Ethical issues in internet counselling

This paper examines the advantages and difficulties associated with using the internet as a communication medium for counselling. Access to the internet is increasing rapidly and counselling services are starting to be offered to clients. Such services may be particularly attractive to clients who may not be able to find such services locally. The disadvantages of using the internet for counselling include the loss of the non-verbal communication level. The paper addresses the ethical implications of counselling in this medium. It concludes that there is a need for more guidelines in professional codes of practice.     

MANAGEMENT OF GERIATRIC INCONTINENCE IN NURSING HOMES

A behavioral management system designed to reduce urinary incontinence was evaluated in two nursing homes with a pretest-posttest control group design with repeated measures. The primary components of the system were prompting and contingent social approval/disapproval which required approximately 2.5 minutes per patient per hour to administer. The frequency of correct toileting for experimental subjects increased by approximately 45%. The experimental groups were significantly different from the control groups on both incontinence and correct toileting measures. The results are discussed in view of the management issues inherent in nursing home settings.     

Counselling, careers education and pastoral care: Beyond the National Curriculum

The National Curriculum and other recent educational reforms in the UK have had the effect of compartmentalising children's education into the measurable—usually the academic—and of undervaluing its socio-emotional aspects. A symposium presenting different views of the implications of these reforms is introduced. A plea is made for all professionals involved in education to move from a reductionist view to one which truly enhances the whole child.     

Should Genetic Testing be Offered for Children? The Perspectives of Adolescents and Emerging Adults in Families with Li-Fraumeni Syndrome

Whether children should be offered genetic testing for cancer risk is much debated but young voices are rarely heard in these conversations. The current study explored perspectives of genetic testing held by adolescents and emerging adults in families with Li Fraumeni syndrome (LFS). Twelve 12- to 25-year-olds in families with LFS completed qualitative interviews for this study. All believed that testing should be offered for children but many qualified this statement saying parental approval would be needed and testing should be optional. Genetic testing was seen as way to learn of risk status, allow for disease prevention efforts, and reduce uncertainty and anxiety. Perceived disadvantages included negative emotions associated with the testing result. Participants generally felt that children should be involved in the testing decision, but that parents could unilaterally decide to have a child tested in certain circumstances (e.g., young age, high risk). All who were aware of having been tested and of their test result (n = 7; 4 positive) said testing had no negative impact on their outlook and they agreed with the decision to undergo testing. Implications of these findings for clinical practice and future research are discussed.     

Psychosocial Impact of Familial Adenomatous Polyposis on Young Adults: A Qualitative Study

The aim of this study was to explore in detail the psychosocial impact of either having familial adenomatous polyposis (FAP) or being at risk for FAP amongst young adults. In-depth interviews were conducted with eleven individuals aged 18–35 with a clinical or genetic diagnosis of, or at risk of developing FAP. While being at risk did not seem to have a major psychosocial impact upon clinically unaffected participants, clinically affected individuals discussed a number of major stressors including issues in relation to changes in body image and physical functioning as a result of surgery, concerns about discussing FAP with new partners, difficulties in relation to childbearing decision-making, and impact on employment. Genetic counseling was described as being highly effective in providing support, but most participants were not aware of any other support services. Providing longer-term support through ongoing genetic counseling appears necessary to adequately address the ongoing challenges faced by young adults who are dealing with FAP.     

The driver whose heart was full of sand: Leigh's story - a play therapy case study of a bereaved child

This paper describes the therapeutic journey of Leigh (not his real name), a nine-year-old boy who was referred for play therapy due to the death of his 15-year-old brother. The play therapy was offered through a joint project called 'Playing through Loss' and run jointly between a UK university and the local branch of a national bereavement organisation. The project was set up to offer play therapy to bereaved children in the local area. Leigh had eight sessions of therapy and this paper describes the major themes of his play and makes some preliminary explorations of the meaning the play may have had for him. Interestingly some of his play focused on a computer game called 'Zelda' and an exploration of the powerfulness of this as a therapeutic tool is also explored. The therapist's theoretic orientation is described along with her perceived role as 'loyal companion'. Finally, the process by which Leigh worked with his loss is discussed.     

A Deleuzian rethinking of time in healthy lifestyle advice and change

Time is a powerful but under‐examined element in healthy lifestyle advice, particularly in the promise of stable states of future health achievable through sustained lifestyle change. But such linear, sequential time frames reinforce notions of rational choice, personal control, and responsibility despite common experiences of diet and exercise regimens as non‐linear, effortful, and difficult to maintain. An over‐simplification of time thus contributes to the logic of blame when people fail to achieve healthy lifestyle goals, producing spoiled health identities and abject bodies as people struggle to sustain what can be unsustainable. Addressing these problems, we argue that Deleuze's philosophy offers tools to develop an alternative approach in health promotion. Deleuze affords a conceptualisation of multidimensional, embodied, and affective temporalities of health, which give rise to plural subjectivities and disrupt linear models of time. This framework affords a recognition of multiple time frames, such as histories and imagined futures that form part of a living present and shape lifestyle behaviours and identities. Deleuzian concepts that tie into his philosophy of time and form his process ontology, including monism and rhizomes, affect, becoming, and assemblages, are discussed in relation to health promotion. The article concludes that Deleuze offers a critical theory of time that enables a mapping of the ways that people embody multiplicity, non‐linearity, and fluidity as they negotiate healthy lifestyle advice. His concepts illuminate ways in which people can be oppressed and limited by discourses of healthy living, but also point to new, more affirmative directions for health promotion and healthy lifestyle advice.     

Enhancing Outcomes for Struggling Readers: Empirical Analysis of The Fluency Development Lesson

This study investigated the efficacy of the Fluency Development Lesson (FDL) in improving reading achievement in primary grade struggling readers. 30 readers, enrolled in a summer reading clinic, participated in daily 40-min mini-reading lessons across 5 weeks. During the fluency lessons, readers practiced and developed their literacy skills through participation in repeated readings, word work, rehearsal, and performance. Assessments measured comprehension, reading fluency, including word recognition accuracy, reading speed, and prosody. Control students also took the pre- and post-intervention tests; their performance did not change with repeated testing. The Fluency Development Lesson students showed significant gains on all measures.     

Explorations of participants’ experiences of a Personal Development Group held as part of a counselling psychology training group: Is it safe in here?

This paper aims to extend understanding of student counsellors’ perceptions of participation in personal development (PD) groups during training. PD participants were invited to record their experiences in relation to these groups over a three month period. The accounts were then subjected to thematic analysis. Safety was found to be a dominant theme–both in the sense of how the group felt safe for them and also how the safety was threatened. These concepts are discussed and lessons the data has offered in terms of good practice in facilitating PD groups during counsellor training programmes are elucidated.