Disability and the law: Attitudes of police, lawyers, and mental health professionals.

A literature review on the attitudes of police officers, lawyers, and mental health professionals toward the disabled indicates that police officers' attitudes are related to the extent of their formal education and the amount of information they have about relating to persons with various types of disabilities. Lawyers who have disabled clients tend to be more knowledgeable and to have more positive attitudes than lawyers without such clients, but it is not easy to turn lawyers into advocates for disabled clients. Mental health professionals, who may be called on to provide advice to police officers or lawyers or to testify in court cases, have some negative aspects that may impair their helpfulness, but their attitudes are more positive than those of less educated persons. Data also indicate that the attitudes of psychologists are less negative than those of psychiatrists. It is concluded that rehabilitation psychologists need to undertake studies of the attitudes of these groups and to set up programs designed to change the attitudes of members of these professions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Professional responsibility, therapeutic jurisprudence, and preventive law.

In this essay, the author considers how therapeutic jurisprudence and preventive law might inform the field of professional responsibility. He suggests that many principles underlying professional responsibility standards are rooted in hidden psychological assumptions about the interaction between clients and lawyers. These principles often are ignored. Scientific research into the psychological assumptions underlying professional responsibility norms could have numerous beneficial effects, including clarifying professional responsibility norms and teaching lawyers to deal with clients in a way that will help clients cope with the legal system and avoid tensions with their lawyers. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Expectations and preferences of nonclients for a university student counseling service.

Investigated the relationship between preferences and expectations about a university student counseling sevice in a population of 100 student nonclients. In addition, differences between nonclients' self-perceptions and their perceptions of counseling-service clients were investigated. Nonclients were administered a 157-item questionnaire on an individual basis to investigate these variables. It was hypothesized that discrepancies between preferences and expectations, as well as between perceptions of self and of clients, might be indicative of nonclients' willingness to become future clients of the counseling service. Results indicate that nonclients wanted the counselor to be significantly more active than they expected him to be. In addition, they perceived clients of the service as suffering significantly more from psychological and interpersonal problems than they themselves were. In light of the findings, it is suggested that there is a need for dissemination of information with regard to the process and modes of treatment offered by the counseling service. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Waiting list dropouts in a university counseling center.

Surveyed 59 clients at a university counseling center who had been placed on a waiting list and subsequently decided not to renew their request for counseling. Ss were asked why they did not renew their request and whether they were still interested in counseling. Responses were analyzed in terms of type of problem, time on the waiting list, and degree of urgency. Most Ss did not report negative reactions or effects from their placement on the waiting list, although Ss in the highest urgency category tended to report that the wait was too long. 30 Ss stated that the intake interview was enough or that the problem had been resolved, while 23 were still interested in counseling. It is suggested that (1) high-urgency clients should be given priority at university counseling centers, (2) directive crisis-intervention approaches can be used to resolve issues at intake sessions, (3) assessment should identify clients whose motivation for counseling is related to developmental issues that need to be dealt with immediately, and (4) alternative treatments such as groups or workshops should be made available to waiting-list clients. (10 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cultural and linguistic bias in mental health evaluations of deaf people.

Examines assessment issues related to deaf clients, focusing on cultural and linguistic bias. Reliability and validity problems encountered when administering intellectual and personality assessments to hearing-impaired Ss are discussed. Factors influencing psychological assessment are addressed, including inaccurate beliefs and problems with rapport, miscommunication, and using interpreters. It is recommended that research be conducted to refine the psychometric properties of assessment instruments used, that psychologists become more sophisticated about deaf culture, and that psychologists interested in working with deaf clients need to become more skilled in the use of sign language. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Counseling psychologists' perceptions of the occurrence and effects of unrealistic expectations about counseling and psychotherapy among their clients.

Surveyed counseling psychologists working in practice settings regarding their perceptions of the occurrence and effects of their clients' unrealistic expectations about counseling. A majority perceived some of their clients as having unrealistically high expectations about the need for concreteness; the likelihood of counselor nurturance, directiveness, and empathy; and the probability of a beneficial outcome. Most responded that some of their clients have unrealistically low expectations about the need for immediacy, motivation, openness, and responsibility, and the likelihood of confrontation. Psychologists view most unrealistic expectations as having a detrimental effect on counseling. Exceptions that can have a facilitative effect on counseling are unrealistically high client expectations about the needs to be motivated and open and to assume personal responsibility and unrealistically low expectations for counselor directiveness. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Patients' use of denial: coping with the unacceptable

Nurses working with terminally ill or bereaved clients and their families need to understand the defence mechanism of denial and how it helps people to cope with unacceptable physical and psychological threats.     

Psychological complaints and disorders of students

Objectives of our investigation are the assessment of the prevalence of psychological disorders of students, the kind of symptoms and complaints and the frequency of treatment required. Secondly it is investigated whether the disorders of the clients consulting a counseling service are clinically relevant. The method has been a multidimensional field study of 346 students at the University of Heidelberg compared with 342 patients of the Psychotherapeutic Counseling Service of the University. RESULTS: 16% of the students assess themselves as severely mentally disordered and in need of treatment. This group shows objectively and clinically significant more frequent and more distinct psychological symptoms. The patients consulting a psychotherapeutic counseling service show the same degree of psychological symptoms as the persons of the control group who assess themselves as being in need of treatment. Depressive syndromes, working disorders, anxieties and interpersonal conflicts are the dominant areas of complaints. In the provision of counseling and treatment for students with psychological disorders, a psychotherapeutic counseling service plays its specific role.     

International and American students' expectancies about counseling.

Investigated whether students from different backgrounds differ in their expectancies about counseling on a university campus. Ss included 40 American, 39 Chinese, 35 African, and 36 Iranian freshmen and seniors who completed a questionnaire measuring college students' expectancies about counseling. Significant differences among the 4 nationality groups were observed on 12 of the 17 expectancy scales. It was found that American Ss expected the counselor to be less directive and protective and expected themselves to be more responsible for improvement. In contrast, the Chinese, Iranian, and African Ss expected to assume a more passive role and expected that the counselor would be a more directive and nurturing authority figure. (7 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of briefing upon client satisfaction with the initial counseling contact.

Administered the Counseling Readiness scale of the Adjective Check List to 44 male and 41 female student naive clients at a counseling center. Half of the Ss were then provided relevant information about therapist directive-nondirective behavior prior to initial contact. Results show female Ss who had been briefed and were high in counseling readiness were most satisfied with initial contacts, and able to elicit more directive interviewer behavior. While briefing failed to influence the initial subjective satisfaction of male and female clients with low-counseling readiness, it did significantly reduce the incidence of early termination in this group. (20 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Victims of auto accidents: The quiet victims.

Discusses victims of automobile accidents as individuals in need of mental health counseling and suggests that mental health professionals should be employed to assess psychological damages to the victim and/or to assist in psychological rehabilitation. The need for established systems (legal, correctional, and mental health) and for individual lawyers and mental health professionals to interact with each other to provide this assistance is discussed. (2 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Helping Clients Heal: Does Forgiveness Make a Difference?

Broken trust, broken hearts, and broken spirits: these are all potential issues facing clients who have been hurt by others. Some have claimed that helping clients explicitly forgive those who have hurt them is a legitimate therapeutic intervention. However, do clients need explicit forgiveness interventions? Do clients want them? After they are received, are these interventions helpful? For the majority of 59 clients from 3 university counseling centers the answers were mostly affirmative. They had experienced a hurt that they wanted to forgive and wanted to talk about in therapy. Those who talked explicitly about forgiveness reported more overall improvement in their presenting symptoms. Implications for using explicit forgiveness interventions with clients are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Collaborative versus directive interventions in the treatment of eating disorders: Implications for care providers.

Given that individuals with eating disorders, are typically ambivalent about changing their eating patterns, what approach is most helpful in working with this challenging group? This research compared the responses of clients with eating disorders and those of care providers to written clinical vignettes. All participants rated collaborative interventions as more acceptable and more likely to produce positive clinical outcomes than directive interventions. In addition, clients who were least ready for change rated directive interventions as less acceptable and less likely to produce adherence than did clients who were more ready. Despite participants' clear preference for collaborative interventions, directive interventions were rated as equally likely to occur. The implications of participant preferences and reasons that these preferences may not be reflected in actual clinical practice are addressed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The cognitive mediational paradigm for research on counseling.

Argues that knowledge about counseling effects will not advance until researchers in counseling conduct investigations that obtain reasonably direct data about specific cognitive operations of counselors and clients in ecologically valid counseling contexts, and relate these cognitive data to interactive behavioral data and counseling outcomes. A theory of cognitive processing in counseling is presented, and a research paradigm is described that considers cognitive processes and attempts to link such processes to the interactive behaviors of counselors and clients and to client learning outcomes. Some of the methodological and conceptual issues related to the operationalization of this cognitive mediational paradigm are considered, and a few illustrative research programs are described. (67 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Competence models in adult psychopathology: A report on a National Institute of Mental Health workshop.

Describes a National Institute of Mental Health workshop focused on psychological strengths. Topics spanned 4 principal domains of psychological strengths: self/personal, cognitive, biological/temperamental, and occupational/social perspectives. It is argued that much can be gained from redirecting the focus of clinical work, even with severely disordered clients, and research to include consideration of psychological strengths and protective factors. The need for developing strength assessment instruments is also considered. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Patients' attitudes toward advance directives and end-of-life treatment decisions

Much of the patient education about advance directives described in the literature involves explaining the purpose of advance directives to patients and guiding them through the process of issuing a directive. However, well over half of the subjects in this study claimed to know enough about the directives to issue one, and almost all subjects expressed a preference for issuing directives when healthy. Although health care agencies that wish to adhere to the PSDA must continue to ask all patients if they have issued an advance directive, aggressive patient education programs that press hospitalized patients to consider issuing an advance directive may be perceived by patients as coercive and uncaring. Patient education may be more likely to achieve the goals of the PSDA if it is provided before hospitalization and if patients are encouraged to discuss their care preferences with family members who would be in a position to speak for them at the end of life. Further study of the few patients who choose to issue an advance directive would be informative. When and why they chose to issue the directive should be explored. Patients who report issuing an advance directive but do not provide their physician or hospital with a copy of the directive upon admission should also be studied to determine if this represents a desire not to activate the directive during the current admission or simply confusion about the disposition of this document. Finally, most studies of advance directives have been cross-sectional. Longitudinal study of patients who issue advance directives are needed to determine the effectiveness of these documents in influencing the end-of-life treatment that patients receive.     

Stigma of psychological therapy: Stereotypes, interpersonal reactions, and the self-fulfilling prophecy.

Investigated stereotypes of counseling center clients and examined how these preconceptions influence social interaction. 136 undergraduates, told they were participating in a study of the acquaintance process in social interactions, were randomly assigned to be perceivers or targets. Ss engaged in a brief getting-acquainted conversation. Targets were randomly assigned to conditions in which perceivers were told that their conversational partner, the target, had been recruited either from among students seeking psychological therapy (clients) or from students in introductory psychology courses (nonclients). As was predicted, perceivers rated clients less favorably than they did nonclients before they interacted. Futhermore, consistent with previous research on the self-fulfilling prophecy, judges' ratings of the interactions revealed that perceivers behaved more negatively toward clients than toward nonclients, and clients came to behave in a less socially desirable manner than did nonclients. It is suggested that fear of rejection that makes people reluctant to seek psychological therapy appears to be justified. (30 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cultural commitment and attitudes toward seeking counseling services in American Indian college students.

Counseling attitudes were assessed for American Indian college students rating themselves as either strongly or weakly committed to both Tribal and Anglo cultures. Participants strongly committed only to Tribal culture displayed more negative attitudes toward seeking counseling, recognizing a personal need for counseling, having confidence in mental health professionals, and interpersonal openness than those strongly committed only to the Anglo culture or to both cultures. Strongly committed participants demonstrated more negative attitudes toward interpersonal openness than those weakly committed to both cultures. Women showed more positive attitudes toward these issues than did men. It is recommended that counselors consider cultural commitment in understanding the hesitancy among potential American Indian clients to use conventional psychological services. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The cancer specific advance directive

BACKGROUND: Advance directives are an important part of end of life care, but current advance directive documents do not address the specific issues facing cancer patients. The authors' purpose was: 1) to develop a cancer specific advance directive, 2) determine whether oncology outpatients find this directive more acceptable than a generic advance directive, and 3) describe oncology outpatient preferences for life-sustaining treatment. METHODS: A cancer specific advance directive ("The Cancer Living Will"; the full text of the updated version is available at the University of Toronto Joint Centre for Bioethics website [URL: www.utoronto.ca/jcb]) was developed in four steps: 1) literature search, 2) key informant interviews, 3) focus groups, and 4) evaluation of face and content validity. Subsequently, 91 volunteer oncology patients were given copies of the cancer specific advance directive and the generic advance directive ("The University of Toronto Centre for Bioethics Living Will") from which it was adapted. Acceptability of the advance directive was measured by determining the participants' preferred directive. Participants recorded their treatment preferences in both the cancer specific and generic advance directives. RESULTS: Of 60 patients who returned their questionnaires, 50 expressed a preference for the advance directive. Thirty-two patients (64%; 95% confidence interval (CI), 49-77%) preferred the disease specific Cancer Living Will and 18 patients (36%; 95% CI, 23-51%) preferred the generic Centre for Bioethics Living Will. Most participants who preferred the Cancer Living Will did so because it was more specific and relevant to their situation. CONCLUSIONS: The authors have developed and evaluated a cancer specific advance directive that they believe can be recommended for clinical use with cancer patients.