Treating survivors of war trauma and torture.

Psychologists are in a unique position to assist individuals and groups in the world who have survived torture and war trauma. Symptoms of posttraumatic stress disorder and other psychological diagnoses can be treated effectively by mental health professionals and trained lay counselors in the smallest of communities in the world. This article proposes a model for the treatment of survivors of torture and war trauma. This model has been designed to be useful to mental health professionals and to lay individuals in communities who constitute the front line in treatment: health providers, midwives, ministers, and teachers. The model is presented through examples of its use in the training of mental health counselors in the United States and in the training of promotores (health promoters) and comodrones (midwives) in Guatemala.     

Trauma healing in refugee camps in Guinea: a psychosocial program for Liberian and Sierra Leonean survivors of torture and war

From 1999 to 2005, the Minneapolis-based Center for Victims of Torture (CVT) served Liberian and Sierra Leonean survivors of torture and war living in the refugee camps of Guinea. A psychosocial program was developed with 3 main goals: (a) to provide mental health care, (b) to train local refugee counselors, and (c) to raise community awareness about war trauma and mental health. Utilizing paraprofessional counselors under the close, on-site supervision of expatriate clinicians, the treatment model blended elements of Western and indigenous healing. The core component consisted of relationship-based supportive group counseling. Clinical interventions were guided by a 3-stage model of trauma recovery (safety, mourning, reconnection), which was adapted to the realities of the refugee camp setting. Over 4,000 clients were provided with counseling, and an additional 15,000 were provided with other supportive services. Results from follow-up assessments indicated significant reductions in trauma symptoms and increases in measures of daily functioning and social support during and after participation in groups. The treatment model developed in Guinea served as the basis for CVT's ongoing work with survivors in Sierra Leone and Liberia. ((c) 2006 APA, all rights reserved).     

Are There Atheists in Foxholes? Combat Intensity and Religious Behavior

After battle, the moral and mortality stresses influence different soldiers in different ways. Using two large-scale surveys of World War II veterans, this research investigates the impact of combat on religiosity. Study 1 shows that as combat became more frightening, the percentage of soldiers who reported praying rose from 42 to 72 %. Study 2 shows that 50 years later, many soldiers still exhibited religious behavior, but it varied by their war experience. Soldiers who faced heavy combat (vs. no combat) attended church 21 % more often if they claimed their war experience was negative, but those who claimed their experience was positive attended 26 % less often. The more a combat veteran disliked the war, the more religious they were 50 years later. While implications for counselors, clergy, support groups, and health practitioners are outlined, saying there are no atheists in foxholes may be less of an argument against atheism than it is against foxholes.     

A Story about the Counselors in the Land of Help

Licensure is an issue of interest to many counselors. In some ways, however, the issue of licensure seems to be unresolved among them; in other words, some counselors want licensure, some don't, and others really don't seem to care one way or the other. This article recounts what happened to the counselors in the Land of Help when they were confronted with licensure and what they were able to do about it.     

Training for institutional change

If counselors are going to perform functions different from dyadic therapeutic counseling, institutions preparing counselors must change the context and processes of their programs. Assisting an individual to change is difficult; intervention for institutional change is infinitely complex. Yet many of the concepts and skills are the same for both. Dustin describes the procedures he has used to equip counselors to utilize the basic principles of change with an organization as a target. Other trainers may use other methods in this relatively new extension of counselor functioning; what is clear, however, is the need for new training models if our goals of creating humane environments is to be reached.     

The Emergence of Counseling in Sierra Leone

Sierra Leone has endured a turbulent history, including a decadelong civil war and the devastation of Ebola virus disease. Despite the psychological consequences of such events, only limited therapeutic services are available. The authors review mental health services in Sierra Leone and document the emergence of counseling as a profession in the face of challenges. They conclude by highlighting the multiple contributions that professional counselors can make to address critical mental health needs in Sierra Leone.     

The Role of the School Counselor in Facilitating Sexual Development

Because there is a trend in the helping professions toward recognizing sexuality as an integral and important dimension of healthy personality development, school counselors and other school personnel have become committed to assisting students in understanding and dealing with their sociosexual needs and concerns. Yet school counselors need to be better prepared to meet these needs. This article suggests skills and attitudes that are necessary for accomplishing the goals of counseling on issues of human sexuality, and how counselors can acquire these skills and attitudes.     

Counseling Outcomes: Counselor Characteristics and Client Results

Eighteen counselors in one of the administrative areas of the California Department of Human Resources and 697 of their closed cases were studied in order to discover whether differences in employability outcomes did exist. The study attempted to answer the following questions: (a) How many clients achieve employability during their relationships with employment counselors? (b) What is the final disposition of cases that are closed other than employable? and (c) To what degree do counselors engage in placement activities and what influence do these activities have on employable closures? The study provides evidence that some counselors had significantly more clients achieve employable status than did other counselors.     

Defining the Role of Laboratory Genetic Counselor

An increasing number of genetic counselors are moving into non-clinical roles, where their primary duties do not involve direct patient contact. According to the National Society of Genetic Counselors Professional Status Survey in 2010, 23% of counselors working in non-clinical roles identified laboratory or genetic testing as their primary area of work. Using a survey, we identified 43 genetic counselors who work predominately in laboratory settings. The two primary tasks performed by participants, include acting as a customer liaison (95%) and calling out test results (88%). Nineteen participants (44.2%) also reported spending a considerable amount of time signing reports. The most prevalent areas of job satisfaction were support from laboratory directors (76.8%), autonomy (76.7%), interactions with clinicians (69.7%) and interaction with other genetics counselors (67.5%). This is the first study specifically looking at the roles of laboratory genetic counselors, which is an expanding area of genetic counseling.     

Developmental Indices Among Central American Immigrants Exposed to War‐Related Trauma: Clinical Implications for Counselors

In this study, the authors examine the separate levels of depression, anxiety, and posttraumatic stress (PTS) among 68 Central American immigrants who had been exposed to war‐related trauma, as a function of developmental disruptions resulting in mistrust, identity confusion, and isolation. Findings indicate that variance in depression, anxiety, and PTS could be explained by the examined developmental disruptions. Clinical implications for counselors engaging in culturally sensitive trauma treatment and suggestions for research are discussed.     

How Chaos and Complexity Theory Can Help Counselors to Be More Effective

Chaos and complexity theory can help counselors to assist clients in new and unique ways. Chaos and complexity theory do not need to replace other counseling theories but can provide an alternative view. Using chaos theory in counseling requires, however, a revaluation of counselors' assumptions about the world, particularly about linearity, prediction, and control. This article uses a case study to illustrate how counselors can use chaos and complexity theory in their work with clients. This theory can offer an alternative framework to assist counselors in conceptualizing their clients and their practice.     

Elementary School Counselors in California

The number, school location, academic preparation and experience, and functions and duties of “elementary school counselors” in California were studied. Questionnaires were answered by 175 counselors, 118 elementary school principals, and 312 teachers in schools employing counselors. The number of children in the participating schools was 133,125, or five per cent of all pupils in grades K-8 in the State. Counselors reported that they spent 50 per cent of their time working with pupils, 17 per cent with teachers, 10 per cent with administrators, 12 per cent with parents, and 11 per cent with probation, welfare, and other officials. The counselors and the principals generally agreed on the rank order of importance of the functions of elementary school counselors and on the most important skills and personality characteristics counselors should have. The teachers reported that counselors gave them most help by testing individual pupils, counseling with pupils, helping them with classroom problems, and participating in parent conferences. Elements of an ideal counseling program at the district and school level as well as deficiencies in present programs were described by the respondents.     

Is empathy ear-to-ear or face-to-face?

If counselor and counselee cannot see each other, is the quality of their relationship affected? This study compares the empathy ratings of trained and untrained counselors in three different situations: counseling by telephone, in a confessional-type arrangement, and face-to-face. Although trained counselors scored significantly higher empathic understanding ratings than untrained counselors, there was little difference among the ratings for the three methods used.     

Examining the Association Between Self-Reported Multicultural Counseling Competencies and Demographic Variables Among Counselors

The authors examined the association between demographic variables and self-reported multicultural counseling competencies among counselors. A national sample of 220 counselors affiliated with university counseling centers participated in this investigation. Counselors responded to 40 Likert-type statements about multicultural awareness, knowledge, skills, and relationships. Results from a series of multivariate and univariate analyses indicated that Asian American and Hispanic counselors reported more multicultural knowledge than did White counselors, and African American, Asian American, and Hispanic counselors reported more competence in multicultural awareness and relationships than did White counselors. No effects were found for other demographic variables. Implications of these findings are discussed.     

Peer Observed Interaction and Structured Evaluation (POISE): A Canadian Experience with Peer Supervision for Genetic Counselors

Peer observation, while often used in other professions, has not been formally applied in genetic counseling. The objective of this study was to pilot a method of peer evaluation whereby genetic counselors observed, and were observed by, each other during patient interaction. All of the available genetic counselors participated in both rounds of the pilot study (six in round one, seven in round two). The genetic counselors that observed the session used an observation room. Most participants reported learning a new skill. Sensitivity to, and comfort with, the feedback process improved. We conclude that Peer-Observed Interaction and Structured Evaluation (POISE) provides an opportunity to refresh counseling approaches and develop feedback skills without causing undue team discord. This new approach to peer supervision in genetic counselling offers a live observation approach for genetic counsellor supervision.     

Counselor Competence: Some Proposals in Search of Advocacy

The competence of school counselors is traditionally assessed by administrators, who also determine which qualified and unqualified applicants will be admitted to practice and which practitioners will be retained, and pass various other judgments about guidance services and the persons who perform them. It is postulated that the public and professional interests would be better served were these judgments made by skilled counselors. Several methods are proposed by which school guidance workers might monitor their own services in order thus to sustain and improve quality according to appropriate professional criteria. To these ends, it is recommended that practitioners be involved directly in counselor education; that counselors-in-practice evaluate and judge each other through employment of several suggested approaches; and that committees of counselors be formed locally to select and supervise new guidance personnel, determine fitness of counselors for continued practice, and perform a complaint investigation function.     

An Introduction to Neuropsychological Assessment

Since its inception in the 1940s, clinical neuropsychology has evolved into a field encompassing a diverse and sometimes bewildering array of theoretical points of view and technical approaches. The purpose of this article is to acquaint counselors with the primary historical developments, current perspectives, and clinical applications of neuropsychology so that they can make optimal use of this valuable diagnostic approach. Neuropsychological assessments are significant for counselors in evaluation, remediation, and ongoing counseling of clients and their families. These assessments allow the identification of patients whose cognitive deficits have been underestimated or overestimated by other diagnostic procedures and provide clinically relevant information about potential for and specific means to promote recovery. Advocacy for clients, as broadly conceived, is also an important role for counselors.     

The Fully Functioning Employment Service Counselor

Fully functioning employment service counselors are individuals who feel personally and professionally significant and who use personal and professional competencies to foster an accurate image of themselves with clients and other professionals within the employment service. They are aware of the changing demands and the expanding scope and goals of employment counseling occurring over the past 10 years, although many others in the employment service, including training and supervising counselors, are not. These counselors must take the responsibility for bringing others into their scope of awareness: They must define, through their own actions, their developing identity.     

Psychological aspects of genetic counseling. VIII. Suffering and countertransference

Two common forms of countertransferential problems seen in genetic counseling, associative and projective, are described and illustrated. Both forms have the potential of reducing the quality of empathy counselors provide counselees. When counselors experience the same problems as the counselees they counsel it is virtually impossible to avoid facing countertransferential reactions which may not always promote the counselees' interests and/or redound to their benefit. Genetic counselors, like other personal counselors and psychotherapists, have a professional responsibility to be aware of, monitor, contain, and learn from their countertransferential experiences.