AIDS/HIV in the work of family therapy trainees

A group of family therapy trainees were asked about their experience at work and knowledge of AIDS/HIV. The majority had already encountered AIDS-related issues in the context of their work. On the whole, they were well informed about AIDS/HIV, although specific gaps in their knowledge were identified. It is recommended that provision be made for the training of family therapists in this area.     

The interface between counselling and neuropsychological assessment of patients with AIDS/HIV

Manifestations of central nervous system dysfunction in adults and children with AIDS/HIV are common. The contribution of counselling in relation to these patients is described. This includes: contributing to the assessment of patients, addressing ‘dreaded issues' while patients are still well, helping patients to find solultions and manage problems, engaging the support of friends and the family in managing patients, ‘translating’ the results for the patient from formal assessments, discussing treatment options and helping parents and prospective parents to manage behaviour problems in their children. Counsellors also have a special role in advising and consulting colleagues about the management of these patients. Counselling in a clinical setting is, however, inextricably bound to limitations in the medical care of this patient group.     

Psychological consequences of involvement in a new religious movement or cult

It has frequently been suggested that the psychological consequences of involvement in new religious movements or cults can be profound for those who come into contact with them. To explore this further a study was carried out to investigate the relationship between personality, group membership of The Family (a new religious movement or cult) and mental health. Sixty six subjects (22 males, 44 females) in three different groups took part in this study. Group 1: Ex-members who felt negative about their involvement with The Family. Group 2: Present day members of The Family. Group 3: Ex-members who felt positive about their involvement with The Family. They completed two personality inventories (The Revised Eysenck Personality Questionnaire combined with the psychoticism scale of the Short Form of the Revised Eysenck Personality Questionnaire and the Beck Sociotrophy-Autonomy Scale). The results from this study were consistent with previous research indicating that experiences within the group increase social dependency and decrease autonomy for those who leave, whilst increasing the need for autonomous or individualistic achievement and lessening social conformity for present day members. This study suggests that some of the psychological difficulties which people have reported experiencing on leaving these groups are likely to be alleviated, to a degree, by time and from contact with a support group.     

The influence of personality and theoretical models on applicants to a counselling psychology course: A preliminary study

We examined whether personality variables in prospective condidates for a postgraduate program in counselling psychology were associated with an interest in models of counselling or therapy. The models were classified as directive models or non-deiective models of counselling. Using the Millon Index of Personality Styles we found that subjects who expressed an interest in the directive models of counselling (e.g. cognitive behavioural therapy) scored higher on scales measuring interpersonal boldness, systematizing and conforming in comparison to subjects who expressed an interest in non-dieective counselling (e.g. psychodynamic) who scored greater on intuitiveness (a perference for intangible, unstructured and symbolic). Implication for training and future research in this area are discussed.     

Supervising professionals involved in the psychological care of people infected with HIV/AIDS

The provision of psychological care for people with HIV/AIDS in the last decade has led to a demand for professional supervision of counsellors and other professionals who work with this patient group. While there are many similarities in the supervisory process with professionals working with patients with other medical and psychological problems, there are also unique and specific issues which stem from working with people with HIV/AIDS. Some of these are discussed in this paper. The supervisory process described relates to a systemic conceptual framework. Tasks in clinical supervision and dijiculties in supervision are highlighted. Suggestions are offered for setting up and developing supervision sessions in clinical practice.     

The meaning of bad news in HIV disease: Counselling about dreaded issues revisited

HIV disease is a slow, progressive immunological disorder. As there is neither a cure nor a vaccine, morbidity and mortality arising from HIV infection will continue to challenge health care providers, including those who counsel these patients. Psychological preparation for ‘bad news’ and support for those whose health is deteriorating is an important task in HIV counselling. This paper describes what may be considered bad news for people living with HIV, how to prepare them for unwelcome changes in their medical condition and how to give bad news, should the need arise.     

Transformational Leadership and Organisational Citizenship Behaviour: A Moderated Mediation Model of Leader‐Member‐Exchange and Subordinates' Gender

Transformational leadership (TL) enhances follower Organizational Citizenship Behavior (OCB) as mediated by leader‐member exchange (LMX). However, the strength of the positive associations among TL, LMX and OCB is subject to significant variability. Accordingly, we draw on several theories (self‐identity, role congruency, self‐concept, and social exchange) to propose that followers' gender moderates the relationships between all three of these variables. We argue differences in societal expectations and/or underlying motivation combine to make leadership of lesser importance to OCB among females than males. Using 202 supervisor‐subordinate dyads from Taiwan, a moderated mediation model of TL‐LMX‐OCB, with subordinate gender as a moderator, was tested. As hypothesised, each of the positive associations among TL, LMX and OCB were weaker for females than for males, thus accounting for some of the variability in the strength of the associations typically observed. Relatedly, although LMX fully mediated the TL‐OCB relationship in the entire sample, this effect was not observed among female subordinates. Further research is required to assess the degree to which these findings apply beyond the Confucian Asian societal cluster.     

When the solution becomes a part of the problem in the psychosocial management of an AIDS patient

This paper describes the important role a professional has in defining the nature of psychosocial problems with patients. An example is described in which a patient with AIDS was referred to a psychiatrist. The effect of this on the patient was that he believed that his problems were more serious than how he usually viewed them. This created a new problem in the management of the patient. The authors stress the importance of counsellors and their referrers discussing patient management issues in advance, so that different views do not impede the care of patients.     

Addressing ‘Dreaded issues’: A Description of a unique counselling intervention with patients with AIDS/HIV

The authors describe an approach to counselling patients with AIDS/HIV in which the patients main anxieties can be addressed. A definition of ‘AIDS Counselling’ and ‘Dreaded issues’ is offered. The choice of method is derived from experience with over 1,000 patients. A therapeutic strategy is used in which hypothetical and future-orientated questions asked by the counsellor can help to sidestep denial and resistance with patients. Clinical case examples are described in order to illustrate the approach. Some of the advantages as well as the limitations of the approach, for patients and staff, are considered.     

HIV counselling in the 1990s and beyond

It is 15 years since AIDS was first described in the medical literature. Reports of immune system disorders among gay men in large cities in the USA in 1981 signalled the start of what has now become a pandemic affecting millions of people. The psychological impact of HIV infection has been well-documented and it is widely reported that psychological treatment is mosdy provided for the treatment of adjustment reactions. Counselling for HIV prevention and HIV antibody testing has also been at the forefront of psychological support services. More recenuy, there has been a determined effort among counsellors to develop a range of psychotherapeutic approaches to help people to cope with and adjust to living with terminal illness. Most research published in the 1980s on the psychological impact of HIV addressed the infected individual. This symposium introduces a growing interest in the field for counselling those who are affected by HIV, including families, health-care workers and communities. This trend is becoming the focus of many counselling programmes worldwide and is likely to continue throughout the 1990s and beyond.