The long‐term effects of counselling: The process and mechanisms that contribute to ongoing change from a user perspective

Aims: This qualitative study aimed to expand the limited evidence base about the long‐term effects of psychological therapies.Method: We conducted in‐depth interviews with 15 people, 1–3 years after primary care counselling, to investigate whether they could identify enduring benefits and the mechanisms that brought about and maintained them. From their narratives, we developed a model of the change process of counselling and mechanisms that were perceived as essential to produce lasting benefit. The model conceptualised movement through distinct phases: engagement; exploration of internal and external worlds; consolidation and negotiated ending. Results: Mechanisms integral to sustained impact were: the active engagement of people during and between sessions to work toward their own solutions; and acquisition through the change process of skills which could be further built on after the counselling ended. These enabled ongoing, dynamic change in the way people conducted their lives and relationships. Conclusion: A key concept in securing long‐term benefit was co‐production, both during counselling and in taking ownership of and using the ‘box of skills’ acquired. Support of the model was reinforced through comparison with the experience of three interviewees who reported no long‐term benefit.     

COMMENTS ON SIX RESPONSES TO DEMOCRACY AND TRADITION

This paper is a rejoinder to papers by Sabina Lovibond, Nicholas Wolterstorff, Sumner B. Twiss, G. Scott Davis, M. Cathleen Kaveny, and John Kelsay on the author's recent book Democracy and Tradition. The argument covers a host of topics, ranging from epistemology and methodology to human rights, the common law, and Islamic ethics.     

Development of the emotional self-disclosure scale

The Emotional Self-Disclosure Scale (ESDS) was developed to assess how willing people are to discuss specific emotions with different disclosure recipients. Internal reliabilities (Cronbach's alpha) and test-retest were consistently high for each of the subscales on the ESDS for three specific disclosure recipients: female friends, male friends, and spouses/lovers. A final set of results indicated that women's and men's emotional disclosures varied as a function of their gender and the personal characteristics of the disclosure recipient. Although men and women reported a similar pattern of willingness to discuss their emotions with their male friends, additional results revealed that women were more willing than men to disclose information about their feelings of depression, anxiety, anger, and fear to their female friends and spouses/lovers. The implications of these findings for men's and women's emotional expressivity are discussed.Portions of this paper were presented at the 33rd annual meeting of the Southwestern Psychological Association, New Orleans, Louisiana, April 1987.     

TWO GENERATIONS OF MOTHERS AND DAUGHTERS: ROLE POSITION AND INTERDEPENDENCE

Using both partners as informants and three interdependence measures (contact, aid, and attachment) as criterion variables, we address the assumption that women's orientation to and dependence on other generations differ because of unique roles. In 135 pairs of student women and their mothers and 119 pairs of middle-aged women and their mothers, we ask how a woman's role position interacts with her partner's role position in regard to interdependence. Both dyadic and individual role combinations are examined. In younger pairs, we examine the combination of daughter's marital status and both mother's launching and work statuses; in older pairs, we examine the combination of mother's marital status and both daughter's launching and marital statuses. Regression analyses demonstrate that, except for younger pairs where married daughters and their mothers are less interdependent than single daughters and their mothers, interdependence is remarkably unrelated to role positions, singly or in combination. Results suggest normative pressures toward new conjugal bonds and stability in women's family roles.     

Modeling and the Michigan Experimental Simulation Supervisor: An overview and some prospects

A data-generating system (MESS) is described which facilitates the construction and study of behavioral science models of various types. The system provides a spectrum of options that make it possible to employ MESS in a variety of classroom situations with relatively unsophisticated students.     

Multisystemic therapy: monitoring treatment fidelity

The challenges of specifying a complex and individualized treatment model and measuring fidelity thereto are described, using multisystemic therapy (MST) as an example. Relations between therapist adherence to MST principles and instrumental and ultimate outcome variables are examined, as are relations between clinical supervision and therapist adherence. The findings provide modest support for the associations between MST adherence measures and instrumental and ultimate outcomes. Results also show that adherence can be altered when clinical supervision and adherence monitoring procedures are fortified. The modest associations between adherence measures and youth outcomes argue for further refinement and validation of the MST adherence measure, especially in light of the well-established effectiveness of MST with challenging clinical populations and the increasing dissemination of MST programs.     

Attentional load and implicit sequence learning

A widely employed conceptualization of implicit learning hypothesizes that it makes minimal demands on attentional resources. This conjecture was investigated by comparing learning under single-task and dual-task conditions in the sequential reaction time (SRT) task. Participants learned probabilistic sequences, with dual-task participants additionally having to perform a counting task using stimuli that were targets in the SRT display. Both groups were then tested for sequence knowledge under single-task (Experiments 1 and 2) or dual-task (Experiment 3) conditions. Participants also completed a free generation task (Experiments 2 and 3) under inclusion or exclusion conditions to determine if sequence knowledge was conscious or unconscious in terms of its access to intentional control. The experiments revealed that the secondary task impaired sequence learning and that sequence knowledge was consciously accessible. These findings disconfirm both the notion that implicit learning is able to proceed normally under conditions of divided attention, and that the acquired knowledge is inaccessible to consciousness. A unitary framework for conceptualizing implicit and explicit learning is proposed.