An Overview of Feminist Counseling

Course #76884 - $30-


Study Points

  1. Discuss the demographic landscape of the United States as it pertains to gender.
  2. Analyze how sex and gender influence cognitive scripts and behaviors.
  3. Describe the historical context of feminism.
  4. Identify and define the different types of feminism.
  5. Discuss the role of gender biases in mental health diagnosis, assessment, and clinical practice.
  6. Identify the premises of feminist counseling.
  7. Outline interventions and therapy goals based on feminist counseling.
  8. Discuss ethical implications within the context of feminist counseling.
  9. Explain key controversies and future directions of feminist counseling.

    1 . Which of the following demographic statements is FALSE?
    A) Women make up less than half of the U.S. population.
    B) A woman who graduates from college will earn less in her lifetime compared to her male counterpart.
    C) In 2000, 23% of women and 26% of men graduated college, a smaller gap than was present in 1970.
    D) Women 85 years of age and older in the U.S. outnumber their male counterparts by 1.9 million.

    WOMEN IN THE UNITED STATES: SOCIODEMOGRAPHIC PROFILE

    Currently, women make up more than half of the U.S. population. As of 2021, U.S. Census data shows that, overall, women slightly outnumber men; 50.6% of the total population is female [74]. In 2021, there were 168 million women in the United States, outnumbering their male counterparts by about 4 million [74]. There were 3.8 million women 85 years and older, outnumbering men in this age group by 1.6 million [74].

    Over the years, the educational disparity between men and women has decreased. In 1970, 5% more men than women graduated from college. However, this gap has disappeared in the past 50 years; in 2021, 36.1% of women 25 years of age or older had attained a Bachelor's degree or higher, compared with 33.9% of men [74].

    This is also reflected in the occupational sectors, as more and more women are represented in professional fields. Overall, in 2021, 79.1 million women 16 years of age and older (58.2%) participated in the civilian labor force [74]. In 2019, the U.S. Census showed that 26.7% of persons working in science, technology, engineering, and mathematics (STEM) fields were women; in 1970, only 17% of workers in comparable fields were women [65,74]. In the medical fields, the number of female physicians and surgeons increased to 38.2% (from 32%) and female dentists to 32.9% (from 23%) between 2010 and 2019 [79]. Although women have made great strides in the last three decades, there continue to be disconcerting trends. In 2019, women were still not well represented in the business, management, and financial services sector (43.7%) and in the computer, engineering, and sciences sector (24%) [79].

    Women tend to be over-represented as nurses, administrative assistants, and elementary and middle school teachers [79]. The U.S. Census Bureau indicates that women are still more highly represented as secretaries and administrative assistants than any other occupation [79]. In 2019, full-time employed women in the United States earned only 80.8% of the median annual salary of men; this was an increase of 6.3% compared with 2004 [49,74]. In 2018, the median income for full-time employed men was $55,291, while for women it was $45,097 [136]. A female college graduate will earn $1.2 million less during her lifetime compared to her male counterpart [49].

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    2 . What is the key difference between the terms "sex" and "gender"?
    A) Gender is innate, while sex is dynamic.
    B) Gender is a biologic concept, and sex has sociologic connotations.
    C) Sex is a biologic classification based on reproductive organs, and gender is tied to social characteristics associated with men and women.
    D) All of the above

    SEX AND GENDER

    The terms gender and sex are often used interchangeably and have been conflated over the years. However, it was not until the 1970s that it was advocated that the two terms not be used interchangeably [80]. The term "sex" conveys that sex differences are biologic and fixed [137]. It has referred to physiological aspects such as genitalia and chromosomes [32]. On the other hand, gender is a sociologic concept and refers to the characteristics and traits that are viewed as appropriate to men and women as defined by societal norms [16,32,138]. In other words, gender is a social construct influenced by societal, institutional, historical, and cultural norms [63]. Gender affects patterns of societal, community, familial, and individual expectations; processes of daily life; intrapsychic processes; and social interactions [47]. Gender is also defined by existing institutions and ideologies and is imbued with views about power differentials. Meanwhile, sex is the biologic classification based on reproductive organs (i.e., male and female) [63]. Upon birth, an individual is classified as male or female based on the appearance of their genitals [16]. Sex revolves around what is biologic or natural, while gender is related to what is learned due to the social, political, and cultural influences [16]. This has important implications for discussions of differences between men and women. Is it implied that these differences are natural and unchangeable? Or can they be altered through activism and changes in social and institutional forces [80]?

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    3 . The difference perspective argues that differences between the genders are shaped by the different subcultures in which men and women reside.
    A) True
    B) False

    SEX AND GENDER

    There are also four general approaches or perspectives to conceptualizing gender [110]. The deficit approach makes the assumption that women's behaviors and responses reflect a deficit, often in comparison to men's behaviors. The dominance perspective frames understanding of behaviors under the headings of men's power and women's subordination. The third approach is the difference perspective, which argues that differences between the genders are shaped by the different subcultures in which men and women reside. Finally, the dynamic or social constructivist perspective emphasizes the dynamic nature of interaction and the meanings ascribed to these interactions [110].

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    4 . Which of the following cognitive structures are influenced by gender?
    A) Attributions
    B) Expectancies
    C) Perceptions about men and women
    D) All of the above

    SEX AND GENDER

    Knowledge of an individual's gender provides information that ultimately influences how people behave, think, and react to individuals [38]. Hoffman and Pasley assert there are five cognitive structures influenced by gender [38]:

  1. Perceptions about men and women

  2. Attributions, or explanations based on being male or female

  3. Expectancies, or predictions based on whether one is male or female

  4. Assumptions regarding the nature of men and women

  5. Beliefs or standards, or the underlying systems that define how men and women "should be"

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    5 . Which of the following classifies women as a vulnerable population?
    A) Marginalization and oppression
    B) The notion that biology is destiny
    C) Gender stereotypes and prejudice
    D) Increased risk for physical, psychologic, and/or social harm and the lack of resources for protection from these harms

    SEX AND GENDER

    A vulnerable population is defined as a group that is more at risk of physical, psychologic, and social harm or lacks the means to protect themselves [1]. A group's lack of protection may be due to past or existing marginalization or lack of access to services due to social, economic, and/or political circumstances [70]. Consequently, women as a group can be classified as a vulnerable population [1]. For example, women are twice as likely to be diagnosed with depression, and studies show that gender differences in presentation of depressive symptoms may start as early as adolescence [81]. They are also 1.5 to 2 times more likely than men to be diagnosed with an anxiety disorder [141]. Women are at a higher risk of violence by their intimate partners, and in some countries, they are at higher risk for human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS). Their gender and the differential access to resources and privileges impacts their protective capacities. A woman may be afraid to ask her spouse/partner to wear a condom because to do so could be perceived as accusing him of adultery and could result in negative repercussions, such as domestic violence [1]. Women who perceive and experience sex discrimination (conceptualized as a social stressor) are more likely to have poor health or a diagnosis of clinical depression [142].

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    6 . In which wave of feminism did the women's suffrage movement take place?
    A) First wave
    B) Second wave
    C) Third wave
    D) Postmodernist wave

    HISTORICAL SNAPSHOT OF THE FEMINIST MOVEMENT AND FEMINIST THERAPY

    The feminist movement can be classified in three different waves. The first wave spanned the 19th century to the early 20th century. Middle-class women in the 1830s formed charitable and benevolent societies to help sex workers and the destitute. They later embraced the cause of slavery and put voice to the abolitionist movement [24]. Feminists during this time also advocated for the importance of bringing women's influence into men's spheres, such as for women's right to vote [112]. The Seneca Falls Declaration of 1848 rejected the prevailing doctrine of women's innate inferiority. After the Civil War, these first-wave feminists took up the temperance movement, which continued into the early part of the 20th century. During this time, they also focused on social welfare and labor reform, advocating for reform of working conditions in factories and for women and child laborers, specifically limiting women's working hours, developing minimum wage, and banning child labor [24]. Women's enfranchisement was also another key issue during this wave [90]. After women won the right to vote in 1920, this first wave of feminism waned and lost momentum [16]. In this first wave, issues of class and race can affect women's lives were largely ignored, as the recognized movement was largely co-opted by upper-class White women [90,112].

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    7 . The second wave of feminism in the United States began in the 1960s and continued until the 1990s.
    A) True
    B) False

    HISTORICAL SNAPSHOT OF THE FEMINIST MOVEMENT AND FEMINIST THERAPY

    The second wave of feminism in the United States began in the 1960s and continued until the 1990s. The 1960s were a time of civil, social, and political discontent. The youth of this generation questioned the existing authority and government structures, the Vietnam War, and the marginalization and oppression of various minority groups (e.g., racial/ethnic minority groups, women, and gays and lesbians). In Betty Friedan's book The Feminine Mystique, she analyzed the time period after World War II and the social, cultural, and political forces that reinforced notions of women's bodies, domesticity, and femininity and how they impeded women's freedoms [144]. She later co-founded the National Organization for Women (NOW) [19].

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    8 . Which wave of feminism places emphasis in making feminism more inclusive, diverse, and palatable to younger generations of women?
    A) First wave
    B) Second wave
    C) Third wave
    D) Postmodernist wave

    HISTORICAL SNAPSHOT OF THE FEMINIST MOVEMENT AND FEMINIST THERAPY

    The third wave of feminism started in 1990 and continued to around 2013 [112]. With roots in black feminist work, this wave is considered diverse, with no one philosophical stance; however, the third wave was viewed as a new feminist discourse for understanding gender relations that takes into account the inadequacies of the previous waves [48,82]. Third-wave feminists saw themselves as, "making right some of the second wave's wrongs. In many cases, feminists of the third wave perceived themselves as rebelling against their second-wave predecessors [88]. They posit many of their arguments in response to or in reaction to second-wave positions on sexuality, power, and culture" [57]. Third-wave feminists gave women the latitude to define feminism for themselves, and they strove to make the movement more inclusive and diverse [48]. This third wave has underpinnings in postmodernism, contending for individual choice and individualized feminism [112]. These feminists targeted young women who may believe in feminism but are concerned with the negative connotations [4]. Feminists of this period emphasized individual empowerment; however, critics assert that they did not adequately focus on collective activism to challenge systemic injustices and inequities perpetuated by structural forces [146]. While Ms. was the platform for many feminists in the second wave, the third wave took on utilizing homemade pamphlets (zines) and the Internet to disseminate their views using blogs, art, and music [88].

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    9 . What is intersectionality in the context of feminism?
    A) Neocolonialism
    B) Emphasis on exclusivity
    C) The importance of all feminists to work collaboratively to find where oppression intersect
    D) Multiple factors such as race, ethnicity, socio- economic status, and religion exist alongside with gender to create multiple oppressions

    HISTORICAL SNAPSHOT OF THE FEMINIST MOVEMENT AND FEMINIST THERAPY

    Third-wave feminists argued for intersectionality. The first and second waves of feminism downplayed the role of ethnicity and race and instead emphasized the unity of all women—the sisterhood of women and issues pertinent to all women [48]. Third-wave feminism argues that multiple, simultaneous oppressions exist, including oppression stemming from gender and race/ethnicity, and they are inseparable and intertwined [48]. In other words, women inhabit simultaneous conditions of marginality based on race, class, sexual orientation, age, and many more factors [82,144]. As a result, the third wave of feminism advocated for a more inclusive approach, embracing other social groups (e.g., racial/ethnic minority women, gay women, etc.) [4]. Queer theory, for example, emerged during this period [144]. There are three core tenets of intersectionality [84]:

    • Social identities are not unidimensional but multidimensional.

    • Focus should be on oppression and marginalization, because it can be argued that everyone occupies multiple social locales.

    • Macrostructural forces, such as racism, poverty, sexism, and discrimination, intersect with social identities on the micro level, which ultimately produces disparities.

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    10 . One of the solutions to remedy gender inequality proposed by liberal feminists is the dismantling of capitalism.
    A) True
    B) False

    TYPES OF FEMINISM

    Liberal feminists argue that the differences between men and women are due to sex role socialization and patriarchal ideologies embedded in social institutions [52]. The fight for gender equality is at the heart of liberal feminists' work, with a goal to pave equal opportunities and access for men and women [175]. One of the solutions to remedy gender inequality proposed by liberal feminists is the implementation of laws to provide equal access [49; 175].

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    11 . Which type of feminism argues that the solution is to develop a separate "womanculture"?
    A) Liberal feminism
    B) Global feminism
    C) Radical feminism
    D) Marxist feminism

    TYPES OF FEMINISM

    Radical feminists link women's oppression to the sexism that permeates every dimension of day-to-day lives [49; 175]. They argue that gender differences are rooted in the notion of essentialism [52,148]. Essentialism propounds that women's identity is linked to a single trait, specifically that women are more caring and nurturing and less aggressive than men. Neither essential gender role is superior, but the existing social order is predominantly patriarchal and reinforces male attributes [52,148]. Sexism is so deeply ingrained that some radical feminists have argued for separatism, advocating for an exclusive "womanculture"—a female science, female religion, female arts, rejection of the nuclear family, etc. [17,115]. In other words, existing institutional structures should be recreated to be more woman-oriented [176]. These political tenets had underpinnings of destruction, and Valerie Solanas's SCUM Manifesto became the prominent symbol for radical feminists [115]. One of the major criticisms of radical feminism lies in their assertion for essentialism, focusing on the objectification of a woman's body and a reductionistic explanation linking women's roles to biology [148].

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    12 . Marxist feminism focuses on
    A) the oppression of neocolonialism.
    B) the role of capitalism in the oppression of women.
    C) the role of race and ethnicity on the oppression of women.
    D) fighting for equal opportunities and access for men and women.

    TYPES OF FEMINISM

    Marxist feminism is viewed as revolutionary. Although these feminists argue for structural change, they focus on class structure, as they believe women's oppression is rooted in capitalism [17; 149; 175]. Women's socioeconomic positions and classism are at the heart of this type of feminism. Marxist feminists trace patriarchy and women's oppression to women's roles being historically limited, meaning that patriarchy can only be eradicated if the separation of public and private work (i.e., housework) disappears [175]. Therefore, women are doubly oppressed as a result of their sex and class [149]. To Marxist feminists, domestic work is considered productive work, because although this work is "invisible," it is still important [116]. Therefore, Marxist feminists target women's work (both paid and unpaid) and focus on raising revolutionary consciousness of working women to instigate change [17]. They also posit that classism results in disparities in access to resources, manifested as, for example, healthcare disparities. However, beyond this, Zrenchik and McDowell assert that classism also results in the unequal distribution of respect and admiration [91]. Segments of the poor in society are therefore often labeled as "immoral," "criminal," or "dirty" [91]. Marxism feminism has resurfaced in recent years as globalization has increased poverty, migration, and violence around the world [150]. Marxist feminists attempt to understand these trends as the struggle within class, race, and gender.

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    13 . Global feminists emphasize the issues of oppression, marginalization, and discrimination among all women globally.
    A) True
    B) False

    TYPES OF FEMINISM

    Global feminists emphasize the issues of oppression, marginalization, and discrimination among all women globally. They maintain that other non-dominant and non-Western perspectives should be taken into account, focusing on oppression as it relates to neocolonialism (economic structures created by former colonial powers to maintain colonies' dependencies) and global capitalism [16,118]. Issues such as education, sex work, and access to health care are important topics for global feminists [16].

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    14 . Which of the following classifications of feminism focuses on women in developing countries?
    A) Ecofeminism
    B) Postcolonial feminism
    C) Poststructural feminism
    D) Women-of-color feminism

    TYPES OF FEMINISM

    The focus of postcolonial feminism is on women in developing countries. Postcolonial feminists argue that Western and androcentric models of feminism are not appropriate for women born and living in developing countries, particularly those that experienced white/Western imperialism [149]. Their struggles and subjective experiences are uniquely different from white women in Western industrial countries [149].

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    15 . What was an early explanation for mental illness in women?
    A) Sin
    B) A wandering womb
    C) The inherent weakness of women
    D) All of the above

    GENDER BIASES

    The notion of abnormality is heavily influenced by social and cultural norms. Early philosophers have depicted women as irrational beings [16]. Harris and Lighter assert that, historically, when women were the focus of attention in the mental health fields, they were "in the role of patient or repository of psychopathology, not as exemplar of healthy personality development" [36]. In the 1700s and 1800s, women's mental illness was linked to sin and vice [152]. Later, women's mental illness was tied to the "weaker" female constitution due to menstruation, pregnancy, and menopause [71,152]. Some even argued that a woman's womb moved aimlessly throughout the body, causing insanity and draining life energy [71]. Hysteria, a disorder that involved the nervous system, was commonly diagnosed among women in the 18th and early 19th centuries, and many physicians believed this was a natural state for women (e.g., excitability, difficulty, egocentrism), but a "morbid state" for men [120].

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    16 . Existing traditional personality theories are based on traditionally female values and benchmarks of normality.
    A) True
    B) False

    GENDER BIASES

    Some have argued that the negative construction of women's bodies and behaviors essentially functioned as social control. Women's roles were maintained and perpetuated by labeling socially unacceptable behaviors as "hysterical," "insane," or "neurotic" [71]. Overall, a feminist approach to science minimizes a "masculine" approach to ensure it is not the predominant perspective [153]. Existing traditional personality theories are based on traditionally male values and benchmarks of normality; a feminist approach advocates for a shift to honoring women's values and experiences [177].

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    17 . Which of the following personality disorders is diagnosed more frequently in men than women?
    A) Histrionic personality disorder
    B) Antisocial personality disorder
    C) Borderline personality disorder
    D) Dependent personality disorder

    GENDER BIASES

    Some experts have argued that the DSM is androcentric and that the diagnostic labels are gender biased and judgmental of women, arising from the psychopathologization of women and their roles [121,177]. In 1968, the DSM-II portrayed hysterical personality disorder as an extreme parody of femininity [120]. Personality disorders like dependent personality disorder, borderline personality disorder, and histrionic personality disorder reinforce notions about the pathology of dependency and emotionality, attributes generally ascribed to women [154]. Interestingly, dependent personality disorder is not associated with men, despite the fact that, historically, men were often reliant on women to care for the home and to provide caregiving [27,72]. Borderline personality disorder is also diagnosed more often in women than men and is characterized by impulsivity, instability in relationships, and intense fear of abandonment, which consequently leads to behaviors to avoid abandonment [95]. Women who express volatility and anger are more likely to be categorized as having borderline personality disorder and prescribed medication [178]. Overdiagnoses of certain psychiatric conditions are a reflection of how social institutions respond to women who deviate from socially accepted norms of femininity [178,179].

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    18 . What is the overarching goal of feminist therapy?
    A) To make the personal political
    B) To identify potential feminists
    C) To raise community consciousness
    D) To assist clients to break out of stereotypical expectations regarding gender norms

    BASIC PRINCIPLES OF FEMINIST THERAPY

    Although there are several types of feminism, a few principles or overarching themes are common among them and in feminist therapy. It is important to remember that feminist therapy is not meant to exclude men or to isolate women from men. The goal of feminist therapy is to assist every individual to break out of stereotypical expectations regarding gender norms and behaviors that ultimately lead to dysfunction [4]. Feminist therapists believe that gender, power, and culture are important contextual factors influencing clients' personal experiences and views [181].

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    19 . One way to promote egalitarian relationships in the clinical process is for the practitioner to be transparent with the objectives of the therapy and to avoid the use of clinical and professional jargon that the client cannot understand.
    A) True
    B) False

    BASIC PRINCIPLES OF FEMINIST THERAPY

    Another important aspect of feminist counseling is de-emphasizing hierarchal relationships. Patriarchal ideologies and power imbalances permeate society. As such, many relationships that women experience may be hierarchal and oppressive. In feminist counseling, the therapeutic relationship should minimize hierarchal relationships and reflect a more collaborate and egalitarian partnership between the client and the clinician [15,158]. One way to promote egalitarian relationships in the clinical process is for the practitioner to be transparent with the objectives of the therapy and to avoid the use of clinical and professional jargon that the client cannot understand [20,181]. Many women may have felt disempowered by the medical community [181]. Facilitating mutual goal-setting and providing information about therapy are also recommended [158].

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    20 . Nonsexist therapy is characterized by
    A) emphasizing change at the cultural level.
    B) a focus on the environment in which the client lives.
    C) advocating for social change to eradicate oppression.
    D) assisting clients to adjust to discrimination and gender role inequalities.

    BASIC PRINCIPLES OF FEMINIST THERAPY

    Feminist practitioners advocate for social change in order to eradicate injustices and oppression. On the other hand, a nonsexist clinician focuses on assisting women to minimize the distress they experience due to traditional gender role socializations and to adjust to discrimination and gender role inequalities. Feminist counseling/therapy emphasizes change at the macro level, to cultural, social, and political forces, that will help to eliminate women's problems and result in social justice. Nonsexist counseling/therapy focuses more on a client's intrapsychic state rather than the environment in which the client exists [20].

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    21 . Which of the following is NOT a step in gender role analysis?
    A) Identification of gender role beliefs and expectations
    B) Rejection of relationships built on enforced gender role norms
    C) Implementation of a specific plan to address internalized beliefs
    D) Discussion of how gender role expectations have affected the client's life

    FEMINIST INTERVENTIONS AND STRATEGIES

    The goal of gender role analysis is to assist clients to identify the specific gender role expectations and messages that influence their behaviors as well as behaviors that they engage that might reflect specific gender role expectations that ultimately impede them from achieving their goals [124,177]. Five steps are necessary in true gender role analysis. First, the clinician helps the client to identify various gender role beliefs and expectations experienced from early childhood [60]. Second, the clinician and the client discuss how these expectations have affected the client's life negatively and positively. Third, the client works to identify internalized beliefs based on these gender role expectations. Fourth, with the help of the clinician, the client will decide which of the internalized beliefs he/she would like to address. Finally, a specific plan is developed to implement and monitor changes [60]. It is important for clients to understand the sources of gender role messages and to identify what reinforcers and punishments exist for adhering to these messages [159]. Clients should be encouraged to evaluate the costs and benefits if they were to eliminate certain messages.

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    22 . Feminist therapy should be limited to work with women.
    A) True
    B) False

    FEMINIST INTERVENTIONS AND STRATEGIES

    Again, feminist therapy is not limited to women. For example, men who are diagnosed with body image dissatisfaction can use bibliotherapy within a feminist framework to educate themselves on healthy body image, nutrition, and self-esteem [97]. Any intervention aiming to ultimately empower clients to move out of socially learned scripts may be feminist.

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    23 . A feminist counselor is working with a client who is having difficulties adjusting to her new job. The client states that she does not feel confident about talking with her husband about helping her with various household chores so she can balance her time better. After discussing various intervention plans, the client states she would like to learn some new skills—assertiveness, time management, and coping. Which theoretical orientation may be helpful in guiding this case?
    A) Reframing
    B) Social action
    C) Balancing power
    D) Assertiveness training

    FEMINIST INTERVENTIONS AND STRATEGIES

    Assertiveness has been defined as behaviors that involve standing up for one's rights without violating the rights of others [60,161]. Assertive skills training frequently involves cognitive-behavioral strategies to assist clients in verbalizing their needs/desires, developing social skills, and reducing anxiety that arises when executing assertive behaviors [161]. Many feminist practitioners argue that women may need to be taught assertiveness skills due to the fact that assertiveness is not usually considered a desirable female attribute. The underlying assumption of assertiveness training is that after women are educated about their personal rights and taught skills to overcome perceived barriers, other positive outcomes (e.g., enhanced self-esteem) will follow [25].

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    24 . How is the practitioner-client relationship viewed within a feminist therapeutic context?
    A) Patriarchal
    B) Hierarchical
    C) Collaborative
    D) Rational-emotive

    FEMINIST INTERVENTIONS AND STRATEGIES

    Feminist practitioners work with clients to promote awareness of the differences in power relations between men and women in society (also known as power analysis) [60,124]. The first step is to explore definitions of power with the client and to assist clients to identify which definition of power best fits within the client's value orientation. Subsequent steps involve helping the client to recognize internalized messages about power and to alter them [15]. In order to model egalitarian relationships, the therapeutic environment becomes crucial. As discussed, in feminist counseling and therapy the clinician/client relationship is collaborative. Instead of the clinician simply diagnosing the client's distress, the therapist and client dialogue and work collaboratively to discuss potential reasons and meanings of the symptoms [29]. Clients are given the position of the expert and control what occurs in therapy. They also have the freedom to voice disagreements with the practitioner [18].

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    25 . In feminist psychoanalysis, the client is encouraged to explore how Oedipal issues reinforce existing gender identities and male domination.
    A) True
    B) False

    FEMINIST INTERVENTIONS AND STRATEGIES

    As discussed, many feminists have criticized Freudian concepts such as penis envy, the Electra complex, and mothers as roots of psychologic disorders. One of the predominant themes in feminist psychoanalysis is that because of experiences during infancy, women tend to have a deeper emotional connection with others [12]. In feminist psychoanalysis, the client is encouraged to explore how Oedipal issues reinforce existing gender identities and male domination [60]. The role of the clinician is to simultaneously serve as the mother and therapist to facilitate the client's work in balancing the tasks of individuating and emotionally connecting with others [12].

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    26 . All of the following elements are at the heart of feminist family therapy, EXCEPT:
    A) Avoidance of gender as a topic in therapy
    B) A collaborative and nonhierarchical therapist-client relationship
    C) Encouragement of egalitarian relationships by valuing female partners' needs
    D) Promotion of awareness of nontraditional and nonstereotypical relational patterns and teaching skills to make changes

    FEMINIST INTERVENTIONS AND STRATEGIES

    This type of therapy focuses on the family system, a group of individuals characterized by marked transactional patterns and dynamics of interpersonal relationships [66]. These patterns are the focal points, as they influence how members act and react [66,185]. Six elements have been identified as the heart of feminist family therapy [68,128]:

    • A collaborative and nonhierarchical therapist-client relationship

    • Gender as a topic in therapy

    • Encouragement of egalitarian relationships by valuing female partners' needs

    • Promotion of awareness of nontraditional and nonstereotypical relational patterns and teaching skills to make changes

    • Affirmation of women's stories, experiences, and feelings

    • Reframing problems within the larger sociocultural context

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    27 . Which of the following statements regarding the ethics of care is FALSE?
    A) A morality of care is based on sense of connectedness and social relationships.
    B) A morality of justice is based on the concept of an autonomous being who can make rational decisions.
    C) Feminist practitioners have embraced Lawrence Kohlberg's theory on moral development in their work with women.
    D) Research demonstrates that when women make ethical decisions, they take into account the social context and interpersonal relationships.

    ETHICAL ISSUES

    Kohlberg's theory of moral development has been criticized for being androcentric, meaning the dilemmas capture male moral development and do not apply to women. Furthermore, some experts argue that Western conceptualizations of ethics are based on the premise that there are a set of universal, rational, neutral, objective, and impartial rules that are applied to everyone [53]. For example, the concept of justice is based on the assumption that the individual is autonomous and independent, with a rational ability to exercise control [46]. Carol Gilligan, a leading critic of Kohlberg's work, asserted that men and women have different ways of conceptualizing morality, and therefore, the decisions made will be different [35]. In her study, for example, girls did not want to make a moral decision without considering the social context; they wanted to avoid conflict, and their thinking reflected a need to take into account interpersonal relationships using principles of care (e.g., empathy, awareness of others and their feelings) [186]. In a cross-cultural study in Turkey, women managers scored higher on reproductive moral imagination (i.e., taking on the perspectives of another individual) than men [101]. The authors argued that women tend to take interpersonal relationships into account in their moral decision making.

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    28 . Which area does the Feminist Therapy Code of Ethics NOT cover?
    A) Justice
    B) Social change
    C) Therapist accountability
    D) Overlapping relationships

    ETHICAL ISSUES

    The Feminist Therapy Institute developed a Feminist Therapy Code of Ethics, which offers a set of guidelines to supplement rather than replace the code of ethics of the field in which a practitioner practices (Table 1). The Feminist Code of Ethics covers five areas that direct practice, training, and research [30]:

    Cultural diversity and oppressions

    Power differentials

    Overlapping relationships

    Therapist accountability

    Social change

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    29 . Which of the following is NOT a step in the feminist ethical decision-making model?
    A) Select a solution
    B) Create a committee
    C) Implementation and evaluation
    D) Define the problem

    ETHICAL ISSUES

    The feminist ethical decision-making model involves seven steps. Although it is presented in a linear manner, the practitioner frequently moves back and forth through the steps [37].

    Step 1 involves recognizing the problem. The recognition of the problem is influenced by a range of factors, including the practitioner's level of experience and his/her values system. Often, a feeling of discomfort might arise for the practitioner, and it will be crucial to identify feelings and reactions that might influence understanding of the problem.

    Defining the problem is step 2. This consists of identifying the nature of the conflict and whether it stems from potential discrepancies between the code of ethics, laws, clinical issues, and agency guidelines. To the extent possible, the client should assist in defining the nature of the problem. Defining the problem also involves evaluating how the practitioner's and client's contextual factors (e.g., gender, race/ethnicity, age, and other social variables) affect the situation. On the emotional-intuitive side, the practitioner should begin to examine his/her feelings of potential discomfort.

    Step 3 of the feminist ethical decision-making model is generating solutions. As various potential solutions are brainstormed, a cost-benefit analysis should also be conducted for each option. The risks and benefits should also be considered. The client should be involved to the fullest extent possible in the brainstorming and cost-benefit analysis. The emotional-intuitive component continues in this step, as the practitioner should reflect on initial reactions that arise with each option.

    The next step is selecting a solution. Practitioners should determine the solution that is the best fit both emotionally and rationally for both the client and him or herself. It should be a solution that meets everyone's needs, can be implemented, and is acceptable to both parties [37,165].

    Reviewing the process is step 5. In the review process, the practitioner should carefully consider how a solution was reached. Questions that may be helpful to this process include:

    • "Do I want to be treated in this manner?"

    • "How am I using my power?"

    • "To what extent am I comfortable in being transparent with others in the solution identified?"

    • "Does this feel right?"

    Implementing and evaluating the solution should be undertaken next. The plan will be implemented, and the consequences can be observed and noted. In some cases, new information comes to light and the problem will be redefined.

    The final step in the process is continuing reflection. The lessons learned from the experience should be reflected upon in order to be applied to future situations. Practitioners should determine what they would do differently, what they have learned, and how they have changed as a result of the decision [165].

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    30 . In what ways are there parallels between feminism and multiculturalism?
    A) They both argue for exclusivity.
    B) They both challenge the established norms.
    C) They both advocate that a postmodernist lens be used to view the world.
    D) They both emerged in the 1980s, during a political environment of conservatism.

    KEY CONTROVERSIES AND TRENDS

    Feminism and multiculturalism share many commonalities and roots. Both concepts grew out of social movements in the 1960s that challenged the established norms. Both recognize the marginalization and discrimination experienced by women and racial/ethnic minority groups and how this is reinforced and perpetuated by societal infrastructures, and both emphasize strength, human growth, and potential instead of pathology [55]. The client, rather than the clinician, is considered the expert in telling his/her story [103]. Because of their concerns with oppression and marginalization, counselors from both perspectives are entrenched in social advocacy work, fighting for justice and equality, and reducing disparities [103]. Despite sharing similar values and coming out of a shared history, these two philosophies have remained in their distinct spheres [55].

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