VARIABLES RELATED TO BREAST SELF-EXAMINATION: Model Generation

Using a prospective design, variables from several relevant social psychological theories that would predict breast self-examination were identified. The participants included a probability sample of 362 women who were 35 or older. Instruments were tested for validity and reliability. Data were collected from each participant twice, 1 year apart, using an in-person interview for Time 1 and a telephone interview for Time 2. Results of standardized path coefficients (beta) indicated that breast self-examination (BSE) at Time 2 was directly related to BSE at Time 1 (.76). Indirect paths for susceptibility (.40), health motivation (.46), and barriers (-.54) were identified. All paths mentioned were significant (p5.01). Findings have implications for interventions to increase BSE in women 35 and older.     

The relationship between alliance ruptures and hope for change through counseling: A mixed methods study

The negative impact of alliance ruptures on clients’ experiences within the therapeutic process is well documented. One such negative influence may include clients’ hope for counseling as a helpful process. This study used a mixed methods design to explore how alliance ruptures are related to hope for change through counseling. Quantitative data (N = 105) indicated that those who experienced ruptures reported lower levels of the components of hope for change through counseling, (a) pathways and agency, and (b) goal identification. More frequent ruptures and rupture repairs were significantly related to participants’ (n = 35) pathways and agency. Phenomenological analysis of qualitative participants’ (N = 5) experiences elicited 218 meaning units grouped into four themes: disengagement and mistrust in therapy, deepened distress, questioning one’s hope for and belief in therapy, and resilience for therapy. Qualitative and quantitative data indicate that alliance ruptures are related to lower degrees of hope for change through counseling. Results suggest that clients’ perceptions of ruptures fostered disengagement and mistrust of therapists. However, when therapists act to repair ruptures, they may effectively re-engage some degree of hope for change through counseling in clients. Lastly, the role of clients’ persistence in therapy despite experiencing ruptures is discussed.