Volume 32, Number 2, April 2010
1. Empathy and Sympathy: Therapeutic Distinctions in Counseling
Arthur J. Clark
At various times in the treatment process, mental health counselors may inadvertently equate the concepts
of empathy and sympathy. This confusion is understandable because there is ambiguity between
the two terms that could contribute to miscommunication in counseling. This article clarifies the therapeutic
distinctions between empathy and sympathy through the dimensions of aim, appraisal, apprehension,
2. Tablets or Talk? A Critical Review of the Literature Comparing Antidepressants and Counseling for
Treatment of Depression (Pages 102-124)
Brad Hagen; Gina Wong-Wylie; Em Pijl-Zieber
Antidepressants are generally considered to be the standard treatment for depression, despite a large
body of research evidence documenting the equal or superior efficacy of counseling. This article provides
a critical review of the literature comparing the efficacy of antidepressants and counseling for
adults with depression. Highlighted are several issues that must be considered when reviewing the literature,
including methodological problems, the placebo effect, trauma and depression, comparative
safety profiles, and the marketing of antidepressants. Implications for mental health counseling practice
and research, including the suggestion that counseling alone should be the first treatment of choice for
most persons with depression, are discussed.
3. Comorbidity of Bulimia Nervosa and Substance Abuse: Etiologies, Treatment Issues, and Treatment Approaches
Rebecca J. Carbaugh; Shari M. Sias
Recently the comorbidity of substance abuse and eating disorders has become a concern. Treating these
disorders is particularly important for bulimia nervosa, which is characterized by “binge eating and
inappropriate compensatory methods to prevent weight gain” (American Psychiatric Association, 2000,
p. 589). In this article we explore common pathways to the development of bulimia nervosa and substance
abuse, how treatment is begun, and treatment options (cognitive behavioral therapy/coping skills
training and dialectical behavioral therapy). A case study shows the application of coping skills training
and dialectical behavioral therapy in clinical practice.
4. Counseling Adult Women Survivors of Childhood Sexual Abuse: Benefits of a Wellness Approach (Pages 139-153)
Elizabeth A. Hodges; Jane E. Myers
Adult women survivors of childhood sexual abuse may face numerous lifelong challenges.
Recommended therapeutic interventions for survivors assume that the process of reliving and exploring
the abuse experience leads to psychological healing. Yet such therapeutic approaches may be traumatizing
for both client and counselor, and seem to be somewhat limited in affecting change in the numerous
areas of concern of many survivors. Strength-based wellness counseling interventions may help survivors
develop coping skills to enhance both overall quality of life and everyday functioning across multiple
domains, while also providing a healthy foundation from which to explore and reframe their abuse
experiences. A case example demonstrates this approach.
5. The Effects of Self-Construal and Masculinity vs. Femininity: A Comparison of American and Japanese Attitudes Toward Mental Health Services
This study investigated how interdependent/independent self-construals (SC) and masculinity or femininity
moderated Japanese and American college students’attitudes toward mental health services. Data
were analyzed from a survey that asked 316 American students (122 men and 194 women) and 362
Japanese students (147 men and 215 women) about their attitudes toward seeking professional help,
their sense of self in relation to others, and their level of masculinity or femininity. Japanese and male
participants tended to hold more negative help-seeking attitudes than did American and female participants.
In both countries individuals with independent SC held positive attitudes. However, the roles of
interdependent SC and masculinity/femininity were different for Japanese and American participants.
While previous studies indicated that SC and gender have predictive roles, mental health counselors
should be aware that other factors, such as indigenous beliefs about mental illness, may explain the
national difference in help-seeking attitudes. Implications for mental health professionals are addressed.
6. Faculty and Student Curricular Experiences of Nonerotic Touch in Counseling (Pages 168-185)
David Burkholder; Michele Toth; Kevin Feisthamel; Paula Britton
This phenomenological study explored both faculty and student curricular experiences of nonerotic
touch in counseling. Data analysis demonstrated that counselor educators experienced uncertainty and
apprehension in training students on the use of nonerotic touch. Students received inadequate training
and internalized an assortment of conceptualizations about whether to touch in counseling, which
caused them confusion, frustration, and insecurity. The emergent themes of this research mirrored
empirical and theoretical research and strengthened the case for improving the training mental health
counselors receive on the topic of nonerotic touch.