Applying the principles and techniques of solution-focused therapy to career counselling

Career counselling aims to help clients become more effective agents in solving problems in their vocational aspects of life. To achieve this goal, theorists and practitioners are called upon to form useful helping approaches that can help clients in a more efficient and effective manner. This article proposes an alternative model toward this end by considering and adopting principles and techniques from the solution-focused therapy in career counselling practice. After a very brief introduction of the basic features of the solution-focused counselling, the paper reviews some key theoretical principles of the solution-focused therapy, and connects these principles to career counselling context. It then illustrates several solution-focused counselling techniques that are particularly applicable to career counselling intervention.     

Dose response effects of cognitive-behavioral therapy in a school mental health program

ABSTRACT

School mental health (SMH) programs have been shown to be effective in providing evidence-based interventions to underserved youth. However, limitations of SMH programs are that they can entail holiday breaks, typically do not operate through summer, and often require pulling students from class to receive therapy. These limitations suggest that treatment must be expeditious and potent. Although researchers have investigated dose response to treatment, no studies were located that addressed dose response to treatment in SMH programs. The present study addressed this gap by evaluating the dose response to SMH treatment in a sample of 133 adolescents. Adolescents were assessed at baseline, post-treatment, and at multiple time points throughout treatment. An average treatment response of a 26.81-point decrease in Youth Outcome Questionnaire (YOQ-30) score was found across 14 sessions of cognitive-behavioral therapy (CBT). Further, adolescents exhibited reliable change in YOQ-30 score within an average of 2.91 sessions. Finally, it was found that baseline scores on the Depression and Hyperactivity subscales of the Behavior Assessment System for Children, 2nd Edition, along with YOQ-30 score, predicted treatment response. These findings advance our understanding of dose response to CBT in SMH settings, and create opportunities to better inform effective treatment strategies in similar contexts.     

Solution-Focused Brief Therapy and the Kingdom of God: A Cosmological Integration

The core cosmological dimension of Solution-Focused Brief Therapy (SFBT) and Christianity emphasizes a similar truth—the future is now. As humans live in their preferred realities, they experience the future, problem free solution for their lives from a SFBT perspective. The Christian tradition emphasizes the in-breaking Kingdom of God beginning with the Christ event. The end has entered the now. However, the final consummation of the end-times is still as yet in the future which means that sin and death are part of the world. This Christian understanding of sin and fallenness provides humility to SFBT’s inherently positive view of the world (Bidwell, D. R. Am J of Pastor Couns, 3:3–21, 1999), while SFBT encourages Christians to see the kingdom of God in the now instead of the future.     

Chapter 1 Pluralism,Pragmatism, and the Therapeutic Endeavor in Brief Dynamic Treatment

Abstract

This article places representative formulations of brief dynamic psychotherapy in the larger context of psychoanalytic thought, reviews relational perspectives that inform contemporary approaches to time-limited treatment, and identifies tasks in continued development of theory, research, and practice. In doing so, it emphasizes the need to consider a broader range of psychopathology, dysfunction, and need in formulations of brief intervention and to develop more flexible and realistic approaches in treatment of vulnerable and underserved populations. The growing emphasis on theoretical pluralism and pragmatism in therapeutic practice generally should facilitate efforts to broaden the base of brief dynamic treatment.     

Development and validation of the solution-focused inventory

Solution-focused coaching and solution-focused therapy are strengths-based approaches which emphasize people's resources and resilience and how these can be used in the pursuit of purposeful, positive change. The Solution-focused Inventory (SFI) is a 12-item scale with three subscales: Problem Disengagement, Goal Orientation and Resource Activation. Three studies in this article provide support for the validity of the SFI as a measure of solution-focused thinking. The SFI negatively correlated with psychopathology and positively correlated with measures of well-being, resilience and perspective taking. Test–retest reliability over 16 weeks was 0.84. Cronbach's α for the 12-item scale was 0.84. It also demonstrates sensitivity to purposeful change in that participation in a leadership development coaching intervention was associated with significantly increased scores on the SFI, whilst scores for the control group did not change.     

The effects of mindfulness-based cognitive therapy on recurrence of depressive episodes, mental health and quality of life: A randomized controlled study

Depression is characterized by a large risk of relapse/recurrence. Mindfulness-based cognitive therapy (MBCT) is a recent non-drug psychotherapeutic intervention to prevent future depressive relapse/recurrence in remitted/recovered depressed patients. In this randomized controlled trial, the authors investigated the effects of MBCT on the relapse in depression and the time to first relapse since study participation, as well as on several mood states and the quality of life of the patients. 106 recovered depressed patients with a history of at least 3 depressive episodes continued either with their treatment as usual (TAU) or received MBCT in addition to TAU. The efficacy of MBCT was assessed over a study period of 56 weeks. At the end of the study period relapse/recurrence was significantly reduced and the time until first relapse increased in the MBCT plus TAU condition in comparison with TAU alone. The MBCT plus TAU group also showed a significant reduction in both short and longer-term depressive mood and better mood states and quality of the life. For patients with a history of at least three depressive episodes who are not acutely depressed, MBCT, added to TAU, may play an important role in the domain of relapse prevention in depression.     

Carers of adults with mental illness: Comparison of respite care users and non‐users

The aim of this study was to investigate the rate, type and duration of respite care use in carers of an adult with mental illness, and the differences between respite care users and non‐users on demographic, caregiving context and adjustment variables. A total of 106 carers completed a postal survey questionnaire. The majority (76%) of carers who accessed care used it weekly, fortnightly or monthly. The most common types of respite services were in‐home, day programs, and residential respite. The mean duration of respite care periods was 58.18 hr each time respite was used. Compared to respite care non‐users, carers who accessed respite care were more likely to live with their care‐recipient and provide more caregiving. They also reported more benefits associated with their caregiving. Findings suggest that respite care services need to be varied, available for carers on a weekly to monthly basis with a range in duration, but catering for higher use of 2‐day respite periods. Carers who are highly engaged in a range of caregiving tasks and who live with their care recipient are more likely to have a greater need for respite care. Future research should examine the effects of a range of respite care factors on carer adjustment outcomes.     

The role of primary prevention in mental health services: A review and critique

Community psychology in the West has had a growing impact on mental health service provision. One facet of this development has been the advocacy of an increased focus on the primary prevention of mental illness. This paper reviews both theoretical and practical work in this area in order to assess the current role and relevance of primary preventive interventions. There is a discussion of primary prevention's historical and theoretical contexts, of its conceptualisations and definitions, of criticisms of its relevance and efficacy, and of examples of its practice. It is argued that primary prevention is inappropriately marginalised in current service provision and that there is a need to engage in the long-term planning and evaluation of primary preventive interventions in order to facilitate their fuller incorporation into national and local policies on mental health.     

Differential relationships in the association of the Big Five personality traits with positive mental health and psychopathology

According to the two continua model of mental health, psychopathology and positive mental health (emotional, psychological, and social well-being) are related but distinct continua. This study investigates the two continua model by examining whether psychopathology and positive mental health show differential associations with the Big Five personality traits. The paper draws on data of the representative LISS panel (CentERdata). Participants (N = 1161; age 18-88) filled out questionnaires on personality, psychopathology, and positive mental health. Personality traits were differentially related to psychopathology and positive mental health, supporting the two continua model. Emotional stability (reversed neuroticism) is the main correlate of psychopathology, whereas the personality traits extraversion and agreeableness are uniquely associated with positive mental health.     

Mechanical Chair Massage and Stress Reduction in the Seriously Mentally Ill Consumer: A Preliminary Investigation

In the present study, the authors evaluate the effectiveness of a mechanical massage chair in reducing stress for people with serious and persistent mental illness. This preliminary investigation involves the use of massage therapy for 19 people with serious mental illness, using a standardized massage protocol. Stress levels were assessed using a 7-point Likert scale, administered before and after each treatment session. Self-reported stress was found to be significantly reduced, with participants reporting an average stress reduction of 1.48. This preliminary investigation demonstrates that use of a mechanical massage chair can significantly reduce self-identified stress levels in persons with serious mental illness.     

Positive mental health,positive affect and suicide ideation

Background/ObjectivePositive mental health (PMH) has been shown to confer resilience against suicide ideation. However, the mechanisms underlying the positive effect of PMH on suicide ideation/behavior are largely unknown. The current study aimed to determine whether positive affect mediates the association between PMH and suicide ideation.MethodA total of 150 adult outpatients (65.3%; female; age: M(SD)=37.79(13.50), range:18–77) completed measures on PMH, positive and negative affect, as well as suicide ideation. Data were collected using self-report questionnaires. Linear hierarchical regression analysis was used to analyze the data. Positive affect was considered to mediate the association between positive mental health and suicide ideation.ResultsWhile positive affect fully mediated the significant negative association between PMH and suicide ideation, negative affect did not reveal to be a significant mediator of this relationship.ConclusionsThe protective influence of PMH against suicide ideation is due to heightened positive affect: If positive mental health translates into positive affect, then suicide ideation becomes less likely.     

Crisis for community mental health: The use of groups in the struggle for survival

The task of community mental health is to provide quality services to clients despite funding cutbacks. This paper describes the recent evolution in conceptualization and service delivery in one center. The outcomes are a philosophy that is customer oriented, and treatment that draws upon brief techniques, in group and long term contexts.     

The stigma of having a parent with mental illness: Genetic attributions and associative stigma

Children often report associative stigma because they are ‘contaminated’ by association with a parent who has a mental illness. An exploratory study was conducted to investigate the role of genetic attributions in the aetiology of associative stigma. The first hypothesis was that genetic attributions would predict associative stigma over and above the contribution of biochemical and stressful‐event attributions, while the second hypothesis was that the relationship between genetic attributions and associative stigma would be mediated by the perceived likelihood that children would develop the same disorder as their parents. Two‐hundred‐and‐two individuals were asked to read a hypothetical scenario describing a teenage girl whose mother had been diagnosed with either schizophrenia or depression. Both hypotheses were supported. The findings of the study have implications for a number of professions working in the community such as teachers and psychologists. Additional avenues for future research are also explored.     

Understanding public opinion relating to the establishment of community mental health facilities: implications of a discourse analytic approach

This paper demonstrates a novel approach to investigating the problem of public opposition to community mental health facilities. With the move towards community care, organizations setting up mental health facilities have encountered public opposition. It has been argued that this is due, in part, to the attitudes held by the public towards mentally ill people. A knowledge and understanding of attitudes towards this client group therefore has the potential to be of practical use to policy makers and practitioners who have a responsibility to consult on, and implement, community care for mentally ill people. The survey approaches and hypothetical situations used in previous British studies of community attitudes towards mentally ill people have, however, failed to take account of the rhetorical richness and complexity of the attitudes likely to be expressed in real‐life community care contexts. By contrast, the study reported in this paper used a discourse analytic approach to explore the views expressed about mentally ill people in a ‘hot situation’. Specifically, people's views were explored in the contexts of the arguments they used to challenge or advocate a supported accommodation project for mentally ill people in their community. This paper examines some of these arguments and discusses the theoretical implications for traditional approaches to attitude research. In conclusion, the potential practical utility of the findings is considered. Copyright © 1999 John Wiley & Sons, Ltd.     

The relationship between shame and perceived biological origins of mental illness among South Asian and white American young adults

Mental illness (MI) affects one in four people in their lifetime and a failure to seek help for MI can have grave consequences. To decrease stigma and increase help seeking, prior campaigns have promoted the biological origins of MI. Even though some research supports the efficacy of this approach, other research does not. We propose cultural differences as a partial explanation for these inconsistent results. The current study assessed ethnic differences in the relationship between perceived causes of MI, shame associated with MI and perceived family support for help seeking. White and South Asian American (SAA) undergraduate students completed an online survey (n = 177). Results indicated that SAAs were significantly more likely than whites to perceive character deficits as the cause of MI. Further, among those who had sought help for MI, ethnic differences emerged in perceptions of MI based on perceived cause. SAAs who believed that MI had biological origins perceived more shame and less family support for seeking help compared to SAAs who believed MI was due to character deficits. The converse was true for whites – those who believed that MI had biological origins perceived less shame and more family support for help seeking compared to whites who believed MI was due to character deficits. The results of the current study illuminate the role that culture plays in perceptions of MI. Further, these results have implications for interventions targeting South Asian populations and for mental health outreach in general.     

Development and initial validation of the Brief Adolescent Life Event Scale (BALES)

We report initial validity analyses of the Brief Adolescent Life Event Scale (BALES). This instrument addresses negative and positive events pertinent to the well being of adolescent boys and girls, and is designed for use in studies utilizing an extended research protocol. Selection of items was guided by emerging perspectives on positive psychology , action theory , and personality vulnerability , as well as by new developments in statistical modeling theory. The 36 items of the scale tap negative and positive events, each of which addresses interpersonal and achievement life domains. Using a large sample of early-adolescents ( N = 895), we confirmed the hypothesized structure that includes four domain-level latent factors (i.e., negative interpersonal events, negative achievement events, positive interpersonal events, positive achievement events), and two overarching factors (negative events and positive events). Indices of positive and negative events predicted adolescent depressive symptoms in expected ways, and positive events buffered the effect of negative events on depressive symptoms. These findings encourage an informed use of the BALES and highlight considerations involved in the development of brief measures of stress and coping processes.     

A Reply to the Commentaries of Drs DiBenedetto and Pakenham

This commentary addresses some of the cogent responses offered by Drs. DiBenedetto and Pakenham and the idea of an alternative approach to addressing the self‐care needs of our profession.     

The stigma of mental illness: Explanatory models and methods for change

For people with mental illness, diminished quality of life and loss of personal goals does not result solely from the symptoms, distress, and disabilities caused by their psychiatric disorder. Quality of life and personal goals are also hindered by people who embrace the stigma that accompanies mental illness and mental health care. This paper reviews evidence of the impact of mental illness stigma and strategies for seeking to ease its impact. To achieve these goals, we (a) describe the ways in which stigma harm people with mental illness, (b) summarize models that explain the development and maintenance of these stigmatizing effects, and (c) review strategies that have been shown to decrease the impact of stigma. Concerns about stigma are on the political agendas of many mental health advocacy groups. It has recently also become the focus of extensive research. Our goal in this paper is to balance the practical concerns raised by mental health advocates against data that support or contradicts specific assertions.