Presenting concerns of emerging adults seeking treatment at an early intervention outpatient mood and anxiety program

This study examined presenting concerns and characteristics of emerging adults (EAs) seeking treatment at an early intervention program for mood and anxiety disorders to better understand presenting concerns when treatment is needed. During an intake assessment conducted by a social worker or clinical psychologist, participants (N = 548; 62% female, 38% male) reported their top three current life concerns, which were analyzed qualitatively using thematic analysis. Participants completed a battery of questionnaires assessing demographic information, symptomatology, and daily functioning. Females presented with significantly higher levels of anxiety, and both females and younger individuals (age 16–18) presented with significantly higher levels of depression compared to males and older individuals (age 19–26), respectively. The two most commonly reported presenting concerns were problems in interpersonal relationships and academics, and females were more likely to report academic concerns than males. The majority of participants reported seeking help for a wide range of problems commonly faced by EAs (83.7%), and participants rarely expressed concerns about particular symptoms of mood and/or anxiety disorders (16.3%). EAs and those supporting EAs may benefit from learning when psychosocial concerns are indicative of mental health challenges warranting professional attention.     

Intake Concerns of Racial and Ethnic Minority Students at a University Counseling Center: Implications for Developmental Programming and Outreach

The presenting concerns of racial and ethnic minority students at a university counseling center were examined. Results revealed that family and romantic relationship issues, academic concerns, and depression were among their primary concerns. Implications for developing outreach programs to address the mental health needs of similar college students are discussed.     

The Use of Metaphor to Address Gender and Sexual Orientation Stereotypes in Counseling: A Feminist Perspective

The role of metaphor in psychology is reviewed, focused on gender and sexual orientation stereotypes. Feminist therapy principles are explored in relation to addressing the presence of stereotypes within a therapeutic context. Implications for working with clients presenting with disordered eating, agoraphobia, sexual violence, and sexual identity concerns are discussed.     

"There is no evidence to suggest...": changing the way we judge information for disclosure in the informed consent process

Feminist health activists and medical researchers frequently disagree on the adequacy of the informed consent processes in clinical trials. I argue for an informed consent process that reflects the central importance of patient-participant autonomy. Such a standard may raise concerns for medical researchers about their capacity to control the quantity and quality of the information they disclose to potential participants. These difficulties might be addressed by presenting potential participants with differently sized disclosure packages.     

Integrating Sex and Couples Therapy: A Multifaceted Case History

Traditionally, sexuality has not been a focus in couples therapy training, research, or practice, although it is an important, often complex issue for many couples. This article tells the story of a couple presenting for sex therapy due to their unconsummated marriage, and is told to exemplify how sex therapy and couples therapy can be integrated in order to best meet the needs of couples. As the story unfolds, the multilayered facets of the presenting issue are revealed. The therapy incorporates and weaves together family of origin history, intrapsychic and cognitive issues, relational dynamics, patterns of interaction, and physiological/medical concerns into a postmodern couples therapy with behavioral interventions. This combined approach recognizes the value of each method on its own and their greater usefulness when blended together.     

Understanding and Incorporating God Representations Within Counseling

The religious and spiritual identity of a client may be relevant to the counseling process, and thus counselors should be prepared to integrate these components within treatment. The authors consider the assessment and exploration of God representations (i.e., God images and concepts) to understand and integrate religious and spiritual meanings within the context of a client's presenting concerns. The authors provide examples, strategies, and considerations for how to apply God representations within counseling.     

An AIDS Hotline: Analysis of Callers,Presenting Problems,and Social Factors1

This research is an analysis of all calls received by an AIDS hotline over an 8-month period. Caller demographics and types of presenting problems of callers are reported. Overall, callers were most concerned about how the virus was transmitted and requested information about HIV testing for themselves, a partner, a friend, or a relative. Despite the fact that adolescents are at high risk for contracting HIV, few adolescents called the hotline, but those who did were more likely to request safer sex information than HIV testing information. In contrast, all other age groups requested HIV testing more than safer sex information, often by a 2:1 or 3:1 margin. Men called most frequently because of concerns about self, whereas women called most frequently with concerns about others. These results are discussed in the context of the AIDS epidemic and in terms of social factors.     

Thinking and Working Relationally: Interviewing and Constructing Hypotheses to Create Compassionate Understanding

In the initial interviews of family therapy sessions, the therapist faces the challenge of obtaining and organizing the information that is most relevant toward understanding the essential concerns that families and couples bring to therapy. This article describes the process of clinical interviewing and case conceptualization used in training family therapists at the Ackerman Institute for the Family. This approach helps the therapist bring forward, and organize, specific information into relational hypotheses, or systemic‐relational conceptualizations, that allow both family members and the therapist to understand presenting problems within their relational contexts. While always provisional, relational hypotheses help anchor the therapist in a systemic‐relational frame and provide a conceptual through‐line to guide the ongoing work of the therapy. The process of interviewing and the construction of clear and complex conceptualizations of presenting problems are illustrated through case examples.     

Positive Psychology and Indian Psychology: Birds of the Same Feather

Positive psychology and Indian psychology share similar concerns regarding human life. But Indian psychology has more to offer towards our understanding of happiness and well-being than what Positive psychology can at this point of time, because of latter’s paradigmatic limitations. This commentary draws attention to certain shortcomings of the target article: (a) in presenting the contemporary Positive psychology perspective; (b) in conceptualizing IP with reference to its epistemological position; (c) and in equating certain concepts from PP and IP and their implications.     

One Woman's Development and Resilience in the Face of Complex Trauma: A Relational–Cultural Study of Growth Through Counseling

Many counselors feel pressure to use manualized treatment approaches because of pressure from 3rd‐party payers. Unfortunately, this is not always the best practice, especially in cases of complex trauma, in which a very strong therapeutic relationship is a vital component of successful treatment. Relational–cultural theory provides an alternative conceptual lens for treating complex cases and is a natural fit for counselors' professional identity. This case illustrates how a counselor used a relational–cultural conceptualization as a guide in treating a client with complex presenting concerns.     

Photography as a therapeutic tool for substance abuse clients who have a history of sexual abuse

Symptoms of sexual abuse among persons in substance abuse treatment facilities may be difficult to recognise since presenting symptoms frequently mirror those associated with substance abuse. Additionally, treatment may be difficult due to a lack of previous verbal processing and shared negative defence mechanisms that are resistant to traditional talking therapy. The use of photography is presented here as a method of treatment initiation and exploration for substance abuse clients who have a history of sexual abuse. The paper reviews rationale, advantages, current applications and practitioner concerns associated with the use of photography as a therapeutic tool.     

Concerns of Older Veteran Callers to the Veterans Crisis Line

When the Veterans Crisis Line (VCL) was implemented, it was uncertain if veterans, and particularly older male veterans, would utilize the service. We examined VCL use by a growing group of veterans at increased risk for suicide: those aged 60 and older. Real‐time clinical data were gathered from a weekly random sampling of calls. Approximately 25% of calls were from veterans aged 60 or older; over 80% reported benefit from the call. Several significant differences in presenting concerns between older and younger callers were found. Targeted outreach to encourage older veterans to use the VCL is suggested.     

Under Reporting of Suicide Ideation in US Army Population Screening: An Ongoing Challenge

Previous research in US Army Soldiers shows rates of mental health concerns as two to four times higher on anonymous surveys than on postdeployment health assessments. In this study, Soldiers presenting for health reassessment completed two questionnaires on suicide risk factors: one linked to the health assessment and one anonymous. About 5.1% of respondents reported suicide ideation on the anonymous questionnaire, 3.0% on the linked questionnaire, and 0.9% on the health reassessment. About 56.4% who reported suicide ideation anonymously told nobody of their thoughts. Current screening procedures identify only one in seven Soldiers experiencing suicide ideation and highlight the need for alternative risk‐detection strategies.     

Mitigating the Mental Health Impact of Marginalization and Discrimination

In honor of the life and work of Aaron T. Beck, this paper describes the application of cognitive therapy to management of marginalization stress among minoritized communities. Collaborative empiricism, cognitive restructuring, and behavioral interventions are highlighted as being particularly useful in a contemporary multicultural approach for the anxiety, depression, stress, and other sequelae of marginalization due to a stigmatized identity. Although primarily illustrated through recent work with transgender and gender diverse adults, the discussion extends to other groups including racial, ethnic, and sexual minorities and immigrants. This work illustrates the power of Dr. Beck’s approach to address the presenting concerns of contemporary clinical work.     

Knowledge and Attitudes About Later Life Sexuality: What Clinicians Need To Know About Helping the Elderly

In the family therapy field we have often overlooked the elderly and in particular addressing sexual concerns within the context of couples therapy with the elderly (Van Amburg, Barber, & Zimmerman, 1996). The projected life-span of the elderly has increased due to improvements in medical technology and due to a better quality of life which promotes longevity. Included in this paper are the specific age-related physical, emotional, and sexual changes common in later life as well as a clinical case vignette of an elderly couple presenting with a sexual issue. Current sexuality education programs for the elderly are reviewed as well as clinical implications for therapists who treat the elderly.     

Strengthening Couples from a Single-Parent Household Using Relational Cultural Therapy

ABSTRACT

Individuals initially learn about intimate relationships from observing others, such as their parents or caregivers’ relationship, which may positively or negatively affect their own romantic relationship. This article focuses on the application of Relational-Cultural Therapy (RCT) concepts to establish resilience among couples with at least one partner from a single-parent household. Some individuals from single-parent households may not have witnessed romantic relationships to confidently engage in adult romantic relationships. Additionally, clinicians may not consider family background as a source of contention for a couple’s presenting concerns. Thus, this article provides creative interventions and implications to assist counselors in working with couples.     

A Conceptual Overview of the Self‐Presentational Concerns and Response Tendencies of Focus Group Participants

Focus group respondents are often requested to perform tasks that require them to convey information about themselves. However, despite the potential for respondents to have self‐presentational concerns, research on focus group productivity has virtually ignored extant scholarship on impression management. This shortcoming is addressed by presenting a conceptual overview of the effects of self‐presentational concerns on focus group participation. A product of this overview is a conceptual model that posits that the amount and nature of information that people convey about themselves to others is a function of their eagerness to make desired impressions and their subjective probabilities of doing so. According to the model, when focus group participants are highly motivated to make desired impressions, they may be reluctant to present unbiased images of themselves. However, they are not likely to deceive unless they are confident in their abilities to ascertain and enact desired images. Those who are motivated to make desired impressions but are doubtful of doing so are likely to protect themselves by concealing self‐relevant information or avoiding self‐relevant issues. Implications of this model for research and practice are discussed.     

Not Only a Messenger: Towards an Attitudinal‐Representational Theory of Pain

The main goal of this paper is to present a theory of the most salient aspect of the phenomenal character of pain – namely, the painfulness of pain or its negative affective quality. This task involves developing an account of the evaluative structure of pain, according to which painfulness is constituted by a (subjectively) frustrated (first‐order) conative attitude that is directed towards the bodily condition the obtaining of which the pain represents. The argument for the proposed Attitudinal‐Representational Theory of Pain proceeds by presenting an explanatory challenge that concerns crucial aspects of the reason‐giving force of pain, and showing that, unlike extant theories of pain, it successfully accounts for them.     

Ductus: A software package for the study of handwriting production

Ductus is a software tool designed to analyze and aid understanding of the processes underlying handwriting production. Ductus is a digitizer-based device that provides online information on the handwriting process. It consists of two distinct modules that operate independently. The first module concerns stimulus presentation. It is particularly suited to experiments with children and patients presenting handwriting pathologies. The second module is devoted to data analysis. Apart from the geometrical aspects of handwriting, such as trajectory formation, Ductus provides a wide range of kinematic information, such as velocity, duration, fluency, and pauses, linked to the mastery of the movement itself. Ductus is available free from the authors. It works on a Windows platform with Wacom digitizers.     

UCLA's Career Counseling Center: A Dialogue About a Unique Service

In this interview, two counseling psychologists describe aspects of a relatively unique career counseling service that has been validated by 40 years of success in the marketplace. Composed of 3 intensive individual interviews and 15 to 25 hours of educational and psychological testing, the service assists clients in identifying and beginning pursuit of suitable educational and occupational goals. The counselors describe how they organize and sift through test results to formulate recommendations for a client's unique career circumstances, why they accept responsibility for developing and presenting concrete recommendations, and what the changes in their clients' concerns suggest about the evolution of work in the United States. Their specificity and professionalism will help counselors understand the craft of career counseling.