The Use of Structured Clinical Interviews for Assessment in Counseling

The purpose of this article is twofold: to summarize some of the major issues concerning structured clinical interviews and to review data available on some of the most widely used interview schedules. One of the key challenges with the practitioner—scientist approach to counseling is the ability to compare information from a variety of clients and counselors. A structured clinical interview can be considered an empirically driven instrument that has preestablished questions and scoring procedures that make it a useful assessment tool. Through its use, comparisons can be made among clients, and the reliability of assessment and diagnosis can be increased.     

Australian lawyers' views on competency issues in older adults

Lawyers are often called upon by their older clients to draft contracts, make up wills or powers of attorney, or provide other forms of legal advice or service. With the increasing numbers of older people in the population, the numbers of older clients for legal practitioners is likely to increase. Older people are also at increased risk for impaired cognitive processes that can affect their ability to make reasoned judgements in civil contracts and other legal arrangements. Here we report on the results of a survey of 302 Australian solicitors as to their experience and practices in determining the capacity of older clients to make legal decisions. The responses, reflecting a 20.7% return rate, showed a wide range of experience in conducting capacity assessments, with a mean of 15.7 years (SD = 10.59). There was a very wide range of practices in determining capacity with no consensus. The most frequent form of questions older clients were asked related to personal and family history. Less than one-quarter asked for the rationale of the decision: the most appropriate form of question in the literature. The results suggest a need for further training of solicitors in the assessment of the capacity of older clients to make legal decisions.     

Ethics and Counseling Decisions

Although some behavioral scientists and practitioners contend that man has no genuine moral choices to make, common sense and philosophical reflection ineluctably affirm the moral nature of man. When young people are faced with moral decisions, they often seek the assistance of a counselor. Although such counselors are routinely expected to aid clients in making decisions about their education and their careers, there is considerably less agreement about their responsibility for helping students to make moral choices. The central thesis of this article is that a knowledge of ethical theories, the practical principles which flow from them, and the method of decision-making which they indicate will enable the counselor to assist his clients with their moral problems.     

Clients' experience of bodywork psychotherapy

One-hundred and fifty ex-clients of 17 Energy Stream Psychotherapists were sent a questionnaire about their experience of their therapy. Sixty-eight clients completed the questionnaire. Of these 77% were highly satisfied or satisfied with their therapy. The frequency of use of some key Reichian psychotherapy techniques was explored. They were found to be used relatively frequently with at least 75% of the clients and rated as helpful by most clients. Also investigated were Rogers' core conditions, which were found not to be present as often as expected. The possible impact of transference on this is discussed. Some non-specific factors such as feeling listened to, or being given feedback, were generally found to be present and valued. Respondents also answered various qualitative questions about their experience of the therapy, including being asked to provide a metaphor for it. What emerges is a picture of an articulate, informed group of therapy consumers often with previous and subsequent experience of therapy. The questionnaire, which combines a mixture of quantitative and qualitative items, can be used with suitable modification to explore other clients' experience of bodywork psychotherapy.     

Who drops-out? Do measures of risk to self and to others predict unplanned endings in primary care counselling?

Aims: Unplanned endings, where clients unilaterally end therapy, are of concern for psychological therapy services generally as they raise questions about the appropriateness of the treatment and it's delivery for some clients. Limited available data indicates that those who drop-out often have more severe symptoms at entry, and have poorer clinical outcomes. This raises further questions about risk to self and others for those clients who leave therapy prematurely and how these clients might be identified and kept engaged. Method: This paper uses a large dataset of CORE data collected routinely in a primary care counselling service between 2000 and 2003. Logistic regression was utilised to consider different measures of risk and other client characteristics recorded at assessment to predict drop-out from the service. Results: These indicate that younger age, greater psychological distress at assessment, an addiction problem and greater risk to others, are associated with an unplanned ending. However, no reliable logistic regression model could be produced. This may be partly due to data quality issues or important characteristics not being available in the data. Implications for practice: The paper concludes that counsellors should actively seek to minimise unplanned endings, as amongst them may be represented the more distressed and risky clients referred to primary care counselling.     

Counseling Philanthropic Donors

People who wish to make direct gifts to charities or other nonprofit organizations are faced with an overwhelming number of choices. There exist several types of sources of information to help potential donors choose whether, where, and how much to give. Each of these has its limitations, and at some point the size of the gift contemplated by the donor can justify the marginal cost of consulting with an advisor, particularly when the donor is already consulting with legal or financial planners for estate or other planning. Fundraisers and nonprofit organizations advocate for advisors to encourage their clients to donate. This raises the questions of the proper role of, and the duties incumbent on, those who counsel potential donors on donations (whether or not such counsel is given in connection with other professional advice). After reviewing the situation that gives rise to these issues, this article discusses answers to these questions and how philanthropy and client service can be furthered as part of the same process.     

When Love Hurts: Treating Abusive Relationships

This paper describes an integrative approach for treating couples in abusive relationships. Because of the power inequities that often obtain in such cases, the therapist faces special challenges. Both partners must be defined as clients, yet the two are not on equal footing. Sustaining moral clarity in a context of such psychological ambiguity is crucial, and it requires skills beyond those we typically associate with the art and craft of the interview. A mutative factor in any therapy requires bearing witness to injustices large and small—leading the author to raise questions about the place of the moral work of psychotherapy in our therapy-saturated society. She poses an urgent social question: Is it possible to intervene therapeutically in abusive relationships to make love safer for women and less threatening to men?     

A Kinetic Sculpture Intervention for Individuals Grieving the Deaths of Family Members

This article presents a creative intervention called kinetic sculpture for loss adaptation in grief counseling. This intervention is supported by professional literature regarding Bowenian family systems and creativity in counseling. The deaths of family members may generate much uncertainty for clients regarding functioning of their family systems. Kinetic sculpture allows clients to create visual examples of family equilibrium before, in the midst of, and after the deaths of family members. Insight gained from engaging in this intervention can aid clients in making aspirational plans for their own adaptations to loss. In this article, we present step-by-step instructions for creating the kinetic sculpture, make recommendations for process questions to accompany the intervention, and apply the kinetic sculpture in a case example.     

A Stabilization Group Approach for Heterogeneous Populations of Trauma Clients

High prevalence and long-lasting implications of human-inflicted trauma call for effective treatment approaches reaching clients in need of trauma-specific treatment. Numerous approaches exist, but often with limited empirical support. There is also a tendency toward segregating treatment approaches depending on type of exposure history and presenting symptoms. This might exclude clients in need of trauma-specific treatment; therefore, treatment approaches that can reach more heterogeneous groups of clients are needed. In this article, a group-based treatment approach adjusted to include clients with a wide range of trauma-related problems and traumatic experiences will be presented. A brief outline of the approach is presented, together with the theoretical and empirical background, to facilitate implementation by practitioners and empirical testing.     

A Danish Model for Treating Victims of Rape and Sexual Assault: The Multidisciplinary Public Approach

High prevalence and long-lasting implications of human-inflicted trauma call for effective treatment approaches reaching clients in need of trauma-specific treatment. Numerous approaches exist, but often with limited empirical support. There is also a tendency toward segregating treatment approaches depending on type of exposure history and presenting symptoms. This might exclude clients in need of trauma-specific treatment; therefore, treatment approaches that can reach more heterogeneous groups of clients are needed. In this article, a group-based treatment approach adjusted to include clients with a wide range of trauma-related problems and traumatic experiences will be presented. A brief outline of the approach is presented, together with the theoretical and empirical background, to facilitate implementation by practitioners and empirical testing.     

Technical Considerations When Handling Questions in the Initial Phase of Psychotherapy

Responding to patients' questions throughout the therapeutic process can be challenging. Questions posed at the beginning of treatment have unique features which make them especially difficult to negotiate. When handled skillfully and tactfully, questions asked during this phase can provide the therapist with important opportunities to foster engagement in treatment. Questions can provide valuable information about the patient's internal world, afford the opportunity to socialize the patient to the therapeutic process, and aid in rapport-building. This article will focus on ways to understand and handle questions patients ask during the initial phase of treatment. Vignettes will be presented and specific responses therapists can offer to patients will be discussed.     

Learning Journals as a Counseling Strategy

This article explores the use of learning journals as a counseling strategy that can be used to complement a counselor's therapeutic orientation. The authors postulate that learning journals will have therapeutic effects on clients that will lead to enduring positive changes, discuss the development of appropriate learning taxonomies to evaluate learning journals, and make recommendations for practice.     

A personal construct psychology view of relapse: indications for a narrative therapy component to stuttering treatment

Relapse following treatment for stuttering is a common problem for many clients. It has often been suggested that one factor contributing to relapse is the client's difficulty in adjusting to a new role as a fluent speaker. In this tutorial article, we first present a personal construct view of relapse, which suggests that this difficulty may be addressed by increasing the meaningfulness of the fluent speaker role for the speaker. Section 3 proposes that post-treatment success for persons who stutter may be facilitated by the use of a narrative approach to counseling in which the meaningfulness of the fluent speaker role is elaborated. In this approach, clients are guided through a process of deconstructing their stuttering-dominated personal narrative, followed by the reconstruction of an alternative narrative that is more compatible with being a fluent speaker. EDUCATIONAL OBJECTIVES: The reader will (1) learn about a personal construct psychology perspective on resistance and relapse in stuttering therapy, (2) be able to describe a narrative approach to counseling for people who stutter that is directed toward the long-term maintenance of fluent speech and the steps of deconstruction of the dominant stuttering narrative and reconstruction of a new, more fluent personal narrative, and (3) be able to prepare a series of narrative interview questions with which to engage clients in conversations that may facilitate the deconstruction and reconstruction processes.     

The descriptive adequacy of qualitative findings

Abstract

This article describes ways of understanding early injuries in the life journey affect the experience of clients in therapy. After introducing Langer's (1951) distinction between discursive and presentational symbolism, I describe the ways that presentational symbolism is used to subsume early life experiences including early traumas. Many clients wind up stuck in early developmental injuries and often have experiences that seem chaotic both to them and their therapists. However, if the therapist can understand the nature of presentation‐ally symbolized experiences, a truly transforming relationship can be created. Clinical examples will be used to illustrate my points.     

Virtues,Values, and the Good Life: Alasdair MacIntyre's Virtue Ethics and Its Implications for Counseling

The philosopher Alasdair MacIntyre's critique of modern ethics and his virtue‐centered alternative suggest that counseling can be considered a form of applied virtue ethics, helping clients cultivate the qualities necessary to live the good life. Although similar to developmental theory and positive psychology, this perspective also questions whether counseling is value neutral and suggests that counseling should account for the (often hidden) traditions, virtues, and practices of the good life it promotes. Comparison with spiritual direction suggests ways counseling can apply the insights of this model ethically within a pluralistic setting.     

Modifying Dialectical Behavior Therapy for Deaf Individuals

Therapies that rely on written materials, information, or procedures involving familiarity with the dominant culture (e.g., colloquialisms, history) often pose barriers to people who use another language, have low English literacy, or are less familiar with the dominant culture. All this applies deaf individuals. One of the most well-validated mental health treatments for reducing suicidality in those diagnosed with borderline personality disorder is Dialectical Behavior Therapy (DBT; Koons et al., 2001; Linehan et al., 1999; Linehan et al., 2006; Linehan et al., 2002; Verheul et al., 2003). Unfortunately, its heavy reliance on written materials, prevalent use of metaphors, and other culture-bound characteristics make DBT inaccessible to the average deaf consumer. We describe the potential benefits that DBT could offer deaf clients, some of which are uniquely related to the life experiences and societal challenges faced by deaf people. Barriers to accessing standard DBT treatment and the materials used are described. Modifications of DBT materials and methods that we have found effective with deaf clients are detailed. It is concluded that DBT materials and methods can be successfully modified for use with this population. Available resources and additional benefits of employing DBT with deaf clients are noted.     

THEORIZING RELIGION AND QUESTIONING THE FUTURE OF ISLAM AND SCIENCE

Will there be any joint future for science and Islam? Although such questions have recently received considerable attention, more basic questions are often ignored. This article aims at addressing some of those more basic questions through exploring the assumptions that underlie different possible understandings of the question about the future of Islam and science. By investigating the relation between conceptualizations of religion and the question about the future of Islam and science, it will be argued that different understandings of the concept of religion (i.e., whether it denotes real objects, whether it is universal, and whether it is belief centered) lead to extremely different readings of the question. Besides, it will be argued that different answers to the question about the future of Islam and science can be understood in terms of the inference to best theological explanation; thus, the criteria that one assumes for the best theological explanation result in different criteria for evaluation of the answers.