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PurposeTest hope as mediator of relationships between attachment and depressive symptoms for trauma patients, and evaluate relationships among psychological variables (i.e., attachment, hope, and depression) and medical variables (i.e., patient admission disposition, length of intensive care unit (ICU) stay, discharge status, intubation, and days on ventilator).DesignQuantitative descriptive design using multiple regression and correlational techniques.Participants106 participants were recruited from among admitted patients at a nationally verified university Level I trauma center.ResultsHope was a significant mediator of the relationship between attachment and depression. Admission to the ICU instead of less intensive care was associated with lower secure attachment and elevated avoidant attachment. Longer ICU stays were related to lower secure attachment, elevated anxious attachment, low hope, and elevated depression. Discharge to a facility (rather than home) was associated with elevated anxious attachment and elevated depression. Intubation and days on a ventilator were associated with elevated anxious attachment. Secure attachment, anxious attachment, and hope were related to depression.Conclusionscreening trauma patients for personality and psychological characteristics that hamper recovery may improve outcomes. Hope-enhancing interventions may decrease attachment-predicted depression and improve recovery for trauma patients.

Police officers often continue to face numerous threats and stressors in the aftermath of a disaster. To date, posttraumatic growth (PTG) has been studied primarily in the context of significant trauma; thus, it is not known whether stressful life events are associated with PTG. This study investigated the development of PTG among 113 police officers working in the New Orleans area following Hurricane Katrina. Hierarchical regression was used to evaluate if gratitude, social support, and satisfaction with life moderated the relationship between stressful life events (as measured by the total life stress score) and PTG, after adjustment for age, sex, race, level of involvement in Hurricane Katrina, and alcohol intake. Results indicate that stressful life events are independently associated with PTG. Gratitude, satisfaction with life, and social support were seen to moderate this relationship; as stressful life events increased so too did PTG-particularly among officers with higher levels of gratitude (B = 0.002, p ≤ .05), satisfaction with life (B = 0.002, p ≤ .05), and social support (B = 0.001, p ≤ .05). These findings suggest that promoting satisfaction with life, interpersonal support, and gratitude may be beneficial to those who are regularly at risk of trauma exposure.

The symptoms of ADHD are highly subjective, and there is ample empirical evidence that demonstrates the ease with which impairments in attention can be feigned on many commonly used subjective and objective measures of attention. We examined the combination of two assessment measures, NV-MSVT and IVA+, to screen for performance validity and ADHD symptoms in college students. Results indicated that the NV-MSVT was effective in differentiating between students with potential high impairment, such as ADHD, and possible malingerers. In addition, in vivo clinical data (N = 350) resulted in lower validity cut-off scores on the IVA+ than had been previously suggested. Clinical implications and future research are also discussed.

The effect of a 6-week loving-kindness meditation (LKM) on the multidimensional empathy of 103 master's-level counseling students was evaluated, in addition to the correlation between reported levels of time spent meditating and empathy. Statistical analyses indicated that participants who received the LKM intervention experienced gains in dimensions of empathy. A significant relationship between quantity of meditation and perspective taking was noted. Implications and suggestions for future research are explored.

Counseling is defined as "a professional relationship that empowers diverse individuals, families, and groups to accomplish mental health, wellness, education, and career goals" (American Counseling Association; ACA, 2010). The term counselor encompasses many subfields, such as clinical mental health counselors, rehabilitation counselors, addictions counselors, career counselors, school counselors, and marriage and family therapists. Professionally, a counselor's role includes facilitating growth and development, helping clients to form healthy relationships, collaborating with clients on their counseling goals, and promoting social justice through advocacy practices. In addition, counselors must be self-aware, self-reflective, and practice self-care. These ethical mandates are in place to protect the welfare and dignity of clients (ACA, 2014). Counselors engage in rewarding, yet emotionally demanding, work. Those who work in the helping professions are at risk for burnout, compassion fatigue, and vicarious trauma. Professional helpers report higher levels of stress than workers across all other industries (American Psychological Association, 2007). Therefore, in addition to having the skills and attributes necessary for effectively helping their clients, counselors also must take care of themselves. The personal wellness of counselors is now emphasized because counselor characteristics affect counselor efficacy, the counseling process, and counseling outcomes (Norcross, 2002; Roach & Young, 2007; Shallcross, 2013).Counseling outcome research points to interpersonal variables between clients and counselors as integral to client progress (Norcross, 2002; Westen, Novotny, & Thompson-Brenner, 2004). Treatment approaches and techniques account for only 10% to 15% of the variance in counseling outcomes. On the other hand, common factors (i.e., elements that are evidenced across therapeutic approaches regardless of theoretical orientation) account for about 30% of counseling efficacy (Hauser & Hays, 2010; Norcross, 2002; Okiishi, Lambert, Nielsen, & Ogles, 2003). According to the literature, one common factor that is integral to client progress is the therapeutic alliance (Hauser & Hays, 2010; Norcross, 2002; Baldwin, Wampold, & Imel, 2007). The therapeutic alliance is the collaborative, purposive, and complex working relationship between the counselor and client (Baldwin et al., 2007).Counselor characteristics play an important part in the development of the therapeutic alliance (Baldwin et al., 2007; Castonguay, Constantino, & Holtforth, 2006; Hauser & Hays, 2010). A number of studies have suggested that the characteristics of effective counselors would include empathy, warmth, accepting attitude, open-mindedness, flexibility, personal and interpersonal awareness, social-cognitive maturity, social-emotional wellbeing, and self-care (Bauer & McAdams, 2004; Lambie, Smith, & leva, 2009; Norcross, 2002). Lambert and Okiishi ( 1997) noted the importance of exploring what constitutes effective counselor characteristics, attitudes, and practices. More than a decade later, researchers are still trying to identify these characteristics (Hauser & Hays, 2010).In response to the obvious need for exploratory research to identify and examine characteristics of effective and well-balanced counselors, the present study aims to provide new groundwork in determining such characteristics, practices, and attitudes by obtaining information directly from supervisors working in the counseling field. To this end, counseling supervisors brainstormed and organized elements perceived to be associated with effective and well-balanced counselors.MethodThis study addresses the first phase of a multi-phase mixed-methods research project. The intent was to create a foundation for understanding the characteristics of effective and well balanced counselors from the perception of counseling supervisors. …

Media and societal conditions affect fear development in youth; thus, counselors must remain current in their understanding of these fears in order to meet children's health, educational and developmental needs. Because of the changing content and course of children's fears, it is imperative that treatment approaches evolve concurrently. Therefore, there is a need for a review and expansion of the current understanding of children's fears and anxiety and related treatment considerations. This article aims to connect research and literature regarding children's fears with current conceptions of emotions, affect regulation and resilience in order to advocate for a holistic and modern approach for addressing fear in children.Keywords: affect regulation, anxiety, children, fears, resilienceMore than a century of research confirms the need for professional counselors to remain current in their understanding and treatment of the fears of children and adolescents (Burnham, 2009; Hall, 1897; Jersild & Holmes, 1935). When discussing youths' fears, the literature includes the terms fear, anxiety and anxiety disorders. Fear is defined as a distressing emotion resulting from a real or perceived threat, and anxiety is the anticipation (i.e., fear) of a potential future threat (American Psychiatric Association [APA], 2013). The terms fear and anxiety are often used interchangeably or in tandem in the literature as they appear to reflect similar underlying neurobiological processes. Anxiety disorders are included in the discussion because they are psychological disorders that are viewed as developmentally inappropriate or as reflecting pathological levels of fear and anxiety (APA, 2013; Klein, 2009).While the content and severity of children's fears varies greatly, the evidence is clear that as society changes, approaches to treating children's fear and anxiety must be adapted (Burnham, 2009). Burnham (2009) concluded that contemporary fears of today's youth are influenced by global events (such as natural disasters, war and terrorism), societal changes, and television and media exposure. Stress and negative events contribute to heightened fear responses in children (Ollendick, Langley, Jones, & Kephart, 2001). Any stressful incidents that children experience have the potential to generate fear-related disorders (Robinson, Rotter, Robinson, Fey, & Vogel, 2004). Because of the ever-changing nature of society, it is essential for counselors to remain cognizant of the impact that current events might have on the children with whom they work, particularly in relation to their fears and coping mechanisms.Current literature points to positive emotions and affect regulation as means of increasing resilience (Fredrickson, 2001; Fredrickson, Cohn, Coffey, Pek, & Finkel, 2008; Hannesdottir & Ollendick, 2007). Resilience, or the ability to overcome adversity, is an essential component of coping with fears and anxiety effectively (Masten, 2001). The increase in adversities during the past decade, such as terrorist attacks, war, hurricanes and school shootings (Burnham, 2005, 2007, 2009), warrants a renewed focus on children's fears and the promotion of resilience (Burnham, 2009; Tugade, Fredrickson, & Barrett, 2004).Fears, worries and other stressors (e.g., academic issues, conflict, change) are typical aspects of human development; however, children often do not learn effective or appropriate skills to help them cope with these challenges (Robinson et ah, 2004). Although children may develop coping mechanisms in the absence of direct instruction, these are often avoidant mechanisms that lead to poorer outcomes (Abei, Giger, Plattner, Metzke, & Steinhausen, 2013). Maladaptive fear responses can lead to the development of anxiety disorders (Kiel & Buss, 2014). Anxiety is the most prevalent childhood disorder and a strong predictor of adult psychopathology (Weems & Silverman, 2006). Thus, teaching children helpful ways to cope with fears can promote healthy development. …

Through in-depth interviews, the authors examined 10 master's-level counseling students' perceptions of gatekeeping. Case analysis resulted in 3 major themes pertaining to the necessity of gatekeeping, vital components, and counseling student characteristics. Implications of the findings are also discussed.

Loving-kindness meditation (LKM) is a type of mindfulness-based meditation that emphasizes caring and connection with others. LKM incorporates nonjudgmental awareness of the present moment, which enhances attention, presence, acceptance, and self-regulation; it also entails directing caring feelings toward oneself and then others and emphasizes both self-care and interconnectedness. Thus, LKM is suitable for helping clients forge healthy connections with themselves and others. This article examines the use and implications of LKM in counseling.

Mild traumatic brain injury (MTBI) and posttraumatic stress disorder (PTSD) are considered the “signature injuries” of combat soldiers returning from Iraq and Afghanistan. Both disorders can greatly affect the functioning of soldiers, yet the disorders often go undetected or are misdiagnosed by both military and civilian health care providers. This article provides information about MTBI and PTSD in returning combat soldiers along with implications for assessment and diagnosis.