Delivering Parent-Child Interaction Therapy in an Urban Community Clinic

Extensive evidence supports the efficacy of Parent-Child Interaction Therapy (PCIT) for reducing behavior problems in young children; however, little is known about the use of PCIT in a community mental health center (CMHC). This paper provides four clinical case examples of families who were referred to and successfully completed PCIT in an urban CMHC. The families were ethnically and socioeconomically diverse and presented with a wide range of treatment concerns and needs (e.g., autism, severe maternal psychopathology, involvement in child protective services, and complex family configurations) in addition to disruptive behavior. Our data and clinical observations suggest that PCIT decreased behavior problems, improved parent-child interactions, and, in some cases, reduced parental stress, with differing levels of change across families. Overall, the cases demonstrate that PCIT can be transported into a CMHC, and they illustrate supplemental services or minor accommodations to the established treatment protocol used to address individual family needs. Issues regarding the balance between fidelity and flexibility in transporting PCIT to a community setting are discussed, and future research topics are recommended.     

Client Perceptions of the Impact of Genetic Counseling: An Exploratory Study

Twenty-eight former genetic counseling clients seen at a major Midwestern university were recruited to be interviewed about their genetic counseling experiences, including most and least helpful aspects, what they learned, how this information impacted their decision-making, and their perceptions of their genetic counselors' behaviors. Responses were inductively analyzed, and several themes were identified, including: Clients sought genetic counseling to obtain genetic-medical information; a majority accurately recalled this information; genetic counseling influenced decisions for about 50% of the sample; decision-making was affected by several extra-session factors; a majority experienced distress during the session; most perceived genetic counselor responses as nondirective and liked this approach; counselor behaviors regarded as directive involved discussion of pregnancy termination; participants disagreed about the need for and provision of genetic counselor support; most regarded the session as helpful and stated that they would seek genetic counseling again. Suggestions for addressing these issues in practice and research are given.     

Counseling and Mental Health Care in Palestine

The authors provide a brief overview of counseling and mental health care in Palestine, including their history and a summary of their current status. Finally, a discussion is presented of future trends in the development of the profession with regard to recent changes in the region.     

The Relative Influence of Client Characteristics on the Process and Outcomes of Premarital Counseling: A Survey of Providers

To explore the influence of client characteristics in premarital counseling, a five factor model is presented that includes the social context, family-of-origin influences, individual characteristics, couple interactional processes, and motivation for attending premarital counseling. The findings demonstrate that providers believe that many client characteristics influence the degree to which couples benefit from premarital counseling. Providers rated the influence of the client characteristic factors in the following order (from most to least influential): couple interactional processes, family-of-origin influences, individual characteristics, motivation for premarital counseling, and the social context. Recommendations for future theory development, practice, and research are discussed.The findings presented in this article were part of the authors doctoral dissertation at the University of Florida.     

The Role of Expectations in Effective Genetic Counseling

The goals for this investigation were to assess individuals' expectations for social support from genetic counselors, and to explore how these expectations influence perceptions of genetic counselor effectiveness. Two studies were conducted to address these goals. Results from the first study show that individuals most frequently expect genetic counselors to provide options and support following the disclosure of distressing test results, while data from the second study demonstrate that expectations play a significant role in individuals' assessment of genetic counselor effectiveness. These findings shed light on what individuals expect from genetic counselors following the disclosure of medically positive test results and inform how these expectations influence the success of genetic counseling sessions.     

Preconception Genetic Counseling: Three Years of Experience at a Community-Based Health Center

In the United States, access to genetic education and services is not equally available to all segments of the population, especially to women of minority backgrounds and low incomes. In response to this issue, the Preconception Genetic Health Education Program (PGHEP) was implemented in September of 1993 at the Woodlawn Maternal and Child Health Center in south side Chicago. The goal of this program is to provide access to genetic services to a previously underserved population. Women attending the family planning clinics are offered free, confidential preconception genetic screening and counseling on-site. As of January 1, 1997, 1300 women have participated in the program. The development and implementation of the PGHEP, client self-reports of family histories and beliefs, and implications for future delivery of genetic services are discussed.     

来访者动机:心理咨询与治疗理论与实践的整合

来访者动机是影响行为改变和治疗结果的重要因素,是贯穿心理咨询与治疗过程的关键问题。自我决定理论(SDT)是关于动机行为的一种宽泛理论,将动机看成一个随自主水平变化的连续体,认为来访者自主水平越高,治疗效果越好,并强调治疗师的自主支持对来访者参与和坚持改变的重要性;动机访谈(MI)则是在成瘾行为治疗中发展起来的一种临床技术和策略,遵循来访者中心的原则激发和增强来访者动机。在健康行为领域两种治疗模型有不同的起点、焦点和发展路径,研究者却发现两者可以系统而有机地整合,促进了有实证支持的实践发展。     

The Emergence of Counseling in Sierra Leone

Sierra Leone has endured a turbulent history, including a decadelong civil war and the devastation of Ebola virus disease. Despite the psychological consequences of such events, only limited therapeutic services are available. The authors review mental health services in Sierra Leone and document the emergence of counseling as a profession in the face of challenges. They conclude by highlighting the multiple contributions that professional counselors can make to address critical mental health needs in Sierra Leone.     

Improving Empathy in Children: Interactive Read-Aloud as a Counseling Intervention

ABSTRACT

The authors describe interactive read-alouds as an effective counseling strategy to improve empathy levels in school aged children. The importance of reading development and empathy development were considered as well. Results of the literature review indicate reading development is an essential building block in school aged children’s future academic development. Furthermore, empathy development in students was deemed important. A lesson plan was created to provide school counselors with a means of implementing the interactive read-aloud as a counseling strategy.     

Mental Health Literacy and Peer-to-Peer Counseling Referrals Among Community College Students

Mental health literacy (MHL) has utility for promoting peer-to-peer referrals to mental health support services among university students. However, there is a gap in the extant literature about the potential usefulness of MHL for supporting the mental health of community college students, a population facing a number of mental health conditions. The authors examined the construct validity and the utility of 3 dimensions of MHL as predictors of peer-to-peer referrals to the counseling center among community college students. Results of confirmatory factor analyses supported the dimensionality of the instrumentation and a hierarchical logistic regression analysis revealed that MHL was a significant positive predictor of peer-to-peer referrals to the counseling center. Implications for counseling practice and future research are discussed.     

Predictors of Early Termination in a University Counseling Training Clinic

Despite the existence of counseling dropout research, there are limited predictive data for counseling in training clinics. Potential predictor variables were investigated in this archival study of 380 client files in a university counseling training clinic. Multinomial logistic regression, predictive discriminant analysis, and classification and regression trees converged on the use of a 4‐predictor model (client age, income, perceived difficulty, and functional impairment) for classifying counseling dropouts. Implications for research and practice are discussed.     

Factors Predicting Attrition Within a Community Initiated System of Care

We designed this study to elucidate child, family, and service level characteristics that may influence attrition from a continuum of care developed and maintained by a community initiated collaboration of local clinics and agencies. Subjects included 117 children and adolescents referred to the Middlesex County system of care from 1992–1999. Data were collected through a retrospective case review. The strongest predictors of attrition from the system of care both before and after the establishment of an individualized service plan included depressed/isolated symptoms, substance abuse, general risk for psychiatric problems, number of referral reasons and urgency status at program intake. Among youth exiting residential placement, those completing recommended services were more likely to be returned home earlier or within the expected time frame than were dropouts. Our study presents important preliminary findings regarding characteristics related to treatment adherence within a community initiated systems of care.     

Psychology Without Psy Professionals: Exploring an Unemployed Centre Families Project as a Mental Health Resource

The activities and technologies of the psychology (Psy) disciplines, in the process of privileging professional understandings of distress, could be seen to be potentially facilitating corrosion in the capacity of the lay public to understand and ameliorate their distress. This paper draws on the experiences of people who use an Unemployed Centre Families Project in the South of England to provide an example of community mental health work that does not draw on the dominant discourses, institutions or practitioners of the Psy sciences. Through interviews with centre users, staff and volunteers, a picture emerges of a community space that provides a variety of services, projects and opportunities that have a very considerable positive impact on the mental well‐being of the centre users. This picture highlights non‐medical intersubjective processes that offer possibilities for recoveries from mental distress but that are often neglected and subordinated in the professional worlds of Psy and psychiatry. Such centres facilitate social networks and practical help, and transitions in identity can be beneficial for those experiencing mental distress. In so doing, they make prominent some of the key limitations of biomedical approaches to recovery. Copyright © 2015 John Wiley & Sons, Ltd.     

Expanding Perspectives: Systemic Approaches to College Students Experiencing Depression

Family and peer systems significantly influence college students' mental health. Nevertheless, many clinicians use treatment models that fail to consider multiple factors from different systems of individuals' lives. The authors discuss research highlighting the influence of students' systems on their mental health, specifically depression. Next, they provide a brief introduction to systems theory and approaches and use 2 case illustrations to present systemic approaches for treating students with depression. Implications for future research and practice are discussed.     

Predictors of Counseling Students' Decision to Pursue a Gerocounseling Specialization

The authors examined which variables predicted the likelihood of counseling students' decision to pursue a gerocounseling specialization by using logistic regression analysis. Results found that overall interest, perceived preparation, training willingness, and importance were predictive factors. Curriculum strategies on how to implement these variables into existing counselor education course work are discussed.     

Incorporating a Psychological Counselor in a Cancer Risk Assessment Program: Necessity, Acceptability, and Potential Roles

Evidence suggests that cancer risk assessment may be associated with increased psychological distress. This exploratory study assessed the necessity and acceptability of incorporating psychological counseling into routine clinic procedures at a cancer risk program. Following a visit to a university-based cancer risk clinic, patients (N = 102) completed an anonymous self-report instrument. Participants reported experiencing current stress and anxiety (41%), depression (29%), and suicidal ideation (2%). Patients with a history of cancer were more likely to be experiencing current emotional difficulties. Sixty-nine percent of the participants found the visit with the psychological counselor to be helpful, while 41% of the participants reported interest in follow-up psychological services. Interest in receiving future psychological services was positively correlated with levels of anxiety, depression, and cancer worry. This pilot study demonstrates the acceptability and potential role for psychological counselors in increasing adjustment in high-risk patients undergoing genetic counseling for inherited cancers.     

Predictors of Mental Health Among College Students in Guam: Implications for Counseling

The authors investigated sociodemographic predictors of the mental health status of college students (N = 308) in Guam. Results indicated prevalence rates of 17.8%, 40.2%, and 25.6% for moderate or more severe levels of depression, anxiety, and stress, respectively. Psychological distress was found to be predicted by gender, ethnicity, living arrangement, and academic level. Comparisons with college students in the U.S. mainland and Hong Kong were also examined. Implications for counseling services and strategies are discussed.     

An Exploration of Young Clients' Experiences in Counseling With Post‐Master's Counselors

This phenomenological study adds to current literature about clients' meaningful experiences in counseling by exploring the experiences of eight young clients (ages 8–18) in individual counseling with post‐master's counselors in an outpatient setting. Interviews with these clients revealed the following six themes: (a) the process of growth, (b) having a safe place to talk, (c) counselor accepts and meets the client where they are, (d) counseling is a team effort, (e) supportive accountability from the counselor, and (f) understanding self and others. The final theme includes two subthemes: learning coping and emotion management skills, and learning better ways to communicate and behave. Findings and implications for counselors are discussed.     

The Scope of Client Aggression Toward Social Workers in Israel

The phenomenon of client violence toward social workers has been documented in various parts of the world. The goal of this study is to describe the phenomenon and explore the relationship pattern between contextual variables and clients’ aggression. The study encompassed a sample of 645 workers in 34 municipal social service agencies. Of the entire sample, 80% reported being exposed to some form of aggression at least once over the last 3 months. The findings highlight 2 broad axes related to client aggressiveness: frequency and level of aggression. With respect to frequency, we can discern a continuum running from common types of aggressive behaviors to rare ones. The other axis focuses on the level of aggressiveness used, from minor types of client aggression, such as verbal assaults and threats, increasing to more severe ones, such as property damage, and, finally, to physical injury. The routineness of aggression in the work environment lends it the appearance of being normal, and functioning in such an environment desensitizes social workers to clients’ aggressiveness. Also examined and discussed are organizational and personal factors that contribute to the aggressive behavior of clients, including seniority, gender, workload, inadequate service conditions, and coworkers’ aggressive behavior.