“Out on the edge of my comfort”: Trainee counsellor/psychotherapists' experiences of spirituality in therapy—A qualitative exploration

The integration of spirituality into counselling and psychotherapy poses complex challenges. Personal spirituality, professional competency and ethical considerations may impact on trainees' experiences of integrating spirituality into therapy. This study adopted an inductive, qualitative approach to explore trainee counsellor/psychotherapists' experiences and perceptions of integrating spirituality into therapy. Six trainee counsellors and psychotherapists were recruited using purposive sampling from a professional counsellor and psychotherapist training institution in the UK. In‐depth, semi‐structured interviews were conducted, audio‐recorded and transcribed verbatim. Thematic analysis of the interviews revealed two overarching themes: spirituality provides support but needs a warning; and spirituality is relevant but undervalued. These themes encompass a wide range of trainee concerns associated with integrating spirituality into therapy. Participants reported that they felt unprepared to work therapeutically with clients' spiritual beliefs. However, the value of spirituality in providing support to both the trainee and their clients was highlighted by several participants. Some participants described integrating clients' spirituality as having a positive impact on the therapeutic relationship, but often felt threatening to the trainee. This research has implications that are important for counselling and psychotherapy training and developing enhanced consideration of client spirituality and the interpersonal environment in which therapy is delivered.     

Using Case Documentation to Strengthen Counselor Trainees' Case Conceptualization Skills

A format for organizing case notes is presented that could increase counselor trainees' case conceptualization skills. The STIPS format of case note writing consists of 5 major sections, including documenting clients' current Signs and symptoms, Topics discussed in counseling, counseling Interventions used, clients' Progress and counselors' continuing plan for treatment, and finally, any Special issues of importance regarding clients (e.g., suicidality). The structure and design of this STIPS format is intended to enhance trainees' ability to acquire relevant facts about clients, better understand clients' presenting problems, better monitor counseling processes, and better evaluate and adjust treatment interventions.     

Interpreting Behavioral Genetic Results: Suggestions for Counselors and Clients

Treatment strategies often are premised on modifying either environmental factors or clients' interpretations of the interpersonal environment, which are assumed to be causing problem behaviors or emotional distress. A more complete analysis would take into account the role played by genetic transmission in an individual's personality, for example, intraversion- extraversion and sense of personal control, and in the occurrence of psychopathological disorders, such as depression. When developing interventions, both counselors and clients may be helped by behavioral genetic information (a) indicating the heritability of propensities or disorders as well as (b) confirming the importance of environmental influences that hold out the possibility of change.     

Transitional Faith: A Developmental Step Toward Religious Maturity

Nonjudgmental exploration of religious concerns may be a vital component of psychotherapy with religiously oriented clients. This article summarizes a recent stage model of psycho-religious functioning that was developed to help psychotherapists work with religious material in clinical practice. Following this introduction a case study is presented that illustrates my clinical work with a young woman in the transitional stage of development. The presentation depicts the entanglement of her spiritual struggles with her emotional and interpersonal conflicts. Because transitional faith is a pivotal point in the developmental spectrum, counselors and therapists working with clients in this stage can play a key role in promoting clients' spiritual development.     

The relationship between the assertive behavior of parents and the behavior of their children

Abstract

This investigation attempted to measure the relationship between parents' and their children's assertive and interpersonal behavior in order to identify the family population which can best profit from interpersonal skills training. Subjects were 60 volunteer mothers and fathers and 95 children, ages six to twelve, from a white upper socio-economic suburban population. The adult assessment measures were Fundamental Interpersonal Relations Orientation-Behavior (FIRO-B) and the Adult Self-Expression Scale. The child assessment measures were Fundamental Interpersonal Relations Orientation-Behavior Children (FIRO-BC) and Self-Expression Scale: Children. The most notable result of this study indicates that contrary to most published literature on the family, assertiveness relates to affection rather than control; that assertiveness training should be subordinated to interpersonal skills training; that the FIRO instruments provide a more effective assessment of family interaction than do assertiveness instruments.     

Schizotypal Personality Questionnaire-Brief: factor structure and convergent validity in inpatient adolescents

We examined the internal consistency, factor structure, and validity of the Schizotypal Personality Questionnaire-Brief (SPQ-B). Two hundred thirty-seven psychiatrically hospitalized adolescents were administered the SPQ-B and a battery of well-established self-report instruments. The SPQ-B demonstrated adequate internal consistency. Exploratory factor analysis provided mixed support for the SPQ-B 3-factor structure of interpersonal deficits, cognitive-perceptual deficits, and disorganization. The Interpersonal and Cognitive-Perceptual subscales demonstrated convergent and discriminant relationships with other measures of interpersonal impairment and cognitive abnormalities. We concluded that the SPQ-B is a promising measure for evaluating schizotypal personality disorder features, specifically interpersonal and cognitive-perceptual deficits, with adolescent psychiatric inpatients.     

Counsellor response to clients' metaphors: An evaluation and refinement of Strong's model

Experienced counsellors recorded clients' metaphors, their responses to the metaphors and their views on the effects of the interchange. Two of the three responses in Strong's model of counsellor response to clients' metaphors were used frequently. They were: explicating what is implicit in a metaphor and therapeutically extending or modifying it. The third response proposed by Strong'the counsellor creating and delivering a 'therapeutic metaphor''was used only once. A further kind of response was found: the counsellor recognizing and remembering a client's metaphor for possible future use. Overall, Strong's model was supported. The effect of counsellor orientation on counsellor response to clients' metaphors and the value and use of metaphors in counselling are briefly discussed, and some guidelines suggested.     

A Grammar of Love

Abstract

Recently researchers in the family therapy field have encouraged a focus on aspects of therapy common across all models that are important to therapeutic change. The purpose of this study was to build on the “common factors” literature by exploring clients' perspectives of what was useful to their therapeutic experience. Quantitative and qualitative measures were used to collect data from 41 clients who participated in therapy at a university-based family therapy clinic. Quantitative results indicated that therapeutic relationship, client motivation, extratherapeutic factors, and hope and expectancy accounted for 49% of the variance of clients' perception of change and 73% of the variance of clients' perceptions of therapy helpfulness. Qualitative results indicated the therapeutic relationship to be the most helpful aspect of clients' therapeutic experience.     

Assessment of Religious Beliefs Form

Religion may be a source of spiritual strength or a source of conflict and guilt. This article outlines the importance of assessing the religious beliefs of clients for treatment purposes and provides a format for the counselor to utilize. Because counselors may be unaware of their clients' individual perspectives, it is important to evaluate a clients' belief system from a holistic perspective during the intake process.     

Toward a Bahá'í Concept of Mental Health: Implications for Clinical Practice

The author highlights the emerging interest in understanding religious beliefs as a resource for more fully conceptualizing clients' psychological functioning. Although various authors have explored religious theories of mental health in an effort to increase understanding of clients' problems, there is a dearth of information on the Bahá'í client and how this particular religion conceives of mental health. The purpose of this article is to create an initial formulation for a Bahá'í concept of mental health and to discuss its clinical implications to aid in counseling Bahá'í clients.     

A study of Muslim Asian women's experiences of counselling and the necessity for a racially similar counsellor

A survey of four Muslim Asian women of varying ages was carried out, for whom the author had previously acted as a counsellor. The survey was designed to explore the extent to which client and counsellor racial similarity affected the therapeutic alliance, as the counsellor/author was of a similar race to all four clients. It was the author's belief that racial similarity in itself would not procure positive counselling outcomes, and hence this study attempted to explore the clients' perceptions of qualities extrinsic to race, including interpersonal skills, styles and approach to counselling of the counsellor, in order to duduce whether in fact these factors were more singnificant to the outcomes than race. The majority of clients did not feel racial similarity was an essential quality, although one client expressed cultural awareness as being a preferable quality. This has suggested that it is not essential for client and counsellor to be racially similar in order to achieve successul counselling outcomes.     

Treatment‐seeking young adults from families with alcohol problems. What have they been through? What state are they in?

Aims: This study surveys the childhood experiences of treatment‐seeking young adult offspring of problem drinkers (AOPDs) and their psychological state at treatment baseline. Methods: Clients (N=502) entering a Danish nationwide treatment facility for young AOPDS completed the survey. Clients completed the Adult Children of Alcoholics Trauma Inventory, The Family Tree Questionnaire, the CORE–OM 34, Major Depression Inventory, and the Work and Social Adjustment Scale at treatment start. Results: A total of 48% of the clients' mothers and 75% of the clients' fathers were problem drinkers. Both parents were problem drinkers in 25% of cases, and 27% had at least one problem drinking stepparent. Mothers had on average drunk during 11.4 years of the clients' childhood (0–18 years). Fathers had on average drunk during 13.4 years; 46% knew or believed that at least one of their parents suffered from a psychiatric illness; 44% reported physical violence; 63% reported psychological abuse; and 38% had not spoken to anyone about their family's problem. A further 20% had only spoken to a parent or sibling. Conclusions/implications: The study highlights the high degree of variation in AOPD clients' childhood experiences and in their levels of distress, corresponding with studies of non clinical samples. The study offers a bleak image of the extent of parental drinking and of other negative factors in these clients' childhood homes, coupled with the finding that clients have often not spoken to others about their parents' drinking. Mentioning parental drinking to a counsellor is thus a potentially highly significant counselling event, demanding counsellor sensitivity and attention.     

The first to know: A systemic analysis of confidentiality and the therapist's family

Abstract

One of the most common yet unrecognized breaches of confidentiality occurs when family therapists share confidential information with their own families. For many therapists, the boundaries between professional and private seem unclear, especially pertaining to disclosing clients' confidential information. Therapists are encouraged to examine their own practices concerning sharing confidential information with their families. Therapists' families have their own rules, patterns, boundary issues, and power struggles which affect therapists' behaviors. Therapists can discuss this issue with their families and develop postures that insure clients' privacy.     

Time Perspective Therapy: A New Time-Based Metaphor Therapy for PTSD

Time perspective therapy (TPT) is a new time-based therapy that focuses on clients' perceptions of their past, present, and future. Based on Zimbardo's temporal theory and the utilization of the Zimbardo Time Perspective Inventory, the authors have developed this new narrative therapy approach for the purpose of treating clients diagnosed with posttraumatic stress disorder. The goal of TPT is to identify clients' six time perspective factors and then work with and balance these perspectives to promote a more positive future orientation, replace their traumatic past negativity, and thereby create a more responsive and healthier individual.     

Using the myers‐briggs type indicator® in career counseling

The Myers‐Briggs Type Indicator® (MBTI®; I. B. Myers & K. C. Briggs, 1943/1976) is a personality instrument with numerous applications. The focus of this article is on its utilization in the career counseling process. Although limitations of the instrument exist and ethical issues regarding its usage have been itemized, information gained from clients' MBTI® assessments have been proved to be useful to professionals in counseling and strategizing with clients about clients' psychological preferences, optimal career families, and potential employment opportunities.     

Addressing Clients' Experiences of Racism: A Model for Clinical Practice

This article synthesizes the literature relevant to coping with racism to provide a 4‐stage model for addressing clients' discriminatory experiences. Major suggestions drawn from the literature include applying frameworks with a contextual lens, using broaching and eliciting skills to promote client exploration of racism and the effects of racism on persons of color, enhancing client racial and ethnic identities, and tailoring interventions to the clients' culture and preferred coping strategies.     

How Psychotherapists Address Hypothetical Multiple Relationships Dilemmas with Asian American Clients: A National Survey

This study examined how psychotherapists address hypothetical nonsexual multiple relationships dilemmas with Asian American clients and identified predictors of conservative decisions and the use of culture-based rationales. This survey of 787 Asian American and non-Asian American psychotherapists revealed that clinicians rely on mostly their personal policies and seldom focus on the clients' cultural backgrounds. Psychotherapists who consider their clients' Asian culture have more cultural knowledge and awareness, have been mental health providers longer, and are Asian American and female. Clinicians who avoid multiple relationships tend to cite formal policies as justification and are less likely to consider clients' cultural worldviews, the therapeutic relationship, or their own values. The results are discussed in terms of specific revisions needed in the American Psychological Association Ethics Code, the benefits of more frequent consultation with colleagues and supervisors about ethical dilemmas, and recommendations for psychotherapists.