Counseling the Contemporary Woman

Counseling the Contemporary Woman
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This book provides a comprehensive exploration of the challenges women may face as they navigate the multiple roles that they carry. Attention is given to the unique cultural identities that women embody and suggestions are provided to help counselors acknowledge the various aspects of each client’s intersectional identity. In addition to theory, we provide suggestions for practical application of relevant interventions and strategies for helping women achieve their goals. A foundation is provided that explore the multiple layers of development that occur during adolescence, adulthood, midlife, and older adulthood. Women face numerous challenges related to identity development and relationships. These challenges can generate psychological and emotional distress that lead women to seek professional assistance in finding solutions to their issues. With more choices than in generations past, women can face unexpected and unanticipated challenges and barriers to their individual and relational development. This book is organized around contemporary developmental and relational rites of passage women experience in adulthood. Traditional rites of passage include birth, menarche, marriage, and death. These events still hold significance but women’s lives today follow expanded and complex trajectories. Numerous transitions, such as attending college, navigating employment opportunities and the relational challenges that women face in various areas of life, are presented and addressed in this book from a clinician’s perspective providing practitioners with insight and practical knowledge. In this book, we cover choices related to such topics as career, relationships, parenthood, and support networks. We also explore the struggles that women face including abuse, depression, anxiety, feelings of low self-worth, loss, and addictions. Best practices in counseling women are highlighted and utilized in case study examples. The relationships created by women impact their lives and this book helps the reader to gain insight into how women can take ownership for their relationships and choices.

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Suzanne Degges-White. Counseling the Contemporary Woman

Acknowledgments

Foundational Perspectives and Theory

Reenvisioning the Feminine Ideal

Multicultural and Social Justice. Counseling Foundations

Intersectionality: A Critical Lens for Women’s Issues

Addressing the Complexity of Women’s Diversity

Age and Generational Influences

Developmental or Other Disability

Religion and Spiritual Orientation

Ethnic and Racial Identity

Socioeconomic Status

Sexual Orientation

Indigenous Heritage

National Origin

Implications for Counseling and Advocacy

Conclusion

References

Integrating Feminist Therapy into Counseling Practice

Feminist Thought Meets Feminist Therapy

Feminist Therapy: Not for Women Only

What Does Empowerment Look Like?

The Four Realms of Personal Power

Feminist Therapy in Practice

Feminist Therapy Techniques

Assertiveness Training

Relabeling and Reframing

Social Identity and Gender Role Analysis

Power Analysis

Bibliotherapy

Conclusion

References

Integrating Relational-Cultural Therapy into Counseling Practice

A Relational-Cultural Therapy Understanding

Core Components of RCT

Mutuality

Mutual Empathy

Authenticity

Growth-Fostering Relationships

The Five Good Things

Relational Images/Expectations

Central Relational Paradox

Condemned Isolation

Disconnection

Relational-Cultural Therapy in Practice

Relational-Cultural Therapy Techniques

Cross-Cultural Application of. Relational-Cultural Therapy

Conclusion

References

Development from Adolescence through Older Adulthood

Counseling Adolescent Girls

Case Vignette: Sofia

Emotional, Behavioral, and Cognitive Changes

Identity Development

Sexual Identity and Sexual Activity

Relationships with Parents

Mother–Daughter Relationships

Father–Daughter Relationships

Friendships

Romantic Relationships

Relationship with Self and Media

Best Practices

Cultural Considerations

Ethical Considerations

Advocacy Opportunities

Case Vignette Wrap-Up: Sofia

Interventions: Strength-Based Approach

Brief Conceptualization

Final Wrap-Up

Questions for Reflection

References

Counseling Emerging and Young Women

Case Vignette: Agneshka

Physical Development

Emotional, Behavioral, and Cognitive Changes

Identity Development

Sexual Identity

Relationships

Relationships with Parents

Friendships

Romantic Relationships

Pursuing Commitment

Transition to Committed Life and Family Life

Divorced and Single Mothers

School and Work Transitions

Challenges in the Workforce

Best Practices for Working with. Emerging Adult Women

Cultural Considerations

Ethical Considerations

Advocacy Opportunities

Case Study Wrap-Up: Agneshka

Interventions: Strength-Based Approach

Brief Conceptualization

Final Wrap-Up

Questions for Reflection

References

Counseling Midlife Women

Case Vignette: Cara

Physiological Changes That Occur. during the Midlife Period

Perimenopause and Menopause

Hot Flashes

Sleep Disturbances

Aging Bodies

Bone Density

Cardiovascular System

Skin and Hair

Weight Gain

Suggestions for Client Education

Psychological and Emotional Changes. That May Occur during Midlife

Mood Swings and Irritability

Depression

Anxiety

Relational Challenges That May Appear. during Midlife

Relationship to Self and Purpose in Life

Intrapersonal Concerns

Jung’s Perspective on Midlife Development

Erikson’s Perspective on Midlife Development

Relationships with Others

Romantic Relationships

Sexual Relationships

Caring for Others

Family Relationship Changes

Friendships and Social Support Networks

Cultural Considerations

Ethical Considerations

Advocacy Opportunities

Case Vignette Wrap-Up: Cara

Intervention Strategy: Reframing Negative Self-Assessment

Career Skills and Fantasy Focusing

Questions for Reflection

References

Counseling Older Adult Women

Case Vignette: Jordan

Physical Development

Psychosocial Development

Optimal versus Successful Aging

Disengagement Theory

Activity Theory

Continuity Theory

Selective Optimization and Compensation Theory

Counseling Approaches with Older Women

Reminiscence

Life Review

Guided Autobiography

Women in Relationships

Relationship with Self

Relationships with Friends

Relationships with Partners

Sexuality

Relationships with Parents

Relationship with Adult Children and Grandchildren

Mother–Adult Daughter Relationships

Grandparents

Sibling Relationships

Best Practices

Cultural Considerations

Ethical Considerations

Advocacy Opportunities

Case Vignette Wrap-Up: Jordan

Interventions: Strengths-Based Approach

Brief Conceptualization

Final Wrap-Up

Questions for Reflection

References

Career Counseling

Career Counseling over the Career Span

Case Vignette: Maria

Early Career Development

Importance of Mentorship in Early Career Development

Revisiting the Case of Maria: Family Life

Priorities in Life

Work–Life Balance

Challenges and Opportunities

Revisiting the Case of Maria: A Return to Work

Changes in the Workplace

Midcareer

Revisiting the Case of Maria: Her Family Grows

Career Advancement

Revisiting the Case of Maria: Ten Years Later

Working Longer

Dealing with Younger Bosses

Revisiting the Case of Maria: Unexpected Changes Arise

Delaying Retirement

Grandparents as Parents

Reframing

Retirement

Revisiting the Case of Maria: Retirement

Implications for Counselors

Early Career

Midcareer

Career Advancement

References

Counseling Concerns. of Relational Focus

Counseling Women Dealing with Family-of-Origin Issues

Case Vignette: Rania

Family-of-Origin Issues

Foundational Theory of. Narrative Family Counseling

Narrative Therapy Best Practices

Metaphors

The Miracle Question

Psychoeducation and Unfinished Business

The Empty Chair Technique

Genograms

Conclusion

Cultural Considerations

Ethical Considerations

Advocacy Opportunities

Case Vignette Wrap-Up: Rania

Questions for Reflection

References

Counseling Contemporary Couples

Case Vignette: Aretta

Fostering Hope Program

Isolation and Connection

Anger and Regret

Grief and Loss

Expectations and Hope for Family Planning

Partner Support and Communication

Mindfulness, Self-Compassion, and Self-Care

Cultural Considerations

Ethical Considerations

Advocacy Opportunities and Reflections

Case Vignette Wrap-Up: Aretta

References

Counseling Women Facing Contemporary Family Challenges

Case Vignette: Eleanor

The Family Life Cycle

Parental Separation and Divorce

Blended Families

Social Influences and the Family

Bullying and Hazing

Peer Pressure

Drugs and Alcohol

Sexuality and Sexual Identity Formation

Best Practices When Working with Families

Genograms

Family Mapping

Family Sculpting

Cultural Considerations

Ethical Considerations

Advocacy Opportunities

Case Study Wrap-Up: Eleanor

Questions for Reflection

References

Counseling Survivors of Emotional and Physical Abuse

Case Vignette: Meredith

Cycle of Abuse

Best Practices

Trauma-Focused Cognitive Behavioral Therapy

Attachment-Based Therapy

Somatosensory Interventions

Cultural Considerations

Ethical Considerations

Advocacy Opportunities

Case Vignette Wrap-Up: Meredith

Questions for Reflection

References

Counseling Strategies for Building Healthy Support Networks

Case Study: Trinidad

Positive Effects of a Healthy Support Network

Loneliness

Types of Loneliness

Combating Loneliness

Social Isolation

Strategies to Increase Social Engagement. and Support Networks

Friendship Traits Client Self-Assessment Intervention

Traits of Integrity

Traits of Caring

Traits of Congeniality

Support Needs Self-Assessment Intervention

Strategies for Helping Clients Connect to Others

Suggestions for Finding Potential Friends

A Note about Social Media

Helping Clients Terminate Unhealthy Relationships

Diversity Considerations

Ethical Considerations

Advocacy Opportunities

Case Vignette Wrap-Up: Trinidad

Questions for Reflection

References

Individual Concerns

Counseling Women with Body Image Concerns

Case Vignette: Sadie

Prevalence and Risk Factors

Body Image Concerns by Diagnosis and Behavior

Treatment Interventions

Intentional Checking

Body Maps

Art Therapy

Body Image Journal

Ethical Considerations

Cultural Considerations

Best Practices

Case Vignette Wrap-Up: Sadie

Questions for Reflection

References

Counseling Women with Low Self-Esteem

Case Vignette: Roberta

Acceptance and Commitment Therapy Best Practices

Strength Bombardment

Fostering Psychological Flexibility

Finding Exceptions

Cognitive Defusion

“Acting as If”

Cultural Considerations

Ethical Considerations

Advocacy Opportunities

Case Vignette Wrap-Up: Roberta

Questions for Reflection

References

Counseling Women with Depression

Case Vignette: Yvonne

Women Affected by Major Depressive Disorder

Women Affected by Other Forms of Depressions

Persistent Depressive Disorder (PDD)

Perinatal and Postpartum Depression (PPD)

Premenstrual Dysphoric Disorder and. Perimenopausal Depression (PMDD)

Depression as a Co-occurring Disorder

Suicidality Assessment

Risk Factors and Warning Signs

Protective Factors

Treatment for Depression

Practical Considerations

Best Practices

Cultural Considerations

Ethical Considerations

Advocacy

Resources for Counselors and Clients

Case Vignette Wrap-Up: Yvonne

Treatment Plan

Brief Case Conceptualization

Outlook for Yvonne

Questions for Reflection

References

Counseling Women with Anxiety

Case Vignette: Chu

Anxiety Disorders

Specific Phobias

Foundational Theory of. Cognitive Behavioral Therapy

Best Practices

Psychoeducation

Thought Stopping

Mindfulness and Relaxation Techniques

Deep Breathing Body Scan

Anxiety Visualization

Visual Arts Interventions

Exercise and Physical Activity Interventions

Diversity Considerations

Ethical Considerations

Advocacy Opportunities

Case Vignette Wrap-Up: Chu

Questions for Reflection

References

Counseling Women with Addictions

Case Vignette: Sylvie

Does Gender Matter in Addiction Onset?

Common Reasons for Substance Use in Women

Addiction and Treatment

Transtheoretical Model of Change (TTM)

Motivational Interviewing (MI)

Alcohol Addiction

Residential Treatment

Pharmacological Treatment

Cognitive Behavioral Therapy

Mutual-Help Groups

Opioid Addiction

Treatment

Cultural Considerations

Ethical Considerations

Advocacy Opportunities

Case Vignette Wrap-Up: Sylvie

Questions for Reflection

References

Caring for Self and Caring for Others

Women with Chronic Illness and Disabilities

Case Vignette: Zahra

Disability Perspective

Gendered Disability Experience

Health and Disability

Access to Health-Care Services

Sexual and Reproductive Health

Social Participation

Educational Outcomes

Employment Outcomes

Violence

Cultural Considerations and. Inclusive Implications for Counselors

Case Vignette Wrap-Up: Zahra

Questions for Reflection

References

Counseling Women Who Caregive

Case Vignette: Sonya

Types of Caregivers and Their Identities

Caregiver Identity

Issues Women Caregivers Face

Stress and Burden

Unknown Territory

Roles and Relationships

Family Discord

Anticipatory Grief

Bereaved Caregivers

Complex Emotional Responses after Loss

Unexpected Gifts

Practical Considerations in Counseling

Self-Care

Addressing Grief

Support and Resources

Best Practices

Cultural Considerations

Ethical Consideration

Advocacy Opportunities and Resources

Caregivers Assessments

Organizations for Caregivers

Online Resources

Case Vignette Wrap-Up: Sonya

Interventions: Grief Counseling Using Both a Meaning-Reconstruction Lens and a Strengths-Based Approach

Brief Conceptualization

Final Wrap-Up

Questions for Reflection

References

Coping with Grief and Loss. over the Lifespan

Counseling Women Who Have Lost Their Mothers

Case Vignette: Camille

Foundations of Grief Work

Types of Grief

Grief Models and Best Practices

Mother–Daughter Relationships and Implications of Loss

Clayton’s Phases of Grief

Doka’s Styles of Grief

Worden’s Tasks of Mourning

Grief Implications in Identity Development

The Bereavement of Adult Children

Developmental Approaches and Influencing Factors

Cultural Factors in Bereavement

Cultural Difference in Mother–Daughter Relationships

Ethical Considerations

Advocacy Considerations

Counselor Interventions

Case Vignette Wrap-Up: Camille

Conclusion

References

Counseling Women Who Have Lost a Partner

Case Vignette: Cynthia

Grief and Bereavement

Grief Phases

Grief Tasks

Complicated Grief

Disenfranchised Grief

Types of Death

Anticipated Death

Unanticipated Death

Bereavement as a Risk Factor

Resilience in Loss

Transitioning from Widowhood to Single Life

Practical Considerations

Best Practices

Cultural Considerations

Ethical Considerations

Advocacy Opportunities

Case Vignette Wrap-Up: Cynthia

Interventions: Strengths-Based Approach

Brief Conceptualization

Final Wrap-Up

Questions for Reflection

References

Counseling Women Experiencing Fetal and Perinatal Loss

Case Vignette: Khloe

The Experience of Fetal Loss and Perinatal Death

Counseling Women Coping with. Fetal or Perinatal Loss

You Are Not Alone

The Story of Us

Rebooting the Self

The Process of Grieving

Ethical Considerations

Cultural Considerations and. Empowerment Opportunities

Case Vignette Wrap-Up: Khloe

Intervention Strategy: Connecting with Client, Showing Respect, and Sharing Knowledge

Telling Her Story and Examining Identity

Questions for Reflection

References

Counseling Women Who Have Lost a Child

Case Vignette: Karla

Potential Grief Responses to Loss of a Child

Normal and Complicated Grief

Type of Death: Natural or Unnatural Causes

Best Practices for Mothers Suffering Grief. after the Loss of a Child

Making Meaning from Memories

Traumatic or Unnatural Deaths

Cultural Considerations

Ethical Considerations

Advocacy Opportunities

Case Vignette Wrap-Up: Karla

Questions for Reflection

References

Index

About the Editors

List of Contributors

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This project is the culmination of the efforts of many individuals who are dedicated to doing what they can to better the lives of others. We celebrate the investment of energy and time by all of the clinicians who work with women, as well as the energy and time invested by their clients who work on themselves. We are grateful to everyone who advocates for the needs of women and to those who strive to provide the best care they can. We hope this book provides helpful information as well as validation of the work that is done to enhance the lives of others. We also would like to acknowledge the support of our editorial team at Rowman & Littlefield, including Courtney Packard and Mark Kerr.

Chapter 1

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Behavior rehearsal occurs when a counselor asks a client to practice, in session, the statements or questions that the client wants to use outside of session. For instance, if a client feels that her work supervisor is unfairly assigning work tasks based on gender, her counselor can ask her to state, in session, what she would like to express to her supervisor. She might try out statements such as, “Mr. Jackson, I feel that you assign me more of the background research on projects than you do the men in our department. I’d like the opportunity to meet with potential clients, not just do the fact-finding on their businesses.” The counselor can invite her to practice the statement several times in session as well as play out the potential conversation through role play by having the client and counselor take turns playing out the roles of employee and supervisor. This allows the counselor the opportunity to try and manipulate the conversation in ways that will give the client practice in keeping to the facts and refusing to allow herself to be “derailed” in her advocacy for her rights on the job. The counselor may also encourage the client to practice the statement in front of a mirror to help her practice assertive, strong posture and facial expressions.

Learning to be accepting of one’s shortcomings can be especially challenging when a client has been taught that her identity has little value and is an impediment to success. Counselors can provide clients with the space to discuss the negative messages they receive about their gender, appearance, identity, and so on. Following the discussion, the counselor can help the client to tease out any “truths” in the message and help the client to “own” her weaknesses without any sense of shame. For instance, if a client acknowledges that she is stronger in “street smarts” than “book smarts,” she can discuss ways her “weakness” has strengths and become less defensive about her lack of formal education.

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