Counseling Skills Research Articles

Using Vision Boards to Support the Development of Early Student Counselors

ABSTRACT One of the primary functions of clinical supervision is to facilitate counseling skills development. The integrative developmental model (IDM) suggests specific challenges facing masters-level student counselors at each developmental level. For early student counselors, this includes heightened anxiety, perfectionism, and struggles with self-concept and wellness. We propose using vision boards as a supervision tool to address these developmental challenges through creative arts-based interventions. The process of engaging in creative arts-based supervision decreases supervisees’ anxiety and increases self-awareness, perspective-taking abilities, and cognitive complexity, making personal growth more accessible. Vision boards visually represent student counselor growth and development and function as a means to document student counselor progress for evaluation and gatekeeping purposes. A case study is presented to explore the application of the vision board within the framework of the IDM. Finally, implications and limitations are discussed.

Translational Quotient as an Innovative Outcome Parameter to Assess the Effectiveness of Training Methods: A Feasibility Study in Assessing the Baseline Psychiatric Skills of Primary Care Doctors in their Real-world Live Outpatient Clinic

Background: The effectiveness of training methods in medical education is critical, particularly for primary care physicians (PCPs) who frequently encounter psychiatric issues in their practice. Traditional assessment methods often fail to evaluate skill acquisition in real-world clinical practice. The Translational Quotient (TQ) is proposed as an innovative outcome measure to assess PCPs’ ability to apply psychiatric skills in their live outpatient consultation among their general patients. This study aims to evaluate the feasibility of using the TQ in real-world outpatient clinics and to understand the baseline psychiatric skills among PCPs using TQ. Methods: Actively practicing MBBS-qualified PCPs enrolled in the Diploma in Primary Care Psychiatry (DPCP) program across various districts were invited to participate. Baseline TQ assessments were conducted in the PCPs’ live clinics, with psychiatrists observing live consultations either remotely or in-person for the first five consecutive general consultations. Each consultation was scored using a standardized TQ proforma, which evaluated six criteria: elicitation of psychiatric symptoms, clinical reasoning, medication choices, counseling, time management, and overall clinical skills. Results: A total of 25 PCPs participated, with an average baseline TQ score of 15.7% (4.72 out of 30). Most participants (72%) scored 5 or less, highlighting significant gaps in psychiatric skills. Analysis revealed no significant associations between TQ scores and PCP demographics such as age, gender, and prior psychiatric training, but regional differences were noted, with lower scores in Karnataka compared to Bihar. Conclusions: The TQ is a feasible and practical tool for assessing real-world psychiatric skills among PCPs. The baseline scores indicate a pressing need for targeted psychiatric training to bridge the treatment gap in primary care. Future training programs should focus on enhancing diagnostic accuracy, treatment planning, and patient communication to improve mental healthcare outcomes in primary care settings.

Simulation-Based Approaches for Training Communication and Counseling Skills in Clinical Education in Audiology: A Scoping Review.

This review article aimed to obtain an understanding of the positive outcomes and challenges associated with the use of simulation-based approaches for teaching communication and counseling skills in clinical education in audiology as described in the literature. A scoping review was conducted during October 2023 to identify published journal articles that described how simulation-based approaches were used for teaching or assessing communication and/or counseling skills among audiology students. Database searches yielded 208 articles initially. Following abstract screening and full-text review, 17 articles were included for analysis. Most studies focused on using simulation-based approaches for teaching, and there was a stronger focus on pediatric audiology. Most studies involved the use of standardized patients, with data collected via quantitative approaches using rating scales and surveys. Simulation-based approaches can offer positive learning experiences and practice opportunities for students acquiring communication and counseling skills. However, the benefits of simulation over traditional methods are unclear. Students may struggle to integrate technical and communication skills in simulated learning experiences. Engaging with simulation-based approaches may provide important practice opportunities, but these methods are not sufficient to ensure acquisition of communication and counseling skills. More qualitative studies are needed to understand the nuances of if and how students might acquire such skills via simulated learning experiences. We offer some suggestions for improvement of future studies on this topic.

Experiences of Low-Income Indonesian Pregnant Women Regarding the Challenges of Receiving Health Services: A Qualitative Content Analysis.

The information needs of low-income pregnant women are multisectoral, encompassing both pregnancy-related and non-pregnancy-related information. Barriers to receiving information for low-income pregnant women are specific and complex. This study aimed to explore the experiences of low-income Indonesian pregnant women regarding the challenges of receiving health information. A qualitative study was conducted using content analysis according to Graneheim and Lundman's approach between January and June 2022. A total of 17 women were selected for this study using purposive sampling. In-depth interviews were done following semi-structured interview guidelines, concluding when saturation was reached. Nvivo software version March 2020 was used for organizing data and analysis. Three themes emerged concerning receiving health information among low-income women, including encountering barriers to accessing information and care, access to ineffective information sources, and difficulties in applying pregnancy health information. This study shows that barriers to receiving information are specific to low-income pregnant women. Therefore, solution approaches must also be specific. Efforts to improve receiving health information can be achieved through developing educational materials that are easy to access and understand, improving e-health literacy, refining counseling skills among village midwives, holding culturally tailored educational programs, improving mothers' health literacy by family and husbands, integrating counseling with a focus on critical literacy, and formulating policies to alleviate the midwife's workload.

Examining Counselor's Executive Function Skills Across Career Phase: Comparing Preservice, Novice and Experienced in Healthcare Performance

Executive function became an internal counselor skill that plays a role in navigating complex client problems, making informed decisions, and maintaining professional effectiveness. Counselor executive function skills were not primarily developed during preservice education. This study aims to examine executive function skills by comparing the performance of preservice, novice, and experienced counselors. This research method uses a non-experimental quantitative design involving 99 counselors (36 experienced, 28 novice, and 35 preservice). Measurements used the Counselor's Executive Function Questionnaire (CEFQ), and the data results were analyzed using descriptive and comparative analysis (ANOVA). The results showed there were no significant differences between preservice, novice, and experienced counselors. However, experienced counselors still show the most important differences among others. These results predict that education and experience factors are unstable and may trigger executive dysfunction. This research suggests exploring executive function skill factors related to counselor performance, as well as programming counseling evaluation and supervision to optimize counselor professional growth.

Addressing Barriers to Autopsy and Genetic Testing in Stillbirth Workup

The cause of death in many stillbirths remains unexplained, in part because of systematic barriers to complete workup. We review the importance of placental pathology, fetal autopsy, and genetic testing in stillbirth workup. Placental pathology is useful in 65% of stillbirths, and fetal autopsy is useful in 42%. Currently, only 21% of stillbirths in the United States undergo autopsy. Barriers to complete stillbirth workup include cost of autopsy and genetic testing, availability of perinatal pathology expertise, health care professional knowledge about workup, and availability of skilled counseling to support bereaved parents in making decisions about autopsy and genetic workup. We propose solutions to overcome these barriers, including policy changes to expand access and a framework for high-quality patient counseling and decision support.

Psychosocial support for counselors working with HIV-Serodiscordant couples

ABSTRACT Living in HIV serodiscordant relationship poses psychosocial challenges to couples. These necessitate proper counseling. This paper explored the psychosocial support for counselors working with HIV-serodiscordant couples at a regional hospital. The study used descriptive and exploratory approaches, underpinned by an interpretative phenomenological analysis design (IPA). Participants were selected using a non-probability snowball sampling technique. A total of nine participants took part in the study. Data were collected using an in-depth interview guide and analyzed using an interpretive phenomenological analysis framework. Three themes emanated: knowledge deficiency on serodiscordancy among the counselors, limited/lack of support and ways to recommend HIV-serodiscordant couples services. The findings indicates that there is need to enhance, strengthen, and provide comprehensive psychosocial support services to discordant couples. To support and improve the knowledge, confidence and skills of counselors, the following should be implemented: provision of training, introducing debriefing sessions to reflect on discordant cases, follow-up on discordant couple’s post diagnosis to offer psychosocial support services, and establishment and strengthening of the support groups.

Addressing the Gap: A Pilot Study to Improve Graduate Student's Counseling Self-Efficacy Through Online Support Groups for Care Partners of People With Acquired Brain Injuries

Purpose: The purpose of this technical report is to (a) describe the development and pilot testing of a university training initiative for graduate students in speech-language pathology to conduct online support groups for care partners of individuals with acquired brain injuries and (b) share preliminary data on students' self-efficacy in their counseling skills as a result of training. Method: Four graduate students completed an intensive summer counseling training program consisting of two 90-min student orientations to counseling skills and two online support group sessions for care partners of people with acquired brain injuries. A mixed methods analysis of pilot data collected over the summer of 2023 was conducted. Students completed the modified Counselor Activity Self-Efficacy Scales for speech-language pathologists within 1 week of beginning their counseling training and within 1 week after their clinical training experience. Students also submitted a short reflection paper within 24 hr of their two support group sessions to discuss their overall performance within the session and assess their self-efficacy in their counseling skills. Results: Preliminary data evidenced significant pre- to posttraining gains in two primary counseling areas: (a) psychoeducation (i.e., students' ability to provide information to care partners) and (b) empathy when addressing care partners' concerns regarding their loved one's communication disorder. Students' reflection papers illustrated their sense of growth as clinicians and paralleled the findings from their questionnaires. Conclusions: Our preliminary results highlight the importance of providing counseling opportunities for student clinicians in speech-language pathology graduate programs. Our online clinical model offers an example for replicability across universities to foster self-efficacy in students' counseling skills as part of their graduate studies. “Key” ingredients are provided for replication when developing a student-led online support group program for care partners of individuals with acquired brain injuries.

Spanish language opportunities in genetic counseling training programs in the United States.

This cross-sectional survey study explores ongoing initiatives to foster diversity and inclusivity within the field of genetic counseling, specifically focusing on opportunities within graduate programs for students to enhance language and counseling skills in Spanish, thereby fostering language concordance in genetic counseling settings. With a response rate of 44.8% (26/58) across genetic counseling graduate programs, our study provides an overview of educational offerings in Spanish, encompassing patient-facing, non-patient-facing, and combined opportunities. Of the programs that completed the survey, 73.1% (19/26) offer Spanish language opportunities. Several perceived benefits were identified by those that offer opportunities, including fostering cultural humility and diversity within the field, increasing awareness and accessibility of genetic counseling services, and facilitating involvement in research within minority groups. The information gathered from this study can be a resource for graduate programs seeking insights into effective strategies to incorporate Spanish language opportunities. Additionally, these results may also serve as a source of inspiration for students who want to apply their Spanish language skills in their training and future careers. Lastly, we propose ideas to enhance and expand the training of bilingual genetic counseling students in Spanish.

Culinary Medicine and Teaching Kitchens: Dietitians Leading Innovative Nutrition Training for Physicians.

The objective of this evaluation was to determine the impact of a pop-up Teaching Kitchen (TK) at a national cardiovascular conference. The 60-minute session was hosted in a hotel conference room and led by two registered dietitians. Participants prepared 12 recipes, enjoyed a family-style meal, and explored nutrition behaviour change strategies for patients. Using Likert-scaled and open-ended questions, pre-/post-online surveys assessed change in perceived nutrition counselling skills, attitudes, and confidence; post-survey also assessed effectiveness of session components and further training needs. Pre-survey response was 72% (18/25). Twenty-one participants attended the event (14 pre-registrants, six from waitlist, and five drop-ins); 81% completed the post-survey. Positive shifts were reported in nutrition competence, particularly attitudes towards using recipes in nutrition counselling, and increased skills and confidence discussing eating on a budget and SMART (Specific, Measurable, Achievable, Relevant, and Time-Bound) goal setting with patients. Components of the TK session that enhanced nutrition competence were key patient messages and the shared meal. Preparing and eating together in a hands-on format was most enjoyable. Promoting healthy eating behaviours requires understanding the complexity of individual and societal food literacy. With high physician interest, dietitians are well positioned to deliver culinary medicine interventions and support physicians' confidence in health promotion and chronic disease prevention and management.

Doing the Inner and Outer Work: Culturally Responsive Practices in Gender-Affirming Voice Care

Purpose: This article aims to raise clinical awareness of (a) the barriers and forms of oppression that transgender and gender-expansive (TGE) people face, (b) the ways in which discrimination can subconsciously be enacted by practitioners and institutions, and (c) to provide actionable steps for providing gender-affirming voice care (GAVC) services. Method: This article draws on empirical evidence of inequitable access/barriers to resources and the heightened risk to well-being for TGE people, as well as the theoretical foundations from the field of psychology that lead to culturally responsive care of the voice. It clarifies and expands the tenets of gender-affirming practice and trauma-informed care and identifies action steps for practical application in this specialized area of voice. It highlights the need for greater self-reflection and ongoing education when providing GAVC services, particularly as it relates to the practitioner's understanding of the intersections of racism, transphobia, neurodivergence, and disability justice. Conclusions: In addition to having strong voice skills, practitioners who are lifelong learners, remain pliable to learning new ideas, and have a strong and sincere desire to provide GAVC are needed to work with this population. Those providing GAVC are recommended to first deepen their self-reflection skills and understanding of their own identities, as well as acquire a humble understanding of the 2SLGBTQIA+ community, especially in terms of the intersections of race and gender expression. The authors recommend personal and professional work through a justice, equity, diversity, and inclusion (JEDI) journey. This includes increasing one's counseling skills in order to provide tailored support that is specific to the client's needs. This article aims to provide a concrete entryway for the practice of gender-affirming care as it applies to the voice, while acknowledging that maintaining ethical gender-affirming practices requires a lifelong commitment to continuing education.

Cross-Site Evaluation of Alcohol Screening and Brief Intervention Implementation Programs in Healthcare Systems Serving Individuals of Reproductive Age.

With US Centers for Disease Control and Prevention funding, from 2018 to 2022, 4 large healthcare systems (n = 53 health centers across 7 states) serving people of reproductive age trained staff and provided implementation support for alcohol screening and brief intervention (SBI). This cross-site evaluation explores each healthcare system's implementation approach to implement SBI, reduce excessive alcohol use, and prevent prenatal alcohol exposure (PAE) and fetal alcohol spectrum disorders. The SBIRT (Screening, Brief Intervention, and Referral to Treatment) Program Matrix framed the multilevel strategies to implement alcohol SBI programs from 2018 to 2022. Qualitative and quantitative data sources examined outcomes, guided by one logic model, through systems-level process data and provider-level performance metrics. Data analyses utilized frequencies and means for quantitative data and themes for qualitative data according to an established framework. Successful approaches within systems included using electronic health records, flexible implementation and workflow protocols, customized training and technical assistance programs, quality assurance feedback loops, and stakeholder buy-in. Centralized management structures were efficient in standardizing implementation across health centers. Decentralized management structures used tailored approaches, enhancing provider/staff SBI acceptance. Across systems, 1259 staff (eg, clinicians, medical assistants) were trained to provide alcohol SBI services and reported pre-post training increases in self-efficacy in performing brief intervention; skills in PAE counseling; and confidence in screening. Fifty-three (48 providing data) health centers implemented alcohol SBI, screening 106 826 patients over the study period with most of the 10 087 patients who screened positive for excessive alcohol use receiving a BI. Maximizing the use of technology, employing flexibility in program delivery, and institutionalizing processes and protocols improved workflow, efficiency, and program reach. Ongoing partnership and stakeholder communication identify areas for ongoing improvement, engagement, and best practices for sustainability around substance use screening, which are essential with increases in substance use since the pandemic.

Clients’ experiences during three phases of a time-limited psychodrama group: A case study

Although it is known that the group stages share similar dynamics and the leaders have certain tasks in each stage, the experiences of group members could differ in each stage. The main purpose of this case study is to understand how guidance and psychological counselling students participating in a psychodrama group are affected by the process and how they experience each stage of the group. In this context, a 12-week psychodrama study was conducted with group members (n = 9), and qualitative data were collected to determine the self-perceptions of the members at the end. The thematic analysis of the study revealed six main themes: first emotions, difficulties, self-awareness, changing emotions, achievements and what they left to time. In the first sessions, it was observed that the members had difficulties in disclosing themselves and role-playing because they were excited, scared and worried. In the proceeding sessions, as the members gained confidence in the group and realized that they would not be judged, they relaxed and disclosed themselves. Many of the members who experienced many realizations noted the changes in themselves in the final sessions and emphasized that they needed time for some skills to be realized. In addition, the development of counselling skills such as empathy, listening and self-awareness as a result of the research reveals that psychodrama is a promising approach in developing and teaching counselling skills. Practical recommendations are presented for mental health professionals and researchers based on the study findings.

A Randomized Trial of Virtual Reality Training to Improve Firearm Safety Counseling Skills

ObjectiveTo evaluate the efficacy of Resident Education And Counseling on Household (REACH) Firearm Safety, a novel virtual reality (VR) intervention. MethodsWe conducted a single-center, randomized controlled trial among pediatric residents in a Midwestern academic primary care center comparing REACH Firearm Safety with didactic training (intervention) to didactic training alone (control). In the intervention arm, participants practiced firearm safety counseling with virtual characters and received immediate feedback. All residents completed audio-recorded standardized patient (SP) encounters before and after the training as well as a retrospective pre-post survey. Two reviewers, blinded to the allocation arm, used a standardized assessment tool to generate performance scores. Outcomes of interest included the difference between groups in SP performance scores and self-reported confidence. ResultsFrom March to July 2023, 62% of eligible pediatric residents (n = 47/76) completed the allocated study tasks (intervention 19, control 28). In both groups, SP performance scores and self-reported confidence improved. Compared to the control group, the intervention group demonstrated improvement in sharing information on secure storage devices (P = 0.009) and increased confidence in providing information on secure storage (P = 0.002). ConclusionsCompared with didactic training alone, a VR intervention using deliberate practice improved residents’ skills and confidence related to firearm safety counseling.

Evaluating counselling skills of community health workers for pregnant adolescents in Limpopo province.

Adolescent pregnancy carries significant global ramifications. Community health workers (CHWs) play a role in empowering adolescents through counselling skills, thereby promoting informed decision-making for better outcomes. The study aims to evaluate the counselling skills of CHWs in their efforts to support pregnant adolescents (PA) in Limpopo province. The research was carried out with CHWs in the Mopani and Vhembe districts of the Limpopo province. A quantitative descriptive approach was used to evaluate CHWs' counselling skills for PAs in Limpopo. A sample of 81 respondents was selected using simple random sampling. Ethical approval was obtained. Data were collected using a questionnaire guided by the Theory of Reasoned Action. Descriptive statistics were analysed using Statistical Package for Social Scientists version 24. The questionnaire's validity was assessed using Cronbach's alpha, resulting in a correlation coefficient of 0.710. The study identified significant variations in counselling recommendations. Preparation: Using private space with fewer distractions showed considerable variability (standard deviation = 0.218). Introduction: High variability was observed in using the SOLER method (standard deviation = 0.316). Working phase: Suggesting rather than advising had notable variability (standard deviation = 0.396). Termination: Avoiding abrupt endings and informing clients about the session's conclusion demonstrated variability (standard deviation = 0.283). Additionally, the majority (64%) of the participants found record-keeping unnecessary, which demonstrated the highest variability (standard deviation = 0.482). The study revealed CHWs' proficiency in counselling techniques and emphasised the importance of following the counselling stages. The research highlights the importance of evaluating the counselling skills of CHWs and identifying areas for improvement to develop targeted interventions and enhancing health outcomes for PAs.

Are Advanced Counseling Skills Really Valued in Counselor Education and Supervision PhD programs?

Are Advanced Counseling Skills Really Valued in Counselor Education and Supervision PhD programs?

Assessing the knowledge and skill of ASHA community health workers in blood pressure measurement and primary care of hypertension.

India has a high burden of hypertension, and community health workers (CHWs) can contribute to its primary care. Studies of small-scale interventions have shown that trained CHWs can be useful contributors to hypertension care. No assessments are available in India on effectiveness of CHW training when conducted on a large scale. A study was conducted in Chhattisgarh, where 38,000 Accredited Social Health Activist (ASHA) CHWs had been trained in blood pressure (BP) measurement and counselling skills related to hypertension. The study involved a skill test and a knowledge test with ten points each, administered to two representative samples of trained CHWs - 433 in rural areas and 422 in urban slums. The mean skill score out of 10 was 7.79 (7.59-7.99) and 8.11 (7.93-8.29) for the rural and urban CHWs, respectively. Around 75.3% (71.0-79.1%) of the rural and 80.3% (76.2-83.9%) of urban CHWs were able to score 70% (7 out of 10) or higher in the skill test. The mean knowledge score out of 10 was 8.18 (8.04-8.33) and 8.82 (8.78-8.93) for the rural and urban CHWs, respectively. Around 83.2% (79.3-86.4%) and 95.0% (94.4-96.7%) of the rural and urban CHWs, respectively, were able to score 70% or higher in the knowledge test. The ASHAs in Chhattisgarh demonstrated the necessary competence to contribute to BP measurement and primary care of hypertension. It shows feasibility of training a large number of CHWs in such skills. Efforts to equip and support the 1 million strong cadre of ASHAs across India need to be speeded up.

Development of a Hybrid Training Package of Narrative Counseling Based on Parebhasan Culture to Improve Counselor Skills in Madura

Multicultural counseling is an essential approach for counseling services in Indonesia, with thousands of cultures and local wisdom. Multicultural Counselling is one of the keys to understanding the student's views, characteristics, and values based on their cultural background. One of the multicultural counseling developments is integrating Madhura's Parebhasan into the narrative counseling model. This research aims to develop a hybrid training design to improve counselor skills using narrative counseling based on Madhura's Parebhasan. This research used ADDIE's model to develop the training program. Data collection from 20 counselors in Madura used the reflection and training test and performance observation form. Data analysis uses descriptive, graphical, correlation, and regression analysis. The research results show that mastery of the material and practices in training affect the counselor's performance. Five Madhura's Parebhasans are integrated and suitable for escalating the effect of the narrative counseling procedure. The hybrid training package of Narrative Counseling based on Parebhasan has been developed and validated in practice. This research suggests testing the effectiveness and evaluating the implementation for the specific needs and problems of the students.

Fostering Safe Schools: Empowering Educators and Parents in the Fight Against Violence in Early Childhood Education Setting

Bullying was a concerning issue among pre-schoolers within kindergarten settings, though its definition remained debated. This research’s aim is to uncover the forms of bullying, its causes, and impacts on children, as well as the intervention programs implemented by early childhood education teachers. This research engaged 87 teachers in anti-violence training, collecting data via bullying worksheets and interviews with 18 preschool teachers. The results showed that in early childhood education, verbal bullying involved the use of degrading words, while physical bullying included actions that hurt the victim's body. Relational bullying impacted social exclusion, whereas emotional bullying focused on hurting the victim's feelings. Internal causes included aggressive tendencies and low social values, while external causes included negative environmental influences and upbringing. Victims experienced depression, isolation, and learning disorders. The abuser might lose empathy, have difficulty forming relationships, and show aggressive behavior in the future. Teachers communicated openly with perpetrators and victims to help understand the root causes of behavior and provide emotional support. Follow-up actions taken by early childhood education institutions included counseling, developing empathy and social skills, strengthening positive values, and creating a safe environment. Parental involvement through education and open communication was also an important factor in creating a conducive environment for positive child development and preventing bullying.

Understanding HIV care providers’ support for tobacco cessation among people living with HIV in Western Kenya: a formative qualitative study

IntroductionHealthcare providers are required to support people living with HIV (PLHIV) to quit tobacco use for improved health outcomes, but it is unclear to what extent they adhere to these...