Graduate training and the treatment of suicidal clients: the students' perspective

Existing literature suggests that graduate programs may not provide adequate training in working with suicidal clients. Therefore, we surveyed 238 predoctoral psychology interns and assessed the prevalence of clients engaging in suicidal behaviors and the amount of formal training in managing suicidal clients received. Results showed approximately 5% of participants indicated a client suicide and 99% indicated they had treated at least one suicidal client during their graduate training. In contrast, results demonstrated only 50% of the participants reported attending programs where formal training was offered. These findings suggest a continued need for increased formal training in managing suicidal clients in graduate psychology programs.     

Teaching preschool children to report suspicious packages to adults

Law enforcement agencies stress that public reporting of terror‐related crime is the predominant means for disrupting these actions. However, schools may be unprepared because the majority of the populace may not understand the threat of suspicious materials or what to do when they are found on school grounds. The purpose of this study was to systematically teach preschool children to identify and report suspicious packages across three experiments. In the first experiment, we used multiple exemplar training to teach children to identify the characteristics of safe and unsafe packages. In the second experiment, we taught participants to identify the locations where packages should be considered unsafe. Finally, in the third experiment, we used behavioral skills training to teach participants to avoid touching unsafe packages, leave the area where they were located, and report their discovery to an adult. Results suggest the participants quickly developed these skills. Implications for safety skills in young school children are discussed.     

Non‐parametric three‐way mixed ANOVA with aligned rank tests

Research problems that require a non‐parametric analysis of multifactor designs with repeated measures arise in the behavioural sciences. There is, however, a lack of available procedures in commonly used statistical packages. In the present study, a generalization of the aligned rank test for the two‐way interaction is proposed for the analysis of the typical sources of variation in a three‐way analysis of variance (ANOVA) with repeated measures. It can be implemented in the usual statistical packages. Its statistical properties are tested by using simulation methods with two sample sizes (n = 30 and n = 10) and three distributions (normal, exponential and double exponential). Results indicate substantial increases in power for non‐normal distributions in comparison with the usual parametric tests. Similar levels of Type I error for both parametric and aligned rank ANOVA were obtained with non‐normal distributions and large sample sizes. Degrees‐of‐freedom adjustments for Type I error control in small samples are proposed. The procedure is applied to a case study with 30 participants per group where it detects gender differences in linguistic abilities in blind children not shown previously by other methods.     

Software for advanced ANOVA courses: A survey

In response to a survey of faculty regarding their commercial software preferences for advanced analysis of variance courses, it was found that the most frequently used packages were SAS, SPSS^x, and BMDP, all originally mainframe packages. The fourth choice, SYSTAT, was written for microcomputers but is currently also available for other host computers. Difficulty for students was the most frequently cited reason fornot using one of these four packages. The most important criteria for choosing software packages were variety of designs, accuracy, and ease of use. Cost was a factor only for microcomputer licenses. Packages using the general linear model approach were paramount to some, while others would not consider such packages. Instructors decried the lack of the “ideal program,” but the diversity of their desires makes it clear that no program could be ideal for all of them. Many faculty seemed unaware of newer software packages or of the extent to which older packages (particularly Minitab) have been modified; some had their choices constrained by departmental limitations. Better dissemination of information about statistical software is needed, whether it be from software publishers or through the professional literature.     

Direct observation of quality of care in residential settings

Direct-observation procedures were used to objectively and efficiently assess several classes of service provided for individuals residing at two state facilities for the developmentally disabled. Time samples were taken of the condition of the clients' physical environment and of the clients themselves. The ongoing behavior of both clients and staff also was recorded. Each residence was observed at least three times during both regular work hours and evening/weekend hours. Results showed that both facilities scored high in the categories regarding the physical condition of the living areas, as well as the categories concerning the condition of the clients. Greater variability was seen in the data on client and staff behavior. More generally, the results indicate that time-sampling procedures can be used efficiently to collect data on multiple aspects of service delivery for large numbers of individuals.     

SUPPORTED EMPLOYMENT AS AN INTERVENTION PACKAGE: A PRELIMINARY ANALYSIS OF FUNCTIONAL VARIABLES

In this two-experiment investigation, the long-term (at least 6 months) employment of 51 moderately mentally retarded clients who were placed into 64 supported employment positions was first evaluated relative to 10 training and posttraining components that comprised a supported employment training package. In Experiment 1, chi-square analyses were used to identify three components that differentiated successful (employed for at least 6 months) from unsuccessful clients. In Experiment 2, 4 successful clients were further evaluated in a nonconcurrent multiple baseline design to determine whether the three variables identified during the group analysis (client advocate, collateral behavior, and follow-up plan) were included in the training packages. These results are discussed in terms of the need to establish better the functional variables of supported employment training programs.     

Information search and presentation in advisor–client interactions

When making a decision, people often search for more information supporting than conflicting with their preferred alternative. This can be counterproductive because potential risks and liabilities of the intended decision may be overlooked. However, when confronted with a decision problem, people often turn to advisors for help. We examined what kind of information advisors search for when confronted with a client’s decision problem and what information they present to their clients. Experiment 1 suggested that advisors (participants in the role of travel agents or friends) conducted a more balanced information search than personal decision-makers. However, when presenting information to their client, mock travel agents passed on more information supporting their recommendation than conflicting with it, whereas friends presented information in a balanced way. Experiment 2 replicated the balanced information search of advisors and suggested that this effect was partly mediated by the advisors’ increased accuracy motivation. Practical and theoretical implications are discussed.     

Never ready: Addictions counselors dealing with client death

This study explored the experiences of addictions counselors who have undergone client death and the immediate and long-lasting impacts of client death on addictions counselors through the consensual qualitative research (CQR) method. We conducted semistructured interviews with 10 participants exploring their lived, in-depth, experiences in working with clients with addictive disorders with focus given to the death of clients and how they responded to the experience. Results from a data analysis process using the CQR method indicate eight domains: (a) professional ethics, (b) coping skills, (c) client care, (d) preparation for profession, (e) experience of addiction, (f) agency impact, (g) exploring the death experience, (h) recommendations, and 28 categories embedded in each of these domains. Implications for counselor education, training, and practice are discussed.     

Transformations in Therapeutic Practice

In her training of therapists, Virginia Satir sought to change the way her trainees perceived themselves, their clients, and the therapeutic endeavor. The change she sought was a movement from hierarchical models of therapy where clients were diagnosed in terms of paradigms of how they ought to be to an organic model where the therapist attempts to understand the client by entering the client's internal context. Contemporary training in the Satir model attempts to bring about the same change. Research indicates that the trainers are succeeding.     

MPTinR: Analysis of multinomial processing tree models in R

We introduce MPTinR, a software package developed for the analysis of multinomial processing tree (MPT) models. MPT models represent a prominent class of cognitive measurement models for categorical data with applications in a wide variety of fields. MPTinR is the first software for the analysis of MPT models in the statistical programming language R, providing a modeling framework that is more flexible than standalone software packages. MPTinR also introduces important features such as (1) the ability to calculate the Fisher information approximation measure of model complexity for MPT models, (2) the ability to fit models for categorical data outside the MPT model class, such as signal detection models, (3) a function for model selection across a set of nested and nonnested candidate models (using several model selection indices), and (4) multicore fitting. MPTinR is available from the Comprehensive R Archive Network at http://cran.r-project.org/web/packages/MPTinR/.     

The integrity of Web-delivered experiments: can you trust the data?

Data from Web-delivered experiments conducted in browsers by remote users of PsychExperiments, a public on-line psychology laboratory, reveal experiment effects that mirror lab-based findings, even for experiments that require nearly millisecond accuracy of displays and responses. Textbook results are obtained not just for within-subjects effects, but for between-subjects effects as well. These results suggest that existing technology is adequate to permit Web delivery of many cognitive and social psychological experiments and that the added noise created by having participants in different settings using different computers is easily compensated for by the sample sizes achievable with Web delivery.     

Client attendance measures in counselling psychology trainees

Counselling supervisors and educators have yet to reach a consensus about standard measures for evaluating the performance of graduate student therapists. Compared to self‐reports and rater judgements, client attendance records provide low‐inference behavioural data partially reflective of clients’ engagement with therapists. This naturalistic study evaluates client attendance data using archival records of 92 doctoral students in beginning and advanced counselling practica who produced data for 771 clients, 3,949 scheduled sessions and 3,186 attended sessions. Providing evidence of the sample representativeness for clinicians, results indicated that the mean number of sessions attended per client for student therapists (5.65) was very similar to that reported in the literature for outpatient therapists (<6). As expected because of structural differences in client assignment, beginning and advanced students evidenced statistically significant differences on attendance variables such as number of clients and scheduled sessions. In contrast, attendance ratios were equivalent across counsellor experience, suggesting that these individual difference variables could be useful for evaluation of therapist competencies related to client engagement.     

The Kawa Model: Therapists' Experiences in Mental Health Practice

This pilot study sought to gather information related to the experience of occupational therapists, using the Kawa Model of practice in a mental health setting. Two therapists utilized the model with one client, each over a six-week period. Through qualitative inquiry, the participants (therapists) revealed that, although initially apprehensive about using a new model, they found that the Kawa Model increased client/therapist interaction and energy levels and challenged them to push the boundaries of therapeutic practice. This research suggests that exploration of new models of practice may be beneficial in terms of facilitating successful partnerships and outcomes with clients in mental health settings.     

COMPARISON OF STAFF TRAINING STRATEGIES TO PROMOTE GENERALIZED TEACHING SKILLS

Two studies compared the effectiveness of different strategies for promoting generalization of staff skills in teaching self-care routines to clients with developmental disabilities. In Study 1, 9 direct-care staff members of group homes were trained sequentially through four conditions: (a) the provision of written instructions, (b) performance-based training using a single client program exemplar and simulated clients (single case training), (c) performance-based training using actual developmentally delayed clients as trainees (common stimuli training), and (d) performance-based training using multiple client program exemplars with simulated clients (general case training). The results indicated that staff members did not reach all generalization criteria until general case training was provided. Because staff members had been trained sequentially through several conditions in Study 1, a second study controlled for potential sequence effects. In Study 2, 7 staff members were trained using only the general case strategy after baseline. All staff members reached generalization criteria with only general case training, replicating the findings of Study 1. Together, the two studies demonstrated that the general case training strategy was more effective at promoting generalized training effects across clients, settings, and client programs than other commonly used staff training approaches.     

A solution-focused approach to working with clients who are suicidal

Self-harm and suicide are amongst the most challenging and frightening problems that therapists and counsellors can encounter in the course of their work. The risk of clients harming themselves in the course of treatment can debilitate the therapists from acting creatively and collaboratively, and make their actions defensive, focused solely on risk assessment rather than therapeutic change.Yet it is precisely a creative and collaborative response, such as that engendered by solution-focused therapy and other models, that is the most likely to facilitate change and re-empower clients to take back charge of their lives. This article describes a solution-focused approach to working with suicidal clients that can be used in conjunction with traditional approaches and which focus on establishing safety as well as assessing risk.Working from this model the clinician shifts to identifying client strengths and coping skills, to collaborating with the client to establish meaningful goals and to helping the client envision a positive future. Arguably, such an approach can increase collaboration between therapist and client and lead to a more client-centred safety plan.     

Using SAS PROC NLMIXED to fit item response theory models

Researchers routinely construct tests or questionnaires containing a set of items that measure personality traits, cognitive abilities, political attitudes, and so forth. Typically, responses to these items are scored in discrete categories, such as points on a Likert scale or a choice out of several mutually exclusive alternatives. Item response theory (IRT) explains observed responses to items on a test (questionnaire) by a person’s unobserved trait, ability, or attitude. Although applications of IRT modeling have increased considerably because of its utility in developing and assessing measuring instruments, IRT modeling has not been fully integrated into the curriculum of colleges and universities, mainly because existing general purpose statistical packages do not provide built-in routines with which to perform IRT modeling. Recent advances in statistical theory and the incorporation of those advances into general purpose statistical software such as the Statistical Analysis System (SAS) allow researchers to analyze measurement data by using a class of models known as generalized linear mixed effects models (McCulloch & Searle, 2001), which include IRT models as special cases. The purpose of this article is to demonstrate the generality and flexibility of using SAS to estimate IRT model parameters. With real data examples, we illustrate the implementations of a variety of IRT models for dichotomous, polytomous, and nominal responses. Since SAS is widely available in educational institutions, it is hoped that this article will contribute to the spread of IRT modeling in quantitative courses.     

Characteristics of residential retarded clients as predictors of staff expectations and frustrations

The purpose of this study was to examine the relationship of four client characteristics—functioning level, aggressive behavior, self-injurious behavior, and attractiveness—with staff expectations of and frustration with clients. Forty staff members who worked with severely and profoundly retarded individuals served as participants. Staff members rated each client with whom they worked on the extent to which the client could behave better and learn faster as well as the level of frustration experienced in working with the client. A client's functioning level was related to staff perceptions such that the higher the functioning level, the more the client was seen as having the potential to behave better or learn faster than (s)he was presently demonstrating. Staff frustration was related to client aggression indicating that as aggression increased so did staff frustration in working with that client. Implications of the results are discussed.     

心理咨询的LIWC语言特征对咨询效果的预测

语言是心理咨询的重要内容。语言探索和词频统计（Language Inquiry and Word Count, LIWC）被广泛用于分析语言使用的心理意义。本研究收集了28名当事人共144次有效咨询录音及每次会谈后当事人的症状自评结果。将录音转录成文本后,抽取当事人的LIWC语言特征,进行主成分降维,结果获得8个因子,解释了总体方差的75.11%。一般线性回归中,躯体感受、功能词、情绪、认知和口语赘词对当事人的症状水平具有显著的预测作用,进一步多层线性模型中,躯体感受和情绪用词显著预测咨询效果。LIWC文本特征能够呈现与当事人症状相关的信息,为未来计算机自动化监控咨询过程和结果提供了新视角。     

Client perceptions of hindering experiences in counselling

The purpose of this study was to increase understanding of what clients perceive as hindering experiences in counselling. In‐depth interviews combined with concept mapping were used to gather, organize, and understand clients' perceptions of hindering aspects of therapy. In the initial data gathering stage, 8 adult client participants, aged 18 or older (average of 14.1 sessions) were asked to respond to the following open‐ended questions:

相似文献   

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.