Counseling Outcomes Research Articles

Development and Validation of the Career Counseling Outcome Questionnaire in Two Clinical Settings

This study reports the development and initial validation of the Career Counseling Outcome Questionnaire (CCOQ) in two individual career counseling settings using a college sample ( n = 1,140) and a community sample ( n = 161). Exploratory and confirmatory factor analyses revealed five correlated factors in both samples: (a) knowledge of the career decision-making process (4 items), (b) knowledge of the self (3 items), (c) knowledge of career information (3 items), (d) anxiety towards career decision-making (3 items), and (e) career undecidedness (2 items). The CCOQ scale scores changed in the expected theoretical direction during the career counseling interventions and did not change when clients were not receiving counseling. Except for anxiety, all CCOQ subscales predicted satisfaction with the career decision twelve months after counseling. The CCOQ total score predicted satisfaction with the decision twelve months after counseling, over and beyond a widely used instrument assessing sources of career decision difficulties (i.e. the Career Decision Difficulties Questionnaire; CDDQ). Career counselors could use the CCOQ to monitor the effectiveness of their interventions in complement to diagnostic measures such as the CDDQ.

성인 상담라포와 상담회기평가 간 관계에서 작업동맹의 매개효과

Objectives The purpose of this study was to examine the mediation effect of the working alliance on the relationship between counseling rapport and counseling session evaluation among clients. Through this, the aim is to provide data that can be utilized in counseling and education by highlighting both the positive and negative aspects of counseling rapport and the working alliance experienced by clients. Methods To this end, a study was conducted on 220 adult clients nationwide who were currently receiving counseling from counselors who had national qualifications and counseling-related academic qualifications. The Counseling Rapport Scale, Counseling Session Evaluation Scale, and Working Alliance Scale were used, and the collected data were analyzed using SPSS 26.0 and SPSS Process Macro v4.1. Results The research results are as follows: First, the structural model depicting the relationships among counseling rapport, working alliance, and session evaluation was confirmed to be suitable for the data. Second, counseling rapport was found to have a positive impact on the working alliance. Third, counseling rapport was analyzed to influence session evaluation through the mediation of the working alliance. Consequently, it was established that counseling rapport affects session evaluation not only directly but also indirectly through the working alliance Conclusions The results of this study indicate that as counseling rapport positively forms, it leads to a stronger working alliance with the counselor, which in turn positively influences session evaluations. The ability of counselors to establish counseling rapport and a working alliance in initial sessions is shown to be a crucial factor in positively affecting counseling outcomes. This underscores the importance of counselor education and training programs.

Efficacy of Cognitive-Behavioral Therapy in Optimizing Counseling Outcomes for Fast Remission of Social Anxiety with Panic Attacks

Aims: The case study evaluates the efficacy of Cognitive Behavioral Therapy in optimizing counseling outcomes for social anxiety and panic attacks within an academic setting. Counseling sessions were conducted with a 23-year-old female client over a four-month period at T.S Government College.<br /> Method: The study utilized a single case study design A-B-A. The client presented with symptoms of social anxiety and panic attacks, impacting various aspects of her life including academic performance, interpersonal relationships, social interactions and family dynamics.<br /> Results: Cognitive Behavioral Therapy techniques including Cognitive Restructuring, Social Skills Training, Role Play and Role Reversal, and Systematic Desensitization through Gradual Exposure, were implemented over 8 sessions. Assessment tools including pre-post ratings, behavioral observations and therapy blueprints were utilized to assess the severity of social anxiety.<br /> Conclusion: A significant decrease in the severity of social anxiety and panic attacks based on both subjective self-reporting and objective observations suggesting Cognitive Behavioral Therapy as an approach of counseling for individuals with social anxiety with panic attacks in educational setting.<br /> <i>Keywords: </i>Cognitive Behavioral Therapy, case study, case report, social anxiety, panic attacks, cognitive restructuring, systematic desensitization, role play, role reversal, social skills training

Evaluation of a Counselling Service for the Elderly

An evaluation of WellElder, a counselling service for the elderly, was conducted using four years of accumulated client information and counselling outcome data. This information was collated, analysed, and compared with the New Zealand literature and with information from other countries on counselling the elderly. Findings showed that there was considerable similarity between clients using the WellElder service and clients of all ages at other community-based services in New Zealand and abroad. In addition, outcome data demonstrated that the large majority of clients were receiving brief counselling, fewer than six sessions, and that the counselling being offered to clients was effective in meeting their needs. The implications of these findings are discussed in relation to agency policy and development.

Unlocking Success in Counseling: How Personality Traits Moderates Its Effectiveness.

Psychological distress is widespread among university students, with depression being notably more prevalent compared to the general population. University counseling services are crucial for addressing these mental health challenges, and numerous studies have demonstrated their effectiveness in reducing psychological distress and improving overall well-being. However, there is limited research on what factors predict the success of university counseling. This study aims to evaluate whether counseling improves well-being, specifically by reducing depressive symptoms, and to explore whether personality traits influence counseling outcomes. Participants included 125 Italian university students (64.8% female, mean age = 22.69; SD = 3.04) who utilized counseling services. They completed a socio-demographic questionnaire, the Beck Depression Inventory-II (BDI-II), and the Personality Inventory for DSM-5-TR (PID-5-TR) at three points: immediately after the intake interview (T0), just before the intervention (T1), and after the fourth session (T2). Linear mixed models were used to analyze changes in depression levels, revealing a significant reduction in depressive symptoms from pre- to post-intervention. Among personality traits, only antagonism showed a significant interaction with time. Additionally, higher detachment scores were associated with higher depression levels. These findings emphasize the need for focused attention on students' emotional issues and suggest that personality traits may influence the effectiveness of counseling.

Analysis of the Counseling Competency Scale-Revised Using Trainees’ Self-Assessment Data

Objective The Counseling Competencies Scale – Revised (CCS-R) measures counselor trainees’ therapeutic skills and dispositions and is a tool for counseling outcome research and evaluation. Prior research on the CCS-R has focused on supervisors’ ratings of counselors’ competencies. Our study evaluated the factor structure of CCS-R scores based on the counselors’ self-reports. Method The present study utilized confirmatory factor analysis to test if the factor structure of the CCS-R fits using self-reported scores on the measure. Results The data (N = 998) produced a good fit with the factor structure of the CCS-R. Conclusions The results demonstrated that the CCS-R model from prior research is consistent when the scale is used as a self-report measure. The results demonstrated evidence of construct validity when applying CCS-R as a supervisee self-report tool. Future research can look for additional ways to demonstrate the construct validity of the CCS-R across different supervisee groups.

Parental magnetic resonance imaging for the evaluation of fetuses with brain anomalies.

To evaluate the role of parental magnetic resonance imaging (MRI) in assessing fetuses with suspected brain anomalies and its use in prenatal counselling. A retrospective, multicentre chart review was conducted on fetuses who underwent brain MRI because of suspected brain abnormalities between January 2008 and December 2022, with one or both parents who underwent brain MRI (MRI-Trio) as part of prenatal counselling. Clinical and demographic data were collected, including fetal and parental MRI findings, prenatal counselling outcomes, genetic testing results, family and previous pregnancy history, neurological examinations of the born children up to 24 months of age, and autopsy reports of fetuses from terminated pregnancies. MRI-Trio concordance was defined as at least one abnormal brain feature identified with similarity in the fetus and the parents. The live-born children were assessed postnatally through either neurodevelopmental evaluations or telephone interviews. Sixty pregnancies were included (41.7% with concordant and 58.3% with discordant MRI-Trio). Forty-two children were born (70%) and 17 pregnancies were terminated (28.3%). One case of in utero fetal death (1.7%) was reported. The most common brain findings were multiple anomalies (n = 26, 43.3%), isolated disorders of the corpus callosum (n = 17, 28.3%), atypical periventricular pseudocysts (n = 6, 10%), and anomalies of the anterior complex (n = 4, 6.7%). MRI-Trio enabled better prognostication. When MRI-Trio was concordant, counselling was more favourable (n = 22, 36.6%) and the majority of live-born children exhibited typical development (p < 0.001). MRI-Trio is a valuable tool for identifying dominantly inherited brain anomalies that may not hold developmental significance or are associated with favourable outcomes, acknowledging the potential for variable penetrance, which may result in more severe presentations. Concordant MRI-Trio findings can enhance the accuracy of prenatal counselling, potentially reducing the incidence of termination of pregnancy.

Dietary Counseling Outcomes in Patients with Lung Cancer in an Upper-Middle-Income Country: An Open-Label Randomized Controlled Trial.

Background: Malnutrition harms treatment outcomes, QoL, and survival in lung cancer patients. Effective dietary counseling can improve nutrition, but few randomized controlled trials have focused on lung cancer patients. The objective of this study was to determine if dietary counseling improves nutritional and treatment outcomes when compared to routine care. Methods: This open-label parallel RCT was conducted at Maharaj Nakorn Chiang Mai Hospital in Thailand. The investigators used computer-generated blocked randomization to assign patients to dietary counseling by a nutritionist or routine care. The nutritionist sessions occurred before treatment, with follow-ups at 3-4 weeks and 12 weeks. The primary outcome was the mean percentage change in the body weight of patients at 12 weeks. Secondary outcomes included changes in the BMI, nutrition score, QoL, serum albumin level, lymphocyte count, energy and protein intake, treatment response, PFS, and OS. Results: Between April 2020 and May 2022, after completing recruitment, 80 lung cancer patients were randomized: 43 to dietary counseling and 37 to routine care. The dietary counseling group showed significant benefits, with smaller decreases in body weight at 3-4 weeks (-0.8% vs. -2.6%, p = 0.05) and 12 weeks (-1.1% vs. -4.3%, p = 0.05). They also had higher energy and protein intake levels and better treatment response rates. The secondary outcomes and significant adverse events did not differ significantly between the groups. Conclusions: Dietary counseling helps to maintain body weight, maintain dietary intake, and enhance treatment responses in lung cancer patients. Although not all nutritional markers or survival outcomes were affected, these findings highlight the importance of early nutritional interventions.

Cross-cultural validation of the genetic counseling outcome scale in Korea.

The Genetic Counseling Outcome Scale (GCOS-24) was developed to measure patient-reported outcomes to evaluate the effectiveness of genetic counseling and testing services. In the current study, the Korean version of GCOS (K-GCOS) was developed to reflect the sociocultural characteristics of Korea, and its clinical applicability was assessed. Overall, 231 Koreans, including patients with genetic diseases and their family members, participated and completed the K-GCOS, Hospital Anxiety and Depression Scale (HADS), Multidimensional Health Locus of Control (MHLC) scale, and Satisfaction with Life Scale (SWLS). Validity was examined by assessing the correlations between K-GCOS scores and other relevant scale scores. Reliability was confirmed using Cronbach's alpha and test-retest scores, measured over 2 weeks. We performed exploratory factor analysis of the five structures of GCOS-24. For K-GCOS, four-factor structures were identified: "cognitive-behavioral control," "uncertainty about control," "hope," and "emotional regulation." Four original GCOS-24 items were removed because of low factor loadings and small inter-item correlations. K-GCOS-20 scores were positively correlated with SWLS (r = 0.456) and MHLC-internal (r = 0.213) scores but negatively correlated with HADS (anxiety r = -0.428, depression r = -0.469) and MHLC-internal (r = -0.278) scores. These findings demonstrate that K-GCOS-20 is a reliable and valid tool for evaluating genetic counseling services in Korea.

Parent-reported genetic counselor adherence to the NSGC practice resource for communicating a potential prenatal diagnosis: Impact on the Down syndrome diagnosis experience.

In 2011, the National Society of Genetic Counselors (NSGC) published practice resources about communicating a prenatal or postnatal diagnosis of Down syndrome (DS). However, the impact of GC adherence to those recommendations on patient experiences has been unknown. The objective of this analysis was to investigate perceived GC adherence to professional recommendations for delivering a DS diagnosis and the impact on parental diagnosis experiences and the information and support offered. Parents of children with DS born between 2016 and 2021 completed a survey distributed by 12 local DS organizations and the national DS Diagnosis Network to assess prenatal diagnosis experiences and the provision of support and information by health professionals. Participants were queried about whether their GC followed specific recommendations from the NSGC practice resource. Respondents were also invited to describe their diagnosis experience. An overall perceived adherence score was calculated (percentage of elements GC demonstrated/total number of elements). Open-ended responses were inductively coded by a GC and GC student to identify categories and to perform a sentiment analysis where 1 was completely negative, 2 was mixed/more negative, 3 was neutral, 4 was mixed/more positive, and 5 was completely positive. The GCs were blinded to participants' perceived adherence scores while performing the sentiment analysis. Of the 242 parents who completed the survey, 161 respondents answered questions about GC's perceived practice resource adherence. The median perceived adherence score was 42.9% (IQR 21.4-71.4)%. A total of 61 people provided an open-ended response about their prenatal diagnosis experience with a GC and were assigned a sentiment score. The median sentiment score was 3 (IQR 1-5). Kendall's Tau analysis showed that higher perceived practice resource adherence was associated with more positive sentiment scores. These results suggest that NSGC practice resource adherence may improve the prenatal diagnosis experiences of parents of children with DS and have the potential to improve counseling outcomes.

Feasibility assessment of using ChatGPT for training case conceptualization skills in psychological counseling

This study investigates the feasibility and effectiveness of using ChatGPT for training case conceptualization skills in psychological counseling. The novelty of this research lies in the application of an AI-based model, ChatGPT, to enhance the professional development of prospective counselors, particularly in the realm of case conceptualization—a core competence in psychotherapy. Traditional training methods are often limited by time and resources, while ChatGPT offers a scalable and interactive alternative. Through a single-blind assessment, this study explores the accuracy, completeness, feasibility, and consistency of OpenAI's ChatGPT for case conceptualization in psychological counseling. Results show that using ChatGPT for generating case conceptualization is acceptable in terms of accuracy, completeness, feasibility, and consistency, as evaluated by experts. Therefore, counseling educators can encourage trainees to use ChatGPT as auxiliary methods for developing case conceptualization skills during supervision processes. The social implications of this research are significant, as the integration of AI in psychological counseling could address the growing need for mental health services and support. By improving the accuracy and efficiency of case conceptualization, ChatGPT can contribute to better counseling outcomes, potentially reducing the societal burden of mental health issues. Moreover, the use of AI in this context prompts important discussions on ethical considerations and the evolving role of technology in human services. Overall, this study highlights the potential of ChatGPT to serve as a valuable tool in counselor training, ultimately aiming to enhance the quality and accessibility of psychological support services.

Transferability of Effective Consultation Skills for Decision-Making Support in the Voluntary Surrender of Older Adult Drivers' Licences in Super-Aged Japan.

Previously, we identified eight effective consultation skills to support decision-making in the voluntary surrender of older adult drivers' licences in super-aged Japan. This study aimed to clarify the transferability of these skills. We collected text data by interviewing 11 safe-driving counsellors (four police officers, four clerical staff and three nurses) in the License Division of the National Police Agency from February to March 2022. Interviews were semi-structured and conducted by telephone or email. During the interview, participants were asked to recall their experiences as counsellors providing decision-making support to older drivers and to compare their experiences with the eight consultation skills. We analysed the content of the responses by quantitative text analysis with KH Coder 3 software. As a characteristic of the words and phrases used by counsellors in their narratives about consultation skills, the most frequently extracted words from among 3147 words were think, parties and family, and promote had the highest mediation centrality. The eight subgraphs were 'Respecting the will of relevant parties from their standpoint is natural', 'Listening attentively and empathetically to relevant parties is effective', 'Presenting objective data to guide decisions is successful', 'Showing cognitive functioning test results is often effective', 'Counselors with medical expertise can elicit positive counseling outcomes', 'Intervention by medical or police counselors facilitates the decision to surrender voluntarily', 'Counseling skills need to be improved' and 'A diagram of the 8 skills is helpful for inexperienced counselors'. The results suggest that the eight consultation skills have similarities and are transferable. This transferability might contribute to practical application or cohort follow-up study research. These skills can be incorporated into counsellor training, and counsellors can be expected to use these skills in the future. Regardless of the safe-driving counsellor's years of experience, the skills can help them provide uniform and accurate support in decision-making regarding the voluntary surrender of older adult drivers' licences. These skills are a promising approach to help older adults lead safe and secure lives as they age.

Impact of Personalized Behavioural Nutritional Interventions on Nutrition Counselling Outcomes

Impact of Personalized Behavioural Nutritional Interventions on Nutrition Counselling Outcomes

Developing a minimum data standard for student mental health services in the UK: A qualitative study with staff from university support services

AbstractObjectiveThis study is part of the Student Counselling Outcomes Research and Evaluation (SCORE) initiative that is pooling university counselling service data to improve datasets and evidence for counselling in this sector. This study aimed to explore university counselling staff views about which data should be included in a national minimum data standard (MDS) to provide evidence for counselling in the sector.MethodSemi‐structured focus groups were conducted with university counselling staff including counsellors, service leaders and mental health advisors. They explored data to include in an MDS, current data collection practices, service and sector level data collection barriers. Two researchers performed content analysis involving identifying fields for inclusion. Thematic analysis was used to identify contextual issues surrounding data collection. Ten focus groups were conducted with 41 participants across 26 university counselling services.ResultsContent analysis identified fields of information for the MDS within the categories of student characteristics, demographics, clinical assessment and service evaluation. Thematic analysis explored context and culture surrounding data collection, barriers and facilitators, institutional influence and ideal data collection practices. This highlights the need for service support and training around data collection, clear processes, and adequate IT infrastructure and staff resources.DiscussionThese findings will inform the development of an MDS as part of the SCORE study. The next stage will involve further development of the MDS and piloting in services. The longer term aim is to implement an MDS across university counselling services, enabling the growth of evidence for the sector which may allow increased funding and service provision.

Pentingnya Membangun Hubungan Antar Kualitas Pribadi Konselor Dan Kualitas Pribadi Konseling

This research aims to explore the importance of building a relationship between the personal qualities of a counselor and the personal qualities of counseling in the context of counseling services. Through a qualitative approach, data was collected through in-depth interviews with counselors who have experience in the field of counseling. Data analysis was conducted using content analysis method. The results of the study indicate that the relationship between the personal qualities of the counselor and the personal qualities of counseling has a significant impact on the effectiveness of counseling services. The personal qualities of the counselor, such as empathy, patience, and honesty, contribute to the creation of a positive relationship with clients, which in turn enhances counseling outcomes. The implications of this research highlight the importance of developing the personal qualities of counselors through continuous training and supervision to improve the effectiveness of counseling services

Experience in psychological counseling supported by artificial intelligence technology.

In recent years, artificial intelligence (AI) technology has been continuously advancing and finding extensive applications, with one of its core technologies, machine learning, being increasingly utilized in the field of healthcare. This research aims to explore the role of Artificial Intelligence (AI) technology in psychological counseling and utilize machine learning algorithms to predict counseling outcomes. Firstly, by employing natural language processing techniques to analyze user conversations with AI chatbots, researchers can gain insights into the psychological states and needs of users during the counseling process. This involves detailed analysis using text analysis, sentiment analysis, and other relevant techniques. Subsequently, machine learning algorithms are used to establish predictive models that forecast counseling outcomes and user satisfaction based on data such as user language, emotions, and behavior. These predictive results can assist counselors or AI chatbots in adjusting counseling strategies, thereby enhancing counseling effectiveness and user experience. Additionally, this study explores the potential and prospects of AI technology in the field of psychological counseling. The research findings indicate that the designed machine learning models achieve an accuracy rate of approximately 89% in analyzing psychological conditions. This demonstrates significant innovation and breakthroughs in AI technology. Consequently, AI technology will gradually become a highly important tool and method in the field of psychological counseling. In the future, AI chatbots will become more intelligent and personalized, providing users with precise, efficient, and convenient psychological counseling services. The results of this research provide valuable technical insights for further improving AI-supported psychological counseling, contributing positively to the application and development of AI technology.

The association of socioeconomic status with the success of chat-based online counseling for children and youth: A latent change score modeling approach

Children and youth from lower subjective socioeconomic status (SES) backgrounds are at a heightened risk of mental disorders. Online counseling is a valuable tool to reach those less likely to seek professional help, but its success across different SES backgrounds remains unclear. This study explores the association between subjective SES and online counseling outcomes. Children and youth (N = 2139) between 10 and 24 years-of-age received chat-based online counseling and reported on SES, negative feelings before and after the chat, and perceived helpfulness of the chat via an online assessment tool. The results of a latent change score model showed a significant association between SES and negative feelings before chatting, indicating that lower SES predicted more negative feelings (r = −0.26, p < .001). Further, SES was indirectly associated with the change in negative feelings from before to after counseling, mediated by the extent of negative feelings before the chat (β = 0.07, 95%CFI = [0.05–0.10]). Current findings extend research on online counseling programs in the context of SES. Despite higher counseling needs among low SES individuals, they do not benefit proportionally from existing online services in this sample. Future research should investigate barriers to help-seeking and implement specialized counselor training programs.

How do we know whether treatment has failed? Paradoxical outcomes in counseling with young people.

In both routine practice contexts and research studies, evidence from standardized self-report symptom measures, administered pre- and post-treatment, is predominantly used to determine whether psychotherapy has been successful. Understanding the nature of unsuccessful psychotherapy requires an ability to evaluate the credibility of outcome data generated by such techniques. An important body of research has identified discrepancies between outcomes assessed through symptom measures and those obtained from other sources. However, not enough is known about the extent to which such paradoxical outcomes exist. This study analyzes the relationship between outcomes, as assessed by a standardized self-report measure, and as assessed by ratings of young people's descriptions of change at post-counseling interviews. Participants were 50 young people (13-16 years old) who had taken part in a trial of up to 10 weeks of school-based humanistic counseling. Our primary standardized measure was the Young Person's CORE (YP-CORE). To assess young people's experiences of counseling change, three independent raters scrutinized transcripts of post-counseling interviews, and scored levels of helpfulness on a 1 (Not at all helpful) to 10 (Extremely helpful) scale. Inter-rater reliabilities were 0.94 (Cronbach's Alpha) and 0.96 (McDonald's Omega). Sensitivity analyses were conducted to explore relationships between helpfulness ratings and other outcome measures, i.e., satisfaction with counseling (ESQ) and the Goal-Based-Outcome Tool (GBO), and process measures, i.e., the Working Alliance Inventory (WAI-S) and the Barret Lennard Relationship Inventory (BLRI). Multilevel analysis indicated that helpfulness ratings were not significantly associated with changes in YP-CORE scores. Analyzed categorically, 38% of those showing reliable improvement on the standardized measure were below the median for self-described helpfulness, and 47% of those not showing reliable change were at or above the median for self-described helpfulness. Sensitivity analyses demonstrated closer correlations between helpfulness ratings and other outcome measures (ESQ and GBO), and between helpfulness ratings and process measures (WAI-S and BLRI). Our results raise questions about reliance on symptom change outcome measures for defining treatment success and failure, given their disparity with clients' own descriptions of the helpfulness of therapy. Implications for practice and research are discussed.

Demography of brain stem death and factors leading to successful consent for organ donation

BackgroundThere is a widening gap between the patients requiring transplants in proportion to the availability of organs donated. After brain stem death (BSD), counselling for consent is mandatory and if successful, and viable organs are recovered. A low consent rate for donation results in failed donation in a number of potential donors. Many potential donors fail to make a donation due to various social and familial reasons resulting in a poor consent rate. The aim of this study was to identify the variables that lead to donation denials. MethodsThis retrospective study, carried out from Jan 2009 to Dec 2021 at a tertiary centre with an active transplant and donation programme, analysed BSDs and their counselling outcomes. ResultsA total of 10998 patients were admitted to the intensive care unit, with 2401 (21.8%) deaths. BSD was diagnosed in 8.5% of all deaths, with donor suitability seen in 77.1% (n = 158) cases. After counselling, 55.7% families consented for organ donation. Amongst the families declining consent, most had multiple reasons. The commonest reasons were a difference of opinion among the family members (70%) and unclarity of BSD concept (44.3%). Other reasons included fear of mutilation, religious beliefs, and hope of a miracle. ConclusionAs most reasons of denial are social and related to public awareness, a meticulous transplant program with enthusiastic coordinators coupled with augmentation of public awareness, responsible media reporting, and improved doctor–patient–relative communication would result in enhanced rates of consent.

Enhanced adherence counselling outcomes among people living with HIV with virological failure: Single-centre experience in Pune, India.

World Health Organization has recommended enhanced adherence counselling (EAC) for people living with HIV (PLHIV) with virological failure. This study aimed to assess the outcomes of EAC and its associated factors among PLHIV with virological failure. Data collected between March 2020 and February 2022 on viral load (VL) testing at antiretroviral therapy (ART) centre in Pune, India were reviewed. PLHIV with viral load ≥1000 copies/ml followed by three EAC sessions and a repeat viral load test were included. Multivariate logistic regression analysis was used to assess the factors associated with virological suppression (<1000 copies/ml). Of 170 PLHIV, 81 (47.6%) showed virological suppression. Being literate (p = 0.027), females (p = 0.021), on second-line ART regimen (p = 0.020), and with EAC initiation within a month (p = 0.016) were significantly associated with virological suppression. No association was found between reported barriers to treatment adherence and virological suppression. Early initiation of EAC is crucial for virological suppression among PLHIV with high viral load. It is important to highlight the significance of treatment adherence among individuals on first-line ART regimen. The use of effective visual tools during EAC sessions may help in achieving virological suppression among those with low literacy.