The professional identity of counselling psychologists in health care: a review and call for research

Despite (a) anecdotal evidence which suggests that it is possible to be a counselling psychologist in non-traditional settings, and (b) the potential integration of counselling psychology foci with the medical model, there has been some discussion about whether counselling psychologists who practice in health care settings might experience a change in their professional identity. Professional identity is defined here as a sense of connection to the values and emphases of counselling psychology. The retention of professional identity seems important for counselling psychologists in health care settings. This is considering that the application of counselling psychology principles has the potential to make their contributions unique among mental health professionals in the health care arena. Here, the authors describe the evolution of ‘counselling health psychology’ and address issues of professional identity. Limitations of existing literature are examined. Recommendations for future research are also made.     

Minority stress and mental health among Dutch LGBs: examination of differences between sex and sexual orientation

Minority stress is often cited as an explanation for greater mental health problems among lesbian, gay, and bisexual (LGB) individuals than heterosexual individuals. However, studies focusing on sex or sexual orientation differences in level of minority stress and its impact on mental health are scarce, even more so outside the United States. Performing secondary analyses on the data of a Dutch population study on sexual health, the present study examines the robustness of the minority stress model by explaining mental health problems among men and women with mostly or only same-sex sexual attraction, and men and women who are equally attracted to same-sex and opposite-sex partners in the "gay-friendly" Netherlands (N = 389; 118 gay men, 40 bisexual men, 184 lesbian women, and 54 bisexual women). Results showed that minority stress is also related to mental health of Dutch LGBs. Participants with a higher level of internalized homonegativity and those who more often encountered negative reactions from other people on their same-sex sexual attraction reported more mental health problems. Such negative reactions from others, however, had a stronger link with mental health among lesbian/gay than among bisexual participants. Openness about one's sexual orientation was related to better mental health among sexual minority women, but not among their male counterparts. Suggestions for future research, implications for counseling, and other societal interventions are discussed.     

Addressing Urgent Community Mental Health Needs in Rwanda: Culturally Sensitive Training Interventions

Rwandan leaders in the health and educational sectors have begun to discuss the necessity for establishing culturally appropriate community-based mental health counselling services in Rwanda, especially trauma counselling. The need for a community psychology approach is anchored in the lingering effects of the genocide and the continuing post-traumatic stress symptoms suffered by many in the population. Capacity building in an effort like this would require the design of multi-level counselling curricula that are sensitive to the social structures within Rwandan culture. These curricular endeavours call for the development of a National Counselling Centre to serve as a structural mechanism for organizing community-based counselling initiatives. We consider the community health services needs in Rwanda here, along with associated challenges and strategies for effective mental health services in a country with a recent history of genocide. A community psychology approach to mental health would benefit Rwandan society by making trauma counselling and recovery services available and accessible to citizens throughout the country.     

诠释与转换：积极心理健康及其当代理解

积极心理健康是积极心理学理论系统的一个重要组成部分,也是积极心理学理论本身在心理健康领域的一种应用。积极心理健康以积极为核心观念,以人的积极品质为研究对象,注重人的个体差异的研究思路,引领和推动传统心理健康从关注人的消极品质转向人的积极潜力,从而使心理健康的主题既符合时代潮流又具有深厚的思想底蕴。     

Refusing to be Marginalized: Groupwork in Mental Health Services for Women Survivors of Childhood Sexual Abuse

Childhood sexual abuse is a major aetiological factor in the development of mental health difficulties experienced by women. Although this conclusion is supported by two decades of extensive research, it has had little impact on the provision of mainstream mental health services. It remains exceptional for there to be specialist therapy or counselling provision for women survivors of childhood sexual abuse within statutory mental health services. This represents a serious gap in service provision and, it is argued, results in extended and inappropriate treatment for women survivors using mental health services. In this article, the development of a multi-agency approach to the provision of groupwork for women survivors of childhood sexual abuse within mental health service is described. A women-centred model of groupwork is outlined. Evaluation and funding are discussed. It is argued that, as a time-limited and effective treatment option, groupwork for women survivors of childhood sexual abuse should form a central part of service provision within statutory adult mental health services.     

An Examination of Disclosure,Mental Health Treatment use,and Posttraumatic Growth Among College Women Who Experienced Sexual Victimization

Few investigations have sought to identify factors associated with posttraumatic growth among survivors of sexual victimization. The present study examined the relationship between posttraumatic growth, disclosure, and mental health treatment use following sexual assault. Undergraduate female psychology students (N = 85), who reported a prior history of sexual victimization, completed measures assessing trauma exposure, posttraumatic growth, disclosure, and mental health treatment use. Results revealed that degree of disclosure of the assault to support sources and mental health treatment use following sexual assault was related to increased posttraumatic growth. Findings have valuable implications for treatment interventions for survivors of sexual trauma.     

An audit of a school-based counselling provision for emotional and behavioural difficulties in primary school children

The presence and prevalence of mental health problems in young children ad well as therapeutic interventions is less well understood than the same problems in adults, Long-term consequences of childhood mental health problems have been noted, yet provision of services at the age appropriate level is ofter limited. This sudy presents a case note audit of 540 children attending an innovative programme for counselling and therapy in school-based centres based in 8 inner London Primary schools. This represented 22.4% of all children attending the schools, with an overage age at referral of 8.1 Years. 53.8% of boys compared to 46.2% girls ew referred emanating from varied backgrounds. The majority of the children spoke English at home (86%) and the only significant differences according to home language related to concern over social interactions. Comparisons between children cared for by both parents(48%) and those cardd for by a single parent (37.3%) showed the latter group to have higher distress and concerns affection school work, home situation, stress for significant life events and lowered coping. Atendance and defaulting rates were good, with no significant differences among those who attended regularly. Many of the conderns surrounded self-esteem and social/family factors. The level of distress was significantly lowered after counselling (t = 17.5 p_.001) 51.45 of the children experienced significant life events which preceded their referral, 30.9% triggered the referral and 45.6% during the course of counselling. Distress caused by life events was generally high with coping levels moving down after multiple exposure. The data is discussed in the light of future provision of care for children.     

儒家文化与中国人健康心理的交互建构

中国传统文化的主体是儒家文化,文化与健康心理之间存在着相互作用、相互建构的关系。儒家文化与中国人的健康心理的交互建构作用主要表现在三个方面:一是心理问题躯体化,即文化心理与躯体症状的交互建构; 二是心理问题道德化,即文化心理与德行标准的交互建构; 三是心理问题生活化,即健康心理与伦理规范的交互建构。它们既是中国人健康心理与行为的典型表现特征,也是儒家文化与中国人的健康心理和行为交互建构的结果。心理健康、道德健康、伦理健康三者之间是一个相互作用、相互建构、协调发展的完整体系。中国心理健康服务要充分发挥心理健康理论的建构特性和行动特征,促进心理健康服务理论与实践协调发展。     

Counselling psychology in South Africa

The origin and development of counselling psychology in South Africa has been profoundly influenced by the country’s sociopolitical history and the impact of apartheid. As a result of this, counselling psychologists in the country face a number of challenges and opportunities for the future. In this paper we provide a portrait of counselling psychology in South Africa by describing the current character of the specialty and the context in which South African psychologists work. We critically discuss the challenges that the specialty faces to meet the country’s mental health care needs, contest the current Scope of Practice; affirm multiculturalism without essentialising or reifying race and ethnicity, and build an evidence base for community interventions in the country. We also consider how, in the future, counselling psychologists in South Africa may make a more meaningful contribution within public health and the country’s health care and education systems.     

Lesbian Youth Support Information Service (LYSIS): Developing a Distance Support Agency for Young Lesbians

The Lesbian Youth Support Information Service (LYSIS) was established in 1991 as a result of research conducted into the needs and experiences of young lesbians. This research found that young lesbians are vulnerable to mental health problems, including depression, attempted suicide, self-harming behaviours and alcohol misuse, as well as isolation and social rejection. There were also strong indications that young lesbians are most vulnerable when they are coming to terms with their sexual orientation. LYSIS offers support to young lesbians in four main ways: correspondence counselling; telephone counselling; peer support; and information. LYSIS is part of an umbrella organization, the Lesbian Information Service (LIS), which provides indirect support for young lesbians including publishing, education and training, projects and campaigning.     

Sexual Abuse Prevention for Individuals with Mental Retardation: Considerations for Genetic Counselors

It is now widely recognized that children, adolescents, and adults with mental retardation are especially vulnerable to sexual abuse. Because at least 10% of genetic conditions are reported to include mental retardation as a feature, the provision of services to individuals with mental retardation represents a substantial portion of the case load for many genetic counselors. Our objective is to educate genetic counselors and other health professionals about this vulnerable population in order to enhance the frequency and efficacy of inquiry into sexual education and sexual abuse prevention training for patients with mental retardation. The following review article is intended to assist genetic counselors by increasing their knowledge of factors that lead to sexual abuse and provides recommendations for integrating this information into the counseling interaction.     

Challenges and opportunities in moving toward a public health approach in school mental health

These three outstanding papers are important for the discipline of school psychology, the field of school-based mental health, and more generally for systems of education and mental health for children and adolescents. As the authors emphasize, there is an unprecedented focus on improving programs that remove barriers to learning and enhance development, health, and mental health in youth, in the most universal natural setting—the schools. The authors also correctly highlight that school psychology is uniquely positioned to play a leading role in this reform and change effort. Two interconnected themes of the public health approach—applying the evidence base and moving toward preventive and population-focused interventions—are emphasized in these papers, and while they focus on school psychology, the issues discussed are generalizable to the many disciplines that operate within educational and mental health systems. In the following discussion, I react to the papers' two major themes, discuss realities that should be addressed for progress to be made, and comment on their implications for school psychology.     

Exploitation in therapy and counselling: a breach of professional standards

Exploitation in therapy and counselling may occur in only a minority of cases, but when it does, its effects are potentially damaging to both the client and the profession. Exploitation in therapy may take the form of psychological, covert and overt abuse. The most reported form of abuse of the therapeutic relationship is of a sexual nature. However, psychological abuse usually forms the backdrop to sexual exploitation, preceding and perpetuating the sexual involvement. Sexual exploitation in therapy is an abuse of the power imbued in the therapist by nature of his professional role. It allows the therapist a sexual gratification which he would not have been likely to achieve outside the therapeutic relationship. The prevention of sexual exploitation in therapy is an issue of concern to training, employing and professional organisations who seek to maintain high standards of counselling delivery. Determining the variables which may contribute to exploitation is fundamental to avoiding its incidence. This paper discusses the factors underlying the use of therapy and counselling as a medium for therapist abuse. It examines (i) the prevailing conditions for abuse to occur, (ii) how the therapist overcomes client resistance, and (iii) the implications for the maintenance of professional standards.     

How counselling psychologists are perceived by NHS clinical psychologists

The aim of the study was to obtain data reJlecting NHS clinical psychologists' perceptions of counselling psychologists. A 19-item questionnaire was devised and sent by post to 303 clinical psychology departments throughout the United Kingdom in July 1995. 161 replies were received from areas including mental health, community care, general hospital, neurological rehabilitation, learning disabilities and combinations of these. Results showed considerable confusion among clinical psychologists around the identity and competencies of counselling psychologists. Much of this confusion seems to be attributable to a lack of information regarding the content of training and a lack of awareness that counselling psychologists are now chartered under the auspices of the British Psychological Society. The survey suggests that counselling psychologists should work to clarify their identity and increase communication with professional colleagues before their contribution to the provision of psychological care can be recognised.     

Schädigungsmechanismen beim sexuellen Missbrauch von Kindern

The criminal intervention in child sexual development is carried out in a protean event of increasing exploration of ones own body, also reciprocally with other children and ultimately the development of shame. This process is part of the identity development of children, to which their bodily sexual self-concept also belongs. Against this background, the multitude of sexual activities also of smaller children is presented in order to discuss the question of whether the quality and intensity of the various acts of sexual abuse (manifest violence versus apparently violence-free usurpation) lead to different mental and social sequelae. Thoughts are presented on how this harm could have arisen. Excluded are the particularly complex problems of ideological excessive assaults in religious or pedagogic faith communities. The article is intended as an incentive to discussion.     

Community Counselling in African Contexts

This article explores community counselling as a form of professional practice for psychologists, with a particular focus on practices that are relevant in African contexts. The discussion identifies and discusses various models of practice identified in community psychology, including an ecological perspective, a public health and community mental health framework, interventions that focus on promoting a sense of community, indigenous approaches to community counselling and a critical or social action framework. Examples relating to each of these models of practice are drawn from various African settings, providing practitioners with some insights into how theory can be operationalised into practices that are relevant to African contexts. The article concludes with a discussion on community research, with a particular focus on ethical considerations relevant to a community approach in African contexts. The latter discussion emphasises the importance of working with the community as partners, and suggests the possibility of developing a Code of Ethics aimed specifically at guiding community counselling practice in African contexts.     

A personal view: Counselling and women

This personal view explores a number of gender issues relating to counselling and women clients. Attention is drawn to the lack of content of many training courses in the psychology, sociology and biology of women. Links are drawn between a woman's position in society and mental health. It is argued that counsellors need to be alert and sensitive to women's special needs and to avoid an emphasis on intra-psychic aspects at the expense of acknowledgment of societal pressures.     

Mental health of outpatient pediatric patients

The purpose of this study is to estimate the percentage of mental health problems in a pediatric outpatient Norwegian clinic. We used the Strengths and Difficulties Questionnaire to screen for mental health problems. Families of children aged 4–11 took part in the study, and 380 out of 982 possible families consented to take part, and 349 families contributed with questionnaire data. The main referral reasons for the patients were asthma, eneuresis and stomach pain. Mothers reported that 17.4% of boys and 17.8% of girls displayed mental clinical problems. The prevalence of problems did not differ significantly between somatic diagnostic groups. Although the study has low participation, it underlines the necessity of screening all pediatric patients for mental health problems. Future research in pediatric clinics should include factors of psychology because pediatric problems are not caused by somatics alone.     

The Longitudinal Impact of a Family-Based Communication Intervention on Observational and Self-Reports of Sexual Communication

Parents can play a vital role in shaping teenagers’ sexual attitudes, behavior, and contraceptive use through communication, however, less is known about how to modify parent–adolescent communication among youth with mental health problems. The impact of a family-based sexual risk prevention intervention on both observational and self-report of parent–adolescent sexual communication was examined at 12 months among adolescents with mental health problems. Of the 721 parent–adolescent dyads recruited for the study, 167 videotapes of sexual discussions between parents and adolescent were coded for the family-based intervention and 191 videotapes for the active comparison. Longitudinal analyses examined differences between conditions (family-based vs. comparison) in self-reported and observed parent–adolescent sexual discussions and also examined the impact of gender on intervention response. More parent I-statements, healthier parent body language, and fewer adolescent Negative Vocalizations were detected for family-based intervention participants 12 months after participating in the brief intervention (11?h of total intervention time) relative to those in the comparison condition. Parents in the family-based intervention also self-reported better sexual communication at 12 months. The current study provides supporting evidence that a relatively brief family-based intervention was successful at addressing parent–adolescent sexual communication among a mental health sample.