of a culture-centered counseling theory.

Supervision and evaluation.

Emphasis on the crossed dyads of racial identity development between counselor and client.

Ethics



Multicultural Counseling Practices

Assessment Perspectives: Are assessment tools culturally sensitive and appropriate?

Culturally-Specific Inventories: It is important to assess clients from their own frame of reference.

Clinical Research Issues: Most theories and assessment instruments were developed with white, middle class subjects as models.



Future Directions of Multicultural Counseling

Within Group Application: Understanding the differences within ethnic groups (e.g. The Hispanic group is composed of Cubans, Mexicans, Puerto Ricans etc.)

Culture-Centered Interventions: Traditional methods of healing within the client’s community needs to be considered.

Other Nontraditional Populations: Diversity does not just encompass race and ethnicity but can include the poor, the aged, religion etc.

Ethical Issues: Is cultural ineffectiveness unethical? Should it or shouldn’t it be?



Counseling Clients with Disabilities

Themes in counseling could include: Independence vs. dependence; personal loss, coping with crisis, and/or maintaining employment.

Three phases of humans services are: prevention, intervention and postvention.

Prevention: The focus is on education or awareness of the likelihood of an activity or situation causing physical, or psychological problems.



Counseling Clients with Disabilities (continued)

Intervention: Detection of signs of disease or critical situations followed by an intervention or strategy to reduce the level of harm.

Postvention: Helping the client cope with new limitations and help restore optimal functioning.

The ultimate rehabilitation goal is to improve a client’s quality of life and enhance physical and psychosocial adjustment.



Common Problems for Clients with Disabilities

Lack of motivation.

Secondary gain.

Reluctance to participate in rehabilitation.

Depression and anxiety.

Poor body image.

Problems with self-concept.



Common Problems for Clients with Disabilities (continued)

Loss of control.

Loss of reward and pleasure.

Loss of independence (physical and economic).

Difficulty in adjusting to the disability.

Inability to access the environment.



Common Problems for Clients with Disabilities (continued)

Impaired social or vocational roles.

Changing family dynamics or relationships.

Disruption of social life.

Negative attitudes toward own disability.

Social rejection and social isolation.

Decreased sexual activity.



Adaptive Tasks to Help Clients Cope With Disabilities

Help clients deal with pain and incapacitation.

Help clients deal with stress.

Help clients manage negative feelings.

Help clients regain a positive self-image.

Help clients gain a sense of competence.



Adaptive Tasks to Help Clients Cope With Disabilities (continued)

Help clients change their lifestyle.

Help clients gain independence.

Help clients mange their relationships.

Prepare the client for an uncertain future if additional losses are likely.


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