Can CORE assessment data identify those clients less likely to benefit from brief counselling in primary care?

Studies show that counsellors in primary care see many clients with difficulties of a severity similar to those found in secondary care services. Evidence from both RCTs and studies of routinely collected data indicates that many of these ‘clinical’ clients benefit from brief counselling intervention. However, little is known about why some benefit while others fail to do so despite completing their counselling contract. This paper considers client characteristics recorded at assessment and aims, using logistic regression analysis, to identify those characteristics predictive of a poor outcome. Results indicate that a number of characteristics are associated with poor outcome; the most important predictors are economic inactivity and aspects of the patient's condition, particularly continuous/recurrent depression, with some differences between genders. However, the models produced were not acceptable in their predictive power. This may be partly due to data quality issues or important characteristics not being available in the data. The paper concludes that being unemployed or on state benefits may be a proxy measure of severity that has an important impact on outcome for all patients, and particularly for males. Some reasons are suggested and areas of future research are identified.     

Which psychological resilience attributes are associated with lower aspects of anxiety in boys with an autism spectrum disorder? Implications for guidance and counselling interventions

The effect of psychological resilience as a buffer against anxiety was investigated in a sample of 39 boys with high-functioning autism spectrum disorder (ASD) via individual online questionnaire responses to standardised inventories for assessing anxiety and psychological resilience. Ability to handle problems, make good decisions, think before acting and help others were the most powerful buffers against Generalised Anxiety Disorder, while thinking before acting significantly buffered social phobia. Believing that they were able to handle problems was significantly associated with less emotional anxiety about school, work or social activities, being irritable, unable to relax and fatigue. As well as describing the pathways between the components of psychological resilience and anxiety, these findings also suggest several specific directions for training programmes aimed at equipping boys with an ASD with skills to cope more effectively with anxiety.