A Comparison of Successful Smoking Cessation Interventions for Adults and Adolescent

This review of the counseling literature analyzes the motivating and impeding factors for adults and adolescents regarding smoking cessation. Adults and adolescents prefer to stop smoking on their own; however, even brief counseling will increase their chances of success. In addition to giving support, counselors can facilitate smoking cessation by increasing clients' motivation and teaching stress management. Counselors must be aware of how the social environment can influence a client's smoking status. With recent increases in adolescent smoking, particularly among African Americans, counselors should be prepared to help an increasing population of clients who will require smoking cessation assistance.     

A self-determination process model of physical activity adoption in the context of a randomized controlled trial

Objective: The PA Counseling (PAC) trial tested a primary care intervention using Self-Determination Theory (SDT) as the guiding framework. This paper presents specific results related to SDT constructs in a physical activity (PA) context. Specifically, whether patients who received both brief autonomy supportive PA counseling from their health-care provider and intensive (3 month) autonomy supportive counseling from a PA counselor would report greater levels of autonomy support, autonomous motivation, perceived competence and PA adoption, than patients receiving only brief counseling. In addition, we tested Williams’ SDT process model in the context of PA adoption.Method: Measures of autonomous motivation and perceived competence for PA were measured at baseline and 6 weeks. PA was assessed at baseline and 13 weeks. An autonomy support index was calculated by multiplying minutes of counseling by perceptions of autonomy support. Group differences in autonomy support, autonomous motivation, perceived competence and PA were examined. The SDT process model of PA adoption was tested via path analysis.Results: The results showed higher autonomy support and autonomous motivation at 6 weeks and higher PA levels at 13 weeks for the experimental group. The SDT process model for PA adoption showed that autonomous motivation and perceived competence at 6 weeks significantly predicted 13-week PA for the experimental group.Conclusions: This study provides a rigorous field test of SDT theory in a PA context. It demonstrates the versatility and applicability of the SDT model for health behavior change. SDT-trained PA counselors appear to provide valuable contribution to facilitating patient behavior change, by increasing patient autonomous motivation for PA.     

Sex Education and Intellectual Disability: Practices and Insight from Pediatric Genetic Counselors

Intellectual disability (ID) with or without other anomalies is a common referral for genetic counseling. Sessions may include discussions of reproductive implications and other issues related to sex education. Patients with ID regularly meet barriers when trying to obtain sex education due to the misperceptions of others as being either asexual or that such education would promote inappropriate sexual behavior. In this pilot study, we surveyed genetic counselors to explore their experiences with being asked to provide sex education counseling and their comfort in doing so for patients with ID ages 9–17. Results were analyzed from 38 respondents. Caregivers and patients most frequently requested information on puberty, sex abuse prevention, and reproductive health. Genetic counselors were most comfortable when they could provide sex education counseling within the context of a particular condition or constellation of features. They were least comfortable when they lacked familiarity with the patient, caregiver, or the family’s culture. The most frequently cited barriers that prevented genetic counselors from providing sex education counseling were lack of time, lack of training, the patient’s ID being too profound, and a belief that genetic counselors should not be responsible for providing sex education counseling. While many respondents reported that providing sex education counseling is not considered within the scope of a genetic counselor’s practice, they also noted that patients’ families initiate discussions for which counselors should be prepared. Respondents indicated that resource guides specifically designed for use by genetic counselors would be beneficial to their practice. Genetic counselors have the opportunity to embrace the role of advocate and broach the issue of sexual health with caregivers and patients by directing them toward educational resources, if not providing sex education directly to effectively serve the needs of patients and caregivers.     

Counselors' and clients' ethnic similarity and therapeutic alliance in time-limited outcomes of counseling.

51 pairs of clients and counselors at a Southwestern university counseling and research training clinic were assessed for ethnic similarities in relation to the therapeutic alliance and counseling outcomes in 6 sessions of counseling. Analysis showed after 6 sessions symptom distress was reduced. Also, counselors and clients who had similar ethnicity had significantly more positive counseling outcomes than ethnically dissimilar pairings, but ethnic similarity was not related to the nature of the therapeutic alliance and therapeutic alliance was not a correlate of counseling outcomes.     

Predicting burnout and job satisfaction in workplace counselors: the influence of role stressors,job challenge,and organizational knowledge

The present study examines the antecedents of burnout and job satisfaction among counselors employed in workplace settings. Workplace counselors face the unique demands of managing dual client relationships (individual and organization) within the counseling setting. Antecedents of the job‐related outcomes of burnout and satisfaction are likely to vary from other counseling settings as a function of these unique demands. Survey results from 82 workplace counselors indicated that role conflict was a significant predictor of the experience of burnout and that intrinsic job satisfaction was significantly predicted by the counselors' perceptions of job challenge, as well as by the level of organizational knowledge.     

Commentary: Educating and Counseling About HIV in the Second Decade

The authors of the articles in this special feature confront the most important and challenging questions about the current educational and counseling issues related to HIV (human immunodeficiency virus). As educators and counselors, we must look closely at both the characteristics and determinants of human behavior, direct our efforts at both individuals and their communities, work respectfully in all communities to produce humane change, and foster self-esteem for all individuals and group pride in all communities. Education and counseling will become critically cross-linked in effective programs.     

Parental Involvement in School Counseling Services: Challenges and Experience of Counselor

School counselors include parents as informants in school counseling for various reasons like for consultation and client’s intervention which could lead to a different experience. The objective of the present study was to explore the challenges faced by school counselors when involving parents in the school counseling process and the ways they handle the challenges. The participants consisted of seven school counselors, with whom in-depth interviews were conducted. The subjective experiences of the school counselors were objectively interpreted by the researcher using interpretative phenomenological analysis. The research results were categorized into master and subordinate themes using double hermeneutics. The results revealed that although school counselors have their own individual perceptions of challenges and methods of handling parental inclusion in the school counseling context, there still exist similarities in their methods of handling. The study highlights school counselors’ beliefs about parents’ perceptions and expectations of counseling as well as parents’ reaction toward their child’s problem as a challenge. The findings throw light on the need for stronger evidence-based practices and policies for school counseling programs. Training and competence-building programs for school counselors would improve the service delivery.     

Comparative Effectiveness of Student and Professional Counselors

A sample of 160 beginning freshmen, half males and half females, received six and one-half hours of academic adjustment guidance from same-sex professional counselors. Upperclassman student counselors gave equivalent guidance to all other beginning freshmen at Southwest Texas State College. A matching sample of 80 men and 80 women was subsequently drawn from the 316 freshmen receiving student-to-student counseling. Age, sex, measured scholastic ability, measured study orientation, and high school academic achievement were employed as matching variables. The four professional and eight student counselors completed 50 clock hours of identical pre-counseling training, used identical guidance materials, and followed identical counseling activity sequences. Equivalent counseling facilities were provided for all counselors. Test, questionnaire, and scholarship data were employed to evaluate the comparative effectiveness and acceptability of counseling given the professional counseled and the student counseled groups. Student counselors were found to be as effective as professional counselors on all criteria of counseling effectiveness. Furthermore, freshmen counseled by student counselors made significantly greater use of the information received during counseling, as reflected by first-semester grades and residual study problems. It was concluded that carefully selected, trained, and supervised student counselors provide a practical and productive addition to the college's guidance program.     

Counseling and Human Sexuality: A Training Model

In recent years sexuality has been broadly defined as a fundamental dimension of personality. Mental health practitioners need to respond to the increased awareness of human sexuality as a vital aspect of personal development. To date, few programs or workshops assist mental health counselors in developing the necessary skills to confront sexual concerns in the counseling relationship. This article presents a counseling and human sexuality course model that provides counselors with an information base in human sexuality and assists them in exploring the emotional aspects of sexuality. This course model assumes that mental health counselors will provide a valuable service to their client populations once they have become more willing and able to explore sexual conflicts.     

Coping with the stress of pastoral counseling

Using a stratified random sample of the three membership categories of the American Association of Pastoral Counselors, this study investigated the experience of stress, related to the pastoral counseling profession, among 143 pastoral counselors and 95 of their spouses. In addition, the study examined how pastoral counselors were coping with stress by evaluating self-reported functional and dysfunctional behaviors. The data indicated that pastoral counselors and their spouses did not report high levels of stress related to the pastoral counseling profession. However, significant differences were found by work setting and age for pastoral counselors regarding the level of stress experienced. The data also indicated that pastoral counselors reported using more functional stress reduction behaviors than dysfunctional stress reduction behaviors.     

Gay and bisexual male clients' perceptions of counseling: the role of perceived sexual orientation similarity and counselor universal-diverse orientation

A recurring question in multicultural counseling is whether client-counselor similarity on sociodemographic characteristics benefits counseling. A related issue is how counselor orientation to diversity relates to counseling process and outcome, both as a main effect and in interaction with counselor-client sociodemographic match. This cross-sectional study investigated these questions in relation to gay and bisexual male clients' counseling experiences by examining clients' perceived similarity to their counselor in sexual orientation, as well as counselors' self-reported orientation to diversity (assessed in terms of level of universal-diverse orientation [UDO]). Data were from 83 male-male client-counselor dyads recruited from lesbian/gay/bisexual-affirming counseling practices, where clients identified as gay or bisexual and counselors identified as gay, bisexual, or heterosexual. Counselor UDO was positively and uniquely associated with client ratings of the working alliance, session depth, and session smoothness. Perceived sexual orientation similarity was not directly related to any of the counseling-related criterion variables. Moreover, when counselors reported low levels of UDO, perceived similarity was negatively associated with the client-rated alliance and perceived improvement. Client religious commitment-a control variable in all analyses--was uniquely and negatively associated with client ratings of perceived improvement in counseling.     

Ready,Set, Go: The Transtheoretical Model of Change and Motivational Interviewing for “Fringe” Clients

The author explores the applicability of the Transtheoretical Model of Change (TTM) and motivational interviewing (MI) as a collaborative approach in counseling “resistant” or ambivalent clients. The TTM and MI provide an empirically tested framework for employment counselors to assess and empower clients who are often labeled resistant or ambivalent (e.g., youth, mandated clients, street workers, single parents) about readiness for change. Together, the TTM and MI focus counselors to accept clients' current levels of readiness and intrinsic motivation, thereby supporting clients in the effort to reduce their ambivalence. Examples are given of how the TTM and MI may be practiced.     

Role Conflict and Role Ambiguity of Employment Counselors

The relationship of role conflict and role ambiguity to job satisfaction and other variables was examined in a national sample of 506 employment counselors. A survey was mailed to USES counselors in ten states. Regression analysis showed that the 11 personal and organizational variables included in the study accounted for only a small amount of the variance in role conflict or role ambiguity. On the other hand, role conflict and role ambiguity were negatively and significantly related to job satisfaction of the counselors. These stress variables were related positively and significantly to counselors' propensity to leave the agency. Privacy of counseling facilities and time spent in counseling activities were two variables contributing most to explaining variance in role stress. Both related negatively and significantly to role conflict and role ambiguity.     

Personal and Organizational Characteristics of Employment Counselors

Eleven personal and organizational variables were measured in a large national sample of employment counselors. Data indicate that female counselors were younger than males, older counselors had higher educational levels than younger ones, and as the level of education increased, so did the number of professional association memberships and time spent in counseling activities. Employment counselors with first-line supervisors who had counseling experience tended to be older, spent more time in counseling activities, had higher education levels, and belonged to more professional associations than did counselors whose supervisors did not have counseling experience.     

Christian Couple Counseling by Professional,Pastoral, and Lay Counselors from a Protestant Perspective: A Nationwide Survey

Couple counseling is widely practiced by Christian counselors, but there are almost no empirical data investigating it. The present study presents data from a national web-based survey of counselors from the American Association of Christian Counselors (AACC). We describe the nature of Christian couple counseling, as well as counselors' religiousness and their attitudes toward integrating religion and spirituality into couple counseling. Christian couple counselors were highly religious and their personal religiosity affected their attitude toward incorporating religion in counseling. There were differences between professional, pastoral, and lay counselors suggesting that each be treated separately rather than be lumped generically as Christian couple counseling.     

The draft and counseling

This article regards draft counseling as a specialized extension of personal, educational, and vocational counseling. It can be a necessary and valuable outreach program and is needed because most students are unaware of their rights under the Selective Service System. Professional counselors have a crucial role to play in draft counseling by helping to establish a Draft Information Center, by training and supervising students and faculty as draft counselors, and by serving as a referral source for individuals needing further counseling. Suggestions are included for the establishment of a Draft Information Center in high schools and colleges.     

Focus Groups: A Practical and Applied Research Approach for Counselors

Focus groups are becoming a popular research approach that counselors can use as an efficient, practical, and applied method of gathering information to better serve clients. In this article, the authors describe focus groups and their potential usefulness to professional counselors and researchers. Practical implications related to the use of focus groups in counseling practice are discussed, and case examples are provided demonstrating how focus groups can be useful to counselors.     

Games in Clinical Genetic Counseling Supervision

Games are defined as ongoing series of complementary ulterior transactions that are superficially plausible but have a concealed motivation to maximize pay-offs and minimize penalties for the initiator. While some games are harmless and part of socialization, others are destructive. Destructive game-playing in clinical supervision, in which game-playing (initiated by either supervisors or students) interferes with a student's realization of internship goals, has been documented in some allied healthcare professions but has not yet been studied in genetic counseling. Genetic counselors and clinical supervisors of genetic counseling students were anonymously surveyed regarding their experiences with destructive game-playing. Results show that such games do occur in genetic counseling clinical supervision. Some games are the same or similar to ones previously described in other health-care professions; others may be unique to genetic counseling. The purpose of this paper is to document these games as a first step to facilitating dialogue, understanding and awareness of them.     

Transference,Insight, and the Counselor's Intentions During a Counseling Hour

The interactive effects of transference and client insight on session quality, and the relationship between transference and counselor intentions, were studied within the context of a single counseling session. Thirty-eight experienced counselors audiotaped one counseling session and rated their intentions for each intervention. Counselors also rated transference, insight, and session quality. As hypothesized, when transference was high, client insight was positively related to session quality. Furthermore, negative transference was related to several counselor intentions. Negative transference may signal counselors to focus on the relationship and underlying client issues, and to avoid structuring and directing behavior change.