Health Beliefs,Religious Values,and the Counseling Process: A Comparison of Counselors and Other Mental Health Professionals

A. E. Bergin (1985) studied the religious values and beliefs of mental health professionals and the relationship of those values to the counseling process. This study replicated Bergin's research with a sample of professional counselors. Differences were found in each of 10 beliefs areas and 10 values areas between the total sample in both studies. Within-group differences revealed greater similarities between professional counselors and social workers and marriage and family therapists and greater differences between counselors and either psychologists or psychiatrists. Implications for counseling and counselor training are discussed.     

Privileged Communication in Selected Helping Professions: A Comparison Among Statutes

The authors present findings of an examination and assessment of existing privileged communication statutes and rules of evidence in the 50 states and the District of Columbia for clients of selected helping professionals: psychologists, social workers, marriage and family therapists or counselors, school counselors, and licensed professional counselors. Data are reported regarding the extent to which each of these professional groups has succeeded in establishing that their clients' communications with them are entitled to legal privilege, the scope of privilege extended, and specified exceptions to privilege. The report concludes with implications and suggested guidelines for practice.     

Violence: Incidence and Frequency of Physical and Psychological Assaults Affecting Mental Health Providers in Georgia

Threats to the physical safety and psychological well-being of mental health professionals present serious problems, according to 1,131 licensed mental health professionals in the state of Georgia. The professionals included clinical social workers, marriage and family therapists, professional counselors, psychiatrists, psychologists, and social workers. From a total of 6,431 surveys sent out, 1,131 (18%) were returned. The results revealed 2,696 separate accounts of 14,120 acts of physical or psychological assaults committed by 8,292 perpetrators. The results also showed that 61% of the respondents had been victimized in violent acts of a psychological or physical nature and that 29% had feared for their lives at least once during their professional careers. These data are consistent with other research that indicates that 6 out of 10 professionals will be assaulted during their professional careers.     

Violence: incidence and frequency of physical and psychological assaults affecting mental health providers in Georgia

Threats to the physical safety and psychological well-being of mental health professionals present serious problems, according to 1,131 licensed mental health professionals in the state of Georgia. The professionals included clinical social workers, marriage and family therapists, professional counselors, psychiatrists, psychologists, and social workers. From a total of 6,431 surveys sent out, 1,131 (18%) were returned. The results revealed 2.696 separate accounts of 14,120 acts of physical or psychological assaults committed by 8,292 perpetrators. The results also showed that 61% of the respondents had been victimized in violent acts of a psychological or physical nature and that 29% had feared for their lives at least once during their professional careers. These data are consistent with other research that indicates that 6 out of 10 professionals will be assaulted during their professional careers.     

Somatoform Disorder: Treatment Utilization and Cost by Mental Health Professions

Administrative data from Cigna for 149 somatoform cases were analyzed to determine the cost, number of sessions, dropout rates, and recidivism rates. Comparisons on these outcomes were made between medical doctors, psychologists, master’s nurses, master’s social workers, marriage and family therapists, and professional counselors. Recidivism rates and number of sessions are higher than for other mental health problems. There were no significant difference in total cost by profession, but did indicate a significant difference in cost per session for MDs. Analyses indicate that masters and doctoral level providers produced the same drop out and recidivism rates.     

Psychologists' and social workers' self-descriptions using DSM-IV psychopathology

There is limited information on mental health of psychologists and social workers despite their rendering mental health services, so their subjective perception of mental disorder was explored via a self-evaluation survey in which they self-diagnosed the presence of DSM-IV disorders within themselves. The sample of 128 professionals included 63 psychologists and 65 social workers. The presence of Axis I traits was reported by 81.2%, the three most frequent traits being mood, obsessive-compulsive disorder, and eating disorder. Axis II traits were reported by 73.4% of subjects, the three most frequent conditions being narcissistic, avoidant, and obsessive-compulsive personality traits. While a high percentage of subjects reported the presence of either an Axis I or Axis II disorder, the average severity reported was low. More psychologists reported on mood, social phobia, and eating problems than social workers, while the latter reported more on psychotic problems. Psychologists reported more Axis II traits, especially paranoid, narcissistic, and avoidant subtypes. More women than men reported eating problems, while more men reported schizoid and avoidant personality traits. In conclusion, manifestations of subthreshold psychiatric conditions were prominently reported. These findings suggest encouraging mental health care professionals to explore treatment for problems if present.     

The Credentialing of Professional Psychologists and Its Implication for the Other Mental Health Disciplines

Professional psychology was the first mental health profession to challenge the preeminence of psychiatry and in so doing blazed the trail for clinical social workers, mental health counselors, marriage and family therapists, and addiction counselors. Social work has followed one decade behind psychology's footsteps, and the other rapidly emerging mental health professions are not too far behind social work. This article reviews the lessons learned by professional psychology when it adopted the strategy of statutory regulation, freedom of choice, control of its own training and of its national organization, and future strategies for Medicare and eventually for the enactment of universal health care. These lessons are important to the professions following psychology.     

Profession Differences in Family Focused Practice in the Adult Mental Health System

There is a large gulf between what psychiatric services should (or could) provide and what they do in practice. This article sought to determine practice differences between the differing professions working in adult mental health services in terms of their family focused work. Three hundred and seven adult mental health professionals completed a cross‐sectional survey of family focused practices in adult mental health services. Findings highlight that social workers engaged in more family focused practice compared to psychiatric nurses, who performed consistently the lowest on direct family care, compared to both social workers and psychologists. Clear skill, knowledge, and confidence differences are indicated between the professions. The article concludes by offering direction for future profession education and training in family focused practices.     

The Cognitive-Developmental Approach and the Practicing Counselor: An Opportunity for Counselors to Rethink Their Roles

At the present time, psychologists who describe the stages of human growth concur on the importance of cognitive elements, although they also recognize the affective and social components of development. Kohlberg's thinking was influenced by the work of Dewey and Piaget, and has been confirmed by his longitudinal study of 50 Chicago boys and by numerous other researches throughout the world. In his conception, discussions of moral problems (dilemmas) are the basis for moral growth. Through them the less mature become aware of the perspectives of those who have reached a higher level of moral judgment. These ideas and practices have been applied with young people in The Cluster School in Cambridge, Massachusetts, where the ideas of justice for all and fairness have become the real themes of the school. The authors' challenge to counselors as consultants and facilitators is one of becoming deliberately involved in the value and moral growth of students. Allen E. Ivey reacts to this article by urging a value-centered advocacy model for counselors.     

Exposure therapy for social anxiety disorder in people who stutter: An exploratory multiple baseline design

Background & objectives: Social anxiety disorder (SAD) is a debilitating condition, and approximately half of adults who stutter have SAD. Cognitive-behavioral therapy (CBT) has shown promise in decreasing social anxiety symptoms among adults who stutter, but exposure, arguably the essential component for successful CBT for SAD, has been understudied and underemphasized. Aims of this study were to develop an exposure therapy protocol designed specifically for people who stutter and have SAD and evaluate its potential efficacy in reducing social anxiety and stuttering severity using a multiple baseline design.Methods: Six participants received ten sessions of exposure therapy. Participants reported daily social anxiety, and social distress and stuttering severity were evaluated at major assessment points.Results: There were substantial reductions in social anxiety and considerable improvements in affective, behavioral, and cognitive experiences of stuttering. No consistent change was observed for stuttering frequency. Gains were mostly maintained after six-months.Conclusions: Results suggest that the novel exposure approach may decrease social distress, but not necessarily influence speech fluency. These findings underscore the importance of the assessment and treatment of SAD among adults who stutter and suggest that the integration of care between clinical psychologists and speech-language pathologists may prove beneficial for this population.     

焦虑障碍的系统式家庭治疗

焦虑障碍是最常见的心理障碍之一.其具有症状重、病程慢、复发率高、社会功能明显缺损等特点,给个人、家庭和社会造成了巨大的负担.家庭环境因素在焦虑障碍的发病、转归和预后方面都起到重要作用.本文介绍了国内外关于焦虑障碍患者家庭特点和家庭互动模式的研究结果.系统式家庭治疗作为一种家庭治疗模式,具有其独特的治疗理念和方法,国内外研究结果表明系统式家庭治疗用于焦虑障碍具有良好疗效.今后,还应该运用更加多元化的研究方法探讨中国焦虑症家庭动力学特点和家庭功能,并采用更加严格的随机对照设计,进一步证实系统式家庭治疗对焦虑障碍的治疗效果.     

The Counselor Is a Psychologist

School counselors are anxious about their status and identity as professional workers. They are criticized by other helping professions for their superficiality, and they are being dispossessed of their basic helping functions by school psychologists and social workers. Solutions proposed are abandonment of the guidance model for counselors, and adoption of the counseling psychologist model geared to a two-year master's degree level. Counselors are being called upon increasingly to function as psychological specialists in behavior change and their training has become firmly based in the psychological aspects of behavioral science. Statements by the American School Counselors Association and a growing number of counselor educators emphasize the psychological base of counseling practice.     

Supervision Needs of Correctional Mental Health Counselors

Supervision of mental health counselors and psychologists is a developing field within psychology. Supervision models and needs are being researched and defined. Supervision for correctional mental health counselors and psychologists is an important part of correctional psychology, but has received very little research attention. There are many aspects of correctional psychology that are unique from the field of psychology as a whole; this is certainly true for supervision of correctional mental health staff. This article examines the supervision needs of correctional mental health counselors and psychologists. An application of one supervision model to correctional psychology is presented.     

Development of Family Therapy in Ireland

In Ireland family therapy is a small profession, with under 200 registered therapists. The Irish family therapy movement began in the mid-1970s. By 1980 the Family Therapy Network of Ireland in the Republic of Ireland and the Northern Ireland Branch of the UK Association Family therapy had been founded. At present there are three main family therapy training centers in Ireland: two in the south (the Mater University Hospital, affiliated to University College Dublin and Clanwilliam Institute) and one in the north (at Queen’s University Belfast). There is no statutory registration and licensing of family therapists in Ireland. Accredited professional family therapy programs in Ireland are 4-year part-time courses culminating in masters level qualifications. A primary degree in medicine, nursing, psychology, social science or education is a prerequisite for entry. Family therapists in Ireland work in both private practice and the public health service. Most family therapists in the public sector are employed as social workers, psychologists, psychiatrists or nurses, and conduct family therapy as part of their broader professional roles. Couple therapy in Ireland is provided by family therapists, and also by voluntary couple counselors based in networks of local centers, some of which were originally religiously affiliated, without a formal connection to national family therapy associations. The three major future challenges for Irish family therapy are creating a research infrastructure, developing a career structure in the public health service, and introducing statutory registration.     

Knowledge and Beliefs about Bulimia Nervosa and its Treatment: A Comparative Study of Three Disciplines

Poor Mental Health Literacy (MHL), i.e. knowledge and beliefs about bulimia nervosa (BN), among health professionals may contribute to low rates of recognition and less optimal management. The aim of this study was to investigate the BN-MHL of health professionals. A total of 534 professionals selected randomly from Internet based lists were surveyed with a MHL questionnaire regarding a fictional vignette of a woman with BN. One hundred and thirty-six dieticians, 68 psychologists and 97 counselors, total 56% (n = 301) responded. The majority of respondents indicated the woman in the vignette suffered from BN (49%) or an eating disorder (20%) and endorsed evidenced based approaches. On post hoc between group analyses there was a trend (p = .02) for dieticians and psychologists to be more likely than counselors to accurately identify the diagnosis of BN. Dieticians and psychologists were also more likely than counselors to endorse a psychologist as the most helpful treatment provider (p<.001) and to be more likely to endorse cognitive behavioral therapy as the most helpful treatment (p<.001). These results indicate a need for greater training and support for non specialist primary care health professionals.     

Families in Crisis

Abstract

Families are in crisis. With an increasing array of problems affecting children in the home, from child abuse to familial alcoholism, schools are facing a vast array of behavioral and emotional concerns affecting childhood behavior. Unfortunately, many negative behaviors are learned at home. Violent and aggressive behaviors, for example, as well as drug and alcohol abuse, are often demonstrated by parents. From a community perspective, schools are in a pivotal position from which to intervene. Yet, many school-based mental health professionals, including school psychologists, school counselors, and school social workers, lack the knowledge to provide direct interventions. This article examines contemporary problems facing families, considers the home-school linkage, and explores interventions for schools and school-based mental health professionals.