Treating survivors of war trauma and torture.

Psychologists are in a unique position to assist individuals and groups in the world who have survived torture and war trauma. Symptoms of posttraumatic stress disorder and other psychological diagnoses can be treated effectively by mental health professionals and trained lay counselors in the smallest of communities in the world. This article proposes a model for the treatment of survivors of torture and war trauma. This model has been designed to be useful to mental health professionals and to lay individuals in communities who constitute the front line in treatment: health providers, midwives, ministers, and teachers. The model is presented through examples of its use in the training of mental health counselors in the United States and in the training of promotores (health promoters) and comodrones (midwives) in Guatemala.     

Trichotillomania: Identification and Treatment

Trichotillomania is a disorder distinguished by recurrent hair pulling resulting in hair loss ( American Psychiatric Association, 2000 ). This review of the literature provides a broad overview of the disorder so that counselors can better understand, describe, identify, and implement effective treatment for clients with trichotillomania. Phenomenology, impairment, etiology, multicultural considerations, differentiation, comorbidity, and current treatment approaches are presented.     

Supervision for Counselors Working With Eating Disorders Groups: Countertransference Issues Related to Body Image,Food, and Weight

Because of similarities in age, education, and background, group counselors and members of eating disorders groups may easily identify and connect with each other. Although it can be positive, such overidentification may also create countertransference issues and demand attention in supervision. A model of supervision based on parallel process is presented to address these issues. The article describes (a) societal values related to eating disorders and countertransference; (b) specific themes in eating disorder groups and their impact on group process; (c) examples of countertransference related to body image, food, and weight; and (d) guidelines for supervision of female counselors working with eating disorders groups.     

Trauma Competency: An Active Ingredients Approach to Treating Posttraumatic Stress Disorder

Meta‐analytic studies have extracted 4 common elements among effective posttraumatic stress disorder treatments: cognitive restructuring and psychoeducation, a deliberate and continually improving therapeutic relationship, relaxation and self‐regulation, and exposure via narrative of traumatic experiences. The authors present a clinical treatment structure catalyzing these active ingredients into discrete therapeutic tasks that counselors can focus on to maximize treatment effectiveness. The 4 tasks represent an attempt to identify critical competencies and baseline standards for the field of trauma counseling.     

Trauma and substance use: the role of defences and religious engagement

Substance use disorders commonly co-occur with posttraumatic stress disorder and are associated with greater impairment. There is some evidence to suggest that different coping strategies, including defence mechanisms and religious forms of coping, may buffer the relationship between trauma and SUDs. The purpose of this study was to evaluate the potential moderating roles of defence mechanisms and religious coping on the already-established relationship between trauma symptoms and substance abuse. Data were gathered from a sample of college students (N?=?380). Trauma symptoms were associated with increased substance use and abuse. The use of immature defences was significantly associated with trauma and substance use. Increased substance abuse was also associated with higher rates of negative religious coping. Individuals who endorsed trauma symptoms were also more likely to use positive and negative religious coping. Defences and coping did not moderate the relationship between trauma and substance use.     

Using Creative Techniques With Children Who Have Experienced Trauma

Verbal and emotional forms of expression can be difficult for young children who have experienced trauma. Creative methods and approaches such as puppets, sandtray, letter writing, and art are therapeutic mediums that provide an outlet for a young client’s story of trauma to be told. Children can use puppets to depersonalize and share feelings with a counselor that would provide insight into their coping strategies. Similarly, sandtray is another nonverbal approach that gives children the opportunity to externalize their feelings safely and can be easily used with extroverted and introverted clients. Letter writing and art can empower children and give them hope for the future. In summary, creative techniques can allow counselors to help explore stories of trauma with young clients.     

Preventing Vicarious Trauma: What Counselors Should Know When Working With Trauma Survivors

Counselors in all settings work with clients who are survivors of trauma. Vicarious trauma, or counselors developing trauma reactions secondary to exposure to clients' traumatic experiences, is not uncommon. The purpose of this article is to describe vicarious trauma and summarize the recent research literature related to this construct. The Constructivist Self‐Development Theory (CSDT) is applied to vicarious trauma, and the implications CSDT has for counselors in preventing and managing vicarious trauma are explored.     

共情的双刃剑效应：COVID-19心理热线咨询师的继发性创伤应激和替代性创伤后成长

关注新型冠状病毒肺炎流行期间的心理援助热线咨询师由共情带来的消极和积极影响及机制, 并探究从消极影响转变为积极成长的内在机制具有重要的理论和实践意义。本研究以国内疫情期间, 776名在教育部华中师范大学心理援助热线平台上工作的咨询师(平均年龄42.57岁, 平均咨询经验12.44年)为研究对象, 使用问卷法测量热线心理咨询师的共情、正念、寻求意义、继发性创伤应激(Secondary Traumatic Stress, STS)和替代性创伤后成长(Vicarious Posttraumatic Growth, VPTG)。采用潜变量结构方程模型进行分析, 结果发现：(1)咨询师的共情正向预测STS和VPTG; (2) 正念在共情和STS间起部分中介作用, 寻求意义在共情和VPTG间起部分中介作用; (3) 共情还可以分别通过STS、STS-寻求意义、正念-STS、正念-STS-寻求意义的中介路径对VPTG起正向预测作用。该结果提示要辩证看待共情带来的消极和积极影响, 关注从消极反应到积极成长的转变, 这不仅能够深化共情及其影响的理论, 还能为相关研究应用提供启示。     

督导重要事件对新手咨询师专业成长的影响

目的：了解个别督导过程中重要事件的类型、内涵及对新手咨询师专业成长的影响。方法：采用重要事件法，访谈4对受督者和督导师，并用共识性质性研究法分析。结果：有益重要事件包括督导关系、概念化、历程化、个人化4大类；督导促进了新手咨询师干预技巧能力、治疗计划目标等8个专业领域的成长。结论：督导对于新手咨询师专业成长非常重要。各类督导事件对于新手咨询师的促进作用并不均衡。     

督导重要事件对新手咨询师专业成长的影响

目的：了解个别督导过程中重要事件的类型、内涵及对新手咨询师专业成长的影响。方法：采用重要事件法,访谈4对受督者和督导师,并用共识性质性研究法分析。结果：有益重要事件包括督导关系、概念化、历程化、个人化4大类;督导促进了新手咨询师干预技巧能力、治疗计划目标等8个专业领域的成长。结论：督导对于新手咨询师专业成长非常重要。各类督导事件对于新手咨询师的促进作用并不均衡。     

The transgenerational trauma and resilience genogram

The understanding of trauma within counseling has expanded to include the salience of ecosystemic factors and to acknowledge the importance of multicultural and social justice considerations. Transgenerational trauma and resilience offers a framework that examines trauma across generations, attends to ecosystemic concerns, and adheres to a strengths-based perspective. However, given the complexity of trauma counseling and attending to the multitude of ecosystemic factors, counselors and psychologists may struggle to conduct comprehensive assessments and interventions with their clients. Genograms have long been used to clarify complex family and psychological patterns through visual representations, and are, therefore, a promising tool to meet this need. The Transgenerational Trauma and Resilience Genogram (TTRG) was created as a dynamic tool that can assist practitioners in conducting compressive trauma assessment and intervention from a transgenerational trauma and resilience framework. The TTRG emphasizes an ecosystemic view of trauma, culturally relevant and strength-based interventions, and attention to sociopolitical concerns that may impact trauma and recovery. The author explicates the use of the TTRG in trauma counseling, including the theoretical foundations and implications for trauma and recovery. A case example of the use of the TTRG and implications for counseling practice using the TTRG and its guiding principles are provided.     

Supervision Needs of Correctional Mental Health Counselors

Supervision of mental health counselors and psychologists is a developing field within psychology. Supervision models and needs are being researched and defined. Supervision for correctional mental health counselors and psychologists is an important part of correctional psychology, but has received very little research attention. There are many aspects of correctional psychology that are unique from the field of psychology as a whole; this is certainly true for supervision of correctional mental health staff. This article examines the supervision needs of correctional mental health counselors and psychologists. An application of one supervision model to correctional psychology is presented.     

Assessment and Diagnosis of Eating Disorders: A Guide for Professional Counselors

Despite the prevalence of and risk associated with disordered eating, there are few guidelines for counselors on how to conduct an eating disorder assessment. Given the importance of the clinical interview, the purpose of this article is to provide recommendations for the assessment and diagnosis of eating disorders that (a) specifically focus on assessment in the context of a clinical interview and (b) can be used by counselors whether or not they specialize in eating disorder treatment.     

Chaos Theory as a Model for Life Transitions Counseling: Nonlinear Dynamics and Life's Changes

Chaos theory is presented for counselors working with clients experiencing life transitions. It is proposed as a model that considers disorder, unpredictability, and lack of control as normal parts of transition processes. Nonlinear constructs from physics are adapted for use in counseling. The model provides a method clients can use to reconstruct their own alternative life narratives, a framework in which life stories are understood, and a means to facilitate cocreation of adaptive interventions.     

The Role of Religious Coping and Resilience in Individuals With Dissociative Identity Disorder

Survivors with dissociative identity disorder (DID) often report a history of traumatic events in their lives. Past studies indicated a link between trauma, resilience, and spiritual coping in both positive and negative aspects of a survivor's life. This article includes a review of existing literature salient to these constructs in relation to i ndividuals with DID, as well as results from a study examining the relationships between these constructs and individuals with DID (N = 52). Implications are discussed based on the findings for counselors treating individuals with DID.     

Training the Millennial Learner Through Experiential Evolutionary Scaffolding: Implications for Clinical Supervision in Graduate Education Programs

They are the Millennials – Generation Y. Over the next few decades, they will be entering genetic counseling graduate training programs and the workforce. As a group, they are unlike previous youth generations in many ways, including the way they learn. Therefore, genetic counselors who teach and supervise need to understand the Millennials and explore new ways of teaching to ensure that the next cohort of genetic counselors has both skills and knowledge to represent our profession well. This paper will summarize the distinguishing traits of the Millennial generation as well as authentic learning and evolutionary scaffolding theories of learning that can enhance teaching and supervision. We will then use specific aspects of case preparation during clinical rotations to demonstrate how incorporating authentic learning theory into evolutionary scaffolding results in experiential evolutionary scaffolding, a method that potentially offers a more effective approach when teaching Millennials. We conclude with suggestions for future research.     

Meta‐Analysis of Trauma‐Focused Therapies for Treating the Symptoms of Posttraumatic Stress Disorder

This meta‐analysis of 46 between‐groups studies published between 1997 and 2015 detected treatment effects ranging from large to small when comparing trauma‐focused therapies with no treatment (g = ?1.05), supportive interventions (g = ?0.91), other interventions (g = ?0.57), and non‐trauma‐focused cognitive behavior therapies (g = ?0.08) for the treatment of posttraumatic stress disorder (PTSD). The independent random‐effects models detected modest publication bias and a negligible influence of moderating variables on treatment outcomes. Considerations for counselors who treat PTSD and suggestions for researchers are provided.     

Best Practices for Counseling in Cardiac Rehabilitation Settings

Heart disease is the leading cause of death in the United States and can affect individuals of all ages, gender, ethnicity, and socioeconomic status. This article reviews the research on psychosocial interventions in cardiac rehabilitation programs and discusses the evolving set of best practices for counselors working in a new setting with people who have experienced the trauma of cardiac disease. Recommendations for best practices for counselors who work in this emerging area are provided, including recommendations for facilitating posttraumatic growth.     

Creative Supervision for Counselors Working in a Hospice Setting

The number of individuals receiving hospice care in the United States is on the rise. Many individuals who suffer from debilitating health issues use the care of helping professionals in a hospice environment. Supervision approaches for counselors who encounter grief, loss, death, and bereavement issues in hospice settings are needed. The authors introduce three creative interventions for use with supervisees in one of the four stages of the integrative developmental model of supervision. One intervention, the “Rock Talk,” is more thoroughly explained and then demonstrated in a case illustration of a supervisee using the intervention to say goodbye to a hospice client.