Does psychopathology predict counseling duration?

Many university counseling centers have adopted case management policies in an effort to conserve limited resources. Fearing that students with more severe problems will consume too many clinical resources, many counseling centers have decided to refer such students to external agencies or providers for mental health services. However, this fear might be unwarranted because empirical research has not shown a substantial relationship between psychopathology and counseling duration. This investigation examined whether a new treatment-planning inventory, the Butcher Treatment Planning Inventory, might be useful for better understanding the relationships between various problem areas and counseling duration. Participants were new clients (students and staff members) at a university counseling center in the southeastern USA. Professional staff members and graduate students in counselor education, clinical psychology, and clinical social work provided counseling services to the participants. Lower scores on several scales predicted counseling duration. In other words, clients with lower scores on these scales (representing less psychopathology) attended more counseling sessions than clients with greater psychopathology. Therapists' background also predicted counseling duration; clients who worked with either a professional staff member or graduate student in counselor education attended more sessions than clients who worked with a graduate student in clinical psychology. The results of this study, combined with previous research, suggest that measures of psychopathology are not very useful for identifying which clients will complete long-term counseling. Until better information becomes available, actuarial tables remain the most efficient means for predicting counseling duration.     

The Student Counseling Virtual Pamphlet Collection: An innovative resource

Many university student counseling centers are now adapting pamphlets for the World-Wide Web, creating what the author refers to as virtual pamphlets. The author searched 52 university student counseling center Web sites, uncovered 200 virtual pamphlets, and brought them together as the Student Counseling Virtual Pamphlet Collection. In just a few months, there are already multiple indications that this innovative resource is considered valuable. Moreover, this paradigm can be applied, and different virtual pamphlet collections developed, to promote the education of clients who receive other mental health, general medical, or even non-health-related services.     

Counseling Older Adults with Dementia: A Survey of Therapists in Massachusetts

Although much has been written about therapeutic interventions with caregivers, little is known about the counseling services that are available for victims of dementia. The present study was designed to explore community mental health center (CMHC) services and therapists' experiences in providing psychotherapy to this population in Massachusetts. Only 27 of the 36 CMHCs in the state reported providing mental health services to older adults with a dementing illness. A survey of therapists who specialized in working with older adults found that the percentage of older adult clients estimated to have dementia averaged about half of their caseload. Older persons in the early phase of a dementing illness were most frequently referred for depression and anxiety, whereas those with moderate decline were most frequently referred for management of disruptive behavior. The most common services provided to clients with dementia consisted of assessment and individual counseling. The latter finding indicates a discrepancy between what is practiced and the professional literature. Most of the psychotherapy described in the literature concerns group interventions, which were rarely provided by the mental health centers in Massachusetts. The centers tended to offer individual counseling; however, little information on how to provide this form of treatment can be found.     

Prevalence of mental health problems in Australian university health services

General practice patients report greater mental health problems than the general population, and students attending one university health service have reported greater prevalence rates at the end of the academic year. This study assessed the overall prevalence rate of mental health problems in university students using a cross‐sectional survey design of 1,168 students from three large, predominantly urban, Australian university health services. Approximately half of the students attending university health services reported elevated levels of psychological distress. The majority of severely distressed students had not sought any professional assistance for mental health problems. While there is scope for general practitioners to take a lead role in the identification of mental health problems in tertiary students, adequate treatment pathways need to be available. Implications for the role of universities in prevention work are discussed.     

The Treatment of Substance‐Abusing Clients in Multiservice Mental Health Agencies: A Practice Analysis

This article examines the work behaviors related to counseling substance‐abusing clients by mental health service providers in multiservice mental health agencies. The results support the need for specialized knowledge and skills in working with substance‐abusing clients.     

School‐Based Health Centers: Implications for Counselors

School‐based health centers (SBHCs) have been established to provide comprehensive physical and mental health care and preventive services for students. Growing evidence of outcome effectiveness has spurred the rapid development of these centers. SBHCs have received little coverage in the counseling literature. This article provides a review of the issues and opportunities that SBHCs offer for the counseling profession.     

The Relation Between Masculine Role Conflict and Psychological Distress in Male University Counseling Center Clients

This is the first study to examine the relations between components of masculine gender role conflict and specific symptoms of psychological distress in a sample of men seeking counseling services. One hundred and thirty male clients from 2 university counseling centers completed the Gender Role Conflict Scale and the Symptom Checklist-90-Revised. Participants reported moderate to high levels of psychological symptoms, which were correlated with components of masculine role conflict. Results of simultaneous multiple regressions supported previous findings in nonclinical samples of relations between masculine role conflict and depression and interpersonal issues. In addition, masculine role conflict significantly predicted paranoia, psychoticism, and obsessive compulsivity. Implications for counseling and future research are discussed.     

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.     

Career development with transgender college students: implications for career and employment counselors

The number of transgender college students continues to increase every year. These students face unique challenges that many college and university career centers are not prepared to handle. This article describes some of the challenges facing trans‐gender students and college career centers. A professional development design is proposed to assist career professionals who work with transgender clients in college career centers and community mental health agencies. Implications for career and employment counselors are also provided.     

Independently Licensed Counselors' Work Values

Prospective clinical mental health counseling students need to know if their work values align with those of independently licensed counselors before investing their time and accumulating debt. Analyzing the work values of 463 independently licensed counselors in the United States, we found 89% expressing social (altruistic) work values and 22% expressing intrinsic work values. Independently licensed counselors want to help clients become fully functioning and self-actualized by maintaining unconditional positive regard, being congruent, and providing empathy. Clarifying these work values and their interaction can help prospective and current clinical mental health counseling students determine their future job role.     

Effects of client and counselor sex on client attendance at counseling

The present study examined the relationship between sex of client, sex of counselor, client's presenting problem, and the length of time the counseling dyad stayed together. Dyads engaged in personal counseling had significantly more sessions than dyads engaged in vocational counseling or test feedback. Clients receiving personal counseling were more likely to terminate unilaterally than clients receiving vocational counseling or test feedback.A preliminary version of this article was presented at the meeting of the American Psychological Association, Montreal, September 1980.     

Multicultural Issues in Predoctoral Internship Programs: A National Survey

The present study examined the extent to which internship training directors (ITDs) addressed multicultural issues in their predoctoral training programs. Regarding the overall sample, ITDs reported varied levels of attention to specific multicultural issues. By internship agency type, ITDs at university counseling centers reported significantly greater attention to multicultural issues than did ITDs at community mental health centers, state hospitals, medical schools, and private psychiatric hospitals. Results clearly indicated the need for increased attention to multicultural issues in all internship programs.     

Assessing general maladjustment with the MMPI-2

The validities of 7 MMPI-2 (Butcher, Graham, Ben-Porath, Tellegen, & Kaemmer, 2001) measures of general maladjustment were compared using a composite criterion measure based on self-reported symptom severity and clinicians' ratings of symptom severity and level of functioning. Participants were 274 male and 425 female clients at a community mental health center and 105 male and 247 female clients at a university psychological clinic. All MMPI-2 measures were significantly related to the composite criterion measure for both male and female clients in both settings. The mean score on 8 clinical scales (M8) consistently was the best indicator of maladjustment. Although other MMPI-2 measures sometimes added significantly to the variance accounted for in the criterion measure, increments were small and probably not clinically meaningful. However, M8 added significantly and meaningfully to each of the other MMPI-2 measures in predicting maladjustment. Implications for using the MMPI-2 to assess general maladjustment in outpatient mental health settings are discussed.     

United States and Japanese college students' attitudes toward seeking professional psychological help

The purpose of the study was to find how nationality, sex, and past experience of seeking professional psychological services are related to attitudes toward seeking professional psychological help. Three hundred Japanese college students and 300 US college students responded to the Attitudes Toward Seeking Professional Psychological Help (ATSPPH) questionnaire. The ATSPPH consists of four subscales: Need (recognition of need), Stigma Tolerance (the degree of tolerance against stigma associated with help‐seeking action), Openness (interpersonal openness), and Confidence (confidence in mental health professionals). As predicted, past experience of seeking professional psychological service and sex were important predictor variables of performance on the ATSPPH scales. Those who had past experience of seeking professional psychological help had more favourable attitudes toward seeking professional psychological help than those who never consulted psychological professionals. Similarly, in testing the past experience separately with the two nation groups, past experience with seeking professional psychological services was found to be a predictor of the overall attitudes toward seeking professional psychological help among Japanese and US participants. Furthermore, Japanese participants with past experience also showed greater recognition of need for professional psychological help and confidence in psychological health professions than Japanese without past experience. The degree of stigma tolerance associated with help‐seeking behaviour and the tendency of interpersonal openness, however, did not differ between Japanese participants with and without the past experience of seeking professional psychological services. The same results were also found among the US participants. In terms of sex as a predictor variable, females tended to have more positive attitudes toward seeking professional psychological help than males. There was a significant nationality by sex interaction effect. US females had significantly more favourable attitudes than the other three groups, indicating that there was sex difference in help‐seeking attitudes in the US group, but not in the Japanese group. If the sex variable is ignored, Japanese students have less favourable overall attitudes toward seeking professional psychological services than US students. Other results and limitations of the study are discussed.     

Premature Termination from University Counseling Centers: A Review

Many clients leave counseling prematurely (i.e., without their counselors' agreement). Understanding premature termination is crucial to the effectiveness and efficiency of the counseling enterprise. The authors review research on client attrition from university counseling centers, explore implications for practice, and offer suggestions for future research. Methodological problems and sparse data on some variables preclude firm conclusions, although there are some promising directions, such as theory-based studies, exploration of cognitive-expectancy factors, and client-counselor interaction research. It is becoming increasingly clear that premature termination is not a unitary phenomenon and that dropouts are a heterogeneous group, suggesting the need for greater conceptual and methodological precision in the study of counseling attrition.     

Employment and Roles of Counselors in Mental Health Agencies

The authors studied the employment of counselors with master's degrees in multiservice mental health agencies. The study focused on the types of clients seen, the direct care services provided, and the administrative duties performed. Results suggested that the employment of counselors does not differ significantly from the employment of individuals with master's degrees in psychology and social work. Also, the data indicated that counselors are delivering direct care services that traditionally have been offered in mental health centers, that clients seen by counselors demonstrate a range of mental disorders, and that counselors are responsible for fulfilling various administrative duties.     

GENDER AND SERIOUS MENTAL ILLNESS: A Feminist Perspective

Perhaps in reaction to criticisms of "woman as problem" formulations, psychological literature has nearly ignored women with serious mental illnesses (SMI), although epidemiological research indicates that women are overrepresented in these diagnoses. Data are presented on characteristics, functioning, and services received for a sample of nearly 2,500 SMI clients. Statistical clustering of clients with similar profiles produced four out of six clusters with significant differences in proportions of female versus male clients represented. The results indicate that the extent to which SMI clients display gender-related symptoms and behaviors is a significant factor in clinician perceptions and in service utilization. However, results also show substantial overlap in gender composition of the clusters. Discussion centers on the quality of care and appropriateness of services for female clients. Future research is suggested, utilizing a feminist understanding of women's diversity and of sociopolitical factors related to mental health.     

Inter- and intra-group differences in psychological concerns among international students

With data gathered from 47 university counseling centers in the United States, this study addresses both inter- and intra-group differences in symptomatology at intake among international students. In Study 1, symptomatology among international students was explored in comparison to US ethnic groups. In Study 2, intra-group differences in symptomatology among international students were examined. In Study 1, data consisted of 14,421 international, White American, African American, Asian American, and Latina/Latino American counseling center clients who completed the CCAPS-62 at intake. Partially supporting our hypothesis, results indicate significant findings among international students in the social anxiety and academic distress domains of the CCAPS-62. Contrary to our expectations, Asian American students reported significantly greater concerns across many domains when compared to other groups. In Study 2, international students (n = 607) were further divided into five continents of origin: Asia, Africa, North America, South America, and Europe. Results indicate that in multiple domains, international students from Asia and Africa reported significantly greater concerns than those from Europe, North America, or South America. Implications of findings for university counseling centers and universities at large are discussed.     

University Counselling Services in Australia and New Zealand: Activities,Changes, and Challenges

The high prevalence of stress and psychological distress in university students highlights the need for adequate support services to enable students to achieve their goals. This study aimed to describe counselling services available to university students in Australia and New Zealand and to benchmark them against international services. Participants were five Australian and three New Zealand Counselling Services. Results showed that counselling services are using a variety of formats and e‐technologies to deliver services to students, but are hampered by limited resources compared with their international counterparts. These include very high counsellor student ratios, lower average number of consultations per student, and lower mental health qualifications of counsellors. This has even greater implications in the context of higher education reform in Australia that may further widen the gap between needs of students and available counselling services. Inadequate counselling support can negatively impact on students, universities, and the community through lost potential.     

Serving Clients With Hearing Loss: Best Practices in Mental Health Counseling

This article examines the risk factors and characteristics of clients with hearing loss, including inequitable access to education and mental health care services, financial barriers, communication problems, and societal discrimination. Culturally specific counseling approaches and techniques for mental health counselors serving clients with hearing loss are presented, with a focus on building counselor competency and client employment skills. The use of interpreters in therapeutic settings is also discussed.