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.     

Illness Representations, Self-Regulation, and Genetic Counseling: A Theoretical Review

In this article the Self Regulatory Theory (Leventhal, 1970; Leventhan H., Benyamini, Brownlee, Diefenbach, Leventhal E.A., Patrick-Miller, & Robitaille, 1997) is presented as a framework for conceptualizing genetic counseling. Findings published in the genetic counseling literature are re-interpreted from the perspective of the theory. Clients are seen as active information processors rather than passive receivers of information. Research related to clients' representations of genetic causality of disease and specific genetic conditions is reviewed. Associations of genetic illness representations to self representations, coping and health behaviors are examined, and suggestions are made for applications of the theory in research and clinical practice.     

A Practical Account of Autonomy: Why Genetic Counseling is Especially Well Suited to the Facilitation of Informed Autonomous Decision Making

In genetic counseling, facilitation of autonomous decision-making is seen as a primary aim and respect for autonomy is used to justify a nondirective counseling approach whereby clients are free to make their own choices after being given all necessary information. However in the genetic counseling literature, autonomy as a concept appears to be interpreted variably and often narrowly. We offer a practical account of autonomy that is coherent, consistent and philosophically defensible for the genetic counseling setting. At the same time we demonstrate how nondirective counseling may serve to frustrate rather than facilitate client autonomy. We suggest that promoting purposeful dialogue rather than counseling that is nondirective is more conducive to client autonomy.     

Essential Elements of Genetic Cancer Risk Assessment, Counseling, and Testing: Updated Recommendations of the National Society of Genetic Counselors

Updated from their original publication in 2004, these cancer genetic counseling recommendations describe the medical, psychosocial, and ethical ramifications of counseling at-risk individuals through genetic cancer risk assessment with or without genetic testing. They were developed by members of the Practice Issues Subcommittee of the National Society of Genetic Counselors Familial Cancer Risk Counseling Special Interest Group. The information contained in this document is derived from extensive review of the current literature on cancer genetic risk assessment and counseling as well as the personal expertise of genetic counselors specializing in cancer genetics. The recommendations are intended to provide information about the process of genetic counseling and risk assessment for hereditary cancer disorders rather than specific information about individual syndromes. Essential components include the intake, cancer risk assessment, genetic testing for an inherited cancer syndrome, informed consent, disclosure of genetic test results, and psychosocial assessment. These recommendations should not be construed as dictating an exclusive course of management, nor does use of such recommendations guarantee a particular outcome. These recommendations do not displace a health care provider's professional judgment based on the clinical circumstances of a client.     

Sex Bias in Counseling: A Reply and Critique

The social importance of the gender-bias issue in counseling implores that our beliefs about the issue be predicated on evidence rather than on ideological considerations.     

Assessment of the Content and Process of Genetic Counseling: A Critical Review of Empirical Studies

This article reviews studies that assessed the process and content of genetic counseling communication. A systematic search of the literature was undertaken of studies that audio- or videotaped genetic counseling sessions conducted by genetics health care providers and subjected them to communication analyses. A total of 18 studies (published in 34 articles) were identified that met the eligibility criteria. Studies show that providers speak more than clients, that a large proportion of communication is biomedical rather than psychosocial and that the teaching model of genetic counseling is widely implemented. Higher levels of counselor facilitation of understanding and empathic responses, lower levels of verbal dominance (ratio of counselor to client talk) and the provision of a summary letter of the consultation are associated with more positive client outcomes. Findings from these studies should be used as an evidence base for teaching and continuing education of genetic counseling providers.     

Psychological Separation,Self-Control,and Weight Preoccupation Among Elite Women Athletes

Given the paucity of research on the prevalence of eating disorders in college athletes, the authors raised two questions: (a) Is weight preoccupation more prevalent among elite women athletes than among their nonathletic counterparts? (b) Does the empirical link between psychological distress and weight preoccupation pertain to elite athletes as well? Results showed that 10.9% of a sample of elite swimmers could be characterized as “weight preoccupied,” a percentage comparable to the general population of college women. In addition, the athletes reported using significantly more benign than punitive self-control strategies, suggesting for them, weight preoccupation is a means to an end rather than an indication of an eating disorder. Implications for counseling are discussed.     

Unemployment in the Postindustrial Age: Counseling Redundant Workers

Currently, in the United States, redundancy counseling, dealing with jobless or displaced workers, is the exception rather than the rule in cases of plant closures. It is likely, however, that redundancy counseling will become more common in the future, as more U.S. manufacturers turn to production sharing. Indeed, it has been suggested that redundancy counseling might replace the traditional unemployment compensation system as a better method of dealing with unemployment in a rapidly changing, highly technological world.     

The counselor: who? what?

The author examines the criticisms of counselors which center on such factors as age, sex, race, and elitism. Areas of confusion regarding the functions of the counselor are related to the teacher-counselor issue, the professional functions of the counselor, and the basic purpose of counseling. The counselor is seen primarily as doing psychological counseling with individuals and groups, rather than teaching or advising.     

Assessing and Constructing a Meaningful System: Systemic Perspective in a College Counseling Center

The author describes an application of family systems therapy to treatment in a college counseling center. This approach organizes treatment around the “meaningful system” rather than the family system and includes nonfamily significant others in treatment. Using the Brief Therapy model of the Mental Research Institute, the author addresses special considerations in providing systemic treatment in a college counseling center, assessment and construction of a meaningful system, and specific working procedures. Two case illustrations are provided.     

A study of college women: Androgyny and perceptions of a feminist therapist

The present study examined the dimensions of instrumentality and expressiveness with respect to sex role orientation and perceptions of a feminist therapist. Also investigated was the willingness of the subjects to see a feminist and a traditional therapist for personal and career counseling. The 167 undergraduate female students from various programs completed the Bem Sex Role Inventory, the Adjective Check List to describe their perceptions of a feminist therapist, and four willingness scales. Results indicated that the subjects, regardless of sex role orientation, perceived the feminist therapist as predominantly instrumental rather than expressive or androgynous. In addition, the subjects, regardless of sex role orientation, were more willing to see a traditional therapist for personal counseling but more willing to see feminist therapist for career counseling.     

Barriers to and Motivations for Physician Referral of Patients to Cancer Genetics Clinics

Although it is well known that under-referral of colon cancer patients to cancer genetics clinics is a chronic problem, no study has yet examined why physicians may be ordering testing independently rather than referring patients to cancer genetics clinics. The current study explored variables which may impact a physician’s preference for ordering testing independently or referring patients to outside cancer genetics experts. An online questionnaire, distributed to the membership of the American College of Gastroenterology and the American Society of Colorectal Surgeons, yielded responses from 298 physicians. Motivations to refer to cancer genetics clinics rather than order testing independently included fear of genetic discrimination and a belief that patients benefit from genetic counseling about the risks, benefits and consequences of testing. These results suggest that in order to increase referrals, genetic counselors must educate physicians about the unique benefits patients receive from participating in genetic counseling.     

Effect of positive,negative, and mixed occupational information on cognitive and affective complexity

A series of concentrated research studies over the past 8 years has significantly demonstrated that cognitive complexity in the vocational realm is positively related to congruence or appropriateness of vocational choice. Moreover, research has shown that introducing occupational information significantly reduces, rather than increases, cognitive complexity. The results of the study reported here relate to changes in cognitive complexity as a function of the type of occupational information introduced, namely, information with respect to the advantages of occupations; the disadvantages of occupations, or a combination of positive and negative features of occupations. Our results clearly demonstrated that while positive occupational information alone leads to greater simplicity, negative or mixed information significantly retards the trend toward greater simplicity. Results are discussed from both theoretical and practical perspectives, especially with reference to the typical occupational information provided in routine vocational counseling.     

Reproducing gender in counseling and psychotherapy: Understanding the problem and changing the practice

In this article I argue that the concept of gender is misunderstood by the majority of psychologists. Increasingly the term “gender” is mindlessly replacing the term “sex,” obfuscating decades of theory and research that elucidated gender as a complex social-psychological variable rather than a bifurcated individual-difference variable tied to biological sex. As a consequence, gender is largely ignored as an “active” variable in counseling research and practice. Current theory and research on gender as they apply to counseling and psychotherapy are first described. Then ways in which gender processes are often reproduced in counseling and psychotherapy and factors contributing to this practice are illuminated. Finally, areas particularly vulnerable to reproducing gender are described and some examples provided of the reproducing, and the disrupting, of gender processes in counseling.     

Theorizing the Narrative Dimension of Psychotherapy and Counseling: A Big and Small Story Approach

In this article, we develop a theoretically substantiated narrative framework for assessing psychotherapy practices, based on a big and small story approach. This approach stretches the narrative scope of these practices by making explicit and advancing small story counseling. We demonstrate how this framework can be a reflection tool by systematically applying six story dimensions to an example from army counseling. Small story dimensions one (multiple storytellers) and three (ways of ordering experience) draw attention to which persons and stories we do not engage with in counseling practices. Small story dimension two (future and on-going temporal orientation) marks a shift towards language of (future) potential, rather than a language of deficit. Small story dimensions four (low tellability) and five (fluent moral stance), reinstate the art of listening to client words, and remind us to resist the inclination to interpret these too easily in terms of a specific counseling theory or moral framework. Finally, small story dimension six (embeddedness) encourages counseling-on-the-move. Finally, we discuss the implications of widening the narrative scope of psychotherapy and counseling, such as the need to develop small story competence and to assess the therapeutic quality of everyday talk.     

Elementary School Counseling with Unstructured Play Media

The need for utilizing unstructured play media in counseling with elementary school children is discussed. The suggestion is made that through play activities the child learns ways of operating in social situations, tests various roles, and expresses his frustrations and concerns. Limiting the child to verbal expression in counseling is seen as being as inappropriate as limiting an adult to the use of puppets. The elementary school counselor's use of play in counseling is designed to facilitate the expression and communication of the normal child rather than to provide data for analytical purposes. Responses to verbal and nonverbal clues, therefore, include reflection and summarization more often than interpretation. Advantages of unstructured over structured materials are discussed; illustrations show the need children feel for amorphous materials in communicating feelings.     

Transitional Adolescents,Anxiety, and Group Counseling

One hundred-eighty college-bound high school seniors were studied to determine whether small group counseling would affect their anxiety level. 60 students comprised the experimental group and 60 students each the 2 control groups. 6 small group counseling sessions were conducted during the spring just prior to high school graduation and 6 more in the fall, following college enrollment. Comparison of anxiety levels was made at the conclusion of each series of counseling sessions. The students of the experimental group showed significantly lower anxiety scores than did those of the control groups, both in the spring and in the fall. The conclusion was drawn that experience in small group counseling was followed by significantly lower levels of anxiety in transitional adolescents.     

Dimensions of counseling for career development

Counseling practice has not reflected current thinking about career development and career process. Four types of career counseling are described: Type 1, a traditional vocational counseling approach which helps the client with a specific decision; Type 2, which is concerned with teaching decision-making skills; Type 3, which views career development as a process rather than an end-point toward which all decisions lead; and Type 4, which focuses on creating in the individual the ability to utilize his own strengths to achieve self-determined objectives and to influence the nature of future opportunities.     

Counseling and Human Resource Development: Response to “Career Development in Business and Industry”

The author responds to an article by Dorn (1986) on career development in business and industry. Clarification regarding definition, job titles, job roles, and points of entry for behavioral science professionals is provided. Emphasis is placed on human resource development rather than the more generic use of counseling or career development in business and industry.