Assessment of client/patient satisfaction: development of a general scale

The development and shaping of a general scale to assess client/patient satisfaction is reported. The scale, the CSQ, was constructed empirically by the authors. The CSQ is a response to several problems and issues that currently cloud the measurement of consumer satisfaction in health and human service systems. These problems and issues in assessing satisfaction are described. Finally, we present practical expriences to date in using the CSQ along with general psychometric qualities of the scale and correlations of CSQ results with client characteristics, service utilization, and service outcomes.     

Artifact in client satisfaction assessment: experience in community mental health settings

Artifact in client satisfaction assessment is discussed and the results of a study of three factors thought to mediate client satisfaction ratings; (a) general life satisfaction, (b) mode of administration, and (c) psychological symptomatology, are reported. A standard client satisfaction questionnaire (CSQ) was modified to yield parallel forms and was administered orally and in writing to 92 clients in two mental health day treatment programs. Satisfaction ratings obtained from these clients were quite similar to out-patient ratings obtained in previous studies conducted in this setting and using the same measures. Oral administration of the CSQ produced 10% higher satisfaction ratings than written administration (p less than .05) and less missing data (p less than .01). Satisfaction ratings were also obtained using a simple graphic instrument. Graphic ratings were comparable to CSQ ratings. Satisfaction with life in general and level of psychiatric symptoms together accounted for 25% of CSQ variance. The implication of these findings for future client satisfaction research is discussed.     

Counseling Satisfaction of Gay,Lesbian, and Bisexual College Students

This paper investigates the satisfaction of gay male, lesbian, and bisexual college students with their counseling experiences. The sample of 31 research participants was interviewed using the Gay/Bisexual Counseling Satisfaction Survey, a demographic questionnaire, and the Beck Depression Inventory (BDI). Results indicated strong satisfaction with current counseling and counselors. Sexual orientation issues and loneliness were the most frequent presenting problems; these were positively associcated with counseling satisfaction, as was reporting barriers to counseling. BDI scores were copmarable to nonclinical samples, although there was frequent reporting of suicidal ideation. Implications for service delivery to this population are discussed.     

The satisfaction of Finnish adoptive parents with statutory pre-adoption counselling in inter-country adoptions

We examined how satisfied Finnish adoptive parents were with statutory pre-adoption counselling in inter-country adoptions. The data were collected through the Finnish Adoption Study using a retrospective survey measuring satisfaction with received pre-adoption counselling. All adoptive parents with a child under the age of 18, adopted from abroad between the years 1990 and 2007, were included. The sample of the study comprised parents of 1451 children and a total response rate of 55.7% was achieved. The data consisted of self-scored reports of satisfaction as well as open answer questions. Parent satisfaction and associated variables were analysed using chi-square and multiple logistic regression. Of the respondents, 81.7% reported satisfaction with the pre-adoption counselling they had received. The level of satisfaction was stable over time and did not differ according to service provider, whereas family type and sending country were associated with satisfaction. However the explanations for satisfaction were different for those services provided in units specialized in adoption and for those provided by municipal child protection services. The components found to explain satisfaction and dissatisfaction were experience, adoption knowledge, and attitude of the social worker, service accessibility and availability issues, as well as the content of the pre-adoption counselling offered.     

Career Counseling From the Counselee Perspective: Analysis of Feedback Questionnaires

The effectiveness of career counseling as perceived by counselees was measured using evaluation questionnaires. The results showed that 75% of the respondents rated the career counseling they received as satisfactory. A systematic difference was found between satisfaction with counseling as a result of the enhancement of the counselees' personal understanding and satisfaction as a result of the assistance they perceived in decision making. Respondents were more positive concerning their gains in self-understanding than about the help they felt they were given in arriving at a career decision. On the average, counselees rated discussions with the counselor as more important in counseling than were objective tests, interest inventories or vocational information. Respondents who reported that counseling helped them in both their personal and career problems were more satisfied than those who reported being helped solely in either their personal problems or their career decisions. The theoretical and practical implications of these results for career counseling are discussed.     

Job Satisfaction,Leisure Satisfaction,and Psychological Health

Job satisfaction, leisure satisfaction, and psychological health were measured for 189 adult men who were employed full time. Job satisfaction and leisure satisfaction were found to be significant positive predictors of psychological health. Stepwise regression analyses indicated that job satisfaction was the better predictor of psychological health, but leisure satisfaction added significantly to the prediction. Although job satisfaction was significantly higher for white-collar (professional) workers than for blue-collar workers, the prediction of psychological health by the independent variables was not affected by occupational status. Theoretical and counseling implications are discussed.     

What Factors Influence Marital Satisfaction? Differences Between First and Second Marriages

This study examined differences in marital satisfaction between first and second marriages and how additional factors can help explain satisfaction differences between the marriage types. Participants in first marriages reported higher levels of satisfaction than remarried individuals. Regression analyses demonstrated marriage type to be a moderator of satisfaction in second marriages; as education increased, satisfaction also increased. Length of marriage was found to significantly influence satisfaction in first marriages, but not second marriages. In both first and second marriages, participants currently in counseling reported lower satisfaction scores. The need to understand remarriages' distinct characteristics apart from first marriages is discussed.     

Clinic-based service programs for increasing responsible sexual behavior

Three general classes of clinic-based programs to increase responsible sexual behavior are considered: (a) clinic-based educational/counseling programs, (b) school clinic-based condom distribution programs, and (c) clinic-based STD/HIV screening programs. Consistent condom use may double in response to clinic-based counseling. However, consistent use seldom exceeds 50% of coital exposures. Extensive and personalized counseling interventions reduce incident sexually transmitted infections by 5% to 10%. Increases in responsible sexual behavior following school-based condom distribution programs is reported in some but not in all studies. Screening programs for sexually transmitted infections are associated with decreases in rates of some infections. STD/HIV screening should be considered an important aspect of healthy sexuality and an adjunct to other counseling efforts.     

Psychosocial characteristics and service needs of Canadian suburban male youth at risk for homelessness

Homeless youth represent a tremendously underserved population. Using participatory research methods, a self-report needs assessment was conducted with 187 male, suburban youth (16 to 18 years old) who were homeless or were vulnerable to homelessness. Over half of the participants indicated that they had been or currently were homeless, and generally reported serious problems regarding mental health, self-esteem, delinquency, substance use, family relationships, traumatic experiences, and scholastic achievement. Approximately one-third of the participants reported no service use (despite endorsing a variety of needs). The most common type of service used was therapy or counseling, particularly for those individuals who had been on probation. Implications of research findings, including recommendations for services to address the needs of the study population, are discussed.     

Parent-adolescent concordance on perceived need for mental health services and its impact on service use

Mental health service underutilization among African American adolescents is well documented, yet not fully understood. Discordance between adolescents and their parents on perceived need for seeing a counselor for an emotional need or psychiatrist for psychiatric or medical services may help explain low service use among this population. This exploratory, prospective study examined the relationship between parent-adolescent concordance on perceived need for emotional counseling or psychiatric services and mental health service use. The relationships between gender and perceived service need and concordance and adolescent severity of depressive symptoms were also explored. Parent-adolescent dyads (n = 108) receiving community-based adolescent outpatient mental health services responded to interview questions concerning their perception of whether an emotional counselor and a psychiatrist were needed in the past six months. Findings revealed low parent-adolescent concordance on perceived need for an emotional counselor and a psychiatrist. A greater proportion of adolescents reported a need than parents. There was no association between gender and perceived need for an emotional counselor and a psychiatrist. Lower rates of parent-adolescent concordance were found among youth reporting elevated depressive symptoms compared to youth reporting normal range symptoms. Concordant dyads kept a higher number of appointments than discordant dyads. Implications for clinical social work practice and future research are discussed.     

Mental health services: use and disparity among diverse college students

OBJECTIVE: In this empirical study, the authors examined (1) actual use of counseling for emotional problems and (2) the assumptions that ethnicity, sex, social class, and psychological distress are associated with disparities in use of counseling. PARTICIPANTS: Participants were 1,773 diverse undergraduate students at an urban university. METHODS: The authors collected data via self-administered questionnaires between 1999 and 2005; they used a cross-sectional correlational research design, including analysis of variance statistical procedures. RESULTS: Students' level of counseling use (10%) was similar to that estimated for a national college sample. Students reporting higher levels of distress were more likely to use counseling; however, more than three-fourths of students who reported clinically significant levels of distress had not received counseling. CONCLUSIONS: The authors observed no disparities in use of mental health services in terms of sex, ethnicity, and socioeconomic status.     

Exerting power or striking back: a gendered comparison of motivations for domestic violence perpetration

This study compares the motivations for using violence and the context in which violence occurs among male and female domestic violence perpetrators. One hundred twenty-five participants in batterer intervention counseling in Los Angeles County, California, were surveyed. The sample was approximately half male and half female. Males and females were found to differ in their motivations for using violence in relationships. Females reported using violence in response to prior abuse, citing revenge and retaliation as a primary motivation. Because treatment approaches are commonly derived from the power and control model, which indicates that violence is used to gain power and control, batterer intervention counseling may not be appropriate for women, who appear more motivated by the desire to maintain personal liberties in a relationship where they have been victimized. Treatment must walk the fine line between addressing victimization issues and holding women accountable for decisions to use violence.     

The Use of the Computer in Counseling College Students

The purpose of this study was to examine the usefulness of a computer program in helping clients clarify their concerns and identify goals for behavior change, prior to their first session counselor. A counseling treatment consisting of three initial computer-interaction sessions, followed by two sessions with a counselor, was compared to a treatment consisting of five sessions with a counselor and no computer interaction, and to a no-contact control group. Participants were 46 college students. The two treatment groups achieved their self-determined goals, as measured by the Goal Attainment Scale (Kiresuk & Sherman, 1968), and reported similar levels of satisfaction with counseling than students working with the computer-based counseling system. It was concluded that computers may be effectively used as part of the counseling process, allowing for a more efficient use of the counselor's time. However, more research is needed to identify the type of counselor intervention needed to facilitate the acceptance of these systems by students.     

Nonverbal communication of pharmacists during counseling leading to patient satisfaction: evidence from Iranian retail market

The purpose of this study was to investigate the impact of nonverbal communication of community pharmacists on patients’ satisfaction throughout the counseling process. Eight dimensions of nonverbal communication have been taken into account: vocalics, kinesics, proxemics, haptics, oculesics, olfactics, chronemics, and atmospherics. To gather data relevant to the aim of this study, a survey was conducted among the pharmacies in the city of Tehran (Iran). A questionnaire was offered to patients waiting to receive their medicine asking them about the nonverbal communication of the pharmacists and the degree of their satisfaction of service encounters. Proposed hypotheses were tested with a structural equation modeling approach using the Smart PLS software package. The results strongly support the theoretical model and suggest that there is a significant correlation between all components of nonverbal communication (excluding proxemics and haptics) and consumers’ satisfaction. The originality of this article is that it is the first empirical research to evaluate all aspects of the nonverbal cues of pharmacists and their effects on patient satisfaction. Considering the relatively high growth rate of the Iran retail market, this study has profound implications for academia and the practice of pharmacy.     

Social and Health Service Use and Treatment Outcomes for Sexual Minorities in a National Sample of Substance Abuse Treatment Programs

This study examines substance use severity, levels of social and health service utilization, and the impact of service utilization on treatment outcomes for sexual minorities versus non-minorities. The sample included 3,094 clients from the National Treatment Improvement Evaluation Study (NTIES). Substance use severity among sexual minorities and non-sexual minorities was similar at treatment entry and at 12 months post-discharge. Differences in social and health service utilization were significant for substance abuse counseling and health services. Significant interactions between sexuality and access services and sexuality and mental health services were also found. Practice and research implications are discussed.     

Post-adoption needs of families adopting children with developmental disabilities

The post-adoption service use and needs of 125 families who had adopted children with developmental disabilities were examined using a structured mail questionnaire. Although satisfaction with services used was generally high, many families did not have access to basic family support services such as respite care, life planning and support groups. Income was the only demographic variable which correlated with service need. Middle income families (mean = $30,000 to $34,999) were more likely to need support groups and babysitting for other children than either lower or higher income groups. Of particular note in this study is the relatively high incidence of transracial adoptions. Thirty-one percent of the sample had adopted children of a different race than the family. The implications of the findings and service recommendations are discussed.     

“Hello! I know you help people here,right?”: A qualitative study of young people's acted motivations in text-based counseling

Mediated counseling services are becoming more and more common, thanks to the advance and availability of ICTs. The research on motivations for choosing such a service over a face-to-face one is a relatively new field of research and previous studies identified the most common motivations as narrated by clients in ex-post interviews. The present study aims to contribute to this field of research by identifying and describing how these motivations are directly enacted within the conversations between the counseling professional and the client. Twentyone WhatsApp conversations were analyzed using Qualitative Content Analysis. Results show that motivations expressed ex-post by young people found in previous research (e.g. privacy and autonomy, control over the counseling process, anonymity, accessibility of text counseling) are present in the conversations, but are more complex and nuanced in natural discursive productions. The article also presents the pragmatic implications of these occurrences in the practice of mediated counseling.     

Social support characteristics among nonclinical African-American and Filipino-American parents with school-age children

This study is the first phase of a project to develop a culturally-appropriate, family-mediated social support intervention program. This phase consisted of in-home interviews with 26 African-American (AF) and 26 Filipino-American (FA) parents who were not receiving counseling or social services for parent-child conflict, and self-reported adequate personal and family functioning. In general, parents were college educated and employed full-time and had house-hold incomes of over $25,000. On average, AF parents were 35 years old, with 4 people in the household, including 2 children (mean AGE = 10 years). FA parents were older, averaging 45 years, and had 6 people in the household, including 3 children (mean AGE = 12 years). Mean scores on standardized measures reflected high self-esteem and positive attitudes toward their children and families. Social network size averaged 32 and 38 members for AF and FA mothers respectively, and 24 and 29 members for AF and FA fathers. Most parents reported that fewer than 50% of their network members knew each other. Data also suggested that parents reported a generally positive orientation to utilizing support resources, and favorable perceptions of and satisfaction with support form family and friends. Analyzes revealed that only functional support variables were significantly associated with parent well-being. Study limitations, service implications, and further research directions are discussed.     

Life satisfaction in midlife childless and empty-nest men and women

The primary purpose of this study was to contrast the life satisfaction of midlife empty-nest and childless individuals. Seventy-two men and women reported on their satisfaction with 11 areas of life as well as with regard to children. Empty-nest individuals were more satisfied than childless persons with regard to their decisions regarding children; however, the childless individuals were not unhappy with their decisions. Empty-nest individuals were also more positive than childless individuals about contact with children. There were no differences between the two groups with regard to areas of life satisfaction not related to children; nor were there significant gender differences in life satisfaction. The results were discussed in relation to both theory and data concerning midlife satisfaction and adjustment.SMS AssociatesThe research was completed by James E. Bell in partial fulfillment of the requirement for the masters of counseling degree at Arizona State University.