Pretenured faculty members experience unique challenges as they respond to the demands and opportunities of an academic appointment (A. E. Austin & R. E. Rice, 1998; M. D. Sorcinelli, 1994). Given the emphasis on wellness within the counseling framework, it is imperative to identify and address the experiences of pretenured counselor educators. This article offers an overview of some of the challenges that pretenured faculty members encounter and provides recommendations for promoting their wellness and success in academia.

OBJECTIVE Development of a numerical score to measure the microbial spectrum of antibiotic regimens (spectrum score) and method to identify antibiotic de-escalation events based on application of the score. DESIGN Web-based modified Delphi method. PARTICIPANTS Physician and pharmacist antimicrobial stewards practicing in the United States recruited through infectious diseases–focused listservs. METHODS Three Delphi rounds investigated: organisms and antibiotics to include in the spectrum score, operationalization of rules for the score, and de-escalation measurement. A 4-point ordinal scale was used to score antibiotic susceptibility for organism-antibiotic domain pairs. Antibiotic regimen scores, which represented combined activity of antibiotics in a regimen across all organism domains, were used to compare antibiotic spectrum administered early (day 2) and later (day 4) in therapy. Changes in spectrum score were calculated and compared with Delphi participants’ judgments on de-escalation with 20 antibiotic regimen vignettes and with non-Delphi steward judgments on de-escalation of 300 pneumonia regimen vignettes. Method sensitivity and specificity to predict expert de-escalation status were calculated. RESULTS Twenty-four participants completed all Delphi rounds. Expert support for concepts utilized in metric development was identified. For vignettes presented in the Delphi, the sign of change in score correctly classified de-escalation in all vignettes except those involving substitution of oral antibiotics. The sensitivity and specificity of the method to identify de-escalation events as judged by non-Delphi stewards were 86.3% and 96.0%, respectively. CONCLUSIONS Identification of de-escalation events based on an algorithm that measures microbial spectrum of antibiotic regimens generally agreed with steward judgments of de-escalation status.

The author discusses the rationale for counselor education programs' promotion of the development of multicultural counseling competence in counselor trainees. The current status of multicultural counseling competence is discussed, and recommendations are made regarding how counselor education programs and faculty can enhance multicultural competence. An Appendix provides specific action‐based recommendations.

In higher education, occupational satisfaction is influenced by the environment as well as by the dispositional variables explored for occupational satisfaction in general. Within the context of counselor education, there are no empirical studies that explore the occupational satisfaction of counselor educators. This article provides an overview of the empirical research exploring group differences based on gender, tenure status, and minority status in occupational stress, coping strategies, and personal strain ratings for counselor educators. Implications for counselor education and future research are discussed.

Many mental health counselors identify adolescent clients as the most "difficult" clients with which to work because it is a challenge to engage them in the counseling experience (Church, 1994; Hanna et al., 1999; Gil, 1996). At-risk youth tend to be ill equipped to engage in traditional counseling interventions, which require them to be verbal and to disclose thoughts and feelings (Hanna et al., 1999; Davis-Berman & Berman, 1994). Wilderness therapy, a specialized approach within adventure-based counseling (Fletcher & Hinkle, 2002), provides an alternative treatment modality that maximizes the client's tendency to spontaneously self-disclose in environments outside the counseling office (Hanna et al.). This article provides an overview of wilderness therapy as a treatment modality and identifies the associated therapeutic factors in an effort to inform mental health counselors.