Goal Of Counseling Research Articles

Hospital pharmacists' perceptions of medication counseling: A focus group study.

Medication counseling sessions are key times for a pharmacist to speak to patients about their medications and the changes made to their therapies during their hospital stay. To explore hospital pharmacists' perceptions of their roles and goals in patient medication counseling, and perceived barriers and facilitators to achieving their goals. Hospital pharmacist focus groups were held in two tertiary referral hospitals. Eligible pharmacists had provided medication counseling within the previous six months in inpatient and/or outpatient settings. Interested pharmacists attended a focus group designed to elicit their opinions and perceptions of patient medication counseling. Focus groups were audio recorded and transcribed verbatim. Inductive thematic analysis was applied to the data to identify initial patterns (codes) which were then organized into common overarching themes using NVivo(®) software. The codes were reviewed for reliability by pharmacists independent of the focus groups. Six, 1-h focus groups were conducted with a total of 24 pharmacists participating. Saturation of information was determined after four focus groups. Greater than 80% consensus was achieved for reliability of the identified codes. A number of themes emerged from these codes around the goals, roles, and the barriers and facilitators to meeting these goals. Pharmacists' patient-centered goals in medication counseling were to build rapport, to empower patients and to improve patients' experience, health and safety. These goals would be accomplished through specific roles such as being an assessor, educator and problem-solver. Pharmacists frequently cited time pressures caused by systemic (hospital), and pharmacy specific processes as key challenges to achieving their goals. Factors that enabled pharmacists to meet their goals were those related to effective interprofessional collaboration and the quality of professional practice (such as training, expanded roles and advanced planning for discharge). Hospital pharmacists emphasized patient-centered goals in medication counseling and outlined the challenges to meet those goals. The findings from this study will be used to develop strategies for effective communication and inform pharmacy practice changes to improve patient care.

Examining hospital pharmacists' goals for medication counseling within the communication accommodation theoretical framework.

Medication counseling opportunities are key times for pharmacists to speak to patients about their medications and any changes made during their hospital stay. Communication Accommodation Theory (CAT) posits that an individual's goals drive their communication behavior. The way in which pharmacists communicate with patients may be determined by the goals they set for these medication counseling sessions. To examine hospital pharmacists' goals in patient medication counseling within the CAT framework. Hospital pharmacist focus groups were held in two teaching hospitals. Interested pharmacists attended a focus group designed to elicit their goals in patient medication counseling. Focus groups were audio recorded and transcribed verbatim. NVivo(®) software was used to assist in coding and organization. The codes were reviewed for reliability by pharmacists independent of the focus groups. An inductive thematic analysis was applied to the data. Six 1h focus groups were conducted with a total of 24 pharmacists participating. Saturation of information was achieved after four focus groups. Greater than 80% consensus was achieved for reliability of the identified codes. Patient-centered themes constructed from these codes were to build rapport, to empower patients and to improve patients' experience, health and safety. Exemplars provided by pharmacists for the goals of building rapport and empowering patients were aligned with five CAT communication behaviors (approximation, interpretability, discourse management, emotional expression and interpersonal control). Patient-centered goals described by hospital pharmacists for medication counseling aligned well with CAT behaviors necessary for effective communication. Further research using the CAT framework to examine the effectiveness of hospital pharmacist-patient exchanges that include both participants' perspectives is required to better understand how well pharmacists communicate with patients.

Spiritual and Sexual Identity: Exploring Lesbian, Gay, and Bisexual Clients’ Perspectives of Counseling

ABSTRACTAlthough religious and spiritual issues have emerged as areas of focus in counseling, very few scholars have explored the meaning and experiences of lesbian, gay, and bisexual (LGB) clients who addressed their sexual and religious/spiritual identities in counseling. Using consensual qualitative research (CQR; Hill, 2012), the current study explores the perspectives of 12 LGB persons who sought counseling that involved religious/spiritual concerns. Four themes in participant interviews are identified, including (a) self-acceptance, (b) goals of counseling, (c) identification with counselor, and (d) counseling environment and relationship. Implications of findings for the counseling field are discussed.

Chloe's Law: A Powerful Legislative Movement Challenging a Core Ethical Norm of Genetic Testing.

Since the early 1970s, the ethical norm governing counselors involved in testing and screening for genetic conditions related to reproduction has been strict neutrality. Counseling about reproductive genetics was to be patient centered but nondirective. Many advocates for people with Down syndrome believe that high abortion rates following a diagnosis of this condition show an unfounded bias against those with Down syndrome. These advocates have succeeded in enacting federal and state legislation that requires women who receive a prenatal diagnosis of Down syndrome to receive positive information about the condition, thereby ending the nominal goal of value-neutral counseling and setting the stage for further normative shifts in clinical reproductive genetics as counseling expands because of cell-free testing.

Discernment Counseling for "Mixed-Agenda" Couples.

This article describes discernment counseling, an approach to working with couples where one partner is leaning toward divorce and the other wants to preserve the relationship and work on it in couples therapy. These "mixed-agenda" couples are common in clinical practice but have been neglected in the literature. The goal of discernment counseling is clarity and confidence regarding the next steps for the relationship, based on a deeper understanding of each partner's contributions. Sessions emphasize individual conversations with each partner. An analysis of 100 consecutive cases found that about half of the couples chose to start couples therapy in order to reconcile, with most of the rest choosing the divorce path. Longer term follow-up information is also presented.

25 years of tinnitus retraining therapy.

This year marks 25 years of tinnitus retraining therapy (TRT), the approach that aims to eliminate tinnitus as a problem by extinguishing functional connections between the auditory and the limbic and autonomic nervous systems to achieve habituation of tinnitus-evoked reactions and subsequently habituation of perception. TRT addresses directly decreased sound tolerance (DST) as well as tinnitus. TRT consists of counseling and sound therapy, both based on the neurophysiological model of tinnitus. The main goal of retraining counseling is to reclassify tinnitus into the category of a neutral stimulus, while the main goal of sound therapy is to decrease the strength of tinnitus-related neuronal activity. A unique aspect of TRT is that because treatment is aimed to work above the tinnitus source, and at connections linking the auditory and other systems in the brain, the etiology of tinnitus is irrelevant. Any type of tinnitus, as well as somatosounds, can be successfully treated by TRT. Over 100 publications can be found on Medline when using "tinnitus retraining therapy" as a search term. The majority of these publications indicate TRT offers significant help for about 80 % of patients. A randomized clinical trial showing the effectiveness of TRT has been published and another large study is in progress. The principles of the neurophysiological model of tinnitus, and consequently TRT, have not changed in over 25 years of use, but a number of changes have been introduced in TRT implementation. These changes include the recognition of the importance of conditioned reflexes and the dominant role of the subconscious pathways; the introduction of the concept of misophonia (i.e., negative reactions to specific patterns of sound) and the implementation of specific protocols for its treatment; greater emphasis on the concurrent treatment of tinnitus, hyperacusis, misophonia, and hearing loss; extensive modification of counseling; and refinements in sound therapy. The effectiveness of TRT has increased significantly during the past 25 years, presumably due to changes incorporated in its implementation. The main improvement has been to shorten the average time until seeing clear improvement from 1 year to 1 month, with a statistically significant improvement seen at, and after, 3 months. Furthermore, there is a higher effectiveness and a shorter treatment time for DST and an increased extent of help for hearing loss.

A Mobile-Assisted Working Model for Supporting Daily Family Life

Despite rapid technological development, very few new technology-assisted tools have been developed specifically for use in family services. This article describes a new, mobile-assisted working model designed to enhance the quality of daily family life. The model has its origins in the existing research on daily family life and on the diary method, which has been widely used in data collection in family research. The model provides support for the daily life of client families in the intervals between meetings with family counselors via the use of text messages. The pilot study explored family members’ and family counselors’ experiences of using the model. Data on 26 parents and four children participating in the new mobile-based service were collected via feedback text messages and web questionnaires. The research findings are also based on interviews with family counselors ( n = 6). Although clients’ experiences of the model varied widely, the results show that, in general, it was regarded as effective in invoking reflection, keeping the goals of family counseling in mind and implementing family practices at home. On the basis of the experiences of the family counselors, the mobile-based working model offers a new, systematic, and structured tool for use in working with families and monitoring processes in families.

Clearing the Air: A Qualitative Investigation of Genetic Counselors' Experiences of Counselor-Focused Patient Anger.

Patient anger is challenging for healthcare professionals to manage, particularly when it is directed at them. This study comprises the first in-depth investigation of genetic counselors' experiences with patient anger. Using a brief survey and interview methods, this study explored prevalence and context of patient anger directed at the genetic counselor, how genetic counselors manage patient anger directed at them, and possible thematic differences due to genetic counseling experience. Individuals enrolled in the National Society of Genetic Counselors (NSGC) listserv were invited to participate in a study of their experiences with patient anger directed at them. A majority of survey respondents (95.7%, 243/254) reported experiencing patient anger directed at them, and 19.4% reported having feared for their safety because of patient anger. Twenty-two survey respondents were purposively selected to participate in individual interviews. Inductive and cross case analysis yielded prevalent themes concerning patient triggers for anger, including bad news, logistical mishaps, and perceived counselor characteristics. Interview results further suggest unaddressed patient anger negatively affected patient and counselor emotional well-being and hindered genetic counseling goals. Prevalent challenges included genetic counselor attempts to accurately recognize, understand, and effectively manage patient anger without taking it personally. Commonly recommended strategies for addressing anger were empathy (i.e., understanding origins of patient anger), anticipating and acknowledging anger, maintaining personal, professional and legal protection, and debriefing with colleagues. Themes were quite similar across counselor experience levels. The findings underscore the importance of training and continuing education regarding patient anger. Additional findings, practice implications, and research recommendations are presented.

Beliefs of Counselor Trainees about Forgiveness

AbstractCounselors might be able to help clients to forgive after interpersonal hurts and one of the first tasks of working toward forgiveness with clients is helping them understand exactly what forgiveness means. However, a who wants to use forgiveness in his/her work must first know what forgiveness is, what forgiveness is not, and which factors affect the forgiveness process. The purpose of the present study is to determine the beliefs of trainees about forgiveness. The scope of this study includes how trainees define forgiveness, as well as their beliefs about their own forgivingness, the factors affecting forgiveness, and the importance of forgiveness in counseling. A qualitative study was conducted with 59 undergraduate students attending the Division of Psychological Counseling and Guidance in Dokuz Eylul University, Turkey, during the 2012-2013 academic year. The data from individual interviews were analyzed using content analysis techniques. The results indicated that the trainees considered forgiveness to be a conditional process in an interpersonal context and attributed some conditions about the offender and the offense to their forgivingness. In particular, apology and awareness of the offender about his/her fault affected their decisions to forgive. In the counseling process, forgiveness was considered an important issue and mostly regarded as a characteristic.Keywords: Forgiveness * Counseling * Counselor trainees * Counselor development * Therapeutic toolsForgiveness is a concept that has been studied in different cultures and religions for thousands of years (Denton & Martin, 1998) through religious and philosophical studies. Until the 1980's the concept was ignored in psychological studies, but it is currently seen as an important issue for psychological research (Bugay & Demir, 2011, 2012; Erguner-Tekinalp & Terzi, 2012; Legaree, Turneri, & Lollis, 2007; McCullough, Bellah, Kilpatrick, & Johnson, 2001; McCullough, Pargament, & Thoresen, 2000). Forgiveness is an important element for both spiritual development and psychological healing (Gartner, 1988). Forgiveness is considered as a tool to reach the therapeutic goals of counseling (Berecz, 2001; Hope, 1987; Murray, 2002; Wade, Bailey, & Shaffer, 2005) as well as a counseling technique (Fitzgibbons, 1986).Actually, being an effective warrants an integration of field knowledge with techniques and skills within the personality characteristics and self-awareness of counselors (Ikiz & Karaca, 2011; Johns, 1996). In order to reach the intended outcomes involving client growth, the therapeutic relationship itself is the main determinant of the counseling process. The relationship is one of the most important factors in outcome variance (Tursi & Cochran, 2006). The construction of a therapeutic relationship impacts a counselor's growth to establish a meaning for life, to cope with his/her own stress and traumatic life events, and to develop his/her own spirituality and mental health (Jodry, 2003). Effects of forgiveness on counseling students' overall wellness were investigated, and forgiveness was found to contribute a significant proportion of variance in wellness for trainees (Moorhead, Gill, Minton, & Myers, 2012). They emphasized that counselor trainees who were more inclined toward forgiveness also reported meaning-making processes toward self and others (Moorhead et al., 2012, p. 90). In the present study, we examine trainees' thoughts and experiences about forgiveness, and the place of forgiveness in counseling applications according to their views, to draw attention to their personality development by considering interpersonal and intrapersonal processes. Moreover, a review of the concept of forgiveness and its treatment in counseling provided in the paper will help readers to establish a concrete perspective for the importance of forgiveness, both in education and applications. …

Bullying Prevention in Middle Schools: A Collaborative Approach

Collaborative, proactive anti-bullying interventions and policies that strive to create and sustain a safe environment for all adolescents.IntroductionSchool bullying reaches across all ages and grades, and is associated with serious mental health issues such as suicide, homicide, and other acts of violence. According to the U.S. Department of Education and Justice (2011), 37% of middle school students reported being victims of bullying. Bullying is a subtype of aggression, but is different from other types of altercations in that it is characterized as an unequal relationship between the bully and the victim (Olweus, 1993); consists of a series of repetitive behaviors as opposed to a specific, isolated incident (MacNeil 8c Newel, 2004); and is intentional. For instance, the bully's intention is to hurt another by repetitively engaging in harmful behaviors based on a perceived imbalance of power (Kowalski, Limber, & Agatston, 2008).There are several different types of bullying that are classified as physical, verbal, relational, and cyber bullying. Physical bullying may involve hitting, punching, threatening acts, and kicking. Verbal bullying includes such actions as name-calling or teasing. Relational bullying (also known as social aggression) involves spreading rumors or excluding someone from others or events (Espelage 8c Swearer, 2003), ignoring others, spreading nasty rumors, leaving hurtful messages on desks, making prank phone calls, and/or giving death stares. Finally, cyber bullying is using technology to harass, exclude, or degrade another through such means as instant messaging, e-mail, chat rooms, and videos using cell phones, social networking sites, etc. (Espelage, 2004).Although similarities exist between each of these types of bullying, there are subtle distinctions, such as gender differences. Males tend to engage in more physical types of aggression, whereas females use more relational types of aggression (Carbone-Lopez, Esbensen, 8c Brick, 2010). Males who bully are often taller and/or stronger than their victims (McMaster, Connolly, Pepler, 8c Craig, 2002), and tend to choose victims that are physically weaker and shorter or based on friend choice or another's clothing. Females tend to choose victims based on looks, affect, weight, or good grades (Harris, 2004). Furthermore, females are more likely than males to be victims of sexual bullying such as sexual innuendos and unwanted sexual attention. This type of aggression usually begins during the middle-school years, and bridges the gap between bullying and dating violence with the potential to worsen into other forms of abuse (Fredland, 2008) throughout adulthood.Bullying behaviors are most often experienced between sixth and eighth grades, with a decline in upper grade levels (U.S. Department of Education and Justice, 2011). Yet, it is speculated that this decline is not necessarily due to a decrease in bullying, but rather due to a reduction in reporting of incidents, and/or a transformation into more adult forms of aggression such as sexual harassment (Fredland, 2008). Peers usually view these more adult forms of bullying as more socially acceptable.Aggressive behaviors can be seen along a continuum with the bully at one end of the scale, the victim at the other end, with bully-victims and spectators somewhere in between (Espelage, 2004). Despite the role one plays in a bullying incident-whether it is the victim, bully, bullyvictim, or bystander-all are impacted by this aggressive act.Both school counselors and teachers share the goal of nurturing student development, yet each professional strives to reach this goal through different paradigms. Studies reveal a positive association amongst classroom guidance, academic achievement, and personal/social growth, yet collaboration is rare (Stringer, Reynolds, 8c Simpson, 2003) despite school counselors' unique education to integrate school counseling goals with those of the school curriculum. …

Group Counseling with South Asian Immigrant High School Girls: Reflections and Commentary of a Group Facilitator

The diversity of the U.S. school population speaks to a need to provide support for youth from various backgrounds. As a school-based mental health counselor, the first author observed that the South Asian immigrant students at her school did not utilize any of the counseling services provided. Because South Asians are typically collectivistic, the counselor chose group counseling as a potential intervention and hoped to provide a place for the students to address issues related to orienting to a new school in a new country. In this article, the authors weave information about the South Asian population into the first author's reflections and commentary on initiating and conducting a group with South Asian high school girls. Recommendations for group counseling in schools with South Asian immigrants are provided.Keywords: South Asian, immigrant, youth, schools, group counselingThe United States has seen a marked increase in the number of children who have at least one parent bom outside the United States (Capps et al., 2005). Between 1995 and 2012, the population of first- and secondgeneration immigrant children in the United States increased by 66% (Child Trends Data Bank, 2013). This sharp rise is important for American cities because 95% of all children of immigrants attend urban schools (Fix & Capps, 2005). Furthermore, according to a recent update from the Asian American Federation and South Asian Americans Leading Together (2012), the South Asian American population was the fastest growing major ethnic group in the United States from 2000-2010. Relationship building is part of acclimatizing to a new country for immigrant youth, and it is in the schools that these youth build new friendships and create social networks (Suarez-Orozco, Suarez-Orozco, & Todorova, 2008). For South Asian youth in American schools, group counseling can provide a setting for students to connect to others who share similar stories and experiences. Groups can offer a safe place for them to discuss their cultural norms, exchange stories of challenges and hope, and enhance their social development in a new country as they form emerging adult identities.As a school-based mental health counselor in a public urban high school on the northern California coast, the first author's responsibility is to provide overall behavioral health support through assessments, counseling (short- and long-term, individual, group, crisis), staff and teacher consultations, and presentations on mental health issues to students, parents and teachers. When two South Asian students were referred for individual counseling, the first author wondered if other South Asian students might be experiencing challenges associated with adjusting to a new school in a new country. She also was personally aware of difficulties associated with identity development for adolescents negotiating different home and school cultures. She decided that counseling focused on prevention of problems related to acculturation and identity could be helpful to the South Asian students in her school. Because the South Asian collectivistic orientation is consistent with the goals of group counseling (Sharma, 2001), she chose this approach. As a South Asian herself, the first author believed that her understanding of South Asian culture could contribute to her effectiveness as facilitator of a group with this population. Thus, the first author developed a simple strategy for recruitment and set out to create a group for South Asian immigrant high school students.Although in many cases the first author's expectations about the group were met, she also confronted surprises and challenges. This article is the result of discussions with the second author in which the first author shared her reflections and commentary on the facilitation of students' exploration of issues in the group. The goal is to impart the first author's personal knowledge and perceptions, so that counselors working with South Asian youth may consider how her experience might inform their group work with this population. …

Identifying hereditary cancer: Genetic counseling and cancer risk assessment

The goal of cancer genetic counseling, risk assessment, and testing is to identify individuals and families at risk for hereditary cancer, such that targeted management strategies can be used to reduce associated morbidity and mortality. Involvement of a qualified cancer genetic service provider helps to ensure that at-risk individuals identified and offered appropriate education, risk assessment, genetic testing, and follow-up risk management strategies. There are multiple screening and hereditary risk models available to help the clinician identify who needs to be referred to cancer genetic counseling and to facilitate the cancer risk assessment process. Genetic testing should only be pursued with fully informed consent in the context of pretest counseling to ensure that the individual understands the benefits, risks, and limitations of genetic testing, possible results, and their implications. Incorporating psychosocial assessment throughout the counseling session may assist the individual in their understanding of genetic testing in the context of their support resources and coping mechanisms and may help with decision making. There is a growing public awareness of and interest in cancer genetic testing, as well as increasing complexity of available testing options and results. It is therefore essential that cancer genetic professionals, primary care providers, and oncology practitioners work together to ensure that genetic testing for hereditary cancer syndromes is used in the most appropriate and effective way.

Using formative research to develop a counselor training program for newborn screening in Ghana.

Sickle cell disease (SCD), sickle cell trait (SCT) and related conditions are highly prevalent in sub-Saharan Africa. Despite the public health implications, there is limited understanding of the unique needs regarding establishing and implementing extensive screening for newborns and appropriate family counseling. We sought to gain understanding of community attitudes and beliefs about SCD/SCT from counselors and potential counselors in Ghana; obtain their input about goals for counseling following newborn screening; and obtain guidance about developing effective counselor education. Five focus groups with 32 health care providers and health educators from 9 of 10 regions in Ghana were conducted by trained facilitators according to a structured protocol. Qualitative data were coded and categorized to reflect common themes. Saturation was achieved in themes related to genetics/inheritance; common complications of SCD; potential for stigmatization; marital strain; and emotional stress. Misconceptions about SCT as a form of SCD were prevalent as were cultural and spiritual beliefs about the causes of SCD/SCT. Potential positive aspects included affected children's academic achievement as compensation for physical limitations, and family cohesion. This data informed recommendations for content and structure of a counselor training program that was provided to the Ministry of Health in Ghana.

Automated conversation system before pediatric primary care visits: a randomized trial.

Interactive voice response systems integrated with electronic health records have the potential to improve primary care by engaging parents outside clinical settings via spoken language. The objective of this study was to determine whether use of an interactive voice response system, the Personal Health Partner (PHP), before routine health care maintenance visits could improve the quality of primary care visits and be well accepted by parents and clinicians. English-speaking parents of children aged 4 months to 11 years called PHP before routine visits and were randomly assigned to groups by the system at the time of the call. Parents' spoken responses were used to provide tailored counseling and support goal setting for the upcoming visit. Data were transferred to the electronic health records for review during visits. The study occurred in an urban hospital-based pediatric primary care center. Participants were called after the visit to assess (1) comprehensiveness of screening and counseling, (2) assessment of medications and their management, and (3) parent and clinician satisfaction. PHP was able to identify and counsel in multiple areas. A total of 9.7% of parents responded to the mailed invitation. Intervention parents were more likely to report discussing important issues such as depression (42.6% vs 25.4%; P < .01) and prescription medication use (85.7% vs 72.6%; P = .04) and to report being better prepared for visits. One hundred percent of clinicians reported that PHP improved the quality of their care. Systems like PHP have the potential to improve clinical screening, counseling, and medication management.

Primary care-based, targeted screening programme to promote sustained weight management

Objective. To identify overweight and obese subjects at increased cardiovascular risk in the community, and provide them with lifestyle counselling that is possible to implement in real life. Design. Longitudinal cohort study. Setting. The communities of Harjavalta and Kokemäki in south-western Finland. Subjects. A tape for measurement of waist and a risk factor questionnaire was mailed to home-dwelling inhabitants aged 45–70 years (n = 6013). Of the 4421 respondents, 2752 with at least one cardiovascular risk factor were examined by a public health nurse. For the subjects with high cardiovascular risk (n = 1950), an appointment with a physician was scheduled. The main goal of lifestyle counselling for the 1608 high-risk subjects with BMI ≥ 25 kg/m2 was weight reduction of at least 5%. Among these, 906 had completed self-administrated questionnaires at baseline and form the present study population. Main outcome measure. Success in weight management. Results. At the three-year follow-up visit, 18% of subjects had lost ≥ 5% of their initial weight and 70% had stabilized their weight, while 12% had gained weight ≥ 5%. Newly diagnosed glucose disorder (OR 1.37 [95% CI 1.02–1.84]) predicted success in weight management, whereas depressive symptoms (OR 0.61 [95% CI 0.42–0.90]), excess alcohol use (OR 0.63 [95% CI 0.44–0.90]), and number of drugs used (OR 0.91 [95% CI 0.83–0.99]) at baseline predicted poor outcome. Conclusions. A primary care screening programme to identify overweight or obese individuals can promote sustained weight management. Psychological factors, especially depressive symptoms, are a critical component to consider before attempts to change the lifestyle of an individual.

Treatment Fit: A Description and Demonstration via Video of a Brief and Functional Treatment Fit Model

Treatment fit is the degree to which the counselor and the client agree upon the presenting issues, counseling goals and the initial treatment plan. Research indicates that treatment At is one of the strongest predictors of client outcome. As such, a brief functional treatment At model (TFM) is presented to assist counselors in conducting multidimensional needs assessments and developing co-created treatment plans. Application of this model is demonstrated with a case study. In addition, a Ank to a video demonstration of this model is included, along with a discussion as to the need for including links to videos in counseling journals.Keywords: treatment fit, multidimensional needs assessment, treatment plan, counseling goals, video demonstrationThis is an exciting time in the mental health profession as health care specialists and policy makers are recognizing the value of counseling in increasing the quality of patient care while decreasing overall health care costs (Burtnett, 2012; Curtis & Christian, 2012; Lee et al., 2012; Wos, 2013). As such, counselors are increasingly being recognized not just as mental health providers, but as viable health care professionals who may well be the crucial link in improving a flawed and exorbitantly expensive health care system (American Psychological Association [APA], 2012; Brill, 2013; Paquette et al., 2003). With this positive momentum, however, it becomes even more imperative for counselors to consistently utilize evidence-based practices (i.e., empirically supported counseling strategies), which include practice-based evidence (i.e., continuous feedback between counselor and client) to ensure optimal treatment. Unfortunately, the utilization rates of evidence-based practices by counselors are minimal and inconsistent (Beutler, 2009; Olmstead, Abraham, Martino, & Roman, 2012), which may in part be the reason why the general public, when surveyed, have indicated that the primary reason for not seeking counseling was their lack of confidence in positive outcomes (Harris Interactive, 2004). One could argue that while it is critically important for counselors to continue conducting innovative treatment research, it is equally imperative that counselors increase efforts in implementing well-established evidencebased counseling strategies (Olmstead et al., 2012).One of the best predictors of client outcome is treatment fit (APA, 2012; Budd & Hughes, 2009; Kim, Ng, & Ahn, 2009), the process by which the client and counselor collaboratively assess mental health issues, set goals, and create an initial treatment plan. At the heart of treatment fit is the collaboration between client and counselor including continuous feedback about issues, goals and treatment to ensure the optimal provision of care. A parallel to treatment fit in the medical community is the increasing use of checklists to ensure that evidencebased procedures are being properly implemented. In surgical safety research, for instance, Haynes et al. (2009) found in a large multi-site international study that when medical professionals followed a brief surgical checklist (e.g., the patient has verified his or her identity, the surgical site, and procedure and consent), patient deaths decreased from 1.5% to 0.8% and inpatient complications following surgery decreased from 11.0% to 7.0% (Haynes et al., 2009). As demonstrated in this surgical safety study, the consistent application of evidencebased procedures had a significant impact on patients' lives. Similarly, the purpose of this article is to show how evidence-based counseling strategies that comprise treatment fit can help counselors more consistently and frequently implement treatments that work in order to increase the likelihood of positive client outcomes.This article is comprised of two primary objectives. The first objective is to describe a brief, functional, firstsession counseling protocol for ensuring treatment fit with clients. …

Genetic Counselor Perceptions of Genetic Counseling Session Goals: A Validation Study of the Reciprocal‐Engagement Model

Although some researchers have attempted to define genetic counseling practice goals, no study has obtained consensus about the goals from a large sample of genetic counselors. The Reciprocal-Engagement Model (REM; McCarthy Veach, Bartels & LeRoy, 2007) articulates 17 goals of genetic counseling practice. The present study investigated whether these goals could be generalized as a model of practice, as determined by a larger group of clinical genetic counselors. Accordingly, 194 genetic counselors were surveyed regarding their opinions about the importance of each goal and their perceptions of how frequently they achieve each goal. Mean importance ratings suggest they viewed every goal as important. Factor analysis of the 17 goals yielded four factors: Understanding and Appreciation, Support and Guidance, Facilitative Decision-Making, and Patient-Centered Education. Patient-Centered Education and Facilitative Decision-Making goals received the highest mean importance ratings. Mean frequency ratings were consistently lower than importance ratings, suggesting genetic counseling goals may be difficult to achieve and/or not applicable in all situations. A number of respondents provided comments about the REM goals that offer insight into factors related to implementing the goals in clinical practice. This study presents preliminary evidence concerning the validity of the goals component of the REM.

Pengembangan Internal Locus of Control dalam Pelayanan Konseling dan Implikasinya terhadap Perbedaan Budaya Klien

The goal of counseling, among other thing,  is to develop an internal locus of control of a clients. Research, especially in western cultures, has shown that those with an internal locus of control were correlated to their characters, they are: hard work, problem solving skilss, optimistic, engaging in social activities and high in achievement motivation. However, for clients who are not from western cultures a tendency to foster an internal locus of control in the counseling process should be considered properly. This paper describes how to enhance client’s internal locus of control for those who do not embrace western cultures Â

Effects of a Genetic Counseling Model on Mothers of Children with Down Syndrome: A Brazilian Pilot Study

Down syndrome occurs in approximately 1:600 live births. Genetic counseling is indicated for these families and may be beneficial for adaptation to the challenges that accompany by this diagnosis. Although the basic counseling goals are similar, there are many models of genetic counseling practiced around the world. The aim of this article is to report the results of a pilot study that evaluated the level of satisfaction with a model of service delivery of genetic counseling practiced in Brazil, the knowledge assimilated about Down syndrome and whether this process resulted in a feeling of well-being and psychological support. Thirty mothers of under 6-month-old children with Down syndrome were interviewed after having two sessions of genetic counseling in a public healthcare service within a period of 30days. A semi-structured questionnaire was developed by the researchers to collect identification, socioeconomic and demographic data and to assess the client's satisfaction with the model of genetic counseling. Data were collected using both open and closed questions. The reported level of satisfaction was high. The knowledge assimilated about Down syndrome after only two sessions was considered technically vague by raters in 44% of cases. Most mothers (96.7%) reported that genetic counseling was beneficial and provided psychological support. The model was considered satisfactory, but further research is needed to identify ways to improve knowledge retention by this population. These results highlight the utility of referring families for genetic counseling when there is a suspicion of a diagnosis of Down syndrome.

The emergence and evolution of HIV counselling in Zambia: a 25-year history

HIV-related counselling practices have evolved since emerging in Zambia in 1987. Whereas, initially, the goal of HIV counselling was to provide psychological support to the dying and their families, as knowledge about HIV grew, counselling objectives expanded to include behavioural change, encouraging safer sexual practices, encouraging disclosure, convincing people to test, treatment adherence and shaping HIV-positive people's sexual and reproductive choices. This paper highlights a number of key shifts in counselling practices in Zambia over the last 25 years, demonstrating the relationship between those shifts, changes in medical technology, (inter)national political will and the epidemiological maturity of the disease.