咨询期望与人格特质的相关性及对临床心理干预的启示

本研究探析了人格因素与咨询期望的相关性及对临床工作的启示.通过方便抽样选取样本348人,用心理咨询预期简表、卡特尔16项人格因子问卷进行调查.咨询期望在性别之间无差异,心理咨询中的个人承诺与聪慧性、稳定性等人格因子呈正相关;与怀疑性、忧虑性等呈负相关.对咨询师专业性的期待与乐群性、稳定性等人格因子呈正相关;与怀疑性、忧虑性等呈负相关.人格中的有恒性、聪慧性等对个人承诺有正向影响,而忧虑性、怀疑性对其有负向影响.有恒性、乐群性对专业性期待有正向影响,而忧虑性则产生负向影响.在临床心理咨询中要想达到理想效果,需要依据来访者的人格特点,评估并适时调整咨询期望.     

Expectation and burnout in the developmental disabilities field

Psychological burnout was assessed in staff members at workshops and community residences for the developmentally disabled. Participants also rated expectations for client progress and for their own contribution to clients. They reported on change in expectation since they entered the field. High expectations were related to low burnout; workers who reported experiencing large negative expectation change were most burned out. Burnout seemed to be prevented when staff members made an expectation shift from reliance on client progress to a sense of personal efficacy. This finding is discussed in terms of personal causation, internal control of reinforcement, and adaptation-level theory. There was little evidence of client depersonalization, a usual component of burnout. Such a burnout pattern may be a function of the ethic of community care for the developmentally disabled.     

Evaluating Genetic Counseling: Client Expectations,Psychological Adjustment and Satisfaction with Service

Periodic evaluations of genetic counseling services are useful for determining the effectiveness of counseling in meetings its psycho-educational aims, as well as identifying where improvements to the service may be made. This study aimed to evaluate the genetic counseling services provided by Genetic Services of Western Australia (GSWA) to determine the impact of counseling on client expectations, satisfaction with the service, and psychological adjustment, defined as wellbeing and perceived personal control (PPC). A total of 122 clients participated in a self-administered survey conducted pre- and post-counseling. Client expectations of the service as a means of providing information were met, and opportunities for counselors to meet client’s expectations of psychological support were identified. Furthermore, counseling was found to maintain and enhance psychological wellbeing of clients. The role of counseling in facilitating the development of PPC was a key contributor to a high sense of satisfaction in clients.     

Persuasibility and the power of belief

Recent empirical and theoretical developments suggest that clients who genuinely believe in the effectiveness of counseling are likely to improve regardless of the validity of the counselor's approach. This improvement is based on a “psychological placebo effect” that arouses client expectations for improvement and provides clients with additional security and self-confidence to deal with life more effectively. These considerations are discussed in the context of placebo reactivity, client susceptibility to persuasion, and counselor expectations for client improvement.     

Client Adherence to Asian Cultural Values,Common Factors in Counseling,and Session Outcome With Asian American Clients at a University Counseling Center

Based on data from 61 Asian American clients at a university counseling center, the study found that client‐perceived match on client‐counselor belief about problem etiology was related to counselor credibility, empathy, and cross‐cultural competence; the client‐counselor working alliance; session depth; and the likelihood of the client recommending the counselor to another client. An interaction effect showed that both strong match on belief about problem etiology and high client expectation for counseling success were associated with strong client‐counselor working alliance.     

The counselor perspective on the use of directives in counseling in China: Are directives different in China as in the United States?

Eight Chinese counselors were interviewed about their use of directives in counseling. They typically believed that directives can be beneficial in counseling Chinese clients. They used directives to extend the influence of counseling beyond sessions, meet client needs and expectations, and fit their own personality and orientation. In terms of conditions that need to be met for directives to be helpful, they identified client factors such as readiness, communication styles, past experience, and insight; the counselor factor of ability to communicate directives; and the therapeutic relationship. They emphasized the importance of clients acquiring a new perspective as a result of directives. Cultural factors in using directives are discussed.     

Life Design Counseling: A study on client's operations for meaning construction

This study evaluated the adequacy of the micro-theory of client operations to explain meaning construction during Life Design Counseling. Four adolescents were interviewed about their second counseling session. Their recollections were stimulated through the replay of counseling videotapes. The resulting transcribed interviews were qualitatively analyzed. Results confirmed a sequence of client operations evolving from the symbolic representation of experience and reflexive self-examination towards making new realizations and revisioning self. Moreover, clients reported negative and positive session moments evidencing that clients' attention and activity during the session was not restricted to meaning construction operations. Practical implications for life design counseling are derived from the results and discussed.     

Genetic Counseling for Personal Genomic Testing: Optimizing Client Uptake of Post-Test Telephonic Counseling Services

The field of genetic counseling faces a broad challenge: many potential clients may not be aware of the value and benefit of genetic counseling services, and therefore may not utilize those services. Navigenics is a personal genomic testing company that provides telephonic genetic counseling services for multifactorial diseases and pharmacogenetics. When first offered in 2008, utilization of the Navigenics genetic counseling service was less than expected. To explore the basis for under-utilization and potential mechanisms for increasing uptake, Navigenics initiated a quality improvement study, in which three different methods of engaging clients in the uptake of genetic counseling services were assessed over the course of 1 year. Outcomes showed significant differences in uptake rates between methodologies (7.5%, 24.6%, and 60.1%), yielding an 8-fold increase in service utilization when post-test telephonic outreach to all clients was performed. Further, utilization spanned all risk levels based on client results, evidence that not only clients with high-risk results were motivated to engage in the genetic counseling service. This research indicates that implementing strategies to educate clients about genetic counseling can positively impact client engagement and utilization of available services.     

当事人的投入与会谈效果、咨询效果的关系研究

本研究探索了当事人会谈时的投入与即时会谈效果的关系;当事人咨询初期的投入与整体咨询效果的关系。结果发现当事人会谈时的投入与即时会谈效果、在咨询初期的投入与整体咨询效果都呈现显著的正相关。进一步回归分析发现,当事人在咨询初期的投入与整体咨询效果呈现正U型的偏态分布,少数投入水平最低的当事人获得中等水平的咨询效果,中等投入水平的当事人咨询效果最差,投入水平最高的当事人的咨询效果最好。     

会谈中的当事人阻抗及工作同盟的影响因素:一项过程研究

从心理咨询过程研究视角,以38个会谈为对象,考察咨询师指导和当事人特质逆反对当事人阻抗的影响,并检验三者对工作同盟的影响。结果:指导正向预测阻抗,特质逆反则不能,二者的交互作用也不显著;阻抗负向预测工作同盟,指导则不能,二者的交互作用和中介作用都不显著,但阻抗的中介效应相对更大。结论:咨询师指导增加当事人阻抗;当事人阻抗破坏工作同盟,并在咨询师指导对工作同盟的影响过程中可能起中介作用。     

Career counseling meets motivational interviewing: A sequential analysis of dynamic counselor–client interactions

Motivational Interviewing (MI) is a client-centered communication style with the aim to resolve client ambivalence within a change-related counseling. Its potential benefit for career counseling has been discussed by several scholars but no empirical research has investigated MI in this context so far. The current study used process measures from MI to investigate dynamic interactions within a career counseling intervention. Overall, we analyzed two videotaped sessions of 14 unique counselor–client dyads. Verbal behavior of counselors and clients were coded with two observational coding schemes from MI (one for counselors and one for clients, respectively). Behavior profiles of counselors were compared with benchmarks of good MI. Furthermore, client verbal ambivalence was compared between sessions. Finally, we conducted lag sequential analyses to analyze temporal dynamics between counselor behavior and immediate client verbal responses across N = 6883 behavioral events. Our results showed, first, behavior profiles of career counselors did significantly differ from recommended counseling benchmarks of good MI practice. Second, as assumed on the basis of past studies, client ambivalence decreased across sessions. Third, MI consistent counselor behaviors showed a positive sequential association with client positive career talk, whereas MI inconsistent counselor behaviors showed the reverse pattern. Our results suggest that counseling behaviors recommended from MI are facilitating career interventions. We discuss how trainings in MI could amend career counseling interventions and provide ethical implications when integrating MI into career counseling programs.     

Predicting Dropout in Counseling Using Affect Coding of the Therapeutic Relationship: An Empirical Analysis

This study used an observational research method to examine affective counselor–client exchanges during the initial session of counseling for clients who dropped out of counseling and clients who remained in counseling. Results confirmed significant differences in the affect codes of clients and counselors between the 2 groups. Discriminant function analyses classified 77% of counselors and clients in the correct groups and correctly classified over 94% of clients who returned for 4 or more sessions.     

Counselors Under Fire: Youth Opportunity Centers

Intensive interviewing of counselors, supervisors, clients, and community workers associated with a sample of Youth Opportunity Centers led to the conclusion that assumptions of client-centered therapy are untenable in such settings. The assumptions not found tenable are: (a) client comes voluntarily; (b) client wants help; (c) client accepts counselor's authority; (d) client comes as individual; (e) counselor accepts client. Because of bureaucratic conditions of government programs, because of poverty and demoralization of clients, and because of race and other differences, counseling (except of a highly directive sort) is not possible. A group approach which takes into account the organized nature of the client population is personally recommended and described.     

Exploring Counselor-Client Agreement on Clients’ Work Capacity in Established and Consultative Dyads

Counselor-client agreement on the work capacity of clients living with serious mental illnesses informs the counseling relationship and facilitates accurate assessments of client eligibility for public programs. In this exploratory mixed-methods study, we assessed counselor-client agreement on clients’ work capacity in 61 established therapeutic dyads and compared it with 30 dyads involved in an initial assessment session. Intraclass correlation coefficients and mountain plots were used to examine counselor-client agreement. Results revealed moderate counselor-client agreement of work capacity for both dyads. Counselor interviews illuminated sources of discordance. These results have practical implications for assessing the work capacity of clients.     

The Use of Preliminary Information in Vocational Counseling

One hundred twenty-one clients seeking vocational counseling were assigned to three experimental groups representing audio, visual, and audiovisual methods of information presentation, or to a control group. After exposure to information relevant to their concerns, they were given an opportunity to return for a regular appointment. The audio and visual methods differed significantly in terms of percent of those who returned (audio = 69 percent, visual = 39 percent). Returnees in the visual group averaged fewer counseling sessions although the differences were not statistically significant. In general, returnees had indicated a somewhat greater number of problem areas and more frequently were sophomores and seniors. Results suggest that tape recordings (audio method) tend to induce clients to return for further counseling more readily than does the same information in mimeographed form (visual method). The likelihood of a client returning is seen as a function of the type and urgency of the problem as well as the preliminary information he receives.     

Does Motivational Interviewing (MI) Work With Nonaddicted Clients? A Controlled Study Measuring the Effects of a Brief Training in MI on Client Outcomes

This study investigated the relationships between motivational interviewing (MI) and client symptoms, attendance, and satisfaction. Seventy‐nine clients attending a university‐based counseling center were purposefully assigned to treatment or control conditions. Statistical analyses revealed client symptoms in both groups improved. However, clients assigned to treatment conditions attended more sessions and missed fewer sessions than clients in the control group. Implications for using MI and suggestions for additional research are explored within the study.     

Latent profiles of work motivation in adolescents in relation to work expectations,goal engagement,and changes in work experiences

Motivation plays a key role in successful entry into working life. Based on a cross-sectional and a one-year longitudinal study, we used a person-centered approach to explore work-related motivation (i.e., autonomous goals, positive affect, and occupational self-efficacy) among 577 students in 8th grade (Study 1) and 949 adolescents in vocational training (Study 2). Based on latent profile analysis, in both studies we identified four groups that were characterized by different levels of overall motivation and one group characterized by low positive affect and mean levels in autonomous goals and self-efficacy. Profiles characterized by high levels of motivation showed the highest levels of positive work expectations and goal engagement and the lowest levels of negative work expectations in Study 1 and the highest levels of person-job fit, work engagement, and job satisfaction in Study 2. Moreover, latent difference score analysis showed that motivational profiles predicted changes in person-job fit and work engagement across one year but not in job satisfaction. The results imply that career counselors should be aware of characteristic motivational patterns of clients that may require specific counseling approaches.     

Spa in Counseling

A place may be made in nearly every counseling session for spa: uplifting, positive experiences in which the focus is placed directly on helping clients feel good about themselves. With many clients, a few minutes at the end of each interview may be saved for these positive experiences; with some clients the entire effort of an individual session may be that of spa. The simplest of the several examples of spa in counseling offered in this article is the activity “Things I Can Do,” in which the counselor helps the client focus on and savor some of the most often-repeated actions of which he or she is capable: breathe, walk, talk, eat, sleep, think, and so on. All counseling clients can benefit from the emerging sense of wellness that can come from spa in counseling.