Counseling 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”

Counseling Special Populations 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 Special Populations 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. “Copyright © Allyn & Bacon 2004”

Counseling Special Populations 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. “Copyright © Allyn & Bacon 2004”

Counseling Special Populations 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 Special Populations 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. “Copyright © Allyn & Bacon 2004”

Counseling Special Populations Problems Faced by Gay, Lesbian and Bisexual Clients  Cultural Homophobia  Cultural Heterosexism  Internalized Homophobia  Homophobia and Heterosexism in Counselors “Copyright © Allyn & Bacon 2004”

Counseling Special Populations Identity Development of Gay, Lesbian and Bisexual Clients  Identity confusion  Identity conflict  Identity denial  Community identity  Coming out or not “Copyright © Allyn & Bacon 2004”

Counseling Special Populations 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 “Copyright © Allyn & Bacon 2004”

Counseling Special Populations Special Situations in Counseling for Gay, Lesbian and Bisexual Clients (continued)  Loneliness  Guilt  Depression  Suicide “Copyright © Allyn & Bacon 2004”

Counseling Special Populations 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. “Copyright © Allyn & Bacon 2004”

Counseling Special Populations 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. “Copyright © Allyn & Bacon 2004”

Counseling Special Populations 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 “Copyright © Allyn & Bacon 2004”

Counseling Special Populations 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. “Copyright © Allyn & Bacon 2004”

Counseling Special Populations 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? “Copyright © Allyn & Bacon 2004”

Counseling Special Populations 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. “Copyright © Allyn & Bacon 2004”

Counseling Special Populations 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. “Copyright © Allyn & Bacon 2004”

Counseling Special Populations 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. “Copyright © Allyn & Bacon 2004”

Counseling Special Populations 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. “Copyright © Allyn & Bacon 2004”

Counseling Special Populations 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. “Copyright © Allyn & Bacon 2004”

Counseling Special Populations 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. “Copyright © Allyn & Bacon 2004”

Counseling Special Populations 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. “Copyright © Allyn & Bacon 2004”