Working with domestic violence: Ethical dilemmas in five theoretical approaches
Therapists working with domestic violence are trained in many different theoretical models, each based on different values and assumptions. Each model raises different ethical dilemmas. In this paper, five theoretical approaches are evaluated in relation to the ethical principals of: respect for clients' autonomy: beneficence: non-maleficence: and justice. The inverse relationship between respect for autonomy and beneficence and non-maleficence is discussed. The hierarchical asymmetry involved in the therapeutic relationship is also explored.
Constructing a Sense of Self Following Early Sexual Experiences with Adults: a Qualitative Research Study
The aim of this research project was to develop a fuller understanding of the process of constructing a sense of self following early sexual experiences with an adult. Using narrative inquiry, a sample of twenty-two men and women aged twenty-five to seventy were interviewed about their early sexual experiences, at the age of fifteen or under with someone over eighteen. Participants told four different narratives about these experiences: narratives of silence; of ongoing suffering; of transformation and transcendence. These four narratives have been examined in the light of the literature relating to childhood sexual abuse, and the victim and survivor discourses. To an extent they changed current conventional views about child sexual abuse. The implications for therapists working with men and women who have experienced child sexual abuse are discussed.
The Impact of Psychosocial Development and Attachment Styles on Subsequent Partner Selection and Marital Satisfaction in South Korea
This study explores the impact of the psychosocial development and attachment styles of individuals on subsequent partner selection and marital satisfaction among Korean couples. A sample of 100 co-habiting Korean married couples (N=200) and 100 couples planning to marry (N=200) were collected via convenience sampling, and this research focuses on heterosexual couples. Data were assessed using four psychological measures consisting of 162 questions, which solicited socio-demographic data, the degree of unfulfilled psychosocial tasks and psychosocial resources, the attachment styles and the quality of the couple's relationship. The data was analyzed using descriptive statistics: Chi-square, t-test, Mann-Whitney U test, ANOVA, and a Tukey post hoc analysis. The findings indicate that similarities exist between partners in partner selection in both married and planning to marry couples in their psychosocial development and attachment styles.
How Counsellors Cope with Traumatized Clients: Personal, professional and organizational strategies
This qualitative study examined the experiences of counsellors and their perceptions of resources that helped them cope with traumatized clients and difficult client sessions. The research was conducted using in-depth interviews with a purposive sample of eight counsellors working in five counselling agencies. The study identified how counsellors develop their own personal and professional strategies for coping with challenge, and the supportive structures and coping strategies provided by agencies. From these counsellors' stories of learning to cope with traumatized clients and traumatic material, we highlight some recommendations that may facilitate the development of effective coping strategies for the prevention or amelioration of vicarious traumatization.
Opportunities and challenges of FIFO and DIDO healthcare services in rural and remote Australia
Objective: Most rural and remote regions face chronic health workforce shortages. Strategies designed to redress this problem include Fly-In Fly-Out (FIFO) and Drive-In Drive-Out (DIDO) health services. The aim of this paper is to examine the opportunities and challenges involved in these forms of service delivery. Design: Detailed review of recent literature relating to FIFO and DIDO services in rural & remote Australia. Results: FIFO and DIDO have obvious short-term benefits for rural Australians seeking health care services in terms of increasing equity and accessibility to services and reducing the need to travel long distances. However, there are significant long-term disadvantages such as the potential for burnout among FIFO and DIDO health professionals who travel long distances and work long hours, often without adequate peer support or supervision. A further disadvantage, particularly in the use of visiting medical practitioners to provide generalist services, is the lack of development of a sufficiently well-resourced local primary health care system in small rural communities.Conclusions: Given the potential negative consequences for both health professionals and rural Australians, this paper cautions against the increasing use of FIFO and DIDO services, without the concurrent development of well-resourced, funded and staffed primary health care services in rural and remote communities.
Collectivistic Culture of Vietnamese in Australia and the United States: Implications for Psychotherapy
Research related to psychotherapy conducted in Australia and the United States indicates that Southeast Asians are not as receptive to mental health services as their Caucasian counterparts. Prior research has explored underlying factors that result in Asian clients’ reluctance to seek therapy as a viable option to ameliorate their psychological issues. Little is understood regarding whether traditional models of therapy are well suited for Vietnamese clients. In this study, 27 Vietnamese participants over the age of 18 were recruited from Australia and the United States. Using narrative inquiry methodology, participants were invited to discuss Vietnamese attitudes towards psychological distress, how cultural values affect their attitudes towards psychotherapy and its relevance for addressing their personal concerns and psychological problems. Findings from the study related to three main themes: the collectivist perspective of Vietnamese immigrants; the cultural rift between those that maintain traditional values and those that have assimilated to a Western, more individualist perspective; and Vietnamese ideas about psychotherapy. The importance of understanding the collectivistic culture of Vietnamese clients in the context of mental health services is discussed in detail. The mismatch between traditional, individualistic therapy concepts and clients who remain collectively oriented, despite exterior adaptations to Western culture, needs to be recognized. This research challenges the field of psychotherapy to re-examine whether Western therapy adequately fulfills the needs of Vietnamese clients and highlights the importance of collectivist considerations, hierarchical relationships, communications styles, and the cultural rift. Recommendations are made for adapting psychotherapy to better suit Vietnamese clients.
Understanding the complexity of child sexual abuse: A review of the literature with implications for family counseling
Working with families in which there have been incidences of child sexual abuse is one of the most challenging assignments for a family counselor. Beyond ethical and legal mandates for reporting such assaults, less is understood about the long-term effects on victims. After reviewing the literature on child sexual abuse and gender differences, this article critically examines the major approaches to understanding and treating such issues in family counseling. Clinicians are cautioned to examine their own assumptions about the meaning of such experiences for their clients. Implications are discussed for the practice of family counseling.
Navigating the Challenges of Trauma Counselling: How Counsellors Thrive and Sustain Their Engagement
This qualitative study explored the factors that help counsellors exposed to indirect trauma thrive personally and professionally, and sustain their engagement in trauma counselling work. The existing literature details the challenges of indirect trauma exposure in trauma work. However, the ways in which counsellors are able to derive rewards and maintain their engagement in trauma counselling work are less well recognised. The study used a grounded theory approach, with semistructured interviews conducted with 18 therapists. The study found four main interrelating themes: thriving in trauma work; navigating the empathic journey; empathic stamina and engaging in self-reflexivity; and sustaining interest and commitment. Important factors included attending to both the adverse and rewarding aspects of trauma work, having access to appropriate support structures, and incorporating variability and diversity in the work. This study extends the current understanding of the processes, practices, and strategies that promote the rewarding and sustaining aspects of trauma counselling work.
Modes of Supervision
In Australia and the United Kingdom, lifelong supervision has become a requirement for counsellors and psychotherapists and has been built in to the professional codes of conduct as a mandatory requirement (Neufeldt, 1999, cited in Feltham, 2000). The most commonly adopted mode of supervision in Australia is the individual mode, where a less-experienced therapist consults with a more experienced therapist about their caseload face-to-face. This form of supervision, often heavily based on case discussion, is normally conducted at least once a month and is seen as vital to the ethical practice and ongoing professional development of counsellors and psychotherapists. In this chapter we begin by describing our own personal experiences of supervision - both exceptional and ordinary. We then describe four different modes of supervision including individual, group, peer and self-supervision and the different techniques that can be used within each mode. We explore the strengths and weaknesses of each of these modes of supervision. We discuss ways of empowering supervisees to seek out the supervision that they need. In the process, we challenge the assumption that the individual mode of supervision is the most appropriate mode for counselling supervision in all cases.
Therapists are Socially Constructed Too
Therapists are trained to recognize that their clients are influenced strongly by their own families, and by the social, cultural, and political context in which they live. Some therapists have come to view their clients' behavior and experiences as socially constructed. From this perspective, they conceive of therapy as the construction of a new, more functional narrative between the collaborators in the process. However, within this framework what can be forgotten is that therapists are socially constructed too, and are just as influenced by societal and cultural beliefs as their clients. In this paper, this phenomenon is examined through the use of case study. Implications for the practice, teaching, and supervision of therapy are discussed.