Assessment of HIV counselling and social care services in a London hospital

The use of, and satisfaction with, counselling and social care services was investigated among HIV-infected clients attending HIV specialist climes at Guy's Hospital and Southwark Social Services, London. A survey of 71 clients with HIV infection was carried out using a self-administered questionnaire. The greatest demand was for advice about income support, housing, counselling for the HIV test, counselling for depression or anxiety, psychological support for coping with HIV, help with sleeping problems, mobility allowance, and help with furniture/household appliances. Overall, 57% thought the service was good or excellent; 66% of respondents thought they would use the services in the future. Over nine in ten clients had used the psychosocial support services at some stage since their HIV diagnosis, although only two-thirds anticipated that they would have need of these services in the future. The psychosocial support service will need to remain responsive to the shift in demand for this service, as well as the changing needs of clients who use it.     

Chronicity, severity, and timing of maternal depressive symptoms: relationships with child outcomes at age 5

The relationships between severity, chronicity, and timing of maternal depressive symptoms and child outcomes were examined in a cohort of 4,953 children. Mothers provided self-reports of depressive symptoms during pregnancy, immediately postpartum, and when the child was 6 months old and 5 years old. At the age 5 follow-up, mothers reported on children's behavior and children completed a receptive vocabulary test. Results suggest that both the severity and the chronicity of maternal depressive symptoms are related to more behavior problems and lower vocabulary scores in children. The interaction of severity and chronicity of maternal depressive symptoms was significantly related to higher levels of child behavior problems. Timing of maternal symptoms was not significantly related to child vocabulary scores, but more recent reports of maternal depressive symptoms were associated with higher rates of child behavior problems.     

Integrating biological and social processes in relation to early-onset persistent aggression in boys and girls

This study examined the relationship between biological and social risk factors and aggressive behavior patterns in an Australian high-risk sample of 370 adolescents. Perinatal, temperamental, familial, sociodemographic, and behavioral data were collected during interviews completed during pregnancy. immediately postpartum, and when the children were 6 months old and 5, 14, and 15 years old. Youths were given tests of verbal and neuropsychological functioning at the age 5 and age 15 follow-ups. Youths were divided into early-onset persistent aggression, adolescent-onset aggression, and nonaggressive behavior groups. Results revealed that the interaction of biological and social risk factors was significantly related to early-onset persistent aggression. Gender and developmental phase of measurement moderated the relationship between biosocial risks and the outcomes of early-onset persistent aggression and adolescent-onset aggression.     

Maintenance of Treatment Gains: A Comparison of Enhanced,Standard, and Self-directed Triple P-Positive Parenting Program

This report describes the 3 year outcomes of three different variants of the Triple P-Positive Parenting Program, a behavioural family intervention. Families were randomly assigned to one of three intervention conditions or to a waitlist condition. At 1 year follow-up there were similar improvements on observational and self-report measures of preschooler disruptive behaviour for Enhanced, Standard and Self Directed variants of Triple P. At 3 year follow-up (completed by 139 families), each condition showed a similar level of maintenance of intervention effects. Approximately 2/3 of preschoolers who were clinically elevated on measures of disruptive behaviour at pre-intervention moved from the clinical to the non-clinical range. Across conditions, there was a comparable preventive effect for each intervention for these high risk children. The implications of the findings for the development of brief, cost effective parenting interventions within a public health framework are discussed.     

Counselling psychology in primary health care: A review

This paper reviews the development of counselling psychology within the field of primary health care. Issues discussed include liaison between counselling psychologists and other professionals, evaluation of treatment in primary care, family therapy in general practice and general practitioners’ skills in counselling. The need for training and evaluation of counselling are discussed and suggestions are made for further research.     

Genograms in counselling practice: A review (Part 1)

Genograms are an important clinical tool for many counsellor, therapists and other health care professionals and can be used for assessment, gathering information on family relationships and exploring themes in counselling practice. This article reviews the recent literature on genograms and examines the efficacy and use of this tool from a number of perspectives including the use of genograms in health care, psychological counselling and in genetic counselling. The predictive value, and future development of the use of the genogram in counselling are also discussed.     

Selective Disclosure: A Pilot Investigation into Changes in Family Relationships Since HIV Diagnosis

The aim of this research was (1) to determine the impact of HIV infection on the family as experienced by a sample of HIV infected males and females attending a London hospital HIV/AIDS service, and (2) to examine the feasibility of conducting this investigation in a clinical setting. Fifty patients (predominantly gay males and heterosexual females) attending an HIV outpatient clinic were assessed using a self-administered questionnaire covering family relationships and disclosure of HIV. The results showed a similarity for gay males and heterosexual females in the definition of 'close family', yet a difference in the disclosure of HIV status to their family of origin. We conclude that the impact of HIV on the family can be examined in a clinical setting, although the question of validation must be addressed.     

AIDS Counselling: Clinical Application and Development of Services

The reasons for the provision of AIDS counselling services, and the ways in which they have developed, are described. The role of the counsellor both in medicine, and in the field of AIDS/HIV infection, is outlined. The psychosocial difficulties accompanying this illness are reviewed. Stress is placed on the need to consider not only the client, but also their sexual partners, family, friends, colleagues and even other members of the health-care team. Further investigations need to be carried out to clarify where AIDS counselling services fit with other medical and paramedical services.     

Another dragon in the kitchen: Psychological experiences of hepatitis C treatment among HIV‐hepatitis C co‐infected gay men

Background: Increasing numbers of HIV‐infected gay men acquire hepatitis C virus (HCV) co‐infection, which causes serious medical consequences. Treatment for HCV is associated with many severe side effects, in some cases psychological, and many patients subsequently fail to adhere, even when psychological services are utilised, to improve treatment adherence. Objective: This qualitative study aimed to explore the experiences of HIV‐infected gay men undergoing treatment for HCV in order to inform psychological services to better meet specific treatment needs of this population. Methods: Thirteen HIV‐infected gay men who had undergone HCV treatment were interviewed and a qualitative analysis was conducted. Participants described HCV and its treatments in the context of their relationships and lifestyles. Findings: Four domains emerged: HCV diagnosis and treatment; HCV treatment education; change in sense of self; and sexual risk‐taking. Adhering to treatment was a significant challenge for all participants and emerged across all domains. Discussion: Psychological services for this population of co‐infected gay men should assist this clinical population not only with adherence to hepatitis C treatment but should also be available at an earlier stage in the process to help patients make informed choices about whether or not to begin a course of treatment. Assessing factors such as coping strategies, treatment readiness and knowledge, self‐awareness, and level of risk‐taking, can guide clinicians in tailoring treatment and adherence planning for HIV/HCV‐co‐infected gay men.