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Chapter 7
Competence, Assessment, and Diagnosis
FOCUS QUESTIONS
1. If you were a prospective client seeking counseling, how would you go about finding a
counselor who is competent to help you?
Points instructors may want to make:
2. How do counselors determine whether they are competent to counsel a particular
client?
Points instructors may want to make:
3. Do you think it is appropriate for a counselor to refer a client whose beliefs and
behaviors conflict with the personal values of the counselor?
Points instructors may want to make:
4. What do you think should be done if a counselor becomes addicted to alcohol and is
not counseling effectively?
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Points instructors may want to make:
5. Evaluation, as an end in itself, is a very different process from counseling. Why would a
counselor want to be an evaluator?
6. To what degree do you believe counselors are competent to administer and interpret
psychological tests?
Points instructors may want to make:
7. The DSM-5 system for diagnosis is based on pathology and the medical model of mental
illness, whereas counseling is grounded in the wellness model. Why must counselor
learn to diagnose clinical disorders?
Points instructors may want to make:
IN-CLASS ACTIVITY
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Title: Personal Definitions of Competence
Learning
Goal: To learn about students’ and others’ understanding of competence and to
explore personal feelings of incompetence related to the counseling profession.
Procedures: Give a brief introduction to the concept of competence and then assign class
members to small groups. Allow each member of the group to discuss what he
or she believes competence to be. Then, allow group members to discuss their
own areas of personal and professional competence and areas in which they
question their competence.
Discussion
Questions: What do you think it means to be competent? With which clients or in what
situations would you feel incompetent to counsel right now and why? What did
you learn about yourself and others through the in-class activity? What was this
exercise like for you?
Point/Counterpoint (Debate) Topics
Title: Responding to Illegal Activities of Other Counselors
Learning
Goal: To consider the arguments for reporting illegal conduct of colleagues that do not
pose a direct risk to clients.
Procedures: Assign (or allow students to volunteer) 2 groups of students (preferably 3-5
students per group) to each take one of the positions described below and
prepare a 5-minute argument in favor of that position. Have each group present
its argument. Next, allow the groups to confer for 2 minutes and then have each
group present its rebuttal to the other group’s argument. Lastly, have the class
members who served as the audience vote for which side was most persuasive.
Point: Counselors should not be expected to report activities of their colleagues that
are illegal (i.e., lying to healthcare companies for reimbursement, not reporting
income to IRS, having a sexual relationship with a minor), but do not pose direct
harm to clients.
vs.
Counterpoint: Counselors should have a duty to report illegal activities of their
colleagues (i.e., lying to healthcare companies for reimbursement, not reporting
income to IRS, having a sexual relationship with a minor), even if they do not pose
direct harm to clients.
Title: Filing Ethical Complaints Anonymously
Learning
Goal: To consider the arguments both for and against counselors filing ethical
complaints anonymously.
Procedures: Assign (or allow students to volunteer) 2 groups of students (preferably 3-5
students in each) to each take one of the positions described below and prepare a
5-minute argument in favor of that position. Have each group present its
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argument. Allow the groups to confer for 2 minutes and then have each group
present its rebuttal to the other group’s argument. Have the class members who
served as the audience vote for which side was most persuasive.
Point: Counselors should be able to submit ethical complaints anonymously.
Anonymity allows counselors to submit complaints without fear of retaliation, which
might prevent reporting.
vs.
Counterpoint: Counselors should not be able to submit ethical complaints
anonymously. Anonymity may lead to the filing of unwarranted complaints.
OUTSIDE CLASS ACTIVITY
Title: Reflections on Incompetence
Learning
Goal: To reflect on personal and professional areas of competence and how to further
develop as a counselor.
Procedures: Write a 3-6-page paper reflecting on your personal and professional feelings of
incompetence, as they relate to counseling. Discuss ways in which you intend to
continue to develop competence as a professional counselor throughout the
course of your career.
Topic for Self-Reflection/Journaling
Topic: Reflect on what you have learned about cultural bias in diagnosis. Consider the
cultural characteristics of your intended future clientele and discuss steps you will take, as a
counseling practitioner, to assure that you do not perpetuate bias in diagnosis.
CASE STUDY
Bill is an elementary school counselor. A child he counsels has told him that his father
drinks heavily and seldom works. The child also states that his mother works all the time and
does her best to care for him and his siblings. The mother asks Bill if he would be willing to
testify in court that she is a better parent than her son’s father, so that she can get custody of her
children. Bill appropriately declines, saying that his role is to counsel children, not to evaluate
which parent is better. Despite Bill’s response, he receives a subpoena and his principal, after
checking with the school prosecuting attorney for the board, tells Bill he must go to court and
answer any factual questions asked. After he is sworn in as a witness, Bill is asked to give
information regarding his interactions with the child. He then is asked by the mother’s attorney
to offer his opinion of the mother’s parenting skills and state whether he believes the child would
be better off in the custody of his mother or his father.
Case Study Discussion
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Counselors should not agree to serve as evaluators in court unless they are hired to serve as
expert witnesses or unless their job description requires them to serve as evaluators of some type.
Bill should respond that he does not have adequate information to form a professional judgment
about the matters when he is asked to evaluate the mother’s parenting skills or to give his
opinion as to who would be the better parent. Counselors who take sides in custody battles lose
the possibility of a relationship with both parents and compromise their objectivity as counselors.
SHORT PAPER OR ORAL CLASS PRESENTATION TOPICS
1. State Licensure Requirements – How Do I become Licensed?
2. What steps will I take in the future to maintain my competence?
3. The Pros and Cons of Testing Clients for Counseling Purposes
4. The Advantages and Disadvantages of Using the DSM-5