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Preface vii

In Chapter 2, “Professional Counseling Organizations, Licensure, Certification, and Accreditation,” by Joshua C. Watson, Bradley T. Erford, and Grafton T. Eliason, students are introduced to the American Counseling Association (ACA) and its divisions, branches, and professional partners so that students can become familiar with the wide array of professional associations advocating for counselors and clients. This chapter offers a glimpse of the many credentials that professional counselors can earn. An overview of state licensure, national certification, and counselor education program accreditation processes (e.g., CACREP and CORE) is provided to answer student questions early and to make students aware of the choices that exist for future professional credentialing. Various accountability mechanisms found at the state level for educational systems and mental health agencies are also reviewed.

Section One ends with Chapter 3, “Ethical and Legal Issues in Counseling,” by Lynn E. Linde and Bradley T. Erford. The chapter is a comprehensive introduction to ethical and legal issues in counseling practice, covering new editions of the ACA and ASCA ethical codes, confidentiality, privilege, subpoenas, malpractice, records and personal notes, child abuse, suicide, HIPAA, FERPA, minor consent, and ethical decision making. A professional counselor must always remember that how one conducts oneself personally and professionally reflects not only on oneself, but also on one’s colleagues.

Section Two, “Counseling Processes and Approaches,” provides an in-depth review of counseling theories, process, and skills. Chapter 4, “Theories of Counseling,” by Bradley T. Erford and Ann Vernon, portrays the nature and quality of the counseling relationship as more significant than any other factor in counseling. Regardless of the setting, and whether they are working with individuals, families, or groups, counselors have a professional responsibility to develop a foundation and clear rationale for their theoretical orientation to serve clients best.

Professional counselors operate out of theories that best fit their personal philosophies of human change and the counseling process. Chapter 4 highlights the significance of theory to counseling practice and provides a brief overview of the major theoretical paradigms. Students will also explore their own beginning preferences for theoretical orientation with the intent of continuing their personal and professional exploration to discover their personal style.

Chapter 5, “The Counseling Process,” by Donna S. Sheperis, orients students to counseling processes and approaches, providing a brief overview of the stages of the counseling process and approaches to helping clients. The counseling process embodies the art and science of helping. Professional counselors bring their training, experience, and personalities into the process. Once initiated, counseling occurs over a series of stages that includes information gathering and the application of theory to generate relevant goals, treatment, assessment, and termination. In Chapter 5, students beginning the path to becoming professional counselors are encouraged to consider their fit with the process and profession of counseling.

Chapter 6, “Counseling Microskills,” by Joseph B. Cooper, provides an overview of the fundamental skills that constitute the key elements of effective helping relationships.

The skills in this chapter focus on Ivey, Ivey, and Zalaquett’s’s (2013) microskills hierarchy.

At the heart of this hierarchy is the basic listening sequence, an interrelated set of skills that not only fosters the development of rapport with clients, but also aids in the identification of interventions to help achieve a successful resolution to the clients’ presenting concerns.

Examples of the skills in use, along with practice exercises to foster individual skill development, are provided.

Section Three, “Client Issues and Advocacy,” explores the knowledge, skills, and attitudes required of the counselor when working with clients across the life span and with

viii Preface

common presenting problems (e.g., substance use, eating disorders, behavioral difficulties, crisis intervention), as well as multicultural competence, consultation, and supervision.

Chapter 7, “Crisis Prevention and Intervention,” by Judith Harrington and Charlotte Daughhetee, recognizes that crises, suicide and homicide continue to play increasingly important roles in American society and on the world stage. Suicide and homicide affect us personally as we, family members, friends, and those in extended social networks struggle with the ever-increasing challenges of modern life. The effectiveness of the care given by professional emergency first responders, as well as the effectiveness of ordinary people in responding to their own crises and the crises of those about whom they care, is improved by background knowledge involving current trends in and treatments for suicidal and homicidal impulses.

Chapter 8, “Mental Health and Rehabilitation Counseling,” by Catherine Y. Chang, Amy L. McLeod, and Nadine E. Garner, provides a broad overview of the general mental health settings and client issues (i.e., drug and alcohol counseling, mental health counseling, career counseling, and rehabilitation counseling). The field of counseling is becoming increasingly specialized, with certifications and licensures available for addictions counselors (National Certified Addictions Counselor [NCAC]; Master Addiction Counselor [MAC]), mental health counselors (Licensed Professional Counselor [LPC]—term may vary depending on the state), career counselors, and rehabilitation counselors (Certified Rehabilitation Counselor [CRC]). Although these areas are not distinct, and clients may enter counseling with a mental health, substance use, career, or rehabilitation issue, or any combination of the four, it is important for professional counselors to have a basic understanding of each area.

Chapter 9, “School, College, and Career Counseling,” by Nadine E. Garner, Jason Baker, and Molly E. Jones, describes the unique characteristics of working as a professional counselor in the increasingly multicultural settings of elementary and secondary schools; college and university campuses; and career counseling.

Chapter 10 “Human Development Throughout the Life Span,” by Bradley T. Erford briefly describes developmental characteristics of infancy and toddlerhood (birth to age 3 years); early childhood (ages 4 to 6 years); middle childhood (ages 6 to 11 years); early adolescence, midadolescence, and later adolescence (ages 11 to 24 years); young adulthood (ages 24 to 40 years); middle adulthood (ages 40 to 60 years); and later adulthood (ages 60 years and older). The information in these approximate age categories serves as a basis for examples of interventions that helping professionals can use to facilitate development at several of these stages.

In Chapter 11, “Multicultural Counseling,” by Geneva M. Gray, multicultural counseling applications are reviewed to help students integrate principles of cultural diversity into the counseling process from the beginning of their training. This chapter features multicultural applications of identity development and counselor competency (multicultural implications are highlighted throughout the other chapters of the text too). Cultural identity developmental processes and culturally specific information and intervention strategies are presented across the cultural dimensions of socioeconomic status, race, ­ethnicity, gender, sexual orientation, spirituality, ability level, and age.

Chapter 12, “Assessment, Case Conceptualization, Diagnosis, and Treatment ­Planning,” by Bradley T. Erford, reviews each of these major counseling tenets. Assessment is the systematic gathering of information to address a client’s presenting concerns effectively. A case conceptualization reflects how the professional counselor understands the nature of the presenting problems and includes a diagnostic formulation. Treatment plans outline counseling outcome expectations and interventions to meet these expectations.

Preface ix

In Chapter 13, “Supervision and Consultation,” by Mark A. Young and Alan Basham, an introduction to supervision and consultation is provided to help students understand the theory and practical applications of these two essential counselor roles. In particular, the chapter helps counselors in training understand how to get the most out of their relationships with supervisors and understand what will be expected of them as future supervisors to the next generation of counselors in training. Models, techniques, types of activities, and important skills used to fulfill the role of consultant or supervisor are presented.

An innovative facet of this text is the integration of advocacy counseling and the introduction of professional advocacy strategies. Chapter 14, “Advocating for the Counseling Profession,” by Amy Milsom, answers important questions about advocacy counseling, including: “What does it mean to advocate for the counseling profession?” “Why is professional advocacy important?” “In what ways can professional counselors advocate for the profession?” Counselors can best serve their clients by advocating for a strong professional presence in the public and legislative venues. A positive view of the counseling profession by citizens and legislators helps remove barriers for clients and promotes the worth and dignity of diverse individuals.

In addition, obtaining social justice for clients demands that professional counselors understand and practice advocacy counseling according to the standards developed by the ACA. Chapter 15, “Advocacy Counseling: Being an Effective Agent of Change for ­Clients,” by Donna M. Gibson, proposes that the core purpose of advocacy counseling is to address external barriers that interfere with human development. Although this purpose can be met by advocating for the profession of counseling, it is often met by advocating at the individual client level. Through an examination of the advocacy competency domains (Ratts et al., 2015), specific guidelines are provided on how to increase clients’ empowerment and how to be a successful advocacy counselor.

Section Four, “The Effectiveness of Counseling,” addresses the crucial issues of accountability and outcome in counseling. The future of the counseling profession lies in the ability of counselors to show that counseling practices are effective in helping clients reach their stated goals. Counselors in training need to learn to conduct needs assessments, outcome studies, and program evaluation to determine what services are needed, and the effects of those services. Chapter 16, “Accountability in Counseling,” by Bradley T. Erford, proposes that accountability is a central responsibility of all professional counselors. At its core, accountability shows the effect that a professional counselor has in producing changes in clients and program stakeholders. The process of outcome studies is approached from traditional research methods perspectives and contemporary perspectives, including action research and single-subject research designs.

Counselors also need to realize that a great wealth of extant literature exists to inform their daily counseling practice with clients. This literature is reviewed in Chapter 17, “­Outcome Research in Counseling,” by Bradley T. Erford, to bolster the students’ knowledge of what does and does not work in counseling, and so counselors can use effective counseling interventions. Professional counselors have an ethical responsibility to use counseling methods grounded in theory and empirically validated through research. It is now known that counseling is effective in many forms and for many client conditions.

Chapter 17 reviews research on the effectiveness of counseling in several areas: client– counselor characteristics, individual approaches, group approaches, career intervention, and school-based student interventions. This body of information should be used by professional counselors to inform their practice and increase treatment efficacy.

x Preface

Orientation to the Counseling Profession: Advocacy, Ethics, and Essential Professional Foundations provides a wealth of information on the most foundational and emerging issues of the counseling profession. It was specifically designed to orient counselors in training, regardless of specialty area, to the profession of counseling that we have all dedicated our careers and lives to improving. Enjoy!

Supplemental Instructional Features Supplemental to this text are pedagogical tools helpful to counselor educators choosing to use this text as a course text. The companion Instructor’s Resource Manual with Test Bank contains at least 50 multiple choice questions and 20 essay questions per chapter. Numerous case studies and activities included in the text can stimulate lively classroom discussions. PowerPoint® lecture outlines are also available. Instructor supplements can be downloaded from the Instructor Resource Center at www.pearsonhighered.com.

Also available with MyCounselingLab® This title is also available with MyCounselingLab—an online homework, tutorial, and assessment program designed to work with the text to engage students and improve results. Within its structured environment, students see key concepts demonstrated through video clips, practice what they learn, test their understanding, and receive feedback to guide their learning and ensure they master key learning outcomes.

• Learning Outcomes and Standards measure student results.

MyCounselingLab organizes all assignments around essential learning outcomes and national standards for counselors.

• Video- and Case-Based Exercises develop decision-making skills.

Video- and Case-based Exercises introduce students to a broader range of clients, and therefore a broader range of presenting problems, than they will encounter in their own pre-professional clinical experiences. Students watch videos of actual client-therapist sessions or high-quality role-play scenarios featuring expert counselors. They are then guided in their analysis of the videos through a series of short-answer questions. These exercises help students develop the techniques and decision-making skills they need to be effective counselors before they are in a critical situation with a real client.

• Licensure Quizzes help students prepare for certification.

Automatically graded, multiple-choice Licensure Quizzes help students prepare for their certification examinations, master foundational course content, and improve their performance in the course.

• Video Library offers a wealth of observation opportunities.

The Video Library provides more than 400 video clips of actual client-therapist sessions and high-quality role plays in a database organized by topic and searchable by keyword. The Video Library includes every video clip from the MyCounselingLab courses plus additional videos from Pearson’s extensive library of footage. Instructors can create additional assignments around the videos or use them for in-class activities. Students can expand their observation experiences to include other course areas and increase the amount of time they spend watching expert counselors in action.

Acknowledgments All of the contributing authors are to be commended for lending their expertise in the various topical areas. As always, Kevin Davis of Pearson has been wonderfully responsive and supportive. At Aptara, thanks go to the production team (Sudip Sinha, Production Project Manager; Ramesh Rawat, Production Lead). Finally, special thanks go to the outside reviewers whose comments helped to provide substantive improvement to the original manuscript: Maria D. Avalos, University of Texas of the Permian Basin; Laura Choate, Louisiana State University; Pit Kolodinsky, Northern Arizona University; Kara P. Ieva, Rowan University; and Waganesh Zeleke, Duquesne University.

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Brief Contents Section One

Foundations of Professional Counselor Identity Chapter 1

Chapter 2

Chapter 3

Section Two

Chapter 5 Chapter 6

Section Three

Becoming a Professional Counselor: Philosophical, Historical, and Future Considerations ■ Bradley T. Erford and Gerta Bardhoshi 3 Professional Counseling Organizations, Licensure, Certification, and Accreditation ■ Joshua C. Watson, Bradley T. Erford, and Grafton T. Eliason 35 Ethical and Legal Issues in Counseling ■ Lynn E. Linde and Bradley T. Erford 70

Counseling Processes and Approaches Chapter 4

1

113

Theories of Counseling ■ Bradley T. Erford and Ann Vernon 115 The Counseling Process ■ Donna S. Sheperis 160 Counseling Microskills ■ Joseph B. Cooper 192

Client Issues and Advocacy

217

Chapter 7

Crisis Prevention and Intervention ■ Judith Harrington and Charlotte Daughhetee 219 Chapter 8 Mental Health and Rehabilitation Counseling ■ Catherine Y. Chang, Amy L. McLeod, and Nadine E. Garner 249 Chapter 9 School, College, and Career Counseling ■ Nadine E. Garner, Jason Baker, and Molly E. Jones 280 Chapter 10 Human Development Throughout the Life Span ■ Bradley T. Erford 311 Chapter 11 Multicultural Counseling ■ Geneva M. Gray 337 Chapter 12 Assessment, Case Conceptualization, Diagnosis, and Treatment Planning ■ Bradley T. Erford 373 Chapter 13 Supervision and Consultation ■ Mark A. Young and Alan Basham 406 Chapter 14 Advocating for the Counseling Profession ■ Amy Milsom 435 Chapter 15 Advocacy Counseling: Being an Effective Agent of Change for Clients ■ Donna M. Gibson 458

Section Four

The Effectiveness of Counseling

487

Chapter 16 Accountability in Counseling ■ Bradley T. Erford 489 Chapter 17 Outcome Research in Counseling ■ Bradley T. Erford 520 xii

Contents About the Editor xxvi About the Authors xxviii

Section One

Foundations of Professional Counselor Identity

1

Chapter 1 Becoming a Professional Counselor: Philosophical, Historical, and Future Considerations ■ Bradley T. Erford and Gerta Bardhoshi

3

Preview 3 Counseling and Professional Counselors: Where We Are 3 How Do Counselors Differ from Psychologists and Social Workers? 6 The Philosophical Underpinnings of Counseling 7 How We Got Here: People, Issues, and Societal Forces That Have Shaped the Counseling Profession 9 1900–1920 9 1921–1940 15 1941–1960 17 1961–1980 18 1981–2000 19 2001–Present 20 Where We Are Going 22 Evidence-Based Practices, Research-Based Practices, and Outcomes Research 22 Managed Care 23 Multiculturalism, Diversity, and Social Justice Counseling 24 Technology 25 Gatekeeping 26 Professional Advocacy and Social Advocacy Counseling 26 Mentoring and Leadership Training 29 Bonding and Splintering of Facets of the Counseling Profession 29 Developing a Commitment to Career-long Wellness 30 Summary

34

Chapter 2 Professional Counseling Organizations, Licensure, Certification, and Accreditation ■ Joshua C. Watson, Bradley T. Erford, and Grafton T. Eliason 35 xiii

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Preview 35 Professional Counseling Organizations 35 American Counseling Association 36 American Counseling Association Divisions 39 American College Counseling Association 40 American Mental Health Counselors Association 41 American Rehabilitation Counseling Association 41 American School Counselor Association 41 Association for Adult Development and Aging 41 Association for Assessment and Research in Counseling 42 Association for Child and Adolescent Counseling 42 Association for Counselor Education and Supervision 42 Association for Creativity in Counseling 43 Association for Humanistic Counseling 43 Association for Lesbian, Gay, Bisexual, and Transgender Issues in Counseling 43 Association for Multicultural Counseling and Development 44 Association for Specialists in Group Work 44 Association for Spiritual, Ethical, and Religious Values in Counseling 44 Counselors for Social Justice 45 International Association of Addictions and Offender Counselors 45 International Association of Marriage and Family Counselors 45 Military and Government Counseling Association 45 National Career Development Association 46 National Employment Counseling Association 46 American Counseling Association Regions and Branches 48 Other Essential Professional Counseling Organizations 50 American Counseling Association Foundation 50 Chi Sigma Iota 50 Council for Accreditation of Counseling and Related Educational Programs 51 Council on Rehabilitation Education 51 National Board for Certified Counselors 51 Professional Development 51 Benefits of Joining Professional Counseling Organizations 52 Additional Benefits for Professional Counselor Members 52 The American Counseling Association Member Services Committee 53

Contents xv

Additional Benefits for Student Members 53 Ethical Standards 54 Legislative Advocacy 54 Supporting the Mission of the Profession 54 Relationship Between the American Counseling Association and the American Psychological Association 56 Some Key Challenges That Need to be Addressed by Counseling Professionals 56 National Accreditation 58 International Efforts at Program Registry 60 State Accreditation 60 State Professional Certification and Other Credentials 60 State Licensure 61 Education 62 Supervised Experience 62 Examination 63 American Association of State Counseling Boards 63 License Portability 64 Certification/Licensure for Professional School Counselors 64 Benefits and Drawbacks of Counseling Licensure 65 National Certification 65 Commission on Rehabilitation Counselor Certification 66 Summary

68

Chapter 3 Ethical and Legal Issues in Counseling ■ Lynn E. Linde and Bradley T. Erford 70 Preview 70 Ethical Standards and Laws 70 American Counseling Association Code of Ethics 72 The Practice of Internet or Technology-Assisted Distance Counseling 83 American School Counselor Association Ethical Standards for School Counselors 83 Decision Making Using Ethical Standards 85 Additional Sources of Information and Guidance: Courts, Laws, and Regulations 91 Court System 91 Statutory Law 92 State and Local Agencies: Regulations and Policies 92 Making Decisions 93 Additional Legal Considerations 95

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Professional Competence 95 “Can I Be Sued?” and “What Is Malpractice?” 96 Subpoenas 98 Confidentiality 100 Limits to Confidentiality 101 Confidentiality and Privileged Communication 102 Minor-Consent Laws 103 Records and Personal Notes 104 Educational Records 104 Personal Notes 108 The Health Insurance Portability and Accountability Act (HIPAA) of 1996 109 Child Abuse 109 Suicide 110 Summary

Section Two

112

Counseling Processes and Approaches

Chapter 4 Theories of Counseling ■ Bradley T. Erford and Ann Vernon 115 Preview 115 The Significance of Theory 115 Ethics of Applying Counseling Theory 116 What Makes a Good Theory? 117 Theoretical Paradigms 117 Psychodynamic Paradigm 121 Humanistic/Existential Paradigm 125 Behavioral/Cognitive-Behavioral Paradigm 127 Family Systems Paradigm 136 Emergent Theories 142 Applying Theory to Practice 151 View of Human Nature 152 Goals of Counseling 153 Role of the Professional Counselor 153 Techniques and Approaches 153 Flexibility 154 Theoretical Integration 155 Integrative versus Eclectic Counseling 155 Why an Integrative Approach? 156 Summary

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Contents xvii

Chapter 5 The Counseling Process ■ Donna S. Sheperis 160 Preview 160 The Professional Counselor 160 Counselor Characteristics 161 Common Issues for the Beginning Counselor 162 Client Characteristics 164 Cross-Cultural Counseling Competence 165 Basic Counseling Paradigm 166 The Counseling Process and Stages of Change 166 The Helping Process—The Helping Relationship 168 The Art of Helping 168 Helping as a Science 169 Common Factors in Helping 170 What Brings Clients to Counseling? 171 Initiating Counseling 174 Counseling Environment 174 Helping Relationship 175 Role of Theory 177 Structure of Counseling 178 Informed Consent 178 Information Gathering 179 Exploring and Working Together 180 Goal Setting and Positive Counseling Outcomes 182 What Happens When Change Does Not Happen? 183 Integration and Termination 185 Becoming a Professional Counselor 188 Personal Strengths and Challenges 188 Summary

191

Chapter 6 Counseling Microskills ■ Joseph B. Cooper 192 Preview 192 Essential Counseling Microskills 192 Attending Skills 193 Eye Contact 193 Body Position 194 Vocal Tone 195 Basic Listening Sequence 196 Open and Closed Questions 197

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Reflecting Skills 201 How to Reflect Meaning 210 Summary

Section Three

216

Client Issues and Advocacy 217

Chapter 7 Crisis Prevention and Intervention ■ Judith Harrington and Charlotte Daughhetee Preview 219 Crisis Theory 219

219

Concepts 222 Resilience and Post-Traumatic Growth 224 Counselor Safeguards: Professional Burnout, Compassion Fatigue, Secondary Traumatic Stress, Vicarious Trauma, and Transcrisis 227 Crisis Counseling 232 How Does Crisis Counseling Differ from Traditional Counseling? 232 Ethical Considerations 232 Risk Assessment: Suicide and Homicide 234 Significance of the Problem 234 Principles of Assessment 236 Suicide Risk Assessment 237 Clinical Interview Modality 237 Homicide Assessment 238 Intimate Partner Violence 243 Child and Elder Abuse 243 Special Topics in Crisis Intervention and Prevention 244 Community Disasters 244 School System Adaptions 245 Safety Concerns 247 Summary

248

Chapter 8 Mental Health and Rehabilitation Counseling ■ Catherine Y. Chang, Amy L. McLeod, and Nadine E. Garner Preview 249 Counseling Career Choices 249 Counseling in Mental Health Settings 250 Background 250 Community/Agency Setting 251 Hospitals 252 Corrections 254

249

Contents xix

Private Practice 255 Marriage and Family Counselors 257 Pastoral Counseling 257 Wilderness Therapy 258 Mental Health Counseling Issues 259 Depression 259 Anxiety 261 Eating Disorders 262 Addictions 263 Drug and Alcohol Treatment Approaches 264 Alcohol and Drug Use Issues in Special Populations 266 Rehabilitation Counseling 269 Summary of Rehabilitation Laws 270 Disability Eligibility and Demographics 272 Adaptation to Disability 274 Rehabilitation Counseling and Technology 274 Vocational Rehabilitation Counseling 275 Multicultural and Social Justice Issues in Rehabilitation Counseling 276 Summary

278

Chapter 9 School, College, and Career Counseling ■ Nadine E. Garner, Jason Baker, and Molly E. Jones 280 Preview 280 Counseling in the Schools 280 Background 280 Elementary Counseling 281 Middle School/Junior High Counseling 282 High School Counseling 283 Current Issues Affecting All School Counseling Settings 283 Multicultural and Social Justice Issues in Schools 286 College/University Counseling and Student-Life Services 289 Background 289 College and University Counseling 290 Student-Life Services 293 Counseling College and University Students Who Have a Disability 296 Multicultural and Social Justice Issues in College Counseling and Student-Life Services 297

xx Contents

Career Counseling Issues 298 Major Theories of Career Development 299 Technology Use and Career Resources 308 Social Justice Issues in Career Counseling 309 Summary

310

Chapter 10 Human Development Throughout the Life Span ■ Bradley T. Erford 311 Preview 311 Counseling and Human Development: A life span perspective Infancy and Toddlerhood 314

311

Motor Development in Infancy and Toddlerhood 314 Emotional Development in Infancy and Toddlerhood 315 Cognitive/Language Development in Infancy and Toddlerhood 315 Early Childhood 316 Social Development in Early Childhood 316 Emotional Development in Early Childhood 316 Cognitive Development in Early Childhood 317 Developmental Interventions in Early Childhood 318 Middle Childhood 319 Social Development in Middle Childhood 319 Emotional Development in Middle Childhood 319 Cognitive Development in Middle Childhood 320 Developmental Interventions in Middle Childhood 321 Adolescence 321 Early Adolescence 321 Developmental Interventions in Early Adolescence 323 Midadolescence 324 Developmental Interventions in Midadolescence 325 Late Adolescence (Emerging Adulthood) 326 Developmental Interventions in Late Adolescence (Emerging Adulthood) 327 Early Adulthood 328 The Worker in Early Adulthood 328 The Partner in Early Adulthood 328 The Parent in Early Adulthood 329 Developmental Interventions in Early Adulthood 329 Middle Adulthood 330 Physical Changes in Middle Adulthood 330 Cognitive Changes in Middle Adulthood 330

Contents xxi

Key Developmental Tasks in Middle Adulthood 331 Developmental Interventions in Middle Adulthood 332 Later Adulthood 332 Accepting Life in Later Adulthood 333 Redirecting Energy to New Roles and Activities in Later Adulthood 333 Physical Changes in Later Adulthood 333 Cognitive Changes in Later Adulthood 334 Dealing with Loss in Later Adulthood 334 Developmental Interventions in Later Adulthood 334 Summary

336

Chapter 11 Multicultural Counseling ■ Geneva M. Gray 337 Preview 337 Multiculturally Competent Counseling 337 Key Issues in Multicultural Counseling 340 Etic versus Emic Debate 340 How Much of Counseling Is Multicultural? 340 Assessment and Treatment 341 Evidence-Based Practices in Multicultural Counseling 342 Cultural Identity Development and Multicultural Counseling 342 Cultural Identity Development Models 344 Racial and Ethnic Identity Development 345 Feminist Identity Development 348 Sexual Identity Development 348 Spiritual Identity Development 349 Counseling Culturally Diverse Individuals 350 Socioeconomic Status and Poverty 350 Racial and Ethnic Diversity 352 Gender 358 Sexual Minorities 361 Spirituality 363 Counseling Individuals with Disabilities 367 Counseling the Elderly 368 Social Justice in Counseling 368 Multicultural Organizational Development: Creating a Culturally Sensitive Environment 369 Summary

371

xxii Contents

Chapter 12 Assessment, Case Conceptualization, Diagnosis, and Treatment Planning ■ Bradley T. Erford 373 Preview 373 A Comprehensive Approach to Understanding Client Issues and Designing Plans to Help 373 Assessment 374 Testing and the Counseling Profession 375 Why Should Professional Counselors Know About Testing? 376 Categories of Tests 376 Types of Tests 377 Qualities to Consider When Evaluating Tests 379 Cultural Fairness 381 Technology and Testing 381 Ethical Considerations 381 Testing Resources 382 Intake Interviews 382 What Is a Mental Status Examination? 383 What Are the Elements of a Suicide Assessment and an Exploration of Intent to Harm Others? 384 Behavioral Observation 386 Environmental Assessment 386 Developmental Considerations 387 Case Conceptualization 390 Diagnosis 394 Social Justice Counseling and Assessment, Diagnosis, and Treatment 396 Benefits of Diagnosis 397 Drawbacks of Diagnosis 398 Treatment Planning 398 Treatment Plans 399 Comprehensive Models of Assessment and Treatment Planning 402 Summary

404

Chapter 13 Supervision and Consultation ■ Mark A. Young and Alan Basham 406 Preview 406 Use of Supervision and Consultation in Counseling Supervision 409 Models of Supervision 410

406

Contents xxiii

Supervision Formats 412 Supervision Interventions 414 Supervisory Relationship 418 Consultation 423 Models of Consultation 424 Consultant Roles 426 Consultation Skills 428 Consultation Settings 429 Summary

432

Chapter 14 Advocating for the Counseling Profession ■ Amy Milsom 435 Preview 435 Defining Advocacy 435 Brief History of Counselors Advocating for the Profession 436 Current Counseling Advocacy Agendas 437 Why Advocate? 439 Prerequisites to Effective Advocacy 444 Process of Advocacy 446 Identify the Problem 447 Assess the Availability of Resources 447 Engage in Strategic Planning Activities 448 Train Professional Counselors to Advocate 449 Implement a Plan of Action 450 Celebrate Accomplishments 451 Ways to Advocate 451 Identifying Yourself as a Professional Counselor 451 Serve Your Community 452 Use the Media 454 Technology 454 Target Policy Makers 456 Summary

456

Chapter 15 Advocacy Counseling: Being an Effective Agent of Change for Clients ■ Donna M. Gibson 458 Preview 458 Advocacy Counseling 458 When to Advocate 459 Advocacy Counseling and Intervention Competencies 461

xxiv Contents

Counseling and Advocacy Intervention Competencies: Community 469 Counseling and Advocacy Interventions Competencies: Public Policy 477 Counseling and Advocacy Intervention Competencies: International and Global Affairs 483 Summary

485

Section Four The Effectiveness of Counseling

487

Chapter 16 Accountability in Counseling ■ Bradley T. Erford

489 Preview 489 Accountability 489 Using a Counseling Program Advisory Committee 491 Conducting a Needs Assessment 492 Data-Driven Needs Assessment 492 Perceptions-Based Needs Assessment 497 Evaluating Programs 504 Service Assessment 505 Outcome or Results Evaluation 506 Important Assessment Terms 507 Practical Program Evaluation Considerations 508 Aggregated Outcomes 508 Designing Outcome Studies 510 Single-Subject Research Design 513 Action Research 516 Reporting Results 516 Accountability and Social Justice Counseling 518 Accountability and Technology 518 Summary

518

Chapter 17 Outcome Research in Counseling ■ Bradley T. Erford 520 Preview 520 How Research Assists Counselors: The Importance of and Barriers to Conducting Outcome Research 520 How Effective is Counseling? 527 Facets of Counseling that Contribute to Outcomes 528 Which Client and Professional Counselor Factors Contribute to Successful Outcomes? 531

Contents xxv

The Effectiveness of Individual Counseling 533 The Effectiveness of Group Counseling 535 Process Issues in Group Outcome Research 535 Group Counseling with Children 536 The Effectiveness of School-Based Interventions for Children and Adolescents 538 Specific Types of School-Based Interventions 539 Implications for the Future of Professional Counseling 542 Collaborate with Researchers 542 Advocate for Outcome Research Funding 544 Increase Knowledge and Use of Outcome Literature 544 Putting It All Together: Working for the Future 546 Summary

References 549 Credits 578 Index 585

547

About the Editor

xxvi

Bradley T. Erford, PhD, LCPC, NCC, LPC, LP, LSP, is a professor in the school counseling program of the Education Specialties Department in the School of Education at Loyola University Maryland. He was the 61st President of the American Counseling Association (ACA) for 2012-2013. He is the recipient of the ACA Research Award, ACA Extended Research Award, ACA Arthur A. Hitchcock Distinguished Professional Service Award, ACA Professional Development Award, ACA Thomas J. Sweeney Award for Visionary Leadership and Advocacy, and ACA Carl D. Perkins Government Relations Award. He was also inducted as an ACA Fellow. In addition, he has received the Association for Assessment in Counseling and Education (AACE) AACE/MECD Research Award, AACE Exemplary Practices Award, AACE President’s Merit Award, the Association for Counselor Education and Supervision’s (ACES) Robert O. Stripling Award for Excellence in Standards, Maryland Association for Counseling and Development (MACD) Maryland Counselor of the Year, MACD Counselor Advocacy Award, MACD Professional Development Award, and MACD Counselor Visibility Award. He is the editor of numerous texts including: Orientation to the Counseling Profession (Pearson Merrill, 2010, 2014, 2018), Crisis Intervention and Prevention (Pearson Merrill, 2010, 2014, 2018), Group Work in the Schools (Routledge, 2016), Clinical Experiences in Counseling (Pearson Merrill, 2015), Group Work: Process and Applications (Pearson Merrill, 2011), Transforming the School Counseling Profession (1st through 4th editions; Merrill/Prentice-Hall, 2003, 2007, 2011, 2015), Professional School Counseling: A Handbook of Principles, Programs and Practices (1st - 3rd editions, pro-ed, 2004, 2010, 2016), Assessment for Counselors (1st & 2nd editions, Cengage, 2007, 2012), Research and Evaluation in Counseling (1st & 2nd editions, Cengage, 2008, 2015), and The Counselor’s Guide to Clinical, Personality and Behavioral Assessment (Cengage, 2006); and ­co-author of eight more books: Mastering the NCE and CPCE (Pearson Merrill, 2011, 2015), 35 Techniques Every Counselor Should Know (Merrill/Prentice-Hall, 1st & 2nd editions, 2010, 2015), Free Access Assessment Instruments for Common Mental Health and Addiction Issues (Routledge, 2013), Educational Applications of the WISC-IV (Western Psychological Services, 2006) and Group Activities: Firing Up for Performance (Pearson Merrill, 2007). He is also the General Editor of The American Counseling Association Encyclopedia of Counseling (ACA, 2009). His research specialization falls primarily in development and technical analysis of psycho-educational tests and has resulted in the publication of more than 70 refereed journal articles, 100 book chapters, and a dozen published tests. He was a representative to the ACA Governing Council and the ACA 20/20 Committee: A Vision for the Future of Counseling. He is a past president and past treasurer of AACE, past chair and parliamentarian of the American Counseling Association - Southern (US) Region; past-chair of ACA’s Task Force on High Stakes Testing; past chair of ACA’s Standards for Test Users Task Force; past chair of ACA’s Interprofessional Committee; past chair of the ACA Public Awareness and Support Committee; chair of the Convention and past chair of the Screening Assessment Instruments Committees for AACE; past president of the Maryland Association for Counseling and Development (MACD); past president of Maryland Association for Measurement and Evaluation (MAME); past president of Maryland Association for Counselor Education and Supervision (MACES); and past president of the Maryland Association for Mental Health Counselors (MAMHC). He is a senior associate editor and past associate

About the Editor xxvii

editor for quantitative research for the Journal of Counseling & Development. Dr. Erford has been a faculty member at Loyola since 1993 and is a Licensed Clinical Professional Counselor, Licensed Professional Counselor, Nationally Certified Counselor, Licensed ­Psychologist and Licensed School Psychologist. Prior to arriving at Loyola, he was a school psychologist/counselor in the Chesterfield County (VA) Public Schools. He maintains a private practice specializing in assessment and treatment of children and adolescents.

A graduate of The University of Virginia (Ph.D.), Bucknell University (M.A.), and Grove City College (B.S.), he teaches courses in counseling assessment, lifespan development, research and evaluation in counseling, school counseling, and stress management (not that he needs it).

About the Authors

xxviii

Jason Baker, PhD, LPC, is an associate professor and program coordinator of the master’s program in school counseling in the Department of Psychology at Millersville ­University. He received his doctorate in counselor education and supervision from Regent University. His areas of research interest include rural school counseling, technology in counseling and counselor education, and sustainability efforts and issues in K-12 and higher education settings.

Gerta Bardhoshi PhD, CSC, LPC, is an assistant professor in the counselor education and supervision program in the Department of Rehabilitation and Counselor Education at the University of Iowa. She received her doctorate in counselor education and supervision from the George Washington University. Her areas of research pertain to counselor burnout, school counselor self-efficacy, and program development and evaluation.

Alan Basham, MA, is a retired counselor educator at Eastern Washington University, where he taught in CACREP-accredited school counseling and mental health counseling programs. He is past president of the Washington Counseling Association and the Association for Spiritual, Ethical and Religious Values in Counseling (ASERVIC), a division of the ACA. Alan has written chapters in several texts, co-authored a volume on leadership ethics and teamwork, drafted the ACA’s Code of Leadership, and contributed to the ACA’s position papers on High Stakes Testing and Test User Qualifications. He is especially interested in integrating spirituality into the counseling process, in applying Native American perspectives, and in creating support systems on university campuses for military veterans and their families as they adjust to college and civilian life.

Catherine Y. Chang, PhD, is an associate professor and program coordinator of the counselor education and practice doctoral program in the Department of Counseling and Psychological Services at Georgia State University. She received her doctorate in counselor education from The University of North Carolina at Greensboro. Her areas of research interest include multicultural counseling and supervision, professional and social advocacy in counseling, Asian and Korean concerns, and multicultural issues in assessment.

Joseph B. Cooper, PhD, LPC, NCC is an assistant professor in the department of counseling at Marymount University in Arlington, Virginia. He received his doctorate in counselor education from the University of North Carolina at Charlotte, and has over 16 years of experience providing individual, family, and group substance abuse and mental health counseling services in the agency, school, and private practice settings. His current research interests include attachment theory, intensive short-term dynamic psychotherapy, and neurophysiology. He maintains a private practice in Washington, DC, and is a guest faculty member for the intensive short-term dynamic psychotherapy program at the Washington School of Psychiatry.

Charlotte Daughhetee, PhD, is a professor of counseling at the University of Montevallo and serves as the Chair of the Counseling, Family Consumer Sciences, & Kinesiology Department. She received her B.S in Early Childhood Education from Indiana University in 1980, her M.Ed. in Counseling from the University of South Carolina in 1988 and her Ph.D. in Counselor Education from the University of South Carolina in 1992. She is a Licensed Professional Counselor (LPC), Licensed Marriage and Family Therapist (LMFT) and a National Certified Counselor (NCC) with over 27 years of clinical counseling

About the Authors xxix

e­ xperience. She has worked in K12, university, and private practice settings with clients of all ages. Her research interests include counselor trainee evaluation and crisis intervention.

Grafton T. Eliason, EdD, LPC, NCC, is a professor in the Department of Counselor Education at California University of Pennsylvania. He has published on the topics of career counseling, death, dying, and spirituality, and has a special interest in existential philosophy and religion. He received his doctorate in counselor education and supervision from Duquesne University, and he is an ordained Presbyterian minister.

Nadine E. Garner, EdD, LPC, is an associate professor in the Psychology Department and graduate program coordinator of the School Counseling program at Millersville University of Pennsylvania. She is co-author of A School with Solutions: Implementing a Solutionfocused/Adlerian-based Comprehensive School Counseling Program. Dr. Garner provides training in solution-focused counseling to counselors and educators both nationally and abroad. She also consults with school districts that seek to implement a solution-focused approach into their comprehensive developmental counseling curriculum. As a former K–12 professional school counselor at Scotland School for Veterans’ Children, Dr. Garner developed a comprehensive conflict resolution/peer mediation program.

Donna M. Gibson, PhD, LPC, NCC, completed her doctorate in counseling and counselor education at the University of North Carolina at Greensboro and is an associate professor in the counselor education programs at the University of South Carolina. She has served as Member-at-Large for Membership and President of AACE. Her research interests include pedagogical issues in teaching assessment, K–12 career assessment, leadership in school counseling and counselor education, professional identity development in counseling and counselor education, and relational/cultural theory.

Geneva M. Gray, PhD, LPC, is an assistant professor at Argosy University–Atlanta Campus. She received her doctoral degree in Counselor Education and Practice from Georgia State University in 2007. She is a licensed professional counselor in Georgia and provides clinical services for children, adolescents, and families. She has completed research in the areas of addictions, LGBT issues in counseling, and multiculturalism. In addition, Dr. Gray served as past president and past-secretary of the International Association for Addiction and Offender Counselors (IAAOC).

Judith Harrington, PhD, LPC, LMFT, is an assistant professor at the University of Montevallo, AL, and also in full time private practice for 30 years in Birmingham, AL, providing counseling and consultation to individual, couples & families, groups and agencies.

She is an approved trainer for assessing and managing suicidal risk curriculum for mental health professionals on behalf of the Suicide Prevention Resource Center at SAMHSA and the American Association of Suicidology. Since 2008, she has instructed the graduate counselor education curriculum on suicide for the University of Alabama at Birmingham and the University of Montevallo. She served for five years on the Standards, Training, and Practices Committee for the National Suicide Prevention Lifeline at SAMHSA. She has served the suicidally bereaved community by facilitating the SOS Bereavement Group for 14 years, and was the first- and twice-elected president of the nonprofit Alabama Suicide Prevention and Resources Coalition (ASPARC). Her state and ASPARC was awarded a three year Garrett Lee Smith Youth Suicide Prevention grant for which, among its many initiatives, she developed the Comprehensive Suicide Prevention Resource Directory for mental health professionals and concerned citizens, found at www.legacy.montevallo.edu.

Molly E. Jones is a graduate student in the School Counseling M.Ed. and certification programs at Millersville University of PA and the graduate assistant for the School

xxx About the Authors

­ ounseling program and the Center for Sustainability. She holds an undergraduate degree C in Psychology from Elizabethtown College Lynn E. Linde, EdD, is the Senior Director of Professional Affairs at the American Counseling Association. She formerly was the Coordinator of Clinical Experiences in the school counseling program at Loyola University Maryland. She received her doctorate in counseling from The George Washington University. She is a former Branch Chief for Pupil Services at the Maryland State Department of Education. She was the 2009–2010 President of the American Counseling Association and 2012–2103 Treasurer. She was the Southern Region representative to the ACA Governing Council, Past Chair of the ACA– Southern Region, and Past President of the Maryland Association for Counseling and Development, and has served on numerous committees and task forces, including the 2014 ACA Ethics Revision Task Force. She is an ACA Fellow, a recipient of the Carl Perkins Award, and a number of awards from ACA, its entities, and from the State of Maryland.

Amy L. McLeod, PhD, LPC, NCC, is an assistant professor and co-director of training in the Counseling Department at Argosy University–Atlanta. Her research interests include multicultural issues in counselor education and supervision, assessment and diagnosis, women’s issues, and crisis and trauma counseling.

Amy Milsom, DEd, NCC, LPC-S, is an associate professor at Clemson University. She earned her doctorate from Pennsylvania State University and is a former middle and high school counselor. Her primary research interests are in the areas of students with disabilities, postsecondary transitions and college readiness, and school counselor preparation.

Donna S. Sheperis, earned her PhD in counselor education from the University of Mississippi. A core faculty member in the mental health counseling program of Lamar University, Dr. Sheperis is a licensed professional counselor, national certified counselor, and approved clinical supervisor with more than 20 years of experience in community counseling and private practice settings. Her primary areas of interest include counselor development, ethics, and supervision.

Ann Vernon, PhD, NCC, LMHC, is professor emeritus and former coordinator of counseling at the University of Northern Iowa; she is also a counselor in private practice, where she works extensively with children, adolescents, and their parents. Dr. Vernon is the former director of the Midwest Center for REBT and vice president of the Albert Ellis Board of Trustees. She is the author of numerous texts, chapters, and articles, including Thinking, Feeling, Behaving and What Works When with Children and Adolescents.

Joshua C. Watson, PhD, LPC, NCC, ACS, completed his doctoral study at the ­University of North Carolina at Greensboro and is an associate professor in the counselor education program at Texas A&M University–Corpus Christi, with primary teaching responsibilities in assessment and educational statistics courses. His research interests include counseling student-athletes, wellness, and counselor-training issues. He is a past president of the Association for Assessment in Counseling and Education (AACE) and ACA Governing Council representative.

Mark A. Young, PhD, LMHC, NCC, completed his doctorate at Idaho State University and is currently an assistant professor and director of the marriage and family counseling program at Gonzaga University. His teaching and research interests are in couples and family counseling, supervision, and professional development.

SECTION ONE

Foundations of Professional Counselor Identity Section One, “Foundations of Professional Counselor Identity,” provides an in-depth look at the foundational issues in counseling, covering historical and future issues, professional identity, associations, credentialing, and legal and ethical dimensions of practice. Chapter 1, “Becoming a Professional Counselor: Philosophical, Historical, and Future Considerations,” explores the definition and philosophical underpinnings of the terms counseling and professional counselor. Key to this understanding is the development of a firm foundation in the knowledge of the numerous historical events and key people that gave rise to the counseling profession. Important issues facing counselors as the profession moves into the future are identified and discussed, including outcomes-based research, managed care, multiculturalism, social justice counseling and advocacy, technology, and gatekeeping. Finally, wellness practices within the counseling profession are given a special focus.

In Chapter 2, “Professional Counseling Organizations, Licensure, Certification, and Accreditation,” students are introduced to the American Counseling Association (ACA) and its divisions, branches, and professional partners so that students can become familiar with the wide array of professional associations advocating for counselors and clients. This chapter offers a glimpse of the many credentials that professional counselors can earn. An overview of state licensure, national certification, and counselor education program accreditation processes (i.e., CACREP and CORE) is provided to answer student questions early and to make students aware of the choices that exist for future professional credentialing. Various accountability mechanisms found at the state level for educational systems and mental health agencies are also reviewed.

Section One ends with Chapter 3, “Ethical and Legal Issues in Counseling.” The chapter is a comprehensive introduction to ethical and legal issues in counseling practice, covering new editions of the ACA and ASCA ethical codes, confidentiality, privilege, subpoenas, malpractice, records and personal notes, child abuse, suicide, HIPAA, FERPA, minor consent, and ethical decision making. A professional counselor must always remember that how one conducts oneself personally and professionally reflects not only on oneself, but also on one’s colleagues.

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CHAPTER

1

Becoming a Professional Counselor Philosophical, Historical, and Future Considerations Bradley T. Erford and Gerta Bardhoshi

Preview This initial chapter explores the definition and philosophical underpinnings of the terms counseling and professional counselor. Development of a firm foundation in the numerous historical events and key individuals who gave rise to the counseling profession is vital to understanding it. Important issues facing professional counselors as the profession moves into the future are identified and discussed, including outcome-based research, licensure portability, managed care, multiculturalism, social justice, technology, and gatekeeping.

Finally, a section on counselor wellness addresses important self-care practices for optimizing personal and professional functioning.

Counseling and Professional Counselors: Where We Are A thorough understanding of the counseling profession’s origin and historical progression provides a framework within which the counseling student can increase his or her identification with the profession, gain a sense of pride in the profession, develop an identity as a professional counselor, understand where that identity fits within the professional circles, and be armed with knowledge necessary to advocate for the profession. Perhaps even more important, this understanding ensures the next generation of professional counselors will continue to move forward, not mistaking innovation for history; will anticipate how events will impact the profession; and will be likely to make important contributions to the profession.

In the 1990s, authors (e.g., Gladding, 1996; Heppner et al., 1995) warned that the field of counseling could cease as a specialty or become obsolete if specialization and preparedness did not advance in step with society’s needs. Understanding the history of counseling along with its current status seems an appropriate and necessary place to begin, and no better way exists to gain such awareness than first to understand where they came from and how they arrived at this place. A profession without a known history lacks direction and trajectory, and for this reason, counseling students and new professionals must gain a complete understanding of the profession they have chosen. This chapter discusses what counseling is today, the philosophy underlying counseling, the history of the profession, current trends within the field, and the importance of wellness and counselor self-care.

3

4

Section 1 • Foundations of Professional Counselor Identity

Before delving into the past, a look at the counseling profession’s current status, meaning, and philosophy is warranted. While the practice of offering counsel has probably always occurred in some fashion in human society, counseling as a distinct helping profession is relatively new when compared to other mental health disciplines. In addition, the general public, as well as professional counselors, is often perplexed by and has difficulty ascertaining the true meaning, purpose, and intention of what counseling is, what it is not, and how it differs from other closely related helping professions.

The meaning of counseling can be ambiguous for several reasons. First, the word counseling has been used broadly to refer to everything from financial consultants and lawyers to home designers and wedding planners. Second, the word has carried different connotations over the years, even within the counseling profession. Finally, the word counseling describes many different activities a counselor actually does (e.g., educate, coordinate, advocate, assess). For the sake of clarity, counseling is defined as specific, specialized, and distinguishable from other mental health disciplines by its philosophy, its evolution, and its focus.

About a half century ago, the purpose of a counselor was said “to facilitate wise choices and decisions” or “to promote adjustment or mental health” (Tyler, 1969, p. 10).

Clearly, two agendas were represented. This is because counseling largely evolved from the guidance movement and actively differentiated itself from psychotherapy. Historically, guidance referred to guiding or helping others make choices about vocation, lifestyle, or education. In contrast, psychotherapy assumed a medical model, meaning the person receiving help was somehow ill. The goal of psychotherapy was to alleviate the sickness, with the therapist as expert using information about the client’s past to provide insight into thoughts previously kept out of awareness. As can be seen even in this brief discussion, guidance and psychotherapy were concerned with very different things (pro-developmental and remedial, respectively), though they had much in common as well. From these two agendas, modern counseling evolved, its roots grounded in both foundations while its boughs reached into new therapeutic directions. Table 1.1 provides some distinctions between the modern conceptions of counseling and psychotherapy.

The Association for Specialists in Group Work (2007) provides a helpful differentiation between definitions of counseling and psychotherapy in the group work context that carries over nicely to work with individual clients and families. Psychotherapy involves an in-depth, long-term commitment (i.e., 12–50+ sessions) requiring advanced therapeutic training and expertise and addressing serious, long-term, and enduring conditions, such TABLE 1.1 Historical Distinctions Between Counseling and Psychotherapy Psychotherapy

Counseling

Long-term (up to 2 years) Medical model Alleviate symptoms Past is most important Goal of insight Therapist as expert

Short-term (less than 6 months) Wellness model Improve quality of life Focus on the here and now Goal of change Counselor as collaborator

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DANCE ON STILTS AT THE GIRLS’ UNYAGO, NIUCHI

Newala, too, suffers from the distance of its water-supply—at least the Newala of to-day does; there was once another Newala in a lovely valley at the foot of the plateau. I visited it and found scarcely a trace of houses, only a Christian cemetery, with the graves of several missionaries and their converts, remaining as a monument of its former glories. But the surroundings are wonderfully beautiful. A thick grove of splendid mango-trees closes in the weather-worn crosses and headstones; behind them, combining the useful and the agreeable, is a whole plantation of lemon-trees covered with ripe fruit; not the small African kind, but a much larger and also juicier imported variety, which drops into the hands of the passing traveller, without calling for any exertion on his part. Old Newala is now under the jurisdiction of the native pastor, Daudi, at Chingulungulu, who, as I am on very friendly terms with him, allows me, as a matter of course, the use of this lemon-grove during my stay at Newala.

FEET MUTILATED BY THE RAVAGES OF THE “JIGGER” (Sarcopsylla penetrans)

The water-supply of New Newala is in the bottom of the valley, some 1,600 feet lower down. The way is not only long and fatiguing, but the water, when we get it, is thoroughly bad. We are suffering not only from this, but from the fact that the arrangements at Newala are nothing short of luxurious. We have a separate kitchen—a hut built against the boma palisade on the right of the baraza, the interior of which is not visible from our usual position. Our two cooks were not long in finding this out, and they consequently do—or rather neglect to do—what they please. In any case they do not seem to be very particular about the boiling of our drinking-water—at least I can attribute to no other cause certain attacks of a dysenteric nature, from which both Knudsen and I have suffered for some time. If a man like Omari has to be left unwatched for a moment, he is capable of anything. Besides this complaint, we are inconvenienced by the state of our nails, which have become as hard as glass, and crack on the slightest provocation, and I have the additional infliction of pimples all over me. As if all this were not enough, we have also, for the last week been waging war against the jigger, who has found his Eldorado in the hot sand of the Makonde plateau. Our men are seen all day long—whenever their chronic colds and the dysentery likewise raging among them permit—occupied in removing this scourge of Africa from their feet and trying to prevent the disastrous consequences of its presence. It is quite common to see natives of this place with one or two toes missing; many have lost all their toes,

or even the whole front part of the foot, so that a well-formed leg ends in a shapeless stump. These ravages are caused by the female of Sarcopsylla penetrans, which bores its way under the skin and there develops an egg-sac the size of a pea. In all books on the subject, it is stated that one’s attention is called to the presence of this parasite by an intolerable itching. This agrees very well with my experience, so far as the softer parts of the sole, the spaces between and under the toes, and the side of the foot are concerned, but if the creature penetrates through the harder parts of the heel or ball of the foot, it may escape even the most careful search till it has reached maturity.

Then there is no time to be lost, if the horrible ulceration, of which we see cases by the dozen every day, is to be prevented. It is much easier, by the way, to discover the insect on the white skin of a European than on that of a native, on which the dark speck scarcely shows. The four or five jiggers which, in spite of the fact that I constantly wore high laced boots, chose my feet to settle in, were taken out for me by the all-accomplished Knudsen, after which I thought it advisable to wash out the cavities with corrosive sublimate. The natives have a different sort of disinfectant—they fill the hole with scraped roots. In a tiny Makua village on the slope of the plateau south of Newala, we saw an old woman who had filled all the spaces under her toe-nails with powdered roots by way of prophylactic treatment. What will be the result, if any, who can say?

The rest of the many trifling ills which trouble our existence are really more comic than serious. In the absence of anything else to smoke, Knudsen and I at last opened a box of cigars procured from the Indian store-keeper at Lindi, and tried them, with the most distressing results. Whether they contain opium or some other narcotic, neither of us can say, but after the tenth puff we were both “off,” three-quarters stupefied and unspeakably wretched. Slowly we recovered—and what happened next? Half-an-hour later we were once more smoking these poisonous concoctions—so insatiable is the craving for tobacco in the tropics.

Even my present attacks of fever scarcely deserve to be taken seriously. I have had no less than three here at Newala, all of which have run their course in an incredibly short time. In the early afternoon, I am busy with my old natives, asking questions and making notes. The strong midday coffee has stimulated my spirits to

an extraordinary degree, the brain is active and vigorous, and work progresses rapidly, while a pleasant warmth pervades the whole body. Suddenly this gives place to a violent chill, forcing me to put on my overcoat, though it is only half-past three and the afternoon sun is at its hottest. Now the brain no longer works with such acuteness and logical precision; more especially does it fail me in trying to establish the syntax of the difficult Makua language on which I have ventured, as if I had not enough to do without it. Under the circumstances it seems advisable to take my temperature, and I do so, to save trouble, without leaving my seat, and while going on with my work. On examination, I find it to be 101·48°. My tutors are abruptly dismissed and my bed set up in the baraza; a few minutes later I am in it and treating myself internally with hot water and lemon-juice.

Three hours later, the thermometer marks nearly 104°, and I make them carry me back into the tent, bed and all, as I am now perspiring heavily, and exposure to the cold wind just beginning to blow might mean a fatal chill. I lie still for a little while, and then find, to my great relief, that the temperature is not rising, but rather falling. This is about 7.30 p.m. At 8 p.m. I find, to my unbounded astonishment, that it has fallen below 98·6°, and I feel perfectly well. I read for an hour or two, and could very well enjoy a smoke, if I had the wherewithal—Indian cigars being out of the question.

Having no medical training, I am at a loss to account for this state of things. It is impossible that these transitory attacks of high fever should be malarial; it seems more probable that they are due to a kind of sunstroke. On consulting my note-book, I become more and more inclined to think this is the case, for these attacks regularly follow extreme fatigue and long exposure to strong sunshine. They at least have the advantage of being only short interruptions to my work, as on the following morning I am always quite fresh and fit.

My treasure of a cook is suffering from an enormous hydrocele which makes it difficult for him to get up, and Moritz is obliged to keep in the dark on account of his inflamed eyes. Knudsen’s cook, a raw boy from somewhere in the bush, knows still less of cooking than Omari; consequently Nils Knudsen himself has been promoted to the vacant post. Finding that we had come to the end of our supplies, he began by sending to Chingulungulu for the four sucking-pigs which we had

bought from Matola and temporarily left in his charge; and when they came up, neatly packed in a large crate, he callously slaughtered the biggest of them. The first joint we were thoughtless enough to entrust for roasting to Knudsen’s mshenzi cook, and it was consequently uneatable; but we made the rest of the animal into a jelly which we ate with great relish after weeks of underfeeding, consuming incredible helpings of it at both midday and evening meals. The only drawback is a certain want of variety in the tinned vegetables. Dr. Jäger, to whom the Geographical Commission entrusted the provisioning of the expeditions—mine as well as his own—because he had more time on his hands than the rest of us, seems to have laid in a huge stock of Teltow turnips,[46] an article of food which is all very well for occasional use, but which quickly palls when set before one every day; and we seem to have no other tins left. There is no help for it—we must put up with the turnips; but I am certain that, once I am home again, I shall not touch them for ten years to come.

Amid all these minor evils, which, after all, go to make up the genuine flavour of Africa, there is at least one cheering touch: Knudsen has, with the dexterity of a skilled mechanic, repaired my 9 × 12 cm. camera, at least so far that I can use it with a little care.

How, in the absence of finger-nails, he was able to accomplish such a ticklish piece of work, having no tool but a clumsy screw-driver for taking to pieces and putting together again the complicated mechanism of the instantaneous shutter, is still a mystery to me; but he did it successfully. The loss of his finger-nails shows him in a light contrasting curiously enough with the intelligence evinced by the above operation; though, after all, it is scarcely surprising after his ten years’ residence in the bush. One day, at Lindi, he had occasion to wash a dog, which must have been in need of very thorough cleansing, for the bottle handed to our friend for the purpose had an extremely strong smell. Having performed his task in the most conscientious manner, he perceived with some surprise that the dog did not appear much the better for it, and was further surprised by finding his own nails ulcerating away in the course of the next few days. “How was I to know that carbolic acid has to be diluted?” he mutters indignantly, from time to time, with a troubled gaze at his mutilated finger-tips.

Since we came to Newala we have been making excursions in all directions through the surrounding country, in accordance with old habit, and also because the akida Sefu did not get together the tribal elders from whom I wanted information so speedily as he had promised. There is, however, no harm done, as, even if seen only from the outside, the country and people are interesting enough.

The Makonde plateau is like a large rectangular table rounded off at the corners. Measured from the Indian Ocean to Newala, it is about seventy-five miles long, and between the Rovuma and the Lukuledi it averages fifty miles in breadth, so that its superficial area is about two-thirds of that of the kingdom of Saxony. The surface, however, is not level, but uniformly inclined from its south-western edge to the ocean. From the upper edge, on which Newala lies, the eye ranges for many miles east and north-east, without encountering any obstacle, over the Makonde bush. It is a green sea, from which here and there thick clouds of smoke rise, to show that it, too, is inhabited by men who carry on their tillage like so many other primitive peoples, by cutting down and burning the bush, and manuring with the ashes. Even in the radiant light of a tropical day such a fire is a grand sight.

Much less effective is the impression produced just now by the great western plain as seen from the edge of the plateau. As often as time permits, I stroll along this edge, sometimes in one direction, sometimes in another, in the hope of finding the air clear enough to let me enjoy the view; but I have always been disappointed.

Wherever one looks, clouds of smoke rise from the burning bush, and the air is full of smoke and vapour. It is a pity, for under more favourable circumstances the panorama of the whole country up to the distant Majeje hills must be truly magnificent. It is of little use taking photographs now, and an outline sketch gives a very poor idea of the scenery. In one of these excursions I went out of my way to make a personal attempt on the Makonde bush. The present edge of the plateau is the result of a far-reaching process of destruction through erosion and denudation. The Makonde strata are everywhere cut into by ravines, which, though short, are hundreds of yards in depth. In consequence of the loose stratification of these beds, not only are the walls of these ravines nearly vertical, but their upper end is closed by an equally steep escarpment, so that the

western edge of the Makonde plateau is hemmed in by a series of deep, basin-like valleys. In order to get from one side of such a ravine to the other, I cut my way through the bush with a dozen of my men.

It was a very open part, with more grass than scrub, but even so the short stretch of less than two hundred yards was very hard work; at the end of it the men’s calicoes were in rags and they themselves bleeding from hundreds of scratches, while even our strong khaki suits had not escaped scatheless.

NATIVE PATH THROUGH THE MAKONDE BUSH, NEAR MAHUTA

I see increasing reason to believe that the view formed some time back as to the origin of the Makonde bush is the correct one. I have no doubt that it is not a natural product, but the result of human occupation. Those parts of the high country where man—as a very slight amount of practice enables the eye to perceive at once—has not yet penetrated with axe and hoe, are still occupied by a splendid timber forest quite able to sustain a comparison with our mixed forests in Germany. But wherever man has once built his hut or tilled his field, this horrible bush springs up. Every phase of this process

may be seen in the course of a couple of hours’ walk along the main road. From the bush to right or left, one hears the sound of the axe— not from one spot only, but from several directions at once. A few steps further on, we can see what is taking place. The brush has been cut down and piled up in heaps to the height of a yard or more, between which the trunks of the large trees stand up like the last pillars of a magnificent ruined building. These, too, present a melancholy spectacle: the destructive Makonde have ringed them— cut a broad strip of bark all round to ensure their dying off—and also piled up pyramids of brush round them. Father and son, mother and son-in-law, are chopping away perseveringly in the background—too busy, almost, to look round at the white stranger, who usually excites so much interest. If you pass by the same place a week later, the piles of brushwood have disappeared and a thick layer of ashes has taken the place of the green forest. The large trees stretch their smouldering trunks and branches in dumb accusation to heaven—if they have not already fallen and been more or less reduced to ashes, perhaps only showing as a white stripe on the dark ground.

This work of destruction is carried out by the Makonde alike on the virgin forest and on the bush which has sprung up on sites already cultivated and deserted. In the second case they are saved the trouble of burning the large trees, these being entirely absent in the secondary bush.

After burning this piece of forest ground and loosening it with the hoe, the native sows his corn and plants his vegetables. All over the country, he goes in for bed-culture, which requires, and, in fact, receives, the most careful attention. Weeds are nowhere tolerated in the south of German East Africa. The crops may fail on the plains, where droughts are frequent, but never on the plateau with its abundant rains and heavy dews. Its fortunate inhabitants even have the satisfaction of seeing the proud Wayao and Wamakua working for them as labourers, driven by hunger to serve where they were accustomed to rule.

But the light, sandy soil is soon exhausted, and would yield no harvest the second year if cultivated twice running. This fact has been familiar to the native for ages; consequently he provides in time, and, while his crop is growing, prepares the next plot with axe and firebrand. Next year he plants this with his various crops and

lets the first piece lie fallow. For a short time it remains waste and desolate; then nature steps in to repair the destruction wrought by man; a thousand new growths spring out of the exhausted soil, and even the old stumps put forth fresh shoots. Next year the new growth is up to one’s knees, and in a few years more it is that terrible, impenetrable bush, which maintains its position till the black occupier of the land has made the round of all the available sites and come back to his starting point.

The Makonde are, body and soul, so to speak, one with this bush.

According to my Yao informants, indeed, their name means nothing else but “bush people.” Their own tradition says that they have been settled up here for a very long time, but to my surprise they laid great stress on an original immigration. Their old homes were in the south-east, near Mikindani and the mouth of the Rovuma, whence their peaceful forefathers were driven by the continual raids of the Sakalavas from Madagascar and the warlike Shirazis[47] of the coast, to take refuge on the almost inaccessible plateau. I have studied African ethnology for twenty years, but the fact that changes of population in this apparently quiet and peaceable corner of the earth could have been occasioned by outside enterprises taking place on the high seas, was completely new to me. It is, no doubt, however, correct.

The charming tribal legend of the Makonde—besides informing us of other interesting matters—explains why they have to live in the thickest of the bush and a long way from the edge of the plateau, instead of making their permanent homes beside the purling brooks and springs of the low country.

“The place where the tribe originated is Mahuta, on the southern side of the plateau towards the Rovuma, where of old time there was nothing but thick bush. Out of this bush came a man who never washed himself or shaved his head, and who ate and drank but little.

He went out and made a human figure from the wood of a tree growing in the open country, which he took home to his abode in the bush and there set it upright. In the night this image came to life and was a woman. The man and woman went down together to the Rovuma to wash themselves. Here the woman gave birth to a stillborn child. They left that place and passed over the high land into the valley of the Mbemkuru, where the woman had another child, which

was also born dead. Then they returned to the high bush country of Mahuta, where the third child was born, which lived and grew up. In course of time, the couple had many more children, and called themselves Wamatanda. These were the ancestral stock of the Makonde, also called Wamakonde,[48] i.e., aborigines. Their forefather, the man from the bush, gave his children the command to bury their dead upright, in memory of the mother of their race who was cut out of wood and awoke to life when standing upright. He also warned them against settling in the valleys and near large streams, for sickness and death dwelt there. They were to make it a rule to have their huts at least an hour’s walk from the nearest wateringplace; then their children would thrive and escape illness.”

The explanation of the name Makonde given by my informants is somewhat different from that contained in the above legend, which I extract from a little book (small, but packed with information), by Pater Adams, entitled Lindi und sein Hinterland. Otherwise, my results agree exactly with the statements of the legend. Washing?

Hapana—there is no such thing. Why should they do so? As it is, the supply of water scarcely suffices for cooking and drinking; other people do not wash, so why should the Makonde distinguish himself by such needless eccentricity? As for shaving the head, the short, woolly crop scarcely needs it,[49] so the second ancestral precept is likewise easy enough to follow. Beyond this, however, there is nothing ridiculous in the ancestor’s advice. I have obtained from various local artists a fairly large number of figures carved in wood, ranging from fifteen to twenty-three inches in height, and representing women belonging to the great group of the Mavia, Makonde, and Matambwe tribes. The carving is remarkably well done and renders the female type with great accuracy, especially the keloid ornamentation, to be described later on. As to the object and meaning of their works the sculptors either could or (more probably) would tell me nothing, and I was forced to content myself with the scanty information vouchsafed by one man, who said that the figures were merely intended to represent the nembo—the artificial deformations of pelele, ear-discs, and keloids. The legend recorded

by Pater Adams places these figures in a new light. They must surely be more than mere dolls; and we may even venture to assume that they are—though the majority of present-day Makonde are probably unaware of the fact—representations of the tribal ancestress.

The references in the legend to the descent from Mahuta to the Rovuma, and to a journey across the highlands into the Mbekuru valley, undoubtedly indicate the previous history of the tribe, the travels of the ancestral pair typifying the migrations of their descendants. The descent to the neighbouring Rovuma valley, with its extraordinary fertility and great abundance of game, is intelligible at a glance—but the crossing of the Lukuledi depression, the ascent to the Rondo Plateau and the descent to the Mbemkuru, also lie within the bounds of probability, for all these districts have exactly the same character as the extreme south. Now, however, comes a point of especial interest for our bacteriological age. The primitive Makonde did not enjoy their lives in the marshy river-valleys.

Disease raged among them, and many died. It was only after they had returned to their original home near Mahuta, that the health conditions of these people improved. We are very apt to think of the African as a stupid person whose ignorance of nature is only equalled by his fear of it, and who looks on all mishaps as caused by evil spirits and malignant natural powers. It is much more correct to assume in this case that the people very early learnt to distinguish districts infested with malaria from those where it is absent.

This knowledge is crystallized in the ancestral warning against settling in the valleys and near the great waters, the dwelling-places of disease and death. At the same time, for security against the hostile Mavia south of the Rovuma, it was enacted that every settlement must be not less than a certain distance from the southern edge of the plateau. Such in fact is their mode of life at the present day. It is not such a bad one, and certainly they are both safer and more comfortable than the Makua, the recent intruders from the south, who have made USUAL METHOD OF good their footing on the western edge of the CLOSING HUT-DOOR plateau, extending over a fairly wide belt of country. Neither Makua nor Makonde show in their dwellings anything of the size and comeliness of the Yao houses in the plain, especially at Masasi, Chingulungulu and Zuza’s. Jumbe Chauro, a Makonde hamlet not far from Newala, on the road to Mahuta, is the

most important settlement of the tribe I have yet seen, and has fairly spacious huts. But how slovenly is their construction compared with the palatial residences of the elephant-hunters living in the plain.

The roofs are still more untidy than in the general run of huts during the dry season, the walls show here and there the scanty beginnings or the lamentable remains of the mud plastering, and the interior is a veritable dog-kennel; dirt, dust and disorder everywhere. A few huts only show any attempt at division into rooms, and this consists merely of very roughly-made bamboo partitions. In one point alone have I noticed any indication of progress—in the method of fastening the door. Houses all over the south are secured in a simple but ingenious manner. The door consists of a set of stout pieces of wood or bamboo, tied with bark-string to two cross-pieces, and moving in two grooves round one of the door-posts, so as to open inwards. If the owner wishes to leave home, he takes two logs as thick as a man’s upper arm and about a yard long. One of these is placed obliquely against the middle of the door from the inside, so as to form an angle of from 60° to 75° with the ground. He then places the second piece horizontally across the first, pressing it downward with all his might.

It is kept in place by two strong posts planted in the ground a few inches inside the door. This fastening is absolutely safe, but of course cannot be applied to both doors at once, otherwise how could the owner leave or enter his house? I have not yet succeeded in finding out how the back door is fastened.

MAKONDE LOCK AND KEY AT JUMBE CHAURO

This is the general way of closing a house. The Makonde at Jumbe Chauro, however, have a much more complicated, solid and original one. Here, too, the door is as already described, except that there is only one post on the inside, standing by itself about six inches from one side of the doorway. Opposite this post is a hole in the wall just large enough to admit a man’s arm. The door is closed inside by a large wooden bolt passing through a hole in this post and pressing with its free end against the door. The other end has three holes into which fit three pegs running in vertical grooves inside the post. The door is opened with a wooden key about a foot long, somewhat curved and sloped off at the butt; the other end has three pegs corresponding to the holes, in the bolt, so that, when it is thrust through the hole in the wall and inserted into the rectangular opening in the post, the pegs can be lifted and the bolt drawn out.[50]

MODE OF INSERTING THE KEY

With no small pride first one householder and then a second showed me on the spot the action of this greatest invention of the Makonde Highlands. To both with an admiring exclamation of “Vizuri sana!” (“Very fine!”). I expressed the wish to take back these marvels with me to Ulaya, to show the Wazungu what clever fellows the Makonde are. Scarcely five minutes after my return to camp at Newala, the two men came up sweating under the weight of two heavy logs which they laid down at my feet, handing over at the same time the keys of the fallen fortress. Arguing, logically enough, that if the key was wanted, the lock would be wanted with it, they had taken their axes and chopped down the posts—as it never occurred to them to dig them out of the ground and so bring them intact. Thus I have