A Phenomenological Inquiry of Clients’ Meaningful Experiences in Counseling With Counselors‐in‐Training

This study is a follow‐up to Sackett, Lawson, and Burge's ( 2012 ) study that explored the meaningful experiences of clients and counselors‐in‐training (CITs). Using the previous study's themes of clients’ experiences in counseling with CITs as a launching pad, the authors examined in greater depth the meaningful experiences of clients who are in counseling with CITs through qualitative phenomenological interviews. Findings, as well as implications for counselor education, supervision, and counseling, are discussed.     

The Counseling Experiences of Transgender and Gender Nonconforming Clients

The counseling experiences of 13 transgender and gender nonconforming (TGNC) individuals were examined via semistructured, in‐depth interviews. Using multiple standards of trustworthiness (e.g., member checking, negative case analysis), the authors analyzed each interview from an interpretative phenomenological analytic framework. Four main themes were identified: mental health professional selection process, transaffirmative approach, transnegative approach, and support systems beyond counseling. Implications for implementing culturally responsive TGNC affirmative counseling, TGNC sensitive counselor training, and social justice–oriented research are discussed.     

Counselor Empathy or “Having a Heart to Help”? An Ethnographic Investigation of Chinese Clients' Experience of Counseling

Current understanding of counselor empathy is almost entirely based on Western culture. Clients'; perceptions of counselor empathy are scarcely investigated within any non-Western group. Using ethnographic interviews, this study explored the concept of counselor empathy from Chinese counseling clients'; perspectives by exploring their experiences of therapeutic relationships. Although informants did not commonly and explicitly consider counselor empathy as a priority in counseling, preliminary results suggest that they may perceive it in Chinese counseling relationships as a different phenomenon linguistically and conceptually.     

Using Relational Cultural Theory as a Pedagogical Approach for Counselor Education

ABSTRACT

In the article the authors will discuss core concepts of RCT in greater detail while relating these concepts to the counselor education classroom setting. There are many aspects of the counseling process that are open-ended due to the necessity of counselors needing to be responsive to the client’s needs in the moment. It is the assertion of the authors that using RCT in the classroom as a pedagogical framework may be beneficial to the growth of CITs. Through creating and maintaining an environment that supports growth fostering relationships, mutual empathy, authenticity, recognition and healing of disconnection, identification of central relational paradoxes, and processing relational images can all lead to developing relational competence in the CITs who will become the next generation of counselors. Additionally, the authors provide examples of the core concepts in action that are grounded in their experiences, blending RCT into their instructional delivery in their course.     

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.     

Stories Matter: Narrative Themes of Counselor Educators' Religious and Spiritual Competency

Using narrative inquiry, the author explored the multicultural aspects of religious and spiritual experiences, assumptions, and patterns of 9 counselor educators to understand the impact that experiences and beliefs have when supervising and teaching counseling students. A gap exists between counselor standards, ethics, competencies, and practice, because counseling students receive mixed messages about addressing spiritual and religious concerns. Through hermeneutic analysis, 6 themes emerged: (a) religious and spiritual journeys, (b) religious and spiritual practices, (c) relationships, (d) marginalization, (e) modeling, and (f) risk and taboo. Trustworthiness strategies, implications for counselor education, limitations, and directions for future research are described.     

Christian Counselors and Affirmative Counseling of Lesbian and Gay Clients

In this phenomenological study, we interviewed 12 counselors who identified as both religious and able to provide ethical and competent counseling to lesbian and gay clients. Participants discussed their lived experiences providing counseling. Our analysis revealed three primary themes: seeking congruence, responding to lesbian and gay clients, and cultivating competency. We discuss these findings and identify implications for counselor training and practice.     

Using Relational‐Cultural Theory in LGBTQQ Counseling: Addressing Heterosexism and Enhancing Relational Competencies

The authors describe the use of a relational‐cultural theory (RCT) lens (Miller, 1976 ) in counseling practice with lesbian, gay, bisexual, transgender, queer, and questioning (LGBTQQ) clients. A review of LGBTQQ counseling and RCT literature is discussed. A case vignette of a counselor applying RCT tenets to work with a LGBTQQ client is described. Implications for using RCT as a counseling theoretical framework with LGBTQQ clients are reviewed.     

Evaluation of Counselor Effectiveness

This literature review summarizes research in the general area of the evaluation of counselor effectiveness. Research into the role of the counselor continues, and is typically done in reference to a specific setting. The state of the art is such, however, that the evaluation of the counseling process continues to focus primarily on the presence or absence of the core facilitative conditions; program evaluation, conversely, is becoming more sophisticated. Counselor educators have focused on means of presenting counseling experiences and of providing feedback regarding trainee performance and evaluating that performance; much of this work has been directed toward the counseling practicum. The implications of the movement toward certification or licensure are discussed with reference to both practitioners and counselor educators.     

An Exploration of Young Clients' Experiences in Counseling With Post‐Master's Counselors

This phenomenological study adds to current literature about clients' meaningful experiences in counseling by exploring the experiences of eight young clients (ages 8–18) in individual counseling with post‐master's counselors in an outpatient setting. Interviews with these clients revealed the following six themes: (a) the process of growth, (b) having a safe place to talk, (c) counselor accepts and meets the client where they are, (d) counseling is a team effort, (e) supportive accountability from the counselor, and (f) understanding self and others. The final theme includes two subthemes: learning coping and emotion management skills, and learning better ways to communicate and behave. Findings and implications for counselors are discussed.     

Client Perceptions of the Impact of Genetic Counseling: An Exploratory Study

Twenty-eight former genetic counseling clients seen at a major Midwestern university were recruited to be interviewed about their genetic counseling experiences, including most and least helpful aspects, what they learned, how this information impacted their decision-making, and their perceptions of their genetic counselors' behaviors. Responses were inductively analyzed, and several themes were identified, including: Clients sought genetic counseling to obtain genetic-medical information; a majority accurately recalled this information; genetic counseling influenced decisions for about 50% of the sample; decision-making was affected by several extra-session factors; a majority experienced distress during the session; most perceived genetic counselor responses as nondirective and liked this approach; counselor behaviors regarded as directive involved discussion of pregnancy termination; participants disagreed about the need for and provision of genetic counselor support; most regarded the session as helpful and stated that they would seek genetic counseling again. Suggestions for addressing these issues in practice and research are given.     

Are Genetic Counselors and GLBT Patients “on the Same Page”? an Investigation of Attitudes, Practices, and Genetic Counseling Experiences

Gay, lesbian, bisexual, and transgender (GLBT) individuals comprise a growing patient population in genetic counseling, yet literature on working with this population is scarce. This study sought to investigate GLBT patient experiences in genetic counseling and genetic counselor attitudes and practices when counseling GLBT patients. Twenty-nine GLB individuals who had previously participated in genetic counseling, and 213 genetic counselors completed online surveys. No individuals identifying as transgender participated. The patient survey assessed disclosure of orientation, discrimination in genetic counseling, and quality of services received. The counselor survey assessed comfort with and attitudes about counseling GLBT patients, disclosure of counselor orientation, and whether they counsel differently with this population. Every patient denied experiencing discrimination during their session, but 17% reported their genetic counselor assumed they were heterosexual, and 45% indicated intake forms were not GLBT-inclusive. A majority of counselors (91%) reported having counseled GLBT patients and indicated they were comfortable doing so (86%), and 72% indicated no differences in their counseling approaches with GLBT patients. Few counselors (17%) received training in GLBT issues, and most (61%) desired such education. Additional findings and practice and research recommendations are presented.     

An Investigation of Client and Counselor Variables That Influence Likelihood of Counselor Self-Disclosure

Selected client and counselor variables affecting reported likelihood of self-disclosure by 120 experienced clinicians in relation to four scenarios were examined. Variables included client age and diagnosis and counselor gender, experience, and exposure to disclosing counselors in their own experience of counseling. Disclosure likelihood was greatest for high ego-strength diagnoses and for respondents who reported positive disclosures from counselors in their own counseling experiences. Reasons for and against using self-disclosure also were examined. Reasons for disclosing included promoting universality, giving encouragement, modeling, rapport-building, and offering alternatives. Reasons against disclosing included boundary blurring, concern about counselor welfare, merging, and premature closure. Implications for practice and research are discussed.     

Making the Intangible Tangible: Using Expressive Art During Termination to Co-Construct Meaning

In this article, a creative termination activity grounded in relational-cultural theory is presented. In addition to providing a means for summarizing the counseling experience, this activity promotes relational development in the midst of client termination. Following implementation of the activity, the client and counselor are provided tangible, co-constructed gifts that are symbolic of the therapeutic relationship and relational growth. The authors provide a rationale for how this intervention promotes self-awareness, outline directions for implementation, and provide a case illustration to demonstrate how counselors can help promote relational closure and solidify clients’ therapeutic gains.     

Nonsectarian Counseling in Churches: A Delicate Balance

This account of the author's 2 contrasting experiences as a church counselor raises awareness regarding counseling in new venues and in response to congregational and community needs. Church members responded to the invitation to come to counseling before problems became crises; the majority of the members explored midlife and other developmental issues. Specific concerns related to confidentiality and privacy, counselor values and attitudes, the extent of pro bono services, the counselor's relationship with clerics, counseling of clerics, church membership, outreach, and boundaries are addressed, as well as the effective use of discussion groups for youth, men, women, and parents in building a sense of community.     

Spiritual Evolution of Bereavement Counselors: An Exploratory Qualitative Study

This article draws from a phenomenological study on the experience of being a bereavement counselor. Ten bereavement counselors shared their experiences in bereavement counseling. Spiritual and emotional aspects of bereavement counseling with grieving and dying persons are discussed as well as the spiritual effects on and growth processes of the bereavement counselors. Participants also describe their self‐care strategies pertaining to their bereavement counseling work.     

An Exploration of Genetic Counselors’ Needs and Experiences with Prenatal Chromosomal Microarray Testing

Because of the higher yield over traditional chromosomal analysis, chromosomal microarray analysis (CMA) is being used increasingly in prenatal diagnosis. Unfortunately, the clinical implication of many copy number variants found on prenatal CMA is uncertain, complicating genetic counseling. Recognizing that uncertain results will be encountered frequently as more of the genome is assayed prenatally, we set out to understand the experiences and needs of genetic counselors when counseling patients about uncertain prenatal microarray results, their comfort with various aspects of prenatal genetic counseling, and their interest in additional education and training about prenatal microarray testing. We first interviewed 10 genetic counselors about their experiences of providing pre- and post-test genetic counseling about prenatal CMA. Based on the findings from the counselor interviews, we developed items for a survey to assess the prevalence of genetic counselors’ attitudes towards, experience and comfort with, and educational needs regarding prenatal CMA. Based on surveys completed by 193 prenatal genetic counselors, we found that when there is an uncertain CMA result, only 59 % would be comfortable providing genetic counseling and only 43 % would be comfortable helping a patient make a decision about pregnancy termination. Being less comfortable was associated with seeing fewer patients having prenatal CMA testing. Respondents expressed a high degree of interest in additional education about prenatal CMA and counseling about uncertain results. Further genetic counselor education and training aimed at improving counselors’ personal comfort with uncertain results and communicating about them with patients is needed.     

Gay and bisexual male clients' perceptions of counseling: the role of perceived sexual orientation similarity and counselor universal-diverse orientation

A recurring question in multicultural counseling is whether client-counselor similarity on sociodemographic characteristics benefits counseling. A related issue is how counselor orientation to diversity relates to counseling process and outcome, both as a main effect and in interaction with counselor-client sociodemographic match. This cross-sectional study investigated these questions in relation to gay and bisexual male clients' counseling experiences by examining clients' perceived similarity to their counselor in sexual orientation, as well as counselors' self-reported orientation to diversity (assessed in terms of level of universal-diverse orientation [UDO]). Data were from 83 male-male client-counselor dyads recruited from lesbian/gay/bisexual-affirming counseling practices, where clients identified as gay or bisexual and counselors identified as gay, bisexual, or heterosexual. Counselor UDO was positively and uniquely associated with client ratings of the working alliance, session depth, and session smoothness. Perceived sexual orientation similarity was not directly related to any of the counseling-related criterion variables. Moreover, when counselors reported low levels of UDO, perceived similarity was negatively associated with the client-rated alliance and perceived improvement. Client religious commitment-a control variable in all analyses--was uniquely and negatively associated with client ratings of perceived improvement in counseling.     

Addressing Privilege and Oppression in Counselor Training and Practice: A Qualitative Analysis

This qualitative study explored how 16 counselors conceptualize and address issues of privilege and oppression in the counseling session as well as how they perceive their training with respect to these constructs. In an effort to bridge multicultural training and counselor practice, implications for counselor training are provided based on the clinical and academic experiences counselors reported. Additionally, future research directions are included.     

Using mediators and moderators to test assumptions underlying culturally sensitive therapies: an exploratory example

Factors hypothesized to impact Asian American responses to counseling were tested as mediators and moderators of perceived counselor credibility and working alliance. Asian and European American college students (N = 182) were assigned randomly to view simulated directive or nondirective therapy approaches. Mediation analyses examined whether ethnic group differences in initial perceptions were accounted for by therapist understandability and previous therapy experiences. Moderation analyses examined whether expectations for directive therapy, ambiguity tolerance, and resistance influenced initial perceptions across directive and nondirective counseling. Asian Americans rated the counseling approaches significantly less favorably than Europeans Americans. A significant mediation effect was found for therapist understandability, whereas a significant moderation effect was found for expectation for directive therapy on initial perceptions of counselor credibility.