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.
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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.
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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.
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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.
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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.
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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.
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Counseling Special Populations
Problems Faced by Gay, Lesbian and Bisexual Clients
 Cultural Homophobia
 Cultural Heterosexism
 Internalized Homophobia
 Homophobia and Heterosexism in Counselors
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Counseling Special Populations
Identity Development of Gay, Lesbian and Bisexual Clients
 Identity confusion
 Identity conflict
 Identity denial
 Community identity
 Coming out or not
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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
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Counseling Special Populations
Special Situations in Counseling for Gay, Lesbian and
Bisexual Clients (continued)
 Loneliness
 Guilt
 Depression
 Suicide
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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.
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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.
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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
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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.
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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?
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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