Counseling Situations Research Articles

Social and healthcare staff’s self-reported simulation learning needs in small and middle-sized enterprises

Objective: The study describes learning needs of social and healthcare staff in small and middle-sized enterprises, which participate in a simulation-based coaching project. The study aims at producing knowledge that can be used to develop the content of multiprofessional simulation-based coaching.Methods: Data were collected through an online survey using a questionnaire with quantitative and qualitative items. The qualitative data were analyzed using inductive content analysis and the statistical data using SPSS for Windows version 23.Results: The professional development needs of social and healthcare staff in small and middle-sized enterprises emerged in the following areas: the respondent’s professional knowledge base; the respondent’s professional skill base; multiprofessional collaboration; development of the business, and networking between enterprises. The staff recognized their need to develop both personally in the area of key competences, and collaboratively in the organization.Conclusions: The results will be used when planning multiprofessional simulation-based coaching for acute, recurrent and infrequent situations in small and middle-sized social and healthcare enterprises. Simulation pedagogy can also be used to prepare for various client and family counseling situations and to practice communication and interaction for interdisciplinary teamwork.

Kompetensi Kaunseling Melalui Refleksi Kendiri: Satu Kajian Terhadap Kaunselor Pelatih

The counseling competence of a counselor trainer is further enhanced when they are able to perform self-reflection on everything that has been and is being done on the process of counseling operated. This survey was conducted to determine the relation of self-reflection with the three dimension of counseling competence; performing helping skill, managing the counseling process, and handling challenging counseling situations. A total of 100 trainee counselors from four public universities in Malaysia were involved in this study. The instrument used in this study is Self-awareness and Management Strategies (SAMS) Scale to measured the self-reflection, and the Counselor Activity Self- Efficacy Scales (CASES) to measured the counseling competence. Result of the Pearson Product Moment Coefficient indicated there is a significant relationship between self-reflection with counseling competence; performing helping skill and counseling competence;handling challenging counselling A disscussion of the findings are presented and several implications and recommendations for further development of counseling competence of trainee counselors.

Promoting Counseling Competence using Silf-Reflection

Self-Reflection (SR) has received a high degree of attention in extant Counseling Competence (CC). The present study sought to determine the relation of SR subscale; self awareness, and managing strategies with the three general areas in CC; performing helping skill, managing the counseling process, and handling challenging counseling situations. A total of 100 counselor trainees completed The Self-awareness and Management Strategies (SAMS) Scale to measured the SR, and the Counselor Activity Self-Efficacy Scales (CASES) to measured the CC. Result of the Pearson Product Moment Coefficient indicated there is a significant relationship between SR; Self-awareness with CC;handling challenging counselling, and SR;management strategies with all the three general areas in CC. A disscussion of the findings are presented and several implications and recommendations for further development of CC a proposed.

Effect of extended oral contraception use on the prevalence of fetal trisomy 21 in women aged at least 35 years.

To study factors influencing the number of ovulations in reproductive life as risk factors for common trisomies. The present observational study examined data from genetic counseling sessions performed at the 1st Department of Obstetrics and Gynecology, Semmelweis University, Budapest, Hungary, between September 1, 2013, and September 1, 2015, and retrieved data on patients of advanced maternal age (≥35years) who had fetal trisomy 21, 18, or 13 confirmed. Consecutive patients of advanced maternal age with genetic amniocentesis-confirmed healthy fetal karyotypes were also included as a control group. Medical record details were confirmed through telephone interviews with patients; the estimated ovulation number was calculated and compared among patients, as were factors contributing to the number of ovulations each patient had. Data from 12776 genetic counseling situations were examined; 35 patients with fetal trisomies and 100 patients in the control group were interviewed. Shorter mean length of oral contraceptive pill use before trisomic pregnancy (P<0.001) and a higher estimated ovulation number (P=0.012) were identified among patients with pregnancies with fetal trisomies. Fewer ovulatory cycles, potentially resulting from longer oral contraceptive pill use, was associated with healthy fetal karyotypes among patients of advanced reproductive age.

Characterizing Clinical Genetic Counselors' Countertransference Experiences: an Exploratory Study.

Countertransference (CT) refers to conscious and unconscious emotions, fantasies, behaviors, perceptions, and psychological defenses genetic counselors experience in response to any aspect of genetic counseling situations (Weil 2010). Some authors theorize about the importance of recognizing and managing CT, but no studies solely aim to explore genetic counselors' experiences of the phenomenon. This study examined the extent to which clinical genetic counselors' perceive themselves as inclined to experience CT, gathered examples of CT encountered in clinical situations, and assessed their CT management strategies. An anonymous online survey, sent to NSGC members, yielded 127 usable responses. Participants completed Likert-type items rating their CT propensities; 57 of these individuals also provided examples of CT they experienced in their practice. Factor analysis of CT propensities tentatively suggested four factors: Control, Conflict Avoidance, Directiveness, and Self-Regulation, accounting for 38.5% of response variance. Thematic analysis of CT examples yielded five common triggers: general similarity to patient, medical/genetic similarity, angry patients, patient behaves differently from counselor expectations, and disclosing bad news; six common manifestations: being self-focused, projecting feelings onto the patient, intense emotional reaction to patient, being overly invested, disengagement, and physical reaction; five CT effects: disruption in rapport building, repaired empathy, over-identification, conversation does not reach fullest potential, and counselor is drained emotionally; and three management strategies: recognizing CT as it occurs, self-reflection, and consultation. Results suggest CT is a common experience, occurring in both "routine" and emotionally complex cases. Training programs, continuing education, and peer supervision might include discussion of CT, informed by examples from the present study, to increase genetic counselor awareness and skills for managing the phenomenon.

Kompetensi Kaunseling Melalui Refleksi Kendiri: Satu Kajian terhadap Kaunselor Pelatih

The counseling competence of a counselor trainer is further enhanced when they are able to perform self-reflection on everything that has been and is being done on the process of counseling operated. This survey was conducted to determine the relation of self-reflection with the three dimension of counseling competence; performing helping skill, managing the counseling process, and handling challenging counseling situations. A total of 100 trainee counselors from four public universities in Malaysia were involved in this study. The instrument used in this study is Self-awareness and Management Strategies (SAMS) Scale to measured the self-reflection, and the Counselor Activity Self-Efficacy Scales (CASES) to measured the counseling competence. Result of the Pearson Product Moment Coefficient indicated there is a significant relationship between self-reflection with counseling competence; performing helping skill and counseling competence;handling challenging counselling A disscussion of the findings are presented and several implications and recommendations for further development of counseling competence of trainee counselors.

Casual Reading Habits and Interpersonal Reactivity: A Correlational Study

Empathy, as a factor has been widely researched about in counselling and clinical situations. Most recently, it is being explored in terms of positive psychology. Several studies have linked empathy to general well-being and life satisfaction of people. It has also shown a reduction in social conflicts and increased peace-keeping intentions. Therefore it is important to understand factors that can lead to an increase in empathy in individuals. This is a study that attempted to understand if there is a relationship between casual reading and interpersonal reactivity-which measures dimensions of cognitive and emotional empathy. Reading has been linked to several benefits for people among which are also emotional and cognitive maturity. This study tried to understand if these benefits extend to include empathy as well. The respondents were all post-graduate students chosen through convenient sampling method. For this purpose, the researcher developed a Casual Reading Checklist which was aimed at understanding the frequency and range of the casual reading habits of people. A total reading habit score was derived out of the same. Along with this, the Interpersonal Reactivity Index (Davies, 1980) was administered to respondents. This scale helps understand empathy over four distinct dimensions- Perspective-taking, Fantasy, Empathic Concern and Personal Distress. A correlation analysis was undertaken to check if there was a relationship between the dimensions of empathy and casual reading habits. Results indicated a significant correlation between casual reading habits and the combined score from the dimensions of Cognitive Empathy. This was an attempt to understand if there is a possibility of using the habit of reading in the form of psychotherapy for general well-being and life satisfaction-at the individual as well as the societal level.

Errors of commission and omission in novice group counseling trainees' knowledge structures of group counseling situations.

This study investigated how novice group counseling trainees' knowledge structures about group situations differed from experts.' Eight highly experienced group therapists and 54 novice trainees indicated which of the 19 leader interventions they would consider using to respond to the 21 group situations described in the Group Therapy Questionnaire (GTQ, Wile, Bron, & Pollack, 1970). Pathfinder Network Analysis (Schvaneveldt, 1990) was used to generate knowledge structures (cognitive maps) about group situations based on the aggregated response of experts and each trainee's response to GTQ. Comparing trainees' maps with the referent expert map, we found no common errors of commission, that is, relationship between situations in trainees' knowledge maps but not in experts' knowledge maps, but 10 common errors of omission, that is, relationships among group situations in experts' knowledge maps but not in trainees' knowledge maps. Cluster analysis identified 2 subgroups of trainees. Neither of these trainee subgroups incorporated the group's developmental stage into their map of group situations as experts did: experts saw the situations during the beginning and ending phases of the group as similar but different from situations in the middle phase of the group. The first group of trainees had a holistic approach to group situations but tended to make errors in dealing with group situations involving a problematic member. The second group had an atomistic approach to group situations but lacked a clearly differentiated and structured general organization for the situations. They tended to make errors in dealing with challenging situations where the group is avoidant and lacks engagement.

Predictors of change in mental health and distress among women attending a women's shelter

BackgroundIntimate partner violence (IPV) is detrimental to mental health. The Domestic Violence Survivor Assessment (DVSA), which includes a mental health assessment, is often used to evaluate abuse survivors in a counseling situation. The DVSA seeks to outline the cognitive state of women as per the stages of change as they attempt to move toward a life with no IPV.ObjectiveThe objective of this study was to explore predictors of change in mental health and distress among women who entered a women's shelter more than once.MethodsWomen entering a women's shelter more than once over a 3-year period were assessed by a trained social worker using the DVSA. A logistic regression analysis examined relationships between the chosen characteristics and the participants’ mental health through the DVSA stages of change.ResultsWe analyzed complete data for 94 women who entered the shelter a mean of 3.3 times (range 2–8) over a mean period of 16.1 days (range: 1–391). Thirty-six women (36/94; 38.3%) progressed through the stages. The average number of visits among women who progressed through the stages was 4. Our multivariable logistic regression showed women who had more visits to the shelter were almost twice as likely to progress through the stages compared to women who entered the shelter fewer times (OR=1.928; 95% CI=1.292–2.877; p=0.001). In the univariate analysis, only increased number of visits was significantly associated with progressing through the stages of change (OR=1.694; 95% CI=1.237–2.322; p=0.001). The other factors were not significantly associated with a change in mental health and distress (p>0.05).ConclusionsWomen who enter women's shelters more frequently may be more likely to progress through the DVSA mental health stages compared to other women. Women's shelters may be helpful in assisting progression through the stages of change, thereby improving their mental health after abuse.

A24 Genetic Counselling

“Genetic counselling is the process of helping people understand and adapt to the medical, psychological and familial implications of genetic contributions to disease” (NSGC, 2006). In the 20 years since the discovery of the HD gene, guidelines for predictive testing in Huntington’s disease have become a model for genetic counselling across a wide range of inherited conditions. Experience has shown that while many individuals wish to know their genetic status, far fewer actually undergo testing. The predictive testing guidance has been updated in recent years to reflect changes in clinical practice over time and are designed to act as a framework of recommended procedures, rather than regulations, to reflect the uniqueness of each individual wishing to discuss their risk of HD. In this interactive case-based workshop we will consider how genetic counselling for HD can be tailored to meet the needs of the individual and their family. We will look at some of the more challenging genetic counselling situations, such as non-disclosure of genetic information to children at risk of HD, and dealing with the problems of denial of symptom onset where this is causing problems at work or in the home. Research evidence in relation to the provision of genetic counselling services will be highlighted and suggestions made for areas where practice may be enhanced for the benefit of family members.

Health Care Providers’ Perspective on Voluntary HIV Counseling and Testing in Health Clinics in Tanzania - A Qualitative Study

The aim of this study was to explore the perspectives of health care providers on voluntary counseling and testing (VCT) patients for human immunodeficiency virus (HIV) or counseling those living with the virus. Semi-structured interviews were conducted with 12 Tanzanian HIV counselors in different health service clinics in Dar es Salaam, Tanzania. The interviews were analyzed using a qualitative method. Three themes emerged from the interviews: a person-centered approach is necessary to build trusting relationships to negotiate behavioral change; challenges in the variations in counseling sessions as well as the maintenance of confidentiality; and the requirement for privacy and disclosure only with the patient/client's consent. The health care providers, who all had considerably long experiences of VCT, showed confidence in the counseling situation and were aware of the many challenges and barriers they encountered at work as a counselor. They stressed that the basis for creating a trusting relationship between a counselor and a patient was a person-centered approach. Patient confidentiality was an important factor in the counseling work, but confidentiality could also be a challenge and dilemma to protect both the patient and sexual partners at risk, and this should be taken into consideration in counseling guidelines.

Implementation of resources to support patient physical activity through diabetes centres in Atlantic Canada: the effectiveness of toolkit-based physical activity counselling.

The purpose of this study was to determine the effectiveness of toolkit-based physical activity counselling on physical activity and exercise participation of type 2 diabetes patients attending diabetes centres in Atlantic Canada. Patients with type 2 diabetes (n=198) were recruited to a quasiexperimental study comparing the effectiveness of counselling by persons trained to use a physical activity and exercise resource manual (i.e. toolkit) vs. a standard of care counselling situation. Effectiveness was assessed through questionnaires completed by patients, and clinical data were extracted from patient charts before and 6months after a single appointment with a diabetes educator. Primary outcome measures were patient self-reported physical activity and exercise levels, efficacy perceptions and mean glycated hemoglobin. There were no significant differences in primary outcomes over time. Subanalyses of the toolkit-counselled patients revealed a significant interaction for moderate-to-vigorous physical activity (MVPA [p<0.0001]), whereby patients who were not meeting Canadian Diabetes Association guidelines for physical activity at baseline (i.e. <150 MVPA a week; n=44) increased physical activity (from 20±23 to 120±30 minutes) and patients who were active at baseline (i.e. >150 MVPA a week; n=22) decreased physical activity (from 444±32 to 161±41 minutes) at 6 months. A single counselling appointment using the toolkit did not elicit significant changes in physical activity or clinical outcomes measured 6 months later when compared with standard care condition; however, increased physical activity was observed for patients who were inactive at baseline. Repeated counselling or more intensive strategies may be required to increase patient physical activity levels and produce clinical outcomes.

Midwives' strategies in challenging dietary and weight counselling situations

ObjectiveBy enhancing maternal nutritional status, midwives can help women lower the risks of pregnancy complications and adverse birth outcomes as well as improve maternal health during pregnancy and in the long run. Dietary counselling is, on the other hand, not reported to be effective. Poor communication and conflicting messages are identified as possible barriers to adherence with recommendations. Midwives' experiences of providing dietary advice and counselling during pregnancy are sparsely reported. The aim of this study was therefore to explore midwives' strategies when faced with challenging dietary counselling situations. MethodsSeventeen midwives from different parts of Sweden and working within antenatal health care were interviewed by telephone. The interviews were analysed using qualitative content analysis. ResultsChallenges were commonly experienced when counselling women who were overweight, obese, had eating disorders or were from different cultures. The midwives talked in terms of “the problematic women” when addressing counselling problems. Strategies used in challenging counselling situations were Getting acquainted; Trying to support and motivate; Pressure to choose “correctly”; Controlling and mastering; and Resigning responsibility. ConclusionsThe results indicate that Swedish midwives' counselling strategies are quite ambiguous and need to be questioned and that counselling of vulnerable groups of women should be highlighted. We could identify a need for education of practicing midwives to develop person-centred counselling skills.

Interactional power

Since the 1970s, various aspects of power have been at the focus of theoretical and empirical adult education research. Despite the actual interest in political and discursive aspects of power, this article emphasizes the importance of interactional studies when observing and identifying power based on various types of data. As for German interaction studies, three phases can be distinguished, characterized by a) observations of failed participation based on records of classroom behaviour, b) the identification of mutual power negotiation in classroom and counselling situations based on transcriptions, and c) the identification of the power of physical settings in adult education classrooms and in counselling sessions based on visual data. It is presumed that observing/identifying power in adult education classrooms and counselling sessions generally depends not only on the notions of power underlying the studies but also on the data types produced and the methods applied for their interpretation. In addition, the question is raised whether the identification of power can be considered a power practice used by adult education researchers.

Introducing the Cultural Ego for Counselling Immigrants and Local Students in Secondary and Adult Educational Settings

The concept of the ‘Cultural Ego’ was first put forth by Sow (1977) and further developed by Terranova-Cecchini (1991) based on clinical work done in Italy and non-Western countries. It has its foundation in anthropology, neuroscience, psychiatry and psychology (Devereux, 1956), (Linton, 1956), (Sow, 1977), (Berry, 1992), (Kandel, 2006), (Kaes, 2007). Purpose of StudyThe purpose of this study is to show how the Cultural Ego can be adapted for use in secondary and adult education counselling situations. Sources of EvidenceThe Cultural Ego as an instrument of transcultural psychiatric therapy that has been used for more than 30 years in Italy by Fondazione Cecchini Pace, Milan (www.fondazionececchinipace.it). Main ArgumentThe Cultural Ego (universal) is composed of three axes: family, community and ancestral. Cultural Ego therapy helps the patient reconstruct the axes (Terranova-Cecchini, 1991).Counsellors, international program directors, social workers will find a working knowledge of the Cultural Ego useful in assisting their target populations. ConclusionDue its success in the transcultural therapy field, the authors have decided to share it with school counselling professionals. It is especially useful for youths who are torn between their family and school cultures. It may be useful in anti- bullying programs because often inner cultural conflicts create bullies. The concept of the Cultural Ego is applicable not just to immigrants but also members of the dominant culture.

Genetic counseling for susceptibility loci and neurodevelopmental disorders: The del15q11.2 as an example

In recent years, several recurrent copy number variations (CNVs) that confer risk of neurodevelopmental disorders have been identified (e.g., del and dup 16p11.2, del15q13.3, del and dup 1q21.1, del16p13.3, del15q11.2). They are often inherited from an unaffected parent and lack phenotypic specificity. Although there is growing evidence from association studies to consider them as susceptibility CNVs, their clinical utility is debated. Yet the clinician is frequently challenged to deal with these counseling situations without guidelines or consensus. In this report, counseling issues and research opportunities are discussed, with the recurrent 15q11.2 BP1-BP2 (including CYFIP1, NIPA1, NIPA2, TUBGCP5) as an example. Several clinical reports have been published describing patients with del15q11.2 featuring intellectual disability, developmental delay, neurological problems, autism spectrum disorder (ASD), attention problems, speech delay, and dysmorphism. The del15q11.2 was found to be significantly associated with intellectual disability, schizophrenia, epilepsy, and ASD. In this report we discuss how patient-specific and family-specific information may alter the interpretation of del15q11.2 as a contributing factor to the disorder in practical counseling situations. In addition, an association study for ASD in a Belgian Flemish cohort and an overview of reported association studies, clinical reports and genomics data for del15q11.2 are presented.

The attitudes toward sexual minority in a postulated counseling situation.

The attitudes toward sexual minority in a postulated counseling situation.

Breaking Bad News in Counseling: Applying the PEWTER Model in the School Setting

Breaking bad news is a stressful experience for counselors and clients. In this article, the PEWTER (Prepare, Evaluate, Warning, Telling, Emotional Response, Regrouping) model (Nardi & Keefe-Cooperman, 2006)is used as a guide to facilitate the process of a difficult conversation and promote client growth in a school setting. In this structured creative model, communication skills are grouped in a systemic and progressive manner that can be individualized to meet client and situational needs. PEWTER addresses the multiple factors and layers that affect the counseling situation when giving life-changing news. A case example is provided that outlines each phase of the PEWTER model.

The Influence of Divergent Parental Attachment Styles on Adolescent Maturation

The literature on parent–adolescent attachment relationships has proliferated in recent years and has found associations between secure, positive attachment and lower mental health difficulties, more meaningful relationships, and increased career and educational success. In contrast, those adolescents who have failed to form meaningful attachments with caregivers appear to struggle in these areas. It is important for family counselors to understand the role that attachment plays across the life span, but particularly in adolescence, as new relationships develop and relationships change. In addition, family counselors may struggle with boundary issues in counseling situations where insecure attachments are of clinical concern. Thus, this article serves as a review of the most current theory and research in the area of parent–adolescent attachment, as well as implications for family counselors—specifically, incorporating attachment into their conceptualization of cases where the adolescent is the identified client and establishing and maintaining appropriate boundaries with their adolescent clients.

Ethics in Pastoral Care and Counseling: A Contemporary Review of Updated Standards in the Field

This article reviews ethical responsibilities that must be considered when engaging in pastoral care, counseling, and psychotherapy. It discusses important contemporary issues counselors will want to contemplate in pursuing a high quality of care in their counseling practices. Examples and case studies are provided. Readers will be able to: Understand the function of ethical standards in the practice of counseling Be able to differentiate between pastoral care, pastoral counseling, and pastoral psychotherapy and their ethical implications Understand the importance of identifying one's limitations in counseling situations and how to proceed under such circumstances. Understand the need for pastoral counselors to attain the necessary credentials for practice in the area of counseling they intend to undertake. Become aware of the legal requirements when engaged in a counseling relationship.