Domestic violence and group treatment for male batterers

This paper examines the violent behavior of male batterers toward their female partners. Three major theoretical perspectives addressing the etiology of the male batterer's abusive behavior are reviewed. These perspectives, along with an understanding of personality characteristics common among batterers, offer insight into intervention and treatment options. Group intervention has proven to be the most effective form of treatment for batterers. Outcome studies suggest a decline in batterers' abusive behavior as a result of group treatment.     

Revisiting a meta-analysis of helpful aspects of therapy in a community counselling service

This small scale mixed methods study examines helpful events in a community counselling setting, categorising impacts of events according to Timulak’s [(2007). Identifying core categories of client-identified impact of helpful events in psychotherapy: A qualitative meta-analysis. Psychotherapy Research, 17, 305–314] meta-synthesis of significant events research. Comparisons were made between the types of impacts reported as helpful by clients receiving cognitive behavioural therapy (CBT) or relational integrative counselling. Seventy-five clients identified 291 significant events on 216 Helpful Aspects of Therapy (HAT) forms. The findings broadly reflect all nine impacts identified by Timulak (2007). The study also suggests that a potential new category, ‘voicing’ may exist. Differences between the types of impacts reported as helpful by clients in CBT and integrative therapy showed a higher percentage of CBT clients reporting ‘behavioural change/problem solution’, ‘reassurance’ and ‘client involvement’ as helpful. Differences in other categories were not statistically significant.     

Burnout during a long-term rehabilitation: comparing low burnout,high burnout – benefited,and high burnout – not benefited trajectories

Abstract

To focus rehabilitation activities among burnout clients more effectively, it is important to investigate who benefits from burnout interventions. This study (N=85) aimed at identifying burnout trajectories in terms of benefit, that is, subgroups of clients who share similar mean levels and changes in burnout during a one-year rehabilitation intervention (17 days in total) with a six-month follow-up. After identifying the burnout trajectories, the relations of the trajectories with factors describing the clients, antecedents, and consequences of burnout during the one-year intervention were examined. Three burnout trajectories were identified by growth mixture modeling: (a) low burnout (n=39), (b) high burnout – benefited (n=29), and (c) high burnout – not benefited (n=17). Positive changes were detected in antecedents and consequences among the clients in the low burnout and high burnout – benefited trajectories. Recovery from burnout was associated with increased job resources and decreased job demands, as well as with increased job satisfaction and decreased depression. It seems that more precise targeting of rehabilitation is needed since the trajectories revealed not only clients with mild symptoms, but also clients who probably received this treatment too late.     

Longitudinal Assessment of Pain, Coping, and Daily Functioning in Children with Sickle Cell Disease Receiving Pain Management Skills Training

Objective. To conduct intensive pain management skills training (IST) in children with sickle cell disease (SCD) and their parents and to comprehensively evaluate pain, coping, and daily functioning in children pre, immediately post, and 3 months following treatment. Methods. Three children who received IST in nonpharmacological and pharmacological pain management strategies completed a Coping Strategies Questionnaire (CSQ) at pre, post, and follow-up assessments, and daily pain and activity diaries for 18 weeks, spanning from 1 week pretreatment to 11 weeks posttreatment. Results. From pre- to posttreatment, 1 child receiving IST indicated increased report of active coping attempts and all 3 children indicated decreased report of negative thinking on the CSQ. Participants in IST used coping skills on 90% of days with pain and reported the skills to be moderately helpful on the daily diaries. For daily activities such as eating dinner, playing with friends, and hours slept, children participated similarly on days with pain and days without pain during the posttreatment period. Given the small number of participants in this study, individual cases are discussed to highlight similarities and differences in how participants responded to the treatment and during the 3-month follow-up period. Conclusions. In this pilot study, each participant showed improvement in coping and daily functioning after completing the IST program. Individual differences in response to treatment indicate the need for more targeted intervention programs that incorporate pharmacological and nonpharmacological components. The results of this study highlight both the promise and the complications of conducting comprehensive pain intervention and functional outcome studies in children with SCD.     

Therapists' views of the relative benefits and pitfalls of group work and one-to-one counselling for bereavement

Aim: To explore therapists' perceptions of the relative benefits and pitfalls of group work and individual counselling for bereaved clients. Method: Semi-structured interviews with nine experienced bereavement therapists from a range of different contexts generated data which was analysed using grounded theory methodology. Findings: Groups were perceived as having a normalising influence, helping members make new social contacts and practice social skills. Individual counselling was seen as facilitating the initial telling of the story and the expression of extreme emotion. Discussion: The findings suggest that individual counselling may be useful as a primary intervention easing ‘emotional loneliness’ caused by the death of a spouse or attachment figure. Group work may be of more benefit later in the bereavement process, facilitating an engagement with the outside world and alleviating ‘social loneliness’. Implications for practice: This suggests that bereavement services might usefully combine group and individual provision. Initial assessment could help clients clarify their needs and facilitate their choice of service. This would be more cost effective and potentially ease clients' bereavement experience.     

Exploring client contribution in a cognitive intervention for test anxiety

Aim: To study client contributions in cognitive therapy. Specifically, to study ways of making an intervention against test anxiety work, based on interviews with 32 test‐anxious university students. Method: Interviews after their first examination following the intervention were analysed using a thematic analysis. Results: Although most participants reacted positively to the intervention, concerns emerged that adopting positive self‐statements might be deceptive. Concerns about the untruthfulness of positive self‐statements led clients to generate several possible resolutions, namely, to examine flaws in negative self‐statements, to realise that there is more than one realistic way to construe things, to consider the evidence in the form of reduced anxiety, to consider manageable steps, and to seek interpersonal validation of positive self‐statements. Conclusions: The results offer concrete resolutions developed by clients that might be useful for other clients who have reservations about positive self‐statements.     

Guilt and self-sacrifice: The plight of the better-off sibling

In this article, the experience of guilt and its behavioral sequelae, self-sacrifice, in the lives of certain therapy clients is explored. Subjects are adults who perceived as children that they were more gified in some area critical to their parents' values than was a sibling. These clients were successful children, but have come to therapy unsuccessful in some crucial area of their adult lives. Their sibling relationship was of primary importance to them. The relationship was very relevant to the lack of adult success they had experienced. Theory is developed to explain this phenomenon, and illustrative case examples are presented and suggestions are made for treatment.     

Effects of outcome performance feedback on maintenance of client and staff behavior in a residential setting

This study examined effects of outcome performance feedback on maintenance of client and direct care staff behavior in a group home for four clients with severe/profound intellectual disability. Following baseline observations, 8 staff were instructed to prompt and praise interclient interactions and game activity during leisure sessions. Staff training comprised written instructions, in situ modeling and rehearsal, and performance feedback. This was followed by a 17-week maintenance period, during which staff received outcome performance feedback based on independent and self-recorded observations. Results showed that client gains were maintained, but did not stabilize. It was concluded that process feedback should have accompanied outcome feedback until staff behavior levels suitable for durable maintenance were obtained. In addition, successful use of performance feedback as a maintenance tool is highly dependent on which outcome behaviors are selected, and whether these are eventually naturally reinforced.     

Characteristics of patients in routine psycho-oncological care,and changes in outcome variables during and after their treatment

Objective: The primary aim of this study was to determine the characteristics of clients and interventions in routine psycho-oncological care. The secondary aim was to determine the course of symptomatology during and after the psychological interventions.

Design: During a period of nine months, all clients who sought help in one of the seven psycho-oncological care institutes in the Netherlands were approached to participate in the present study (N = 483). Information was gathered with respect to demographic and medical characteristics, and type and duration of the interventions. In addition, depression, anxiety, well-being, quality of life, fatigue and daily function were determined before interventions and three and nine months later.

Results and conclusions: Compared to the Dutch cancer population, patients in psycho-oncological care were more often young and female. Compared to the general Dutch population, they were highly educated and were more likely to have a partner. Clinical levels of depression, anxiety and/or fatigue were found among 83% of the patients. After three months, only 23% had completed their intervention; this figure was 62% after nine months. Symptoms decreased significantly for all outcome variables. An importance difference with randomised controlled trials is the low session frequency and the long intervention time of patients in clinical care.     

Early interventions with disturbed mother-infant relationships

The aim of this paper is to validate the hypothesis that successful psychodynamic intervention in the case of disturbed mother-infant relationships may be possible. Based on 120 referred cases, three types of intervention emerged: Intervention Group A: These mothers feel numbed when their babies are in an acute state of distress and show active signs of refusing to live. Intervention Group B: These mothers feel concern about an on-going difficulty with their baby and are prepared to explore the problem with the therapist. Intervention Group C: These mothers feel angry when their children show signs of distress and react in a persecuted way toward the baby. Due to the difficulty in helping mothers in this situation, a different approach was explored. Clinical case studies are presented to illustrate each of these types of intervention.     

Person‐centred counsellors' experiences of working with clients in crisis: A qualitative interview study

Aims: This study aims to explore and understand person‐centred therapists’ experiences and work with clients at the pivotal point of crisis. Specifically: how do person‐centred therapists experience working with clients in crisis? Do they identify differences in crisis intervention compared to non‐crisis work? What do they perceive as helpful to crisis clients? How relevant are therapists' own experiences of crisis? Method: Participants were all experienced person‐centred therapists. Qualitative, semi‐structured interviews were conducted and the data were analysed qualitatively using person‐centred/phenomenological methodology. Results: Respondents identified differences in their experiences. Typically, therapists described polarity in their experience of danger and opportunity, also heightened energy levels within themselves, perceived higher levels of engagement, faster pace of work, experiences of reaching ‘relational depth’ earlier, and the importance of assisting symbolisation of clients' experience in awareness. Clients were experienced as vulnerable, unable to access previous coping mechanisms, in a state of breakdown and disintegration, but also as wide open, having dropped their usual defences, and more available to engage in therapy and enter the process of change and potential post‐crisis growth. Discussion: The findings are discussed in relation to prevailing models of crisis intervention, person‐centred theory and theoretical developments in post‐traumatic growth in the aftermath of crisis.     

An evaluation of the Garren-Edwards diet and behavior modification program

This study evaluated the efficacy of the Garren-Edwards Behavior Modification Program, which uses the Garren-Edwards Gastric Bubble as an adjunct to treatment. Group therapy sessions were conducted with 23 morbidly obese subjects for 6 months on a biweekly basis. Each therapy session used a five-stage problem-solving sequence designed to facilitate adaptive behavioral alternatives. In evaluating weight change, a multivariate analysis of variance was conducted along with two preplanned orthogonal comparisons. Patients lost significant amounts of weight between initial to 3-month (p<.0001) and 3- to 6-month intervals (p<0001). A similar treatment effect was noted in an additional sample of 24 morbidly obese subjects following 3 months of treatment (p<0005). The findings support the value of longer goal-oriented programs in promoting continued weight loss. Implications for treatment process and therapist interventions prompted by this new format are discussed.     

The lack of effects of enriched and automated environments on the adaptive and maladaptive behavior of mentally retarded persons

This study addressed the relative effects of repeated exposures to an austere institutional dayroom, a toy enriched dayroom, a PUSH (Play Units for the Severely Handicapped) room that contained automated stimulation devices within a physical terrain, and a modular room that contained wall mounted automated stimulation devices, on the adaptive and maladaptive freeplay behavior of six groups of institutionalized mentally retarded individuals (N = 6 per group). Group One was observed in all four settings, whereas the other five were observed in two or more of the active settings. The results indicated that (1) there were only slight differences in object-directed adaptive behavior when the three active settings were compared to the austere setting, and (2) only the higher functioning subjects (Group Five) displayed consistent individual differences on any of the measures when active settings were compared. None of the comparisons, however, revealed statistically significant effects. This study clearly demonstrates the need for active control conditions, raises questions regarding the relevance of much of the previous research, and suggests that further refinements will be necessary before environments such as those in the present study produce meaningful changes in appropriate environmental interaction in the absence of staff mediation.     

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.     

Choice as an Intervention to Improve Behavior: A Review of the Literature

In recent years, choice making has been evaluated as an intervention for people with disabilities. This review examines applied research during the past two decades using choice as a distinct intervention or as part of an intervention package. Fourteen studies published between 1975 and 1996 were identified that implemented choice as an intervention to increase or decrease a target behavior. These studies applied choice-making in the following three broad areas: (a) vocational or domestic activities; (b) academic activities; and (c) leisure, recreational, or social activities. All of the studies indicated that choice-making procedures resulted in behavioral improvements with some, if not all of the participants.     

Personality,Leisure Experiences and Happiness

This study explored the relationships among personality, leisure involvement, leisure satisfaction and happiness in a representative sample of Chinese university students (n = 423). We found that (1) extraversion significantly correlated with almost all kinds of leisure involvement, but neuroticism did not correlate with leisure activities at all; (2) extraversion significantly positively correlated with leisure satisfaction while neuroticism significantly negatively correlated with leisure satisfaction; and (3) while extraversion and neuroticism were significant predictors of happiness, leisure satisfaction had its incremental effects after those of personality traits and other domain satisfaction were controlled. Implications of these findings for developing a Chinese psychology of leisure were discussed.     

Leisure and Its Role as a Strategy for Coping with Work Stress

The purpose of this study was to determine the dimensions of leisure that were important to people coping with work-related stress. Data were provided by 695 principals and deputy principals from secondary schools throughout New Zealand who were experiencing major legislative and organizational change in the education sector. The results produced a robust, replicable, and reliable two-factor structure using FACTOREP, a factor replication procedure. It appears that leisure is best measured in terms of active-challenge and passive-recuperative dimensions when considered in relation to coping with work-related stress. The results show that for the present occupational group, the passive nature of leisure is more important for coping with work stress. These results have implications for those involved in workplace health promotion where the emphasis thus far has been on physical activity and fitness. The results also confirm the importance of determining the most appropriate number of factors to rotate.     

A Kinetic Sculpture Intervention for Individuals Grieving the Deaths of Family Members

This article presents a creative intervention called kinetic sculpture for loss adaptation in grief counseling. This intervention is supported by professional literature regarding Bowenian family systems and creativity in counseling. The deaths of family members may generate much uncertainty for clients regarding functioning of their family systems. Kinetic sculpture allows clients to create visual examples of family equilibrium before, in the midst of, and after the deaths of family members. Insight gained from engaging in this intervention can aid clients in making aspirational plans for their own adaptations to loss. In this article, we present step-by-step instructions for creating the kinetic sculpture, make recommendations for process questions to accompany the intervention, and apply the kinetic sculpture in a case example.     

Dyslexia and the school counsellor: A Maltese case study

Aim: This paper seeks to understand whether Maltese school counsellors are equipped to deal with dyslexic clients, considers whether specific strategies need to be used, and what positive effects, if any, counselling has on these clients. Previous studies: A literature review on self-concept and techniques on how to improve the self-concept of children with Learning Disabilities (LD)/Specific Learning Difficulties (SpLD) will place the current study in context. Method: Questionnaires (available from the authors on request) were distributed to all school counsellors on the island and analysed using content analysis. Findings: Findings from respondents indicate a need for more training, evidence-based knowledge of specific techniques when dealing effectively and successfully with dyslexic clients, specific specialised training to understand dyslexic clients and that counselling has a positive effect on dyslexic clients.