Counseling Training Programs Research Articles

Evaluation of a Training Program for Credit Union Counselors

Abstract Training, Development, and Education assessments have intensified in recent decades, and empirical evidence proves their effectiveness in organizational outcomes. However, the literature shows little research on the results of training in cooperative organizations. This study aimed to evaluate a training program for credit union counselors based on Training, Development, and Education evaluation models associated with logical models. This is an empirical study with a qualitative design. Data collection was performed through an analysis of 229 documents, three semi-structured individual interviews, and a focus group. The results of the research corroborate findings related to the usefulness of the integrated use of systemic evaluation approaches and indicate that these models apply to the context of cooperative training. This study fills a methodological gap in the field of instructional psychology in third sector organizations.

Performance Change in Treating Tobacco Addiction: An Online, Interprofessional, Facilitated Continuing Education Course (TEACH) Evaluation at Moore's Level 5.

Continuing education is essential to build capacity among health care providers (HCPs) to treat people with tobacco addiction. Online, interprofessional training programs are valuable; however, interpretation and comparison of outcomes remain challenging because of inconsistent use of evaluation frameworks. In this study, we used level 5 of Moore's evaluation framework to examine whether an online training program in intensive tobacco cessation counseling achieved sustained performance change among HCPs across multiple health disciplines. The evaluation sample included 62 HCPs with direct clinical duties, who completed the online Training Enhancement in Applied Counseling and Health (TEACH) Core Course in 2015 and 2016. We compared self-reported changes in cessation counseling and clinical practices across eight core competencies from baseline to 6-month follow-up using McNemar's tests and descriptive analyses. Compared with baseline, significantly more HCPs reported providing cessation counseling at 6-month follow-up (44% versus 81%, P < .001). HCPs also reported significant increases in engagement in six of the eight core competencies. Online training in intensive tobacco cessation treatment can result in sustained performance improvement at 6 months. However, availability of resources and clinical context may influence the extent to which HCPs are able to implement their learned skills. Furthermore, continuing education programs should consider the use of consistent evaluation frameworks to promote cross program comparisons.

The Assessment of School Counseling Competencies as a Tool to Support School Counseling Students, Supervisors, and Training Programs

The Assessment of School Counseling Competencies (ASCC) is a measure designed to assess school counseling trainees’ student learning outcomes in four domains: (a) school counseling program development; (b) academic, career, and social/emotional student services; (c) evaluation and assessment; and (d) professional dispositions and behaviors. The ASCC aligns with standards from the Council for Accreditation of Counseling and Related Educational Programs and the American School Counselor Association, supporting sound evaluation processes and continuous programmatic improvement. This article (a) reviews the developmental needs of school counselors in training and the importance of sound evaluation measures; (b) introduces the ASCC as a tool to promote the development of reflective, ethical, and effective school counseling professionals; and (c) offers implications of the ASCC for quality program evaluation and research.

Development and early implementation of an Accessible, Relational, Inclusive and Actionable approach to genetic counseling: The ARIA model

ObjectiveTo describe the training and early implementation of the ARIA model of genetic counseling (Accessible, Relational, Inclusive, Actionable). MethodsAs part of the Cancer Health Assessments Reaching Many (CHARM) study, an interdisciplinary workgroup developed the ARIA curriculum and trained genetic counselors to return exome sequencing results using the ARIA model. CurriculumThe ARIA curriculum includes didactic elements, discussion, readings, role plays, and observations of usual care genetic counseling sessions. The ARIA model provides the skills and strategies needed for genetic counseling to be accessible to all patients, regardless of prior knowledge or literacy level; involves appropriate psychological and social counseling without overwhelming the patient with information; and leaves the patient with clear and actionable next steps. ConclusionWith sufficient training and practice, the ARIA model appears to be feasible, with promise for ensuring that genetic counselors’ communication is accessible, relational, inclusive and actionable for the diverse patients participating in genomic medicine. Practice implicationsARIA offers a coherent set of principles and strategies for effective communication with patients of all literacy levels and outlines specific techniques to practice and incorporate these skills into routine practice. The ARIA model could be integrated into genetic counseling training programs and practice, making genetic counseling more accessible and meaningful for all patients.

Exploring Emotion Regulation in Counselors’ Management of Attraction to Clients

ABSTRACT Recent reports from malpractice insurance providers indicate an increase in the frequency of sexual misconduct among practicing counselors. This qualitative content analysis of practicing counselor survey responses (n = 67) examines reported experiences regarding sexual attraction to clients and related coping strategies. Findings suggest the importance of counselors’ emotion regulation in refraining from temptation to act on attraction. The authors propose increased discussion of emotion regulation and sexual attraction to clients in counselor training programs as well as during supervision.

Influence of Mindfulness, Emotion Regulation, and Perceived Social Support on Burnout

We used canonical correlation analysis to examine the predictive nature of three facets of wellness (mindfulness, emotion regulation, and perceived social support) on burnout in counselors‐in‐training (N = 136). The cognitive reappraisal construct made a significant contribution to the wellness predictor variate. Implications for counselor training programs are discussed.

A narrative literature review: Growing the workforce through increased fieldwork capacity in genetic counseling training programs.

In response to mounting concerns regarding a perceived shortage of genetic counselors, the Genetic Counselor Workforce Working Group (WFWG) was established in 2013 to identify barriers to growth of the genetic counseling workforce. After completing a workforce analysis and confirming a shortage, the WFWG convened a strategic planning session in 2017 to identify goals and strategies that would increase the number of certified counselors to meet the current and future workforce demands and ensure access to genetic counselor services. Subcommittees were formed and charged with achieving assigned goals; one such subcommittee included a curriculum working group to build a dynamic and effective educational infrastructure to increase the number of genetic counselors graduated from accredited training program. This paper reports of progress of the WFWG Curriculum Subcommittee toward achieving this goal through a narrative literature review that identifies innovative education methods that help to increase capacity of fieldwork training, both in genetic counseling training programs and in other health professions. Of the five thematic areas identified in this study, four are analyzed for insight into building clinical capacity: systems/infrastructure, rotation structure/models, skill building, and novel techniques. While additional studies are needed to establish best practices in these thematic areas, there are several take-aways that training programs can begin to utilize as they look to expand training opportunities. While growth of the genetic counseling workforce will continue to be a long-term issue, programs should begin to think creatively and innovatively about how to reach beyond traditional fieldwork training formats to build capacity. The strategies explored in this paper offer feasible and untapped solutions that can help support efforts to establish a sustainable genetic counseling workforce.

Using intervention mapping in motivational interviewing training to improve ART uptake in Gauteng, South Africa.

In South Africa, lay HIV counsellors are at the forefront of many HIV-related behavioural interventions. However, they have limited formal counselling training and little ongoing in-service support, leading to considerable variability in approaches to counselling. We describe the use of Intervention Mapping to develop a motivational interviewing counselling training and support program, titled "Thusa-Thuso - helping you help", for lay HIV counsellors practising in primary health care clinics in South Africa. The program is contextually relevant, locally-produced, scalable, and is designed to impart sustained motivational interviewing counselling skills in lay HIV counsellors for improved antiretroviral therapy (ART) uptake in the universal-test-and-treat era.

Positive and negative professionalism experiences of genetic counseling students in the United States and Canada.

Many aspects of genetic counseling training programs have been examined over the years. However, no study has explored professional or unprofessional behaviors genetic counseling graduate students experience during their training, and how these behaviors influence satisfaction with their training. This exploratory study examined students' experiences with program leaders, instructors, supervisors, and other trainees. Specific experiences included actions of favoritism, bias, negativity, abuse of power, and examples of positive role modeling. A survey was sent to all members of the National Society of Genetic Counselors and program directors in order to reach graduates of Accreditation Council for Genetic Counseling (ACGC)-accredited programs from 2015-2019 who were eligible to participate. Responses to questions relating to demographics, satisfaction with graduate education, behaviors experienced or seen during graduate school, and reporting of inappropriate behaviors were collected and analyzed. Results demonstrated that 95% of the genetic counseling graduates were highly satisfied with their graduate education and those who experienced inappropriate behaviors during their training were somewhat less satisfied (p=.04). Individuals who felt more prepared by their graduate education were more satisfied with their graduate education (p<.01). Being publicly embarrassed or humiliated, being made to feel like a burden in clinic, or being subjected to negative or offensive behavior based on their personal beliefs or personal characteristics (excluding areas of gender, race/ethnicity, or sexual orientation) were all negatively associated with satisfaction (all p<.04). We conclude that this survey could serve as a "Genetic Counseling Training Experiences Assessment" which could be incorporated into annual evaluations required by the ACGC. Implementation of this assessment would enhance the current evaluations of genetic counseling training programs and provide important information regarding student experiences during their training.

Geographical analysis of the distribution of certified genetic counselors in the United States.

The number of certified genetic counselors (CGCs) in the genetic counseling workforce has increased over the past few decades as the number of training programs increases and CGCs expand into new patient-facing and non-patient-facing roles. Few studies have explored the distribution of CGCs across the United States. We sought to identify the U.S. geographical regions with the highest number of CGCs and those regions where the physical presence of CGCs is sparser. Deidentified city, state, and ZIP code information for each CGC in the United States were obtained from the American Board of Genetic Counseling (ABGC) database. A countrywide analysis of the distribution of CGCs was completed using geographic information system (GIS) mapping software. The data were organized into U.S. metropolitan or micropolitan statistical areas, if applicable, and analyzed by CGC per capita. We included a total of 4,554 data points (92.2%) in the analysis. Results showed there is one CGC for every 71,842 people nationwide. Of 3,141 total counties (or county equivalents) in the United States, 535 counties had at least one CGC (17.0%). The majority (98.7%) of CGCs live or work within metropolitan statistical areas (MSAs), which are defined by this study as geographical areas with greater than 50,000 people. Of the MSAs with a CGC, approximately half have more than one CGC per 100,000 people. These results are consistent with the overall distribution of the U.S. population. We believe that the MSAs with the most CGCs per capita are due to associations with specific institutions, that is, genetic counseling training programs, health system headquarters, or genetic laboratories. Although the present study cannot draw definite conclusions regarding direct patient care services provided by CGCs, it does provide a snapshot of current CGC distribution within the country. Knowing the distribution of CGCs provides a tool to conduct further workforce analyses to determine the number of CGCs needed to serve the U.S. population.

Mindfulness Practices in Supervision: Training Counselors’ Experiences

The purpose of this qualitative study was to develop a descriptive understanding of couple and family counseling trainees’ experiences of using mindfulness techniques in their group supervision course. Counselor educators have called for additional research on the topic of mindfulness in counseling training programs because the current literature shows differing outcomes. The six trainees who participated in this study had completed between 1 and 2 years of coursework at the graduate level and were beginning their practicum requirements through the University’s counseling center. The counseling trainees participated in a focused mindfulness activity as a way to transition from their busy everyday routines to discussing and reflecting on their client’s progress, as well as their own experience within the therapy setting. Themes from the trainee’s responses highlighted a positive experience to learning mindfulness. Some trainees, however, expressed concern with using mindfulness in the therapy room until they felt more practiced in the techniques. Overall, our findings indicate that the use of mindfulness as a supervisory tool produced many benefits in the course of training. Implications for both training practices and future research on mindfulness with trainees are discussed.

Effectiveness of a Theory- and Web-Based Adaptive Implementation Intervention on Nurses' and Nursing Students' Intentions to Provide Brief Counseling: Protocol for a Randomized Controlled Trial.

BackgroundBrief counseling can motivate patients to initiate health behavior change. However, increasing the provision of brief counseling by nurses is difficult due to contextual and practitioner-level factors impeding nurses’ motivation and intentions to provide brief counseling (eg, unfavorable attitude toward brief counseling, lack of perceived control linked to barriers). Theory-based implementation interventions could address these practitioner-level factors and support evidence-based practice in the context of brief counseling. Web-based, adaptive e-learning (electronic learning) programs are a novel type of implementation intervention that could address the limitations of current brief counseling training programs, such as accessibility and personalization.ObjectiveThis paper presents a study protocol for evaluating the effectiveness of the E_MOTIVA implementation intervention—a theory- and web-based adaptive e-learning program—to increase nurses’ and nursing students’ intentions to provide brief counseling for smoking, an unbalanced diet, and medication nonadherence.MethodsA two-group, single-blind, randomized controlled trial will be conducted with nurses and nursing students enrolled in a Bachelor of Science in Nursing program in Quebec, Canada. Participants in the experimental group will be allocated to the E_MOTIVA intervention—a theory- and web-based adaptive e-learning program—while participants in the active control group will be allocated to the E_MOTIVB intervention, a knowledge- and web-based standardized e-learning program. The E_MOTIVA intervention was designed to influence the constructs of the Theory of Planned Behavior (eg, attitude, subjective norms, and perceived behavioral control) in the context of brief counseling. The Cognitive Load Index and User Engagement Scale will be used to assess participants’ cognitive load and engagement related to e-learning. Participants will complete the Brief Counseling Nursing Practices Questionnaire–Abridged Version at baseline and follow-up. All study measures will be completed online.ResultsThe study is ongoing. The results of the study will provide answers to the primary hypothesis (H1) that experimental group participants will demonstrate a greater change in the score of intentions to provide brief counseling between baseline (–T1) and follow-up (T4). Secondary hypotheses include greater improvements in scores of attitude (H2), subjective norms (H3), perceived control (H4), behavioral beliefs (H5), normative beliefs (H6), and control beliefs (H7) regarding brief counseling in the experimental group between baseline and follow-up. We also anticipate lower intrinsic and extrinsic cognitive loads (H8, H9), higher germane cognitive load (H10), and higher engagement (H11, H12) in the experimental group.ConclusionsThis study will be among the first in evaluating a novel type of implementation intervention, a theory- and web-based adaptive e-learning program, in nurses and nursing students. This type of intervention has the potential to support evidence-based practice through accessible, personalized training in wide-ranging domains in nursing.Trial RegistrationISRCTN Registry ISRCTN32603572; http://www.isrctn.com/ISRCTN32603572International Registered Report Identifier (IRRID)PRR1-10.2196/18894

An Examination of the Psychometric Properties of the Consultation Self-Efficacy Scale in Taiwan

ABSTRACT The purpose of this study was to examine an adaptation of the Consultation Self-Efficacy Scale (CSES) and its psychometric properties among Chinese-speaking populations. The participants included 428 undergraduate and graduate-level students from school counseling training programs in Taiwan. We performed exploratory factor analyses to examine the factor structure of the Chinese version of the CSES and identified five relevant factors that were different from the original factor structure: (a) Process and Awareness, (b) Client Skills, (c) Cultural Sensitivity, (d) Intervention, and (e) Facilitation. The results of reliability estimates supported the internal consistency of each factor (ω and α >.91). Collectively, the five factors accounted for 67.59% of the variance among the items, indicating its psychometric adequacy. Possible explanations for the restructuring of the CSES factors with the cross-cultural sample are discussed. The validated Chinese version of the CSES can be utilized as a progress monitoring or outcome measure for pre-service and in-service consultation training purposes in Taiwan. Additional validation research is warranted for generalization of its usage to other Chinese-speaking professions.

Stepped-wedge cluster randomised trial of a smoking cessation counselling training programme for midwives treating women with functional health illiteracy and low socioeconomic status (PROMISE): a study protocol

BackgroundIn the Netherlands, midwives are required to use the ‘V-MIS’ (Minimal Intervention Strategy for Midwives) smoking cessation counselling protocol to help pregnant women quit smoking. This counselling protocol is often poorly implemented in midwifery practices. It may also be less suitable for pregnant woman with low socioeconomic status or functional health illiteracy. We created an adapted version of the V-MIS protocol that is intended to facilitate implementation in midwifery practices: PROMISE (PROtocol for growing up smokefree using a Minimal smoking cessation Intervention Strategy in the Early stages of life). For this adapted protocol, midwives use carbon monoxide meters, storyboard leaflets, and specific communication techniques for women with functional health illiteracy. They will receive a face-to-face training in using these materials and communication techniques.MethodsThe effectiveness and implementation of PROMISE will be tested in a stepped-wedge cluster randomised controlled trial. We will randomise clusters of midwifery practices and departments in hospitals. We will then train them, subsequently, at regular intervals (‘steps’). At each step, practices that will receive training cross over from the control condition to the experimental condition. We will measure how well the PROMISE protocol has been implemented by assessing the rate of pregnant women that received detailed smoking cessation counselling from their midwives (primary outcome). Our secondary target group is pregnant women with functional health illiteracy and low socioeconomic status. Among them, we will assess smoking status and health-related outcome before and after pregnancy.DiscussionThe PROMISE smoking cessation counselling protocol is intended to help midwives, OB-GYNs, and other obstetrics professionals to support pregnant women with smoking cessation.Trial registrationDutch Trial Registry: NTR 6305/NL6158. Registered on 20 December 2016.

Effect of an Emotional Intelligence Training Program Developed for Prospective Psychological Counselors on Psychological Counseling Skill Levels

The aim of this study was to test the efficacy of an emotional intelligence training program for prospective psychological counselors on psychological counseling skills. The study group for the research comprised 28 prospective psychological counselors attending the guidance and psychological counseling department of a state university who volunteered to participate in the study. The research used a semi-experimental pattern with pretest, posttest and control group. The 2 × 3 split-plot included the first factor with independent process groups of the experimental and control group (14 students each), while the second factor included the repeated measures related to the dependent variables (pretest, posttest, follow-up). The personal information form and Microcounseling Skill Discrimination Scale were used as data collection tools. Analyses were completed with IBM SPSS program. According to the results obtained, for the experimental group there were significant differences identified between the pretest points and posttest and follow-up test points, while there was no statistically significant difference found between the posttest and follow-up measures. In line with this, it was concluded that the emotional intelligence training program was an effective program to develop the psychological counseling skills of prospective psychological counselors and this change continued 1 month after the treatment.

Engaging with people living with HIV: challenges experienced by Malaysian counsellors

ABSTRACT People living with HIV (PLHIV) suffer from mental issues and need emotional support. Counselling is a part of HIV and AIDS care and management, and provides emotional support to PLHIV. Knowledge about HIV and AIDS care and management is not part of the counselling training curriculum in Malaysia. This study aims to explore the challenges experienced by registered counsellors who engage in counselling sessions with PLHIV. A total of five counsellors participated in this qualitative research. Data were gathered through a series of semi-structured interviews, and each of the interviews was conducted within one and half hours. Each of the participants was interviewed three times. The interviews were audio-recorded with the consent of the participants. The emergent themes were further explored in subsequent interviews until thematic saturation was reached, and data were analysed based on the grounded theory approach. The findings showed that lack of knowledge, limited training, and stigma among the registered counsellors contributed to resistance and poor trust among the PLHIV. Knowledge concerning the care and management of HIV and AIDS can be incorporated in a counselling training programme, and ongoing training related to HIV and AIDS are required.

Genetic counseling education at the undergraduate level: An outreach initiative to promote professional recruitment and support workforce development.

As in many other countries, the field of genetic counseling is in its initial stages of development in India, where there are efforts to streamline the profession and to implement graduate-level training programs. We implemented an elective course on genetic counseling at the undergraduate level in a private university in India to assess students' interest, to provide early exposure for students interested in pursuing the career, and to aid recruitment. To assess satisfaction with the course and recruitment outcomes, we sent a course evaluation survey to 332 students and received 134 responses. Familiarity with genetic counseling topics increased significantly after completing the course. Of the 42 respondents who reported they were planning to pursue formal genetic counseling training, 21% (n=9/42) became interested in the profession as a result of taking this course. Survey respondents who were prospective applicants to genetic counseling training programs referred mostly to the websites of the National Society of Genetic Counselors and the American Board of Genetic Counseling for information on genetic counseling and training. Barriers to entry into the field included lack of shadowing opportunities, inadequate coursework, and limited opportunities to interact with practicing genetic counselors. Respondents stated that additional case studies as well as observation of patient interactions would elucidate the role of a genetic counselor and help define the scope of the practice in India and other countries. Overall, genetic counseling education at the undergraduate level is a scalable way to improve understanding of genetic counseling topics, increase professional interest in the field, and support workforce development.

An inevitable crisis? From first to second year in counsellor training

In a seminal 1973 paper, Robert Clark described the very different “cultures” of the first and second year students in a four year clinical psychology PhD programme. The author applies Clark’s template to his own experiences as trainee or trainer in five different counsellor education programmes, one in the US and four in Australia. Each of the programmes, to varying degrees, demonstrates key features of the pattern identified by Clark, where the first year is “therapeutic” and other-oriented, the second is “professional” and self-focused. The author concludes that all the surveyed programmes exhibited some level of “second year crisis”, in which a significant number of students felt abandoned, dissatisfied, or rebellious. The author extends and refines Clark’s developmental analogy (first year = childhood; second year = adolescence) to reflect recent neurological research, in particular, the shift from a right hemisphere-dominant first year of life, prioritising affiliative needs, to a left hemisphere-dominant second year, prioritising autonomy and control. This shift is paralleled later by a more gradual move from a protective, supportive childhood to necessary, but sometimes conflictual, individuation in adolescence. The first two years of a counsellor training programme broadly echo this process, a process exacerbated by the second year internship/placement, in which students must “leave home” and adjust to unfamiliar, potentially less nurturing, authority figures. Finally, the author suggests introducing more rigorous “academic holding” into the first year, and greater attention to “therapeutic holding” of dissident students in the second, hopefully decreasing student dropout, and achieving a better balanced training experience.

Conscripted curriculum: The experiences of minority genetic counseling students.

While the lack of racial and ethnic diversity in the genetic counseling profession has been discussed for decades, little attention has been paid to the training experiences of under-represented minorities. Under-represented minority graduate students in other disciplines have been reported to experience microaggressions and feelings of isolation during training, and they are often informally enlisted to educate classmates about issues related to race. In 2019, sociologist Lauren Olsen coined the term conscripted curriculum to describe the utilization of minority medical students to elucidate issues of race or ethnicity for their classmates. The conscripted curriculum arises when these topics are taught in a small-group discussion format that relies on students sharing their individual experiences to educate their classmates. In classrooms with limited diversity, the expectation to contribute falls disproportionately on students from non-majority groups. In this qualitative study, we conducted videoconference focus groups with 32 recent graduates of genetic counseling training programs who identified as racial or ethnic minorities. We present the results of two thematic categories that emerged from that study: the participants' perspectives on the cultural competency curriculum in their training programs and the participants' feelings of being pressed into service as spokespeople for their cultural groups. Participants described the cultural competency training as occurring primarily in a small-group discussion format in which students were expected to share their personal experiences. During these discussions, minority students, especially those in less-diverse class cohorts, felt obliged to contribute their perspectives in order to educate non-minority classmates about issues of race and ethnicity, leading to feelings of frustration and exhaustion. The results reflect a conscripted curriculum as described by Olsen (2019). Journal of Health and Social Behavior, 60(1), 55-68, in which minority students bear the burden of educating their classmates about the social basis of race. Genetic counseling training programs should critically examine their cultural competency curriculum to create a more equitable training environment.

Reflections on diversity, equity, and inclusion in genetic counseling education.

Through self-reflection, self-education, and with a learning mindset each of us has embarked on a personal path to understand the impact of racism in our personal and professional lives. This personal work is ongoing, though it was through our individual paths that led us to engage in dialogue on race and racism at the 38th National Society of Genetic Counselors Annual Conference. We initially did not know each other; however, we were drawn by a mutual desire to further the conversation and sought connection with each other after the Conversations Around Diversity Platform Presentations. Through sustained, open dialogue we created a brave space for sharing our emotional and intellectual responses to the conference. Through this dialogue and through written reflections, we recognized an emboldened urgency to author a joint reflection on our shared responsibility as genetic counseling training program leaders to use our privilege in service to our students and future students. We have the evidence that we are not a diverse profession. We have more evidence now than we did before that our profession performs poorly with regards to inclusivity. Our inability to acknowledge, address, and discuss racism and other forms of oppression is damaging to each of us individually and as a group of professionals. We owe it to ourselves, our students, our patients, and colleagues to name our learned biases and behaviors, own them and interrupt them.