Ethical codes and laws provide counselors with guidance for how to approach confidentiality, but there is a gap in the literature surrounding counselors' process of decision-making when managing confidentiality with adolescent clients. This study explored the decision-making process of master therapists concerning adolescent clients. I conducted semi-structured interviews with peer identified master therapist (N=10), all of whom were licensed professional counselors with 15 or more years of counseling experience and whose case load contained 25% or more adolescent clients. Participants included seven females and three males; nine participants identified as Caucasian, and one participant identified as Hispanic. Participants ages ranged from 39-61. I analyzed the data, along with two research partner, according to Grounded Theory (GT) methodology. Through constant comparative analysis, a grounded theory emerged from the data in which participants converged understanding of client safety, relationships, clinical intuition in a process of integrated experience and consultation. With the exception of mandated reported and mortal danger, ethical guidelines and laws did not seem to factor into participants' decision making. Implications for counseling practice, preparation, and research are provided.

Therapist variables are considered an important research topic, because studies suggest that as clients improve in therapy their values shift towards that of their therapist. This study examined the relationship of professional counseling affiliation and counselor values.Five hundred surveys were sent nationally to counselors based on their membership in the American Association of Christian Counselors (AACC), the American Mental Health Counselors Association (AMHCA), and the Association for Multicultural Counseling and Development (AMCD). Counselors completed a questionnaire which was comprised of a subset of the Jensen and Bergin Mental Health Value Instrument, the Religious Commitment Inventory10, and the Multicultural Counseling Inventory. Based on their primary affiliation as either a Christian, Multicultural, or General Mental Health counselor a final sample of 129 respondents was obtained. Group scores were analyzed through MANOVA and ANOVA techniques.The results of this survey found no differences among the various counseling groups for the mental health value of Autonomy or Self-growth. Christian counselors were found to report higher levels of the mental health value of Religiosity and Religious Commitment. Multicultural counselors were found to report higher levels of multicultural counseling competencies, especially in the areas of Multicultural Counseling Awareness and Multicultural Counseling Knowledge.These findings support the notion that there are differences in values among counselors based on their professional affiliation. Accordingly, it is suggested that future research efforts continue to examine the effect of professional counselor affiliation on counselor values. Special consideration should also be given to researching the process by which counselor values affect change in the part of their clients. Finally, counselors are encouraged in their therapeutic practiceto be aware of their operative value systems and share them with their clients as part of an informed consent. / Department of Counseling Psychology and Guidance Services

[Truncated abstract] This PhD project was comprised of three major studies. Study 1 utilised the Nominal Group Technique (NGT) to identify a typology of difficult patients in private practice physiotherapy and to determine strategies physiotherapists use and would like to improve, when dealing with such patients. Physiotherapists (n=37) also shared their expectations of patients and their perceptions of patient expectations of physiotherapy. Results showed that the two areas most difficult to manage were behavioural problems of patients followed by patient expectations. To assist in their interaction with difficult patients, physiotherapists identified communication skills and behaviour modification techniques as strategies they would most like to learn. While physiotherapists expressed the greatest number of expectations in the behavioural domain, identification of patient expectations was not elicited as a strategy to manage difficult patients. Results of this qualitative study contribute to the evolving literature relating to physiotherapist-patient interactions and form a useful basis for educational programs directed at improving the therapeutic relationship in private practice physiotherapy. Study 2 involved applying the NGT with separate groups of patients (n=26) to identify patient expectations of the qualities of a ‘good’ physiotherapist, and to ascertain the characteristics of good and bad experiences in private practice physiotherapy. Findings indicated that the qualities of a ‘good’ physiotherapist related to their communication ability, professional behaviour and organisational ability, and characteristics of the service provided. The most important expectations of patients were for example, symptomatic relief, self-management strategies and ‘hands on’ treatment; associated with the physical domain. When comparing equivalent groups from Study 1, with patient expectations, most patient groups identified that the most important expectations of physiotherapists would relate to patient behaviours such as; compliance, honesty, payment of their account, being punctual, cooperating, trusting and showing respect for their physiotherapist. However, physiotherapists’ rankings of the most important expectations held by patients were not congruent with patient rankings providing an explanation as to why problems may arise in the physiotherapistpatient interaction from the patient’s perspective. Based on the findings of Study 2 it was suggested that physiotherapists should actively seek to involve patients in their management. To do this effectively, physiotherapists would benefit from further training in communication skills to ensure that they can successfully adopt a patientcentred approach and to optimise the physiotherapist-patient interaction in private practice physiotherapy.

Thesis (Ph.D.)--University of North Carolina at Greensboro, 2007. / Title from PDF t.p. (viewed Mar. 3, 2008). Directed by Craig S. Cashwell; submitted to the School of Education. Includes bibliographical references (p. 160-194).

Thesis (H. Sc. D.)--University of Sydney, 2008. / Title from title screen (viewed 11 March 2009). Submitted in fulfilment of the requirements for the degree of Doctor of Health Sciences to the School of Behavioural and Community Health Sciences, Faculty of Health Sciences. Includes bibliographical references. Also available in print form.

Thesis (Ph. D.)--University of Missouri-Columbia, 1996. / Typescript. Vita. Includes bibliographical references (leaves 129-146). Also available on the Internet.

Thesis (Ph. D.)--University of Missouri-Columbia, 1996. / Typescript. Vita. Includes bibliographical references (leaves 129-146). Also available on the Internet.

Narrative Therapy draws on an understanding of how discourse acts to construct, reproduce and deconstruct power relationships. Therapy is focussed on collaborating with clients in a process of re-authoring their self-stories by critically evaluating the positions made available to them in relation to dominant discourses. Whilst there is a large body of theoretical knowledge on post-structuralism and psychotherapy, very few discourse analyses of psychotherapy sessions have been published. Thus, though post-structuralist therapeutic approaches are theoretically well supported, there is an identified gap in the literature on the therapeutic processes that occur within practice. This research aims to further explore these therapeutic processes, focussing specifically on subject positioning with relation to gender in Narrative Couple Therapy, and the influence of the therapist thereupon. It is based on the analysis of a video of a Michael White Narrative Couple Therapy session, "The Best of Friends." Using discourse analysis as a methodological approach, the analysis seeks first to identify talk that signifies discourses of gender difference, and then to explore how the subjects (therapist and clients) are positioned in relation to these discourses. The analysis focuses on the therapist's activities to investigate the influence of his interactions with the partners on how they are positioned or position themselves within stories of gender difference. The analysis shows that, by working reflexively, transparently and collaboratively with the partners, the therapist assists to render power, restrictive discourses, and alternate positions visible to the clients. The therapist resists being drawn into dominant therapy discourses of expert and patient, and instead continuously recognises the knowledges and expertise that the clients bring to the therapy context. He then works closely with the clients to thicken alternative representations of self.

The purpose of the present study was to implement an inexpensive, efficient staff management system that could function effectively in a typical institutional setting. The system utilized feedback with a small amount of social reinforcement from the subjects’ immediate supervisor - a combination that would probably be more acceptable to most institutions than alternatives such as money or rearrangement of work schedules.

One of the qualifications for being a competent speech and language clinician is to be skilled in interactional procedures within a clinic setting. A clinician's interactional skills are developed through training whereby one participates in several clinical settings with clients displaying a variety of speech, language and hearing disorders. Various evaluation methods, both subjective and objective, have been utilized in guiding the clinician towards interactional competency. Interactional analysis systems have been designed to provide more objective feedback. The Boone-Prescott Content and Sequence Analysis System (B-P) is one of several such systems. Although this system has been found to be an asset towards evaluating the clinic session (Boone and Prescott, 1972b) information is lacking as to how the data from the parameters of the B-P Scoring Form reflect the quality of a clinician's interactive skills. Hence, this investigator sought to answer the following question: How do B-P data compare for clinicians who have been highly rated subjectively with those who have been less favorably rated subjectively by supervisors?