Parents’ Perspectives on Counseling for Fetal Heart Disease: What Matters Most?

After diagnosis of congenital heart disease (CHD) in the fetus, effective counseling is considered mandatory. We sought to investigate which factors, including parental social variables, significantly affect counseling outcome. A total of n = 226 parents were recruited prospectively from four national tertiary medical care centers. A validated questionnaire was used to measure counseling success and the effects of modifiers. Multiple linear regression was used to assess the data. Parental perception of interpersonal support by the physician (β = 0.616 ***, p = 0.000), counseling in easy-to-understand terms (β = 0.249 ***, p = 0.000), and a short period of time between suspicion of fetal CHD, seeing a specialist and subsequent counseling (β = 0.135 **, p = 0.006) significantly improve “overall counseling success”. Additional modifiers (e.g., parental native language and age) influence certain subdimensions of counseling such as “trust in medical staff” (language effect: β = 0.131 *, p = 0.011) or “perceived situational control” (age effect: β = 0.166 *, p = 0.010). This study identifies independent factors that significantly affect counseling outcome overall and its subdimensions. In combination with existing recommendations our findings may contribute to more effective parental counseling. We further conclude that implementing communication skills training for specialists should be considered essential.

Self-disclosure in Online versus “Face-to-Face” Counseling: A Survey among Clients (Preprint)

BACKGROUND Research proves the effectiveness of psychological interventions in online settings. There is some evidence that people disclose more personal information online than in real life, however, the results appear inconsistent. OBJECTIVE The primary aim was to find out whether people in online counseling disclosed more than individuals receiving “face-to-face” counseling, whether there were differences between the two settings in regard to counseling outcome and whether people in online counseling disclosed more about the counseling to confidants. METHODS A survey was carried out in various counseling centers offering both online and “face-to-face” services. The Disclosure to Therapist Inventory-VI was used to assess the amount of self-disclosure in both settings. Clients’ attitudes towards revealing counseling aspects to other people in their lives were assessed using the Disclosure About Therapy Inventory. In total N= 80 respondents completed the survey, 31 participants received online counseling (38.8%), 49 people had “face-to-face“ counseling (61.3%). RESULTS Contradicting the hypothesis, the present study disproved the assumption that self-disclosure is higher in online counseling. Whereas both samples showed similar levels of disclosure on different counseling topics, clients in “face-to-face” situations revealed significantly more about two topics: self-actualization vs. adaptation (P= .010, d= 0.6) and self-doubt/shortcomings (P= .003, r= 0.33). Two treatment characteristics, namely counseling duration and motives affected the degree of disclosure. In regard to the counseling outcome participants were moderately satisfied in both groups. People in “face-to-face” counseling reported significantly better treatment outcome in regard to the increased capacity to relate well to others (P= .026, r= 0.25). The assumption that a higher level of self-disclosure is associated with better treatment outcomes was verified only for online counseling (P= .024, ß= .470). Clients in both settings disclosed moderately about aspects of their counseling to confidants with no significant differences between the two groups. CONCLUSIONS The present study could not prove the online disinhibition effect for the counseling setting. As the number of studies conducted on this topic is relatively small the present study calls for further research on larger samples. Thereby, incongruities on self-disclosure can be clarified, possibly leading to the revision of current theories or the development of new ones.