Contemporary Counseling Psychology
Abstract and Keywords
Yogi Berra warned “It’s always risky to make predictions—especially about the future” (cited in Taylor, 2010, p. 218). Nonetheless, in this chapter, I reflect on five areas toward which the discipline of psychology is moving, that also are of importance to counseling psychology and counseling psychologists. These five directions include a focus on individual differences, a long tradition in counseling psychology, that is highlighted in the Handbook in the context of attention to diversity or under-represented populations or multicultural issues; globalization and internationalization and their increasing societal implications, for which counseling psychology is well positioned; the development of translational research, essential for closing the practice–research gap; technological advances that will dramatically change our science and our practice; and knowledge about neural mechanisms and genotypes that will have important implications for understanding interventions, processes, and outcomes in counseling psychology. These five areas are a thin slice of the emerging opportunities that the future will present for counseling psychology. In today’s parlance, ours is a nimble field, with practitioners, researchers, educators, and policy makers who have the skills and dexterity necessary to change with an evolving future and to continue to contribute to the well-being of society and to scientific knowledge.
Several themes that represent the bedrock, as well as the cutting edge, of counseling psychology emerge across almost every chapter prepared for this Handbook of Counseling Psychology. These themes, as explicated by the authors, are embedded in the historical links, the current status, and the future directions of their chapters. The most pervasive theme is a focus on individual differences—often presented in the context of attention to diversity or under-represented populations or multicultural issues. Also underlying each Handbook chapter is the core counseling psychology principle that values individual differences and promotes applications that focus on the individual or groups of individuals. Several chapters were commissioned specifically to focus on areas of diversity in which counseling psychology has been particularly visible. Other chapters point to counseling psychology’s diversity in research methodology. The diversity of the field of counseling psychology also is noteworthy in the range of settings populated and studied by counseling psychologists, as well as in the range of approaches to intervention that counseling psychologists employ.
As Baker and Subich noted (2008), counseling psychology was one of the first areas within applied psychology to devote attention to issues of diversity, social action, and justice; this tradition continues with diversity broadly defined. Although we know more than we did two decades ago, each chapter in the Handbook demonstrates that much work has yet to be done to understand fully the impact of diversity on counseling psychology’s interventions, assessment tools, theories, training, and research methods.
(p. 918) Undergirding all aspects of counseling psychology is the need for diversity training that informs both research and practice. Much has been written about—and guidelines have been developed to—create awareness of the need for multicultural competency of practitioners. But, a broad definition of diversity competency is needed to advance both research and practice. To engage in either domain in a space devoid of diversity competencies will not serve the profession well.
Global Counseling Psychology
In The World is Flat, Friedman (2005) articulated the ways in which technology, transportation, and communication have shrunk the world. The interconnectedness of the world affects individuals, families, human rights, social structures and cultural traditions, economies, and the corporate world. As Wrenn noted in The Counselor in a Changing World (1962), the professional skills of counseling psychologists will continue to evolve to meet new opportunities but, like early counseling psychologists, the professionals of the future will continue to help “people find a place in the world, regardless of their condition, physical, emotional or otherwise” (Baker & Subich, 2008, p. 19).
Migration, international trade, and technological advances in communications and travel are contributing factors to the globalization of counseling psychology. Although differences in roles and functions of counseling psychologists and in professional credentials exist across countries, counseling psychology is present worldwide (Heppner, Leong, & Gerstein, 2008; Hohenshil, 2010), and globalization and internationalization will be important ingredients in the future of counseling psychology. International collaborations and exchanges are occurring on research, practice, and training fronts. These projects are by definition complex and often require substantially more time to complete than do locally conducted projects. Nonetheless, the importance of international collaborations for counseling psychology’s knowledge base cannot be denied.
Counseling psychology’s investment in diversity and multicultural competency provides skills critical for international research, practice, and training. Listening, asking questions, developing relationships, and being nonjudgmental are those strengths of counseling psychology professionals essential to international collaborations. Participation in international conferences and seeking out international attendees at North American conferences provide opportunities to develop lasting partnerships that will lead to collaborative research, enhance the integration of multiple cultural viewpoints into practice and science, and provide learning and exchange opportunities on effective practice and research models. Promoting student and faculty exchange programs, rethinking and internationalizing the curriculum, the inclusion of migration and immigration in diversity discussions, the development of international definitions of practice competencies, and working with a worldwide community of practitioners and researchers, are among the grassroots efforts that can contribute to the internationalization of, and a global perspective for, counseling psychology (Belar, 2007; Miller, 2007). In many ways, the social justice movement advanced by counseling psychology, which seeks equal political, economic, and social rights and opportunities, goes hand in hand with a global perspective of counseling psychology.
Science and Practice
The integration of science and practice, an emphasis within counseling psychology for many decades, will continue to be important as the field strives to develop psychosocial interventions, to promote compliance with medical and safety procedures, and to promote growth in services to under-represented populations. In the same vein, defining and measuring effective outcomes will be essential both to demonstrate the way in which psychological treatment can reduce overall health care costs as well as to develop practice guidelines for counseling psychology (Gelso & Fretz, 2001).
One of the challenges for counseling psychology, one that ultimately will enhance the integration of science and practice, is to develop programs of translational research—simply put, the research needs to be translated into meaningful applications. Conversely, practitioner-driven research questions may serve to make research more relevant and may help to address demands for accountability and evidence-based intervention models (DeAngelis, 2010).
The Role of Technology
Technological advances already are having an influence on the research, training, and practice of psychology, and technology is going to continue to be a major driver in the future. Education has embraced digital classroom presentations (e.g. Smart Boards, PowerPoint, Keynote, Google Presentations), course management systems (e.g., Web Vista, Moodle), Facebook Groups, Ning, Skype, Portfolios (to hold and share academic materials), student response (p. 919) systems (i.e., clickers), Wimba Voice Tools (for audio-based discussions and testing), Wikis and Google docs (for collaborative writing), blogs, and Twitter—all of which were largely unavailable at the turn of the century. Technology also provides mechanisms for promoting academic integrity, such as TurnItIn to check academic integrity on papers and Respondus to lock-down browsers for online testing (personal communication, Jen Mein, September, 2010).
Inevitably, the impact of technology on counseling psychology practice and research will increase, whether the demand is for electronic record keeping or for psychological interventions (Martin, 2009). For example, the movement to digitize health care records to reduce costs and to improve patient care creates the need for counseling psychologists to use electronic health care records. All things electronic, of course, raise questions about security and data privacy and the need to develop tiered levels of access. The net effect of electronic health records may be to increase and enhance communications among health care professionals. This ease of communication may mean that counseling psychologists are more often included in patient treatment plans and, ultimately, more easily included in future health care systems, where they will work closely with physicians and other health care professionals (Chamberlin, 2009). Yet, for counseling psychologists who do not practice in an integrated health care setting, the cost of electronic records (i.e., technology challenges, security issues) may seem to outweigh the benefits.
Technology also has the potential to enhance counseling psychologists’ work with clients. Telepsychology—which includes video counseling, using technology such as Skype and language translation software, and employing e-mail to communicate with clients (Chamberlin, 2009)—will have a far-reaching impact on many aspects of practice. Although technology may bring psychotherapy to clients who would not otherwise have access to care, technology also raises questions about regulations for therapy across state or national borders, ethical and legal concerns about privacy, the need for electronic security measures, the coverage of malpractice insurance, and 24/7 expectations of clients.
Nonetheless, research is showing the potential for technology to advance the effectiveness of psychological treatment. Online interventions, for example, are being assessed for efficacy for such presenting problems as depression, panic disorder, anxiety, insomnia, and binge drinking prevention (Carlbring, Nilsson-Ihrfelt & Waara, 2005; Caspar & Berger, 2005; Clarke, Eubanks, & Reid, 2005; Kenwright & Marks, 2004; Mallen, Vogel, Rochlen, & Day, 2005; Moore, Soderquist & Werch, 2005; Strom, Petterson, & Anderson, 2004). The results also appear promising for online cognitive-behavioral interventions for adjustment of children after traumatic brain injuries (TBI; Wade, Carey, & Wolfe, 2006). As another example, virtual reality technology has been used in intervention studies to activate a person’s fear structure prior to reconditioning of the original frightening stimulus (Rizzo, 2009). Work is ongoing to determine if such virtual reality techniques may be effective for conditions, traditionally resistant to treatment, such as phobias, posttraumatic stress disorder, and panic disorder. Virtual reality therapy approaches, however, are not intended to be administered as self-help programs; rather, such interventions must be administered “within the context of appropriate care via a thoughtful professional appreciation of the complexity and impact of the disorders” (Rizzo, et al., 2009, p. 394). Both the practice and science of counseling psychology will play an important role in establishing the efficacy of technology-based interventions and in assuming that the techniques are administered in an ethical and professionally responsible manner.
Brain imaging technology, applied to the study of human behavior, has the potential to make tremendous contributions to knowledge about the biological bases of affective behavior. Functional magnetic resonance imaging (fMRI) research, which monitors the blood flow in the brain to portray neural activity (Conkle, 2009), provides the foundation for understanding relations among brain activity and emotions, personality, and even activity preferences (i.e., leisure and vocational interests). Often, the reaction to early work that attempted to identify regions of the brain related to psychological constructs was “so what?” Nonetheless, in 2001, Davidson predicted that “the science of emotion is likely to look very different a decade from now” (p. 29). Recent work using fMRI to study the personality of healthy adults (DeYoung et al., 2010) suggests that the progress Davidson predicted is occurring. And, with increased understanding of the biological basis of behavior, translation of science to application is happening.
Work in the arena of affective neuroscience is contributing, through the use of fMRI, to basic (p. 920) science knowledge about social variables that may influence brain development (Siegel, 1999), the biological basis of empathy (Decety & Jackson, 2004; Jackson & Decety, 2004), and depression (Davidson, Pizzagalli, Nitschke, & Putnam, 2002). Some fMRI work shows that, for culturally diverse groups (e.g., American and Korean participants), neural regions correlate with the experience of feeling persuaded (Falk et al., 2009). And research on the neural mechanisms underlying women’s math performance has been linked to research on stereotype threat (Krendl, Richeson, Kelley, & Heatherton, 2008). Although competing explanations have been presented (Gauthier, Tarr, Anderson, Skudlarski, & Gore, 1999), the work of Kanwisher and colleagues (1997; Epstein & Kanwisher, 1998; Downing, Jiang, Shuman, & Kanwisher, 2001) has identified regions of the brain that may process faces, visual scenes depicting places, and images of the human body. Similarly, areas of the brain hypothesized to specialize in thinking about what others are thinking (Saxe & Kanwisher, 2003) and that show brain sensitivity to social rejection (Drevets et al, 1997; Somerville, Heatherton, & Kelley, 2006) have been identified.
Thus, neuroscience is beginning to provide the framework necessary for understanding the relations between counseling interventions and efficacy, as well as interventions matched to client types and diagnoses. The developmental orientation of counseling psychology meshes well with neuroscience that has identified the ways in which changes over the lifespan have an impact on the development of the brain. Theories of neuroplasticity (the development of new neural networks) and neurogenesis (building of new neurons) suggest that counseling interventions may stimulate the development of new neural networks (Ivey, Ivey, & Zalaquett, 2007) and that knowing the neurocircuitry of clients and therapists eventually may help therapists to identify dysfunctional patterns and to tailor treatments to disorders (Good & Beitman, 2006). As fMRI technology improves and allows the brain to be viewed with increasing precision, work in neuroscience has the potential to provide knowledge about the circuitry that supports emotional processing, as well as an understanding of why interventions work and ways in which counseling psychologists can hone skills to understand what clients are feeling. Armed with this knowledge, counseling psychologists will be better able to develop models of intervention that match techniques with the responses of involved brain regions.
Mapping the human genome is another area of biological research that promises to advance understanding of psychological disorders and healthy behavior and to inform the development of interventions that capitalize on knowledge of gene–environment interactions (Reiss, 2010a, b). Gene–environment interactions (G × E) are defined as instances in which individual differences in sensitivity to specific environments are genetically influenced. Much behavior genetics research has concluded that population variance can be partitioned into separate additive and nonadditive genetic components and shared and nonshared environmental effects (Rutter & Silberg, 2002). A growing trend, however, is to recognize the role that gene–environment interactions play in sensitivity to risk and protective processes. For example, research with participants who are twins has found an association between adolescents’ risk for substance abuse and parental substance abuse (suggesting genetic risk) as well as a relation with affiliation with deviant peers (suggesting environmental risk). A significant interaction also was found, such that family risk was elevated in the presence of high environmental risk (implying G × E; Legrand, McGue, & Iacona, 1999).
Although continued research that studies psychological risks within the context of biological processes is needed to investigate behaviors that moderate the gene–environment connection, genetic analyses are beginning to inform interventions. The identification of gene-influenced sensitivities has led to research exploring the extent to which the genotypes of an individual moderate responsiveness (i.e., more or less responsive) to interventions (Leve, Harold, Ge, Neiderhiser, & Patterson, 2010). In the case of family interventions, for example, behavioral genetics research can provide an understanding of the role individual differences play in the adaptation of children to various environments and the way in which adaptation may vary during different developmental stages. This knowledge, in turn, can inform the design of preventive and treatment interventions. Research to better understand why some people benefit more from physical exercise than do others also has been linked to G × E interactions (Nicklas, 2010). The angiotensin-1 converting enzyme (ACE) gene appears to be associated with physical responses to exercise (e.g., individual differences in muscle strength improvement and endurance improvement for people engaged in combined walking and resistance exercise). Knowing a person’s genotype could lead to more effective (p. 921) interventions for motivating people to engage in exercise (or other healthy behaviors), under the assumption that people who respond positively to an intervention are likely to adhere to the treatment plan.
Integrating behavioral interventions and genetic analyses has the potential to lead to a better understanding of individual differences in response to interventions and thus, to more precise selections of interventions to match client diagnosis or client developmental or educational need. The time is opportune to move ahead with translational research that can inform intervention design and improve outcomes by identifying individuals who may benefit most from, or be harmed by, an approach (Plomin & Haworth, 2010).
The counseling psychology model of scientist–practitioner training—grounded in its traditions of assessment, individual differences, and a focus on strengths and assets (Hansen, 1995)—prepares counseling psychology professionals to apply their skills and knowledge to specialties that intersect with other subfields in psychology and to emerging areas within research and practice. This is evident in the work counseling psychologists do in specialties featured in Part Four: Applications—rehabilitation psychology, school-based counseling, health psychology, occupational health psychology, sport psychology, trauma research, and consulting psychology. Tyler, Tiedeman, and Wrenn (1980) noted that the “scientific and professional interests of members of Division 17 [counseling psychology] are multiple and complex”; it is not surprising that counseling psychologists are making important contributions to these areas that flow easily from the foundations of counseling psychology.
Given widespread access to cell phones, mobile devices, and wireless networks, technology-related issues may be at the forefront of emerging client presenting problems. Practitioners report increased incidence of Internet addiction and abuse, Internet pornography, impaired communication skills, information overload, cyber affairs, and cyber-bullying. A broad range of psychological, physical, and social trauma also is increasing demand for interventions and for research that provides an understanding of complicated interactions. Traumatic stress, for example, encompasses problems related to posttraumatic stress disorders following military combat as well as environmental emergencies such as hurricanes, tornadoes, and earthquakes. The psychological effects of institutional oppression and mental health issues related to job stress, including workplace violence, unemployment, and underemployment, also are on the upswing. Older adults, a rapidly increasing population, are increasingly amenable to mental health services. Correlated with these emerging issues is increased demand for skilled practitioners who use science to inform practice and researchers engaged in scientific inquiry who have the skills necessary to translate research results into applications (DeAngelis, 2008; Keita, 2010; Rollins, 2008). As argued in the beginning of this chapter and throughout the Handbook, the core and foundations of counseling psychology are especially well suited to the demand for scientific inquiry and interventions in these emerging areas.
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