APC cheat sheet

ACA Code of Ethics (2014) core principles: autonomy, nonmaleficence, beneficence, justice, fidelity, veracity.

Informed consent must cover: nature of services, counselor qualifications, fees, confidentiality limits, risks/benefits, right to withdraw.

Confidentiality exceptions: serious and foreseeable harm to self/others, abuse of vulnerable persons, court order, and client waiver.

Dual relationships: avoid when exploitation risk exists; document rationale if unavoidable and seek supervision.

Ethical decision-making models (e.g., Forester-Miller & Davis) steps: identify problem, apply code, determine nature/dimensions, potential actions, consult, choose, evaluate.

Counselor impairment: obligation to seek assistance and refrain from practicing when impaired; self-report to licensing board if needed.

Record keeping: retain clinical records per state law and payer requirements; include informed consent, assessments, treatment plans, progress notes, termination summary.

Supervision ethics: supervisors must ensure supervisee competence, obtain informed consent for supervision, and avoid multiple roles with supervisees.

Boundary crossings vs. violations: crossings may be benign and context-dependent; violations are harmful and always unethical.

Multicultural counseling competencies (Sue, Arredondo, McDavis): counselor awareness of own assumptions, knowledge of client worldview, and culturally appropriate intervention strategies.

Cultural encapsulation (Wrenn): counselor treats own cultural assumptions as universal and ignores cultural variation.

Racial identity models (e.g., Cross nigrescence): stages Pre-encounter, Encounter, Immersion-Emersion, Internalization, Internalization-Commitment.

Acculturation strategies (Berry): integration, assimilation, separation, marginalization; integration usually linked to best adjustment.

Microaggressions (Sue et al.): brief everyday verbal/nonverbal slights; types microassault, microinsult, microinvalidation.

Worldview (Ivey): locus of control and locus of responsibility combine to form internal, external, fatalistic, and utilitarian worldviews.

Privilege and oppression operate at individual, institutional, and cultural levels; counselors assess own social locations.

Language access: use qualified interpreters, not family members, and document language of service.

Spirituality/religion is a diversity dimension; assess without imposing values and distinguish spiritual from religious orientation.

Piaget stages: sensorimotor (0-2), preoperational (2-7), concrete operational (7-11), formal operational (11+).

Erikson psychosocial stages: trust/mistrust, autonomy/shame, initiative/guilt, industry/inferiority, identity/role confusion, intimacy/isolation, generativity/stagnation, integrity/despair.

Kohlberg moral development: preconventional (punishment/obedience, instrumental), conventional (interpersonal, law and order), postconventional (social contract, universal principles).

Attachment styles (Ainsworth): secure, anxious-ambivalent, avoidant, disorganized (Main & Solomon).

Vygotsky: zone of proximal development and scaffolding; learning is social and cultural.

Bronfenbrenner ecological systems: microsystem, mesosystem, exosystem, macrosystem, chronosystem.

Brain development: prefrontal cortex matures into mid-20s; risk-taking peaks in adolescence due to limbic maturation before prefrontal control.

Grief models: Kubler-Ross stages (denial, anger, bargaining, depression, acceptance) are non-linear; Worden tasks of mourning.

Aging: crystallized intelligence holds or grows; fluid intelligence declines with age; sensory changes affect counseling (hearing, vision).

Holland RIASEC types: Realistic, Investigative, Artistic, Social, Enterprising, Conventional; congruence between person and environment predicts satisfaction.

Super life-span/life-space theory: career development across life stages (growth, exploration, establishment, maintenance, decline) and life roles.

Trait-and-factor (Parsons): know self, know world of work, true reasoning to match.

Krumboltz social learning theory: career decisions influenced by genetic endowment, environmental conditions, learning experiences, task approach skills.

Gottfredson circumscription and compromise: career aspirations narrowed by gender and prestige; compromise occurs in accessibility, then prestige, then interest.

Work values (e.g., Super): achievement, altruism, autonomy, creativity, economic returns, lifestyle, prestige, safety, social interaction.

Career assessment tools: Strong Interest Inventory (RIASEC), Myers-Briggs Type Indicator (not a career test), O*NET for occupational information.

Career counseling with diverse clients: consider discrimination, acculturation, family expectations, and opportunity structure.

Rogerian core conditions: unconditional positive regard, empathy, congruence (genuineness).

Psychoanalytic: id, ego, superego; defense mechanisms; transference and countertransference; free association, dream analysis.

Cognitive behavioral: identify automatic thoughts, cognitive distortions, and behavioral experiments; ABC model (Ellis) and cognitive triad (Beck).

Solution-focused (de Shazer): miracle question, scaling, exceptions, and strengths; brief and goal-oriented.

Motivational interviewing (Miller & Rollnick): OARS (open questions, affirmations, reflections, summaries); rolling with resistance; stages of change (Prochaska & DiClemente).

Person-centered: actualizing tendency; reflection of feeling; avoid advice-giving and interpretation.

Family systems: boundaries, triangulation, differentiation (Bowen), structural family therapy (Minuchin).

Group vs. individual: group offers universality, altruism, instillation of hope (Yalom therapeutic factors).

Termination: plan from intake, review progress, consolidate gains, address relapse prevention and referrals.

Yalom therapeutic factors: universality, altruism, instillation of hope, corrective recapitulation, imparting information, imitative behavior, interpersonal learning, group cohesiveness, catharsis, existential factors, self-understanding.

Group stages (Tuckman): forming, storming, norming, performing, adjourning.

Group types: psychoeducational, counseling, psychotherapy, task/work groups; leadership style varies by type.

Screening: pre-group interview to assess fit, goals, risk, and informed consent for group participation.

Confidentiality in groups cannot be guaranteed; leaders must state limits and obtain commitment from members.

Co-leadership advantages: shared observation, modeling, continuity; disadvantages: cost, coordination, competition.

Ethical group leadership: protect members from harm, manage scapegoating, address monopolizing, and intervene in conflict.

Group norms: establish early (attendance, punctuality, self-disclosure, feedback) and revisit as needed.

Reliability: consistency; types test-retest, parallel forms, internal consistency (Cronbach's alpha), inter-rater.

Validity: content, construct, criterion (concurrent, predictive); reliability is necessary but not sufficient for validity.

Standard error of measurement (SEM) = SD × √(1 − reliability); used to build confidence intervals around scores.

Norm-referenced vs. criterion-referenced: compare to group vs. absolute standard.

Intelligence tests: Wechsler scales yield Full Scale IQ (mean 100, SD 15); index scores also mean 100, SD 15.

Achievement vs. aptitude: achievement measures learned knowledge; aptitude predicts future performance.

Personality inventories: MMPI-2 (clinical scales, validity scales), NEO-PI-R (Big Five), projective tests (Rorschach, TAT) have lower reliability/validity evidence.

Test bias vs. fairness: bias refers to differential validity; fairness includes opportunity and access.

Ethical test use: only use tests within competence, follow publisher qualifications, protect security of materials, obtain informed consent.

Quantitative designs: experimental (random assignment), quasi-experimental (no random assignment), correlational, descriptive.

Threats to internal validity: history, maturation, testing, instrumentation, regression to the mean, selection, attrition.

External validity threats: sample representativeness, setting, time, reactivity.

Sampling: probability (random, stratified, cluster, systematic) vs. nonprobability (convenience, purposive, snowball).

Statistics: mean, median, mode; standard deviation; correlation coefficient r (−1 to +1); effect size (Cohen's d: .2 small, .5 medium, .8 large).

Inferential errors: Type I (false positive, alpha) and Type II (false negative, beta); power = 1 − beta.

Qualitative methods: grounded theory, phenomenology, ethnography, case study; trustworthiness (credibility, transferability, dependability, confirmability).

Program evaluation: needs assessment, process evaluation, outcome evaluation, cost analysis; logic models link inputs, activities, outputs, outcomes.

Ethics in research: IRB approval, informed consent, minimal risk, confidentiality, and reporting accurate results.

DSM-5-TR uses a multiaxial-free system; diagnoses coded with ICD-10-CM codes.

Mental status exam components: appearance, behavior, speech, mood/affect, thought process/content, perception, cognition, insight/judgment.

Differential diagnosis: rule out medical conditions and substance use before assigning a mental disorder.

Treatment plan components: presenting problem, goals (measurable, time-bound), objectives, interventions, responsible parties, timeline, evaluation method.

Severity specifiers: mild, moderate, severe; course specifiers (e.g., in partial remission, recurrent).

Common diagnoses: major depressive disorder, generalized anxiety disorder, PTSD (requires exposure to trauma), bipolar I vs. II (mania vs. hypomania).

Risk assessment: ideation, plan, intent, means, history, protective factors; document and take action per duty-to-warn/protect laws.

Collaboration: coordinate with psychiatrists, primary care, and other providers; obtain releases for communication.

Termination and referral: when client needs exceed counselor competence, refer and document.