Effects of client and counselor sex on client attendance at counseling

The present study examined the relationship between sex of client, sex of counselor, client's presenting problem, and the length of time the counseling dyad stayed together. Dyads engaged in personal counseling had significantly more sessions than dyads engaged in vocational counseling or test feedback. Clients receiving personal counseling were more likely to terminate unilaterally than clients receiving vocational counseling or test feedback.A preliminary version of this article was presented at the meeting of the American Psychological Association, Montreal, September 1980.     

An empirical examination of client attitudes towards online counseling.

Trends over the past decade have shown that online counseling has grown in terms of popularity among consumers and clinicians alike; however, little, if any empirical evidence exists that examines client attitudes towards online counseling as alternative to traditional face-to-face therapy. Therefore, this study investigated client attitudes towards online counseling. Data was collected from 48 e-clients who received online counseling at the Center for Online Addiction. Variables such as client perceptions and concerns about using online counseling, clients' reasons for seeking online counseling over in-office treatment, and demographic profiles of e-clients were assessed. Results suggested that Caucasian, middle-aged males, with at least a four-year bachelors degree were most likely to use online counseling and anonymity, convenience, and counselor credentials were the most cited reasons they sought online counseling over in-office treatment. The lack of perceived privacy and security during online chat sessions and the fear of being caught while conducting online sessions were the main concerns reported by e-clients. A better understanding of client motives and perceptions towards online counseling helps to guide treatment in using the Internet as a clinical tool, especially as the Internet becomes increasingly more available in previously remote markets and the field of online counseling continues to grow.     

The Effect of Previous Experience on Preference of Approach for Effective Counseling

Students in a general psychology class viewed four videotapes of initial vocational-educational and initial personal concern counseling sessions. The sessions were presented from a client-centered approach and from a behavioral approach, and employed the same client and counselor. After viewing the tapes, the students were asked to indicate which approach they thought would be more effective in helping a client. Results showed that students who had previously experienced counseling preferred a behavioral approach for both the vocational-educational concern and the personal concern. Students with no experience of counseling did not exhibit a preference.     

The effect of previous experience on preference of approach for effective counseling

Students in a general psychology class viewed four videotapes of initial vocational-educational and initial personal concern counseling sessions. The sessions were presented from a client-centered approach and from a behavioral approach, and employed the same client and counselor. After viewing the tapes, the students were asked to indicate which approach they thought would be more effective in helping a client. Results showed that students who had previously experienced counseling preferred a behavioral approach for both the vocational-educational concern and the personal concern. Students with no experience of counseling did not exhibit a preference.     

Career counseling meets motivational interviewing: A sequential analysis of dynamic counselor–client interactions

Motivational Interviewing (MI) is a client-centered communication style with the aim to resolve client ambivalence within a change-related counseling. Its potential benefit for career counseling has been discussed by several scholars but no empirical research has investigated MI in this context so far. The current study used process measures from MI to investigate dynamic interactions within a career counseling intervention. Overall, we analyzed two videotaped sessions of 14 unique counselor–client dyads. Verbal behavior of counselors and clients were coded with two observational coding schemes from MI (one for counselors and one for clients, respectively). Behavior profiles of counselors were compared with benchmarks of good MI. Furthermore, client verbal ambivalence was compared between sessions. Finally, we conducted lag sequential analyses to analyze temporal dynamics between counselor behavior and immediate client verbal responses across N = 6883 behavioral events. Our results showed, first, behavior profiles of career counselors did significantly differ from recommended counseling benchmarks of good MI practice. Second, as assumed on the basis of past studies, client ambivalence decreased across sessions. Third, MI consistent counselor behaviors showed a positive sequential association with client positive career talk, whereas MI inconsistent counselor behaviors showed the reverse pattern. Our results suggest that counseling behaviors recommended from MI are facilitating career interventions. We discuss how trainings in MI could amend career counseling interventions and provide ethical implications when integrating MI into career counseling programs.     

Doctor's Expertise and Managing Discrepant Information from Other Sources in Genetic Counseling: A Conversation Analytic Perspective

The study examines a recurrent interactional pattern in genetic counseling. It describes clinical geneticists' responses in situations in which clients have presented information from other sources that is potentially discrepant with information given by the doctor. The data consists of 12 video-recorded sessions of genetic counseling in Finland, and the method is conversation analysis. There are two primary ways the doctors respond: either they accept the client's information as such, but show that it is not discrepant with the doctor's information, or they reject the client's information. In the latter case they mitigate the ‘wrongness’ of the client's information. The clinical geneticists seem to be working with a dilemma: they need to find a balance between ensuring correct understanding of the information and showing respect for the expertise of others. A particularly complex case is also analyzed and reflected on.     

The Client's Perspective of Genetic Counseling—A Grounded Theory Study

Previous studies of genetic counseling have mainly focused on outcomes defined by researchers or service providers, and have frequently related to changes in reproductive behavior and/or client knowledge. A longitudinal study of 43 families referred to a clinical genetic service was undertaken to ascertain client needs and expectations of the service, and to identify relevant outcomes from the clients' perspective. Semistructured interviews were conducted with each client, prior to and after genetic counseling. The transcribed interviews were analyzed using grounded theory. The need for certainty emerged as a powerful factor that motivated clients to pursue the genetic referral. The client's lay knowledge of the condition, satisfaction of the need for certainty, and the formation of a personalized relationship between the client and the genetics staff significantly influenced the central outcome, identified as a change in the client's psychological adaptation to the genetic condition in the family.     

Relationship Between Counselors' Clinical Hypotheses and Client Ratings of Counselor Effectiveness

The authors assessed the relationship of counseling students' hypothesis formation skill levels to counseling effectiveness. Hypothesis rating scales were selected to assess skill in using a comprehensive range of client data, integrating multiple client dimensions, and forming questions for hypothesis testing. Results indicated that higher ratings of hypothesis formation skill were associated with higher client ratings of counselor effectiveness. A combination of four hypothesis skill ratings predicted more than 60% of the variance in total Counselor Rating Form-Short version (CRF-S) scores, and one or more hypothesis formation skills were predictive of each CRF-S subscale score.     

A study of engagement and premature termination in a university counseling center

Differences between engaged (clients seen for at least two counseling sessions) and nonengaged clients, and between post-engaged premature terminators and clients who terminated with counselor knowledge at a university counseling center were investigated. Five practicum trainees, four professional counselors, and 308 college student clients participated. Professionals had higher rates of engagement and lower rates of premature termination than trainees. Engagement was positively associated with understanding and teaching the client and with longer intake interviews. Premature termination was associated with counselor attractiveness, expertness, and trustworthiness. These characteristics related to premature termination in opposite directions for professional and practicum counselors. Results are discussed in terms of possible different mechanisms operating at the beginning and end of counseling.     

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.     

Client Vocational Interests as Predictors of Client Reactions to Counselor Intentions

It was hypothesized that client vocational interest scores would predict client reactions to counselor intentions in Hill and O'Grady's (1985) process model. Twenty-four volunteer undergraduate clients (17 women, 7 men) assigned to counseling treatment with 24 doctoral students (14 women, 10 men), reviewed 3 videotaped sessions recording intentions and reactions, respectively. Results indicated that client vocational interests were predictive of reactions clients reported in response to counselor intentions. Issues of working with persons with various vocational interests, limitations, and directions for future research are discussed.     

Incidence of critical events in professional practice: a statewide survey of psychotherapy providers

The goal was to tabulate the incidences of clients' suicide, attack by a client, and sexual contact with clients in an Alaskan sample of masters and doctoral-level psychotherapy providers (excluding psychiatrists) and to assess which, if any, demographic or professional characteristics were associated with each critical event. Results from 151 respondents (response rate 43.5%) indicated that 42.7% of providers had experienced at least one client's suicide, 28% had been physically attacked by a client, 4% reported having had sexual contact with a then current client, and 6% reported sexual contact with a former client. Areas for research are outlined, specifically the importance of using methods other than surveys and exploring variables other than standard demographic data.     

Effects of a Genetic Counseling Model on Mothers of Children with Down Syndrome: A Brazilian Pilot Study

Down syndrome occurs in approximately 1:600 live births. Genetic counseling is indicated for these families and may be beneficial for adaptation to the challenges that accompany by this diagnosis. Although the basic counseling goals are similar, there are many models of genetic counseling practiced around the world. The aim of this article is to report the results of a pilot study that evaluated the level of satisfaction with a model of service delivery of genetic counseling practiced in Brazil, the knowledge assimilated about Down syndrome and whether this process resulted in a feeling of well-being and psychological support. Thirty mothers of under 6-month-old children with Down syndrome were interviewed after having two sessions of genetic counseling in a public healthcare service within a period of 30 days. A semi-structured questionnaire was developed by the researchers to collect identification, socioeconomic and demographic data and to assess the client’s satisfaction with the model of genetic counseling. Data were collected using both open and closed questions. The reported level of satisfaction was high. The knowledge assimilated about Down syndrome after only two sessions was considered technically vague by raters in 44 % of cases. Most mothers (96.7 %) reported that genetic counseling was beneficial and provided psychological support. The model was considered satisfactory, but further research is needed to identify ways to improve knowledge retention by this population. These results highlight the utility of referring families for genetic counseling when there is a suspicion of a diagnosis of Down syndrome.     

Outcomes of Client Transfers in a Training Setting

Although transferring clients from one clinician to another is a common practice in most training facilities and community clinics, there is a dearth of empirical studies that explore the impact on client retention and subsequent therapeutic gains. This study explored client retention following transfer to a new clinician in a COAMFTE accredited master level marriage and family therapy program in a Midwestern university over a period of five years. The researchers analyzed the relationship between client, clinician, and therapy process variables and client retentions following transfer. Although client and therapist variables were not significantly correlated with successful transfers, the number of sessions missed prior to transfer and the numbers of co-therapy transfer sessions were. We conclude that at least four co-therapy transfer sessions are appropriate to optimize successful transfers.     

Performance of Mental Health Counselors in Integrated Primary and Behavioral Health Care

Integrated primary and behavioral health care (IPBH) is becoming a preferred mode of service delivery in the United States. Integrated care includes the participation of medical and mental health professionals, such as mental health counselors. The clinical outcomes of these professionals need to be studied to determine their effectiveness in such settings. We examined the performance of 10 mental health counselors on the clinical outcome of 1,747 clients treated in an IPBH center. Analyses using growth curve modeling and pre‐post test design revealed that mental health counselors were effective overall, but they differed in client dropout rates and efficiency in reducing clients' initial symptoms. We used the analyses to rank order counselors based on their effectiveness. Counselors who were the most effective varied in their efficiency but demonstrated the lowest client dropout rates. Implications for future research and counseling practice were discussed.     

Comparison of two group counseling approaches to enhancing confidence in planning careers by undecided Taiwanese college women

This is a report of research comparing two approaches to enhance the career confidence of undecided female college students. 30 women who requested enrollment in career counseling were assigned to two counseling groups (a cognitive reconstructing intervention group and a career decision-making skills training group) and one no-treatment control group based on time of request. After participating in the two career counseling groups for eight sessions in a month, the female college students rated their mean confidence as increased over that of the no-treatment group. Analysis indicated that the indecisive female college students benefitted from career group counseling with an emphasis on self-efficacy and that the cognitive reconstructing intervention was more effective.     

Practice variability in prenatal genetic counseling

This study demonstrated that the content of prenatal genetic counseling sessions varied from counselor to counselor and from center to center. The study was designed to examine which specific issues were included by genetic counselors in prenatal genetic counseling sessions, and to determine which factors led genetic counselors to include or exclude this information from such sessions. Data were collected by randomly surveying 200 full, master degree members of the National Society of Genetic Counselors (NSGC). Respondents provided information by deciding which of 45 specific issues they would include in a standard prenatal genetic counseling session, and which one factor from a bank of 11 factors most accurately described the reason for this decision. The results indicated that the issues included/excluded from sessions varied widely among genetic counselors. The results also indicated that Patient Education/Informed Decision Making (34.5%) played the largest role in decision making overall, with Standard at Center/Departmental Policy (17.6%), Personal Experience/Preference (12.4%), and Applicability (10.9%) serving as the next three most important reasons for including or excluding issues from prenatal genetic counseling sessions.     

Counseling dropout relative to client attractiveness,disturbance, and expected number of sessions

Participants were 12 counseling center psychologist and thir 257 college-student clients. Immediately after intake, clients indicated whether or not they would make an additional appointment, their reasons for not making another appointment, and the estimated number of sessions they would attend. Counselors rated clients' attractiveness and disturbance and estimated the number of sessions they would have with each client. Clients who did not make a second appointment were generally satisfied with the help they received in one session. Client estimates were more predictive than counselor estimates of actual number of sessions. Relative to less attractive and disturbed clients, more attractive and disturbed clients made and kept post-intake appointments.