Counselor Sex Role Orientation,Flexibility, and Working Alliance Formation

The authors examined the hypothesized relationship among counselor androgyny, counselor flexibility, and the establishment of client-rated working alliances. In Study 1, 41 counseling students completed the Bem Sex-Role Inventory (BSRI; Bem, 1981a) and the Counselor Behavior Analysis Inventory (Gabbard, Howard, & Dunfee, 1986). Contrary to the hypothesis, there was no relationship between androgyny and counseling flexibility. In Study 2, 42 counseling students completed the BSRI and videotaped counseling sessions with a recruited client. Analyses revealed a significant relationship between counselor flexibility and client ratings of working alliance, but no relationship between counselor androgyny and counselor flexibility. Research and clinical implications are discussed.     

The helping alliance and premature termination

The study was conducted to determine the relationship between strength of the helping alliance and type of client termination (premature or with mutual knowledge of client and counselor). Participants were 102 client-counselors dyads at a university counseling center. After an average of 8 sessions, clients and couneselors completed Alexander & Luborsky's (1986) Helping Alliance Questionnaires. Clients terminated after an average of 19 sessions. Clients who later terminated with mutual knowledge of their counselors gave significantly higher strength of helping alliance ratings than did clients who later terminated unilaterally and prematurely. Counselors' ratings of strength of helping alliance were only modestly related to clients' ratings and unrelated to type of client termination.     

Telephone counseling and crisis intervention: A review

The empirical research pertaining to the effectiveness of telephone counseling and referral systems personnel was critically reviewed. The assessment was organized according to several evaluation strategies that researchers have utilized to evaluate effectiveness. These strategies included, for example, client self-reports, client "shows" versus "no-shows" following referral, data pertaining to suicide rates, counselor ratings of personal effectiveness, and phone workers' ability to offer empathy to clients. It was concluded that discussions of effectiveness should be constrained by a careful consideration of the specific index of efficacy chosen by investigators as well as methodological issues associated with current research in this area. There is reason to believe that the availability of telephone crisis services may be related to reduced suicide rates among young white females. Also, there is a significant need to empirically associate counseling technique and indices of effectiveness with substantive measures of client outcome in future research. Additional topics reviewed include the probable differential effectiveness of lay workers with various presenting problems of clients, and the role that training and maturity seem to play in successful interventions. Guidelines for the use of evaluation techniques which coincide with service goals are also offered.     

White Counselor Trainees' Racial Identity and Working Alliance Perceptions

Racial identity has been theorized to significantly affect cross-racial counseling relationships (Helms, 1984, 1995). This study examined the direct impact of White racial identity of 124 counselor trainees on working alliance formation in a same-racial and cross-racial vicarious counseling analogue. Regardless of the race of the client, disintegration and reintegration attitudes negatively affected working alliance ratings, and pseudoindependent and autonomy attitudes positively affected working alliance ratings. Implications for counseling, supervision, training, and research are discussed.     

Improvisation as a Meta-Counseling Skill

Counselor education tends to see the development of basic counseling and communication skills as the foundation of clinical training. Improvisation has historically and primarily been connected to theater training and as a performance mechanism. By developing skills in spontaneity and the nature of narrative (or story) one becomes more able to be in-the-moment with a client or clients and thus less anxious and more able to meet the client where they are. As such, improvisation can really be seen as a meta-counseling skill—a skill that can form a firmer foundation for the learning of the basic counseling and communication micro-skills. This article outlines the core concepts of improvisational training for counselors and includes examples of improvisational games that can specifically help in preparing counselor trainees for their future clinical work.     

Characteristics of Clients Judged to Require Long-Term Counseling

This study examines one subgroup of clients seen at a university counseling center, namely, 72 clients who were expected by their counselor to remain in counseling for 10 or more interviews. Ratings were available on psychological characteristics for this sample and for the Counseling Center's total client population. In addition, the total university population could be compared with both of these groups on demographic characteristics. On the basis of pre- and post-counseling ratings of severity of problem, the sample being investigated was divided into Improved and Unimproved groups. Comparative data are examined with regard to class, college, sex, type of residence, type of problem, severity level at onset and termination, number of counseling interviews, motivation for counseling, defensiveness, and counselor's feelings toward client. Long-term counseling and improvement status are found to be a function of most of these variables.     

Can Counselor Trainees Apply Their Skills in Actual Client Interviews?

The authors compared a skill-based training method (Carkhuff's human relations development model) with a conceptual-based training method by measuring (a) trainees' skill application in actual client interviews and (b) client outcomes. Participants were 14 male and 34 female master's degree trainees. Counseling skills were measured by rating segments of audiotaped sessions with field placement clients. Interrater reliabilities of .94 and above were achieved. A self-report instrument measured client outcome. Although the groups did not differ in responding skills at pretest, the skill-based group exhibited greater skill application in client interviews and superior client outcome ratings at posttest. Results support the use of skill-based training methods to increase trainees' skill application in applied settings.     

The use of augmentative alternative communication in psychotherapy

The use of augmentative alternative communication (AAC) in psychotherapy is particularly important for psychotherapists who may have a disability related to speech-language production. The aim of our study was to examine the perceptions of using AAC in psychotherapy. We recruited 186 participants and randomly assigned them to either watch a video of a therapist using AAC or employing traditional talk psychotherapy. Subsequently, we asked participants to complete the Counsellor Rating Form-Short (CRF-S), respond to a question about behavioural intention to seek psychotherapy and complete the Working Alliance Inventory-Observer form (WAI-O). Most participants perceived the use of AAC to be related to the therapist having a disability. The use of AAC had higher ratings on the CRF-S and higher scores on the WAI-O. There were no significant differences in behavioural intention between the therapist using AAC or traditional talk psychotherapy. The use of AAC is a viable option for psychotherapy and is beneficial. Psychotherapists with a disability affecting speech-language production may opt to use AAC as others perceive the therapist positively, the alliance is rated higher and therapists do not need to be concerned with patients not wanting to seek out their services.     

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.     

The Effect of Nonverbal Skills Training on Counselor Trainee Nonverbal Sensitivity and Responsiveness and on Session Impact and Working Alliance Ratings

Counselor trainees (N = 18) were randomly assigned to treatment (nonverbal sensitivity) or control (empathy training) conditions. Trainees saw a recruited client before (first 2 weeks) and after (last 2 weeks) a 15-week counseling methods class. Trainees rated their sensitivity to nonverbal behaviors, counseling self-efficacy, and the extent to which they focused on client nonverbal behavior. Clients filled out the Session Evaluation Questionnaire and Working Alliance Inventory at pre- and posttesting. Trained raters viewed videotapes of the counseling sessions and rated the extent that counselors focused on client nonverbal behavior. As hypothesized, trainees in the treatment condition, when compared with those in the control condition, increased their focus on client nonverbal behaviors. In addition, clients of treatment condition counselors showed significant differences in working alliance ratings. Trainees in both conditions increased their rating of nonverbal sensitivity and self-efficacy from pre- to posttesting. Implications are discussed.     

Comparative analysis of a client's verbal responses in counseling sessions: quantitative case study

This study investigated how the in-session change in a client's verbal behavior might influence the effectiveness of counseling sessions. 10 sessions of counseling with a male undergraduate suffering from depressive mood were conducted by a humanistically oriented counselor. The two most effective and the two least effective sessions were identified according to the client's evaluation of the effectiveness of counseling sessions. Results indicated that over the three segments of the most effective sessions, the client gradually increased responses that indicated exploration of his own emotions, thoughts, and behaviors. By contrast, the client continued talking mainly about past events in a storytelling manner throughout the least effective sessions.     

Effective Challenging Through Additive Empathy

Empathy is a counseling skill that is highly regarded by most practitioners. Constant reflection of only expressed surface feelings however, may perpetuate a limited view of a client's problem. The ability to extend a client's original understanding is a valuable resource for a helper to offer. Through additive empathy, a helper challenges a client to examine a deep and broad perspective for assessing problems and then to take action. The purposes of this article are to identify some elements of additive empathy and to describe practical guidelines for using the skill in counseling and in systematic skill training.     

Preferences for skill versus chance-determined activities: The influence of gender and task sex-typing

Three experiments tested the hypothesis that skill-chance activity preference by men and women is moderated by task sex relatedness. Men and women (total N = 368) opted to perform either skill or chance versions of masculine and feminine tasks, and then provided ratings of performance expectancy, importance of success, and perceptions of task characteristics. Results support the conclusion that men do not prefer skill and women chance as had been found previously, but rather that while men's skill preferences are higher than women's on a masculine taks, women prefer skill more than do men on a feminine task. Skill-chance preferences were primarily a function of the expectancy of success on skill tasks.     

I-Level: a differential counseling system

This article suggests that the counselor, the client, and the counseling strategies employed must be systematically examined in order to maximize the effectiveness of counseling. The authors introduce the Interpersonal Maturity Level Typology as a vehicle through which this can be accomplished. They describe client and counselor types, present the notion of matching, and recommend differential counseling strategies.     

Counseling Canadian Indigenous Peoples: The Therapeutic Alliance and Outcome

The aim of this study was to determine whether client therapeutic alliance ratings and client symptom severity were predictors of counseling outcomes among Canadian Indigenous clients. Participants included 179 Canadian Indigenous clients who completed an outcome measure at the 1st and last sessions and an alliance measure at both the 2nd and 3rd sessions. Results indicated that higher client alliance ratings at Sessions 2 and 3 and baseline client symptom severity were significant predictors of outcome. El objetivo de este estudio fue determinar si las valoraciones del cliente de la alianza terapéutica y la severidad de los síntomas del cliente fueron indicadores de los resultados de la consejería entre clientes indígenas canadienses. Los participantes incluyeron 179 clientes indígenas canadienses que completaron una medida de resultados en la primera y última sesión, además de una medida de la alianza en la segunda y tercera sesión. Los resultados indicaron que unas valoraciones del cliente más altas de la alianza en las sesiones 2 y 3 y la severidad preliminar de los síntomas del cliente fueron indicadores significativos del resultado.     

Therapist Perceptions of Client Reactions

This study examined therapist ability to identify client-reported reactions. Sixteen therapists each saw two volunteer clients for single counseling sessions. In postsession reviews, clients rated the helpfulness of, and indicated their reactions to, each therapist intervention. Therapists also rated the helpfulness of, and indicated their perceptions of client reactions to, each therapist intervention. In 50% of the instances therapists matched clients, that is, reported the same reaction cluster as the clients did. There were higher match rates on the reaction clusters of therapeutic work (62%), supported (54%), and no reaction (46%) than negative reaction (27%) and challenged (14%). When therapists matched on therapeutic work, helpfulness ratings for the following intervention were higher than when therapists did not match. In contrast, when therapists matched on negative reactions and no reaction, helpfulness ratings for the following intervention were lower than when they had not matched. Thus, therapists' ability to match client reactions was related to their ability to generate helpful interventions. Implications for practice and future research are discussed.     

An Exploratory Study of Counselor Judgments in Multicultural Research

Archival data were used to explore intake judgments made by 45 counselors about 344 African-American and White clients seen at a counseling center during a 2-year period. Counselor gender was significantly associated with ratings of client severity of current condition. Neither ethnicity nor counselor experience were predictive of intake judgments.     

Psychological Openness and Counselor Effectiveness: A Further Investigation

The purpose of this study was to crossvalidate previous findings which lend credence to the widely hypothesized positive relationship between a student's psychological openness and his effectiveness as a counselor. Rorschach indicators of psychological openness were compared with supervisor ratings of competence and scores obtained from the application of the Truax Scales of accurate empathy, genuineness, and nonpossessive warmth to tapes of actual counseling sessions. The data offer further support for the hypothesis that psychological openness is an important predictor of success in counselor training.     

Measuring Counseling Effectiveness: The Role of Client,Counselor, and Agency

To measure counseling effectiveness in general, and employment and training agencies in particular, the evaluator must include client, counselor, and agency factors in the evaluation scheme. A model measuring counseling effectiveness discusses representative client, agency, and counselor factors, identifies subfactors, and gives suggestions for measuring each. Many of the client-oriented factors can be assessed through self-report, data for which can be elicited via a detailed questionnaire similar to the one in the appendix.