Creative Interventions for Teaching Empathy in the Counseling Classroom

Empathy is a foundational, necessary component of successful counseling. Relaying an understanding of empathy, including the components and science behind the phenomenon, is critical to the development of counselors-in-training. In addition, creative practice is a pillar of professional counseling, and is linked to experiential learning and meaningful integration of new knowledge in counselor education. The purpose of this article is to provide a review of the definitions of empathy, provide current literature on the science of empathy, and discuss specific creative interventions to use within counseling courses to increase empathic knowledge and skills.     

Predicting group-level outcome variables: An empirical comparison of analysis strategies

This study provides a review of two methods for analyzing multilevel data with group-level outcome variables and compares them in a simulation study. The analytical methods included an unadjusted ordinary least squares (OLS) analysis of group means and a two-step adjustment of the group means suggested by Croon and van Veldhoven (2007). The Type I error control, power, bias, standard errors, and RMSE in parameter estimates were compared across design conditions that included manipulations of number of predictor variables, level of correlation between predictors, level of intraclass correlation, predictor reliability, effect size, and sample size. The results suggested that an OLS analysis of the group means, with White’s heteroscedasticity adjustment, provided more power for tests of group-level predictors, but less power for tests of individual-level predictors. Furthermore, this simple analysis avoided the extreme bias in parameter estimates and inadmissible solutions that were encountered with other strategies. These results were interpreted in terms of recommended analytical methods for applied researchers.     

Utilization of the Tablet Application Proband in Pedigree Construction and Assessment

Many medical institutions have converted to a digital model for record keeping due to the Health Information Technology for Economic and Clinical Health Act. This Act provides incentives to health care systems to accelerate and encourage the adoption of electronic health record (EHR) systems. The pedigree as a tool in medicine provides an efficient method to assess and represent an individual’s health and family health risks that may otherwise not be apparent in the medical record in a clearly identifiable way (Schuette, J. L., & Bennett 2009). Many clinicians continue to construct pedigrees using pen and paper method despite findings of improved identification of at risk patients with similar electronic intake tools (Arar et al. in Personalized Medicine 2011 8:523–32). The goal of this study was to explore the patient and practitioner experience with electronic pedigree programs using Proband, an application developed at The Children’s Hospital of Philadelphia for genetic counselors to construct pedigrees during genetic counseling sessions directly on iPads. The first part of this study looked at the patient experience and assessed time to take the pedigree and the impact of using an electronic pedigree tool on the relationship between participant and genetic counselor. This involved 50 participants and was compared with the traditional paper method of taking a pedigree. There was no statistical significance found between the two different mediums in accuracy, speed, and rapport with provider. The second part of the study assessed the usability of Proband by ten genetic counselors. Overall, the application received a system usability score of 90/100 with a majority (7/10) of counselors agreeing that they would use this application in their clinic. The positive outcome of this study encourages future work to assess the impact and usability of programs on a larger scale as they continue to integrate into current electronic health records.     

“In the Face,a Right Is There”: Arendt,Levinas and the Phenomenology of the Rights of Man

This paper examines the differences between the thought of Hannah Arendt and Emmanuel Levinas concerning the “Rights of Man”, in relation to stateless persons. In The Origins of Totalitarianism, Arendt evinces a profound scepticism towards this ideal, which for her was powerless without being tethered to citizenship. But Arendt’s own idea of the “Right to have Rights” is critiqued here as being inadequate to the ethical demand placed upon states by refugees, in failing to articulate just what states might be responsible for. I argue that the ethical philosophy of Levinas meets this lacuna in Arendt’s thought, via his concept of the Face as the locus of human dignity and to which states can be recalled to responsibility. Levinas wrote several papers on what he called “the phenomenology of the Rights of Man”, and in his phrase, which provides a summation of precisely what is lacking in Arendt’s arguments: “In the face – a right is there”.     

Efficacy of Guided iCBT for Depression and Mediation of Change by Cognitive Skill Acquisition

Guided internet CBT (iCBT) is a promising treatment for depression; however, it is less well known through what mechanisms iCBT works. Two possible mediators of change are the acquisition of cognitive skills and increases in behavioral activation. We report results of an 8-week waitlist controlled trial of guided iCBT, and test whether early change in cognitive skills or behavioral activation mediated subsequent change in depression. The sample was 89 individuals randomized to guided iCBT (n = 59) or waitlist (n = 30). Participants were 75% female, 72% Caucasian, and 33 years old on average. The PHQ9 was the primary outcome measure. Mediators were the Competencies of Cognitive Therapy Scale–Self Report and the Behavioral Activation Scale for Depression–Short Form. Treatment was Beating the Blues plus manualized coaching. Outcomes were analyzed using linear mixed models, and mediation with a bootstrap resampling approach. The iCBT group was superior to waitlist, with large effect sizes at posttreatment (Hedges’ g = 1.45). Dropout of iCBT was 29% versus 10% for waitlist. In the mediation analyses, the acquisition of cognitive skills mediated subsequent depression change (indirect effect = -.61, 95% bootstrapped biased corrected CI: -1.47, -0.09), but increases in behavioral activation did not. iCBT is an effective treatment for depression, but dropout rates remain high. Change in iCBT appears to be mediated by improvements in the use of cognitive skills, such as critically evaluating and restructuring negative thoughts.     

Low Working Memory rather than ADHD Symptoms Predicts Poor Academic Achievement in School-Aged Children

This study examined whether working memory (WM), inattentive symptoms, and/or hyperactive/impulsive symptoms significantly contributed to academic, behavioral, and global functioning in 8-year-old children. One-hundred-sixty 8-year-old children (75.6% male), who were originally recruited as preschoolers, completed subtests from the Wechsler Intelligence Scale for Children–Fourth Edition, Integrated and Wechsler Individual Achievement Test–Second Edition to assess WM and academic achievement, respectively. Teachers rated children’s academic and behavioral functioning using the Vanderbilt Rating Scale. Global functioning, as rated by clinicians, was assessed by the Children’s Global Assessment Scale. Multiple linear regressions were completed to determine the extent to which WM (auditory-verbal and visual-spatial) and/or inattentive and hyperactive/impulsive symptom severity significantly contributed to academic, behavioral, and/or global functioning. Both auditory-verbal and visual-spatial WM but not ADHD symptom severity, significantly and independently contributed to measures of academic achievement (all p < 0.01). In contrast, both WM and inattention symptoms (p < 0.01), but not hyperactivity-impulsivity (p > 0.05) significantly contributed to teacher-ratings of academic functioning. Further, inattention and hyperactivity/impulsivity (p < 0.04), but not WM (p > 0.10) were significantly associated with teacher-ratings of behavioral functioning and clinician-ratings of global functioning. Taken together, it appears that WM in children may be uniquely related to academic skills, but not necessarily to overall behavioral functioning.     

Fearful Inhibition,Inhibitory Control,and Maternal Negative Behaviors During Toddlerhood Predict Internalizing Problems at Age 6

Many, but not all, young children with high levels of fearful inhibition will develop internalizing problems. Individual studies have examined either child regulatory or environmental factors that might influence the level of risk. We focused on the interaction of regulation and environment by assessing how early fearful inhibition at age 2, along with inhibitory control and maternal negative behaviors at age 3, interactively predicted internalizing problems at age 6. A total of 218 children (105 boys, 113 girls) and their mothers participated in the study. Results indicated a three-way interaction among fearful inhibition, inhibitory control, and maternal negative behaviors. The correlation between fearful inhibition and internalizing was significant only when children had low inhibitory control and experienced high levels of maternal negative behaviors. Either having high inhibitory control or experiencing low maternal negative behaviors buffered against the adverse effect caused by the absence of the other. These findings highlight the importance of considering associations among both within-child factors and environmental factors in studying children’s socioemotional outcomes.