A Career Developmental Perspective on the Therapeutic Alliance: Implications for Counseling

This review explores the role played by childhood emotional maltreatment (CEM) in selecting a career in the field of mental health and the potential positive and deleterious effects of these career‐choice motives on the therapeutic alliance. The reviewed findings support the assumption that CEM may serve as a precursor for career choice of professions in the mental health field. Implications are suggested for the counselor/therapist–client relationship, also known as the therapeutic alliance, as well as for career counseling.     

Body-image,quality of life and psychological distress: a comparison between kidney transplant patients and a matching healthy sample

The purpose of the current study was to assess the uniqueness of the condition of kidney transplant recipients in comparison to a sample of matching healthy peers in relation to body-image dissatisfaction and identification, quality of life and psychological distress. Participants were 45 kidney transplant recipients who were under follow-up care at a Transplant Unit of a major Medical Center, and a sample of 45 matching healthy peers. Measures were taken using self-report questionnaires [Body-Image Ideals Questionnaire (BIIQ), Body Identification Questionnaire (BIQ), Brief Symptoms Inventory (BSI), and the SF-12]. The major findings were the following: (i) kidney transplant recipients reported lower levels of quality of life and higher levels of PsD when compared to their healthy peers; (ii) no difference in body-image dissatisfaction was found between the two studied groups; (iii) significant correlations between body-image dissatisfaction quality of life and PsD were found only in the kidney transplant recipients. The kidney transplantation condition has a moderating effect in the association between body-image dissatisfaction PsD but not in the association between body-image dissatisfaction and quality of life; (iv) kidney transplant recipients experienced higher levels of body identification than did their healthy peers. Taken together, these findings highlight the unique condition of kidney transplant recipients, as well as the function that body-image plays within the self.     

Genetic Risk Assessment for Women with Epithelial Ovarian Cancer: Referral Patterns and Outcomes in a University Gynecologic Oncology Clinic

Little is known about genetic service utilization and ovarian cancer. We identified the frequency and outcome of genetic counseling referral, predictors of referral, and referral uptake for ovarian cancer patients. Using pathology reports, we identified all epithelial ovarian cancer patients seen in a university gynecologic oncology clinic (1/04–8/06). Electronic medical records (EMR) were used to document genetic service referral, time from diagnosis-to-referral, point-in-treatment at referral, personal/family cancer history, demographics, and genetic test results. Groups were compared using chi-squared and Fisher’s exact test for categorical variables and t-tests for continuous variables. The study population consisted of 376 women with ovarian cancer, 72 (19 %) of who were referred for genetic counseling/testing, primarily during surveillance. Of those referred, 42 (58 %) had personal or family genetic counseling and 34 (47 %) were ultimately tested or identified due to known family mutation. Family history and prior cancer were associated with referral. Family history, living in a larger community, higher-stage disease, and serous histology were associated with undergoing genetic counseling. Risk assessment identified 20 BRCA1/2 (5.3 %) and 1 HNPCC (0.3 %) mutation carriers. Based on recent estimates that 11.7–16.6 % of women with ovarian cancer are BRCA carriers and 2 % are HNPCC carriers, results suggest under-identification of carriers and under-utilization of genetic services by providers and patients. Interventions to increase medical providers’ referrals, even in a specialized oncology clinic, are necessary and may include innovations in educating these providers using web-based methods. Ease of referral by the introduction of an electronic cancer genetic referral form represents another new direction that may increase genetic risk assessment for high-risk women with ovarian cancer.     

The Contribution of Group Supervision Processes to the Formation of Professional Identity among Novice Psychotherapists

ABSTRACT

Group supervision is a commonly employed method in graduate psychology training. The present study examines the role of group processes in the formation of professional identity among 129 Israeli graduate students following the conclusion of their supervision process. The following three identity statuses were identified: achievement, diffusion, and moratorium. Working alliance and group engagement were significantly higher for achievement students and differentiated between achievement and moratorium students. Cohesion was significantly lower for moratorium students than for students at each of the other two identity statuses. All differences were maintained when controlling for anxiety. Finally, working alliance was found to be the dominant process in predicting committed professional identity status. The findings stress the links between group processes in group supervision and a committed professional identity.