Counseling Abilities Research Articles

Contraception services for incarcerated women: a national survey of correctional health providers

Background Incarcerated women have had limited access to health care prior to their arrest. Although their incarceration presents an opportunity to provide them with health care, their reproductive health needs have been overlooked. Study Design We performed a cross-sectional study of a nationally representative sample of 950 correctional health providers who are members of the Academy of Correctional Health Providers. Results A total of 405 surveys (43%) were returned, and 286 (30%) were eligible for analysis. Most ineligible surveys were from clinicians at male-only facilities. Of eligible respondents, 70% reported some degree of contraception counseling for women at their facilities. Only 11% provided routine counseling prior to release. Seventy percent said that their institution had no formal policy on contraception. Thirty-eight percent of clinicians provided birth control methods at their facilities. Although the most frequently counseled and prescribed method was oral contraceptive pills, only 50% of providers rated their oral contraceptive counseling ability as good or very good. Contraception counseling was associated with working at a juvenile facility, and with screening for sexually transmitted infections. Conclusions Contraception does not appear to be integrated into the routine delivery of clinical services to incarcerated women. Because the correctional health care system can provide important clinical and public health interventions to traditionally marginalized populations, services for incarcerated women should include access to contraception.

Mann und Frau. Aspekte der sexualmedizinischen Beratung von älter werdenden Menschen

In our times, sexuality has become an essential part of life for aging people. For the aging, psychosocial and biological changes, as well as increasing morbidity present challenges to a satisfying sexual life. Hence, the demand grows for health-care providers with basic sexological knowledge and counseling abilities. This article discusses relationships between frequent sexual difficulties and aging related organic processes. A therapeutic concept, the "Sexocorporal Approach", is introduced. This approach is based on a model of ongoing sexual development throughout the lifetime enabling adaptation to new life phases and limiting circumstances through sexual learning processes. Aside from pharmacological treatment, the encouragement of sexual learning presents an effective therapeutic approach for practitioners that can be easily learned and applied.

Smoking Cessation and Exercise Promotion Counseling in Psychologists Who Practice Psychotherapy

Little is known about health promotion within the context of psychotherapy. The present study assessed a sample of psychologists' attitudes and behavior with their psychotherapy clients regarding smoking cessation and exercise promotion counseling. This is a cross-sectional survey study. Surveys were mailed. Licensed psychologists (1000) in Massachusetts were randomly selected to receive surveys. Psychologists practicing psychotherapy at least 5 h/wk were invited to participate. Out of 496 responses, 328 completed surveys were analyzed. Two parallel surveys were developed for smoking (N = 154) and exercise (N = 174) assessing health promotion behaviors and attitudes. Approximately 43% of respondents inquire about smoking and 53% inquire about exercise with new clients. Over 45% advise smoking clients to quit and 50% advise sedentary clients to exercise. Over 80% of respondents felt smoking and exercise should be addressed in psychotherapy; however only 41% of smoking and 65% of exercise respondents felt confident in their counseling abilities. Lack of confidence, beliefs about relevance of smoking and exercise to psychological functioning, and beliefs that such personal choices should not be addressed in psychotherapy significantly predicted smoking cessation and exercise promotion behaviors. Many respondents are engaging in health promotion with their psychotherapy clients. Exercise promotion is occurring more frequently and is viewed more favorably compared with smoking cessation counseling. Health promotion attitudes are associated with counseling behaviors. Limitations include self-selection bias and small sample size.

Growth of AuD programs found to increase training in counseling

Growth of AuD programs found to increase training in counseling

Statewide evaluation of a tobacco cessation curriculum for pharmacy students

Background Previous studies suggest that healthcare professionals are inadequately trained to treat tobacco use and dependence. Because even brief interventions from clinicians improve patient quit rates, widespread implementation of effective tobacco cessation training programs for health professional students is needed. Methods Pharmacy students received 7–8 h of comprehensive tobacco cessation training. Participants completed pre- and post-program surveys assessing perceived overall abilities for cessation counseling, skills for key facets of cessation counseling (Ask, Advise, Assess, Assist, Arrange), and self-efficacy for counseling. Results A total of 493 students (82.3%) completed linkable pre- and post-training evaluations. Self-reported abilities, measured on a five-point scale, increased significantly from 1.89 ± 0.89 to 3.53 ± 0.72 ( P < 0.001). Twenty-two percent of students rated their overall counseling abilities as good, very good, or excellent before the training versus 94% of students after the training. Eighty-seven percent of students indicated the training will increase the number of patients that they counsel; 97% believed it will increase the quality of their cessation counseling. Conclusions Comprehensive training significantly improved pharmacy students' perceived confidence and ability to provide tobacco cessation counseling. The curriculum is applicable to other health professional training programs and currently is being used to train pharmacy, medical, nursing, and dental students.

Training Future Pharmacists at a Minority Educational Institution: Evaluation of the Rx for Change Tobacco Cessation Training Program

Abstract Objective: To estimate the impact of Rx for Change, an 8-h tobacco cessation training program on pharmacy students' perceived counseling skills, confidence for counseling, and future counseling of patients for tobacco cessation. Methods: Unlinked, pre- and post-training surveys were administered to 142 pharmacy students enrolled at Texas Southern University, a primarily minority and historically black educational institution. Results: Post-training counseling abilities were significantly improved over pretraining values for each of the five key components of tobacco cessation counseling (Ask, Advise, Assess, Assist, and Arrange), overall counseling abilities, and confidence for counseling (P &amp;lt; 0.001). Racial/ethnic differences in self-reported overall counseling was observed (P = 0.01). Ninety-one percent of participants believed that the training would increase the number of patients whom they counsel for cessation, and 95% believed that it would improve the quality of counseling that they provide. At least 95% of participants believed that the pharmacy profession should be more active in preventing patients from starting smoking and helping patients to stop smoking. Conclusion: The Rx for Change program had a positive impact on perceived abilities and confidence for providing tobacco cessation counseling to patients. While it is important that all current and future health care providers receive specialized tobacco cessation training, it is particularly important for clinicians of racial/ethnic minority backgrounds, who are more likely to practice in geographic areas with a high density of population subgroups at an elevated risk for tobacco-related mortality. In particular, pharmacists, who are uniquely positioned within the community to provide care to all patients, including the medically underserved, must be equipped with the necessary skills to assist patients with quitting.

Ambulatory management of childhood obesity.

Childhood obesity is one of the most challenging issues facing healthcare providers today. The aims of this study were to describe the ambulatory management of childhood obesity by pediatricians (PDs) and family physicians (FPs) and to evaluate knowledge of and adherence to published recommendations. A 42-item, self-administered questionnaire was mailed to 1207 randomly selected primary care physicians (PDs = 700, FPs = 507) between September 2001 and January 2002. Of 339 (28%) responses, 287 were eligible (PDs = 213, FPs = 74). Most respondents were in group or solo practice (87%) in a suburban or urban, non-inner city location (67%). The average age was 48 years (range = 31 to 85 years), and the mean years in practice was 17 (range = 1 to 55 years). Nineteen percent of physicians were aware of national recommendations. Three percent of physicians reported adherence to all recommendations. Knowledge of recommendations was not associated with a greater likelihood of adherence. However, physicians who were aware of recommendations were more likely to have positive attitudes about personal counseling ability (odds ratio = 2.4, confidence interval = 1.3 to 4.4) and the overall efficacy of obesity counseling (odds ratio = 4.3, confidence interval = 1.7 to 10.8). Poor patient motivation, patient noncompliance, and treatment futility were perceived as the most frequently encountered barriers to obesity treatment. Most physicians are not aware of or adherent to national recommendations regarding childhood obesity. Awareness of recommendations was associated with more positive attitudes about personal counseling ability and the effectiveness of obesity counseling in general.

Nutrition Counseling in the Promoting Cancer Prevention in Primary Care Study

Background. Little is known about the influence of personal and practice-level factors on physicians' dietary counseling practices. Methods. Primary care physicians ( n = 130) were surveyed regarding the frequency that they “ask” patients about their diet, “assess” patients' reasons for and against dietary changes, “advise” patients to eat less fat and more fiber, “assist” patients in changing their diet, and “arrange” a follow-up contact to discuss their diet. In addition, physicians were asked their personal dietary practices, counseling confidence, practice demographics, and medical specialty. Results. Physicians who (a) reported consistently avoiding dietary fat, (b) were more confident in their diet counseling abilities, and (c) were sole owners of their practice were more likely to counsel than physicians who were employees or part owners of the practice. For example, physicians who reported consistently avoiding dietary fat (50.7% of physicians) were 3.2 (95% CI: 1.3–7.9) times more likely to “ask” their patients about their diet and 3.5 (95% CI: 1.5–8.6) times likely to “advise” their patients to eat less fat and more fiber. Conclusions. Given the strong and consistent effects of a physician's dietary pattern on their counseling practices, future studies should examine the impact of modifying a physician's diet on their patients' dietary behavior.

Approaches to the patient with neurogenetic disease

The approach to a patient with a possible neurogenetic disorder is a complex process that challenges the physician's knowledge, diagnostic acumen and counseling abilities. This article focuses on six aspects of the process: 1. Clues suggesting the presence of a genetic disease, 2. The importance of family history, 3. The interpretation of sporadic cases, 4. Genetic counseling, 5. Genetic testing and 6. Available resources.

Important Health Provider Characteristics: The Perspective of Urban Ninth Graders

Clinicians caring for adolescents may be better positioned to provide health care when equipped with an understanding of adolescents' preferences regarding provider characteristics. The purpose of this study is to obtain a manageable framework of adolescents' concerns about health care providers. A series of qualitative and quantitative data-collection methods were used to elicit and organize ideas about health care providers from ninth-grade students in Philadelphia. A 5-point Likert survey, based on ideas generated and prioritized in earlier qualitative stages, was administered in school. Exploratory and confirmatory factor analysis was used to uncover latent factors. A total of 2602 students returned usable surveys. A confirmatory factor analysis model including four latent factors (patient's interpersonal relationship with provider, concern for physical safety, concern for emotional safety, and provider counseling ability) explained 51.6% of the model variability. Urban ninth graders want providers with whom they can develop strong relationships, feel emotionally and physically safe, and turn to for counseling. Communication with adolescent-aged patients should be a standard component of health care training and should promote provider sensitivity to adolescent fears and needs in the health care setting.

Psychological aspects of genetic counseling. XIV. Nondirectiveness and counseling skills.

The difficulties some professionals have in achieving nondirective goals is largely due to the inadequate and ineffective application of basic counseling skills. The "new genetics," with its emphasis on decision-making in association with genetic testing, is among the most demanding forms of personal counseling, the effectiveness of which depends largely on the professional's human experience and counseling abilities. Examples are given showing inadequacies in professional responses to clients in genetic counseling which, in turn, defeat the achievement of a nondirectiveness that is helpful to clients, supports their self-directedness, and leaves them more psychologically prepared for quality decision making. Other models of counseling (e.g., shared decision making) will not fare any better than the nondirective one unless counseling skills of professionals in genetic services are upgraded in a significant way. Professional organizations need to give greater attention to the training and postgraduate supervision of all personnel involved in genetics services.

Reasons why trauma surgeons fail to screen for alcohol problems.

Alcohol screening and intervention have been recommended as routine components of trauma care but are rarely performed. An association exists between current screening and counseling practices and the trauma surgeon's knowledge, attitude, and perceived role and responsibility toward alcohol problems. Random-sample survey (n = 241) of members of the American Association for the Surgery of Trauma. Reported screening and counseling practices. Fifty-four percent of respondents screened 25% or fewer patients, while only 29% screened most patients. The most common reason for not screening was "lack of time." Most (76%) were not familiar with the most common clinically used screening questionnaires, and 83% reported no training in alcohol screening. Screening was more likely if attending physicians perceived a major responsibility for screening (P<.001). Nonscreeners were twice as likely to state screening was "not what I was trained to do" and more frequently believed screening offends patients (P =.001). Independent predictors of screening were perceived major role responsibility (odds ratio [OR], 2.35; 95% confidence interval [CI], 1.38-4.01) and confidence in screening ability (OR, 1.96; 95% CI, 1.05-3.67) and counseling ability (OR, 2.27; 95% CI, 1.34-3.85). Eighty-eight percent of respondents would be willing to devote time to training if shown that counseling is effective. Lack of screening and counseling appears to be due to cognitive factors, not lack of motivation. Skills on how to screen and counsel for alcohol abuse should be taught to trauma surgeons, because a strong correlation exists between screening and confidence in skills. There is a need for education regarding results of effective intervention trials in medical settings.

Health promotion counseling in residency training.

This report describes health promotion counseling attitudes and practices in a family medicine residency that attempted to encourage such counseling. A patient "Health Habits Questionnaire" and matching patient education booklets were developed and distributed. Six grand rounds presentations on counseling were given. On three occasions, residency physicians completed questionnaires about counseling. Despite good personal health habits and positive attitudes toward counseling, the residency physicians had only moderate confidence in their counseling ability and infrequently documented counseling. The residents reported significant improvement in their ability to counsel patients about smoking cessation. Overall, the curriculum appeared to have a limited effect on health promotion.

Ego Development and Counseling Ability During Training

In separate analogue and naturalistic studies, we investigated the impact of ego level on the counseling ability of beginning and advanced students.

WHAT WILL THE SCHOOL COUNSELLOR DO?

Though the school counselor is a newcomer to the educational scene, counseling is not. The good teacher has been alive to those pupil needs that are best served by individual counseling, and many show an impressive untutored counseling ability. Such people are recruited to posts like the house master and the tutor, or find their way into special remedial work where a personal, individual approach is especially needed. Counseling ability remains an indispensable skill to the teacher and his need of it would grow rather than diminish with the advent of the school counselor. There is a need for the school counselor because the volume of need for counseling in one form or another goes far beyond what is reasonable to ask teachers to meet. The demand can be most economically met by a professionally trained specialist that the teacher can all upon for help. Children are increasingly postponing their departure from school and the personal development of young adults responds particularly well to counseling. The new forms of organization of secondary education have brought new needs for counseling.