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Journal of Mental Health Counseling
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Volume 31, Number 3, July 2009


1. Chronic Pain: Biological Understanding and Treatment Suggestions for Mental Health Counselors (Pages 189-200)

David Farrugia; Holly Fetter

Biopsychosocial factors related to chronic pain are discussed as a necessary foundation for understanding and helping clients who are in pain. Familiar evidence-based counseling approaches that have proven useful for working with clients who are in pain are reviewed to identify how practitioners can use their counseling skills to help these clients. Approaches reviewed are assessment considerations, use of psychotropic medications, cognitive-behavioral strategies, hypnosis and imagery techniques, family considerations, and positive psychology.
Full Article

2. Suicidal or Manipulative? The Role of Mental Health Counselors in Overcoming a False Dichotomy in Identifying and Treating Self-Harming Inmates (Pages 201-212)

Devon L. Cummings; Mindi N. Thompson

Suicide is a significant problem within jails and prisons. If self-harming inmates are labeled manipulative and therefore not treated, this may lead to their death, because research demonstrates that these “manipulative” individuals are at risk of suicide and need treatment. Attention to the role of mental health counselors in jails and prisons is therefore necessary. This paper discusses that role and ways to identify, assess, treat, and prevent suicides in jails and prisons. It provides suggestions for research on suicide assessment with incarcerated individuals who are considered manipulative.
Full Article

3. Psychological Differences in Shame vs. Guilt: Implications for Mental Health Counselors (Pages 213-224)

Stephen Parker; Rebecca Thomas

Recent work on the psychological distinctions between shame and guilt has important implications for mental health counselors. In particular, the work of Lewis (1971) and Tangney (1990, 1995; Tangney & Dearing, 2002) identifies psychological differences between shame and guilt and how they are phenomenologically expressed that provides helpful insight to those working with clients experiencing these emotions. This paper draws upon this work to establish criteria for distinguishing shame and guilt and to offer guidelines for their treatment.
Full Article

4. Using Puppets with Children in Narrative Therapy to Externalize the Problem (Pages 225-233)

Sue Butler; Jeffrey T. Guterman; James Rudes

A clinical application is presented for using puppets with children in narrative therapy to externalize the problem. A case example illustrates the clinical application. Implications for the practice of narrative therapy are considered.
Full Article

5. Supervising Trainees who Counsel Clients with Borderline Personality Characteristics: Implications for Training and Practice (Pages 234-248)

Laura Fazio-Griffith; Jennifer R. Curry

This article presents findings from an exploration of clinical supervisors’ perspectives of the process of supervising trainees who counsel clients with borderline personality characteristics. Six supervisors, from private practice settings, nonprofit agencies, and counseling and training centers, participated in three rounds of interviews. They explored the supervision process with trainees who counsel clients who exhibit these characteristics and the influence these characteristics had on the supervision process. Recommendations based on these findings are offered for supervision in clinical practice, counselor education, and training. 
Full Article

6. Influence of the Supervisory Working Alliance on Supervisee Work Satisfaction and Work-Related Stress (Pages 249-263)

William R. Sterner

This article presents an empirical study that identified agency supervisees’perceptions of clinical supervision and its influence on work satisfaction and work-related stress in professional settings. Because there is a paucity of literature addressing supervision of professional counselors, there is a need to better understand what influence supervision has beyond academic settings. Participants were 71 members of the American Mental Health Counseling Association who were selected using a criterion-based random sample methodology. The methodology pulls together a unique combination of variables and instruments for exploration with professional mental health counselors. Results revealed relationships between work setting, supervisees’ perceptions of the supervisory working alliance, work satisfaction, and work-related stress variables. Implications for practice, training, and research are discussed.
Full Article

7. The Experiences of Transgendered Persons in Psychotherapy: Voices and Recommendations (Pages 264-282)

J. Alison Bess; Sally D. Stabb

This study explored the therapeutic alliance and satisfaction between transgender clients and their therapists. The design was qualitative and heuristically based. Seven transgendered participants who had lived full-time as their non-natal gender for at least three months and who had spent at least the majority of a course of therapy discussing their current gender identity were recruited. Interviews were semistructured, and each was transcribed verbatim. Three levels of coding were used for analysis: seven individual depictions in narrative form, a single composite depiction bringing together similarities between the experiences of the participants, and a single exemplary depiction of critical themes. Results suggest that the participants did not experience many of the heterosexist, sexist, and pathologizing biases described in previous studies. Rather, they described supportive and affirming relationships with their therapists. Some participants had had negative experiences with previous therapists. Participants called for further training and education for therapists and other helping professionals. Implications for theory, research, practice, and policy are explored.
Full Article

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