Keyness and Collocations of Therapeutic Rupture Types: A Pilot Study

This study was designed to examine the therapeutic alliance and specific rupture types that counselors experience in a counseling session by employing a cross sectional analysis of a linguistic corpus created from transcriptions of mock counseling sessions. A corpus linguistic program called #Lancsbox 6.0 was used to analyze the collocates of the top words found in therapeutic rupture types. Results of this study show that the word “just,” which was often used as part of a less direct filler expression, was the most frequent word in the confrontation rupture corpus as well as a top five word in the withdrawal and mixed rupture corpuses. Regarding the withdrawal rupture corpus, the node word “know,” a cognitive-oriented token that could create emotional distance, had four high intensity words (collocates), two of which (“I” and “you”) were shared with a confrontation type corpus. Regarding the mixed rupture corpus, the most common word “like” was often used as a preposition and was implicated in low empathy encounters and did not appear as a collocation in the confrontation or withdrawal rupture collocation analysis. Implications for both counseling and research are discussed.

Demographic and Clinical Predictors of Engaging in Tobacco Cessation Counseling at a Comprehensive Cancer Center

PURPOSE: To address challenges promoting tobacco cessation in oncology settings, it is important to understand characteristics associated with patient engagement in tobacco cessation treatment. This analysis examined predictors of participating in at least one tobacco cessation counseling session among patients referred to a comprehensive cancer center's Tobacco Intervention and Psychosocial Support (TIPS) service. METHODS: Patients with cancer who reported current smoking or recently quitting and referred to TIPS between June 2017 and February 2020 were included in the analysis. Independent variables included sex, race and ethnicity, insurance type, cancer diagnosis (tobacco-related or not), age, nicotine dependence, and cigarettes smoked per day at baseline. The outcome variable was completion of at least one tobacco cessation counseling session among those assessed by the TIPS program. Unadjusted and adjusted analyses tested associations between the independent variables and tobacco cessation counseling engagement. RESULTS: Of 360 oncology patients referred to the TIPS program, 224 (62.2%) were assessed and 120 (33%) engaged in at least one counseling session. After controlling for sociodemographics and tobacco use, the results demonstrated that patients diagnosed with tobacco-related cancers were 45.3% less likely to engage in the tobacco cessation program compared with those with non–tobacco-related cancers ( P = .041). CONCLUSION: Patients diagnosed with tobacco-related cancers were less likely to engage in TIPS. Additional therapeutic resources may be needed to engage these patients to address potential explanatory factors, such as stigma, guilt, and fatalism. More research is needed to explore the impact of a tobacco-related cancer diagnosis on treatment engagement.

Interactive Activities to Aid in a Comprehensive Understanding of Mental Health Within the Professional Athletic Training Curriculum

Context Mental health is a significant issue in the United States, with approximately 18.5% of adults and 22% of adolescents having a diagnosable mental illness. Athletic trainers are in a prime position to recognize signs of mental health illness in their patients and to facilitate referral to a mental health professional. Objective To introduce interactive approaches for developing mental health first aid and referral skills in professional athletic training students. Background Although the 2020 Commission on Accreditation of Athletic Training Education curricular content standards require programs to educate students about identification and referral for mental health conditions, the standards do not provide specific suggestions for instructing this content. Description Three educational activities have been implemented into the curriculum: an exploratory counseling session, Mental Health First Aid certification, and a standardized patient encounter. Clinical Advantage(s) The exploratory counseling session improves athletic training students' empathy for individuals living with mental illness. The Mental Health First Aid curriculum has been shown to raise awareness of mental health conditions and positively influence the number of people who receive professional help. Standardized patient scenarios have been shown to increase critical thinking and confidence with mental health cases and to increase knowledge in mental health assessment. Conclusion(s) Students' reflections support that these components have increased their competence and confidence in recognizing, intervening, and making referrals for individuals with suspected mental health concerns.

Ties That Bind

One of the most effective and proven ingredients of successful addiction treatment is the relationship between the therapist and patient. Known as a therapeutic alliance, the strong professional relationship is the most important piece of treatment and, unfortunately, one of the first things damaged when a patient enters a standard treatment facility. This chapter discusses the importance of the therapeutic relationships and how our system of care must change in order to build strong alliances. Touched on are the skills therapists should have and the most effective interventions therapists should know how to efficiently deploy in practice. Addressed are certain principles that should be continually monitored during a counseling session.

The Use of SMART Goals to Create Attainable Health Actions at Community Health Screenings

Background Frontera de Salud is a student-run, interprofessional health organization that delivers primary care to underserved populations in South Texas. The purpose of this project was to evaluate the effectiveness of, and longitudinal adherence to, SMART (specific, measurable, attainable, realistic, time bound) goals created with clients during the Frontera counseling session. Methods Prior to a trip, Frontera personnel received training on developing SMART goals. During the counseling session of the health screening, after a client had undergone tests to measure blood sugar and lipids, a Frontera counselor would create a personalized SMART goal with the client. Several months after the initial health screening, the Frontera client was contacted via phone call to discuss adherence to their SMART goal. Results Of a sample of 150 client records, 58 (38.7%) of those clients were able to be reached via phone call. Of those 58 clients, 38 (65.5%) reported adherence to the SMART goal created during their Frontera counseling session. For those 38 clients, 18 had a diet-related goal (47.4%), 3 had an exercise-related goal (7.9%) and 13 (34.2%) had a goal that encompassed both diet and exercise. Conclusions Among clients contacted for follow-up, almost two-thirds reported adherence to their SMART goal. The most efficacious goals were diet-related. Of concern, only 38.7% of clients were able to be reached for follow-up.

An Exploration of Client Experiences in a Combination of Individual and Family Counseling

Researchers explored client meaningful experiences in a combination of individual and family counseling in this constructivist phenomenological study. The sample consisted of seven participants (three families) who ranged in age from 10 to 51. Participant racial/ethnic identities included two White, two biracial, and two Black. Participant gender identities included five females and two males. Two interviews per client family (one interview following an individual counseling session and another following a family counseling session) revealed the following themes: (a) understanding self and others, with subthemes gaining understanding and acceptance of self, better understanding of each other and how to be with each other, and learning coping skills; (b) setting and working toward goals; (c) processing issues in session, with subthemes counseling is not always what we want, but is maybe what we need, and tension of family versus individual counseling; (d) the counselor; and (e) play.

The Use of Precision Nutrition Among African Americans With Chronic Disease

Objectives To characterize the effects of precision nutrition on dietary behavior change, weight, and waist circumference. To examine perceptions of receiving a personalized nutrition plan. Methods Food as Medicine Phase II is a pilot study that measured the effectiveness of incorporating precision nutrition to improve chronic disease management in a cohort of 24 low income African Americans with either pre-diabetes, type 2 diabetes mellitus, hypertension, elevated blood cholesterol levels, obesity or a combination of these disorders. Anthropometric measures and a food questionnaire were collected pre/post study. DNA samples were obtained from each participant and analyzed at Howard University on SNPs related to nutrient metabolism. Results from the DNA tests were incorporated in a detailed personal nutrition plan developed for each participant. Plans were presented and discussed during an initial individual face-to-face counseling session. Due to COVID 19, a second counseling session was conducted via Zoom. For three months after the 2nd counseling session, participants received weekly text messages reinforcing the information received. Results Participants reported significant improvements in their intake of most recommended foods. Reductions in weight, waist circumference, and in the reported intake of non-recommended foods and beverages were not significant. Most participants either strongly agreed (14) or agreed (4) that the personalized nutrition plan provided useful information. The coronavirus pandemic was mentioned by 20% of participants as a barrier to following their personalized nutrition plan recommendations. Conclusions The results suggest that a personalized approach in providing dietary recommendations utilizing precision nutrition has the potential to increase self-efficacy and improve dietary intake among low income African Americans with chronic disease. It also demonstrated that it is feasible to recruit and retain individuals of African ancestry to participate in an investigation that assesses and discloses gene-associated disease risk. Funding Sources Ardmore Institute of Health

A New Computer Application for Innovation and Evaluation in Counseling

To measure the effect of counselling, outcome measures are obtained after completion of a counseling session because measuring outcomes and changes that occur during and within the counseling session itself is problematic. This problem was addressed by a new method demonstrated with medical students.1 Rarely has a counseling session been documented by clients.2 Using the UfaceME® method, Clients or people acting as clients responded to a series of statements which were repeated every four minutes as they watched video-audio replay of their session. They then observed by viewing and rating a comparison of their responses with those of their counselor. This study shows the benefits of the UfaceME method as an application to measure change that occurs within a counseling session. Significant positive changes were demonstrated in clients’ perception and feelings towards the end of the session compared to the beginning. Implications and results to date include further counseling engagement, healthy behavioral and relational change, improved mental health, and improved self-awareness.

Audit of sweat chloride testing reveals analytical errors

Objectives Sweat chloride testing (SCT) is the mainstay for the diagnosis of cystic fibrosis (CF) and biomarker in the evaluation of CFTR-modifying drugs. To be a reliable and valid tool, analytical variance (CVA) must be minimized. However, external quality assessments have revealed significant deviations in routine clinical practice. Our goal was to identify and quantify technical errors through proficiency testing and simulations. Methods Chloride concentrations of three blinded samples (each as triplicates) were measured in 9 CF centers using a chloridometer in a routine setting. Technical errors were simulated and quantified in a series of measurements. We compared imprecision and bias before and after a counseling session by evaluating coefficients of variation (CV), adherence to tolerance limits, and inter-rater variability coefficients. Results Pipetting errors resulting in changes in sample volume were identified as the main source of error with deviations up to 41%. After the counseling session, the overall CVA decreased from 7.6 to 5.2%, the pass rate increased from 67 to 92%, and the inter-rater variability diminished. Significant deviations continued to be observed in individual centers. Conclusions Prevention of technical errors in SCT decreases imprecision and bias. Quality assurance programs must be established in all CF centers, including staff training, standard operating procedures, and proficiency testing.

The Impact of an Agent’s Voice in Psychological Counseling: Session Evaluation and Counselor Rating

As an agent delivers content during the communication between an artificial intelligence (AI) machine and a person, the voice of the agent is a crucial factor to be considered. Particularly in the fields of eHealth, the perception of users toward an agent is crucial as it significantly affects the communication between the agent and its patients, as well as the treatment results. Thus, this study examined the effects of the voice of an agent on the perception of users toward the agent and its counseling effects. This study developed a psychological counseling agent with four voices according to gender and age, communicated with the subjects through such agent, and measured the perception of users toward the agent and its counseling effects through a questionnaire. Results demonstrated that the female-voiced agent had a higher level of attractiveness than the male-voiced agent, regardless of the age of such voice, and the agent using an older voice had a higher level of expertness and depth than the agent using a younger voice, regardless of the gender of such voice. The findings of this study are expected to be effectively used to design a voice-based AI agent that considers the optimal voice according to the purpose of use.