Experiences of Altruism in the Therapeutic Relationship: Perspectives of Counselors‐in‐Training and Their Clients

The purpose of this phenomenological investigation was to explore experiences of altruism in the therapeutic relationship to better understand how counselors‐in‐training (CITs) and their clients mutually perceived the construct in sessions. Findings from interviews with clients (n = 14) included emotional–relational characteristics and cognitive–behavioral aspects of altruism by their counselors. Findings from interviews with CITs (n = 10) included explorations of the role of altruism in counseling, overall experiences of altruism in counseling sessions, and experiences of altruism with specific clients. Implications for practice and research are discussed.     

Psychological Aspects of Genetic Counseling: XIII. Empathy and Decency

The issues confronting genetic counselees, the demands of the new genetics and other factors suggest strongly the need for greater attention to counseling procedures which convey understanding of clients and help them feel more hopeful and more capable of dealing with their life problems. This should include interventions to help them feel more effective in their coping efforts as well as such ego-bolstering techniques as the expression of kindness, the provision of appropriate rewards, and other attempts to raise the client's self-esteem. These attempts should be a standard part of all genetic counseling. The traditional arguments of potential harm and time limitations often used to avoid counseling efforts are viewed through the lens of countertransference.     

Does psychopathology predict counseling duration?

Many university counseling centers have adopted case management policies in an effort to conserve limited resources. Fearing that students with more severe problems will consume too many clinical resources, many counseling centers have decided to refer such students to external agencies or providers for mental health services. However, this fear might be unwarranted because empirical research has not shown a substantial relationship between psychopathology and counseling duration. This investigation examined whether a new treatment-planning inventory, the Butcher Treatment Planning Inventory, might be useful for better understanding the relationships between various problem areas and counseling duration. Participants were new clients (students and staff members) at a university counseling center in the southeastern USA. Professional staff members and graduate students in counselor education, clinical psychology, and clinical social work provided counseling services to the participants. Lower scores on several scales predicted counseling duration. In other words, clients with lower scores on these scales (representing less psychopathology) attended more counseling sessions than clients with greater psychopathology. Therapists' background also predicted counseling duration; clients who worked with either a professional staff member or graduate student in counselor education attended more sessions than clients who worked with a graduate student in clinical psychology. The results of this study, combined with previous research, suggest that measures of psychopathology are not very useful for identifying which clients will complete long-term counseling. Until better information becomes available, actuarial tables remain the most efficient means for predicting counseling duration.     

Response to A Different Vantage Point Commentary: Psychotherapeutic Genetic Counseling,Is it?

Whether genetic counseling is a form of psychotherapy is open for debate. Early practicioners in genetic counseling described it as such, and this claim has been replicated in recent publications. This commentary is a rebuttal to the claim that genetic counseling is distinct from psychotherapty. We argue that it is a a form of psychoterapy that aims to help clients manage a health threat that affects their psychological wellbeing, paralleling the goals of psychotherapy.     

Psychological Aspects of Genetic Counseling. X. Advanced Counseling Techniques

Four procedures commonly used by experienced counselors are described: simple interview formulations, helping clients think through their problems, reframing, and role playing. Each procedure is illustrated by examples. Among other things, the goal of these procedures is to promote the autonomy and self-directedness of clients and thus are particularly valuable in circumstances requiring a nondirective stance. The need is underscored for a more active counseling stance appropriate to the psychological and problem-solving needs of genetic counselees.     

Who Benefits From Computerized Career Counseling?

The Adaptive Counseling and Therapy (ACT: Howard, Nance, & Myers, 1986) model was used to predict who would benefit from computerized career counseling. Specifically, clients who had more stable goals and aspirations and more defensive independence were expected to derive more benefit from computerized career counseling, an intervention that provides low levels of direction and support. A total of 54 clients who came to the Career Planning and Placement Center seeking career assistance were referred to the System for Interactive Guidance and Information PLUS (SIGI-PLUS). As hypothesized, clients with more stable goals had the greatest gains in vocational identity. Additionally, clients who showed more defensive independence were more satisfied with the SIGI-PLUS treatment. Implications, limitations, and suggestions for future research are discussed.     

Mandated Disciplinary Counseling on Campus: Problems and Possibilities

Because of increased student misconduct in academic institutions, counselors have had to use traditional voluntary counseling models with involuntary disciplinary clients. The authors propose a policy position that would preclude mandated treatment and instead place an emphasis on counseling readiness programming for disciplinary referrals. A stages of behavioral change model is offered as a tool to articulate when counseling can be effective with students entangled in disciplinary procedures.     

WHY NO GUIDELINES FOR BEHAVIOR MODIFICATION?

This paper reviews the guidelines for behavioral programs published by the National Association of Retarded Children. The review discusses a number of reasons why guidelines should not be enunciated for behavior modification, e.g., the procedures of behavior modification appear to be no more or less subject to abuse and no more or less in need of ethical regulation than intervention procedures derived from any other set of principles and called by other terms. The review recommends alternative methods for protecting the rights of clients who participate in behavioral programs. Specifically, behavioral clinicians, like other therapists, should be governed by the ethics codes of their professions; also, the ethics of all intervention programs should be evaluated in terms of a number of critical issues.     

UCLA's Career Counseling Center: A Dialogue About a Unique Service

In this interview, two counseling psychologists describe aspects of a relatively unique career counseling service that has been validated by 40 years of success in the marketplace. Composed of 3 intensive individual interviews and 15 to 25 hours of educational and psychological testing, the service assists clients in identifying and beginning pursuit of suitable educational and occupational goals. The counselors describe how they organize and sift through test results to formulate recommendations for a client's unique career circumstances, why they accept responsibility for developing and presenting concrete recommendations, and what the changes in their clients' concerns suggest about the evolution of work in the United States. Their specificity and professionalism will help counselors understand the craft of career counseling.     

Symptomatic distress and effectiveness of psychological treatments delivered at a nationwide student counseling service

The aim of this study is to investigate the effectiveness of student counseling in Denmark and to compare the symptomatic distress among student counseling clients with that of Danish outpatients. The pre-intervention level of self-reported symptomatic distress among 1256 students closely paralleled that of psychiatric outpatients. Participants in the intervention study were the 739 student clients with two or more counseling sessions. For the 530 (71.7%) participants with both pre- and post-measurements, the mean pre–post Cohen’s d effect size (ES) was .76 on the Global Severity Index of the Symptom Check List-90-Revised. An intention-to-treat analysis of all 739 clients resulted in an ES of .59. The number of recovered clients according to the Jacobson and Truax criteria was 295 (68.8%) of the 429 (80.9%) clients above the clinical cut-off at pre-intervention, while 66 (12.5%) of the 530 clients reliably deteriorated. The mean number of sessions was 5.0. Individual counseling, number of sessions, and ending counseling in agreement predicted better outcome. In line with results from other countries, this study may indicate that in Denmark student counseling is an effective intervention for a highly needy clientele, even though a high proportion of clients deteriorated (12.5%) or dropped out (31.7%).     

A comparison of stress-reduction behavioral counseling and contingent nocturnal EMG feedback for the treatment of bruxism

This study compared the efficacy of two treatment modalities (stress-reduction behavioral counseling and contingent nocturnal EMG biofeedback) on night-time bruxism. The 16 subjects (Ss) were assigned sequentially to one of four treatment groups: (1) stress-reduction behavioral counseling: (2) nocturnal biofeedback; (3) stress-reduction behavioral counseling and nocturnal biofeedback; and (4) waiting-list control group. A portable EMG unit was used to record the nightly total of electrical activity (?20 μV) from the masseter muscle 10 days before and after treatment. The three treatment procedures were found to be significantly superior to no-treatment control group. The outcome of the two treatments which made use of stress-reduction behavioral counseling, although better than the treatment which solely used nocturnal biofeedback, was not significantly better. This study demonstrates that stress-reduction skills learned while awake can have a generalized effect on stress-induced muscle activity during sleep. Implications for further research are discussed.     

Socialization of sex roles in the counseling setting: Differential counselor behavioral and attitudinal responses to typical and atypical female sex roles

Counseling and therapy have frequently been attacked by feminists for the role they play in socializing women to a limited and ultimately untenable sex role. Male counselors in particular have been singled out as special oppressors of women. This study attempted to determine whether, in fact, counselor behavior and attitudes operated as a means of sex-role socialization, and whether male counselors tended to be more biased than female counselors when interacting with female clients. Subjects were eight male and eight female graduate students in counseling psychology who conducted initial interview sessions with two client-confederates, volunteer graduate students trained in role-playing situations representing a typical and an atypical sex-role condition. Videotapes of the interviews were subsequently analyzed to assess counselor reinforcement patterns of specific client cue sentences. In addition to these behavioral data, paper-and-pencil inventories were used to determine counselors' perception of clients, counselors' degree of attitudinal sex-stereotyping, and client-confederates' subjective evaluation of counselors. Contrary to expectations, results indicated that counselors as a whole exhibited more behavioral bias with typical than with atypical clients. Further, counselors reacted more positively toward the atypical than toward the typical clients, and counselor response to a global sex-role inventory indicated that counselors described the healthy, well-adjusted female as significantly more instrumental than the healthy, well-adjusted male. Female counselors appeared to be both more reinforcing and less punishing than male counselors with female clients in both roles, as well as less behaviorally biased than the male counselors. Female counselors also evaluated the atypical clients more positively than did the male counselors, and were in turn evaluated more positively than were the male counselors by clients in both roles. The study concludes with a discussion of implications for counselor training.     

New Directions in Counseling Women

A revolution in counseling women is one logical outcome of recent changes in the social, political, and economic movements that have predisposed individuals to modify their life-styles and value systems. This article discusses four facets of that revolution and concludes that new counselor training programs are required to meet the needs of emerging client populations. The conclusions are supported by research that indicates (a) new sources of knowledge about the development and functioning of women clients; (b) new groups of client populations whose needs are not being met by traditional counseling strategies; (c) innovative procedures specifically tailored to the unique characteristics of these client groups; and (d) revised standards of ethical practice to ensure competent and appropriate services for all client populations. Training programs are outlined that provide guidelines for sex-fair education for all counselors and more intensively focused training for counselors who select the counseling of women clients as a career specialty.     

当事人的投入与会谈效果、咨询效果的关系研究

本研究探索了当事人会谈时的投入与即时会谈效果的关系;当事人咨询初期的投入与整体咨询效果的关系。结果发现当事人会谈时的投入与即时会谈效果、在咨询初期的投入与整体咨询效果都呈现显著的正相关。进一步回归分析发现,当事人在咨询初期的投入与整体咨询效果呈现正U型的偏态分布,少数投入水平最低的当事人获得中等水平的咨询效果,中等投入水平的当事人咨询效果最差,投入水平最高的当事人的咨询效果最好。     

Psychological Aspects of Genetic Counseling. IX. Teaching and Counseling

The goals, philosophies, and procedures of the teaching and counseling approaches to genetic counseling are differentiated and compared. The teaching approach, inherited from academic practitioners earlier in this century, appears to remain the dominant form of contemporary practice. With the introduction of more nonphysician professionals, attempts are being made to combine a teaching model with counseling procedures. The goals of the two models are conspicuously different; one attempts to end up with an educated counselee whereas the other hopes to leave the latter psychologically more autonomous and functional. Both models have strengths and limitations. The teaching model is essentially a form of health education, not counseling, and, with some exceptions, tends to fulfill its goals. The strategy of teaching, however, tends to undermine the psychological self-directedness of counselees and thus interferes with the processes they need to draw on to make autonomous decisions. The strength of the counseling model is in helping counselees reach decisions and deal with the personal meaning of information. However, applying this model makes huge demands on the professional. Greater attention needs to be given by training programs to the pedagogical and counseling skills genetic counselors may need in their professional work.     

Counseling for the transition to adulthood as joint, goal-directed action

Transition is important in the career literature as it identifies times at which people are often likely to consult counselors about issues for which they need help. However, the counseling literature has not provided a conceptualization of, or research on, the joint, goal-directed actions and projects of the counselor and the client, which explicitly reflect the goal-directed nature of the transition itself. To address this issue, 12 counseling dyads, representing 37 counseling sessions, were studied. In these dyads, counseling was observed as the joint, goal-directed action between professional counselors and youth who sought assistance with their transition to adulthood. The data were collected using the action-project method. The counseling sessions were video-recorded, then immediately played back for the counselor and client separately to gather their recalled thoughts and feeling during counseling. Detailed qualitative analysis of the data set addressed the research question, “What are the goal-directed projects that counselors and their clients jointly construct, articulate, and enact relevant to the transition to adulthood?” The findings indicated the relationship and identity are intertwined goal-directed projects within counseling as well as outside of it. These projects contributed to the reframing and reorganization of clients' transition projects outside of counseling in occupational, educational, and familial domains. The findings suggest important implications for counseling youth in transition, that is, counselors and clients explicitly address their joint relationship and identity goals in an effort to realize a mutually satisfactory and important transition to adulthood.     

Understanding and Treating Social Phobia

Social phobia, a relatively obscure disorder, is receiving increased attention due to evidence suggesting that it is more prevalent and debilitative than once thought. The purpose of this article is to help counselors better understand the nature of and treatments for this disorder. Effective behavioral and pharmacological approaches are reviewed, and counseling implications are discussed to increase counselors' confidence in providing treatment to people with social phobia.     

Revisiting relationships between sex-related variables and continuation in counseling

This study examined the relationships between three sex-related variables (client sex, therapist sex, and dyad matching on sex) and continuation in counseling. 245 college students who were clients at three university counseling centers participated. Consistent with previous studies, women comprised 68.2% of the clients seeking services at these counseling centers. Clients' sex was significantly related to counseling duration, explaining 2.2% of the common variance. Female clients, on the average, attended 1.8 more sessions than male clients. However, neither the therapists' sex nor dyad matching on sex was significantly related to the duration of counseling. None of the sex-related variables correlated with premature termination of counseling. The results have implications for providing counseling and outreach services to male students. Despite relatively equivalent rates in the incidence of mental health problems, female students continue to comprise the majority of clients. Therefore, university counseling centers need to communicate their services better to male students in need of mental health services.     

Christian Counseling: A Synthesis of Psychological and Christian Concepts

Strong describes an approach to counseling that synthesizes psychological processes of change with theological concepts of the Christian faith. Clients are assumed to be self-directing and responsible for their behavior, including the changes that counseling is intended to facilitate. The counselor's junction is to equip clients to enable them to change. The key objectives in Christian counseling are described and the counseling process is reviewed in the light of these objectives. The author discusses the place of justification, responsibility, forgiveness, grace, sin, responsible loving, and prayer in the counseling process. Francis Mc Guire makes a response to Strong's article from a perspective that views Zen Buddhism as an integrated psychospiritual system capable of offering a critique and a complementary viewpoint. Herman Slotkin 's think piece is an attempt to define and clarify some of the language and goals of moral education and propose a civic, nonsectarian perspective regarding value and moral awareness.