Family Counseling Sessions Research Articles

선택적 함묵증 청소년의 자기표현 및 관계 향상을 위한 미술치료 단일사례연구

Objectives The purpose of this study is to investigate the effect of art therapy in the improvement of self-ex-pression and interpersonal relationships in adolescents with selective mutism. Methods The research subject is a third-year middle school male student with selective mutism who meets all five criteria of DSM-5 diagnosis. The art therapy of this study was conducted from November 2019 to February 2020, totaling 19 sessions. The research subject received one session per week, each lasting 45 minutes. However, sessions that were conducted in parallel with test and counseling, and the interview counseling of father were ex-tended to 90 minutes each. The parents, who were going through divorce, received individual counseling, family counseling session was conducted once, the father, mother, and a homeroom teacher were provided counseling as needed after the sessions with the subject. The study used HTP for examining changes in self-expression of the research subject with selective mutism, and KSD for exploring changes in relationships. HTP and KSD were evaluated by comparative analysis of pre- and post-test results. The process of change was qualitatively analyzed based on the artwork created during art activities, session transcripts, and counseling journals for each session. Results Firstly, in the post-test of the HTP, the size of the drawings increased by approximately three times, the positioning and composition became more stable, the shading in the human figures disappeared and the depiction of a smiling expression indicated an improvement in self-expression. Secondly, in the post-test of the KSD, the size of the drawings increased by approximately four times, and the positioning, pen pressure, use of an eraser being more stable and the inner aspect of the face being apparent indicated an improvement in interpersonal relationships. Thirdly, throughout the progression across sessions, the subject exhibited emotional stability and genuine self-expression, leading to positive changes in both self-expression and interpersonal relationships. Conclusions considering the combined results, art therapy had demonstrated significant effects on self-ex-pression and interpersonal relationships in adolescents with selective mutism.

Healthcare Experiences of African American Women with the Fragile X Premutation.

This study aims to understand the healthcare experiences of African American women with a fragile X premutation (PM). PM carriers are at risk for fragile X-associated conditions, including primary ovarian insufficiency (FXPOI) and neuropsychiatric disorders (FXAND). There is no racial/ethnic association with carrying a PM, but African American women historically experience barriers receiving quality healthcare in the USA. Obstacles to care may increase mental health conditions like anxiety and depression. Eight African American women with a PM were interviewed to explore disparities in receiving healthcare and to learn about psychosocial experiences during and after their diagnoses. Interviews were transcribed verbatim and independently coded by two researchers. A deductive-inductive approach was used, followed by thematic analysis to determine prominent themes. The average participant age was 52.3 ± 8.60 years, with a mean age at premutation diagnosis of 31 ± 5.95 years. Seven participants had children with FXS. Themes from interviews included healthcare experiences, family dynamics, and emotional/mental health after their diagnosis. Participants reported concerns about not being taken seriously by providers and mistrust of the medical institutions. Within families, participants reported denial, insensitivity, and isolation. Participants reported a high incidence of anxiety and depression. Both are symptoms of FXAND and stresses of systemic racism and sexism. The reported family dynamics around the news of a genetic diagnosis stand apart from other racial cohorts in fragile X research: interventions like family counseling sessions and inclusive support opportunities from national organizations could ease the impacts of a PM for African American women.

Exploration of Application Basic Counseling Skill in Family Counseling Session from Counselor Perspective Experience

Exploration of Application Basic Counseling Skill in Family Counseling Session from Counselor Perspective Experience

Behavioral Changes and Cognitive Decline among Elderly

An individual’s behavior is impacted by a complex interaction of factors such as cognitive impairment, physical and mental health, past habits, personality, and environment. The cognitive decline means that your brain does not work as well as it used to. This study aimed to examine behavioral problems and cognitive decline among the elderly. The research information was gathered using multistage random sampling from various locations of Lucknow city (U.P). A total of 100 elderly were selected for conducting the present study comprising elderly belonging to different ages and both gender. A general information sheet was developed to collect the general information of the respondents. A Revised Memory and Behavioral Checklist scale developed by Teri, 1992, was used to assess the behavioral problems among the elderly. Females were found to have severe cognitive decline and behavioral problems compared to male respondents. Cooperation from family members and counseling sessions may prove beneficial in improving the overall cognitive health of female respondents.

An Exploration of Client Experiences in a Combination of Individual and Family Counseling

Researchers explored client meaningful experiences in a combination of individual and family counseling in this constructivist phenomenological study. The sample consisted of seven participants (three families) who ranged in age from 10 to 51. Participant racial/ethnic identities included two White, two biracial, and two Black. Participant gender identities included five females and two males. Two interviews per client family (one interview following an individual counseling session and another following a family counseling session) revealed the following themes: (a) understanding self and others, with subthemes gaining understanding and acceptance of self, better understanding of each other and how to be with each other, and learning coping skills; (b) setting and working toward goals; (c) processing issues in session, with subthemes counseling is not always what we want, but is maybe what we need, and tension of family versus individual counseling; (d) the counselor; and (e) play.

ACE: Three Adventure-Based Activities to Improve Family Communication

The action-oriented nature of adventure-based counseling (ABC) makes it a good therapeutic modality for family counseling settings. Research studies exploring the integration of ABC with families are positively correlated with increased communication, conflict resolution, trust, and intimacy. The author presents adventure-based family communication experience, a series of three ABC activities integrated with Satir’s communication model to use in family counseling sessions. Each activity is described, and thoughts about how to integrate and process the experience with a family are provided.

Impact of Patient Counseling and Socioeconomic Factors on Initiation of Rehabilitation Program in Spinal Cord Injury Patients Presenting to a Tertiary Spine Unit in India.

Study DesignProspective case series.PurposeThis study aimed to investigate the impact of education, financial income, occupation, and patient counseling on the timing of enrolment in a spinal cord injury (SCI) rehabilitation program.Overview of LiteratureA rehabilitation program following SCI is essential to improve functional outcomes. Socioeconomic factors can affect the timing of enrolment to a rehabilitation program. Literature on the effects of socioeconomic factors among patients with SCI in the Indian scenario is limited.MethodsA prospective, consecutive analysis of patients with SCI was performed with 1-year follow-up. Assessment of the timing of enrolment to a rehabilitation program was performed using the modified Kuppuswamy socioeconomic scores (MKSS). Patients admitted to the SCI unit (group A), underwent intensive individual, group, and family counseling sessions to encourage early enrolment into a rehabilitation program. Patients presenting directly for rehabilitation (group B) were analyzed for comparison.ResultsA total of 153 patients were recruited. Group A was composed of 122 patients who started the rehabilitation program after a mean of 28 days, compared with a mean of 149 days for 31 patients in group B. In group A, 104 patients (85%; mean MKSS, 14.02) and 18 patients (15%; mean MKSS, 15.61) enrolled for rehabilitation <6 weeks and ≥6 weeks, respectively. In group B, 12 patients (39%; mean MKSS, 13.69) and 19 patients (61%; mean MKSS, 12.10) enrolled for rehabilitation <6 weeks and ≥6 weeks, respectively. The total MKSS and scores for education, income, and occupation did not show a significant difference between the two both groups (p>0.05).Conclusions Early patient counseling in the acute care unit helps in the early enrolment of patients with poor socioeconomic demographic profile to a rehabilitation program.

SARS-CoV-2 Infection Among Community Health Workers in India Before and After Use of Face Shields

This study assesses SARs-CoV-2 transmission among community health workers in India before and after instituting use of face shields during family counseling sessions in households with a SARs-CoV-2–infected member.

The effectiveness of family counselling on reducing exposure to secondhand smoke at home among pregnant women in Iran.

INTRODUCTIONPregnant women are often exposed to secondhand smoke that affects them and their child. Our aim was to determine the effectiveness of family counselling using the BASNEF model on reducing exposure to secondhand smoke at home among pregnant women.METHODSA quasi-experimental study was conducted on 103 pregnant women exposed to secondhand smoke. They were selected using a multi-stage cluster sampling method and allocated into intervention (50 people) and control (53 people) groups. Four family counseling sessions using the BASNEF model were held for the intervention group while the control group received routine care. The outcomes were measured before and at one month after the last session of counselling.RESULTSIn the timeframe before the intervention, the number of days in which there was reported exposure to secondhand smoke was 5.08 ± 1.1 in the intervention group, significantly decreasing to 3.5 ± 1.6 after the intervention (p<0.001). No significant change was observed in the control group (p=0.1). Also, the mean scores of all constructs of the BASNEF model increased significantly after the intervention compared to those of the control group (p<0.05).CONCLUSIONSFamily counseling had a positive effect on decreasing the exposure to secondhand smoke at home among a sample of pregnant women. The BASNEF model is useful for implementing educational care programs in these settings.

A clinically structured and partnered approach to genetic testing in Trinidadian women with breast cancer and their families.

Breast cancer (BC) is the leading cause of cancer death in Caribbean women. Across the Caribbean islands, the prevalence of hereditary breast cancer among unselected breast cancer patients ranges from 5 to 25%. Moreover, the prevalence of BC among younger women and the high mortality in the Caribbean region are notable. This BC burden presents an opportunity for cancer prevention and control that begins with genetic testing among high-risk women. Measured response to positive genetic test results includes the number of preventive procedures and cascade testing in family members. We previously reported data on an active approach to promote cascade testing in the Bahamas and report on preventive procedures showing moderate uptake. Here, we describe a clinically structured and community-partnered approach to the dissemination and follow-up of genetic test results including family counseling for the promotion of risk mitigation strategies and cascade testing in our Trinidadian cohort of patients tested positive for BC predisposition genes. As a part of our initial study of BC genetic testing in Trinidad and Tobago, all participants received pre-test counseling including three-generation pedigree and genetic testing for BRCA1/2, PALB2, and RAD51C. The study was approved by the University of Miami IRB and the Ethics Committee of the Ministry of Health, Trinidad and Tobago. We prospectively evaluated a clinically structured approach to genetic counseling and follow-up of BC mutation carriers in Trinidad and Tobago in 2015. The intervention consisted of (1) engaging twenty-nine BC patients with a deleterious gene mutation (probands), and (2) invitation of their at-risk relatives to attend to a family counseling session. The session included information on the meaning of their results, risk of inheritance, risk of cancer, risk-reduction options, offering of cascade testing to family members, and follow-up of proband decision-making over two years. Twenty-four of twenty-nine mutation carriers (82.8%) consented to enroll in the study. At initial pedigree review, we identified 125 at-risk relatives (ARR). Seventy-seven ARR (62%) attended the family counseling sessions; of these, 76 ARR (99%) consented to be tested for their family gene mutation. Genetic sequencing revealed that of the 76 tested, 35 (46%) ARR were carriers of their family mutation. The ARR received their results and were urged to take preventative measures at post-test counseling. At 2-year follow-up, 6 of 21 probands with intact breasts elected to pursue preventive mastectomy (28.5%) and 4 of 20 women with intact ovaries underwent RRSO (20%). In Trinidad and Tobago, a clinically structured and partnered approach to our testing program led to a significant rate of proband response by completing the intervention counseling session, executing risk-reducing procedures as well as informing and motivating at-risk relatives, thereby demonstrating the utility and efficacy of this BC control program.

Transformar la educación superior y obligatoria a través de aprendizaje-servicio y mentoría

El propósito de este trabajo fue determinar el impacto de un programa fundamentado en aprendizaje-servicio y mentoría sobre las competencias profesionales del alumnado universitario, el rendimiento escolar de los estudiantes y la satisfacción de los docentes-tutores de educación obligatoria. Para ello, 40 estudiantes universitarios, previamente entrenados y siempre supervisados por los responsables del programa, efectuaron 352 sesiones de mentoría con 20 escolares, 67 sesiones de coordinación con sus 13 docentes-tutores y 84 sesiones de asesoramiento familiar a sus respectivas familias. Los resultados muestran diferencias estadísticamente significativas en competencias del alumnado universitario, además de mejoras en rendimiento escolar y elevados niveles de satisfacción de los docentes-tutores. Esta intervención ha contribuido a mejorar la eficacia y eficiencia de la educación universitaria y obligatoria.

Abstract P4-10-11: An active approach to genetic counseling in Trinidadian women with breast cancer

Abstract Introduction Breast cancer (BC) is the leading cause of cancer death in Caribbean women. The prevalence of deleterious mutations in BRCA1/2, PALB2 and RAD51C among unselected BC patients in the Caribbean is 5-25%. We previously reported data on low usage of genetic counseling services by Bahamian women. In order to improve the dissemination of genetic testing results to Caribbean probands and their families we developed a structured approach to genetic test result dissemination and family counseling. Methods After approval by the University of Miami IRB and the Ethics Committee of the Ministry of Health of Trinidad &amp; Tobago, we prospectively evaluated the active approach to genetic counseling in 32 BC mutation carriers in Trinidad &amp; Tobago in 2015. The intervention consisted of: 1) initial appointment with referring oncologist for results discussion; 2) review of family tree with proband to identify all relatives at 25% or 50% risk (ARR) who should attend the genetic counseling session; 3) preschedule a counseling appointment for ARR within 2 weeks; 4) written invitation to genetic counseling session; 5) handouts of genetic information given to proband to distribute to family members; 6) offer assistance with contacting family members; 7) free genetic testing to ARR who attended the family counseling session. Results Twenty-five carriers (78%) consented to enroll in the study. At initial counseling, probands identified 158 ARR, however full family pedigree review at post-result counseling/consultation identified 225 ARR. 101 ARR (64%) attended the information sessions and 76 participants (75.2%) consented to be tested for BC gene mutations. Genetic sequencing revealed 35 ARR (46%) were carriers of at least one mutation. The most frequent reasons for ARR not attending the meetings were: living abroad (18%), unable to be contacted (17%), refusing to participate (17%), not showing up (17%), probands being estranged from ARR (12%) or being afraid to know the results (7%). Conclusions In Trinidad &amp; Tobago, a structured approach to the dissemination of genetic test results leads to a significant improvement in the rate of family participation compared to previous efforts (64% in Trinidad &amp; Tobago vs. 9% in the Bahamas). Citation Format: George SH, Bravo GL, Sandoval AC, Palacio S, Ali J, Donenberg TR, Akbari MR, Narod S, Hurley J. An active approach to genetic counseling in Trinidadian women with breast cancer [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P4-10-11.

Process Evaluation of the NYU Caregiver Intervention-Adult Child

A noted limitation of dementia caregiver intervention research is a lack of focus on the mechanisms of successful programs. The purpose of this study was to conduct a process evaluation of the New York University Caregiver Intervention-Adult Child (NYUCI-AC) to describe its delivery and determine which of its components were associated with key outcomes (caregiver stress and well-being; care recipient residential care admission). Adult child caregivers randomly assigned to receive the NYUCI-AC intervention (n = 54) were included. Detailed data on the frequency and duration of each intervention component received, 4-month review checklists, and regular caregiver assessments were collected. Quantitative (descriptive, logistic regression, Cox proportional hazards models, growth curve models) and qualitative thematic analyses were performed. Adult children receiving the NYUCI-AC completed a mean of 5.19 individual and family counseling sessions; it took on average a little over 11 months to do so. All NYUCI-AC counseling components were generally well-received and improved caregivers' management of care-related stress. The individual counseling sessions' clinical benefits in reducing primary subjective stress were most apparent in the first year of the intervention. Caregivers who experienced negative outcomes over time used more family sessions. A key mechanism of benefit for adult child caregivers in the NYUCI-AC was the frequent use of individual counseling sessions. The qualitative and quantitative results emphasize the value of the NYUCI-AC's flexibility in allowing adult child caregivers to choose the timing and use of specific intervention components.

Family-Based Smoking Cessation Intervention for Smoking Fathers and Nonsmoking Mothers with a Child: A Randomized Controlled Trial

To examine whether a family-based intervention targeting both smoking fathers and nonsmoking mothers in well-child health clinics is effective in increasing fathers' abstinence from cigarette smoking. This parallel 2-arm randomized controlled trial recruited a total of 1158 families with a daily-smoking father, a nonsmoking mother, and a child aged 0-18 months from the 22 maternal and child health centers in Hong Kong. The intervention group received the family-based intervention, including 6 nurse-led individual face-to-face and telephone counseling sessions within 1 month after recruitment and a voluntary face-to-face family counseling session (FCS). The control group received a leaflet, a self-help booklet, and brief quitting advice only. Father-reported 7-day and 6-month abstinence, smoking reduction, quit attempts, mother-reported help and support, and child salivary cotinine level were assessed at 12 months. Generalized estimating equation models were used to compare these outcomes between the 2 study groups. Compared with the control group, the intervention group reported a greater prevalence of 7-day (13.7% vs 8.0%; OR, 1.92; 95% CI, 1.16-3.17; P < .01) and 6-month self-reported abstinence (13.4% vs. 7.5%; OR, 2.10; 95% CI, 1.30-3.40; P < .01). Within the intervention group, compared with receipt of individual counseling only, participation in the FCS was associated with increases in fathers' self-reported abstinence (20.2% vs 12.3%; P = .02), mothers' help (66.1% vs 43.8%; P < .01), and support to the fathers (55.0% vs 45.4%; P < .01). The family-based smoking cessation intervention for the families in the well-child healthcare setting was effective in increasing the fathers' self-reported abstinence. Additional participation in the FCS increased mothers' help and support to the fathers. Controlled-trials.com: ISRCTN99111655; Hkuctr.com: HKUCTR-465.

Perceptions of the First Family Counseling Session: Why Families Come Back

This article reports the findings of a study that examined why families choose to return to family therapy after their first family therapy session. The 87 families that were referred to a university family counseling center for assistance with their children’s behavioral problems at school completed an author-developed survey in which they rated the influence of various therapist-related and family-related factors on their decision to return for a second session. Factor analysis of the survey data revealed that the families’ positive experience of the therapist during the first session had the strongest influence on their continuation decision. The findings suggest that family therapists are not helpless victims to client attrition after the first session, but rather, have the strongest potential for influencing client decisions to come back. Specific family therapist actions for maximizing family continuation after the first session are described.

Quality of life of unaffected siblings of children with chronic neurological disorders.

To study quality of life (QoL) of the siblings of children with chronic neurological disorders. Between 1st August and 30th September, 2013, 50 children aged 12-18 y, whose child sibling was suffering from a chronic neurological disorder, were enrolled (Study group). Fifty age- and sex- matched siblings of apparently non-neurologically affected children were enrolled as controls (Control group). Those with more than one affected child or any affected adult in the family were excluded. QoL was assessed by a validated version of the WHOQOL-BREF in Hindi, and QoL was compared between cases and controls. The disorders in the index cases included cerebral palsy, 18 (15 with epilepsy); autism, 15; mental retardation, 12 and epilepsy, 5. The QoL in all domains was significantly poorer in the study group as compared to the controls. 64% study group children had insufficient knowledge about their sibling's condition. More than 1/4th study subjects faced difficulties in studies, play or work. There was no difference among the groups with regard to number of siblings who had 'dropped from the school'. The QoL of unaffected siblings of children with chronic neurological disorders was significantly impaired. Health-workers may consider including older siblings of neurologically affected children during family-counseling sessions, to provide information and suggest coping strategies. This intervention is likely to improve the functioning of the family unit as a whole.

A Case Study on Family Therapy for Husbands with Infidelity Problems: Focused on Changes in Family Relationship

This study describes the family conflict related to the infidelity of a husband through the perspective of family therapy. The purpose of the study was to find the factors that affected infidelity and family conflict. This study also attempted to discover factors that influenced positive changes in family relationship. The data consisted of recorded transcripts and notes taken during 21 family therapy sessions, which included individual, couple, and family counseling sessions. This study used the matrix and network display developed by Miles and Huberman as well as the open coding method to show the results of the study. The therapist employed the MRI’s interactional model and Murray Bowen’s family systems theory in order to treat the family. The results of the study identified infidelity, undifferentiation of self, and dysfunctional communication pattern as factors affecting family conflict. As a result of intervention, the family members experienced the differentiation of self and changed pattern of communication. Through these experiences, the family members improved their relationship. This case study suggested that both MRI model and Murray Bowen’s family systems theory were appropriate models for a Korean couples’ infidelity case.

Comprehensive Evaluation of Drug De-addiction Centres (DDCs) in Punjab (Northern India).

Drug addiction is on the rise in Punjab,India. There are 15 DDCs which are supported by the Indian Red Cross Society. There is alleged mushrooming of private Drug De-addiction Centres (DDCs) in the smaller towns, villages and cities of Punjab. This study aimed to evaluate DDCs in Punjab. A total of 10 DDCs were included in the study and scheduled visits were made to collect data by using a pre-tested questionnaire. The duration of treatment was 1 month at the Red Cross DDCs and it was approximately 6 months at private DDCs. The staff at the private DDCs were inadequate. The major drugs which were abused by patients were Propoxyphene, Alcohol, Bhukki and Cannabis. Patients were usually referred to the DDCs either by family members (35.3%) or social workers (29.8%). About 72.5% of patients were married, 36.3% had passed 10th standard and 54.4% were employed. A majority dropped out of the DDCs due to personal reasons and lack of family support. On comparison, more patients were found to be treated at Red Cross centres (75.3%) than at private centres (65.8%). All DDCs had conducted regular sessions of individual, group and family counseling for patients. Red Cross DDCs ensured that ex-clients received follow-ups and home visits. More patients were satisfied with the services which were provided by the Red Cross DDCs. On the contrary, more patients at the private DDCs complained about harassment fromstaff personnel (p>0.05). It is recommended that all DDCs should be checked regularly, and that the private centres should be provided with additional support from the government, to help run them more efficiently.

Family Burden on Parents of the Children with Cerebral Palsy: Effectiveness of the Family Centered Psycho-Social Intervention Programme

This study was to measure the effectiveness of family centered psycho-social intervention on family burden among the parents of the children with cerebral palsy. A quasi experimental research design without control group was used. Parents were chosen using simple random technique from the list of children in the age group of 1-12years with cerebral palsy registered, in a tertiary care hospital for treatment. Study was carried out during June to November 2013. Data was gathered in two phases. The intervention package included the following: i. group interactive sessions on prevention and coping skills of family burden. ii. Individual and family counseling sessions to the parents and family members. Using SPSS version 17, frequency of variables, mean, standard deviation; paired‘t ‘test and Cohen’s ‘d’ tests were applied to find the outcome. Among the parents most of them (88.6%) were mothers. More than one third (37.1%) parents were between the age group of 26-30years. Most of the parents (91.4%) were living with their family. More than half (65.7%) of parents had consanguineous marriage. The standard of living index indicated almost half (48.6%) of the parents were from lower socio economic background. Paired sample‘t’ test indicated significant reduction in the level (t=2.95, p<0.001) of family burden. There was a very small positive effect (d=0.08) after the intervention program on the group of parents. It showed that family centered psycho social intervention was effective in reducing family burden of the parents of the children with cerebral palsy. This intervention program was to prevent psycho-social health problems of the parents with cerebral palsy. Comparative studies were needed to ascertain the efficacy of this intervention.

Effectiveness of Family Meetings for Family Caregivers on Delaying Time to Nursing Home Placement of Dementia Patients: A Randomized Trial

BackgroundInterventions relieving the burden of caregiving may postpone or prevent patient institutionalization. The objective of this study was to determine whether a family meetings intervention was superior to usual care in postponing nursing home placement of patients with dementia.MethodsA randomized multicenter trial was conducted among 192 patients with a clinical diagnosis of dementia living at home at enrolment and their primary family caregiver. Dyads of caregivers and patients were randomized to the family meetings intervention (n = 96) or usual care (n = 96) condition. The intervention consisted of two individual sessions with the primary caregiver and four family counseling sessions that included family members and friends. The primary outcome measure was the time until institutionalization of the patient. Intention-to-treat as well as per protocol analyses were performed. Survival analyses were carried out to evaluate the effectiveness of the intervention.ResultsDuring 18 months follow-up 23 of 96 relatives with dementia of caregivers in the intervention group and 18 of 96 relatives with dementia of caregivers in the usual care group were institutionalized. No significant difference between the intervention and the usual care group was found in time until institutionalization (adjusted hazard ratio (HR) 1.46, 95% confidence interval (CI) 0.78 to 2.74). The per-protocol analysis revealed no significant effect either (adjusted HR 0.57, 95% CI 0.21 to 1.57), although the number of placements among the adherers was relatively low (9.4%). A subgroup effect was found for patients’ age, with a significantly higher risk of institutionalization for ‘younger’ patients in the intervention group compared with the usual care group (adjusted HR = 4.94, 95% CI 1.10 to 22.13).ConclusionThis family meetings intervention for primary caregivers of patients with dementia did not postpone patient institutionalization more than usual care.Trial Registration: Controlled-Trials.com ISRCTN90163486