Counseling Clients Research Articles

Postpartum long-acting contraception uptake and service delivery outcomes after a multilevel intervention in Kigali, Rwanda

IntroductionPostpartum family planning (PPFP) is critical to reduce maternal–child mortality, abortion and unintended pregnancy. As in most countries, the majority of PP women in Rwanda have an unmet need for...

Implementation of a Learning Collaborative Model Increases Chlamydia Screening at 37 Family Planning Clinics: Lessons Learned From 3 Cohorts.

Chlamydia is the most commonly reported notifiable condition in the United States. Chlamydia disproportionately impacts young women and women of color. Annual screening of sexually active women 24 years and younger is recommended. Between 2016 and 2019, we facilitated 3 learning collaboratives to increase chlamydia screening at a combined 37 family planning clinics funded by the Planned Parenthood Federation of America, the Office of Population Affairs in the Department of Health and Human Services, and the New York State Department of Health. We applied a consistent learning collaborative approach across the 3 cohorts. Participating clinics sought to improve the proportion of clients screened for chlamydia each month, implemented a standard set of recommended practices, attended virtual learning sessions, reported updates on quality improvement efforts and chlamydia screening data monthly, and provided qualitative feedback in an online final assessment. Median screening rates increased by 11%, 22%, and 24% in the 3 collaboratives (P values of <0.01, 0.05, and 0.02, respectively). Increases were sustained after the collaboratives ended though the changes did not reach statistical significance. At least 75% of clinics increased screening rates in each collaborative. Clinics reported that adopting normalizing and opt-out language when counseling clients about screening was both feasible and effective, as was reducing missed opportunities for screening. Learning collaboratives consistently resulted in improvement across 3 cohorts and shed light on barriers and facilitators to screening in family planning settings. Public health practitioners are encouraged to draw on our results and lessons learned to promote screening.

Professional Counselors’ Referral Processes to Complementary Health Practitioners

ABSTRACT There is a growing interest in the utility of complementary health approaches (CHAs) to promote wellness and health in the United States. Research from medical, allied health, and mental health fields reflect this expanding interest; however, very little research focuses on counselors and the integration of CHAs within practice or referral of counseling clients to Complementary Health Practitioners (CHPs). The current study expanded this research using transcendental phenomenology to explore the experiences, perspectives, and processes in use by current independently licensed professional counselors referring to complementary health practitioners (CHPs). The authors discuss and explore implications of these findings.

Counseling Adults With Sensory Processing Disorder: An Exploratory Study

Sensory processing disorder (SPD) is a neurological disorder impacting up to 20% of the global population. The majority of SPD research has been conducted outside the counseling profession and typically examines the presentation of SPD in youth. Therefore, counselors often have limited awareness of this disorder. The purpose of the present study was to conduct an exploratory qualitative thematic analysis (N = 89) examining the primary concerns of adult counseling clients with SPD, as reported by their counselors. Results include 12 themes that were organized into three categories: biological, psychological, and social. Thus, the results reflected the biopsychosocial model, originally outlined by G. L. Engel, as it pertains to SPD. Researchers provided implications for mental health counselors’ practice and suggestions for future research.

Best Practices for Counseling Clients Experiencing Poverty: A Grounded Theory

Poverty is a pressing sociopolitical issue in the United States and worldwide. Poverty experiences have a significant effect on one’s mental health and overall wellness. Therefore, the ability to effectively serve clients experiencing poverty is critically important to professional counselors. However, there are no empirical models for counseling clients experiencing poverty. The authors present the results of a constructivist grounded theory study in which 21 professional counselors who work with clients experiencing poverty were interviewed to identify best practices for working with this population. Five major best practices are identified: (a) awareness, (b) training, (c) knowledge, (d) skills, and (e) advocacy. Implications for professional counseling are included.

The acceptability of using IUDs among Egyptian nulliparous women: a cross-sectional study

BackgroundAlthough intrauterine contraceptive device is highly effective, safe, long term and reversible method of contraception, the general population and physicians refuse. IUDs for nulliparous women due to persistent rumors about its side effects and complications. The aim of this study was to assess the acceptability of IUD use in nulliparous women by both women and health care providers in Egypt.MethodsFive hundred thirty nulliparous women and 200 physicians were interviewed in 10 family planning clinics in Suez and Minia cities – Egypt. The knowledge and attitudes of women and health care providers towards IUD use in nulliparous women were assessed through a well designed questionnaire over 2 years. Those women who accepted using IUD were then followed up for 6 months.ResultsMost of nulliparous women sought for contraception reported a negative impression of IUD method (96.2%). 82.5% of physicians had the same attitude. The reasons for refusing IUD among nulliparous women are fear of side effects including infection (52.8%), and bleeding (37.7%).Also, fear of subsequent infertility 51.9% of women. Regarding the providers, increased pelvic inflammatory disease (PID) represented the highest percentage (70%) for non acceptability, followed by difficult insertion (52.5%). Ninety women who accepted use IUD were followed up 6 months later, 94.4% were still using the method and77.8% were happy with the results.ConclusionThe main barriers that hinder the use of IUD in nulliparous women are the women insufficient knowledge and attitude of their physicians. Good client counseling. Good training for physician to improve their experience would help increase the use of such effective and safe method.

Counseling clients during New York City's COVID-19 pandemic: observations on fundamental elements of emotions management.

New York City is in the grip of the COVID-19 pandemic. Health care centers are stretched beyond capacity. Daily death rates are staggering. The city's population is hunkered down in fear. Our anxiety treatment center is treating patients via video appointments. We are helping anxious individuals adapt to tumultuous changes that we ourselves are experiencing. Our work in this time has reinforced our core beliefs about managing one's emotions; that difficult times require more active coping and that we all draw heavily from social support and familiarity to create a feeling of well-being. These principles and the experiences of our patients are discussed.

Minority status, depression and suicidality among counseling center clients

Objective This study examined race/ethnicity, gender, sexual orientation, and financial stress and their association with depression and suicidality among university counseling center clients. Methods: The sample included 3,189 participants who received services at a university counseling center. Results: Asian American college students reported more depressive symptoms than European American and Hispanic students and were more likely to have a depression diagnosis than European American and African American students. Female and lesbian/gay/bisexual/questioning (LGBQ) individuals had higher depressive symptom scores, were more likely to have a depression diagnosis, and history of suicidal ideation and attempts than male and heterosexual individuals, respectively. Students with high financial stress reported higher depression scores and were more likely to have experienced past and current suicidality. More minority statuses were associated with higher risk for depression and suicidality. Conclusions: Counseling center clients who identified with one or more minority groups had higher risk for depression and suicidality.

Attitudes about medications for alcohol use disorder among individuals with serious mental illness: A health belief model analysis

BackgroundMedications for alcohol use disorder (MAUD) are underutilized in mental health settings. Increasing use of MAUD requires increasing both the availability of these medications and the demand by individuals who could benefit. Few studies have explored the views of individuals with severe mental illness and alcohol use disorder about MAUD. We sought to examine, among individuals treated in publicly funded community mental health clinics, perceived need for and attitudes toward MAUD. MethodsWe conducted 8 focus groups with 87 participants treated in public mental health clinics in Los Angeles County. We aimed to include individuals with a current or past AUD diagnosis and individuals helping others (e.g., a family member) who drink. We examined responses using domains associated with the Health Belief Model to identify factors that shape acceptance of MAUD. ResultsParticipants were 53% female; most were minorities. Average age was 47 years (SD = 11). Twenty-four reported never drinking, 13 of whom had a current or past diagnosis of AUD. Twenty-two reported drinking 4 or more times per week. Three-quarters had not heard of naltrexone. Participants understood that alcohol use has severe adverse consequences and perceived themselves to be highly susceptible to these consequences. Regarding attitudes toward MAUD, participants described an internal locus of control (e.g., their own desires, actions, and effort) as central to addressing problem drinking; this shaped their views that MAUD would have only modest benefits and potentially high burden. Those individuals who had tried MAUD expressed the most optimism about its effectiveness. ConclusionsParticipants worried MAUD would impede the development of self-control over drinking by fostering dependence on medication and undermining self-discipline. Client education and counseling that emphasizes MAUD as a tool to build clients' self-control may increase demand for these medications in mental health settings.

Psychometric Properties of the Outcome Rating Scale: An Item Response Theory Analysis

We assessed the psychometric properties of the visual analog scale (VAS) form of the Outcome Rating Scale (ORS) using item response theory (IRT) with a sample of 2,109 Canadian counseling clients. Findings indicate that the ORS was unidimensional and that the equal-interval assumption was not tenable for the VAS.

Pandemic Pedagogy II: Conducting Simulations and Role Plays in Online, Video-Based, Synchronous Courses

The goal of this paper is to continue to support teachers as they transition their classroom-based courses to an online, synchronous, video-based format in response to recent campus closures resulting from the coronavirus pandemic of 2020, which has rendered classroom gatherings unsafe. Written with teachers in the fields of negotiation, mediation, conflict management and dispute resolution in mind, this paper addresses these fields’ central teaching tool: conducting simulations and role plays. However, the paper will also be helpful for teachers in fields such as business, nursing, law, social work, education and others, who also utilize simulations as a teaching tool. While our focus is on negotiation and mediation simulations, our suggestions should remain valid across many simulated processes, such as patient interviewing, client counseling, coaching, student advising, etc. We will note minor tweaks required for simulating other conflict resolution processes; teachers in other fields can consider how they might tweak our guidance to support simulations in other areas. For a paper on more basic issues to consider in transitioning classroom courses online, see https://ssrn.com/abstract=3552124 .

A Study on the Career Design Types of Adult Clients in Career Construction Counseling

A Study on the Career Design Types of Adult Clients in Career Construction Counseling

Adaptive coping strategies in male infertility, paramedical counselling as a way of support

ABSTRACT Aims: In the last decades, the number of infertile males increased worldwide which gained more focus. The extent to which a person or a couple is able to cope adaptively with the problem of infertility depends on the combined effect of several variables. Our aim was to apply counselling among males suffering from infertility problems. During the therapy – besides providing information – we aim to elaborate the effects of the treatment and experiences, to process information, to develop adaptive coping strategies against stress and to indirectly or directly change health behaviours influencing reproduction. Methods: Only patients with male factor infertility were involved. They were divided into an observed group (n = 57) and a control (n = 51) group after a thorough physical examination and assessment of their reactions to, and awareness of, the disease. Results: The group that received the interventions had an intense awareness of the diagnosis and aims and nature of the indicated treatment. They employed purposeful problem-solving coping strategies, reported being satisfied with the infertility treatment. Conclusions: The counselling of clients with infertility problems a more favourable mental well-being can be established by the active participation of professional helpers. Patients might receive effective, targeted and problem-specific help. Abbreviations: ART: Assisted Reproductive Technology

Emotional Burnout: Prevalence Rate and Symptoms in Different Socio-Professional Groups

Objective: The relevance of the subject matter is connected with the emotional burnout and its long-lasting negative consequences for both the individual and society becoming commonplace. Background: The paper covers the psychological reconstruction of the concept of "burnout" in terms of its implicit understanding and differentiated diagnosis. Method: The consolidated empirical data on the commonness of burnout among various categories of employees obtained using the MBI questionnaire. The descriptive statistics were presented for nine different professional groups (total of 441 people) of different age, degree of personal responsibility and emotional involvement in their job — the frequency analysis of expressiveness of emotional burnout syndrome performed in the context of the procedural-dynamic model. Results: Results revealed that the symptoms of burnout are quantitatively and qualitatively vary in different occupational settings. Based on the content analysis of the data obtained through face-to-face psychological counselling of clients, a list of manifestations and experiences was developed, accompanying burnout complaints as a component of a difficult life situation: emotional and motivational-semantic sphere, life position, behavioural, and psychological and physiological aspects. Conclusion: Attention was drawn to the necessity of clarification of social-psychological norms and clinical signs, which reliably and differentially diagnose its symptoms (in contrast to fatigue, depression or normative age crises). The conclusions provide suggestions and solutions on the principles of psychological prevention and assistance (self-help) in situations of emotional burnout.

Counseling fatigue of HIV/AIDS counselor in Calabar, Nigeria

Objective: There is different perception of HIV/AIDS counselling fatique among counsellors of patients. This descriptive study assessed perceived HIV/AIDS counseling fatigue among HIV/AIDS counselors in Calabar, Nigeria. Materials and Methods: A total of 90 counselors were assessed using a 35-item questionnaire measuring a variety of counseling activities. Fatigue was ranked on a 5-point Likert-type scale. The counseling fatigue was categorized in five subscales: accessibility of clients for HIV Counseling and Testing (HCT), explains and facilitates, monitoring and follow through, trusting relationships, policies in counseling activities, and burnout responses. Results: The results showed that counselors’ perceptions on fatigue were mostly on accessibility of clients for HCT (Mean = 72.50, standard deviation [SD] = 6.124) with statistical significance of Chi-square calculated = 161.419, df = 5; P &lt; 0.001, monitoring and follow through activities (mean = 71.80, SD = 11.23, Chi-square calculated = 31.223; df = 4; P &lt; 0.001), and policies in counseling activities (mean = 66.0 SD = 9.62, (Chi-square calculated = 11.906, df = 6; P &lt; 0.05). Explain and facilitate statistically and significantly correlated with age (r = 0.610, P = 0.000) and years of experience (r = 0.695, P = 0.000). Burnout responses were also statistically significant (Chi-square calculated = 144.000; df = 7; P &lt; 0.001). Conclusion: Findings show HCT counseling activities generally cause fatigue for counselors, however, explain and facilitate counseling activities correlated with age (20–29 years) and years of experience (1–2 years) as these were found to be more fatigued among the participants. The years of experience correlation could be attributed to lack of formal HCT counseling training reported by 20 (20%). Further research is needed to explore counselors’ perceptions of HIV/AIDS counseling fatigue in different cultures.

An Evaluation of Motivational Interviewing Based Treatment in a University Addiction Counseling Training Clinic

The purpose of the pilot study was to examine the effectiveness of a university-based addiction clinic where counseling students treat clients with Motivational Interviewing. Participants (N = 55) were college students referred for alcohol-related problems to an addiction counseling training clinic within a CACREP-accredited counseling program. In the clinic, counseling students screen for problematic drinking through the Alcohol Use Disorders Identification Test (AUDIT) and counsel clients with Motivational Interviewing. The authors examined AUDIT scores from the clinic archives and subjected the scores to paired sample t-tests and Wilcoxon Signed-Rank Tests based on the normality of the subscales. The paired sample t-tests and Wilcoxon Signed-Rank Tests both resulted in statistically significant decreases from pretreatment to post-treatment scores. The findings support the feasibility, preliminary design, and likelihood of positive results of future research that expands the parameters of our pilot study. Implications for research and counselors are discussed.

A community-based HIV counselling and testing programme found a decreasing proportion of new HIV testers in South Africa

This article assesses the history of HIV testing among community-based HIV counselling and testing (CBCT) clients between 2014 and 2018 in 13 South African districts. Consenting clients were tested for HIV and interviewed to categorise as first-time testers or repeat testers. Of the 1 800 753 clients tested for HIV, 15.7% (95% CI [15.6–15.7]) were first-time testers. The rate of identifying first-time testers decreased by 10.7% in four years from 18.4% in year one to 7.7% in year four. A substantial proportion (5.5% [5.4–5.6]) of HIV-positive people not yet on antiretroviral treatment sought HIV re-test, of whom nearly half (48.4% [47.1–49.6]) did not disclose their HIV-positive status during pre-counselling and were re-tested. A decreasing proportion of first-time testers may signal positive progress towards universal HIV testing. This downward trend should be sustained to control the HIV epidemic.

In-depth analysis of clinical case study on parasuicide counselling in Dhanvantri critical care center at Erode

Parasuicide is an apparent attempt at suicide, commonly called a suicidal gesture, in which the aim is not death. Parasuicide is considered to be a serious public health issue. Previous parasuicide is a predictor of suicide. The increased risk of ensuing suicide sustains without decline for at least two decades. Other researchers also eke that those who attempt suicide with the intent to kill themselves can be defined as parasuicide. Studies have found that about half of those who commit suicide have a history of parasuicide. Parasuicide is utmost common in adolescents and young adults. This clinical case study focuses on counselling for parasuicidal early adulthood clients.

The prevalence and associated factors of Treponema pallidum among HIV-positive and HIV-negative individuals who attended voluntary counseling and testing center of St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia: A cross-sectional study design.

Background:Treponema pallidum and HIV are among the most common public health problems in Ethiopia. These infections are interrelated. Treponema pallidum causes genital ulcer which enhances HIV transmission and complicates HIV by causing severe ulcer among HIV-positive individuals. Although Treponema pallidum and HIV have a similar route of transmission, screening services for Treponema pallidum are not available in most of the voluntary counseling and testing centers.Objectives:This study aimed to assess the seroprevalence of Treponema pallidum and sociodemographic factors among HIV-positive and HIV-negative individuals from the voluntary counseling and testing center of St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia.Methods:In this research, a cross-sectional study was conducted and a total of 292 consecutive samples were collected from the voluntary counseling and testing center of St. Paul’s Hospital Millennium Medical College. Data were collected using an interviewer-administered questionnaire. A blood specimen was tested for the presence of Treponema pallidum using rapid plasma reagin and a rapid test kit for HIV. The data were entered and analyzed using SPSS version 20.Results:The overall prevalence of Treponema pallidum was 5/292 (1.7%). All HIV-positive clients were negative for Treponema pallidum. None of the risk factors were significantly associated with Treponema pallidum.Conclusion:In this study, the prevalence of Treponema pallidum was 5/292 (1.7%). None of the study participants were co-infected with Treponema pallidum and HIV.Recommendation:There was a lack of association between syphilis and HIV in this study, but still the prevalence of Treponema pallidum among voluntary counseling and testing center clients is a public health problem. Therefore, Treponema pallidum infection control strategies should be designed in parallel with HIV control strategy and actions should be taken to avert the problem, including the provision of better health education and screening services at voluntary counseling and testing centers parallel with HIV.

The Role of Practice-Based Evidence and Feedback Informed Treatment for Improving Therapy Outcomes

Attrition rates and deterioration of counselling and psychotherapy clients are two major concerns for those delivering psychological therapies across differential modalities. While a variety of correlations are said to contribute to attrition and deterioration such as, client, therapist and clinical level, identifying and improving outcomes for this cohort of people in routine practice is difficult. Even with the addition of hundreds of empirically supported treatments added to the profession, outcomes have not improved in line with these new approaches. Methods to limit the extent of poor outcomes has been established in the extent literature, thus, practice-based evidence is put forward focusing on Feedback Informed Treatment (FIT).