Consultation Sessions Research Articles

The Effectiveness of Group Therapy on Rescuing Patients with Cancer

Recent studies show that the cancer has several negative results. The anxiety, depression and disappointment are more common than the others. Hopefully thinking and cancer in two ways are related together. First the hopeful people use The problem-focused coping strategies more than the others and show less anxious and more agreement to diagnosis and treatment of cancer. So the goal of this survey is the effect of group hope therapy on reciliency of cancer patients. In this survey the Quasi-experiment and pre-test and pro test with control group is used. The society are all of the cancer patients who are coming to Kashan Imam Hassan institution and 16 of them are chose by available sampling and randomly put in two trial and control group. The trial group participated in nine group consultation sessions and the control group had no education. For toleration testing the Conroy Davidson questionnaire 2003 is used. Data are analysed by co variance analysis. The results show that the group hope therapy had a meaning full effect on toleration and the idea of personal competency, negative affection tolerance and acceptation of positive changing and spiritual control and affection s are affected the scales. Hope let people to have no stress and enable them to try to reach to their goals, the hope therapy try to enable people to have a view beyond the current situation and pain and suffering. So the toleration is not more than tolerance of the difficult situations and every things that make better the situation of cancer patients will increase the toreciliency.

The effect of group counseling based on self-awareness skill on sexual risk-taking among girl students in Gorgan, Iran: a randomized trial.

Background Sexual puberty in adolescents occurs before their mental and emotional maturity and exposes them to high-risk sexual behaviors. Because sexual risk-taking occurs before adolescents become involved in a sexual relationship, this study was conducted to identify the effect of group counseling based on self-awareness skill on sexual risk-taking among female high school students in Gorgan in order to suggest some preventative measures. Methods The present parallel study is a randomized field trial conducted on 96 girl students who were studying in grades 10, 11 and 12 of high school with an age range of 14-18 years old. Sampling was done based on a multi-stage process. In the first stage, through the randomized clustering approach, four centers among six health centers were selected. In the second stage, 96 samples were collected through consecutive sampling. Finally, the samples were divided into two intervention and control groups (each one having 48 subjects) through the simple randomized approach. It has to be noted that no blinding was done in the present study. The data were collected using a demographic specifications form and the Iranian Adolescents Risk-Taking Scale (IARS). The consultation sessions based on self-awareness skill were explained to an intervention group through 60-min sessions over 7 weeks. The pretest was conducted for both groups and the posttest was completed 1 week and 1 month after the intervention by the intervention and control groups. Finally, after the loss of follow-up/drop out, a total of 80 subjects remained in the study; 42 subjects in the intervention group and 38 subjects in the control group. Data analyses were done using SPSS v.16 along with the Freidman non-parametric test and the Mann-Whitney and Wilcoxon tests. Results The results showed that the sexual risk-taking mean scores in the intervention group (10.54 ± 15.64) were reduced by applying 1-week (8.03 ± 12.82) and 1-month (4.91 ± 10.10) follow-ups after the intervention. This reduction was statistically significant (p = 14%). However, no statistically significant difference was observed in the control group. Conclusion Group counseling based on self-awareness skill decreased the sexual risk-taking in girl students of the high school. As prevention is prior to treatment, this method could be proposed as the prevention of high-risk sexual behavior to healthcare centers and educational environments and non-government organizations (NGOs) interacting with adolescents.

Themes arising in clinical consultation for therapists implementing family-based treatment for adolescents with anorexia nervosa: a qualitative study

BackgroundOur study aims to explore and describe themes arising in sessions of clinical consultation with therapists implementing Family-Based Treatment (FBT) for adolescents with Anorexia Nervosa (AN). There is currently no literature describing the content of clinical consultation for FBT. Thus, this knowledge will add to the evidence-base on what therapists need from consultants in ongoing clinical consultation.MethodsEight therapists at four sites participated in this study, which spanned a two-year period. Following a two-day training workshop, each therapist treated at least one adolescent patient presenting with a restrictive eating disorder with FBT, focusing on adherence to the treatment manual. Clinical consultation sessions occurred monthly and were led by an external FBT expert. Thirty-five (average per site = 9) audio recorded group clinical consultation sessions were transcribed verbatim and coded for themes. Twenty percent of the transcripts were double-coded to ensure consistency. Fundamental qualitative description guided the sampling and data collection.ResultsThematic content analysis revealed ten common themes relating to the provision of clinical consultation to therapists implementing FBT in clinical practice: encouraging parental meal time supervision,discussing the role of mothers, how to align parents, ensuring parental buy-in, when to transition to Phase 2, weighing the patient and the patients’ knowledge of their weight, the role of siblings in FBT sessions, how best to manage patient co-morbidities, the role of the father in FBT and how best to manage the family meal.ConclusionsIn conclusion, clinical consultation themes aligned with many of the central tenets of FBT, including how to help parents align their supportive approach during the refeeding process, and how to help parents assume control of eating disordered behaviours. This knowledge helps to guide consultants to anticipate common issues brought forward by therapists attempting to implement FBT.

Outpatient scheduling with unpunctual patients and no-shows

We assess appointment scheduling strategies for outpatient services. To this end, we consider a fixed-length consultation session in which K patients have to be scheduled at predefined appointment times, but who may not be punctual. Their effective arrival time deviates from their appointment time by a stochastic unpunctuality time. We assume general, possibly distinct distributions for the patients’ consultation times as well as for their unpunctuality. The heterogeneity of the consultation times is motivated by patient classification: the schedule can be adapted to the patients’ characteristics. Our evaluation approach is based on a modified Lindley recursion in a discrete-time framework and obtains accurate predictions for the moments of the patient waiting times as well as the doctor’s idle times and overtime. This evaluation method is then included in a local search algorithm to provide general insights into appointment scheduling under unpunctual patients. Our results suggest that the proposed method obtains substantial cost reductions when patient classification is correctly exploited. Finally, it is shown that our analysis can also be used to determine optimal sequencing rules for patients who arrive out of turn.

Taking on the doctor role in whole-task simulation.

Untimed simulated primary care consultations focusing on safe and effective clinical outcomes were first introduced into undergraduate medical education in Otago, New Zealand, in 2004. We extended this concept and included a secondary care version for final-year students. We offer students opportunities to manage entire consultations, which include making and implementing clinical decisions with simulated patients (SPs). Formative feedback is given by SPs on the achievement of pre-determined outcomes and by faculty members on clinical decision making, medical record keeping and case presentation. We explored students' perceptions of the educational value of the sessions using post-session questionnaires (n=194) and focus groups (n=36 participants overall). Students are offered opportunities to manage entire consultations with simulated patients RESULTS: Students perceived that the sessions were useful, enjoyable and relevant to early postgraduate practice. They identified useful learning in time management, communication, decision making, prescribing and managing uncertainty. Students identified gaps in their knowledge and recognised that they had been offered opportunities to develop decision-making skills by having to take responsibility for whole consultations and all the decisions included within them. Most students reported positive impacts on learning, although a small minority reported negative impacts on their perceptions of their ability to cope as a junior doctor. These simulated consultation sessions appear to lead to the effective learning of a range of skills that students need in order to work as junior doctors. Facilitators leading such sessions must be alert to the possibility of educational harm arising from such simulations, and the need to address this during the debriefing.

Examination of an Audiologist's Response to Patient's Expression of Symptoms: A Pilot Study.

This pilot study explores audiologist-patient interactions during initial evaluations or consultations. In particular, an audiologist’s response to patient symptoms is examined. Conversations between audiologist and patients were recorded using a digital recorder, which were transcribed, and analyzed using the Codes for Human Analysis of Transcripts and Child Language Analysis computer programs. Mean length of turn and frequency of utterances related to explicit discussion or description of symptoms or the patient’s interpretation of symptoms was determined. Study sample: six audiologist-patient interactions were recorded and transcribed. A single audiologist was used for this pilot investigation. Results suggest that during the initial audiological consultations related to hearing difficulties the audiologist produced more utterances related to explicit description of the symptoms, whereas when during the sessions about complex disorder and hearing aid consultation the audiologist produced more utterances related to the patient’s interpretation of the symptoms. Also, a more equitable distribution of words and utterances per turn are observed during the initial consultation about hearing difficulties when compared to complex disorders and hearing aid consultation sessions where the audiologist was dominant within the interaction. This preliminary study reveals unique insights to audiologist’s communication behavior during audiology consultation session. Efforts are needed to educate and promote appropriate communication between audiologists’ and patients, which could result in increased patient satisfaction.

Client-Centeredness of Family Planning Services in a Resource Limited Setting.

Clients' needs and their satisfaction are priority issues in studying quality in reproductive health services. However, only 24-37% of Ethiopian women were informed about the available family planning methods and their utilization. High national total fertility rate (4.8) and low contraceptive prevalence rate (29%) might be attributed to these and other reasons. This study assessed the level of client-centeredness of family planning services and their determinants in public health facilities of Bahir Dar Town, Northwest Ethiopia. Exit interviews of 326 consecutively enrolled clients were conducted using structured questionnaire. Thirty consultation sessions were observed using a checklist to record client-provider interaction. The outcome variable was client centeredness as measured by perceived informed choice with perceived client-provider interaction as the intermediate variable. The average levels of perceived informed choice and client provider interaction were 70.0% and 67.6%, respectively. Perceived clinical competence of providers, perceived integration and coordination of care, perceived accessibility of services, perceived participation of families and friends in care delivery, perceived physical comfort of the facilities and type of the health facility were the independent predictors of perceived client provider interaction. Perceived degree of client provider interaction, perceived clinical competence of providers, type of health facility and perceived accessibility of services were independent predictors of perceived informed choice (p≤0.01). Client-centeredness of family planning services, as measured by clien-provider interaction and informed choice was not sufficiently assured in the study facilities.

Domiciliary transcranial direct current stimulation over a two year period for treatment-refractory psychiatric and neurological conditions. A three case report

The domiciliary use of transcranial direct current stimulation (tDCS) for treatment-resistant neurological and psychiatric disorders in three adult patients for a two year period is described. The first patient was diagnosed with chronic treatment-resistant depression, the second with fibromyalgia and the third with borderline personality disorder, bipolar disorder, self-harm, drug addiction and she was also pregnant. The three patients sought treatment for their conditions utilizing tDCS. Initial evaluation confirmed previous diagnoses, treatments, motivation and competency. Individual training to self-administer tDCS was provided at the clinic, with subsequent training, supervision, evaluation and consultation sessions accomplished via Skype. Protocols were individualized and subsequently modified as a result of the patient response and need for additional treatment as the therapeutic benefits waned with time. All three patients improved with the tDCS treatment. The most important indicators of improvement, as evaluated by the patients themselves, were the ability to function at work, social interaction and quality of life. Proficiency to self-administer was accomplished within the first week. Protocols were accurately followed and modifications were made as a result of doctor-patient collaboration. Side effects were minor, rapidly identified and treated. Domiciliary treatment can be a viable option for those conditions which respond to tDCS. Specific advantages include increased availability, convenience and lower cost.

Using Multi-component Consultation to Increase the Integrity with Which Teachers Implement Behavioral Classroom Interventions: A Pilot Study

The goal of this pilot study was to evaluate the effectiveness of a multi-component consultation package in improving teachers’ classroom management skills, particularly among teachers with lower baseline levels of knowledge, skills, and intervention-supportive beliefs. Participants were 58 elementary school teachers (93% female; 50% non-Hispanic White) who received up to eight biweekly consultation sessions focused on general classroom management strategies and implementation of a daily report card intervention with one target student with or at risk of ADHD. Teachers were randomly assigned to either a comparison consultation condition designed to mirror current best practices (Frank & Kratochwill, in: Erchul, Sheridan (eds) Handbook of research in school consultation, Routledge, New York, 2014; Noell & Gansle, in: Erchul, Sheridan (eds) Handbook of research in school consultation, Routledge, New York, 2014) or a multi-component condition designed to simultaneously address teacher knowledge, skills, and beliefs as possible barriers to implementation of classroom interventions. Teachers in both conditions showed significant improvements in labeled praise, appropriate response to student rule violations, and general competence in classroom management. In support of the hypotheses, teachers with lower baseline levels of knowledge, skills, and intervention-supportive beliefs demonstrated more improvement in key outcomes in response to multi-component consultation, as compared to the comparison consultation (Cohen’s d ranged from 0.33 to 1.12). Implications for research and practice in school consultation are discussed.

Digital design and manufacturing of wood head golf club in a cyber physical environment

PurposeThe purpose of this paper is to establish a cyber physical environment for digital product design and manufacturing. To realize this goal, the specific issue of integrating design knowledge-based system (KBS) and 3D printing (3DP) system is focused. A graphics generation method is thereby developed to transform the KBS outputs into graphical format which can be directly read and manufactured by 3DP system.Design/methodology/approachA graphics generation method is proposed in this paper. Through organizing alphanumeric outputs of the consultation session with a design KBS into parametric format, the consultation results can be directly used by computer-aided design (CAD) tools to generate graphical models which can be further exported into a 3DP system to produce physical objects.FindingsThe proposed graphics generation method can be effective to link design KBS and 3DP. Therefore, the seamless connection between design and prototyping systems can be realized, which further lays the communication foundation for a cyber physical environment for digital design and manufacturing.Originality/valueThis study provides research insights about potential cyber physical system applications in digital design and manufacturing area. Moreover, this paper contributes an effective technique to integrate design KBS and 3DP.

Evaluation of a Trauma-Focused CBT Training Programme for IAPT services.

Therapists in Improving Access to Psychological Therapies (IAPT) services are often expected to treat complex presentations of post-traumatic stress disorder (PTSD), such as individuals with multiple, prolonged or early life trauma histories and significant co-morbidity, for which they have received minimal training. Although high recovery rates for PTSD have been demonstrated in randomized controlled trials, these are not always replicated in routine practice, suggesting that training interventions are required to fill the research-practice gap. This study investigated the outcomes of a therapist training programme on treating PTSD with trauma-focused cognitive behavioural therapy (TF-CBT). Twenty therapists from ten IAPT services participated in the training, which consisted of workshops, webinars and consultation sessions over a 6-month period. Feedback indicated that participants found the training highly acceptable. PTSD knowledge and self- and supervisor-rated competence on TF-CBT measures improved following the training and improvements were maintained a year later. Client outcomes on a PTSD measure improved following the training. Participants reported attempts to disseminate learning from the course back to their teams. The findings indicate that the training programme was successful in improving TF-CBT knowledge, skills and outcomes for IAPT therapists. Tentative support for training 'trauma experts' within IAPT services was found, although institutional constraints and staff turnover may limit the sustainability of the model.

Tackling community undernutrition at lake Bogoria, Kenya: The potential of spirulina (Arthrospira fusiformis) as a food supplement

Undernutrition remains a major public health concern for many developing nations, particularly in sub-Saharan Africa. In Kenya, undernutrition affects a substantial portion of the Kenyan population, especially children and those living in rural areas. Local and sustainable means of addressing undernutrition is still lacking in many communities in urban, but more so in rural areas of Kenya. Spirulina ( Arthrospira fusiformis ), a cyanobacterium from alkaline inland waters, high in nutrient content, is a potential means of treating undernutrition in the developing world, where it can be easily grown. This paper presents a feasibility study on the harvest of Spirulina from Lake Bogoria in the Kenyan Rift Valley for use as a food supplement for undernutrition mitigation in the surrounding rural communities. A nutrition survey revealed the local population to be deficient in a number of micronutrients, specifically vitamins E and B12 that could be provided through dietary supplementation with Spirulina. A sample of Spirulina was collected from Lake Bogoria and analyzed for nutrient content and the presence of toxins. It was found that Lake Bogoria Spirulina had a dry protein content of 14.6% and is a rich source of dietary iron, with an iron content of 1.86%. A toxicity analysis revealed that Lake Bogoria Spirulina contained 1.15ng/g of microcystins (a group of hepatotoxic small polypeptides produced by several strains of cyanobacteria), which is within levels safe for human consumption according to World Health Organization standards. It was concluded that Lake Bogoria Spirulina is an easily accessible source of food and has the potential to be a sustainable means for the Lake Bogoria community to tackle undernutrition. Finally, using the data gathered, consultation sessions were arranged with key community groups and members to discuss the feasibility and potential for incorporation of Spirulina into the local diet – an ongoing collaborative process between researchers and the community that has already been met with some success. Key words : Spirulina, food, diet, undernutrition, Bogoria, toxicity, microcystins, community, Landsat

Advance Care Planning: Contemporary Issues and Future Directions.

Advance care planning (ACP) is widely considered an essential step toward achieving end-of-life care that is consistent with the preferences of dying patients and their families. ACP comprises a living will and a durable power of attorney for health care (DPAHC); these tools enable patients to articulate and convey their treatment preferences when they are still cognitively intact. In this article, we describe the strengths, weaknesses, and correlates of ACP in the United States, with attention to race and socioeconomic disparities therein. We then discuss other public policies and community programs designed to increase both the number of older adults who articulate their preferences for end-of-life care, and efficacy of ACP for ensuring that patients’ end-of-life treatment preferences are met. We describe the characteristics, strengths, and limitations of Physician Orders for Life Sustaining Treatment (POLSTs), and describe community programs, educational interventions, and public policies aimed toward increasing the prevalence and efficacy of end-of-life preparations. A key policy advance in the early 2010s has been Medicare coverage of one doctor–patient consultation session regarding end-of-life issues; we highlight the potentials and possible pitfalls of this policy. We conclude by identifying areas for future research, and highlighting practices from other nations that may help improve quality of end-of-life care in the United States.

Examining adherence to components of cognitive-behavioral therapy for youth anxiety after training and consultation.

The present study examined 115 service providers' adherence to components of cognitive-behavioral therapy (CBT) for youth anxiety prior to training, post workshop training, and after three months of weekly consultation. Adherence was measured using a role-play with a trained actor. We examined differences in individual adherence to CBT components across time and the relationship between number of consultation sessions attended and adherence ratings following consultation. Findings indicated that somatic arousal identification and relaxation were the most used treatment components prior to training. Adherence to all components of CBT increased following workshop training, except the usage of problem-solving. Adherence to problem-solving, positive reinforcement, the identification of anxious self-talk, and the creation of coping thoughts increased following consultation but usage of problem-solving remained low compared to other treatment components. Overall adherence remained less than optimal at the final measurement point. Number of consultation sessions attended predicted post-consultation adherence to identification of somatic arousal, identification of anxious self-talk, and positive reinforcement. Implications include tailoring future training based on baseline levels of adherence and spending more time during training and consultation on underutilized CBT components, such as problem-solving. Limitations of the present study, including how adherence was measured, are discussed. This study adds to the implementation science literature by providing more nuanced information on changes in adherence over the course of training and consultation of service providers.

Effect of Sexual Counseling on Marital Satisfaction of Pregnant Women Referring to Health Centers in Malayer (Iran): An educational randomized experimental study.

IntroductionOne of the most important factors in marital satisfaction is the satisfaction of a healthy sexual relationship between spouses. During pregnancy marital satisfaction may decrease due to sexual problems. Sexual counseling to pregnant women may reduce the complications of these problems at this time. This study aimed to investigate the effects of sexual counseling on marital satisfaction of pregnant women. This article is sponsored by the Hamadan University of Medical Sciences.MethodsThis educational randomized experimental study was conducted on 80 pregnant women referring to health centers of Malayer. Samples were two groups of experimental and control, with forty participants in each group, four consultation sessions were held, and each session lasted 40 to 90 minutes Data gathering tools were demographic questionnaire and Enriching Relationship Issues Communication and Happiness (ENRICH), a short form of marital satisfaction questionnaire with 47 items. Data were analyzed by Software SPSS 22 and the results were compared by independent t-test, chi-square test, and repeated measure ANOVA.ResultsComparing the marital satisfaction mean scores in the experimental group showed a significant difference between pre-consultation, and the consultation after two and four weeks. Marital satisfaction score of 8.05 ± 51.20 before the consultation was increased to 7.76 ± 54.52 after two weeks and 6.48 ± 59.20 after four weeks (respectively p < 0.001, p < 0.001). In addition, mean and standard deviation of marital satisfaction in the control group before the intervention, two weeks and four weeks after the intervention were respectively 10.10 ± 45.67, 11.75 ± 47.75, and 10.02 ± 46.30 and Bonferroni post hoc test showed a significant difference between before and two weeks after intervention (p = 0.03). However, marital satisfaction before and four weeks after the intervention was not significant (p = 0.59). The results showed that sexual counseling was associated with marital satisfaction and was effective in its promotion.ConclusionSexual counseling can be used as a method of intervention in sexual relationship of spouses particularly in marital dissatisfaction.

Mapping User Needs: Detailed GIS Services at the University of Nevada, Reno

GIS (Geographic Information Systems) is now widely observed to be a valuable tool that can be applied to teaching, learning, and research in many disciplines across academic campuses. The University of Nevada, Reno (UNR) Libraries are offering GIS support in the form of walk-in consultation sessions for the campus community. To learn more about what happens during GIS consultations the UNR GIS team gathered detailed data during the spring 2015 semester about its patrons and the functionality they are using. This knowledge can now be used to reevaluate and improve future GIS tutoring services at UNR Libraries. Lastly, this information is believed to be valuable to other academic libraries providing similar services.

User-Centered Design of Serious Games for Older Adults Following 3 Years of Experience With Exergames for Seniors: A Study Design.

BackgroundSeniors need sufficient balance and strength to manage in daily life, and sufficient physical activity is required to achieve and maintain these abilities. This can be a challenge, but fun and motivational exergames can be of help. However, most commercial games are not suited for this age group for several reasons. Many usability studies and user-centered design (UCD) protocols have been developed and applied, but to the best of our knowledge none of them are focusing on seniors’ use of games for physical activity. In GameUp, a European cofunded project, some prototype Kinect exergames to enhance the mobility of seniors were developed in a user-centered approach.ObjectiveIn this paper we aim to record lessons learned in 3 years of experience with exergames for seniors, considering both the needs of older adults regarding user-centered development of exergames and participation in UCD. We also provide a UCD protocol for exergames tailored to senior needs.MethodsAn initial UCD protocol was formed based on literature of previous research outcomes. Senior users participated in UCD following the initial protocol. The users formed a steady group that met every second week for 3 years to play exergames and participate in the UCD during the 4 phases of the protocol. Several methods were applied in the 4 different phases of the UCD protocol; the most important methods were structured and semistructured interviews, observations, and group discussions.ResultsA total of 16 seniors with an average age above 80 years participated for 3 years in UCD in order to develop the GameUp exergames. As a result of the lessons learned by applying the different methodologies of the UCD protocol, we propose an adjusted UCD protocol providing explanations on how it should be applied for seniors as users. Questionnaires should be turned into semistructured and structured interviews while user consultation sessions should be repeated with the same theme to ensure that the UCD methods produce a valid outcome. By first following the initial and gradually the adjusted UCD protocol, the project resulted in exergame functionalities and interface features for seniors.ConclusionsThe main lessons learned during 3 years of experience with exergames for seniors applying UCD are that devoting time to seniors is a key element of success so that trust can be gained, communication can be established, and users’ opinions can be recorded. All different game elements should be taken into consideration during the design of exergames for seniors even if they seem obvious. Despite the limitations of this study, one might argue that it provides a best practice guide to the development of serious games for physical activity targeting seniors.

Relationship between Nonverbal Behavior of Consultants and Consultees: A Preliminary Study

Little is known about the relationship between the nonverbal behavior of consultants and consultees in problem identification interviews in behavioral consultations. In particular, despite its assumed importance to consultative relationships and consultation success, the effects of nonverbal behavior on behavioral consultations remains unexplored. This short case report describes a study which sought to determine how nonverbal behavior from consultants can control the behavior of consultees. We recorded the occurrence or nonoccurrence of gestures and nodding responses and examined the association between these nonverbal behaviors in consultants and consultees by lag sequential analysis of videotaped sessions. The consultations involved two consultants and one consultee. The consultee presented the cases of two clients with distinct clinical problems and discussed solutions in two consultation sessions with each consultant, for a total of four consultation sessions. Our findings suggest that the experiential differences of consultants influenced the use and effect of nonverbal behaviors in behavioral consultations. Lag sequential analysis further showed that a consultant’s nonverbal behavior, such as hand gestures, controlled that of the consultee. However, the promotional impact of nodding responses by the consultee in response to the experienced consultant was not observed in response to the less experienced consultant. Although our findings were derived from a single consultation series involving only four consultation sessions, they highlight the importance of nonverbal behavior for behavioral consultation success and suggest that consultant education and training programs for nonverbal behavior be continually updated with new knowledge to improve consultation success.

The Effects of Psychodrama and Cognitive Behavioral Therapy-Based Group Work on Test Anxiety

The objective of this research is analyzing comparatively the positive effects of the group counseling practices performed by using the psychodrama techniques in company with the cognitive -behavioral techniques on reducing the exam anxiety of the students. The research having two experimental groups and a control group is a quasi-experimental study based on pretest-posttest design. The research is performed with the students of a private school in Istanbul attending the 10th and the 11th classes. At the end of the practice and evaluation, 32 students having the maximum exam and trait-continuity anxiety levels have been chosen. Randomly 10 students for cognitive behavioral therapy group; 11 students for psychodrama group; and 11 students for control group have been assigned. Exam anxiety that’s the dependent variable of the research has been measured by using “Exam Anxiety Inventory”. Trait and continuity anxiety levels have been measured by “Trait-Continuity Anxiety Scale” as the other dependent variables of the research. Scales have been given to the experimental and control groups as pretests. By the researcher 10 sessions of psychological consultation by using the psychodrama techniques for the first experimental group; and 8 sessions of psychological consultation by using cognitive behavioral therapy techniques for the second experimental group have been performed. For the control group, no work has been done. After the practices, the scales have been given again as the last test. The data obtained as a result of the experimental work has been analyzed by applying the Kruskal Wallis-H test, Mann Whitney-U test and Wilcoxon test. According to the obtained data it is observed that; compared to the control group, the psychological consultation practices performed by using the psychodrama techniques have been effective on exam anxiety total point, perception, delusion and trait anxiety points. No effect has been detected on continuity anxiety points. On the other hand, it is observed that compared to the control group, the psychological consultation practices performed by using the cognitive behavioral techniques have been effective on exam anxiety total point, perception and delusion. But no affect has been detected on trait and continuity anxiety points. In the analyses relating to comparison; in terms of total exam anxiety, perception, delusion sublevel and trait anxiety points of the students, psychodrama techniques applied in the first group have been more affective with reference to the cognitive behavioral techniques applied in the second group. No meaningful difference has been detected when two experimental groups have been compared according to continuity anxiety points.

Danger of words: risk and (mis)comprehension in consultations with the spirits of the povo da rua

Abstract Mediators between different realms, the spiritual entities known as the people of the streets can be taken as the very materialization of the principle of indeterminacy, being considered to be at once dangerous and powerful. Such indeterminacy acts upon processes of objectification and subjectification that unfold at the very heart of ritual. I turn my attention to the sessions of consultation, taking that encounter between clients and entities as a moment of instability, where the vulnerability of language - the danger of words - is at the center of ritual efficacy. If all human encounters involve a risk of un-understanding, such risk is certainly intensified in the session of consultations with the people of the streets, where instability is an implicit quality of the type of knowledge one seeks in such encounters, which are centered on issues of love, disaffections, betrayals and lived violences, all domains inherently unstable.