Klinische Supervision

Clinical supervision is of central significance within different phases of training and is seen as a central part of adequate psychotherapy. Based upon different definitions and models of supervision, this article reviews clinically relevant results of psychotherapy research dealing with issues of supervision. Although the significance of supervision for the quality of psychotherapeutic treatment is sometimes still critically discussed, the amount of evidence for their positive effects increases. The review shows a number of current research deficits that should be compensated in the future.     

‘A baptism of fire’: A qualitative investigation of a trainee counsellor's experience at the start of training

Background: Belief in the effectiveness of professional counselling and psychotherapy training is widespread and generally unquestioned. Few studies have attempted to understand the changes experienced by trainees, or identified which aspects of professional training programmes assist them in the process of becoming therapists. Aims: to investigate how a trainee counsellor changes at the start of training, and to identify which aspects of a professional counsellor training programme were helpful in instigating and supporting change. Method: the experience of one trainee counsellor, Margaret, was captured through three semi-structured interviews conducted at the beginning, middle and end of her first term. The data were subjected to systematic qualitative analysis. Findings: Margaret experienced significant change during her first term. Each interview revealed a different phase of her development. The core categories were: becoming something new (week 3); growth in therapeutic confidence (week 6); surviving ‘stressful involvement’ through supervision (week 11). Experiential learning, in particular group supervision, was helpful throughout. The presence of real clients was identified as the main driver for change. Conclusion: The findings were found to be consistent with a number of other studies, which suggest that training is potentially painful because of the emotional demands it places on trainees, particularly at the start of practice. Consequently trainees require opportunities for experiential learning, peer support and supportive supervision to assist them in their development, but most importantly, given that supportive supervision can only minimise the harm of stressful involvement (Orlinsky & Ronnestad, 2005), they need early positive experiences with clients.     

Racial Microaggressions Against Black Americans: Implications for Counseling

Racial microaggression themes were identified using a focus‐group analysis of self‐identified Black participants. Six categories of demeaning and invalidating messages reflected beliefs of White supremacy that were unintentionally conveyed by perpetrators. Implications for counselors and the counseling process are discussed.     

State of Multicultural Neuropsychological Assessment in Children: Current Research Issues

Scientific attention to cultural considerations in child neuropsychological assessment has not developed parallel to the focus these issues have received in adult and elderly neuropsychological assessment. There are limited data on the presence, magnitude, etiology, and implications of culture-related differences in cognitive test performance among children. This preliminary report reviews the available empirical literature on the current state of multicultural neuropsychological assessment in children. The review identified articles by searching PubMed and PsycINFO databases, and the tables of contents of Developmental Neuropsychology and Child Neuropsychology from 2003-2008. Of the 1,834 abstracts reviewed, ten papers met inclusion criteria for the review. Five studies were completed in America; four of these compared performance between ethnic groups while the fifth examined neighborhood level poverty indicators exclusively within African-American children. Of the five international studies, all established local normative data and/or were exploratory investigations of neuropsychological functions in specific cultural groups, including Taiwanese infants, South African youth, and bilingual British children. Taken together, the results yield important clinical and research data that begin to inform many of the complex and fascinating mechanisms by which ethnic identity and culture impact cognitive development and the neuropsychological assessment of children. A critique of the existing literature and directions for future research are provided.     

"If You're Frail You've Had It": A Theory of Planned Behavior Study of Student Nurses' Attitudes Towards Working with Older Patients

Background: The developed world's population is aging but care of older patients is unpopular in nursing.
Objectives: To determine student nurses' attitudes towards working with older patients and analyze underlying factors.
Method: 172 UK student nurses were surveyed using the theory of planned behavior.
Results: Positive intentions were related to attitudes ( p <0.01) and subjective norms ( p <0.05). Three underlying factors, intolerance ( p <0.01), humanism ( p <0.05), and concern about aging ( p <0.01) differentiated more and less positive participants.
Discussion: Results are only partly consistent with previous findings. Future attitudinal research in this area must be more tightly specified to be relevant to health care and should measure actual behavior and employed nurses' views. Nursing curricula should refer to the three relevant factors.     

Predicting post‐traumatic growth and post‐traumatic stress in firefighters

Emergency service workers (e.g., firefighters, police, and paramedics) are exposed to elevated levels of potentially traumatising events through the course of their work. Such exposure can have lasting negative consequences (e.g., post‐traumatic stress disorder (PTSD)) and/or positive outcomes (e.g., post‐traumatic growth (PTG)). Research had implicated trauma, occupational and personal variables that account for variance in post‐trauma outcomes yet at this stage no research has investigated these factors and their relative influence on both PTSD and PTG in a single study. Based in Calhoun and Tedeschi's model of PTG and previous research, in this study regression models of PTG and PTSD symptoms among 218 firefighters were tested. Results indicated organisational factors predicted symptoms of PTSD, while there was partial support for the hypothesis that coping and social support would be predictors of PTG. Experiencing multiple sources of trauma, higher levels of organisational and operational stress, and utilising cognitive reappraisal coping were all significant predictors of PTSD symptoms. Increases in PTG were predicted by experiencing trauma from multiple sources and the use of self‐care coping. Results highlight the importance of organisational factors in the development of PTSD symptoms, and of individual factors for promoting PTG.     

Locus of control, self-control, and family income as predictors of young children's mathematics and science scores

Locus of control, self-control, and family income were investigated as possible predictors of 138 young children's mathematics and science scores. The children, 60 boys and 78 girls, ranging from 4 to 8 years of age (M = 5.4, SD = 1.3) were administered the Stephens-Delys Reinforcement Contingency Interview Scale, the Self-control Rating Scale, the Comprehensive Mathematics Inventory, and a science test based on the work of D. K. Dickinson. Analysis showed mathematics scores were positively related to income, locus of control, and science scores. Mathematics and science scores were negatively related to lack of self-control. Also, science scores were positively related to locus of control. Multiple regression analysis with mathematics as the dependent variable indicated income had the greatest predictive value followed by self-control and locus of control. The multiple regression model of science was also significant, with locus of control having the greatest influence followed by self-control.     

The Effectiveness of Family History Questionnaires in Cancer Genetic Counseling

The number of individuals receiving genetic counseling for hereditary breast and ovarian cancer syndrome has steadily risen. To triage patients for genetic counseling and to help reduce the amount of time needed by a genetic counselor in direct patient contact, many clinics have implemented the use of family history questionnaires. Although such questionnaires are widely used, scant literature exists evaluating their effectiveness. This article explores the extent to which family history questionnaires are being used in Ontario and addresses the utility of such questionnaires in one familial cancer clinic. By comparing the pedigrees created from questionnaires to those updated during genetic counseling, the accuracy and effectiveness of the questionnaires was explored. Of 121 families recruited into the study, 12% acquired changes to their pedigree that led to a revised probability estimate for having a BRCA1 or BRCA2 mutation and 5% acquired changes that altered their eligibility for genetic testing. No statistically significant difference existed between the eligibility for genetic testing prior to and post counseling. This suggests that family history questionnaires can be effective at obtaining a family history and accurately assessing eligibility for genetic testing. Based on the variables that were significantly associated with a change in probability estimate, we further present recommendations for improving the clarity of such questionnaires and therefore the ease of use by patients.