The Dose-Response Relationship at a College Counseling Center

Abstract

Most college counseling centers have adopted session limits for their psychotherapy clients though little evidence exists to support such cutoff points. In the past eight years, a few studies have been published using survival analysis statistics for investigating the speed of recovery in psychotherapy. The outcome of clients at a university counseling center was studied to assess change across time, on a session-by-session basis. The analysis of these data showed that 14 sessions of psychotherapy were required for 51% of clients to meet criteria for clinically significant change. Results were interpreted as suggesting that limiting psychotherapy at college counseling centers may result in improvements that are not clinically meaningful for the majority of clients receiving services.     

Using Screenwriting Techniques to Create Realistic and Ethical Role Plays

The author describes an innovative training strategy that can be used to make role plays a more realistic learning experience for counseling students. The method involves using techniques that screenwriters use to create believable characters and applying these techniques to help students create realistic role‐play clients. This approach also resolves some of the ethical and practical concerns that have been raised regarding role plays in which student clients discuss personal issues in practice sessions. Evaluations of the method, cautions, and implications for future research are discussed.     

Clients’ Expected Number of Counseling Sessions,Treatment Effectiveness,and Termination Status: Using Empirical Evidence to Inform Session Limit Policies

Many counseling centers have session limits to accommodate the increasing number of clients who seek treatment. The current study explored clients' expectations for the number of sessions over the course of one year at a large university counseling center. In contrast to previous research that has suggested clients want ten or fewer sessions, our results suggest that over 60% of clients wanted 20 or more sessions. Moreover, clients who expected 20 or more sessions reported therapy was less effective than clients who expected less than 20 sessions. While actual number of sessions was related to expected number of sessions, termination status appeared to be related to clinical factors and not clients' expected number of sessions. Implications for clinical practice and agency session limit policies are discussed.     

Attitudes Toward Homosexuality among Graduate Counseling Students

The authors surveyed graduate counseling students regarding their attitudes toward homosexuality: its etiology; the mental health of homosexuals; the role of the mental health professional in treating homosexual clients; and myths and fallacies surrounding homosexuality. The results indicate that counseling students feel ill-prepared to deal with homosexual clients, are unsure about the etiology of homosexuality, and that female students respond differently from male students regarding many aspects of homosexuality.     

Experiences of HIV/AIDS Counselors in Zimbabwe and Their Perceptions on the State of HIV/AIDS Counseling in Zimbabwe

This study investigated Zimbabwean counselors' experiences of providing HIV/AIDS counseling and their perceptions about the state of HIV/AIDS counseling in Zimbabwe. The participants were a diverse group of counselors, 30 through 59 years of age, who provided counseling services to HIV/AIDS clients. Participants thought HIV/AIDS counselors in Zimbabwe received minimal support and supervision and were undertrained. They identified that the first sessions with clients were the most difficult. They also found it problematic to work with couples who were serodiscordant (one partner who is HIV positive and the other HIV negative) and couples wanting children. The later stages of the counseling process were also found to be challenging. Though the participants acknowledged they had negative psychological experiences when counseling HIV/AIDS clients, they also expressed feelings of satisfaction and fulfillment in their work.     

Resistance as a factor in career counseling

Conclusion Resistance can no longer be seen as a concept that is relevant only to personal counseling. The career literature includes ample reference to the role of threat and anxiety in inhibiting the decision-making process, a process that is analogous to resistance in the eclectic counseling literature. Assimilation of knowledge about resistance into the planning and implementation of career programming holds promise for helping motivate students/clients to use the career decision-making process more effectively with less defensiveness.     

Understanding Clients and Their Environments: A Simulation

Counselors must be made fully aware of the impact of environmental and societal forces on their clients. Counselor education students need knowledge and skill to attend to the pressures and problems of minority groups. The simulation method described in this article encourages students to experience powerlessness, isolation, and few if any options in order to develop a clearer understanding of their clients and environments. The authors discuss applicability of the simulation beyond counselor education programs.     

Teaching Interpreted Counseling Practice: A Step Toward Multicultural Competence

We conducted an interpretative phenomenological analysis of five counseling students' experiences collaborating with American Sign Language–interpreting students during counseling practice sessions. Themes were identified in developmental domains of counselor self-awareness, counseling relationship, and advocacy interventions. Interdisciplinary collaboration led students to address cultural deficiency models and increase multicultural competency and efforts in social justice.     

Chapter 15 Peer Educators:

Eating disorders are a serious health and mental health problem on college campuses nationwide. This article describes an innovative treatment and prevention program for eating disordered college students. Peer educators are used to provide individual, informational sessions to students with eating disorder concerns and workshops on eating disorders to the campus community. They work with the counseling center by referring more serious eating disordered clients and through consultation with a staff psychologist. The roles and functions of eating disorder peer educators are described, and issues in recruitment, selection, training and ongoing supervison are highlighted. The counseling center's role in the management of eating disorders is also discussed. Specific case examples are presented to clarify the peer educator role in working with eating disordered college students.     

Supervisory and Counseling Process: A Comparative Study

This study compared the process of supervision with that of counseling by examining the behavior of five professional therapists in both situations. Counselors recorded their counseling sessions with 10 clients and their supervisory sessions with 10 trainees. A total of 180 three-minute samples were selected for study. The level of facultative conditions (empathy, respect, genuineness, and specificity) was assessed. The Hill Interaction Matrix was also used to compare the verbal interactions in both counseling and supervising situations. Results indicated that the level of respect and genuineness were equal in the two situations. Contrary to the assumptions made by researchers in the area, the levels of empathy and specificity were significantly lower in supervision than in counseling. When interactions were rated with the Hill Matrix, supervision was significantly less therapeutic than was counseling. The differences found were discussed in terms of their implications for the teaching and learning of psychotherapy, as it related to both the theoretical literature and in terms of its effect on trainees and clients.     

Neophyte Counselor Attire and College Student Perceptions of Expertness,Trustworthiness, and Attractiveness

Strong (1968) proposed that counseling can be viewed as a two-phase process. During the first phase, counselors use various techniques to enhance client perceptions of counselor expertness, trustworthiness, and attractiveness. These perceptions result in influence-power and have an effect on outcome. According to Strong, clients use reputational, behavioral, and evidential cues to assess counselor credibility and attractiveness. Previous research has indicated, however, that counselor attire is not used as an evidential cue when counselors display expert verbal and nonverbal behavior. It was hypothesized that counselor attire is an evidential cue for expertness, trustworthiness, and attractiveness of the inexperienced neophyte counselor-in-training. To test this hypothesis college students participated in group counseling sessions with either a formally or informally attired neophyte counselor. It was found that the informally attired counselor was perceived as more expert, trustworthy, and helpful.     

Counseling Students' Level of Ego Development and Perceptions of Clients

Several current models of counseling supervision provide an outline of the developmental stages of counseling students' growth in conceptual and behavioral skills. Research based on these models, however, has grouped students by experience level rather than by developmental level. In this study the authors investigated the relationship of 63 counseling students' level of ego development and level of experience with their perceptions of clients. Analysis of structural complexity and content of students' perceptions of eight actual clients and their level of ego development revealed no significant main effects or interaction of either ego level or experience level on the structural complexity of client perceptions. Students at high ego levels described their clients more frequently in interactional terms than did those at low ego levels.     

A Theory of Imperfection

In most counseling classes, entering students are very eager to learn techniques and theories of counseling. It is as if the students believe that these techniques will then enable them to be good counselors. If students were to succeed at their initial intention—the mastery of counseling theory and technique—all they would have are tools to distance them from their clients. In essence, the students would have the tools to work on clients and not with them. This article comments on the paradoxical nature of the teaching of counseling theory. The article demonstrates that what is correct are people and not the image people have of themselves. What is correct are the counselor's feelings between his or her clients and him or her. All counselors need do is pay attention to the correctness of their own responses to each client. They can only take a client as far along the road as they have traveled. All counselors really need to know is themselves. At this point their imperfections may be viewed as perfect and they need not depend on theories of counseling.     

Engaging Reflection: A Training Exercise Using Conversation and Discourse Analysis

The author describes an exercise for counselor trainees that promotes counselor reflection on the counseling process. The exercise, which also supports a social constructionist view of counseling, was introduced before, or concurrent with, skill development and required students to combine conversation and discourse analysis of their interactions with “clients.” Methods of analysis are presented, along with specific instructions for the exercise, trainees' comments, and the author's reflections regarding the exercise. We are seeking to complete and be completed … not to understand and be understood cognitively, not to get it right.     

An effect of a mandatory counseling program for college students on academic probation: a preliminary study

This longitudinal study examined the effects of a mandatory counseling program for students placed on academic probation at a university in South Korea. The study compared longitudinal changes over three semesters in the grade point average (GPA) of students who were on academic probation. Two groups, 46 students with mandatory counseling and 49 students without, were used as comparison groups for testing the effects of counseling intervention on GPA improvement. The result suggested that the students who attended five or more counseling sessions beyond two mandatory sessions showed a significantly greater GPA improvement over three semesters in comparison with the students who did not receive the mandatory counseling sessions. Implications for counseling and suggestions for institutional action are discussed.     

Developing Questioning Effectiveness in Counseling

A model based on a hierarchy of questioning skills in counseling situations was developed to facilitate training of counseling students. This model is designed to help counseling students understand the impact of their questions on clients using the various stages in the counseling process as a framework. It is based on a synthesis of current theoretical views on the role and effects of questions in the counseling process. The model helps to identify question types and to assess their effectiveness along a continuum. Implications concerning the mechanisms through which effective questions can be taught are discussed in terms of present theoretical assumptions and the need for developing empirical support for the model.     

All-Inclusive Conceptualization as a Dimension of Trainee Empathic Responding

Investigations into the personality characteristic all-inclusive conceptualization (AIC) indicated that this variable was related to the ability to integrate facilitative interpersonal behaviors. A test of AIC was administered to 28 counseling practicum students who also submitted audiotapes of an initial, middle, and final counseling session. The sessions were rated, using a 5-point Carkhuff scale, as to the level of empathic understanding present. Significant negative correlations were found between scores on the test and rated levels of empathic understanding in each counseling session. The correlations indicated that those trainees who scored higher on the test of AIC offered their clients lower levels of empathic understanding than did their lower scoring colleagues. Implications for this finding are discussed.     

Counselor Gullibility

In this article the author argues that it is mandatory that counselors suspend any disbelief in their clients during the early stages of counseling. Disbelieving interferes with counselor spontaneity and empathy. Indeed, the real work of counseling cannot start until clients perceive counselors as gullible. I offer a justification for being gullible during the initial sessions, along with suggestions for what can be done to develop appropriate levels of gullibility in counselors in training.     

Enrolment choices in Portuguese higher education: do students behave as rational consumers?

As part of a progressive change occurring in the way public sector beneficiaries are conceived, higher education students started to be more and more perceived as clients or consumers. This implies assuming them as rational and conscious actors aware of what to expect from higher education attendance and of its returns. Framed by the metaphor of students as consumers, this paper aims to discuss whether students behave as rational consumers when choosing to enrol in higher education. Based on the findings of a qualitative study analysing Portuguese students’ choices it is possible to conclude that they tend to behave as rational consumers when they decide to attend higher education and when they choose a given institution, but not when they decide on attending a specific study programme. In this last case, instead of comparing the diverse study programmes and collecting information before forming their preference, students first formed this preference and, only then, gathered information. Student socialisation process emerged as a key element in shaping the preference for the study programme and in the vocation to choose it.     

Counselor Education Students’ Exposure to Trauma Cases

In the past two decades there has been an increase in the number of studies that have examined the psychological effects on counselors who provide counseling to clients with trauma experiences. However, little is known about the experiences of counselor trainees who provide counseling to their clients seeking counseling because of trauma. This qualitative study explored the experience of eight doctoral students in a counseling program who completed their master’s-level training in the United States. Three themes emerged from the inductive data analysis process, namely: (1) immediate reactions, (2) information processing, and (3) post-exposure development. Implications for counselors, counselor educators, and clinical supervisors are examined and recommendations to enhance counseling and supervision services are offered.