Spirituality and Multimodal Therapy: A Practical Approach to Incorporating Spirituality in Counseling

The purpose of this article is to describe how the dimension of spirituality can be added to an existing counseling theory, multimodal therapy (MMT; A. A. Lazarus, 1984), to provide counselors with a practical approach to incorporating clients' religious and spiritual beliefs in the counseling process. An explanation of MMT is given, as well as its supporting research. The context of spirituality in counseling is discussed, and the process by which it can be integrated into the MMT model is explained. Two case studies are described to demonstrate how spiritual issues can be assessed and used to strengthen the counseling process. Finally, implications for counseling are discussed.     

EcoWellness: The Missing Factor in Holistic Wellness Models

A growing body of multidisciplinary literature has delineated the benefits that natural environments have on physical and mental health. Current wellness models in counseling do not specifically address the impact of nature on wellness or how the natural world can be integrated into counseling. The concept of EcoWellness is presented as the missing link in wellness models and counseling. Integrating EcoWellness in counseling provides new and potentially powerful interventions to enhance wellness across the life span.     

Integrating Career and Mental Health Counseling: Necessity and Strategies

Individuals seeking counseling might not recognize the interconnectedness of health, mental health, work, and life concerns. Counselors, however, need to be mindful that a person's wellness is interwoven with their work, life roles, and health. Research supports the interrelationship of career development and mental health as well as the effectiveness of an integrated approach to mental health and career counseling. An integrated approach from an ecological counseling perspective is proposed for conceptualizing client issues and intervention strategies.     

Application of the Serious Leisure Perspective to Intrinsically Motivated Serial Homicide

ABSTRACT

This article briefly introduces the multidisciplinary field of leisure sciences before exploring how leisure theory, particularly the Serious Leisure Perspective, can provide important insights into better understanding some forms of serial homicide. It is well known that many serial homicide offenders kill for the pleasure and enjoyment that such behavior provides them. Such expressive cases can be understood as deviant casual, serious, or project-based leisure experience, which helps account for how particular offenders plan, structure, and experience their crimes. Examples of specific serial homicide cases that appear to function primarily as casual, serious, or project-based leisure are presented and discussed.     

Beyond Theory: Martin Buber’s I and Thou and the Role of Contemplation in Integrated Relational Counseling

The current paradigm in mental health practice does not completely protect practitioners from theory-induced blindness. Many clinicians continue to rely on stable theoretical frameworks, which, although helpful, can become a hindrance to integrated relational practice. Overreliance on a particular theory or set of techniques can prevent clinicians from adopting a genuinely relational orientation. This article describes the nature of the contemplative-relational orientation using concepts from Martin Buber’s I and Thou and proposes that clinicians wishing to build competency in integrated relational counseling may benefit from contemplative prayer, meditation, and other mindfulness practices. A clinical vignette is provided and illustrates general features of an integrated relational approach, and empirical evidence is advanced to support the benefits of contemplative practice for mental health practitioners.     

Mothers’ Perspectives on Their Child’s Mental Illness as Compared to Other Complex Disorders in Their Family: Insights to Inform Genetic Counseling Practice

To facilitate the development of a therapeutic alliance in genetic counseling, it is important that the counselor understands how families might perceive the condition that constitutes the reason for the referral. Through training and professional practice, genetic counselors develop a thorough understanding of families' perceptions of the conditions that are common indications for genetic counseling. But, for referral indications that are less frequent, like serious mental illnesses, genetic counselors may feel less confident in their understanding of the family's experience, or in their ability to provide psychosocial support when serious mental illness is reported in a family history. This may impede the establishment of a therapeutic alliance. As research shows that most referrals for genetic counseling related to serious mental illness are for female first-degree family members of affected individuals, we sought to explore how this group perceives serious mental illness. To provide a frame of reference with which genetic counselors may be more familiar, we explored how women perceived serious mental illness compared to other common complex disorders in their family. We conducted semi-structured interviews with women who had a child with a serious mental illness (schizophrenia, schizoaffective disorder, bipolar disorder) and a first-degree relative with another common complex disorder (diabetes, heart disease, cancer). Interviews were transcribed and subjected to thematic analysis. Saturation was reached when nine women had participated. Serious mental illness was perceived as being more severe and as having a greater impact on the family than diabetes, heart disease, or cancer. Themes identified included guilt, stigma, and loss. Some of the most important issues that contribute to mothers' perceptions that serious mental illness is more severe than other common complex disorders could be effectively addressed in genetic counseling. Developing a heightened awareness of how family members experience a relative's mental illness may help genetic counselors to be better able to provide psychosocial support to this group, whether serious mental illness constitutes the primary reason for referral or appears in the family history during counseling for a different referral reason.     

Accountability Through Action Research: Research Methods for Practitioners

This article summarizes how outcome research methodologies can be incorporated into counseling practice in many settings. Performing an outcome study can assist counselors in evaluating their own effectiveness. In addition, more field-based studies can contribute to the empirical knowledge base. An overview of the steps involved in an outcome or evaluative study is discussed, and a summary is provided of instruments and techniques for research in mental health counseling, career counseling, and school counseling.     

Insurance Coverage and Mental Health Service Use by Adolescents with Serious Emotional Disturbance

This paper examines the relationships between insurance coverage, need, and mental health services in a community-based sample of 1,015 youths who were 9, 11, and 13 years old at the beginning of the study. They were followed over a two-year period. A strong measure of need based on a standardized diagnostic interview was available and repeated over three annual waves. Data on service use was collected quarterly across two years. Major findings included: (a) high need (serious emotional disturbance [SED]) was strongly related to use of any mental health services; (b) services use was much more likely to occur with public (Medicaid) insurance coverage than either private or no insurance; (c) considerable unmet need was observed even for youths with SED; (d) school-based mental health services potentially substituted for professional mental health services; and (e) there was little unnecessary use of mental health services in the low need group. The major policy implication of these findings is that the regulation of insurance benefits should be based on level of need, rather than on arbitrary limits which are likely to either reduce the probability of or appropriate amount of care for youths who most need mental health services.     

Rational Emotive Behavior Therapy: The Past,Present, and Future

The intent of this article is to describe the significant contributions Albert Ellis made to rational emotive education and to a preventative approach to psychotherapy, which represents a major shift from many other counseling theories. The author notes that REBT as a preventative mental health approach was very important to Albert Ellis because he believed that it would extend the influence of REBT, but unfortunately he and other REBT practitioners have not put enough systematic emphasis on training teachers to implement rational concepts into the curriculum. Given the number of children and adolescents needing mental health services, this is an area that should be emphasized and would extend Al’s legacy. The article also addresses Dr. Ellis’ contributions in the area of parenting, where once again he was a pioneer in teaching parents how to deal with their irrational beliefs that interfere with effective parenting. The author concludes with a discussion about “where we go from here,” focusing on training at the university level, developing a standardized REE program that includes a train the trainer component, becoming more of a presence in the field of health care, and putting more emphasis on the therapeutic relationship which may attract more people to the theory.     

Differential associations of leisure music engagement with resilience: A network analysis

Background/ObjectiveSeveral factors associated with resilience as the maintenance of mental health despite stress exposure can be strengthened through participation in leisure time activities. Since many people listen to or make music in their leisure time, the aim of the present study was to provide insights into the architecture of how resilience relates to passive and active music engagement.Method511 participants regularly listening to and/or making music completed an online survey on resilient outcomes (i.e., mental health and stressor recovery ability), different resilience factors (e.g., optimism, social support), quantitative music engagement (i.e., time spent with music listening/making) and qualitative music engagement (i.e., use of music listening/making for mood regulation).ResultsBivariate correlations showed that subjects spending more time with music making reported better stressor recovery ability and less mental health problems, while partial correlational network analysis revealed no unique associations for quantitative music engagement. Regarding qualitative music engagement, people using music-based mood regulation reported lower mental health, mindfulness, and optimism, but also higher social support. A more heterogeneous pattern emerged for single music-based mood regulation strategies.ConclusionsOur findings highlight the importance of the individual (mal-)adaptive use of music, painting a more nuanced picture of music engagement and resilience.     

Singing together in the park: Older peoples’ wellbeing and the singingscape in Guangzhou,China

The importance of adapting to later life is becoming increasingly apparent to older people as their concerns about health and wellbeing grow. Based on extensive fieldwork between 2020 and 2021 in Guangzhou, China, with older people who consider “singing together in the park” as an essential and popular everyday leisure activity, this article demonstrates how subject (older people), activity (singing), and place (park) integrate into a therapeutic space, the singingscape. Singingscape is presented in three distinct aspects: on the physical level, singingscape indicates an essential embodied experience of the connection between internal body and external environment, from which the older people can relax physically and mentally and acquire a sense of wellbeing; on the social level, singingscape fosters a positive atmosphere, where older people gain a collective sense of belonging and maintain social rhythm and social interactions with their peers; and on the imagined space level, fanciful landscapes and emotional imagination are advantageous to the wellbeing of older people. In the conceptual sense we argue that singingscape is located, experienced and integrated. Lastly, we advocate that attention should be paid to the construction of urban public spaces as vital infrastructure for older people in their everyday leisure activities.     

The use of leisure counselling as a therapeutic technique

If leisure is defined as free or unobligated time, then leisure is clearly the category of time expenditure that has the greatest potential for making people healthy and happy but it also has the greatest potential for creating problems. Therefore, educating and counselling people on how to make best use of their free time can have a great impact on the physical and mental health of individuals. The intent of this paper is to explain how leisure counselling can be implemented as a therapeutic technique for the benefit of many different types of people. It is also the intent of this paper to provide those who work as counsellors with information about leisure and leisure counselling so that they can help their clients to improve their lives through leisure. Therefore, this paper examines the contributions that both leisure counselling and leisure education can make in promoting maximal physical and psychological well-being, although the main focus is on leisure counselling. The overall conclusion is that effective leisure counselling services can significantly help to improve the physical and mental well-being of individuals and society in general.     

The College Campus Ministry Internship Site: Interfacing Religion and Counseling

This article presents a model for creating internship sites at college campus ministries for students interested in interfacing religion and counseling. More specifically, a systematic process that students can implement in developing these unique training opportunities is provided. Developing campus ministry internship and other training sites can afford students opportunities for (a) specialized supervised experience working with religiously committed individuals, (b) providing consultation and program evaluation services, and (c) becoming a liaison who has the opportunity to influence and educate the next generation of religious leaders and members about mental health issues.     

Defining Location in the Mental Health System: A Case Study of a Consumer-Run Agency

In this ethnographic study of a mental health service agency staffed by “consumers,” or fellow “recipients” of services for serious mental illness, the concept of community narrative provides the framework for examining how such an agency preserves its consumer identity while providing services dictated by the established service system. Locating the agency's narrative in its “origins tale,” analysis revealed five principles comprising the agency's identity: a normalizing view of mental illness, a commitment to helping, a dual-valued understanding of the mental health system, and beliefs in recovery and in the significance of employment as a criterion for recovery. Predicted consequences of narrative functioning emerged in social climate and staff expressions of cohesion and commitment. The local meaning of these narrative themes reveals the agency's view of the consumer element in its work and its solution to the dilemma of being both inside and outside of the mental health system.     

社区心理辅导实验模型的建构及其价值

建立实验模型,探索社区心理辅导的路径、具体实施的方法及其价值,为居民的心理健康和社区精神文明工作提供心理学理论和实践的依据;方法：采用症状自评量表(SCL-90)评估辅导前和辅导后社区居民的心理状况并进行自身比较;结果：l、辅导前居民的心理卫生存在问题较多;2、辅导后居民的心理卫生出现显著的变化;3、与辅导前比较,辅导后的居民心理卫生有明明显进步,特别在敌对的人际关系、偏执的认知方式和焦虑、抑郁的情绪等方面改变最为突出。结论：l、开展社区心理辅导是促进精神文明建设的全新理念和有效方法。2、建立、健全社区心理辅导网络对提高居民心理素质,减少心理疾病的发生、发展具有重要而又深远的作用。3、社区心理辅导实验模型的建立为广泛开展有关工作提供了理论和实践依据。     

Improving Mental Health on College Campuses: Perspectives of Indian College Students

The mental health of college students is increasingly viewed as an important public health priority. However, there has been little attention paid specifically to college students’ perspectives on factors that contribute to mental health challenges or on potential initiatives that could address them. Even less research has focused on students in low- and middle-income countries. In an effort to better understand how to improve mental health and wellness on college campuses, we administered an open-ended survey to 141 Indian college students (M_age = 19.47, 65% female). We asked the students to identify: (a) issues that contribute to mental health problems among college students, (b) potential initiatives or strategies that could be used to improve mental health and wellness, and (c) topics that students would like to learn about in a course about mental health and wellness. Applying thematic analysis, we identified academic stressors (e.g., pressure to succeed, competitiveness) and social stressors (e.g., lack of community, party culture and substance abuse) that students reported as contributors to mental health problems. Students also described mental health promotion strategies that could be implemented by faculty members (e.g., providing academic accommodations for students with mental health concerns), the student body (e.g., establishing peer counseling groups), and individual students (e.g., checking in with others). Finally, they identified topics that they would like to learn about in mental health and wellness courses (e.g., how to identify mental health concerns, how to support friends). By raising several potential targets for mental health and wellness interventions for Indian college students, our study illustrates how open-ended surveys can be a useful and feasible way to solicit input from stakeholders in low- and middle-income countries. Future research will be needed to assess the effectiveness and feasibility of mental health promotion strategies, including those proposed by students.     

Application of Personality Theories and Counseling Strategies to Clients With Physical Disabilities

This article describes how certain relevant theoretical concepts, intervention methods, and criteria for determining therapeutic change, which are borrowed from several personality theories and counseling approaches, can be useful in counseling people with physical disabilities. The clinical utility of each discussed personality theory is explored in the context of the efforts directed at (a) gaining insight into the psychosocial impact of physical disability, (b) counseling for personal adjustment to the disability, and (c) becoming familiar with theory-specific guidelines for assessing therapeutic changes. It is argued that counselors who serve clients with disabilities ought to choose those interventions most congruent with their own theoretical orientation, academic training, work setting, and nature of the disability condition.     

Considering Gestational Life

This paper is an exploration into the question, “What does considering gestational life add to analytic theory and practice?” It attempts to situate prenatal experience in the psychoanalytic dialogue, to explore its place in subsequent mental life, to discuss how this may be useful in clinical process, and to reconceptualize some theory in light of a gestational perspective. Neuro-psychoanalytic theory is utilized with an emphasis on nonconscious mental process which takes the form of implicit memory, providing people with a sense of continuity and well-being or stress. Intra-uterine experience can include pain and suffering. Fetal stress is an integral part of prenatal development and its metaphorical use in clinical practice. Three concepts—gestational being/becoming, geatational holding, and objectless intersubjectivity—are offered as ideas to introduce order and conceptual clarity into the ineffable mysteries of in utero process. A gestational perspective is used to describe how the analyst intuitively tracks the patient’s sense of well-being/stress.     

From Theory to Practice: One Agency’s Experience with Implementing an Evidence-Based Model

As evidence-based practice is becoming integrated into children’s mental health services as a means of improving outcomes for children and youth with severe behavioral and emotional problems, therapeutic foster care (TFC; a specialized treatment approach for such youth) is one of few community-based programs considered to be evidence-based. “Together Facing the Challenge” (TFTC) which was tested in a randomized trial of TFC has been identified as an evidence-based model. We describe the experiences reported by one of the agencies that participated in our study and how they have incorporated TFTC into their on-going practice. We highlight key implementation strategies, challenges faced, and lessons learned as the agency moved forward towards full implementation of TFTC.     

Early trauma and serious mental illness: what role does spirituality play?

For many who experience serious mental illness, spirituality and religion can be common vehicles that provide a sense of coherence and meaning to life. However, in the presence of early trauma, spiritual and religious beliefs may be enhanced or destroyed, or never develop. This paper explores the relationship between spirituality/religion, early trauma, and serious mental illness. Three case examples from a qualitative phenomenological study are presented to illustrate spiritual and religious struggles that can arise and how a person can work through these over time to use spirituality and religion as positive resources for recovery. Tentative implications for practice are offered.