ABSTRACT Student–teacher conflict is a common feature of K‐12 schooling, frequently addressed through exclusionary disciplinary practices that prioritize compliance over relational repair and disproportionately affect Black students. Restorative practices offer an alternative framework focused on accountability, dialogue, and harm repair, but implementation often lacks explicit attention to racialized power dynamics and affective processes that shape conflict escalation. This article advances a conceptual framework positioning counselors as facilitators of racially conscious restorative dialogue through a counseling lens, affect psychology, and restorative practice principles. Drawing on the Multicultural and Social Justice Counseling Competencies and the ASCA National Model, the authors conceptualized counselor‐led restorative dialogue as a structured clinical intervention involving preparation, facilitated dialogue, and follow‐up. A case illustration of a racially charged student–teacher conflict demonstrates the practical application of this framework. Implications are discussed for practice, training, professional development, and policy aimed at reducing disciplinary inequities and strengthening relational trust in schools.
ABSTRACT Clinicians tend to overestimate their clients’ progress in treatment. A potential solution of adding formalized assessments into treatment has led to concerns about client paperwork burden. In this mixed‐method study, we explored adult clients’ reactions to one formal assessment, the Outcome Questionnaire‐45 (OQ‐45). We used purposeful sampling to select 17 clients at a university counseling training center who had either improved, showed little change, or who deteriorated according to OQ‐45. Using semi‐structured interviews and grounded theory, we identified two higher order categories, clinical benefits and threats to accuracy, and two axial categories, OQ‐45 likability and perceived accuracy. A crossover mixed analysis showed strong correlations between OQ‐45 outcomes, clinical benefits, and OQ‐45 likability. We proposed a conceptual model showing how client attitudes toward the OQ‐45 depended on how compatible outcomes were to clients’ perceived benefits received in counseling. Counseling implications and future research directions are discussed.
ABSTRACT Adverse childhood experiences (ACEs) are associated with long‐term mental, physical, and psychosocial difficulties, yet little research has examined how patterns of ACE exposure relate to developmental experiences during emerging adulthood. The present study used latent class analysis (LCA) to identify classes of ACEs among emerging adults ( N = 420) to examine differences across the features of emerging adulthood, psychological functioning, quality‐of‐life indicators, and demographic characteristics. Three distinct ACE classes were identified: low ACE exposure, emotional adversity ACE, and high ACE exposure. Significant differences were found across classes for quality‐of‐life domains, life satisfaction, ego‐resiliency, and meaning in life. Individuals with high ACE exposure reported the poorest outcomes. In contrast, no significant differences were observed across ACEs classes for the features of emerging adulthood. Findings suggest that ACE exposures were not related to whether emerging adults' developmental experiences occurred but were related to the quality with which they were experienced.
This study was designed to understand help-seeking behavior based on Black men's experiences in mental health counseling. Using a critical constructivist grounded theory approach, the participant pool consisted of 11 Black men, who completed semistructured interviews on their counseling experiences. Data from these 11 interviews revealed a core category that Black men continue counseling to pursue healing, challenge stigma, and break stereotypes around masculinity, race, and authentic engagement in mental health. This theory consisted of four clusters (I Can and Will Do This Here, Personal Decisions, Witnessing Change, and Recommendations for Mental Health Services). Relevant implications for clinical practice, education, and research are discussed. Primary focus is on how Black men as clients discussed their own journeys of help-seeking and believed counseling to support the emotional and psychological concerns presented by trauma and racism.
ABSTRACT This study examined how Korean counselors conceptualize counseling expertise across developmental stages. Using text mining of 70 counselors’ written responses, analyses included word frequency, semantic network, and CONCOR clustering. Both groups shared a lexical foundation, with performance competence, continuous learning, and diverse experience emerging as core components. However, intermediate counselors used outcomes‐related terms more frequently, reflecting a task‐oriented framework tied to early‐career performance anxiety, whereas advanced practitioners exhibited a sophisticated structure characterized by a profound shift toward continuous self‐reflection and the critical evaluation of contextual factors. Furthermore, the study identified additional semantic structures of expertise that manifested within the legislative void of Korea, reflecting efforts to navigate professional differentiation amid systemic confusion. In conclusion, the results underscore the necessity of a legal licensing system and program accreditation system alongside contextually responsive counselor education and supervision.
Forty years after introduced wellness into the counseling literature, wellness has become a cornerstone of the counseling profession. Over the same period, a multi-trillion-dollar wellness industry has emerged, positioning wellness as a luxury available only to those who can afford its ever-increasing price. Counselors are uniquely positioned to help clients navigate the wellness economy, yet embedded assumptions within the profession often prevent those with traditionally marginalized identities from receiving wellness counseling. Multiple systemic barriers and four core underlying assumptions limit how the profession has conceptualized and implemented wellness counseling. These are understanding: who defines wellness, how structural constraints limit wellness counseling; the effects of Maslow's Hierarchy on wellness interventions; and how cultural and social contexts affect wellness. Challenging each of these assumptions allows practicing counselors and counselor educators to engage in wellness counseling with all clients in all settings, regardless of immediate needs or systemic barriers.
This qualitative study explored the relational nature of suicidal suffering in anonymous digital communities. Using reflexive thematic analysis, we examined 50 Reddit posts expressing suicidality and 62 corresponding peer responses. Themes from posts reflected relational disconnection, ambivalence about living, and a desire to escape psychological pain, whereas response themes emphasized affirmation, shared resonance, and contextual validation. Although these exchanges do not constitute therapeutic care, findings illustrate how suicidal distress is voiced and relational responses are attempted within anonymous online environments. Implications underscore the relevance of relational frameworks for understanding suicidality and highlight the importance of attending to the digital contexts in which clients increasingly seek connection, recognition, and emotional safety.
While the consequences of the COVID-19 pandemic were widely documented, little is known about specific mental health and social determinants of mental health (SDMH) outcomes according to individuals who tested positive for COVID-19, particularly in rural and underserved regions of the United States. Through a generic qualitative approach, we conducted a thematic analysis to understand how testing positive for COVID-19 shaped the mental health and socioeconomic realities of eight adult residents of New Mexico, guided by the National Institute on Minority Health and Health Disparities (2025) Research Framework. Participants reported adverse emotional experiences, income disruptions, relational rupture, and barriers to quality healthcare. Findings suggest these outcomes are interrelated, provide greater context on the ramifications of a COVID-19 diagnosis on SDMH, and underscore the need for universal SDMH assessment, culturally responsive treatment planning, and multilevel advocacy in counseling practice.
Fear of deportation (FOD) remains a significant stressor for many in the Latine community, regardless of political climate. In recent years, intensified rhetoric and legislative actions have elevated immigration as a central US policy issue, increasing concern about related mental health needs. To inform counseling practice and advocacy, we conducted a rapid review using Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines to synthesize recent research on deportation fears and Latine mental health. Twenty-three peer-reviewed studies, including quantitative, qualitative, and mixed-methods designs, met inclusion criteria. Findings consistently linked FOD with heightened psychological distress, anxiety, depression, and substance use. FOD also affected family functioning, contributing to strained parent-child communication, role reversals, and conflict. These impacts were evident not only among undocumented individuals but also among US citizens in mixed-status families. Results highlight the importance of trauma-informed, culturally responsive, and ethical counseling care, while emphasizing the need for systemic interventions and counselor engagement in community and policy advocacy.
The researchers analyzed data collected from a standardized phone-based treatment program conducted in the Southeastern United States. Participants included older adults receiving home and community-based services, who were determined to be at an elevated risk of depression, loneliness, and thwarted belongingness. Treatment providers were trained in one of two conditions: (a) facilitative listening to foster belongingness, empathy, and narrative reminiscence; or (b) facilitative listening plus evidence-based suicide intervention. Transcription of 67 phone calls was analyzed using qualitative content analysis, which yielded five thematic categories (i.e., biographical context, interpersonal factors, intrapersonal factors, phase of life, and physiological and safety needs) with 21 total subcategories. Findings include both older adult components (i.e., the role of impaired physical mobility, chronic medical illness or pain, and increased dependence on others) as key stressors among the older adult sample, and internal and external protective mechanisms (i.e., social support, religious/spiritual coping, gratitude, resilience, and hope).
Active empathetic listening (AEL) is a foundational skillset used by counselors. However, little is known about how AEL is used and perceived outside of Western cultures. Keicho ((sic)), the Japanese concept of AEL, is described as tilting one's head to listen to others. In this study, we examined how AEL is influenced by Japanese culture and practiced in Japan, using a cross-cultural instrumental case study methodology at a nonprofit organization located in Japan. We used three different datasets: focus group workshop participants, self-narrative poem activities, and individual interviews with the workshop instructor.
Using a cross-sectional design, the authors examined the relationship between first-generation college students' (FGCSs) perceived social support and psychological well-being, considering the mediating role of their meaning in life. Participants (N = 356) were recruited from a randomly selected sample of FGCSs at a 4-year public university in the western United States and completed an online survey. Structural equation modeling with bias-corrected bootstrapping was conducted to test the hypothesized model. Meaning in life partially mediated the relationship between perceived social support and psychological well-being (indirect effect beta = 0.28, 95% CI [0.22, 0.37]). Implications for college counselors and counseling researchers to enhance FGCSs' psychological well-being are provided.
The symptoms of anxiety and depression are commonly reported within military- and non-military-affiliated populations, with considerable evidence available to counselors regarding which relational characteristics function as protective factors among these populations. Less is known about the statistical associations among these variables for those reporting moral injury. We sampled military-affiliated (n = 171) and non-military-affiliated (n = 145) participants who reported experiences of moral injury. Participants provided self-reported responses to the Patient Health Questionnaire-4 (PHQ) and Relational Health Indices (RHI). Predictive modeling revealed a greater proportion of variance in PHQ scores explained by the RHI subscales (Authenticity, Engagement, and Empowerment) among military-affiliated participants (R 2 = 0.28) than among non-military-affiliated participants (R 2 = 0.18). Inspection of individual predictors identified differing influences of model predictors between samples. Implications for the use of relational-cultural therapy and related counseling practices and research are discussed.
This study conducted a content analysis of policies, ethical codes, and regulatory guidelines from 13 national and international mental health organizations to examine how they conceptualize ethical artificial intelligence (AI) in mental health practice. Five overarching themes were identified-ethical practice and client welfare, competence and supervision, justice and inclusion, professional integrity, and governmental and institutional oversight. Together, these themes reveal the field's emerging priorities, areas of conceptual omission, and the varying mechanisms organizations use to uphold ethical and safety standards in AI deployment. Implications for clinical practice, professional education, and policy development are discussed.
The purpose of this meta-analysis was to examine whether culturally adapted cognitive behavioral therapy (CA-CBT) is effective in reducing posttraumatic stress disorder (PTSD) symptoms compared to both waitlist control and alternative treatments, as well as explore study and sample characteristics associated with treatment outcomes. Nineteen between-groups studies (n = 2049) were analyzed using separate random effects models, which revealed large significant effect sizes favoring CA-CBT over waitlist control (g = -2.25; CI95 = -3.26, -1.24; PI95 = -6.02, 1.52) and alternative treatment conditions (g = -0.98; CI95 = -1.34, -0.63; PI95 = -2.13, 0.17). Adaptation quantity emerged as a significant moderator in both meta-regression models; however, the direction of the impact differed between comparison conditions. These results may suggest that adaptation quality, rather than quantity, plays a key role in trauma treatment outcomes. Considerations for culturally adapting CBT for trauma treatment are discussed.
Despite being more likely to encounter and endure higher levels of psychological distress, African American adults are less likely to seek mental health services. Yet previous research lacks an examination of within-group differences among African Americans' help-seeking attitudes, particularly by generation, gender, or the centrality of race. In this study, we used a nonexperimental correlational research design to examine factors that influence attitudes toward mental health help-seeking in African American adults (N = 190). We examined the potential moderating effects of generation, gender, and race centrality on such attitudes. Using an ordinary least squares regression multiple linear regression analysis, we found that perceived stigmatization of others and self-stigma significantly predicted 22% of the variance in help-seeking attitudes, and the relationship between stigma and mental health help-seeking attitudes was moderated by gender on perceived stigma by others in one's social network and perceived stigma by the general public.
This constructivist grounded theory study explored how LGBTQ+ counselors (N = 12) understand their process of cultivating and integrating LGBTQ+ cultural competency and cultural humility in their work with LGBTQ+ clients. The findings of this study can inform future training, leading to better counseling outcomes for this population. The theory of LGBTQ+ counselor development of LGBTQ+CC and cultural humility emerged with five categories: (1) planting the seed; (2) cultivating the nutrient soil; (3) growth and expansion; (4) fruition; and (5) nourishment and remedies for dryness. The emerging theory offers a clear blueprint for the process of cultivation, integration, and application of LGBTQ+CC and cultural humility among LGBTQ+ counselors. The emerging theory in this study explicates the elements of cultural humility in practice, including lack of arrogance, embracing mistakes, and other-orientedness, with suggestions for both training and practice through the lens of the development of LGBTQ+CC and cultural humility.
The purpose of this study was to examine the lived experiences of non-licensed Black, Indigenous, and People of Color (BIPOC) women counselors navigating predominantly White professional counseling environments. Using interpretative phenomenological analysis (IPA), six participants with at least 1 year of counseling-related experience shared their narratives through semistructured interviews. Five key themes emerged: systemic barriers, emotional and psychological impacts, structural exclusion, advocacy, and discrimination. Findings indicate that while participants experienced financial hardship, licensure challenges, racialized labor, and marginalization, they also demonstrated resilience, purpose-making, and culturally responsive advocacy. The results indicate gaps in professional recognition and support for non-licensed BIPOC women and offer implications for inclusive policy, training, and supervision practices in counseling.
Counselors who have had a client die by suicide are often reluctant to seek support from peers due to fears of blame, shame, or invalidation. In this randomized controlled study, we examined whether such counselors are perceived differently by their peers. Participants (N = 453) were licensed professional counselors who were randomly assigned a vignette that either included or omitted reference to the counselor's experience with client suicide and rated the counselor on nine characteristics using a semantic differential scale. We also explored whether participants' personal or professional experiences with suicide influenced their ratings, how often counselors experience client suicide, and whether suicide-related language affected referral likelihood. Results indicated no significant differences between groups, suggesting that counselors who have experienced a client suicide were not viewed more negatively by participants in this study and may represent an important source of peer support, challenging assumptions of stigma within the profession.
In the 1960s, Ralph Greenson conceptualized a model of a patient to consolidate empathy-based knowledge relating to a person. While the framework showed promise for clinical utility, it proved unwieldy and difficult to apply in psychoanalytic practice. Seeking to revise Greenson's creative work, a model of an individual updates and broadens the scope of his original formulation. The conceptual structure involves multiple perspectives of empathy curated from contemporary and classic literature in counseling and related fields of inquiry. Navigating among subjective, objective, and interpersonal empathy modalities, a counselor engages an empathic use of self in formulating a mental representation of a client. This awareness of an increasingly refined and nuanced way of knowing an individual bridges empathy with a wide range of therapeutic skills in the counseling process.
