Psychological counseling as an adjunct to stuttering treatment: Clients’ experiences and perceptions

PurposeStuttering can trigger anxiety and other psychological and emotional reactions, and limit participation in society. It is possible that psychological counseling could enhance stuttering treatment outcomes; however, little is known about how clients view such counseling. The purpose of this study was to gain an understanding of clients’ experiences with, and perceptions of, a psychological counseling service that was offered as an optional adjunct to speech therapy for stuttering.MethodNine individuals who stutter (13-38 years old) participated in semi-structured interviews. Six participants had taken part in psychological counseling; three participants did not do so. Interview data were analyzed using grounded theory as a guiding framework.ResultsFour thematic clusters emerged from participants’ accounts: insights into personal decision-making, why others may not participate in counseling, psychological counseling as a worthwhile part of therapy, and counseling as a necessary component in a stuttering treatment program.ConclusionIn addition to experiencing barriers and facilitators to help-seeking that are reported in related fields, participants accounts also revealed novel facilitators (i.e., a ‘why not’ mentality and the importance of having a pre-existing relationship with the clinician who offered the service) and barriers (i.e., viewing the service as a ‘limited resource,’ and, the overwhelming nature of intensive stuttering treatment programs). Findings suggest that clients value the option to access psychological counseling with trained mental health professionals to support the stuttering treatment provided by speech-language pathologists. Participants made recommendations for the integration of psychological counseling into stuttering treatment programs.     

A Review of: “Pamela J. Burry's Living with “The Gloria Films”: A daughter's memory.”

Abstract

This article examines alternatives for using language and discourse in clinical practice. The goal is to deconstruct deficit language and move toward a competency based psychological service. Deficit and pathology, the native tongue of psychotherapy, tend to initiate permanent stigmatizing patterns of social interaction which further marginalizes clients. This article deconstructs the taken‐for‐granted assumptions and discourses that underpin deficit‐based practice. Through the process of rediscoursing and re‐inventing therapeutic languages, therapists can reverse the self‐sustaining feedback loop initiated by deficit focus. These changes transport possibilities and personal agency into postmodern practice.     

Asociality and engagement in adult offenders in substance abuse treatment

In therapeutic community models for drug treatment, individual recovery is principally structured around group meetings and positive peer influences. Research shows that asocial group members with resistant behaviors and attitudes are at risk for poor treatment outcomes and have the potential to adversely impact the therapeutic group. To gain a better understanding of the asocial client's role in the larger treatment process, in-prison treatment data were used: (1) to model and confirm a two-factor solution of asociality consistent with the literature, and (2) to examine the relationship between asocial clients and treatment engagement for validation of the two-factor model. Exploratory analysis resulted in a three-factor solution representing behavioral responsivity, cognitive distortion, and social disassociation dimensions. Nested ANOVA (i.e., clients nested within prison programs) demonstrated that asocial levels (low, medium, and high risk) predicted treatment engagement. Furthermore, comparisons among asocial risk levels indicated that high asocial clients reported significantly lower engagement levels when compared with low and medium asocial clients. Copyright ? 2012 John Wiley & Sons, Ltd.     

Differential associations of leisure music engagement with resilience: A network analysis

Background/ObjectiveSeveral factors associated with resilience as the maintenance of mental health despite stress exposure can be strengthened through participation in leisure time activities. Since many people listen to or make music in their leisure time, the aim of the present study was to provide insights into the architecture of how resilience relates to passive and active music engagement.Method511 participants regularly listening to and/or making music completed an online survey on resilient outcomes (i.e., mental health and stressor recovery ability), different resilience factors (e.g., optimism, social support), quantitative music engagement (i.e., time spent with music listening/making) and qualitative music engagement (i.e., use of music listening/making for mood regulation).ResultsBivariate correlations showed that subjects spending more time with music making reported better stressor recovery ability and less mental health problems, while partial correlational network analysis revealed no unique associations for quantitative music engagement. Regarding qualitative music engagement, people using music-based mood regulation reported lower mental health, mindfulness, and optimism, but also higher social support. A more heterogeneous pattern emerged for single music-based mood regulation strategies.ConclusionsOur findings highlight the importance of the individual (mal-)adaptive use of music, painting a more nuanced picture of music engagement and resilience.     

A follow-up study on students attending a university counselling service in Northern Italy

The aims of this study were to evaluate the effectiveness of a university counselling service in Northern Italy, to assess the sociodemographic and clinical characteristics of students who used counselling service, and to assess the psychological conditions of the students who ended the counselling after a 4 month follow-up period. The study involved 100 students, who filled out the General Health Questionnaire (GHQ-12), the Brief COPE Inventory, and the Symptom Checklist-90-Revised (SCL-90-R). The results showed that who received counselling were positively affected by this experience. The areas of benefit were psychological well-being, coping behaviours, ability to positively reframe problems and less sense of guilt. Additional studies are needed to identify which factors influence the outcomes of university counselling services in Italy. These studies would be important to evaluate the services rendered, upgrade the skills of counsellors and visualise priority areas of need.     

A multilevel job demands–resources model of work engagement: Antecedents,consequences, and boundary conditions

ABSTRACT

Grounded on the Job Demands–Resources model, the present study conducted 2 studies to test a multilevel model of work engagement. Using data from 606 leader–employee pairs taken from 40 gas stations of a petroleum company, and a 3-wave data from 145 service teams and 542 leader–employee pairs from a variety of service organizations, convergent evidence suggested that (a) the unit leaders’ autonomy-support climate and psychological capital lead to service performance through work engagement and (b) psychological capital could attenuate the positive effect of unit leaders’autonomy-support climate on work engagement. In addition, the unit leaders’ autonomy-support climate acts as a job resource for boosting work engagement when both workloads and emotional demands or job insecurity are high.     

Support for distracted driving laws: An analysis of adolescent drivers from the Traffic Safety Culture Index from 2011 to 2017

IntroductionAdolescent drivers are often the focus of traffic safety legislation as they are at increased risk for crash-related injury and death. However, the degree to which adolescents support distracted driving laws and factors contributing to their support are relatively unknown. Using a large, nationally weighted sample of adolescent drivers in the United States, we assessed if perceived threat from other road users’ engagement in distracted driving, personal engagement in distracted driving behaviors, and the presence of state distracted driving laws was associated with support for distracted driving laws.MethodsThe sample included 3565 adolescents (aged 16–18) who participated in the Traffic Safety Culture Index survey from 2011 to 2017. A modified Poisson regression model with robust errors was fit to the weighted data to examine support for distracted driving laws. Models included age, gender, year, state distracted driving laws, personal engagement in distracted driving behavior, and perceived threat from other road users’ engaging in distracted driving.ResultsApproximately 87% of adolescents supported a law against texting and emailing compared to 66% who supported a universal handheld cellphone law. Support for distracted driving legislation was associated with greater perceived threat of other road users engaging in distracted driving while accounting for personal engagement in distracted driving, state distracted driving laws, and developmental covariates.DiscussionGreater understanding of the factors behind legislative support is needed. Public health interventions focused on effectively translating the risks of cellphone use while driving and effective policy will further improve the traffic safety culture.     

Internalized weight stigma mediates and moderates physical activity outcomes during a healthy living program for women with high body mass index

ObjectivesTo investigate the influence of internalized weight stigma (IWS) on physical activity (PA) outcomes among women with body mass index (BMI) over 30 kg/m².Design and methodData were drawn from an RCT that included 80 primarily inactive women (94% non-Hispanic/Latina white; mean age = 39.6, SD = 4.1, range = 30.0 to 45.0; mean BMI = 38.0 kg/m², SD = 3.9, range = 30.2–44.8 kg/m². Participants completed a 6 month weight-neutral, health-at-every-size or weight-loss-focused group-based healthy living program. PA enjoyment and engagement in moderate-intensity PA (MI-PA) (at least 30 minutes most days of the week) were assessed at baseline and immediately post-intervention. We used intention-to-treat linear mixed-effects modeling to test IWS as a moderator of changes in MI-PA engagement. We also tested a model whereby the positive effects of participating in the program on engagement in MI-PA would be serially mediated by a reduction in IWS and a concomitant increase in MI-PA enjoyment.ResultsThe weight-neutral and weight-loss-focused data were combined for all analyses. The moderation hypothesis was supported with a significant interaction between IWS and time. Participants had significant gains overall in MI-PA engagement from baseline to post-intervention; however, those with high IWS had an attenuated response. The serial mediation model was also supported. The positive effect of the program on engagement in MI-PA occurred through decreased IWS and increased MI-PA enjoyment.ConclusionsSelf-directed stigma and holding negative attitudes about one's weight interferes with positive changes in PA outcomes. Healthy living programs may be less effective for those most vulnerable unless we aim to reduce IWS.     

A discourse analysis of power in relation to PSYCHLOPS (Psychological outcome profiles) in the context of CBT for psychosis

Aims: Outcome measures (OMs) and routine change measurement have developed dramatically in psychological therapies over the last two decades and some therapists have expressed concerns that this, depending on how it is handled by the parties involved, can markedly affect the therapy. However, little research has investigated this. It therefore seemed timely to explore discourses of OMs drawn upon by both parties in the therapy room. Method: PSYCHLOPS (Psychological Outcome Profiles) is a client‐centred measure which offered an opportunity to explore how therapists and clients receiving CBT for psychosis talked about OMs. A useful contrast was provided by the CORE‐OM (Clinical Outcomes in Routine Evaluation‐Outcome Measure). The discourses drawn upon by clients (n=4) and therapists (n=4) were analysed, informed by a Foucaultian framework. Results: OMs were constructed as empowering or disempowering of clients, as being able to do therapeutic work of engagement and containment, and as part of the apparatus of service power, positioning therapists as relatively powerless to question their use. Discussion: It is suggested that client‐centred measures like PSYCHLOPS, although partly aligned with a recovery framework, may become part of top‐down state and service power, and there is a need for more research into the different ways in which OMs are used in therapy and the impacts on therapists, clients and their relationships.     

Student clinicians’ and clients’ perceptions of the therapeutic alliance and outcomes in stuttering treatment

PurposeThe purpose of this study was to examine how the therapeutic alliances (TA) of graduate student clinicians and adult clients who stutter relate to perceived treatment outcomes.MethodsStudent clinicians (N = 42) and adult clients who stutter (N = 22) completed a survey assessing their TA strength and perception of treatment outcomes. Responses were analyzed to determine similarities and differences in how clinicians and clients relate the TA to perceptions of treatment effectiveness, progress, and outcome satisfaction.ResultsResults suggest that clinicians and clients who stutter both relate the TA to treatment outcome, but in different ways. While clinicians associate the TA most with treatment effectiveness and client progress, clients relate the TA most to outcome satisfaction.ConclusionClinicians should be aware that for adult clients who stutter, outcome satisfaction is related to the degree of shared understanding, agreement on daily tasks, and bond they experience with their clinician. To ensure a strong TA and client satisfaction, clinicians should actively seek their clients’ perspective regarding TA status.     

Mobilizing self through short-term dynamic interpersonal psychotherapy: a preliminary report

Background: The key features of short-term dynamic interpersonal psychotherapy (STDIP) are outlined along with the background of its development. Preliminary data demonstrating functional improvement in a small case series of patients is presented.

Methods: Nineteen patients were evaluated at commencement and end of therapy in a pilot study. Instruments used were the Childhood Trauma Questionnaire (CTQ); Beck Depression Inventory (BDI); Brief Symptom Inventory (BSI); COPE (Coping Style Questionnaire); Relationship Styles Questionnaire (RSQ) and Social Adjustment Scale-Self Report (SAS-SR).

Results: This cohort had significantly elevated scores on the CTQ. They demonstrated substantial improvement on measures including the BDI, and several subscales of BSI, COPE, RSQ and SAS-SR.

Conclusions: The small numbers and naturalistic design preclude firm conclusions however the results suggest that STDIP can be used to successfully treat patients, notwithstanding a history of childhood trauma.     

Using Photography to Explore Recovery Themes With Veterans

This author of this study examined if creating photographs to explore a recovery experience could be therapeutic. Veterans from multiple war periods, who were receiving outpatient mental health treatment, voluntarily enrolled in a six-week photography workshop. During the workshop, 31 veterans learned the basics of photography and discussed recovery challenges with peers. For the final class, participants created a six-image portfolio that visually expressed a personal recovery theme. Pre-and post, 10-item Likert scale questionnaires were completed in order to evaluate the benefits of the photography workshop. There was a statistically significant increase in the post test questionnaire score (+0.47 points, p = 0 .001). The findings support the hypothesis that taking photographs while in recovery can improve personal reflection and organization of thinking, as well as promote recovery discussions, communication, social support, and sense of purpose. Recovery themes included dealing with pain, isolation, growth, transformation, and healing.     

Idleness and Inmate Misconduct: A New Perspective on Time Use and Behavior in Local Jails

ABSTRACT

A growing body of literature explores how participation in programming in correctional institutions predicts inmate misconduct. Theory and extant research suggest that engagement in structured and prosocial activities promotes positive behavioral and emotional outcomes, while idleness has a negative impact on inmate behavior and well-being. However, the literature that examines these relationships is largely based on qualitative methodology, small samples, and prison population. Using data from the 2002 Survey of Inmates in Local Jails, this study fills the gap in the literature by examining the associations between engagement in various activities in jail and inmate misconduct. This study also explores individual and jail-level factors that predict inmate engagement in different activities in jails. The results show that watching TV and working in jail are associated with lower misconduct, whereas recreation and reading are associated with higher levels of several types of misconduct. The data also reveal that certain personal and institution-level factors predict the extent of engagement in formal and leisure activities.     

Exploring the Role of Sport Sense of Community in Perceived Athlete Burnout,Sport Motivation,and Engagement

The main purpose of this work was to examine the relationships between the sport sense of community, athlete burnout, engagement, and motivation in adolescent athletes, adopting a longitudinal perspective, and using both person- and variable-centred approaches. A total of 250 adolescent athletes were involved in the study. Athletes' perceptions of burnout, engagement and motivation significantly differed across two different clusters: high and low sport sense of community profiles. Consistent with our hypothesis, sport sense of community dimensions (i.e., satisfaction of needs and influence) negatively predicted athlete burnout and controlled motivation, and positively predicted engagement and autonomous motivation six months later.

Lay Summary: Athlete burnout is associated with negative consequences for athletes’ well-being, whereas engagement reflects a positive state. The sport sense of community refers to the athletes’ relationship with their sport environment. In this study, we provided preliminary evidence of the protective role of the sport sense of community on athlete burnout.     

Who drops-out? Do measures of risk to self and to others predict unplanned endings in primary care counselling?

Aims: Unplanned endings, where clients unilaterally end therapy, are of concern for psychological therapy services generally as they raise questions about the appropriateness of the treatment and it's delivery for some clients. Limited available data indicates that those who drop-out often have more severe symptoms at entry, and have poorer clinical outcomes. This raises further questions about risk to self and others for those clients who leave therapy prematurely and how these clients might be identified and kept engaged. Method: This paper uses a large dataset of CORE data collected routinely in a primary care counselling service between 2000 and 2003. Logistic regression was utilised to consider different measures of risk and other client characteristics recorded at assessment to predict drop-out from the service. Results: These indicate that younger age, greater psychological distress at assessment, an addiction problem and greater risk to others, are associated with an unplanned ending. However, no reliable logistic regression model could be produced. This may be partly due to data quality issues or important characteristics not being available in the data. Implications for practice: The paper concludes that counsellors should actively seek to minimise unplanned endings, as amongst them may be represented the more distressed and risky clients referred to primary care counselling.     

Spiritual Spontaneity

Abstract

Parent-child and parent-adolescent activity groups and parent-child occupation-based intervention meet different mental health needs and provide a different service than what is typically offered in a psychiatric setting. These interventions are designed to promote and/or develop positive interactions and engagement between parents and children in co-occupations.     

The contribution of role satisfaction,meaning in life and work–home conflict to explaining well-being among working grandparents

Background and objectives: The study aimed to examine the relationship of satisfaction with occupied roles as well as the sense of meaning in life and experience of work–home conflict to well-being among working grandparents in Israel.

Design and methods: The research sample consisted of 316 employed grandparents aged 50–80 (153 grandfathers and 163 grandmothers), who were employed in various types of organizations. Data were collected using structured questionnaires. Structural equation modeling was used for data analysis.

Results: The research findings indicate that the sense of meaning in life mediated the relationship between role satisfaction and the two types of work–home conflict. A significant relationship was found between “work interferes with family” conflict and negative affect. Higher personal resources were associated with higher meaning in life. Gender was not related to the experience of work–home conflict or to any of the outcome variables.

Conclusions: The centrality of meaning in life in the model that explains the experience of work–home conflict and its outcomes among working grandparents, derives from its mediating role in the relationship between the experience of role satisfaction and both types of role conflict, as well as from its direct impact on positive and negative affect.     

The antecedents and outcomes of dyadic coping in close personal relationships: a systematic review and narrative synthesis

Background and objectives: Theories of dyadic coping and empirical literature have intermittently and inconsistently highlighted antecedents and outcomes of dyadic coping. The purpose of this review was to systematically identify the antecedents and outcomes of dyadic coping in close personal relationships.

Design: A PRISMA-guided systematic review and narrative synthesis.

Methods: Literature searches were conducted using CINAHL, PubMed, PsycINFO, and citation pearl growing to identify studies that were relevant to the aim of the review. The search strategy and exclusion criteria led to a final sample of 46 studies that each highlighted antecedents and outcomes of dyadic coping among married couples. Each study was critically appraised and analyzed using narrative synthesis.

Results: The narrative synthesis highlighted five antecedents (learning, gender, relationship characteristics, relationship role, and cultural influences) and two outcomes (relationship functioning and personal health) of dyadic coping.

Conclusion: The review exposes inconsistencies in the conceptualization of dyadic coping, highlights a range of antecedents that influence dyadic coping, and suggests that dyadic coping can have positive benefits for relationship functioning and personal health. The findings have implications for future research and practice (e.g. when working with couples to improve relationship functioning).     

Religion as Moderator of the Sense of Control–Health Connection: Gender Differences

ABSTRACT

Objectives. Sense of personal control is a key marker of successful aging, yet little is known about its relation to religiousness and personal adversity among older adults. This study investigated the relation between two different religious orientations, a church-centered religiousness and a non-church-based spiritual seeking, sense of control, physical health, and gender in late adulthood.

Methods. The participants consisted of a community sample of men and women (N = 156) in their late sixties and mid-seventies who were born in the San Francisco Bay Area. Three-way ANOVAs were used to test in separate analyses, the effects of religiousness and spiritual seeking on sense of control among men and women who were either in good or poor physical health.

Results. Both religiousness and spiritual seeking buffered women, but not men, against loss of sense of control due to poor physical health. The buffering effect of religiousness and spiritual seeking was associated with different psychological characteristics: high life satisfaction for religiousness and engagement in life review for spiritual seeking. For men, the absence of a buffering effect of either religiousness or spiritual seeking was associated with disengagement from involvement in daily activities.

Discussion. Our findings highlight (1) the importance of employing multidimensional models of religion in studying its effect on psychosocial functioning in late adulthood and (2) the possibility that men and women who are high in religiousness and spiritual seeking regulate their sense of control using different adaptive strategies.     

Politicizing Survivors of Incest and Sexual Abuse

Abstract

As both a feminist therapist and a survivor of incest, moving myself beyond therapeutic issues into an area of public education has been crucial to my own healing process. Receiving positive responses to my workshops and discussion groups, it became apparent that using a similar approach with clients who were survivors might be beneficial to their healing. As a member of The Counseling Center for Women, a feminist therapy collective in Israel, I suggested we sponsor a public exhibition and a series of programs of the topic of incest and abuse. The Municipality of Tel Aviv was approached to be its governmental sponsor. Entitled “Silent No More,” the program moved therapists and clients from working in the privacy of therapy to a public forum. What began as an uncomplicated educational program became an emotional process and a politicizing of individuals to help others as well as themselves. Moving from a feeling of shame to a sense of empowerment, the exhibition gave us a new sense of self-esteem and strength in our own abilities and our recovery process.