Thesis (Ph. D.)--University of Alabama at Birmingham, 2007. / Title from first page of PDF file (viewed Oct. 31, 2007). Includes bibliographical references (p. 127-134).

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.

This study was designed to determine the effectiveness of group activity therapy as a school based intervention with fourth and fifth grade preadolescents with learning disabilities experiencing behavior problems. The group activity therapy intervention followed humanistic principles and was designed to address the cognitive and social emotional needs of this population. The preadolescents were provided a variety of developmental appropriate materials and activities to encourage self expression and group interaction. The 24 volunteer preadolescents were randomly assigned to the experimental group (n=12) and to the control group (n=12). The treatment group preadolescents were divided into groups of three and participated in group activity therapy one hour per week for 12 weeks. The participants were assigned to groups according to individual needs and personality traits. The control group received no treatment during the study. Pre and post test data were collected from parents using the Child Behavior Checklist (CBC) and the Behavior Assessment Scale for Children (BASC). Analysis of Covariate (ANCOVA) was utilized to determine statistical significance between the treatment group and the control group on the post-test means for each hypothesis. In each case, the post-test specified in each hypothesis was used as the dependent variable and the pre-test as the covariate. Specifically, the preadolescents in the treatment group showed statistically significant decreases in total behavior problems on the BASC (p=.05) and decreases in internalizing problems on both the BASC and CBC (p=.03, p=.05, respectively). While not statistically significant, positive trends were noted on the CBC total behavior scale (p=.08) and on the CBC externalizing scale (p=.09). In addition, Cohen's d effect size was calculated for each hypothesis and post hoc analysis of the subscales to determine practical significance of the treatment on the experimental group when compared to the control group. A large treatment effect size was found on the BASC (d=.91) and CBC (d=.82) total behavior problems scales and on the BASC (d=1.03) and CBC (d=.90) internalizing problems scales. A moderate to large treatment effect size (d=.78) was found on the CBC externalizing problems scale and a medium treatment effect size (d=.53) was found on the BASC externalizing problems scale. Qualitative data was also examined to determine clinical significance of the intervention. This study determined that group activity therapy is an effective intervention for preadolescents diagnosed with a learning disability.

Abstract The purpose of this study was to describe and evaluate the effectiveness of lifestyle counseling interventions on physical activity, body mass index and adherence to lifestyle change in overweight and obese adolescents. Further, the study aimed to describe and evaluate parents’ adherence to a change in lifestyle in their family. The aim was to promote overweight and obese adolescents’ health and develop an effective lifestyle counseling intervention. In the first phase, a systematic literature review was conducted to evaluate the effectiveness of earlier interventions (n=14) on overweight and obese adolescents’ subsequent physical activity, body mass indices and psychological symptoms. In the second phase, the feasibility of developed interventions was assessed with an expert panel. In the third phase the effectiveness of Facebook-delivered lifestyle counseling intervention (Fb) and lifestyle counseling with physical activity self-monitoring (Fb+Act) were evaluated using a randomized controlled trial. A total of 504 overweight or obese adolescents from Northern Finland were invited to study. Adolescents who participated (n=46) and their parents (n=49) were randomly assigned to experimental or control groups. The effectiveness of earlier lifestyle counseling interventions on adolescents’ physical activity and body mass indices were small. The effectiveness of interventions developed in this study on adolescents’ physical activity, body mass indices were small. The Fb+Act group had lower sedentary time compared to the control group during post-intervention measurements. The Fb group body mass index decreased. Adherence to increasing physical activity decreased in adolescents and their parents. / Tiivistelmä Tutkimuksen tarkoituksena oli kuvata ja arvioida interventioiden vaikuttavuutta ylipainoisten ja lihavien 13–16-vuotiaiden nuorten fyysiseen aktiivisuuteen, painoindeksiin ja elintapamuutokseen sitoutumiseen. Lisäksi kuvattiin ja arvioitiin nuorten vanhempien sitoutumista perheen elintapamuutokseen. Tutkimuksen tavoitteena oli edistää ylipainoisten ja lihavien nuorten terveyttä ja kehittää vaikutuksiltaan tehokas elintapaohjausinterventio. Tutkimuksen ensimmäisessä vaiheessa systemaattisen kirjallisuuskatsauksen avulla arvioitiin aikaisempien interventioiden (n=14) vaikuttavuutta ylipainoisten ja lihavien nuorten fyysiseen aktiivisuuteen, painoindeksiin ja psykologisiin tekijöihin. Toisessa vaiheessa arvioitiin suunniteltujen interventioiden toteutettavuutta asiantuntijapaneelilla. Kolmannessa vaiheessa arvioitiin sosiaalista mediaa hyödyntävän elintapaohjausintervention (some) ja elintapaohjausinterventio yhdistettynä fyysisen aktiivisuuden omaseurantaan (some+fa) vaikuttavuutta satunnaistetulla kontrolloidulla kokeella. Tutkimukseen kutsuttiin Pohjois-Suomesta 504 ylipainoista tai lihavaa nuorta vanhempineen ja tutkimukseen osallistuneet nuoret (n=46) ja heidän vanhempansa (n=49) satunnaistettiin koe- ja kontrolliryhmiin. Systemaattisen kirjallisuuskatsauksen mukaan interventioiden vaikuttavuus ylipainoisten ja lihavien nuorten fyysiseen aktiivisuuteen ja painoindeksiin ovat olleet vähäisiä. Tässä tutkimuksessa kehitettyjen interventioiden vaikuttavuus ylipainoisten ja lihavien nuorten painoindeksiin ja fyysiseen aktiivisuuteen oli vähäinen. Some+fa -ryhmän liikkumaton aika oli vähäisempi verrattuna kontrolliryhmään (p=0,021). Some-ryhmän nuorten painoindeksi laski. Nuorten ja vanhempien osalta sitoutuminen fyysisen aktiivisuuden lisäämiseen laski.