对心理咨询及咨询师的期望与要求的研究

目的：了解中国人对心理咨询及咨询师的期望和要求。方法：分别让来访者回答“您认为目前的心理咨询工作存在什么问题”和“您认为咨询师应该是什么样的人”两个开放式问题,及让咨询师自由地写出5条对咨询师的要求。结果：有45．53％和49．59％的来访者作了回答。存在问题较为突出的依次为：不普及,质量和效果不好,不方便,担心守密问题及太贵等。对咨询师的期望较为集中的依次为：丰富的知识,娴熟的技术,态度好,像长辈,有丰富的经验和阅历,口才好,像朋友,像老师,高尚的品德等。男女之间在对咨询师的期望中提及“朋友”及希望咨询师为长者或具备丰富的阅历上存在差异。对咨询师期望中,来访者和咨询师之间在心理品质及知识、技术和能力的比例上存在差异。结论：社会文化、性别、不同角色等均是对心理咨询及咨询师期望和要求的影响因素。     

大学新生对心理咨询的态度

目的了解大学新生对心理咨询的态度和要求。方法根据自编问卷逐题呈现、个别访谈315名普通高校的新生。结果63．5％的被访者愿意去心理咨询;被访者认为自己寝室中有23．3％的人需要接受心理咨询;近8成的被访者将心理咨询作为解决日常心理困扰的手段,而2成多的则认为是“心理有病”才去;被访者对心理咨询室的要求首要条件是安静,对咨询师的首要要求是平易近人;这两方面的要求男女有别。结论还需进一步加强心理咨询宣传工作,并对咨询师和咨询室做出适应来访者性别差异的安排。     

咨询师与非咨询师对网络心理咨询伦理规范的态度

目的:探讨咨询师与非咨询师对网络心理咨询伦理规范的态度。方法:选取咨询师91人(年龄23~63岁)和普通大众及来访者(非咨询师)91人(年龄14~44岁),采用自编网络心理咨询伦理问题调查问卷进行调查。结果:网络心理咨询的优势排在前3位的是"突破空间障碍"、"可以不用真实姓名"、"网络咨询更放松"。关于心理咨询的合理收费,咨询师认为的心理咨询收费的合理价格与非咨询师认为的合理价格差异有统计学意义(P0.001)。咨询师及非咨询师在网络心理咨询伦理态度的23个条目上差异有统计学意义(均P0.05),差异主要存在于对咨询关系、咨询收费与设置的态度上。结论:本研究提示,在网络心理咨询的伦理态度上,咨询师和非咨询师的看法存在一定的差异。     

新手咨询师首次心理咨询实践的专业技能表现

目的:探讨新手咨询师在首次心理咨询实践中专业技能表现的特点。方法:选取某高校心理咨询方向一年级研究生8名为新手咨询师,在同校招募8名大学生志愿者为来访者,对首次心理咨询实践录像,转录文本后进行定性分析,依据Jennings和Skovholt提出心理咨询师专业水准的认知、情绪及关系模型分析新手咨询师专业技能的表现。结果:新手咨询师在单次心理咨询会谈中旨在建立关系所占比例最高,占总体反应的38.48%;对情绪的探索和关注所占比例最低,仅为20.98%。在认知方面,新手咨询师容易受到自身认知的制约,或认同来访者被动接纳或拒绝来访者试图引导改变;在情绪方面,新手咨询师容易忽略来访者的情绪而陷入讲道理的困境,因急于影响来访者而焦虑;在关系方面,新手咨询师很难整合不同角色使专业关系出现问题,或放低专业姿态或执拗于咨询师身份。结论:新手咨询师对来访者的情绪关注不足,认知的开放性尚需提高。     

咨询师使用社交媒体的伦理议题

目的:从来访者视角了解心理咨询师使用社交媒体的情况,探讨相关伦理议题。方法:自编"来访者如何看待咨询师使用社交媒体"问卷,于2017年1~2月采用互联网匿名调查,共收到有效问卷434份[男86人,女348人,年龄(36±7)岁]。结果 :被调查的来访者中51.6%通过社交媒体获取心理咨询和咨询师的信息,35.9%使用社交媒体接受心理咨询。伦理议题包括咨询师未就网络问题的保密性、安全性、真实身份与来访者告知知情同意;来访者与咨询师互加微信、QQ等并在咨询外互动,带来多重关系;咨询师在个人社交媒体的自我暴露让来访者产生负面感受;来访者看到咨询师使用社交媒体进行广告宣传、培训授课时存在夸大宣传、暴露来访者隐私情况等。结论:咨询师使用社交媒体进行心理咨询涉及诸多伦理议题,保密性、多重关系等因互联网特点更加复杂或隐蔽;咨询师在个人社交媒体自我暴露的伦理议题尤其需要引起关注。     

心理咨询中的依恋关系研究综述

依恋理论为心理咨询提供了重要的理论基础,来访者和咨询师会在咨询中建立依恋关系,其关系的互动与发展也是帮助来访者改变和修复的过程。本文梳理了近年来有关心理咨询中依恋关系的实证研究,从来访者的成人依恋、咨询师的成人依恋、双方依恋模式互动、来访者对咨询师的依恋、来访者依恋模式的转化这几个角度综述了依恋关系对心理咨询过程及结果的影响,总结了现有研究的成果与不足,并展望了未来的研究方向。     

即时文字网络心理咨询的社会临场感研究

目的:探索即时文字网络心理咨询中社会临场感的呈现形式、因缺乏社会临场感引发的问题及特有的咨询策略。方法:根据方便取样原则,10名心理咨询师及其来访者自愿参与研究,运用定性研究方法对10例即时文字网络心理咨询记录进行文本分析。结果:1即时文字网络心理咨询在开始阶段、中间阶段、结束阶段以不同形式呈现社会临场感;2由于缺乏社会临场感,在即时文字网络心理咨询中移情和反移情表现更加充分,咨询师权威降低更容易被拒绝;3为增强社会临场感可采用特殊咨询策略,如咨询师与来访者交叉式反应,咨询师需要以密集对峙提供紧张感。结论:社会临场感是影响即时文字网络心理咨询效果的重要因素。     

心理咨询和治疗行业相关人员的伦理意识

目的:了解我国当前心理咨询与治疗行业心理咨询和治疗师、应用心理系学生、参加心理咨询师培训人员的伦理意识现状.方法:对全国范围内601名心理咨询和治疗师,广州、珠海市344名应用心理系学生,以及广州201名参加心理咨询师培训人员,以自编“心理咨询或治疗伦理问题调查问卷”进行调查.结果:三组人员伦理判断有统计学差异的26个条目中,应用心理系学生认同比例较高的有19条,参加培训人员认同比例较高的有4条,心理咨询师认同比例较高的有3条.43.9％的心理咨询师认同“告诉来访者自己生他(她)气了”,远高于心理系学生的19.8％及参加培训人员的21.9％.同时,14.5％认可“因对来访者愤怒而提高嗓音对其说话”,远高于心理系学生的6.4％及参加培训人员的6.5％.三组人员中均有超过30％认可“和朋友不提名字地讨论来访者的事”,“向自己的学生或被督导者、雇员提供咨询”及“与以前的来访者成为生活中的朋友”,约80％赞成“在来访者可能自杀或杀害他人时突破保密原则”,约50％赞成“因为自己的某些突发事件,更改固定的治疗时间”.52.5％心理系学生、37.3％心理咨询师及34.3％培训人员认同“使用计算机化的测验解释报告”.结论:在心理咨询与治疗行业内部,咨询师、参加心理咨询师培训人员及应用心理系学生的伦理判断有一定差异.其中,心理系学生的伦理意识与其他两组人员相差较大,在多个条目中的伦理判断较差,需引起重视.     

选择不同收费水平的来访者的咨询效能与咨询满意

根据Strong提出的社会影响力理论(social influ ence theory),心理咨询是一个人际影响力的过程,只有当来访者认为咨询师具有专业性和吸引力并值得依赖时,才会在咨询过程中产生咨询效能[1].已有研究发现,咨询师的收费高低可能会影响来访者对其咨询效能的知觉[2-3],不过与来访者的咨询满意之间似乎没有直接的关系[4].本研究以来访者的角度为出发点,检验这些选择不同收费水平的来访者对咨询师的咨询效能的知觉及和咨询满意之间的差异.     

心理咨询师能为来访者提供什么?

当我还是一名实 习心理咨询师的时候,在每次开展心理咨询之前,我时常会担心自己的来访者是否能够从此次心理咨询中获益.我一直反问自己,作为一名心理咨询师,我到底能给来访者提供哪些实质性的帮助?在心理咨询中来访者最大的收获是什么?这样的担心消耗掉我很多认知资源,也是一直困扰我的问题.但是,随着一次心理咨询的开展,我逐渐找到了...     

不同性别、年龄的来访者对心理咨询的态度比较

目的：了解不同性别、年龄的来访者对心理咨询的态度。方法：用自编调查表让123名来访者无记名填写。结果：男女之间在最先求助对象、咨询方式以及对咨询师的信任程度上，存在明显不同。在不同的比较中我们发现差别更大，不仅仅表现在咨询的内容上，更多地表现在对心理咨询的态度、咨询对象的选择、对咨询及咨询师的信任程度及心理咨询的作用上。结论：在心理咨询中应该根据不同性别、年龄的来访者对心理咨询的态度的不同，因人而异，针对不同来访者的特点，选择和采取不同的态度和方式，因势利导，更好地发挥心理咨询的作用，促进咨询的成功。     

Goals, benefits, and outcomes of genetic counseling: client and genetic counselor assessment

Most studies of outcomes of genetic counseling have focused on client knowledge, reproductive plans and behavior, or satisfaction. Other measures of the "value" of genetic counseling are needed to guide research assessing the impact of genetic counseling on individuals and populations, as well as to improve the process of providing care. To obtain input from providers, we conducted telephone interviews with six experienced genetic counselors, and then we held a focus group with 10 additional genetic counselors from a variety of practice settings. To obtain input from consumers, telephone interviews were also conducted with 19 past clients of these participating counselors. We found that counselor goals focus on meeting clients' needs, usually educating and providing psychosocial support. Clients often had few goals going into a session because they were unaware of what would be discussed or how the session would be structured. They usually did not expect to receive "counseling," and when they did, it was a welcome surprise. Both clients and counselors commented that a positive interpersonal interaction and "connecting" are primary measures of success. All clients appreciated the large amount of time spent with the counselor, and the manner (clear, comprehensive, and unhurried) of providing information. Many clients said that genetic counseling resulted in improved communication with their partners and other family members. Clients view the counselor as an "expert" and value the counselor as an on-going resource for both information and support. These "outcomes"f genetic counseling need to be assessed, and new measures must be developed.     

对大众心理咨询态度的调查及干预研究

目的了解大众对心理咨询的基本认识及态度,探讨个体心理咨询干预对大学生心理咨询态度的改善。方法自行编制心理咨询态度调查问卷,对扬州1159名群众进行调查。选取19名扬州大学本科生,根据是否接受心理咨询分为实验组与对照组,通过自编问卷前后测进行比较研究。结果①调查中,74.2%的人认同＂当今社会不少人需要心理咨询＂（2χ=942.696,P=0.000）;62.7%否认＂心理问题是否解决完全取决于咨询师＂（χ2=667.435,P=0.000）;42.8%认为心理咨询给人神秘感觉（χ2=587.69,P=0.000）;②男女在开放度上存在极其显著差异（t=3.168,P=0.002）;咨询师与非咨询师在求助信任（t=3.953,P=0.000）、容忍度（t=3.961,P=0.000）和开放度（t=7.078,P=0.000）3项上存在极其显著差异;而国内与国外在求助信任（t=-0.498,P=0.619）、容忍度（t=-0.133,P=0.894）、需求度（t=-1.66,P=0.098）、开放度（t=-1.325,P=0.186）上均无显著差异;③干预后,实验组与对照组在求助信任（t=1.16,P=0.262）、容忍度（t=0.16,P=0.875）上由不显著差异转为显著差异（t=2.622,P=0.018;t=2.488,P=0.048）。结论男性与女性、咨询师与非咨询师对心理咨询的态度存在很大的不同;心理咨询干预对改善大学生心理咨询的态度有一定效果,尤其在求助信任、容忍度2个方面。     

Education about genetic testing for breast cancer susceptibility: patient preferences for a computer program or genetic counselor

The purpose of this study was to describe and compare patient preferences for a genetic counselor or an interactive computer program for various components of genetic education and counseling for breast cancer susceptibility. As part of a randomized intervention study on genetics education and counseling for breast cancer risk, 29 women at moderate risk were educated by both a genetic counselor and an interactive computer program. After both educational interventions, participants completed Likert-style and open-ended questionnaires about what they liked most and least about each intervention, and whether they preferred the counselor or computer for a variety of tasks. Participants were largely satisfied with both the computer program and the genetic counselor. A majority preferred the genetic counselor for addressing their concerns, discussing options and alternatives, being sensitive to emotional concerns, helping to make a decision, being a good listener, assuring understanding, helping to make a good choice, helping to understand genes and breast cancer, telling them what they needed to know, being respectful, setting a relaxed tone, and putting them at ease. However, a majority of the women either preferred the computer program or were neutral about allowing patients to learn at their own pace, helping to avoid embarrassment, making good use of time, explaining genes and breast cancer, and treating the patient as an adult. Qualitative analysis of open-ended questions affirmed that patients valued the personal interactions with the counselors, and liked having their specific questions answered. They liked that the computer was self-paced, informative and private, and could be used without causing embarrassment. We concluded that a computer literate, mostly white group of women at moderate risk for inherited susceptibility to breast cancer preferred interacting with a genetic counselor for personal, individualized components of the genetic counseling process, but accepted or preferred a computer program for being self-paced, private, and informative. By incorporating such a computer program into the genetic education process, it is possible that genetic counselors would be able to spend more time performing the personal, individualized components of genetic counseling.     

Perception of theoretically derived counseling approaches as a function of preference for counseling orientation

Examined the relationship between preference for major counseling orientations and perception of counselor behavior in theoretically derived counseling interviews. Seventy-seven undergraduate students viewed demonstration interviews by Rogers and Lazarus, rated the counselor behavior on the Counselor Rating Form, and were assessed in their endorsement of seven major counseling orientations. A regression analysis performed on the preference scores for seven counseling orientations (predictors) in response to the counselor perception scores on the Counselor Rating Form showed a significant relationship only between the client-centered orientation and Rogers. Lazarus was not predicted from any of the seven orientations. Additional analysis of the Counselor Rating Form data revealed that Lazarus was perceived as more expert, attractive, and trustworthy than Rogers. The results are discussed in relation to previous studies.     

Satisfaction with genetic counseling for BRCA1 and BRCA2 mutations among African American women

OBJECTIVE: The objective of this study was to evaluate satisfaction with genetic counseling for BRCA1 and BRCA2 (BRCA1/2) mutations among African American women. METHODS: Participants were 54 African American women at moderate and high risk for BRCA1/2 mutations who were offered genetic testing as part of a randomized clinical trial designed to compare the effects of culturally tailored genetic counseling (CTGC) and standard genetic counseling (SGC). Satisfaction with genetic counseling was evaluated using a self-administered questionnaire following culturally tailored or standard pre-test education and counseling. RESULTS: Overall, the majority of women (96%) were very satisfied with genetic counseling; however, only 26% reported that their worries were lessened and 22% reported that they were able to cope better. Women who received CTGC were significantly more likely than women who received SGC to report that their worries were lessened (p<0.05). In addition, women with household incomes less than US$ 35,000 were significantly more likely to report that the counselor lessened their worries compared to women with higher incomes (p<0.05). CONCLUSIONS: Most African American women were satisfied with genetic counseling; however, women who received culturally tailored genetic counseling were significantly more likely to strongly agree that their worries were lessened compared to women who received standard genetic counseling. PRACTICE IMPLICATIONS: Discussion of cultural beliefs and values during genetic counseling may be beneficial to African American women, especially those with low incomes.     

高校心理咨询员专业认同的初步研究

目的：了解高校心理咨询员专业认同的现状及其对心理咨询工作的影响。方法：焦点访谈小组包括8位心理咨询员．来自北京7所高校，以类属分析方法对访谈结果进行分析。结果：归纳出三部分内容：内部认同指咨询员对咨询工作及自身是否适合咨询工作的认识；外部认同指咨询员所理解的外部对咨询工作及对咨询员的认识，还包括咨询分支在心理学科的地位，咨询工作在高校工作中的地位；内部认同与外部认同相互关联，其中内部认同具有决定性作用。结论：新近参加工作的高校心理咨询员存在专业认同问题。     

Uncertainty and perceived personal control among parents of children with rare chromosome conditions: the role of genetic counseling

Little is known about the impact of genetic counseling on parental uncertainty or perceived control regarding the prognosis of a child with a chromosomal disorder. By exploring the parents' concerns and needs surrounding the child's diagnosis, a genetic provider can help to facilitate effective coping. This study tested the association of measures of parental uncertainty and perceived control with the perceived helpfulness of the genetic counselor. A survey was distributed to 875 members of the Chromosome Deletion Outreach (CDO) support group. We hypothesized that parents' perceptions about the helpfulness of the genetic counselor would modify the relationship between perceived uncertainty, perceived control, and coping. Among the 363 respondents, there was a significant negative correlation of the perceived helpfulness of seeing a genetic counselor with the levels of uncertainty (rs = -0.20, P-value < 0.001). Lower perceived helpfulness of the genetic counselor, along with less perceived personal control, less benefit of a diagnosis, and lower parental age were significant predictors of the highest perceptions of uncertainty. The Transactional Model of Stress and Coping was used as a framework for interpreting the relationships between parental uncertainty, perceived control, and outcome variables. There was a significant positive correlation between parents' perceived personal control and their reports of helpfulness of the genetic counselor (rs = 0.20, P-value <0.0006). Genetic counseling can be enhanced for parents faced with rare disorders by using interventions focused on reducing feelings of uncertainty and enhancing feelings of control.     

Client reactions to genetic counseling: self-reports of influence

Of 628 clients completing questionnaires six months after genetic counseling, 273 (43.5%) reported that their reproductive plans had been influenced by the counseling session. Of those who said that they were influenced, 144 (52.7%) held the same reproductive plans that they reported before counseling: 41 (15%) were planning more pregnancies, 36 (13.2%) were planning fewer, and 52 (19.1%) became reproductively uncertain. A similar pattern of stability and change appeared in the reproductive plans of those who reported that they were not influenced by genetic counseling. Stepwise logistic regression indicated that clients who reported that their plans were influenced: came to counseling to get information for making a decision about whether to have a child; discussed this decision in depth with the counselor; and had more education than clients who said that they were not influenced. We found no evidence that counseling was supplanting clients' own personal values. In the discussion, we suggest several reasons why clients of higher socio-economic status are more likely than others to report that they are influenced, and discuss the ethical implications of these results.