Improved Outcomes Following a Single Session Web-Based Intervention for Problem Gambling

Research suggests online interventions can have instant impact, however this is yet to be tested with help-seeking adults and in particular those with problem gambling. This study seeks to determine the immediate impact of a single session web-based intervention for problem gambling, and to examine whether sessions evaluated positively by clients are associated with greater improvement. The current study involved 229 participants classified as problem gamblers who agreed to participate after accessing Gambling Help Online between November 2010 and February 2012. Almost half were aged under 35 years of age (45 %), male (57 %) as well as first time treatment seekers (62 %). Participants completed measures of readiness to change and distress both prior to and post-counselling. Following the provision of a single-session of counselling, participants completed ratings of the character of the session (i.e., degree of depth and smoothness) post-counselling. A significant increase in confidence to resist and urge to gamble and a significant decrease in distress (moderate effect size; d = .56 and .63 respectively) was observed after receiving online counselling. A hierarchical regression indicated the character of the session was a significant predictor of change in confidence, however only the sub-scale smoothness was a significant predictor of change in distress. This was the case even after controlling for pre-session distress, session word count and client characteristics (gender, age, preferred gambling activity, preferred mode of gambling, gambling severity, and preferred mode of help-seeking). These findings suggest that single session web-based counselling for problem gambling can have immediate benefits, although further research is required to examine the impact on longer-term outcomes.     

Implementing Single Session Therapy

In recent decades, discussion about clinical practice has been dominated by a focus on evidence‐based treatments, whilst the translation of evidence‐based treatments into practice has been neglected or avoided. The single session therapy (SST) field reflects this general trend. As a result, the community has not benefited from available service improvements simply because they have not found their way into core practice or been translated across state‐wide services. This article draws on a range of implementation projects managed by The Bouverie Centre, in particular a successful state‐wide SST implementation project conducted in collaboration with Victorian community health counselling services, to raise implementation dilemmas and suggest practical ideas about the translation of SST ideas into mainstream clinical practice. It is hoped this discussion will be of interest to those wanting to translate any new idea into practice.     

Single‐Session Approaches to Therapy: Time to Review

In 2001 Bloom produced a comprehensive review of single‐session approaches to therapy (SST). In his paper he outlined the concept of single session therapy and considered the evidence that could be used to support implementation of single session approaches. At the time, Bloom's was probably the most comprehensive review of research on single session therapy available: he considered papers that provided overviews of approaches to developing and delivering single‐session treatment, as well as papers that used controlled and uncontrolled methods to evaluate outcomes. What I will do in this paper is to informally review the literature on single session therapy that has been published since Bloom's 2001 paper. The paper is not intended as a formal review or meta‐analysis of research data, partly because the field still does not have such methodological rigour.     

Single Session Social Work in Hospitals

This paper reports on three complementary research studies that set out to examine the incidence and nature of single sessions in hospital social work practice. The first study was a data‐mining exercise that used statistics recorded by practitioners in nine public hospitals over a 12‐month period to establish the extent of single session work, the clinical areas in which it occurred, and the types of issues it covered. This quantitative information was enhanced with the qualitative findings of the two subsequent studies: the first with hospital social workers; and the second with singlesession clients. We concluded that single session work has not been sufficiently acknowledged in social work education and literature, and that it needs to become a more legitimate part of social work practice and training. At best, it represents social work at its highest level of skill, requiring expertise in quickly building rapport, assessment, and knowledge about sources of practical aid and information.     

Reflections and Learning From an Agency‐Wide Implementation of Single Session Work in Family Therapy

In November 2009, the Bouverie Centre, a centre for training, research, and clinical family therapy in Melbourne, Australia, embarked on a 12‐month trial involving the implementation of single session work as our main model of service provision for all new family appointments. We were interested in evaluating clients' and therapists' experiences of this change in our clinical service delivery. This article discusses some clinical dilemmas that arose for staff in this process, and how they were addressed. Clients' responses to single session work are outlined, followed by a discussion of outcomes of the implementation for our organisation.     

Health promotional education: differences between school nurses' health counselling and teachers' health instruction in the finnish ENHPS

The purpose of the study was to describe school nurses' (N=24) and teachers' (N=25) opinions of how the health‐related goals in their counselling and instruction were attained and to find out the possible differences between the two groups in the Finnish European Network of Health Promoting Schools. The data were collected by a questionnaire and analysed statistically. Some significant differences existed. School nurses ranked non‐intoxicant use, human growth and development and life control highest in their health counselling, whereas teachers underlined health maintenance and well‐being, respect for other people and non‐intoxicant use. School nurses' health counselling covered disease prevention and treatment better compared to teachers' health instruction, whereas health maintenance and well‐being, environmental health, first aid and safety and respect for other people were covered better in teachers' health instruction. Teachers were more promotional and community‐oriented, while school nurses emphasised a more preventive and individually oriented approach.     

When Less is More: Lessons from 25 Years of Attempting to Maximize the Effect of Each (and Often Only) Therapeutic Encounter

The three main findings of studies conducted by Hoyt, Rosenbaum, and myself during the years 1986–1990 at the Kaiser Permanente Medical Group, were

• 1 . Single session is the most common length of psychotherapy.
• 2 . The first session in psychotherapy is potentially the most therapeutic and often has the greatest influence on the outcome of therapy.
• 3 . Single session therapy (SST) is the most cost‐effective mode of therapy.

The fact that less is very often better in psychotherapy is by now one of the most validated and consistent findings in evidence‐based psychotherapy research. We now think of it as a very common, very useful way of conducting therapy, employing many different approaches and methods to address a wide range of presenting problems. In retrospect, 25 years later, I believe that the essence of single session therapy is still about being present in each and every session as a whole. The goal has always been to make the most of every therapeutic session, whether seeing a client only once or over a long period of time. In a personal communication in 1978, Haley (in Talmon, 1990) predicted that a ‘single interview could become the standard for estimating how long and how successful therapy should be.’ This article explains why it didn't happen.     

A Network Therapy Clinic for Clients with Intellectual Disability

Over the past 30 years a systemic approach has been applied to complex cases involving intellectual disability and behaviours of concern. This paper describes a model that draws on systemic family therapy and network therapy as well as the use of a reflective team. A single session intervention was provided for families of people with intellectual disability. A systemic consultation was used as a pre‐session meeting for professionals working with the family. The systemic consultation and single session therapy allowed the family and the professional network to gain insight. Involving the professionals in the therapy session also enhanced the alliance between professionals and family. This approach assists everyone involved in the case to find a way to progress.     

AN EXPLORATION OF THE THERAPEUTIC RELATIONSHIP AND COUNSELLING OUTCOMES IN A PROBLEM GAMBLING COUNSELLING SERVICE

This study examined the relationship between a number of counselling process variables thought to influence counselling outcomes in a sample of 150 clients undertaking short‐term counselling in the state‐wide government funded Gambler's Help problem gambling counselling services in Victoria, Australia. Factors measured included psychosocial well‐being of clients prior to and after counselling, client readiness to change, self‐reported gambling activity levels before and after counselling, self‐assessment of current gambling behaviour, strength of therapeutic alliance, self‐reported counselling outcomes achieved in the area of symptoms, life matters, and related problems and a measure of client satisfaction with the service. The therapeutic alliance was found to have the strongest predictive power with respect to the level of problem resolution achieved by clients across all but one of the problem areas. The implications of these findings for clinical social work practice and education of practitioners are noted.     

Does Reunion Cure Adoption?

Adoption and reunion experiences were examined in birth‐mothers who were reunited with their adult children following a change in adoption laws. Their feelings surprised, bewildered, and sometimes even shocked them. Whilst they described initial reunion meetings in uniformly glowing terms, they also experienced enormous turmoil. Reunion was expected to be a resolution, but in fact, constituted a major life crisis. The policy of one mandated counselling session prior to reunion is examined in this light The author discusses the wider implications of the legislation in terms of society's acknowledgement of past injustice, and the lost potential for healing. Implications for family therapy are discussed.     

Sex Differences in Parenting Behaviors in Single‐Mother and Single‐Father Households

Research on family structure has led some to claim that sex‐based parenting differences exist. But if such differences exist in single‐parent families, the absence of a second parent rather than specific sex‐typed parenting might explain them. We examine differences in mothering and fathering behavior in single‐parent households, where number of parents is held constant, and we describe individualist and structuralist perspectives for potential sex‐based parenting behaviors. We compare 3,202 single mothers and 307 single fathers in the Early Childhood Longitudinal Study (Kindergarten Cohort). Results suggest that, although there are small differences in the parenting behaviors of single mothers and single fathers, differences are sensitive to demographic disparities and do not translate to academic deficits for children in either family type.     

Using live supervision to teach counselling skills to social work students

This article reports on a research project which explored how anxiety can be managed when social work students receive live supervision as they are learning counselling skills. Eight social work students volunteered to participate in an eight session project in which they role played counselling sessions and received live supervision of their work. Their subjective experience of live supervision was elicited via survey reported surveys over the course of the project. They also submitted pre-and post-project recordings of their counselling role plays which were evaluated for changes in skill level. The participants’ survey results showed that, over the course of the project, each participant became less anxious about live supervision and came to find it a valuable learning experience. Their recorded role plays all showed improvements in skill level across a range of domains. The authors contend the establishment and maintenance of positive and trusting relationships between participants and between participants and the supervisor was crucial to the success of this project, as was attention to power dynamics and differences in learning styles. These results suggest that, under the right conditions, live supervision can be a valuable addition to counselling skills teaching strategies with social work students.     

Effective Techniques: The Career‐in‐Culture Interview: A Semi‐Structured Protocol for the Cross‐Cultural Intake Interview

The authors introduce the Career‐in‐Culture Interview (CiCI), a flexible, semistructured interview protocol designed for the career counseling intake session. The contents of the CiCI are based on recent theoretical advances in multicultural counseling and on the social cognitive model of career development. The authors describe a pilot evaluation of the interview and present guidelines for using the CiCI in practice.     

An Evaluation of Caller Satisfaction with Solution-Focused Telephone Counselling

Abstract

‘Practice Forum’ is intended to provide a forum for social work practitioners to share their practice with others; to describe what they are doing and assess its effectiveness.

We extend an invitation to all social work practitioners to submit articles for ‘Practice Forum’ and we look forward to receiving your contribution.

The telephone is a potentially valuable intervention tool in family counselling. The Child, Adolescent & Family Health Service has been experimenting with a response which combines the traditional advantages of telephone counselling with aspects of Steve deShazer's solution-focused approach (deShazer 1985). In 1990 a study was conducted to evaluate caller satisfaction with this approach. Results indicate a high level of satisfaction with the counselling. At a time of increasing funding cuts and lengthening waiting lists, it is important that as many options as possible remain available to our clients. An expansion in effective telephone counselling services may well be one way of achieving this.     

Adolescents’ Views on Families as Metaphors in Hong Kong: Implications for Pre‐counselling Assessment

This interpretative study aims to offer metaphors that describe family meanings from the adolescent’s perspective by encouraging them to give a metaphor with their own explanation on a self‐administering essay form. This study has three objectives: to explore the family meanings as a metaphor from the Hong Kong adolescent’s perspective; to reveal any common and unique features of these metaphors; and to search for the possibilities of collecting metaphors from adolescents as a pre‐counselling assessment tool. The 12 participants for this study were referred to me for family counselling because of poor self‐esteem, loss of life goals or ineffective relationships with their parents. Based on the 12 metaphors, the following five themes can be discerned: (i) gender role in a family, (ii) Chinese culture in a family, (iii) heat in a family, (iv) security in a family and (v) the family as honey and a loan company. Based on the above five themes, there are some common metaphors (e.g. a warm place, honey, a shelter, a boat shelter, a chick and a hen, a volcano, a fire, an oven and a loan company), trans‐cultural and unique metaphors (e.g. a wet market and ‘Kung Fu’ experts), and those that are culturally specified. Both strengths and limitations of collecting and analysing metaphors were discussed.     

Cyber Counselling: An Innovative Field Education Pilot Project

With the ascendancy of the cyber world, client demand for online counselling has increased and is expected to continue to increase dramatically in the coming years. The purpose of this article is to describe an innovative pilot practicum project in which social work graduate interns offered cyber counselling within a university to undergraduate students. In this paper, we describe the key elements of this project, including those that are unique and those that follow typical practicum processes, along with the challenges identified. Implications for practice and social work education are offered.     

Infant locomotion shapes proximity to adults during everyday play in the U.S.

Learning to walk expands infants’ access to the physical environment and prompts changes in their communicative behaviors. However, little is known about whether walking also shapes infants’ proximity to their adult social partners during everyday activities at home. Here we followed 89 infants (42 boys, 47 girls; 92% White, not Hispanic or Latino) longitudinally and documented connections between infant locomotion and infant-adult proximity on two timescales: (1) across developmental time, by comparing data from a session when infants could only crawl to a later session when they could walk (M walk onset = 12.15 months, range = 8-15); and (2) in real time, by testing whether the amount of time that infants spent in motion (regardless of their locomotor status) related to their interpersonal distance to adults. The developmental transition to walking corresponded to a significant, but modest, decrease in infant-adult proximity. Infants’ moment-to-moment locomotion, however, was strongly related to patterns of interpersonal distance: infants who spent more time in motion spent less time near adults and instigated more proximity transitions, resulting in shorter and more dispersed bouts of proximity throughout sessions. Findings shed new light on how infants’ motor achievements can reverberate across other domains of development, and how changes in infant development that researchers often observe over months arise from infants’ moment-to-moment experiences.     

Group Cohesion and Homework Adherence in Multi‐Family Group Therapy for Schizophrenia

This study examined the relationship between levels of group cohesion, defined as whole group relationships, and between‐session therapeutic homework adherence in a multi‐family group therapy (MFGT) for people with schizophrenia. Participants from 18 consenting families attending MFGT groups completed weekly homework adherence ratings, group cohesion and spontaneous between‐session activity measures. Levels of group cohesion at each session were compared with measures of scheduled and spontaneous homework adherence reported at the next session. It was hypothesised that higher levels of group cohesion would be related to homework adherence and other spontaneous between‐session therapeutic activity completed by group members. Results show higher levels of group cohesion were associated with higher rates of spontaneous between‐session therapeutic activity. However, contrary to expectations no significant relationship between cohesion and scheduled homework completion was found. The implications of the findings for group processes and homework adherence are discussed.     

The Goal Trumps the Means: Highlighting Goals is More Beneficial than Highlighting Means in Means‐End Training

Means‐end actions are an early‐emerging form of problem solving. These actions require initiating initial behaviors with a goal in mind. In this study, we explored the origins of 8‐month‐old infants’ means‐end action production using a cloth‐pulling training paradigm. We examined whether highlighting the goal (toy) or the means (cloth) was more valuable for learning to perform a well‐organized means‐end action. Infants were given the opportunity to both practice cloth‐pulling and view modeling of the action performed by an adult throughout the session. Infants saw either the same toy or the same cloth in successive trials, so that the goal or means were highlighted prior to modeling of the action. All infants improved throughout the session regardless of which aspect of the event was highlighted. Beyond this general improvement, repetition of goals supported more rapid learning and more sustained learning than did repetition of means. These findings provide novel evidence that, at the origins of means‐end action production, emphasizing the goal that structures an action facilitates the learning of new means‐end actions.