The School Counselor and Student Sexual Wellness

(Adopted 1988; revised 1993, 1999, 2001, 2006, 2012, 2018, 2024)

ASCA Position

School counselors promote the health and wellness of all pre-K–12 students through the advocacy and support of comprehensive, developmentally appropriate educational efforts related to sexual wellness. Using culturally competent best practices, school counselors collaborate with key school and community partners (e.g., health and physical education instructors, school nurses, community healthcare specialists) in these efforts, while recognizing the importance of student/family confidentiality. Because of the connection between student sexual wellness and social/emotional well-being, school counselors provide student support, counseling and referral services regarding all aspects of sexual wellness, including consent, disease prevention, contraception, sexual and gender diversity and interpersonal violence.

The Rationale

Sexual wellness is a holistic and positive approach to sexuality and sexual health that embraces the idea that sexuality is a fundamental part of human life. To address sexual wellness comprehensively, the physical, emotional, psychological and social aspects related to human development must be considered. In schools, comprehensive sexual education furthers this approach by maintaining open and healthy communication about sexuality in society, including raising awareness about issues related to consent, disease prevention, contraception, sexual and gender diversity, and interpersonal violence (Lara, 2023). School counselors recognize the “connection between comprehensive sex education and social/emotional learning (SEL) with empathy, respect for others and emotional regulation as key outcomes” (Joe, et al., 2023, p. 2). 
 
Sexual wellness is a complex topic due to factors including state laws, school and district policies and procedures, political ideologies and individual opinions. However, due to the interconnectedness of SEL and comprehensive sexual education, school counselors act within their scope of practice by collaborating with key personnel and supporting advocacy efforts, prevention and interventions related to student sexual wellness. The ASCA Ethical Standards for School Counselors (2022) guide school counselors’ work by focusing on adherence to laws and school/district policies and procedures, confidentiality limits and the importance of collaborating with students, school faculty/staff and parents/guardians when students need assistance.

The School Counselor's Role

As part of a school counseling program, school counselors advocate for developmentally appropriate educational efforts related to youth sexual wellness including: 
  • consent
  • prevention of sexually transmitted infections
  • contraception
  • sexual and gender diversity
  • interpersonal violence
School counselors collaborate with key education and community partners to provide advocacy, prevention and intervention support related to student sexual wellness while complying with local, state and federal laws, district policy and the ASCA Ethical Standards for School Counselors (2022). School counselors strive to maintain an up-to-date understanding of evidence-based best practices, recommendations and resources regarding sexual wellness. Additionally, to ethically promote healthy living and positive decision-making, school counselors have a responsibility to examine and address any implicit biases they may hold regarding sexual wellness (ASCA, 2022).
 
Advocating for Sexual Wellness
As systemic change agents, school counselors possess the ability to examine and navigate many systems within a school (Milner & Upton, 2016). Through this role, school counselors collaborate with key school staff and community partners and serve as a voice for developing positive student sexual wellness policies. Advocacy efforts may include:
  • Advocating for more equitable school policies around student sexual wellness, especially when such district guidelines create barriers and marginalize students
  • Aiding in the identification and addition of appropriate and culturally competent evidence-based sexual wellness curriculum
  • Identifying supportive community resources and referrals for students and families (Milner & Upton, 2016)
Prevention of Unwanted Outcomes Related to Sexual Wellness 
School counselors provide preventive strategies to students through instruction, appraisal and advisement; counseling; and collaborating and consulting with families to promote student sexual wellness. School counselors may advocate for a particular focus on prevention with populations less likely to receive adequate sexual wellness education that may impede their development (ASCA, 2022). 
 
Preventive education may include:
  • Collaborating with school health personnel on prevention measures to reduce stigma and increase awareness of sexual wellness.
  • Facilitating classroom lessons on healthy decision-making, self-esteem, positive interpersonal skills and peer relations, setting boundaries and respect for self and body.
  • Family engagement and parent/guardian education of student sexual wellness and developmentally appropriate conversations with their children.
Interventions for Unwanted Outcomes Related to Sexual Wellness 
School counselors provide support to students who disclose sexual-wellness concerns and offer referrals to intervention services as needed. Referring students to appropriate programs and services, as well as collaborating with parents/guardians and community partners, can help shape or influence students’ health and behaviors (Wilkins et al., 2022). Intervention support services may include:
  • Providing short-term counseling to students to help them navigate the social/emotional impact of topics such as teen pregnancy, teen dating violence and sexually transmitted infections 
  • Serving as a liaison between the school and community health care partners to link students and families to further resources
  • Collaborating with school and community health professionals on any potential accommodations a student may need to be academically successful

Summary

School counselors have a primary role in advocating for and enhancing students’ social/emotional well-being, which includes their sexual well-being. School counselors collaborate with key school staff and community partners to support awareness in educational efforts related to sexual wellness while providing resources, prevention and intervention support to students and families following federal, state and local laws, evidence-based best practices and current recommendations.

References

American School Counselor Association. (2022). ASCA ethical standards for school counselors. Retrieved from: https://www.schoolcounselor.org/getmedia/44f30280-ffe8-4b41-9ad8-f15909c3d164/EthicalStandards.pdf

Centers for Disease Control and Prevention. (2023, April 27). YRBSS results. 
https://www.cdc.gov/healthyyouth/data/yrbs/results.htm

Joe, J. R., Shillingford, M. A., Aaron, S., Pharaoh, T., & Gonner, J. (2023). Sexual health and HIV prevention for youth: A survey of school counselors’ beliefs, attitudes, and professional behaviors. Professional School
Counseling, 27(1). https://doi.org/10.1177/2156759x231165494

Lara, L. A. da S. (2023). Sexual wellness: A movement happening worldwide. Revisto Brasileira de Ginecologia e Obstetricia 45(12), 745-746.

Lindberg, L. D., Maddow-Zimet, I., & Boonstra, H. (2016). Changes in adolescents’ receipt of sex education, Journal of Adolescent Health, 58, 621-627.

Milner, V., & Upton, A. W. (2016). Sexually active and sexually questioning students: The role of school counselors. Vistas Online, Article 23.

Wilkins, N. J., Rasberry, C., Liddon, N., Szucs, L. E., Johns, M., Leonard, S., & Oglesby, H. (2022). Addressing HIV/sexually transmitted diseases and pregnancy prevention through schools: An approach for strengthening education, health services, and school environments that promote adolescent sexual health and well-being. Journal of Adolescent Health, 70(4), 540-549. https://doi.or/10.1016/j.jadohealth.2021.05.017

Resources
Center for Disease Control and Prevention: Division of Adolescent and School Health (DASH) http://www.cdc.gov/healthyyouth/about/hivstd_prevention.htm

Family Educational Rights & Privacy Act (FERPA): http://www2.ed.gov/policy/gen/reg/ferpa/index.html Gay, Lesbian & 

Straight Education Network (GLSEN):
https://www.glsen.org/article/call-action-youth-parents-community-members-educators-and-policymakers

Guttmacher Institute State Laws and Policies: https://www.guttmacher.org/state-policy/laws-policies

Health Insurance Portability & Accountability Act (HIPAA) Privacy Rule: http://www.hhs.gov/ocr/privacy/hipaa/administrative/privacyrule/index.html

National Coalition of STD Directors Promoting Sex Healthy through STD Prevention Adolescent Sexual Health: http://www.ncsddc.org/resources/

Sexually Transmitted Diseases – Prevention https://www.cdc.gov/std/prevention/default.htm