Counseling expectations of clients and nonclients for group and individual treatment modes.

A questionnaire that measured expectations about counseling was completed by 40 male and 40 female undergraduates under group or individual counseling expectation conditions, 18 males and 27 females who had sought group counseling, and 20 males and 20 females who had sought individual counseling. An additional 22 males and 28 females indicated their attitudes toward the acceptability of group and individual counseling. Results indicate significant differences between the 2 modes, the sexes, and the 2 populations (clients and nonclients); however, no interaction effects were noted. Results are discussed in terms of how differential beliefs about group and individual counseling may affect participation rates and behaviors and how professionals may better promote counseling services. (17 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Counseling session impact as viewed by novice counselors and their clients.

The Session Evaluation Questionnaire (SEQ) was used to measure the perspectives of 17 graduate-student counselors and their 72 17–39 yr old clients on 942 individual counseling sessions along 2 evaluative dimensions—depth and smoothness—and 2 dimensions of postsession mood—positivity and arousal. A components-of-variance analysis showed that, from both perspectives, SEQ ratings varied greatly from session to session; ratings were only modestly predictable from differences among counselors or among counselor–client dyads. However, averages across 6–20 sessions permitted adequately reliable differentiation among dyads, for example, for comparisons with outcome measures. Correlations between corresponding counselor and client dimensions ranged from moderate to negligible, whether calulated across sessions, across clients, or across counselors, Novice counselors' judgments of session depth and value may have had little relation to their clients' evaluations. On the other hand, counselors' comfort in sessions and postsession positive mood were moderately predictive of client reactions. (32 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Preparing clients for alcoholism treatment: Effects on treatment participation and outcomes.

In this study, 126 clients (87 men, 39 women) entering outpatient alcoholism treatment were assigned randomly to 1 of 3 preparatory conditions: a role induction (RI) session, a motivational interview (MI) session, or a no-preparatory session control group (CG). Clients assigned to the MI preparatory condition attended more treatment sessions and had fewer heavy drinking days during and 12 months after treatment relative to CG clients. Clients assigned to MI, relative to CG clients, also had more abstinent days during treatment and during the first 3 months posttreatment, although this difference was not maintained through the remainder of the 12-month follow-up period. Clients assigned to the RI condition showed no significant advantage over those in the CG condition. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Day hospital and residential addiction treatment: Randomized and nonrandomized managed care clients.

Male and female managed care clients randomized to day hospital (n=154) or community residential treatment (n=139) were compared on substance use outcomes at 6 and 12 months. To address possible bias in naturalistic studies, outcomes were also examined for clients who self-selected day hospital (n=321) and for clients excluded from randomization and directed to residential treatment because of high environmental risk (n=82). American Society of Addiction Medicine criteria defined study and randomization eligibility. More than 50% of followed clients reported past-30-day abstinence at follow-ups (unadjusted rates, not significant between groups). Despite differing baseline severities, randomized, self-selecting, and directed clients displayed similar abstinence outcomes in multivariate longitudinal models. Index treatment days and 12-step attendance were associated with abstinence (p     

Strategies for preparing clients for treatment. A review

Substantial numbers of mental health clients do not return following their initial therapy visits or drop out of treatment prematurely. Two general classes of strategies designed to reduce premature attrition and enhance treatment participation are reviewed. Research on psychotherapy preparatory techniques (role induction, vicarious therapy pretraining, and experiential pretraining) indicates that these educational techniques are effective in reducing early treatment attrition and may be especially effective with populations at high risk for dropout (e.g., lower socioeconomic groups, chronically mentally ill clients, and institutionalized juvenile delinquents). Motivational interviewing, a technique originally developed for clients with alcohol problems, is designed to reduce client ambivalence toward therapy and change and enhance commitment to and motivation for treatment. Research in the alcohol field suggests that a session of pretreatment motivational interviewing enhances treatment outcome. Both motivational interviewing and psychotherapy preparatory techniques are relatively brief and easy to incorporate into existing mental health care.     

Ethical issues in the treatment of weight-dissatisfied clients.

A number of ethical issues must be considered in the treatment of clients who are dissatisfied with their weight. Current societal attitudes of opprobrium toward fat affect psychologists as well as the general public, and may have deleterious effects on the ability to provide competent, responsible, and respectful help to large clients, particularly women. Psychologists should be aware that weight status has a large biogenetic component and that dieting is remarkedly ineffective in producing long-term weight loss. Professionals tend to overestimate the harmful effects of obesity and underestimate the negative impact of dieting on physical and psychological functioning. It is proposed that psychologists accept diversity of body size as a manifestation of human differences, promote overall health over thinness, and help clients become self-accepting instead of self-depriving. (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)     

Psychological interventions with AIDS and HIV: Prevention and treatment.

In the decade since AIDS was first diagnosed, behavioral research has focused intensively on risk reduction change processes and, to a lesser extent, on mental health needs of persons with HIV conditions. Although research to date has yielded important findings for primary prevention efforts and has identified some psychological dimensions relevant to mental health interventions, there is a pressing need for much more systematic intervention outcome research in both the prevention/behavior change and emotional coping areas. Progress in these areas will be facilitated by better linkage of intervention approaches to behavioral theory; identification of intervention elements that produce HIV risk behavior change; evaluated field-testing of promising intervention models; continued focus on populations that remain at risk (such as gay men and iv drug users); and expansion of prevention efforts to urban, poor, and minority populations increasingly threatened as AIDS/HIV enters a "2nd wave." Although AIDS is still a relatively new problem, existing behavioral medicine conceptual models and intervention strategies can be adapted to meet the enormous challenges created by AIDS and HIV infection. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Preparing psychotherapy clients: Rationale and suggestions.

Few practitioners provide systematic preparatory information to beginning psychotherapy clients, although research data suggest that such preparation enhances therapeutic outcome. It is recommended that psychotherapists provide written information early in the treatment process. Although each practitioner may wish to add or delete certain components, it is suggested that such pamphlets should describe the nature of psychotherapy, responsibilities of the client and therapist, confidentiality, effectiveness and risks of treatment, alternative helping systems, and channels for registering complaints about treatment. Excerpts from such a preparatory pamphlet are included. (20 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Assessment and treatment of suicidal clients in a university counseling center.

Two studies addressed assessment and treatment issues pertaining to suicidal student-clients. In Study 1, the theoretical construction and psychometric properties of the Suicide Status Form (SSF) were described. Results suggest that SSF items have good convergent validity, strong criterion-prediction validity, and moderate test-retest reliability. In Study 2, the SSF was applied to a sample of suicidal student-clients. Results suggest differences between client and clinician pretreatment SSF ratings. Client (not clinician) pretreatment SSF ratings could be used to correctly classify clients into acute resolver and chronic nonresolver treatment-outcome groups. Whereas all suicidal student-clients globally improved with treatment, chronic nonresolvers remained suicidally preoccupied throughout the academic year. These findings are discussed with regard to training, clinical practice, and future research. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A survey of psychologists' education, knowledge, and experience treating clients with HIV/AIDS.

Practicing psychologists are providing services to persons with HIV infection and those at-risk for AIDS. However, most practitioners have not received formal training about HIV/AIDS. In this study, the majority of psychologists surveyed had treated persons at-risk for the virus but had not received HIV/AIDS information in formal educational programs. Most respondents obtained knowledge through popular media. There is a growing body of specialized knowledge about HIV/AIDS for mental health professionals. In addition to better serving HIV-infected clients, psychologists with current multidisciplinary HIV/AIDS knowledge will be valuable members of health care teams. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Group treatment for dually diagnosed clients

Group treatment is a widely practiced intervention for persons with dual diagnoses. This chapter reviews the rationale for group treatment and discusses four different approaches to group intervention: twelve-step, educational-supportive, social skills, and stagewise treatment.     

Reactions to the names "Counseling Center" and "Psychological Center."

A questionnaire administered to 376 college students on 3 campuses found consistent differences in Ss' reactions to the names counseling center (CC) and psychological center (PC). CC was associated with the treatment of minor problems and PC with more serious problems. PC was also seen as more medical, expensive, professional, embarrassing to go to, and competent than CC. The CC-PC differences are related to issues in clinical and counseling psychology. (17 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Training psychologists to work with minority clients: A prototypic model with Black clients.

Presents evidence that indicates the failure of current training programs to train clinicians to meet the psychotherapeutic needs of minority clients. Major problems with current training models are their deficiency in providing professionals with sufficient skills to retain minority clients in therapy and their violation of psychologists' ethical standards as established by the American Psychological Association. A course designed to explore issues relevant to the understanding and assessment of minority clients' psychological problems and to provide insights into effective therapeutic intervention for these problems is described. (37 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

AIDS: new developments. VI. HIV reservoirs during intensive antiretroviral treatment

Treatment of human immunodeficiency virus (HIV) infected persons with potent antiretroviral combination therapy results in a strong decline of the viral load in the blood. Whether this effect is reached in all tissues and different infected cell types is an important question. There are several potential virus reservoirs. Lymphoid tissue constitutes the largest virus compartment. With potent, often protease inhibitor containing combinations the HIV-RNA decline in lymphoid tissue runs parallel to that in the blood. The central nervous tissue is a potentially important reservoir, because of the limited penetration of several antiretrovirals, especially protease inhibitors. A few short studies with different combinations showed a decline of the amount of virus in the cerebrospinal fluid. The risk of local resistance developing is not known. There are only few studies of the effects of potent anti-HIV therapy on semen but prostate and testis tissue do not appear inaccessible to treatment. The reservoir of latently infected cells that cannot be reached by the immune system or by the viral replication inhibiting therapy, can possibly be reached with immune stimulating agents. This will cause HIV replication and cell death, while the anti-HIV therapy will prevent further replication of the produced virions. This approach is still experimental, however.     

A self-help group for drug-addicted clients. Assisted implementation in outpatient treatment

26 subjects aged 7-18 years were studied. Diagnoses of bipolar disorders were established using the Kiddie-Schedule for Affective Disorders and Schizophrenia-Present Episode Version-1986 modified for DSM-III-R criteria and for rating the number and duration of manic and hypomanic episodes. Complex cycling patterns were observed. These included numerous brief episodes suggesting continuous rapid-cycling in 80.8% of cases. Mean age of onset was early (8.5 +/- 4.4 years). Psychotic phenomena, suicidality, hyperactivity and 'mixed mania' were highly prevalent. Data in this report provide support for complex and rapid-cycling patterns in childhood onset bipolar disorder.     

高危性行为与性病艾滋病知识及感染状况调查

目的 了解宜昌市嫖客人群艾滋病相关知识、高危行为方式、艾滋病(AIDS)及性病(STD)感染状况.方法 采用个人访谈的形式对450名嫖客人群进行了相关调查与HIV/STD感染状况检测.结果 450名嫖客中有关艾滋病传播等知识单题知晓率在40.56%～90.37%之间;嫖客中阴道交、口交和二者并存分别占81.11%、5.11%和13.78%,其安全套使用率分别为46.03%、4.35%和33.87%,差异具有显著性意义(x2=17.20,P＜0.01);嫖客中HIV抗体、梅毒和生殖道沙眼衣原体检出阳性率分别为0.44%、4.65%和6.13%,生殖器疱疹和尖锐湿疣现患率分别为5.66%和9.43%,4种性病的未使用安全套暴露组与全程使用安全套对照组的相对危险度RR值在7.46～13.91之间,差异具有极显著性意义(x2值在7.01～11.09之间,P＜0.01).结论 宜昌市嫖客人群中的性传播疾病知识知晓率与安全套使用率相对较低,HIV/STD感染率较高,应加强嫖客与暗娼人群的行为干预.     

AIDS treatment advances and behavioral prevention setbacks: Preliminary assessment of reduced perceived threat of HIV–AIDS.

Recent advances in AIDS treatment have brought renewed optimism for prolonging the lives of those infected with HIV. This article examined beliefs about how new treatments may reduce HIV transmission risk among 298 HIV-negative gay and bisexual men attending a gay pride festival. Results from an anonymous survey showed that men who practiced unprotected anal intercourse as the receptive partner (UAR intercourse) were younger, less well educated, and more likely to believe that it is safe to have UAR intercourse with an HIV-positive man who has an undetectable viral load and that new treatments for HIV relieve their worries about unsafe sex. As HIV treatments continue to advance, new challenges for HIV prevention will likely emerge. (PsycINFO Database Record (c) 2010 APA, all rights reserved)