Autism Spectrum Disorder (ASD) (replaces group of disorders called pervasive developmental disorders including autistic disorder, childhood disintegrative disorder, Asperger’s disorder, and pervasive developmental disorder NOS). The new ASD diagnostic criteria describe two primary sets of symptoms: 1) social communication and social interaction deficit, and 2) restrictive and repetitive behavior patterns. Each of these symptom sets (social and behavioral) will include three severity levels to identify the supportive services that are required. These three severity levels are: 1) requiring support, 2) requiring substantial support, and 3) requiring very substantial support. The DSM-5 describes each of these severity levels, with examples, to aid clinicians in making these determinations. Social Communication Disorder is a new diagnosis has been added to capture this group of children who have the social, but not the behavioral characteristics of autism.
RECENT TRENDS IN COUNSELING THAT EFFECT SCHOOL COUNSELORS Cherie Burgess Clinical Counselor Mid-Florida Community Counseling Childrens Home Society DSM-5 CHANGES EFFECTING KIDS Many of the disorders that were previously classified as, Disorders Usually First Diagnosed in Infancy, Childhood, and Adolescence are now classified as Neurodevelopmental Disorders. Autism Spectrum Disorder (ASD) (replaces group of disorders called pervasive developmental disorders including autistic disorder, childhood disintegrative disorder, Aspergers disorder, and pervasive developmental disorder NOS). The new ASD diagnostic criteria describe two primary sets of symptoms: 1) social communication and social interaction deficit, and 2) restrictive and repetitive behavior patterns. Each of these symptom sets (social and behavioral) will include three severity levels to identify the supportive services that are required. These three severity levels are: 1) requiring support, 2) requiring substantial support, and 3) requiring very substantial support. The DSM-5 describes each of these severity levels, with examples, to aid clinicians in making these determinations. Social Communication Disorder is a new diagnosis has been added to capture this group of children who have the social, but not the behavioral characteristics of autism. ADHD symptoms are largely unchanged but age of onset has changed from age 7 to 12. Specifiers have replaced sub-types (inattentive, hyperactive, & mixed). Comorbid diagnosis with Autism is now permitted. Oppositional defiant disorder and conduct disorder have been reclassified and moved into a new group of disorders called Disruptive, Impulse-Control, and Conduct Disorders (previously in Disorders of Infancy, Childhood and Adolescents) Separation anxiety and selective mutism have been reclassified and moved into Anxiety Disorders. However, the new Anxiety Disorder group does not resemble the DSM-IV. It no longer contains obsessive- compulsive disorder or PTSD (previously in Disorders of Infancy, Childhood and Adolescents) Trauma and Stressor-Related Disorders includes Reactive attachment disorder, PTSD and adjustment disorder. Disruptive mood dysregulation disorder (DMDD) is a new disorder listed under Depressive Disorders that captures a child who is chronically irritable and experiences frequent, severe temper outbursts that seem grossly out of proportion to the situation at hand. These children were often previously been diagnosed with pediatric bipolar disorder. These children do not experience the episodic mania or hypomania characteristic of bipolar disorder, and they do not typically develop adult bipolar disorder, although they are at elevated risk for depression and anxiety as adults. (DSM-5 Handouts Available) INCREASED ACCOUNTABILITY Professional Counselors are required to justify their work to their stakeholders. For school counselors, its their principals and school boards. For mental health counselors, its insurance companies. Mental Health Therapists are required to explain their diagnosis using thorough Biopsychosocial Assessments and completing treatment plans that include SMART goals. MUCH LIKE RTI TECHNOLOGY IN TREATMENT Online videoconferencing, counseling and supervision Electronic Medical Records APPS, Social Media Cyberbullying, Young adults and teens presenting with poor social skills and isolation issues As we journey more into the world of Skype, Facebook and other social media, we counselors have to learn to keep up with the Joneses as it were. Those of us who buck the system will be left behind. We have to meet our clients where they are, and it seems they want to be deeper into the 21st century. Think of the host of problems all of these new technologies will bring to the counseling office. We definitely need to be prepared! S. Kent Butler is an associate professor at the University of Central Florida and president of the Association for Multicultural Counseling and Development. INCREASED AWARENESS OF PERSONAL AND SOCIAL RIGHTS Consumers know their rights and are advocating for their rights Be ethical, compassionate and knowledgeable Increased awareness on social justice theories advocating for the poor and/or underrepresented groups The viability of the profession is dependent on our ability to take risks and think differently. We need to stop recreating existing models and practices. For this to occur, we need to admit students into counselor training programs and hire faculty who are unafraid of standing up to the status quo. We need people who will walk the talk rather than people who talk the walk. We need people who will make us uncomfortable. We need people who identify as social change agents within the profession. Don W. Locke, President of ACA CONTINUED NEED FOR A PROFESSIONAL IDENTITY Bradley Erford, past president of the American Counseling Association, states, How can we expect the public to understand who counselors are and what counselors do when we do not even agree on what to call ourselves? Developing a unified profession and helping promote a core identity as a counselor first and specialty area second is the preeminent professional challenge of the next decade (Counseling Today, March, 2012) COUNSELING FOR INFANTS AND CHILDREN Cirecie West-Olatunji, past president of the American Counseling Association and associate professor and director of the Center for Traumatic Stress Research at the University of Cincinnati, writes, The third trend in counseling is attention paid to counseling young children. Working with infants, toddlers and preschool children is an emerging area for counselors that allows them to traverse down the developmental pipeline to apply the core principles of counseling to young children. Such an area is appealing to professional counselors because counseling young children requires a focus on prevention and use of a developmental perspective. SCHOOL AND COMMUNITY COUNSELORS UNITING In order to meet growing student needs, school and community counselors are joining together. School and community counselors are trained to assist students with behavioral, social, and emotional challenges. Under the ASCA model, school counselors are not encouraged to work with individual students in a clinical model. In a school and community counseling partnership, students experiencing significant mental health concerns, substance abuse problems, or other debilitating difficulties would be referred to community counselors. Their role, under the Community Counseling model, would be to support the efforts of school counselors by providing therapeutic counseling to students. While each counselor has a unique role in the comprehensive system, all counselors will engage in some similar activities to engage and educate students. Just as school staff recognize the benefits of counseling, community counselors must realize the main function of the school is to educate students. Community counselors should follow the school counselors lead and embrace the culture of the school. The referral process guides staff members to collaborate and support the educational and emotional needs of students. TRAUMA-INFORMED COUNSELING Trauma-Informed Counseling will require ruling out or treating trauma as the primary cause that keeps clients stuck despite many attempts at counseling. Counselors will be required to learn specific evidence-based treatments (EMDR), as well as other neurobiological treatments that will emerge (Brainspotting), to help people break the recovery logjam not resolved by talk therapy alone. J. Barry Mascari, associate professor and chair of the Counselor Education Department at Kean University. He is also the American Association of State Counseling Boards delegate to the 20/20 initiative. HOLISTIC HEALTH & WELLNESS MODEL Barbara Herlihy, a university research professor in the counselor education program at the University of New Orleans, chair of ACAs International Committee and chair of the ACA Foundation writes, Thus, predictions are that brief-term, evidence-based, cognitive- behavioral approaches will dominate the future of mental health care. We believe that if counselors acquiesce to this status quo, we will contribute to the demise of our profession by rendering ourselves superfluous in a field already crowded with practitioners of the medical model. If, however, we can unite behind our identity as a profession that is uniquely strengths-based, holistic and grounded in the wellness model, we have the potential to turn the tide. NEUROSCIENCE (BRAIN-BASED COUNSELING) Allen Ivey states, There likely will be many new ideas to inform our research, theory and practice, but neuroscience will be at the forefront of what happens to us in the next 10 years. Counseling changes the brain. Counseling colleagues are already applying neuroscience principles as they conduct both counseling and research using functional magnetic resonance imaging (fMRI). In interviewing practice, I constantly maintain awareness of the clients attentional patterns and what likely is occurring in the brain. Relationship and empathic understanding have become even more important. Research demonstrates that high points of client/counselor empathy show in parallel movements on an fMRI. BRAIN SCANS (E.G. PET, CAT & SPECT) Technological advances in neuroscience provide a scientific explanation for its effectiveness. Today, and neurofeedback devices reveal the dynamic interplay between our thoughts and feelings, how feelings are "stored" in the body, and how they affect our thought processes. BRAIN SPECT IMAGING (SINGLE PHOTON EMISSION COMPUTER TOMOGRAPHY) SPECT is much like a PET Scan in that it is a nuclear medicine study that evaluates brain blood flow and activity patterns. In his book, Healing ADD: The Breakthrough Program That Allows You to See and Heal the 6 Types of ADD, Dr. Amen describes how to he uses SPECT studies to help him diagnosis and treat different versions of