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Foundations: autonomy (confident/trust), beneficence (do good, client wellbeing), nonmaleficence (do

no harm, be qualified, avoid dual R), justice (fairness/equity, challenge bias, pro bono), fidelity
(keeping promises/commitment, honest/loyal, advocate)
Confidentiality exceptions: abuse, suicide, intent to harm others, legal orders, insurance
Dual relationships: prosecution, liability costs, 2-5 yr limit, roles, suicide risk, boundaries
Ethics governance: APA/AAMFT and ACA time limits/code of ethics, licensing, rules
Unethical colleague: consult ACPA guidelines, private convo, institutional resources, ethics committee
Environment: private/soundproof/accessible/flexible/furniture/soothing/cult approp/décor/no barriers
Non-verbal: open body language, smiling, headnod, eyecontact, hand movements, warmth, interest
5 verbal responses: Continue (yes/mmhmmh/I see/keep talking), Focus (say more about topic/more
info), Check (reflect/paraphrase), Open vs Closed Q, Switch (change topic)
Empathy: understand the clients exp, but keeping those exp separate from you. Continuum:
subtractivebasicadditive. not all clients respond to empathy the same. used in PCT.
PCT: belief in client’s subjective experience. organismic valuing process & self actualization (trust
client to reach their potential/enhance life). Goals: focus on client not problem. client is responsible for
achieving goals. provide conducive climate to help client be fully functioning. Client probs:
helpless/powerless, can’t make decisions, negative thoughts/emotions. Core conditions: congruence,
unconditional pos reg, accurate empathy. Applications: deep, genuine, caring, focus on here&now,
nonverbals, silence, restating. Strengths=impact on HR globally, empathy, therapist doesn’t act like
expert, emphasize client-cnlr relationship & use of clients own resources. Limitations=lack of
structure, hard to translate core conditions to some groups, cultural barriers
CBT: rational or irrational thinking, self-defeating patterns stunt us, we don’t need to be
loved/accepted. maladjustment: musturbation (moving from wishes/desires to
necessities/shoulds/oughts/musts). Process: taught to accept themselves, point out irrational beliefs,
thoughts relate to emotions, modify thinking, focus on now. Therapist uses persuasion/teaching, not
overly warm/understanding. Client does hw, relax techniq, modeling, roleplaying Strengths=culturally
sensitive, collaborative, individualized Tx, empirically supported, wide application. Limits=clients not
wanting to question cultural values, neg view of dependency, ignore indiv factors
Statistics: suicide is 2nd cause of death. 16% of students have dep. 60%w, 40%m
Acad challenges: testing accommodation, test anxiety, more time, medications,
SAP challenges: policy issues, lack of campus services, parental understanding
Soet & Sevig: grad students=high dep rate, large increase of students using counseling, top 5 reasons:
dep/ED/adhd/anxiety/ptsd. “You are not alone” tactic. Universities need more data to assess better.
grad schools should develop policy/initiatives to cope with stress
Major impediments: stress, anxiety, sickness (cold/flu) family, finances, lack of sleep, anger, dep
Solutions: educate about resources/policies/procedures. provide guidance on how to deal with this
population. administrators go through counseling training. referral system.
Tarasoff: if a client says they will harm someone, counselor must tell that person
MCC: increase in stud diversity, complex cultural dynamics on campus, SAP need to be inclusive
3 MCC parts: knowledge (what you know about cultural groups), awareness (values, attitudes,
assumptions), skills (behaviors/actions that help us be aware)
CC counseling relationships: expands awareness for both parties
Barriers: stigmas against mental health, don’t see therapists like them, under utilization of services,
language barriers, access to services and resources due to economic, lack of culturally relevant
counseling
Steps/strategies: be culturally competent in KSA, keep in mind the barriers/challenges of ethnic clients,
no assumptions, utilize ACA guidelines and colleagues, be comfortable/know yourself

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