A qualitative study of client experiences of working with novice counsellors

Aims: This paper reports on a qualitative analysis of written accounts by clients who participated in a counselling relationship with beginning-level trainees. The purpose of the study was to explore how clients experience the process of counselling with novice practitioners. Method: Consensual qualitative research was used for data analysis. Findings: Three general thematic categories were identified – client perceptions of self in counselling; client perceptions of the counsellor; and client perception of the counselling process. Conclusions: Overall, the findings suggest that these clients saw the interpersonal qualities and skills of the counsellor as major contributors to their experience. Implications: Clinical training of novices should start by developing the interpersonal and collaborative skills of trainees.     

Testing Cognitive and Emotion-Focused Models of Worry in Black and White Samples

Several models have been proposed to conceptualize worry. Broadly, the models can be classified as cognitive (including the Avoidance Model, the Intolerance of Uncertainty Model, and the Metacognitive Model) and emotion-focused (including Emotion Dysregulation and Acceptance-Based models). Although these models have received strong empirical investigation in primarily non-Hispanic White samples, no known study has examined the applicability to racial and ethnic minority groups. The current study compared the proportion of variance explained by cognitive and emotion-focused models of worry in White and Black samples. Results indicated that cognitive and emotion-focused models significantly predicted worry in both Black and White samples. However, the overall amount of variance in worry explained by the models was less for Black samples. Specifically, controlling for gender, the cognitive models explained 53% of the variance in worry in the White sample compared with 19% in the Black sample. Similarly, the emotion-focused models explained 34% of the variance in worry in the White sample but only 13% in the Black sample. These findings suggest that well-established conceptual frameworks for worry failed to explain the bulk of the variance in worry in Black samples, leaving much unknown. Additional research is needed to identify key variables that may further explain worry in ethnic minority samples.     

Person‐centred counsellors' experiences of working with clients in crisis: A qualitative interview study

Aims: This study aims to explore and understand person‐centred therapists’ experiences and work with clients at the pivotal point of crisis. Specifically: how do person‐centred therapists experience working with clients in crisis? Do they identify differences in crisis intervention compared to non‐crisis work? What do they perceive as helpful to crisis clients? How relevant are therapists' own experiences of crisis? Method: Participants were all experienced person‐centred therapists. Qualitative, semi‐structured interviews were conducted and the data were analysed qualitatively using person‐centred/phenomenological methodology. Results: Respondents identified differences in their experiences. Typically, therapists described polarity in their experience of danger and opportunity, also heightened energy levels within themselves, perceived higher levels of engagement, faster pace of work, experiences of reaching ‘relational depth’ earlier, and the importance of assisting symbolisation of clients' experience in awareness. Clients were experienced as vulnerable, unable to access previous coping mechanisms, in a state of breakdown and disintegration, but also as wide open, having dropped their usual defences, and more available to engage in therapy and enter the process of change and potential post‐crisis growth. Discussion: The findings are discussed in relation to prevailing models of crisis intervention, person‐centred theory and theoretical developments in post‐traumatic growth in the aftermath of crisis.     

Counsellors' experiences of working with suicidal clients: An exploratory study

Counselling is increasingly available in a wide variety of contexts, including mental health and psychiatric services. As a consequence, counsellors increasingly work with clients who present with suicidal ideation, expressing either suicidal thought and/or intent in the counselling session. This paper describes an exploratory study that examined the experience of counsellors when working with suicidal clients. The paper considers counsellors' behavioural, cognitive and emotional responses to such suicidal expression, both on a personal and professional level. The research employed semi‐structured interviews. A constant comparative method was used in analysing the transcribed interview text. Results suggest that counsellors experience a range of responses when their clients express suicidal thought, including fear, anxiety, anger and professional impotence. The interviewees also expressed self‐doubts about their professional competence. In addition, they identified the threat of litigation for negligent practice and the lack of confidence in appropriate risk assessment approaches as significant causes for concern. The implications for further research, and practice, are discussed.     

Sexual Harassment and Posttraumatic Stress Symptoms among Asian and White Women

Sexual harassment is a prevalent problem that has been associated with negative psychological and physical health outcomes. Although sexual harassment has been linked to posttraumatic stress (PTS) symptoms, little is known about how PTS symptoms that arose from sexual harassment experiences might be associated with psychological and physical health. This study examined the associations among sexual harassment, PTS symptoms, and psychological and physical well-being in a sample of Asian and White women. In addition, given the lack of research on sexual harassment among Asian women, we investigated the moderating role of ethnicity. Results indicated that greater sexual harassment frequency and PTS symptom severity predicted more depression, overall psychological distress, and physical symptoms. PTS symptom severity and ethnicity moderated the relationship between sexual harassment frequency and physical symptoms. We discuss the implications of these findings and directions for further research.     

Differences in Sexual Behaviors and Teen Dating Violence among Black,Hispanic, and White Female Adolescents

We examined differences in sexual behaviors among White, Black, and Hispanic adolescent females exposed to dating or sexual violence (DSV) using the 2009 Youth Risk Behavior Survey. We also examined the interaction effect of exposure to DSV and race or ethnicity on sexual behaviors. Sexual behaviors were significantly associated with both race or ethnicity and DSV; DSV was a stronger predictor of sexual behaviors than race or ethnicity; and the effect of DSV on condom use was more pronounced among Hispanic adolescents, whereas the effect of DSV on birth control use was more pronounced among both Black and Hispanic adolescents. Adolescent health programs should simultaneously address DSV and sexual risk reduction, with particular emphasis on birth control and condom use among ethnic minority populations.     

An exploration of body dissatisfaction and perceptions of Black and White girls enrolled in an intervention for overweight children

Silhouette measures are one approach to assessing body dissatisfaction in children, although little is known about their use among racially diverse, overweight girls seeking weight-loss treatment. This study assessed racial differences in body dissatisfaction and body size perceptions of 58 girls (ages 6–11, 66% Black, 34% White) participating in a randomized trial for pediatric overweight. Body dissatisfaction did not differ between races; 99% of girls reported an ideal figure smaller than their current one. Black girls selected a larger silhouette to represent their ideal body size, and most girls in both racial groups underestimated their actual size. Outcomes strengthen the argument that, despite an overall preference for a larger body size, obesity might mitigate cultural factors that protect Black girls from body dissatisfaction. Additional research is needed to enhance understanding of children's body size perceptions and dissatisfaction to inform assessment and treatment of pediatric obesity and associated disordered eating symptoms.     

Counsellors' perspectives on self-harm and the role of the therapeutic relationship for working with clients who self-harm

Aims: To gain insight into counsellors' experiences of and ideas about self-harm, and to develop understanding of relational depth when working with clients who self-harm. Method: A qualitative exploration of counsellors' perspectives on working with people who self-harm. The research proposal gained approval from the University Ethics Committee. Data were collected from a sample of counsellors who have experience of working with people who self-harm (n = 8) using tape-recorded interviews. Grounded Theory was used for analysis. Findings: Two major categories emerged from the findings: (i) the activity of self-harm; (ii) the therapeutic relationship with people who self-harm. These categories and sub-categories were integrated to form the core category. Implications: Counsellors have a valuable role to play in the lives of people who self-harm, by embodying confidentiality and so facilitating a sense of trust, by opening minds through acceptance, and by expanding knowledge through participation in research. Conclusions: In order to effectively accompany clients from a life of self-harm to a life of self-healing, counsellors must be aware of and responsive to the many concepts underpinning the emergent categories of the research.     

Christian counsellors' views on working with gay and lesbian clients: Integrating religious beliefs with counselling ethics

Thirty‐one counsellors who identified themselves as practising, committed Christians, returned completed questionnaires that investigated how they integrate their Christian beliefs with their professional ethical code when counselling gay and lesbian clients. It was found that although most respondents believed that they were able to accept gay and lesbian clients, a minority demonstrated incongruence in relation to members of this client group, and were judgmental about perceived gay/lesbian behavious. Counsellors who took a rational stance in their understanding of the Bible and Christianity expressed more open and accepting views. Counsellors with a literalist approach to the Bible appeared to be lacking in acceptance and were unaware that they may not be offering the core condition of respect to their gay or lesbian clients. These findings are discussed in terms of their implications for supervision, research and practice.     

“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.     

Academic and Extracurricular Predictors of Peer Victimization: Evidence of Similarities Across Diverse Racial and Ethnic Categories

Scholars of aggression in educational settings have long been interested in studying sanctions against academic achievement. Though many studies focus on minority students’ experiences, research has not tested the relationship between academic success and peer victimization within individual groups of students that are representative of the United States’ racial and ethnic diversity. The same can be said of studies of extracurricular activities and peer victimization, despite the academic involvement and enrichment those activities entail. This study examines how academic success and extracurricular activities impact the risk of being victimized by peers through verbal, physical, and other bullying-related incidents. Further, this relationship is compared across four racial/ethnic categories (Asian, Black, Hispanic, White). The study analyzes data from the most recent racially diverse and nationally representative education data set (the 2002 Education Longitudinal Study) to do so. Multilevel regression analyses indicate that participation in academic extracurricular activities and academic effort put students at increased risks for victimization. White students’ victimization helps to account for these relationships. The findings not only provide evidence of stigma against academically enriching activities, but also provide additional evidence against the assumption that only marginalized minority groups are stigmatized for academic effort and involvement.     

The deep student: A thematic analysis of counsellor educators' perceptions and experiences

What does it mean when we say a person is “deep” or has a lot of “depth?” We asked counsellor educators to describe the concept of personal depth, how it manifests in counsellors' work, and whether or not it could be trained. Twenty counsellor educators responded, and we analysed their responses using thematic analysis. We unearthed seven major themes of the construct: nondual consciousness, emotions, cognitions, interpersonal attributes, self-awareness, attitude and life experiences. Participants also provided suggestions for training students to cultivate personal depth. Finally, we introduce a depth wheel to conceptualise our results and provide implications for counselling and training.     

Denying Diversity: Perceptions of Beauty and Social Comparison Processes Among Latina,Black, and White Women

The purpose of this study was to investigate Latina, Black, and White women's conceptions of beauty and perceptions of cultural standards of beauty, as well as whether or not the participants were engaging in similar social comparison processes, specifically, the denial of personal disadvantage. One hundred and fifty-seven college women participated: 48 Latinas, 52 Black women, 51 White women, and 6 Others. Results indicate that there are significant differences in Latinas', Black women's, and White women's relationships with their bodies, and their relationships to dominant cultural standards of beauty. In addition, there were differences by race in the tendency to engage in the denial of personal disadvantage response. These findings contribute to the understanding of how racial identity affects, or interacts with, the experience of beauty standards among Latina, Black, and White women.     

Eating Disorders of White American,Racial and Ethnic Minority American,and International Women

Eating attitudes and behaviors related to anorexia nervosa, bulimia, and obesity of White American, African-American, Native American, and some international women are considered from the point of view of cultural influences such as sex role, the media, socioeconomic class, and acculturation to Western society.     

The experiences of person-centred counsellors working with suicidal clients online through the medium of text

ABSTRACT

In this study, we attempt to provide an understanding of the experiences of four UK-based person-centred counsellors working with suicidal clients online using text-based therapies and the impact of their clients’ suicidal ideation upon their “way of being”. The counsellors were selected purposively; each was working as a person-centred counsellor online, was encountering suicidal ideation in their clients, and was a member of a professional organisation. A narrative approach was taken, using unstructured interviews and a stanza format of representation. We found that participants had developed a way of being online that may be distinct from their in-person practice. Challenges included being more directive, lacking physical presence, lacking confidence in assessing risk and questions about empathic understanding. Working online with risk raises specific challenges for person-centred practitioners in line with what is indicated in the little relevant research currently already available.     

Factors Predicting Family Reunification for African American,Latino, Asian and White Families in the Child Welfare System

We examined child, family and system-related factors associated with reunification across African American, Latino, Asian and White families involved in the child welfare system in one large and ethnically diverse California County. Data were obtained from extensive reviews of child welfare case records and multivariate analysis was performed on a wide array of variables not found in previous research. Results indicated that when taking other factors into account, ethnicity was not a strong predictor of reunification. Factors that predicted reunification varied across ethnic groups, with none of the predictors being significant for the Asian group. Implications and suggestions for further research are discussed.