Consent for adolescent vaccination: issues and current practices

To identify and describe implementation of state-level informed consent requirements for adolescent immunizations, current state regulations on informed consent and immunization services for children and adolescents were identified through the LEXIS-NEXIS legal data base. Regulations were coded for informed consent characteristics, consent exemptions, and current immunization requirements. State immunization program directors, project managers, and state hepatitis coordinators were surveyed to catalogue how regulations were implemented and document new policies or regulations under consideration. Parental consent for immunizations is standard practice in 43 states. Most states (n = 34) require separate consent for each injection when more than one injection is required to complete a vaccination, but only for a limited number of medical procedures. Nine states allow adolescents to self-consent for hepatitis B vaccination in sexually transmitted disease clinics and family planning clinics as part of the exemption for minors' receipt of sexual health services. Most states require consent for vaccination services provided to adolescents. Parental consent requirements are a potential barrier to vaccinating adolescents in some settings.     

The current state of sexual ethics training in clinical psychology: Issues of quantity, quality, and effectiveness.

Given the harm caused to clients and the psychology profession by therapist sexual misconduct, sexual ethics training should be given high priority in graduate training programs. The present study surveyed sexual ethics training and student understanding of sexual ethics in clinical psychology doctoral programs from the perspectives of 84 training directors and 451 students. Ninety-four percent of the students had received sexual ethics training; programs provided an average of 6 hr of training. Still, students showed significant deficits in knowledge of sexual ethics principles. Students who had discussed a client attraction with a supervisor showed the best understanding of sexual ethics. Suggestions for ensuring adequate sexual ethics training are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Duration, satisfaction, and perceived effectiveness of cross-cultural counseling.

The relationship between cultural dissimilarity and the duration, satisfaction, and perceived effectiveness of counseling was studied in the context of 70 actual treatment dyads that varied as to the race of the counselor and the client (White or non-White). White counselors provided fewer sessions than non-White counselors, and non-White clients expressed lower levels of overall satisfaction with counseling, regardless of counselor race. No differences in counseling effectiveness were observed as measured by counselor and client ratings of perceived relief, understanding, and coping. Relative to other treatment dyads, however, White clients seeing White counselors attributed their change more to counseling than to other, outside factors. (16 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Training and supervision practices in clinical, counseling, and school psychology programs.

This study surveyed the training directors of counseling, clinical, and school psychology programs accredited by the American Psychological Association on training and supervisory practices and perceptions of various modalities of supervision. Response rates were 74%, 56%, and 45%, respectively. Clinical and counseling psychology training directors reported that videotape review was the most used modality of supervision; school psychology training directors reported that self-report only was the most frequently used. The amount of time involved in conducting live supervision and cotherapy as supervision was seen as a moderate barrier to their use. Cotherapy as supervision was rated as having the most strengths by all program directors. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Internality, controllability, and the effectiveness of attributional interpretations in counseling.

Investigated an attributional approach to counseling in 2 studies. In Exp I, with 58 female and 24 male psychology students, the theoretical basis for the use of attributional interpretations was tested by giving Ss who had just received a negative social evaluation no information or information that stressed 1 of 4 types of causes: internal/controllable, internal/uncontrollable, external/controllable, and external/uncontrollable. Stressing internal/controllable causes produced more positive affective reactions and performance evaluations among internal locus of control respondents (Rotter's Internal–External Locus of Control Scale), whereas externals were more variable in their responses. Exp II (24 Ss) assessed the generalizability of these findings by administering causal counseling to Ss who identified themselves as interpersonally anxious. Utilizing a quasi-counseling design, Ss were exposed to 1 of 2 interpretations emphasizing internal control or coping. Results of Exp II confirm initial conclusions that the effectiveness of causal counseling may depend on the individual's locus of control. (36 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Health promotion, health protection, and preventive services

Health promotion, health protection, and preventive services reflect the 21 priority areas of Healthy People 2000. This article focuses on the cost-effectiveness of health promotion and the role that primary care physicians can play in this initiative.     

Goal attainment, locus of control, and coping style in adolescent group counseling.

15 high school counselors conducted small group counseling sessions with 218 students. Client characteristics included sex, race, and competence as perceived by the counselor. Multiple measures of outcome included goal attainment (Kiresuk-Sherman Goal Attainment Scaling), locus of control (Rotter's Internal–External Locus of Control Scale—I–E), and coping style (Tyler Behavioral Attributes of Psychosocial Competence). Multiple perspectives on outcome were provided by independent student and counselor goal attainment ratings. Students attained both personal and educational goals. Although counselors viewed internal students as achieving more goals, moderate I–E generally predicted goal attainment. Blacks differed from Whites in that externals gained the most goals. "Planfulness" of coping style was related to both student- and counselor-rated goal attainment, and students who attained most goals also responded most "planfully" on the postcounseling assessment of coping style. Results suggest that counseling should include teaching "planful" problem solving, and it should not overemphasize the students' internality. Finally, ways are suggested concerning how counseling approaches might be varied in relation to students' race and existing competencies. (24 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Memory for therapeutic events, session effectiveness, and working alliance in short-term counseling.

Relationships among participants' assessments of the working alliance, effectiveness of counseling sessions, and memories for important therapeutic events were investigated in 10 counseling dyads. Results indicated that counselors exhibited greater specificity of recall of important events for sessions rated as more effective and showed greater specificity of recall than did clients. Counselors evidenced a statistically reliable increase in the bond aspect (quality of counselor–client relationship) of the working alliance over time, but there was no relationship between specificity of recall and the working alliance. Implications of these results for therapeutic work are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Record-keeping practices of clinical and counseling psychologists: A survey of practitioners.

Record keeping by psychologists was examined with survey data. Results indicate substantial variability in policies and practices. Implications of the results are discussed, and it is recommended that more specific guidelines for practitioners be developed in order to reduce the variability in record keeping. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Health claims: history, current regulatory status, and consumer research

During the past 13 years regulatory and consumer communications policies on health claims have been hotly debated and have evolved from a nonregulatory action policy by which health claims were written by manufacturers to one in which claims are carefully proscribed and legally allowed by regulatory agencies. Unfortunately, health claims are not used to full public health potential. This review examines the scientific literature to determine the most effective way to communicate health claims to consumers. The results of health claims studies suggest an evolution in consumer preferences: from complete non-product-specific information in the middle to late 1980s to shorter product-specific claims in 1995 and 1996. Comprehension research suggests that shorter health claims communicate most effectively. Related label research shows that effective messages suggest action, contain text, and graphics, and are placed on the front panel. In conclusion, effective health claims: Are concise Relate to a consumer need or task to be solved Appear on the front panel Combine text and graphics using color Provide an additional benefit beyond the label (e.g., increase the production and availability of more nutritious products and increase consumers' knowledge of nutrition and health).     

Psychologists and rehabilitation: Mandates and current training practices.

Reviews legal and professional mandates concerning the provision of professional services to disabled persons by psychologists. Legal, ethical, accrediting, and licensing implications are considered, especially from the standpoint of the training of psychologists. A survey of all American Psychological Association-approved clinical and counseling training programs was conducted to examine (a) awareness of the Rehabilitation Act of 1973, (b) availability of courses concerning disabilities, and (c) the importance of knowledge of the psychological aspects of disabilities in hiring psychologists. Survey results indicate that psychologists' skills and knowledge may be seriously at variance with what is expected of them, that negative attitudinal factors play a central role and can be dispelled through formal training, and that separate and specialized services for handicapped people are not a viable option. (7 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Racial and ethnic identity theory, measurement, and research in counseling psychology: Present status and future directions.

The present article integrates and expands on the special section contributions of K. O. Cokley (2007); J. E. Helms (2007); J. E. Trimble (2007); S. M. Quintana (2007); and J. S. Phinney and A. D. Ong (2007). The authors of the present article begin with a note on politics and ideology in writings on racial identity development and review general progress the field has made on the topics of racial and ethnic identity development. The present challenges in both explicating clear and concise theories of racial and ethnic identity development and operationalizing and measuring these constructs in paper-and-pencil form are identified. The need for interdisciplinary work on theory testing is highlighted, and select examples of best practices in measuring racial and ethnic identity are presented. The article closes with directions for research in racial and ethnic identity development, and with implications for counseling practice, supervision, and systemic change. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Health behavior, perceptions, practices, and decision making: sub-national and socio-demographic differentials in Bangladesh, 1995

The study examines health behavior, perceptions, practices, and decision making using data from the 1995 Health and Demographic Survey conducted by the Bangladesh Bureau of Statistics. Knowledge about causes of diarrhea and food contamination were higher than knowledge about causes of nightblindness and worm infestation but this knowledge is inadequate. The household's economic condition and the respondent's education were found to be positively associated with disease knowledge and food contamination; the same is also true for health behavior and practices. Sub-national variation in disease knowledge and food contamination exists but did not correspond always with the health behavior and practices. Decisions regarding treatment of disease were made by the husband and wife together in two-thirds of the cases, however, it was not uniform across socio-demographic and sub-national categories.     

Testing practices in university and college counseling centers in the United States.

The frequency and scope of psychological test usage in a counseling psychology setting were studied by sending questionnaires to 372 college and university counseling center directors. The 284 usable responses indicated usage of a total of 158 tests; 35 were mentioned by 10% or more of the respondents. The median number of tests mentioned by a center was 14. The 3 most frequently used types of tests were career counseling, led by the Strong-Campbell Interest Inventory; personality assessment, led by the MMPI; and mental abilities and aptitude tests (e.g., the WAIS and Differential Aptitude Tests). Differences between these results and those of earlier surveys in clinical settings are discussed. The present respondents reported that counseling psychologists in their centers use career assessment instruments more frequently and projective personality instruments less frequently than do the clinicians. (18 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Minor head injury in children: current management practices of pediatricians, emergency physicians, and family physicians

OBJECTIVE: To describe variation in the clinical management of minor head trauma in children among primary care and emergency physicians. DESIGN: A survey of pediatricians, family physicians, and emergency physicians drawn from a random sample of members of the American Academy of Pediatrics, the American Academy of Family Physicians, and the appropriate American Medical Association specialty listings, respectively. Physicians were given clinical vignettes describing children presenting with normal physical examination results after minor head trauma. Different clinical scenarios (brief loss of consciousness or seizures) were also presented. Information was gathered on initial and subsequent management steps most commonly used by the physician. RESULTS: Surveys were returned by 765 (51%) of 1500 physicians. Of these, 303 (40%) were pediatricians, 269 (35%) family practitioners, and 193 (25%) emergency physicians. For minor head trauma without complications, observation at home was the most common initial physician management choice (n = 547, 72%). Observation in office or hospital was chosen by 81 physicians (11%). Head computed tomographic (CT) scan was chosen by 7 physicians (1%) and skull x-ray by 24 physicians (3%) as the first management option. Most physicians (n = 445, 80%) who initially chose observation at home would obtain a CT scan if the patient showed clinical deterioration. In the original scenario, if the patient had also sustained a loss of consciousness, 383 physicians (58%) altered management. Of these, 120 (18%) chose CT, 13 (2%) chose skull x-ray, 1 (1%) chose magnetic resonance imaging, 141 (21%) chose inpatient observation, and 125 (19%) chose a combination of CT scanning and observation. With seizures, 595 (90%) altered management, with 176 physicians (27%) choosing CT scan, 5 (1%) skull x-ray, 60 (9%) inpatient observation, and 299 (45%) a combination of radiological evaluation and observation. CONCLUSIONS: Most physicians surveyed chose clinic or home observation for initial management of minor pediatric head trauma. Clinical management was more varied when patients had sustained either loss of consciousness or seizures. Further study of the appropriate management of minor head trauma in children is needed to guide physicians in their care.     

Training practices in consultation: A national survey of clinical, counseling, industrial/organizational, and school psychology faculty.

Faculty who educate and train psychology students in consulting from clinical, counseling, school, and industrial/organizational graduate programs were identified via mail from department chairs and program directors. Of 197 faculty members identified, 89 (46.9% response rate) completed a detailed survey questionnaire about demographics and professional consulting activities, including teaching practices in consulting in their graduate program. Results were somewhat encouraging within industrial/organizational and school psychology programs and least positive in counseling/clinical programs, especially clinical programs. Detailed results are presented along with some implications for future graduate training in consulting psychology. A call is made for convening a national conference on educational standards in consulting psychology. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Marital quality, parenting, and adolescent internalizing problems: A three-wave longitudinal study.

The present 3-wave, 3-year longitudinal study examined direct and indirect associations between marital quality, parenting, and adolescent internalizing problems, taking into account bidirectional associations between these concepts. Data were used from 428 Dutch families, consisting of 2 biological parents and 2 adolescents with mean ages of 13.4 and 15.2 years (at Time 1). Results from structural equation modeling analyses showed that low marital quality at Time 1 was directly related to adolescent internalizing problems at Time 2 in oldest siblings. However, support was not found for any indirect associations through parenting or for longitudinal associations from adolescent internalizing problems to parents' marital quality. Results are discussed in terms of implications for understanding the mechanism by which marital quality is related to adolescent internalizing problems. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Parenting practices and adolescent depressive symptoms in Chinese American families.

This study examined parenting practices and adolescent depressive symptoms among Chinese Americans. First, confirmatory factor analyses revealed that self-reported parenting practices by mothers and fathers and adolescent perception of parenting practices loaded adequately on three subscales: Inductive Reasoning, Monitoring, and Harsh Discipline. Second, parents' depressive symptoms were related to disrupted parenting practices, which, in turn, were significantly related to the negative evaluation of these behaviors by the adolescents. Adolescents' perceptions of such parenting practices were significantly associated with their depressive symptoms. Third, the relationships were robust even after parental income, education, and generation status were statistically controlled. Overall, the relationships between parenting practices and adolescent depressive symptoms among Chinese Americans seemed to echo those found among European Americans. (PsycINFO Database Record (c) 2010 APA, all rights reserved)