The Treatment and Prevention of Depression: Implications for Counseling and Counselor Training

With depression estimated to exist in as much as 10% of the population, it may be the most prevalent problem facing counselors today. S. D. Hollon, M. E. Thase, and J. C. Markowitz (2002) reviewed the extensive research comparing various psychotherapeutic and pharmaceutical approaches to treating depression. They concluded that certain psychotherapy approaches are as effective as medications, but much remains uncertain about effective treatment. This article reviews the authors' analyses and presents implications for the counseling profession.     

Effect of Parenting Interventions on Perinatal Depression and Implications for Infant Developmental Outcomes: A Systematic Review and Meta-Analysis

Clinical Child and Family Psychology Review - Considering the significant impact of perinatal depression on both maternal wellbeing and infant development, it is important to examine the...     

The Experience of Gender Incongruity in the Christian Church: A Qualitative Study

Journal of Religion and Health - This study was designed to understand the interaction between Christian faith and gender incongruence. An anonymous online survey was advertised to the...     

The Vietnam Veteran Revisited: Implications for Counseling

Vietnam veterans are plagued by an emotional sense of having failed at what society once considered an important job; careful attention, therefore, must be paid to the type of counseling that counselors give them. This article discusses common concerns among the Vietnam veterans and offers suggestions for initiating programs of service.     

The Engineering Undergraduate Experience: A Qualitative Perspective

College experience is central to the life of adolescents. Apart from academic tasks, identity development is an important feature of this developmental stage. This paper reports two studies. One study illustrates the qualitative aspects of the college experience. The second study investigates factors affecting the academic performance of undergraduate engineering students. Time management and its links with college experience and academic performance are explored in this paper. The formation of identity emerges as an overarching concept.     

中国丧亲个体社会支持体验的质性研究

本研究通过对28位丧亲者进行深度访谈,使用解释现象学分析法对质性数据进行分析,探索中国丧亲个体的社会支持体验。结果显示,丧亲社会支持的内容包括后事处理、情感支持、生活恢复帮助,经济与物资支持等。支持来源除家人和朋友之外,还包括同事、相同经历者,以及相关机构等。社会支持通过调节情绪、改变认知等方式促进个体对丧亲的适应。本研究结果为最新丧亲社会支持模型提供了支持,同时也反映出中国社会对丧亲人群的社会支持特色。     

The Experience of Deployment for Partners of Military Personnel: A Qualitative Meta-Synthesis

It is well acknowledged that deployment can have a significant impact on military personnel; however, the effect on their partners who remain on the homefront is less researched. This meta-synthesis aimed to explore the experience of deployment for partners of military personnel to provide a greater understanding of the challenges and responses involved for them. Noblit and Hare's (1988) meta-ethnographic approach was adopted to synthesize 11 qualitative studies that met the inclusion and exclusion criteria. The five core concepts to emerge from the meta-synthesis were the multitude of emotions; methods of coping; communication with their partner; relentless responsibilities; and positive outcomes. These findings provide a developed understanding of how challenges of deployment are managed, including negative outcomes and protective psychological responses and behaviors. The limitations of these findings are discussed, as are clinical implications and recommendations for future research.     

Clinical Implications for Supporting Caregivers at the End-of-Life: Findings and from a Qualitative Study

Despite families providing considerable care at end of life, there are substantial gaps in the provision of supportive care. A qualitative interview study was conducted with 17 caregivers of people supported by an adult hospice to explore the support needs of families. Family members readily identified the ways in which the diagnosis of a life-limiting illness impacted on them and the family as a whole, not just the patient. Implications for practice demonstrate the need to intervene at a family and relational level prior to bereavement, in order to mitigate complicated grief for the surviving family members. Such an approach offers a fruitful prospective alternative to supporting caregivers post-bereavement.     

Personality and Depression: A Validation Study of the Depressive Experience Questionnaire

This study investigated the validity of Blatt's model of depression as indicated by his operational measure of its constructs via the Depressive Experiences Questionnaire (DEQ; Blatt, D'Afflitti, & Quinlan, 1976). Hypothesized relations between the two relevant scales of the DEQ and Tellegen's (1982) Multidimensional Personality Questionnaire, (MPQ) were examined, Participants consisted of 195 women, including 67 hospitalized unipolar depressives, 77 never-hospitalized unipolar depressives, and 51 nonpsychiatric controls. Overall, the results partially supported the validity of the DEQ even though all participants were women and prior studies have indicated the DEQ's greater discriminative validity for men than for women. However, several of the most strongly predicted relations, such as between DEQ Self-Criticism and MPQ Achievement were not confirmed. Coherent, significant relations between scales of the two measures remained after partialling out the effects of severity of depression.     

Therapy Expectations of Adolescents with Depression Entering Psychodynamic Psychotherapy: A Qualitative Study

Patient expectations about therapy have been regarded as a common factor affecting the course and outcome of psychotherapy. However, little is known about the expectations of adolescents. We aimed to explore the therapy expectations of young people (YP) with depression prior to psychotherapy. We conducted semi-structured interviews with six YP (5 female, 15–19 years old) entering psychodynamic outpatient treatment. Interviews were transcribed verbatim and analyzed using Interpretative Phenomenological Analysis. The careful analysis of the YPs’ accounts yielded the following four key themes: not knowing but being cautiously hopeful; therapy as a long and difficult process; therapy as a place to understand oneself and to develop; and the importance of the professional and interpersonal skills of the therapist. The findings suggest to foster realistic treatment and outcome expectations while at the same time individual therapists should pay careful attention to the specific expectations that YP bring into therapy.     

Emotion-Focused Therapy for Couples in the Treatment of Depression: A Pilot Study

Emotion-focused therapy (EFT) for couples was compared to pharmacotherapy in the treatment of major depressive disorder. Eighteen distressed couples in which the female partner met diagnostic criteria for major depressive disorder were randomly assigned to 16 weekly sessions of emotion-focused therapy or pharmacotherapy with desipramine, trimipramine, or trazadone. Twelve couples completed the study. Both interventions were equally effective in symptom reduction. There was some evidence that females receiving EFT made greater improvement after the conclusion of treatment than those receiving pharmacotherapy. The results suggest EFT might be useful in the treatment of comorbid major depressive disorder and relational distress.     

CBT/DBT-Informed Intensive Outpatient Treatment for Anxiety and Depression: A Naturalistic Treatment Outcomes Study

Anxiety and depression are highly prevalent and disabling mental health disorders, with comorbidity often posing as a barrier to successful treatment outcomes, thus creating a need for more intensive treatment options. Outpatient clinicians are more likely to refer patients with severe symptoms of anxiety and depression to inpatient hospitalizations rather than partial hospital programs (PHPs) or intensive outpatient programs (IOPs), despite evidence that inpatient hospitalization is associated with high costs and other risks following discharge. The present study reviews two case studies of patients who received cognitive-behavioral therapy/dialectical behavior therapy (CBT/DBT)-based IOP treatment in a private New York clinic. We evaluated treatment outcomes for 73 adult patients (50.7% female) with a mean age of 29.10 years (SD = 10.30). At intake, patients averaged 2.15 diagnoses (SD = 0.94, range = 4) and the majority (80.8%) were prescribed psychotropic medication. Treatment was structured and individually tailored, with patients receiving an average of 21.77 hours (SD = 15.06) of psychotherapy over 12.63 treatment sessions (SD = 9.76), across 12.21 days (SD = 9.61). We observed a clinically and statistically significant change in symptoms of anxiety (t = 6.24, p < .001), depression (t = 5.55, p < .001), and suicidality (t = 2.32, p < .05) over the course of the IOP. After completing treatment, 68.1% of participants tapered down to once-weekly treatment. The present study highlights the clinical utility of an IOP and suggests that this approach can be effective for adult patients presenting with severe symptoms of anxiety and/or depression.     

Obsessive-Compulsive Disorder: The Process of Parental Adaptation and Implications for Genetic Counseling

Obsessive-compulsive disorder (OCD) has primarily pediatric onset and well-documented unique impacts on family functioning. Limited research has assessed the understanding that parents of children with OCD have of the etiology of the condition, and there are no data regarding potential applications of genetic counseling for this population. We recruited 13 parents of 13 children diagnosed with OCD from the OCD Registry at British Columbia Children’s Hospital, and conducted qualitative semi-structured telephone interviews to explore participants’ experiences with their child’s OCD, causal attributions of OCD, and perceptions of two genetic counseling vignettes. Interviews were audio-recorded, transcribed, and analyzed using elements of grounded theory qualitative methodology. Analysis revealed key components and contextual elements of the process through which parents adapt to their child’s OCD. This adaptation process involved conceptualizing the meaning of OCD, navigating its impact on family dynamics, and developing effective illness management strategies. Adaptation took place against a backdrop of stigmatization and was shaped by participants’ family history of mental illness and their child’s specific manifestations of OCD. Parents perceived genetic counseling, as described in the vignettes, as being empowering, alleviating guilt and blame, and positively impacting treatment orientation. These data provide insight into the process of parental adaptation to pediatric OCD, and suggest that genetic counseling services for families affected by OCD may help facilitate adaptation to this illness.     

Treatment of Comorbid Conduct Problems and Depression in Youth: A Pilot Study

The purpose of this study was to pilot a cognitive behavioral treatment protocol for adolescents with co-occurring conduct problems and depression. A non-concurrent multiple baseline design was used to assess the effectiveness of the intervention. A sample of five adolescents, aged 11 to 14 years, participated; all five families completed the protocol. Results indicated that symptoms of oppositionality were significantly reduced. Moreover, maternal ratings suggested significant improvements in emotion regulation in their children and cohesion in the family. However, symptoms of depression showed little improvement. Results of this study have implications for improving treatment outcomes for youth with these comorbid conditions and may lead to increased conceptual understanding of these comorbid problems.     

The Treatment Planning of Experienced Counselors: A Qualitative Examination

Using consensual qualitative research, the authors examined the treatment planning process of experienced counselors (N = 9). The data analysis resulted in 4 domains: assessment steps, clinical impressions, treatment factors, and treatment strategies. These domains describe the process used by experienced counselors in making clinical decisions and offer insight into the nature of clinical expertise and the need for further research on treatment planning.     

The Cognitive, Learned-Helplessness and Hopelessness Theories of Depression: A Review with Implications for Counsellors

Four theories of depression and the Attributional Style Questionnaire (ASQ) are described and their implications for counselling discussed. Recent research has focused upon the testing of the diathesis-stress component of the reformulated learned-helplessness theory of depression, and in particular upon the role which a hypothesised depressogenic causal attributional style towards events in general, and/or 'depressive attributions' towards specific events, play in the development of depression. It is suggested that the recently revised version of this theory — the hopelessness theory of depression — is both a more fruitful area of future research and of more interest to the counsellor, since it emphasises the role which attributions and other cognitive factors play in the maintenance and prevention of depression, rather than concentrating on a continued search for a cause.     

The Embodied Experience of Microaggressions: Implications for Clinical Practice

Ongoing scholarship in multicultural counseling practice has established the significance of microaggressions in the lived experience of clients and in the client–counselor dyad. Grounded in new research into the embodied experience of oppression, this article reviews key concepts in nonverbal communication and traumatology to illustrate how the body is implicated in the transmission of microaggressions and how counselors can become more attentive, informed, and responsive to how social power differences manifest in the body. Las investigaciones actuales sobre la práctica de la consejería multicultural han establecido la importancia de las microagresiones en la experiencia vital de los clientes y en la díada cliente–consejero. Fundamentado en nuevas investigaciones sobre la experiencia corporal de la opresión, este artículo revisa conceptos clave de la comunicación no verbal y la traumatología para ilustrar cómo el cuerpo está involucrado en la transmisión de microagresiones y cómo los consejeros pueden tornarse más atentos, informados y sensibles a cómo las diferencias de poder social se manifiestan en el cuerpo.