The purpose of this descriptive multiple case study was to explore how counselors implement multicultural and social justice counseling competencies (MSJCC) when providing therapy to Black, Indigenous, and Womxn of Color. This study was informed by critical theory and intersectionality theory to capture the complex dynamics of identity and power through semi-structured interviewing, observations of archived counseling sessions, review of archived client case records, and administration of the Multicultural Awareness, Knowledge, and Skills Survey–Counselor Edition–Revised (MAKSS-CE-R), and the Social Justice Scale (SJS). The six doctoral student co-researchers provided rich portrayals of their experiences implementing the MSJCC, the role of identity, and the impact of power relations. Data revealed one overarching theme (the omnipresence of cultural humility), five themes (learning is a process, it starts with me: the catalyst of self-awareness, this is my identity, understanding clients in context: attending to power and intersectionality, and social justice is awareness: advocacy is intentional and active), and eight corresponding subthemes. Co-researchers provided insight into their experiences of barriers, oppression, resilience, and advocacy. Implications and conclusions from this research provide recommendations for mental health counselors, education programs, and research.

This photovoice study explored the lived experiences of nine Puerto Rican mental health professionals who provided postdisaster counseling services to children. Due to the complex and multilayered experiences of Puerto Rican mental health professionals, this study used intersectionality as the theoretical lens to facilitate thematic analysis of the data. Results from coresearchers' narratives and photographs generated seven major themes: (a) la politiquería of disasters; (b) the impact of compounding disasters; (c) Puerto Rico se levanta: strategies for collective healing; (d) impact of disasters on children; (e) experiences with clients; (f) awareness, action, change; and (g) supporting, connecting, and transforming. The results and discussion provide awareness into the experiences of Puerto Rican clinicians who formed part of disaster response efforts in their own community. Clinical, educational, and research implications are drawn from coresearchers' narratives and insight.

Mindfulness is a practice that has the potential to help counseling students build a variety of skills that are necessary for clinical efficacy, including therapeutic presence, attunement, empathy, cognitive flexibility, and non-reactivity. However, mindfulness is rarely taught to students in mental health training programs, which makes it an untapped possibility to improve counselor education. Additionally, rarely do researchers explore the role of counselor mindfulness and counselor trauma on clients' perceptions of therapeutic presence. Therefore, the purpose of this study is to explore the effects of a 15-week mindfulness training program for counseling students to understand its effect on client's perceptions of therapeutic presence, counselor state mindfulness development, and counselor trauma symptoms. Participants in this cluster-randomized controlled intervention were masters counseling students currently enrolled in clinical practicum accredited by the Counsel for the Accreditation of Counseling and Related Educational Programs (CACREP). Counselors provided data at three timepoints on their state mindfulness, trauma symptoms, and therapeutic presence. Clients provided data at three timepoints on their perceptions of their counselor's therapeutic presence. We analyzed data through repeated measures ANOVA and two-level longitudinal hierarchical linear models. Implications for counselor education, professional counselor development, and future research are offered and limitations are discussed.

The current study sought to explore play therapists' barriers to engaging parents in their clinical work as well as understand the relationship between play therapist characteristics and their attitudes toward parents. Using a demographic questionnaire, Therapist Barriers to Engaging Parents (TBEP), and the Counseling Self- Estimate Inventory (COSE), 136 members of the Association for Play Therapy were surveyed to explore predictors to engaging with parents. Overall, play therapists reported low scores on barriers to engaging parents indicating play therapists are likely to report positive attitudes toward working with parents. Through two multiple regression analyses measuring the predictive value of self-efficacy subscales including Dealing with Difficult Clients and Counseling Process, play therapist identification as a parent, years of experience, and hours of training on parent engagement, both models demonstrated statistically significant findings with large effect sizes. This study found that play therapist self-efficacy was the strongest predictor of play therapists' attitudes toward parents accounting for approximately 80% of the variance in the models. Play therapists' identification as a parent as well as years of practice also predicted their barriers to engaging parents. Hours of training in parent engagement had no relationship to TBEP scores. Implications for practice include a need to …

Polyamory is an identity that describes the ability to experience romantic love with more than one romantic partner at a time. Polyamory is often perceived as being perverse, amoral, and relationally broken or deficient; however, people who identify as polyamorous are found to be as mentally healthy and happy as people who are monogamous. Clients who identify as polyamorous may experience their counselor as lacking familiarity with and knowledge of polyamory or as actively working against their identity. This study was a phenomenological inquiry designed to illuminate the counseling experiences of polyamorous people. Data were collected through semistructured interviews with eight participants and analyzed with a modified van Kaam method with relational-cultural theory as the framework. The three major findings that constitute the essence of this inquiry were: (a) participants experienced disappointment and disrespect in the counselor's ignorance of their vital identities, (b) the necessities of trust and connection between participant and counselor for empowerment and growth, and (c) the complementary nature of relationality in polyamory and counseling. These findings indicated counselors should seek a baseline of education on polyamory. The implications for counselor educators were to strive to envelope counselors-in-training in a culture that supports developing multicultural competency and …

This study aimed to explore supervisee and supervisor experiences of relational depth (RD) within the supervisory relationship and its association with supervisee level of counselor self-efficacy (CSE). Participants in the study were master's level counseling students and their doctoral supervisors in a practicum course. A total of 52 supervisees (aged 22-57; 19.2% male, 80.8% female) and 18 supervisors (aged 25-46; 16.7% male, 83.3% female) participated in the study. Results demonstrated that supervisee perception of the relationship explained approximately 15% of the variance in supervisee CSE. Specifically, supervisee perception of supervisory working alliance (SWA; β = .406, rs2=.997, p = .025) was found to be a significant predictor of CSE while supervisee RD was not a significant unique predictor (β = -.033, rs2=.370, p = .850), with most of the variance explained by RD being shared with SWA. Results also demonstrated that the supervisor perception of the relationship did not significantly explain variance in supervisee CSE. From these results, one may tentatively conclude that the supervisory relationship contributes to CSE, and that RD, as it is currently being measured, may not able to account for variance above or beyond that of the SWA. Extended results are described and summarized using text, …

The effectiveness of a pre-graduation animal assisted therapy internship site was investigated through an ethnographic, phenomenological methodology with mixed-methods components. A total of 12 participants who fit into either the category of supervisor, intern, or administrator involved in the animal assisted therapy practice, were interviewed. A research team analyzed the qualitative interview data and researcher participant field notes and came to a consensus of eight major themes: ranch environment, ranch modalities, community impact, counselor development, relationships, partnership, sense of purpose, and the COVID-19 pandemic. Past historical client data were analyzed (n = 47) to investigate effectiveness of the AAT internship cite through the lens of the clients. Historical client data was divided into three categories, dependent on the client's age and the assessment taken: Adult Self Report (ASR), Youth Self Report (YSR), and Child Behavior Checklist (CBCL). A paired t-test was run for each assessment group to compare the means of the pre-assessment scores and the means of the post assessment scores for the total problems scale and anxiety problems scale. There was a statistically significant decrease in anxiety problems for the CBCL group. There was a marginally statistically significant decrease in total problems for the CBCL group. There were …

Multicultural (MC) counseling and social justice (SJ) are foundational parts of counselors' professional identity, and they are fostered through a developmental process that counselor educators facilitate. The purpose of this study was to explore the relationship between counselor educators' ethnic/racial identity development (ERI), their social justice orientation (SJO) and their multicultural teaching competence (MCTC). MCTC was examined using the constructs of knowledge and sensitivity. Data was collected from a nationally distributed online survey. Data were analyzed using four hierarchical regression models in order to control for socially desirable responding. Results indicated that ERI was a significant predictor of MCTC-Knowledge (p < .001) and that SJO was a significant predictor of MCTC-Sensitivity (p < .001). Socially desirable responding was not significantly related to MCTC. Results suggest the importance of attending to ERI and SJO as separate processes in training future counselor educators.

Assessment is a foundational part of counseling practice, which includes the process of providing assessment feedback to those tested. Millions of children are assessed across the United States through the public-school system, hospital, agency, and private practice settings. Though millions of children are assessed yearly, there has been little research surrounding providing assessment feedback with children. In this study, the author qualitatively explored children's experiences with a developmentally appropriate feedback model, the young children's assessment feedback (YCAF). Participants included ten 6 to 10-year old children, who had not previously gone through psychoeducational testing within the last year. Participants completed a battery of psychoeducational assessments and the YCAF feedback process. Data sources included session transcriptions, session observation notes, child interviews, parent interviews, and expressive arts observation notes. In order to explore the perceptions regarding the YCAF, the author utilized interpretative phenomenological analysis to understand the children's feedback experiences. Findings included the following themes: freedom for self-direction, self-concept, therapeutic relationship, affective responses of child, systemic shifts, and developmental considerations. The themes show that the children in this study saw a variety of benefits and experiences surrounding receiving their own personalized, developmentally appropriate assessment feedback.

Children experience a multitude of benefits in response to interactions with nature. Despite documented effects, children have increasingly spent less time outdoors over the last century and experienced higher rates of physical and emotional illnesses. Although child-centered play therapy (CCPT) is a culturally and developmentally responsive mental health treatment for children, researchers have limited study of environmental structure and materials employed in the therapeutic process of CCPT. In this study, I sought to further research on the integration of nature with CCPT by providing CCPT in an outdoor, contained playroom equipped with traditional CCPT toys and additional nature materials. Participants were 13 children in the southwestern U.S. with parent-reported attentional or self-regulation concerns (9 males, 6 females; ages 5-10, mean age M = 8.0). Parents reported participants' racial identities were 13% Black (n = 2), 13% Latinx (n = 2), 7% Turkish (n = 1), and 67% White (n = 10). Participants received 8 weeks of twice-weekly CCPT in an outdoor playroom. Results of two repeated measures ANOVAs revealed statistically significant improvement in attention on the Brown EF/A Scales and statistically significant improvement in social-emotional competencies on the SEARS-P. Results of this study illustrate the possible benefits of theoretically integrating …

The purpose of the present study was to explore a theoretically based social-cognitive model of posttraumatic stress disorder (PTSD) by investigating attachment-related and social-cognitive predictors of PTSD in a sample of 125 post-9/11 U.S. combat veterans. Subjects completed an online survey assessing PTSD symptomology, attachment-related internal working models, perceived social support, and mentalizing capacity. Path analysis provided empirical support for a respecified version of the model. More negative internal working model of self and poorer mentalizing capacity predicted higher PTSD symptom levels. Contrary to previous findings, greater perceived social support predicted higher, not lower, PTSD symptom levels. Mentalizing capacity mediated the relationship between internal working model of self and PTSD symptoms in a complementary manner, whereas perceived social support as a mediator was dampening. The relationship between internal working model of others and PTSD symptom levels was fully mediated by perceived social support, which buffered the effect of negative working model of others on PTSD symptom levels. These findings underscore the importance of social-cognitive processing, rooted in early attachment experiences, in the development and symptomology of PTSD in trauma-exposed veterans. In preparing clients for trauma work, clinicians may consider employing modalities that promote earned secure attachment and highlight mentalization in …

Depression in childhood is a significant mental health concern, impacting cognitive, affective, social, behavioral, and physical domains. Children who experience depressive symptoms are at an increased risk for physical and mental health, social, and behavioral problems throughout adulthood. Children who are marginalized due to their socioeconomic status, racial and ethnic identities are at an increased risk to experience depression and limited access to mental health care. Further, previous research has demonstrated limited efficacy of depression treatments for young children. In this study, I examined the efficacy of child-centered play therapy [CCPT], a culturally and developmentally responsive treatment, on depression among young children. Participants were 71 children from five Title 1 elementary schools in the southwestern U.S. referred by school personnel for depressive symptoms (49 males, 22 females; ages 5-9, mean age M = 6.21). The sample consisted of 14 (19.7%) African American, 3 (4.2%) Asian American, 15 (21.1%) biracial, 19 (26.8%) Caucasian, and 20 (28.2%) Latino children. Participants were randomly assigned to eight weeks of twice-weekly CCPT treatment group (n = 34) or a waitlist control group (n = 37). Results of doubly multivariate repeated-measures MANOVA revealed statistically significant improvement in depressive symptoms for children who participated in CCPT on …

The purpose of this transcendental phenomenological inquiry was to explore college-aged women's experiences of body positivity and self-acceptance. I applied a conceptual framework that blended feminist identity development model (FIDM) and relational cultural theory (RCT) to answer the following questions: (a) what are the lived experiences of college-aged women who identify as having a positive and accepting body image? and (b) how do college-aged women's intersecting identities contribute to the development of positive and accepting body image? Ten college-age women participated in the current study. The participants provided detailed accounts of their experiences of body image throughout their life. Five overarching themes were identified through data analysis of the interview transcripts: (a) advocating for self and others, (b) beauty expectations and societal definitions, (c) intersecting identities, (d) journey of acceptance, and (e) relationships and community. Participants offered insight into the development of their current position of body positivity and self-acceptance that serve as implications for other relevant contexts. Implications and recommendations drawn from the participants' experiences can inform preventative and treatment care in educational settings, family environments, clinical practice, and integrated care.

Virginia Axline developed a new field of child psychotherapy by applying a nondirective approach to the burgeoning experimentation of utilizing play in therapeutic work with children. While much biographical information is available regarding other leaders in the fields of counseling and psychology, historical research into Axline and her development of child-centered play therapy represent a gap in the literature. The purpose of the current study was to: 1) examine the professional contributions of Virginia Axline; 2) gather personal information regarding Axline that contributes to deeper understanding of her theory; and 3) identify life circumstances or events that influenced Axline's professional contributions. Historical methodology was utilized to locate and examine artifacts and materials necessary to create an interpretive biography of Axline's life and work, with a focus on her professional influences, experiences, and contributions. Historical methods utilized include historiography, oral history, and interpretive biography, with an emphasis on established and accepted source criticism and data synthesis processes. The research yielded a number of historically significant and previously unknown documents valuable to the field of CCPT including personal correspondence, academic writings, and interviews, as well as academic and government records. The research also established new information about and understandings of several of …

Childhood poverty is a prevalent concern in the United States and is associated with poor psychological and academic outcomes. Psychosocial stressors associated with life in poverty may interrupt the development of a positive self-concept, ultimately hampering the academic achievement of children in poverty. As the therapeutic objectives of child-centered play therapy (CCPT) support the development of an increasingly positive self-concept, I explored the impact of CCPT on the academic achievement of children in poverty. Participants were composed of 55 students between the ages of 4-7 years old from seven Title 1 elementary schools in the southern United States. Of the 55 study participants, 12 (22%) were female and 43 (78%) were male. Regarding participant ethnicity, 7 (13%) were African American, 1 (2%) was Asian American, 5 (9%) were multi-racial, 35 (64%) were Latino, 6 (11%) were Caucasian, and 1 (2%) did not report ethnicity. Participants were randomly assigned to either a 16 session CCPT treatment group (n = 25) or a waitlist control group (n = 30). A mixed between-within ANOVA was conducted to evaluate improvement in academic achievement scores between treatment and control groups across time. Results indicated a statistically significant interaction effect on the Early Achievement Composite Score …

Pre-tenured faculty in higher education and as well as mothers have reportedly struggled with low wellness levels, high demands, little social support, and an imbalance of work and home life. Mothers in higher education and in counselor education have reported struggling with work-life balance, high scholarly productivity, and long hours as well as the emotional and physical energy demands of working with counselors-in-training. A search of the professional literature revealed a paucity of quantitative research regarding demographic characteristics, wellness levels, and social support levels of mothers among counselor education faculty (MCEs). Participants for this study were faculties of counselor education programs recruited from the Holland List of Counseling Programs and from the Council for Accreditation of Counseling and Related Educational Programs online directory. A total of 180 MCEs participated (aged 29-63, with mean age 40.6 years; 83% Caucasian, 8% other, 5% African American, 3% Hispanic, <1% Asian). Results showed that faculty rank did not account for a significant difference among wellness scores of MCEs and that reported social support, tenure or non-tenure track, number of children in the care of MCEs, number of children under age 8, number of publications, and teaching workload accounted for 14% of the variance in …

The purpose of this phenomenological study was to explore how LGB college students created meaning out of their coming out process to their parents. I recruited LGB college students who perceived support from their parents during their coming out process and asked the following research question: What are the lived experiences of LGB college students who have experienced support from their parents during the coming out process? Seven White (n = 4), African American (n = 2), and Hispanic (n = 1) college students, three men and four women aged 18-24 years, shared narratives that included time periods before, during, and after their coming out disclosures to their parents. Using an adapted phenomenological analysis, I identified nine major themes: awareness of feeling different, positive relationship with parents prior to coming out, college impacting the coming out process, feeling unsure of how parents would respond to disclosure, parents assuring continued loved and acceptance, parents affirming LGB identity, increased relational depth with parents, increased sense of authenticity, and an appreciation for family's response and support. The findings provide insight into how counselors might work most beneficially with LGB college students and their parents around the coming out process. Opportunities for future research …

The goal of this study was to establish empirical benchmarks for Cohen's d in child counseling research. After initial review of over 1,200 child intervention research studies published from 1990 to 2016, 41 randomized clinical trials were identified in which intervention and control groups were compared with children 3-12 years old (N = 3,586). Upon identification or calculation of a Cohen's d for each study, I calculated a weighted mean d by multiplying the effect size of each study by the number of participants in that study then dividing by total number of effect sizes. The weighted mean accounted for study sample size and served as the suggested medium effect size benchmark. Results indicated effect size is impacted in large part by type of reporter, with parents apparently most sensitive to improvement and yielding higher effect sizes overall; teachers relatively less sensitive, perhaps due to difficulty observing change in a classroom setting; and children self-reporting lowest levels of improvement, perhaps reflecting a lack of sufficient measures of child development. Suggested medium benchmarks for Cohen's d in child counseling literature are .70. for parent report, .50 for teacher report, and .36 for child self-report. Small and large benchmarks are suggested based …

Utilizing the theory of planned behavior, I examined the variables that affect Chinese individuals' help-seeking intention. A total of 251 Chinese individuals participated in this study. Results showed that the variables in the theory of planned behavior accounted for 16% of the variance in help-seeking intention. Specifically, attitude (r = .22, p < .001) and perceived behavioral control (r = .22, p < .001) were found to be significant predictors of help-seeking intention. Based on these results, mental health professionals can design outreach interventions, such as psychoeducational programs, to improve Chinese individuals' help-seeking attitude and perceived behavioral control in an attempt to increase mental health service utilization. Additionally, counselors can discuss with clients' their attitude and perceived behavioral control regarding seeking counseling in an attempt to assist clients in being committed to the counseling process.

An estimated 15 million people in the US have had a near‐death experience (NDE), an experience of usually lucid consciousness during a close brush with death. Following an NDE, experiencers (NDErs) sometimes feel challenged and seek counseling to integrate the experience into their subsequent lives. They have reported psychologically harmful experiences disclosing their NDEs to healthcare professionals, including counselors. Counselors' knowledge and attitude about NDEs appear to be critical variables in their ability to uphold the ethical imperative to do no harm to clients. The recent development of a psychometrically sound instrument to assess these variables, coupled with online availability of a three-part NDE educational program for health professionals, made possible for the first time a large‐scale pre‐post study of the effect of the program on counselors' knowledge and attitude about NDEs. Participants were 212 licensed professional counselors (LPCs) aged 23 to 71 years old (M = 44.93, SD = 12.69); sex self-identified as 12.3% male, 87.3% female, and .5% other; racially/ethnically self-identified as 84% White and 17% non-White and as 6.6% Latino-Hispanic and 92.5% non-Latino/Hispanic; and representing four regions of the US. Results revealed that, compared to control group, composed of LPCs who completed topically unrelated online programs (n …

Professional counselors may choose to increase self-awareness and/or engage in self-care through the use of personal therapy. In particular, counselors may feel reluctant to pursue personal therapy due to stigma related to their professional identity. To date, researchers have paid limited attention to the unique concerns of counselors in personal therapy. The purpose of this phenomenological study was to explore counselors' experiences and decision-making in seeking personal therapy. I addressed the following questions: What contributes to counselors' decision to seek personal therapy? How do counselors make meaning of their experiences in utilizing personal therapy? Participants included 13 licensed professional counselors who had attended personal therapy with a licensed mental health professional in the past three years. I identified six emergent themes through adapted classic phenomenological analysis: presenting concerns, therapist attributes, intrapersonal growth, interpersonal growth, therapeutic factors, and challenges. Participants reported positive changes in personality and relationships, as well as several barriers specifically related to their counselor identity. Findings inform mental health professionals and the field of counselor education and supervision about the personal and professional needs of counselors. Limitations and future research directions are discussed.

Aggressive behaviors in childhood currently serve as the leading cause of counselor referrals within the United States. Children exhibiting maladaptive aggressive symptomology are at an increased risk for highly externalized and problematic behaviors across the lifespan. Emotional self-regulation and empathy are two constructs currently believed to be closely related to aggression, but a lack of research exploring these variables currently exists in the counseling literature. In this study I examined the effect of child-centered play therapy (CCPT), is a manualized, developmentally responsive, and nondirective intervention, on these variables. Participants were 71 students from four Title 1 elementary schools in the southwest U.S. referred by teachers for aggressive behavior (12 females, 59 males; age range 5-10 years with mean age 6.28. The sample consisted of 52.1% (n = 37) children identified as African American, 21.1% (n = 15) as Latina/Latino, 19.7% (n = 14) as Caucasian, and 7% as multiracial (n = 5). Participants were randomly assigned to 8 weeks of a twice-weekly CCPT experimental group (n = 36) or a waitlist control group (n = 35). Results of descriptive discriminant analyses (DDA) of the Social Emotional Assets and Resilience Scale and the Children’s Aggression Scale scores revealed that parents perceived …

A randomized controlled trial study was conducted to test the effectiveness of 16 sessions of the modalities of individual and group child-centered play therapy (CCPT) on improving social-emotional assets, including self-regulation/responsibility, social competence, and empathy. Participants were 56 students in four urban elementary schools in north central Texas, referred by teachers for disruptive or problematic behavior: 10 female and 46 male; ages 5 to 10 years with mean age 7.12; and 21 identifying as Hispanic, 17 as White, 8 as Multiracial, 1 as Asian, and 9 unspecified. Teachers and parents completed the Social and Emotional Assets and Resilience Scale (SEARS; Merrill, 2011) at pre- and post-treatment. With a significance criterion of p< .05, teacher reports provided no statistically significant results. However, parent reports indicated a statistically and practically significant interaction effect with a medium to large effect size, indicating a substantial improvement in children's scores from pre- to post-test attributed to group assignment. Mean differences indicated substantial gains in overall social-emotional assets, according to Total scores, in both individual and group treatment conditions as compared to the waitlist control group. Additionally, both individual and group play therapy was correlated with significant improvement with a large effect for the constructs of …

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.