Gay and bisexual male clients' perceptions of counseling: The role of perceived sexual orientation similarity and counselor universal-diverse orientation.

A recurring question in multicultural counseling is whether client–counselor similarity on sociodemographic characteristics benefits counseling. A related issue is how counselor orientation to diversity relates to counseling process and outcome, both as a main effect and in interaction with counselor–client sociodemographic match. This cross-sectional study investigated these questions in relation to gay and bisexual male clients' counseling experiences by examining clients' perceived similarity to their counselor in sexual orientation, as well as counselors' self-reported orientation to diversity (assessed in terms of level of universal-diverse orientation [UDO]). Data were from 83 male–male client–counselor dyads recruited from lesbian/gay/bisexual-affirming counseling practices, where clients identified as gay or bisexual and counselors identified as gay, bisexual, or heterosexual. Counselor UDO was positively and uniquely associated with client ratings of the working alliance, session depth, and session smoothness. Perceived sexual orientation similarity was not directly related to any of the counseling-related criterion variables. Moreover, when counselors reported low levels of UDO, perceived similarity was negatively associated with the client-rated alliance and perceived improvement. Client religious commitment—a control variable in all analyses—was uniquely and negatively associated with client ratings of perceived improvement in counseling. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Counselor-client agreement on session impact.

We propose a new framework for understanding studies of counselor–client agreement about their counseling. The framework includes five factors: the scope of counseling being studied (process, impact, or outcome), the dimension (index) being rated (in this study, session Depth, Smoothness, Positivity, or Arousal), the measure used to assess agreement (correlations or absolute differences), the level at which the analysis is conducted (session, client, or counselor), and the type of agreement—(a) consensus, the similarity of counselors' own ratings to clients' own ratings; (b) counselor awareness, the similarity of counselors' perceptions of their clients to clients' own ratings; (c) client awareness, the similarity of counselors' own ratings to clients' perceptions of their counselors; and (d) matched awareness, the similarity of counselors' perceptions of their clients to clients' perceptions of their counselors. In a study of session impact (scope), degree of agreement was found to vary substantially with each of the other factors—type of agreement, dimension rated, measure of agreement, and level of analysis. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Three methods in measuring the therapeutic process: Clients' and counselors' constructions of the therapeutic process versus actual therapeutic events.

Explored 3 methods in examining the therapeutic process that (1) assessed how clients construct and interpret the change process and counselors' behavior over time, (2) assessed the content and valence of clients' and counselors' most memorable thoughts immediately after the session, and (3) compared the clients' and counselors' memorable thoughts with the actual content of the counseling sessions. A single-S design was used to examine 3 counselor–client dyads across 7 counseling sessions. The results provided preliminary but rather encouraging support of 2 methodologies, Guided Inquiry and thought listing, that assess how clients and counselors construct and interpret aspects of the therapeutic process. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Session impact, working alliance, and treatment outcome in brief counseling.

Examined associations among working alliance, session evaluations over the course of brief counseling, and counseling outcome. At a training clinic, 61 clients and student counselors from 41 dyads completed ratings of session depth, smoothness, positivity, and arousal after their 1st 12 sessions. Alliance ratings were completed after the 4th session and at termination. Clients and counselors also provided 5 measures of counseling outcome. Results indicated that session evaluations were significantly related to later alliance ratings, and positive alliance ratings predicted subsequent session evaluations. Both linear and curvilinear session effects were suggested. Associations for client ratings were generally stronger than for counselor ratings. Both alliance and session evaluations were significant unique predictors of client-related outcome, but only alliance predicted counselor-rated outcome. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Nonverbal communication and counseling outcome.

Nonverbal abilities and behaviors and verbal–nonverbal (VB–NVB) congruence of both counselor and client were studied in relation to judgments by counselors and clients of counseling outcome. 40 university students were clients; 20 counseling or clinical psychology graduate students were counselors. 40 counseling dyads were videotaped during 30-min counseling sessions. NVB abilities were assessed by the Profile of Nonverbal Sensitivity and an encoding task. Raters judged the presence of 7 NVB behaviors for each 5-sec segment of the videotaped session. Congruence was measured through postsession recall by counselor and client of consistency of feelings expressed through VB and NVB channels of communication. Only VB–NVB congruence was significantly related to outcome, suggesting that the NVB dimension is important primarily as it interacts with the VB dimension. Recommendations are made for use of new methodologies in future research to examine the complex interactions involving NVB communication. (41 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Differential helpfulness of counselor verbal response modes.

28 counselor–client dyads (analog sample consisting of 15 graduate students and faculty and 28 undergraduates) and 16 client–counselor dyads (counseling sample) rated the helpfulness of particular counselor responses in just-completed counseling sessions, using Interpersonal Process Recall. In the counseling sample, counselors also rated the helpfulness of the same responses. The responses were measured for type of response made by objective raters, clients, and counselors. Interpretations received the highest helpfulness ratings from both client and counselor. Advisements were rated as slightly more helpful than nonadvisements, and questions were rated as slightly less helpful than nonquestions. However, counselor response modes account for only a small proportion of the variance in helpfulness ratings, which points out the need for research on contextual variables and response mode subtypes. (32 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of cognitive style and counselor–client compatibility on client growth.

Tests of 2 cognitive style dimensions (serialism–holism and field dependence–independence; measured by the Gandlemuller Test and the Group Embedded Figures Test, respectively) were administered to 60 counselor trainees in graduate clinical and counseling psychology programs and 60 volunteer clients drawn from a university-level applied psychology course. 32 counselor–client pairs matched or mismatched on the 2 dimensions were formed. Counselor and client pairs engaged in 2 50-min therapy sessions that focused on client self-enhancement. In independent rating sessions, matching effects for field dependence–independence were obtained in clients' subjective ratings of improvement in self-exploration skills and in clients' and counselors' subjective ratings of the ease of relating with each other. Implications and applications for achieving maximum counselor–client compatibility in a person–environment interaction model are discussed. (32 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Counselor and helpee perceptions of counselor intentions in relation to outcome in a single counseling session.

Determined whether counseling session could be predicted from different variables (i.e., counselor intentions, helpee's perceptions of counselor's intentions, match between counselor and helpee on intentions), focusing on counselors' and helpees' perceptions. Four 32–43 yr old experienced counselors each saw 4 undergraduate helpees for single 50 min counseling sessions. Counselors and helpees evaluated sessions and then reviewed videotapes during which counselors identified their intentions and helpees rated the helpfulness for each counselor turn. Results indicate that helpees perceived more intentions to support, focus, and clarify and less self-control and resistance than counselors had intended. The highest match between counselors and helpees occurred for getting information, setting limits, and clarifying. Helpees' ratings of helpfulness were highest for counselors' intentions involving needs, resistance, cognitions, and relationships, and lowest for setting limits, getting information, supporting, and focusing. Session outcome was related to different counselor and client perceptions, indicating that participants valued different events within sessions. (18 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Session evaluation and recall of important events as a function of counselor experience.

Session evaluation and type of participant-recalled important event were investigated in 25 novice counselor dyads and 9 experienced counselor dyads during 9 sessions of short-term counseling. Counselor experience was the independent variable and session evaluation was the dependent variable. Results based on the Session Evaluation Questionnaire (W. B. Stiles, 1980) showed a significant interaction effect between counselor experience and role of participant (client or counselor) for session depth. Clients also reported an increase in positive affect over the course of counseling. Experienced counselors recalled more important events involving insight, whereas novice counselors recalled more important events involving exploration of feelings or self-critique. The type of important event recalled by clients also changed over the sessions of counseling. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Client-specific counselor self-efficacy in novice counselors: Relation to perceptions of session quality.

Two versions of a counselor self-efficacy (CSE) measure were administered to 110 prepracticum counselors: a general version, assessing perceived capability to perform basic helping skills and manage the session process with clients generally; and a client-specific version, tapping capability to perform the same behaviors with a specific, current client. Client-specific CSE was found to (a) relate moderately to strongly with general CSE over the course of four counseling sessions, (b) increase significantly over sessions, and (c) account for unique variance in counselors' evaluations of the quality of their sessions. Although it was not a useful direct predictor of clients' session ratings, higher client-specific CSE was associated with greater congruence between counselors' and clients' perceptions of session quality. Implications for further research and training are considered. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cognitive mediation in person-centered and rational-emotive therapy.

Relations among counselor and client cognitive and behavioral variables were examined in relation to counselor and client ratings of counseling effectiveness. Unlike previous cognitive-mediational process research on counseling, the conceptual and coding systems used were tailored specifically to two different counseling approaches. Data were obtained from videotapes of 20 counseling sessions and from 40 stimulated recall interviews with both counselors and clients following the counseling sessions. Ten of the sessions followed a rational-emotive format; 10 followed a person-centered format. Both therapeutic conditions consisted of two dyads, each studied experimentally during 5 sessions selected from brief counseling interventions. Results indicated that variables composed from both cognitive and behavioral data predicted participant ratings of counseling effectiveness more than did behavioral variables alone. As in previous research, such relations seemed to depend on a strong negative correlation between counselor transparency (accurate client perceptions of counselor intentions) and participant ratings of counseling effectiveness. (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)     

Counselor verbal response modes and experienced empathy.

[Correction Notice: An erratum for this article was reported in Vol 34(3) of Journal of Counseling Psychology (see record 2008-10749-001). The second paragraph of the author acknowledgement should have read as follows: We thank Ian Spalding for supervision of the session recordings, Liz Colley for programming and advice on data analysis, Richard Shillcock and Jane Oakhill for response mode coding, and Robert Elliott for comments on a draft.] Client and counselor perceptions of empathy at different stages in the counseling process were examined in relation to the verbal response modes used by counselors in 24 client–counselor dyads. Each of 6 counselors (aged 32–58 yrs) at college counseling centers was studied in counseling with 4 clients, of whom 2 were in initial sessions and 2 were in sessions drawn from ongoing counseling relationships. Clients perceived counselors as showing significantly greater empathy during ongoing than during initial sessions, and counselors perceived themselves as showing significantly greater empathy during initial sessions than did clients rating the same sessions. Clients rated counselors using fewer general advisements as more empathic, whereas counselors who rated themselves more empathic used more explorations and fewer reassurances. At the moment-to-moment level tapped by interpersonal process recall, exploration was the only category strongly associated with both client and counselor experiences of empathic communication in both initial and ongoing sessions. (50 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Empirical investigation of the cognitive mediational paradigm for research on counseling.

Examined relations among counselor and client cognitions, behaviors, and ratings in 29 counseling sessions involving 10 different counselor–client pairs, using stimulated recall and content analysis. Clients were university students; there were 4 counselors with 7–25 yrs' experience and 3 who were counseling interns. The design of the study permitted assessments of the impact of counselor experience (novice vs experienced) and stage of counseling (early, middle, and end) on these variables. Consistency in various parts of the sequential chain of counselor intention (counselor behavior, client perceptions of counselor intention and behavior, client cognitive processing, and client behavior) was lower for interpersonal cognitive than for interpersonal behavioral or intrapersonal cognitive–behavioral links. Consistency across different elements in this chain was observed to account for a significant proportion of the variance in counselor ratings of session effectiveness. Consistent, interpretable patterns observed across counselor intentions, counselor behaviors, and client cognitive processing are discussed. Relatively few effects of stage of counseling or of counselor experience were observed. (32 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Client introversion and counseling session impact.

Tested the hypothesis that insofar as personal counseling is a social encounter, introverted clients may be expected to experience greater distress in sessions than extraverted clients. This expectation was confirmed in a total of 83 clients (aged 17–39 yrs) in a university clinic who completed the Minnesota Multiphasic Personality Inventory (MMPI) during their treatment and completed a session evaluation questionnaire immediately after their sessions. With differences among counselors statistically controlled, relatively introverted (higher MMPI Social Introversion) clients rated their sessions as relatively uncomfortable, unpleasant, tense, rough, and difficult and rated their postsession mood as relatively unfriendly, uncertain, sad, angry, and afraid. Conversely, relatively gregarious, overactive, extraverted (higher MMPI Hypomania scores) clients rated their sessions as relatively comfortable, pleasant, relaxed, smooth, and easy. It is suggested that client introversion should be incorporated explicitly into counseling theories and should be measured as a possible mediating variable in process and outcome research. (40 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

"Counselor verbal response modes and experienced empathy": Correction to Barkham and Shapiro.

Reports an error in "Counselor verbal response modes and experienced empathy" by Michael Barkham and David A. Shapiro (Journal of Counseling Psychology, 1986[Jan], Vol 33[1], 3-10). The second paragraph of the author acknowledgement should have read as follows: We thank Ian Spalding for supervision of the session recordings, Liz Colley for programming and advice on data analysis, Richard Shillcock and Jane Oakhill for response mode coding, and Robert Elliott for comments on a draft. (The following abstract of the original article appeared in record 1986-15306-001.) Client and counselor perceptions of empathy at different stages in the counseling process were examined in relation to the verbal response modes used by counselors in 24 client–counselor dyads. Each of 6 counselors (aged 32–58 yrs) at college counseling centers was studied in counseling with 4 clients, of whom 2 were in initial sessions and 2 were in sessions drawn from ongoing counseling relationships. Clients perceived counselors as showing significantly greater empathy during ongoing than during initial sessions, and counselors perceived themselves as showing significantly greater empathy during initial sessions than did clients rating the same sessions. Clients rated counselors using fewer general advisements as more empathic, whereas counselors who rated themselves more empathic used more explorations and fewer reassurances. At the moment-to-moment level tapped by interpersonal process recall, exploration was the only category strongly associated with both client and counselor experiences of empathic communication in both initial and ongoing sessions. (50 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Client and counselor characteristics and engagement in counseling.

Examined relations among various client and counselor characteristics and engagement in counseling for more than 1 session with 5 female and 4 male practicum counselors and 203 of their clients (128 women, 75 men) who had come to a university counseling center for the 1st time. After the initial interview, clients rated counselors' interest, helpfulness, competence, warmth, and genuineness; counselors rated clients' verbalness, intelligence, capacity for insight, likability, and the severity of clients' problems. Clients also indicated the extent to which counselors identified concerns for which the clients did not initially seek counseling. Findings show that 71 clients returned for more than 1 counseling session. Counselors' perceptions of clients as more disturbed and counselors' desire to see the clients were positively associated with clients' returning for counseling after intake. Identification of concerns for clients by counselors at intake was also positively related to engagement in counseling. (12 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Sex of client and sex and experience level of counselor.

Examined how sex of client and sex and experience level of the counselor affected behaviors in counseling. 12 male and 12 female counselors, half inexperienced and half experienced, each recorded the 2nd counseling session with 1 male and 1 female client. Satisfaction items, frequency counts of counselor and client verbal behavior, activity levels, and judges' ratings were obtained for each session. Results indicate that same-sex pairings had more discussion of feelings by both counselor and client, and that inexperienced males and experienced female counselors were more active and empathic and elicited more feelings from clients than did their counterparts. (17 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Male counselors' discomfort with gay and HIV-infected clients.

Examined male counselors' reactions to gay and HIV-infected clients in light of counselors' homophobia and death anxiety. After completing measures of homophobia and death anxiety, 34 male counselors viewed a videotaped, male client–actor in 1 of 4 conditions: either gay or heterosexual and either HIV negative or HIV positive. The dependent variable, counselor discomfort, was assessed through (1) the ratio of avoidance to approach verbal responses to the taped client, (2) self-reported state anxiety, and (3) recall of certain words used by the client. As hypothesized, counselors experienced greater discomfort with HIV-infected than HIV-negative clients, and counselors' homophobia predicted their discomfort with gay male clients. However, client sexual orientation did not affect counselor discomfort, and death anxiety was unrelated to discomfort with HIV-infected clients. Implications regarding countertransference and counseling were discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)