Article

An Exploratory Examination of the Sexual Intervention Self-Efficacy of Clinical Psychology Graduate Students

Authors:
To read the full-text of this research, you can request a copy directly from the authors.

Abstract

The current study investigated clinical psychology graduate students' self-efficacy regarding addressing clients' sexual concerns and problems. Students with more sexually liberal attitudes had higher self-efficacy beliefs. Sexuality-specific training experiences but not sexual attitudes or anxiety predicted the amount of sex therapy experience gained during graduate school. Students with more didactic education related to sexuality, more sex therapy experience, and more experience observing a clinician conducting sex therapy, had stronger sexual intervention self-efficacy beliefs. These educational experiences contributed to students' self-efficacy over and above general psychology training. The results speak to the importance of direct training to deal with clients' sexual concerns. (PsycINFO Database Record (c) 2012 APA, all rights reserved)

No full-text available

Request Full-text Paper PDF

To read the full-text of this research,
you can request a copy directly from the authors.

... has been written about what counselors and therapists are taught about human sexuality, and pertinent literature tends to be outdated (Jaramillo, 2018). The limited research on clinicians' ability, willingness, and comfort with sexuality has suggested that clinicians are not, in general, sex positive (Ford & Hendrick, 2003;Hanzlik & Gaubatz, 2012;S. Miller & Byers, 2008;S. A. Miller & Byers, 2010;Schover, 1981). In a recent study of why clinicians do not address sexuality with clients, participants stated that sexuality was difficult to discuss and that they saw it as a peripheral issue (Urry, Chur-Hansen, & Khaw, 2019). Counselors justified not discussing sexuality because they believed it was not prac ...
... y brought it up (Urry et al., 2019). This is consistent with other literature that pointed to a lack of training on sexuality, deficits in clinicians' skills in addressing sexuality, a lack of clinician confidence in addressing client sexuality, and clinician discomfort with the topic of sexuality (Dermer & Bachenberg, 2015;Hanzlik & Gaubatz, 2012;S. Miller & Byers, 2008;S. A. Miller & Byers, 2010;Mollen, Burnes, Lee, & Abbott, 2018;Southern & Cade, 2011;Wilson, 2019). Programs are not preparing clinicians adequately to discuss these basic sexual topics, preparing them even less to discuss more "controversial" behaviors such as recreational swinging, group sex, and consensual sexual fetishistic behaviors ...
... group sex, and consensual sexual fetishistic behaviors (Ford & Hendrick, 2003;Mollen et al., 2018). There is a need for more comprehensive training to ensure clinicians are prepared, capable, and comfortable in addressing client concerns related to sexuality in general and specific sexual behaviors (Dermer & Bachen-berg, 2015;Ford & Hendrick, 2003;S. Miller & Byers, 2008;S. A. Miller & Byers, 2010;Mollen et al., 2018). ...
Article
The purpose of this study was to develop a valid, reliable scale to assess people’s comfort with sexual behaviors. The Comfort with Sexual Behaviors Scale (CSBS) was developed through multiple administrations. One factor, general comfort talking about sexual behaviors, accounted for 65% of the variance. The 30-item CSBS was a valid and reliable measure of comfort with discussion of sexual behaviors.
... Directors of clinical psychology programs have suggested sexuality can be competently addressed within general training (Wiederman & Sansone, 1999). By contrast, subsequent findings have revealed the need for specialized training as students with sexuality training report more confidence in addressing sexuality in practice (Miller & Byers, 2008). While all psychologists need knowledge, skills, and a healthy attitude to work effectively with clients regarding sexuality, counseling psychologists may be especially well-suited to spearhead training and research in sexuality. ...
... Recently, Swislow (2016) found that clinical psychology faculty demonstrated significantly more knowledge pertaining to sexual problems than healthy sexuality, consistent with the historical focus on sexual dysfunction (Miller & Byers, 2008Wiederman & Sansone, 1999). While the majority (90%) of faculty members identified human sexuality as highly important, they reported a lack of competence (Swislow, 2016). ...
... Representatives from 38 of the 92 solicited programs participated, resulting in a response rate of 41.3%, consistent with or better than similar studies (e.g., Asher, 2007;Burnes et al., 2017a;Miller & Byers, 2008 . Most programs identified as Ph.D. programs in counseling psychology (n = 16) or offering a Ph.D. and master's-level degree (M.A., M.Ed., or M.S.) in counseling psychology (n = 9). ...
Article
The United States (U.S.) is characterized by some of the poorest sexual health outcomes in the industrialized world, as indicated by the teen and unplanned pregnancy rates, rate of sexually transmitted infections (STIs), and occurrence of sexual dysfunction. Many people seek psychotherapy for sex-related concerns, yet little is known about the specific education psychologists receive during their training regarding sex. Existing research has largely been conducted in Canada and among clinical psychologists. While studies have revealed that few applied psychology graduate programs offer training in sexuality, very little is known about the specific content areas covered by those programs who do offer this training. We surveyed faculty from 38 counseling psychology doctoral programs primarily in the U.S. Results indicated that relatively few programs offer comprehensive training in sexuality with particular areas such as sex therapy, sexual expression, and reproductive health especially unlikely to be covered. Commonly covered topics included sexual development, sexual orientation and gender identity, intimacy, sexual trauma and abuse, and intersectionality. Implications for training and future research are offered.
... Although sex is an essential human activity and sexual dysfunction might affect a substantial part of the U.S. population, practicing psychologists con- tinue to be uncomfortable approaching issues of sex and sexuality in therapy (Ng, 2007). This discomfort might be due to psychologists' attitudes and val- ues around sex in addition to a lack of training about sex and sexual function- ing in psychology graduate programs (Miller & Byers, 2008;Reissing & Di Giulio, 2010). Thus, even though sexuality is an important aspect of one's identity that enhances well-being (Bancroft, 2009), psychologists might not be equipped to approach conversations around sex and sexuality in therapy (Reissing & Di Giulio, 2010;Risen 1995). ...
... Upon closer examination of the sex and sexuality literature in psychology, it is evident that most studies of training programs and psychologists have examined the topic in the context of addressing sexual dysfunction, paraphil- ias, and sexually transmitted infections in therapy (Hanzlik & Gaubatz, 2012;Miller & Byers 2008, 2009Reissing & Di Giulio, 2010). When it comes to healthy sexual functioning or simply discussing sex in therapy, the dearth of research or professional recommendations is apparent. ...
... Hence, sex and sexual functioning is usually discussed in the therapy room when it is a source of their distress or grief for the client; otherwise, it is largely ignored in the con- text of therapeutic work. Furthermore, it is often left to the client to bring up this topic in therapy, as psychologists admit to not addressing sex unless spe- cifically asked by the client (Miller & Byers, 2008;Ng, 2007). Professional psychology, similar to dominant U.S. society, continues to ignore discussing sex unless it is in the context of a medical or psychological illness, potentially reinforcing a sex-negative approach (Glickman, 2000). ...
Article
Counseling psychologists should take an active approach in broaching issues of sex and sexuality, given that clients may hesitate to initiate such conversations due to their discomfort or fears about therapists' attitudes or judgments. Research has suggested that mental health providers need to be skilled and comfortable addressing issues of sex and sexuality in order to provide culturally competent, holistic care for clients. Consistent with a sex-positive approach, which views sexuality as a universal human experience and an important aspect of overall psychological health, quality of life, and relational satisfaction, in this article we present five recommendations for counseling psychologists, encouraging them to integrate topics of sex and sexuality into clinical practice. Following Pederson's (2000) Triad Training Model of awareness, knowledge, and skills, we provide recommendations accompanied with questions and examples of proactive and sex-positive language. © Division of Counseling Psychology of the American Psychological Association.
... Although scholars have documented common implications of inadequate sexuality training, which include adverse clinician reactions (e.g., feelings of embarrassment, anxiety, shock, and sexual arousal; Anderson, 1986), we suggest that a lack of sex-positive training could have additional implications. These may include reluctance to broach sexual topics with clients (Hanzlik & Gaubatz, 2012;Hays, 2003;Ng, 2007); unintentionally impeding clients' disclosure of sexual issues (Hanzlik & Gaubatz, 2012); reduced counselor willingness to treat sexual concerns (Berman, 1997;Miller & Byers, 2008); and avoidance of sexual problems (Reissing & Di Giulio, 2010;Risen, 1995). For sexual concerns that clinicians do not feel competent to treat, consultation and referral are heavily utilized strategies (Miller & Byers, 2009). ...
... A growing body of literature has elucidated the benefits of sexuality-specific education and training on clinicians' (a) knowledge and competency about sexual topics as well as skills in discussing these topics with clients (Alzate, 1990;Berman, 1997;Hanzlik & Gaubatz, 2012;Harris & Hays, 2008;Hays, 2003;Rosen, Kountz, Post-Zwicker, Leiblum, & Wiegel, 2006), and (b) willingness to treat sexual issues (Berman, 1997;Fisher et al., 1988;Miller & Byers, 2008;Reissing & Di Giulio, 2010;Rosen et al., 2006). These findings, however, may not necessarily translate into better client care or more effective treatment. ...
... To help assess the adequacy and effectiveness of sexuality-specific training, Miller and Byers (2008) conceptualized the construct of sexual intervention self-efficacy as the "confidence in one's ability to treat clients with sexual concerns, to relay accurate sexual information, and to exhibit comfort and a lack of bias when discussing sexual issues" (p. 138). ...
Article
Full-text available
In this manuscript, we explore the need for inclusion of sex-positivity training in counseling psychology doctoral program curricula. We surveyed 25 counseling psychology doctoral program administrators throughout the United States and asked about the inclusion of human sexuality coursework and training opportunities as well as sex positivity within their curricula. We report our findings, noting the number of programs that include human sexuality coursework, incorporate sex positivity, discuss sex positivity, and discuss sex positivity from a multicultural lens. The implications of these findings for research, practice, training, and advocacy within counseling psychology are discussed.
... One might assume that the general training MFT/Cs receive during their coursework should prepare them to discuss sexuality and promote sexual health, but research suggests this is not the case (Haboubi & Lincon, 2003;Hanzlik & Gaubatz, 2012;Harris & Hays, 2008;Miller & Buyers, 2012). Although there is little research on clinicians' comfort and training related to sexuality, the existing literature highlights clinicians are sometimes perceived as uncomfortable discussing sexuality (Croft & Amussen, 1993), report being uncomfortable discussing sexuality (Hymer & Rubin, Importance of Training in Sexual Health ª 2015 Australian Association of Family Therapy 1982; Knapp, 1975;Stockwell, Walker & Eshleman, 2010), and want more training on sexuality (Miller & Byers, 2008, 2010Schover, 1981). ...
... Clinicians need to be prepared to have open discourse about sexual development, sexual behaviours, and the meaning of sexual experiences (Miller & Byers, 2008). Professionals, through their attitudes, language, and actions, need to: (1) convey acceptance of others; (2) challenge myths about sexuality; (3) be able to give information about physical, sexual responses (or hindrances to them); (4) discuss sexuality as related to intimacy and emotional expression; (5) understand sex as a source for pleasure, and; (6) be positive toward sexuality (WAS, 2010). ...
... This clearly relates to the lack of training across the different mental health fields, which may lead to a lack of comfort when discussing sexual topics with clients (e.g., Ford & Hendrick, 2003;McCave, 2014;Miller & Byers, 2008, 2010Schover, 1981). Given the breadth of sexual topics about which clinicians should be knowledgeable, it is also unlikely they are comfortable discussing all of them. ...
Article
Full-text available
Sexual health has been declared a sexual right and part of human rights on health and freedom from discrimination. Over 40 years ago the World Health Organization, and other international organisations since, have called for marital, couple, and family therapists to be trained in working with sexuality in a respectful, positive manner that affirms sexual health and sexual expression. Despite this, there have not been significant strides in helping therapists understand a view of sexual health focused on freedom of expression and pleasure, nor significant advances in requirements for professional training in a broad conceptualisation of sexuality. There is also evidence that practitioner comfort with the topic has not significantly changed over time. In this paper, ethical issues impeding the advancement of sexual health services within mental health professions are explored and recommendations for training curriculums are provided.
... Despite the benefits of sexuality training and education for health providers, there continues to be a lack of graduate training programs integrating sexual health into the curricula (Campos et al., 1989;Miller & Byers, 2008;Ng, 2007;Reissing & Di Giulio, 2010;Wiederman & Sansone, 1999). This gap creates an opportunity for clinical researchers and educators to investigate and address barriers preventing integration of sexual health provision into clinical practice, particularly among older adult patients. ...
... Furthermore, a study examining psychologists' sexual intervention, self-efficacy, and willingness to treat sexual issues found that psychologists who received more graduate education in sexual health sought more continuing education in sexuality. More education and training was associated with higher sexual intervention and self-efficacy that was, in turn, associated with more intervention behaviors (Miller & Byers, 2008). Our findings also support the idea that psychologists' attitudes may directly influence their clinical decisions (Dowrick et al., 2000;Van Ryn, 2002). ...
... Several researchers have proposed and developed solutions to improve the education and training of psychologists in both of the areas of sexual health and aging (Hinrichsen & McMeniman, 2002;Hinrichsen, Zeiss, Karel, & Molinari, 2010;Koder & Helmes, 2008;Miller & Byers, 2008. There are limitations to the depth and breadth of education and training that can be expected of programs, but many proposed solutions suggest streamlining the concepts into existing curricula rather than trying to make room for more courses. ...
Article
Studies suggest an association between older adults’ sexual health and quality of life. Despite this, previous research suggests a lack of assessment of older adults’ sexual health. To understand this gap, we examined predictors of practicing psychologists’ attitudes to and assessment of the sexual health of older adults. This study utilized purposive online sampling to recruit 119 US practicing psychologists (median years licensed=11). Participants completed questionnaires on sociodemographics, education and training, and were randomized to a vignette condition depicting a middle-aged or older adult with mood and sexual health concerns. Following the vignette, participants completed a survey on attitudes and their willingness to assess patients’ sexual health. Participants’ vignette condition, sociodemographics, clinical education, experience, and specialty did not predict attitudes toward older adults’ sexuality. However, results indicated that negative attitudes toward older adults’ sexuality (p=.01) and sexuality education and training (p=.001) predicted psychologists’ willingness to assess sexual health. Results indicate that in order to increase psychologists’ assessments of older adults’ sexual health, interventions should focus on changing attitudes toward older adults’ sexuality, and increasing psychologists’ sexuality education and training.
... Following the distinction in type of studies we found within the selection five survey studies, in which researchers were searching for factors affecting self-efficacy, measuring students' self-efficacy at one moment: Tresolini and Stritter (1994), Cassidy and Eachus (2002), Cantrell, Young and Moore (2003), Tang et al. (2004), and Miller and Byers (2008). Besides these we found within our selection twelve intervention studies in which researchers investigated the effects of an interventional treatment with underlying theories different from social cognitive theory. ...
... Three studies (Cassidy & Eachus, 2002;Cantrell et al., 2003;Tang et al., 2004) reveal factors indicating that the amount of experiences is related to students' self-efficacy. Two studies (Tresolini & Stritter, 1994;Miller & Byers, 2008) reveal factors referencing the type of experience. Regarding the self-efficacy sources, four studies describe students' (2008) Sexuality-specific training experiences x x experiences in terms of sources of self-efficacy information. ...
... Tresolini and Stritter (1994) linked the found patterns of experience with all 4 sources of efficacy information. Although all survey studies suggest there is a relationship between identified factors and student self-efficacy, several researchers (Cantrell et al., 2003;Tang et al., 2004;Miller & Byers, 2008) point at the limitations of their studies mentioning sample size and used correlational methods. ...
Article
Full-text available
Researchers working in educational settings are increasingly paying attention to the role students’ thoughts and beliefs play in the learning process. Self-efficacy, a key element of social cognitive theory, appears to be an important variable because it affects students’ motivation and learning. This article investigates empirical literature about the role of students’ self-efficacy in education by focusing on the following research question: which are the factors shown to affect the self-efficacy of students within higher educational settings? The results of a review reveal that educational programmes have the possibility to enhance students’ self-efficacy, and that educational programmes based on social cognitive theory proved to be particularly successful on this score. Several factors appeared to influence students’ self-efficacy and provided evidence of the potency of the main sources of self-efficacy. Directions for future research are indicated.
... If so, cognitive-affective and demographic factors would be unlikely to affect the extent of direct therapy experience. Indeed, Miller and Byers (2008) found that cognitive-affective factors, including sexual conservatism and sexual anxiety, were not associated with the amount of direct sex therapy experience of clinical psychology graduate students. Rather, other training opportunities, such as observational learning and didactic training, were associated with sex therapy experience. ...
... This suggests that some graduate programs provide comprehensive sex education and training to all students, regardless of their sexual attitudes or beliefs. However, the graduate students in the Miller and Byers (2008) study were, on average, only in their third year of training (although participants ranged from 2 to 9 years of training). It may be that direct therapy experience opportunities are more under the control of students as they progress through advanced practicum placements and internship. ...
... Sexual intervention education and training questionnaire (Miller & Byers, 2008). This measure assessed four aspects of participants' sexuality-focused training during their graduate education (including practicum and internship): didactic training, observational experiences, direct therapy experience, and independent study. ...
Article
The current study explored the sex education and training that clinical and counselling psychologists receive during graduate school, practicum placements and internship. There were 162 psychologists who completed an Internet survey. Although nearly all participants had received some form of education related to sexuality during their graduate training, the depth and breadth of training was limited and was not related to how long clinicians had been practising. Modelling and feedback appeared to be underutilized as training methods. Participants reported more training related to sexual problems (e.g., sexual violence, sexual disorders) than healthy sexuality (e.g., contraception, STIs/STDs). Sexuality-specific training experiences but not participant characteristics (e.g., gender, religiosity) or cognitive-affective factors predicted the amount of sex therapy experience gained during graduate school. This suggests that training programs may be largely responsible for the (limited) amount of sex education and training received by students. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
... The goal of the first study was to examine the extent to which clinical and counselling psychology graduate students receive training related to the sexuality issues they are likely to encounter with their clients through didactic education, practicum training, observational learning, and/or direct practice. We surveyed clinical psychology graduate students in APA and CPA accredited clinical and counselling programs (Miller & Byers, 2008); however, the data reported here are from the 115 participants from the 17 CPA accredited psychology programs only. Students in the second year of their program or higher completed an Internet survey. ...
... Graduate training would likely go a long way toward enhancing students' sexual intervention self-efficacy. That is, we found that students who had more extensive coursework, more vicarious learning experiences and therapy experience, and who had made greater use of resources (e.g., books videos, workshops) outside the program had higher sexual intervention self-efficacy (Miller & Byers, 2008). Interestingly, general clinical training was not related to self-efficacy. ...
... A number of studies, including our own, have found that many practicing psychologists have not received adequate sex education and training (Campos, Brasfield, & Kelly, 1989;Miller & Byers, 2008;Nathan, 1986;Reissing & Di Giulio, 2010;Wiederman & Sansone, 1999). To provide a more comprehensive view of the sexuality education and training that the clinical psychologists receive, we surveyed practicing psychologists in Canada and the United States about their sexual education and training in graduate school (including internship) and through continuing education (Miller & Byers, 2009. ...
Article
Sexual experience and expression is of fundamental importance to most people. However, most people do not communicate effectively about sexuality even when it is important to do so. For example, many parents see it as their responsibility to talk to their children about sexuality and yet do not engage in in-depth discussions with their children about sexual topics. Most romantic partners have difficulty telling each other what pleases and displeases them sexually. Many health care professionals do not meet their patients' needs for information about the sexual changes they experience as a result of their disease or treatment. Many psychologists also are not doing a good job of addressing sexuality in the classroom, in practicum and internship settings, and/or with clients. These instances of poor sexual communication are unfortunate as effective sexual communication can have a range of positive outcomes such as more satisfying relationships and positive sexual health and well-being over the life span. This paper reviews sexual communication in all of these contexts, focusing on findings from my program of research spanning more than 30 years. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
... Clinicians' limited education and training related to sexuality as well as their lack of confidence that they can competently address sexual issues (low sexual intervention selfefficacy) are likely key factors in their failure to address their client's sex issues (Berman, 1996;Miller & Byers, 2008. However, this has not been studied empirically. ...
... In the current study, we assessed sexual intervention self-efficacy. We conceptualized sexual intervention self-efficacy as consisting of three components (Miller & Byers, 2008). First, clinicians must feel that they can appear comfortable discussing sexual issues and prevent personal biases from interfering with treatment. ...
... In keeping with Bandura (1997), more direct and vicarious therapy experience, verbal persuasion, and didactic education have been shown to be related to increased general counselling self-efficacy (Daniels & Larson, 2001;Johnson, Baker, Kopala, Kiselica, & Thompson, 1989;Lane, Daugherty, & Nyman, 1998;Larson et al., 1999;Munson, Zoerink, & Stadulis, 1986). Similarly, Miller and Byers (2008) found that psychology graduate students with more graduate level coursework, vicarious and actual therapy experience, and independent study related to sexuality had higher sexual intervention self-efficacy. However, researchers have not examined whether graduate education continues to relate to self-efficacy once clinicians begin their careers. ...
Article
Full-text available
Many clients who are not seeking sex therapy experience sexual concerns that affect their overall psychological well-being. However, they may be hesitant to broach them if clinicians do not ask about these issues. The current study assessed a model of how sex education and training affect clinicians' sexual intervention self-efficacy (confidence addressing sexual issues) and, in turn, their willingness to address sexual issues. Participants who had completed their graduate work and internship and had been working for more than a year providing therapy to adults were recruited for an on-line survey from the Canadian Registrar of Health Service Providers, the American Psychological Association, and provincial licensing organizations; 110 psychologists completed the survey. Psychologists were found to lack self-efficacy, particularly related to their ability to directly address clients' sexual concerns (Skills Self-Efficacy) and ability to relay accurate information (Information Self-Efficacy). They also did not routinely ask clients about sexual issues. Bootstrapping analysis showed that, consistent with the proposed model, participants who had more graduate level sex education obtained significantly more sex education following internship. This, in turn, was associated with significantly higher Skills Self-Efficacy and Information Self-Efficacy and, ultimately, to clinicians engaging in significantly more intervention behaviors. Sex education and training did not relate to self-efficacy regarding appearing comfortable and being unbiased when addressing sexual issues with clients (Comfort/Bias Self-Efficacy). The results were discussed in terms of the role of graduate education in enhancing sexual intervention self-efficacy as well as the role of self-efficacy in psychologists' willingness to treat their clients' sexual problems and concerns.
... Researchers have not investigated how commonly clinicians ask about sexual issues and/or choose to treat, rather than refer clients' with sexual concerns/problems. Further, although research has illustrated that graduate training in psychology tends to focus more heavily on sexual disorders than on healthy sexuality (Miller & Byers, 2008), it is not known whether psychologists' sexual knowledge is equally imbalanced. ...
... There has also been very limited research on whether continuing sex education affects clinicians' assessment and therapy behaviors and/or sexual knowledge. Graduate students in clinical psychology with more sex education and training have been shown to have a greater willingness to treat, rather than refer, clients with sexual problems (Miller & Byers, 2008). Further, clinicians who participate in continuing education courses on specific sexual topics demonstrate greater knowledge and report increased feelings of professional competency specific to the topic area (Hamberger et al., 2004;Wertz, Sorenson, Liebling, Kessler, & Heeren, 1987). ...
... The Post-Internship Sexual Intervention Education and Training Questionnaire was created for the current study and was modeled after Miller and Byers' (2008) Sexual Intervention Education and Training Questionnaire. It assesses four aspects of participants' sex education and training post-internship: colloquia/workshops, books/videos, observational learning, and consultation. ...
Article
The current study explored whether psychologists are receiving continuing education that may assist them in providing intervention to clients with sexual issues. One hundred and five clinical and counseling psychologists completed an Internet survey. Results suggest that observational opportunities are underutilized and that more training related to sexual problems, as opposed to healthy sexuality, appears to be occurring. Participants with more continuing education were more likely to directly ask about and treat clients' sexual concerns/problems. Nonetheless, in general, participants appeared reluctant to directly ask about and treat sexual issues. The implications of these results for designing continuing education programs are discussed.
... For example, elements of professionalism such as appreciating cultural and individual diversity can be fostered by encouraging bias awareness conversations on HST-relevant issues, student presentations on psychotherapeutic treatments for sexuality concerns may encourage evidence-based clinical practice, and interrogating sexuality education received across the lifespan can nurture the critical thinking required for scientific research . Miller and Byers (2008) found sex education in graduate school among psychologists was associated with higher levels of postinternship sex education and training and, in turn, higher self-efficacy with regard to sexual interventions. Sexuality-specific training, though not general training, was associated with greater comfort discussing sexual issues (Hanzlik & Gaubatz, 2012). ...
... Students also expressed discomfort discussing human sexuality in their clinical practice and identified their lack of training as the source of that discomfort. Some participants had received training or had personal experience with a particular aspect of human sexuality that increased their self-perceived clinical competence, suggesting, similar to Hanzlik and Gaubatz's (2012) and Miller and Byers' (2008) findings, that sexuality-specific training and knowledge increases practitioners' comfort and self-efficacy. ...
Article
Counseling psychologists are a cogent fit to lead the movement toward a sex-positive professional psychology (Burnes et al., 2017a). Though centralizing training in human sexuality (HS; Mollen & Abbott, 2021) and sexual and reproductive health (Grzanka & Frantell, 2017) is congruent with counseling psychologists' values, training programs rarely require or integrate comprehensive sexuality training for their students (Mollen et al., 2020). We employed a critical mixed-methods design in the interest of centering the missing voices of doctoral-level graduate students in counseling psychology in the discussion of the importance of human sexuality competence for counseling psychologists. Using focus groups to ascertain students' perspectives on their human sexuality training (HST) in counseling psychology, responses yielded five themes: (a) HST is integral to counseling psychology training, (b) few opportunities to gain human sexuality competence, (c) inconsistent training and self-directed learning, (d) varying levels of human sexuality comfort and competence, and (e) desire for integration of HST. Survey responses suggested students were trained on the vast majority of human sexuality topics at low levels, consistent with prior studies surveying training directors in counseling psychology and at internship training sites (Abbott et al., 2021; Mollen et al., 2020). Taken together, results suggested students see HST as aligned with the social justice emphasis in counseling psychology but found their current training was inconsistent, incidental rather than intentional, and lacked depth. Recommendations, contextualized within counseling psychology values, are offered to increase opportunities for and strengthen HST in counseling psychology training programs. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
... Unfortunately, the knowledge of how to work well with individuals with a kink identity appears to be quite rare among clinicians. Approximately 80% of psychologists support clients with presenting problems involving sexuality (Reissing & Di Giulio, 2010); however, many mental health professionals report feeling ill-equipped to intervene on sexuality-related issues (Miller & Byers, 2008) and even less on kink identities specifically (Kelsey et al., 2013). Most graduate-level programs do not require clinicians to obtain training in human sexuality or sexual diversity. ...
... Clinicians are further encouraged to seek training in these issues through in-depth sexuality training, kink events, conferences, and training seminars. Additionally, based on work by Miller and Byers (2008), it is reasonable to assume that participation in these experiences would further enhance the self-efficacy of therapists working with a broad range of sexuality issues, including the kink community. The present study further suggests that kink leaders believe that avoiding biased beliefs about kink, attending trainings, and communicating acceptance would lead to improved clinical care with this population. ...
Article
Individuals in the kink community often report difficulty with finding affirming mental health care. Similarly, providers often report having limited knowledge of how best to support sexual diversity. This study highlights difficulties faced by kink individuals seeking clinical care and how providers can be more affirming. The current study utilized Delphi methodology to elucidate what clients with kink identities need from clinicians and the therapeutic environment. The study consisted of perspectives from 12 leaders in the kink community from across the United States. The culmination of their input is outlined and organized into five themes: Client Needs, Awareness and Understanding, Kink Client’s Perceptions of Therapists, Therapist Education & Training, and Client’s Perceptions of Therapy. These themes guide recommendations for practice that may be utilized in clinical training and guide clinical self-reflection.
... However, some inferences can be drawn from what is known. In particular, we encourage prepracticum training in interventions that target depressive, anxiety (including trauma), sexual concerns, sleep disorders, and cigarette smoking, given the large number of practicum training clinic clients who are known to present with these problems (e.g., Callahan, Gustafson, et al., 2014;Funderburk & Fielder, 2013;Miller & Byers, 2008). As previously noted, prepracticum typically spans only the first year of training. ...
... As such, dedicated courses focused on disorder specific treatment in all of these areas is not likely to be feasible and speaks to the importance of integrative approaches during prepracticum training (e.g., Cook, Simiola, Ellis, & Thompson, 2017). Even within that context though, training in smoking cessation and treatments pertaining to sexual concerns or sleep disorders is clearly lagging and in need of attention (Kleinfelder, Price, Dake, Jordan, & Price, 2012;Meltzer, Phillips, & Mindell, 2009;Miller & Byers, 2008). Recent findings from a longitudinal study of training programs that spanned approximately 14 years strongly suggest an insufficiency in addiction training as well (Dimoff, Sayette, & Norcross, 2017). ...
Article
Full-text available
Following a brief review of the evidence available at the time, Christensen and Jacobson (1994) concluded that professional training was unwarranted on the basis of client outcomes. As a result, they advocated for psychologists to focus on program development, training, and supervision while promoting an expansion of paraprofessional-, peer-, and self-administered mental health services. In this updated and expanded review, we focus more narrowly on prepracticum and practicum training in doctoral health services psychology and examine the evidence more closely. At the omnibus level, we conclude that evidence for training-as-usual remains lacking. However, closer inspection reveals effective training methods that significantly improve important psychotherapy elements (e.g., relational competencies; Hill et al., 2015) and client outcomes. After review of the empirical literature, we conclude that (1) training-as-usual is insufficient, (2) selection of individuals for training may be of critical importance, (3) training can produce measurable effects, and (4) those changes are both directly and indirectly associated with reduction of attrition and improved client outcomes. Rather than concluding that training is unwarranted, we conclude that training merits evidence-based augmentation.
... Researchers have consistent ly shown that young people who have more conservative sexu al beliefs hold more negative attitudes toward a range of sexual behaviours, including same-sex sexual activity, abortion, mas turbation, and treatment of sex offenders ( Fisher, 2020 ;Haidt & Hersh, 2001 ;Rosselli & Jeglic, 2017 ). Sexually conservative indi viduals also have lower self-efficacy to communicate about sex ual topics ( Miller & Byers, 2008 ). Thus, it is likely that more sexually conservative individuals have less positive and more negative attitudes toward sexual consent and are less likely to en gage in sexual consent behaviour. ...
Article
Because many young adults do not consistently give and receive explicit consent in their sexual relationships, it is important to identify factors associated with sexual consent attitudes and behaviour. In this study, we assessed the extent to which sexual health education, sexual consent education, sexual attitudes, and perceptions of social norms were associated with sexual consent attitudes and behaviour. Participants were 196 undergraduate students between the ages of 18 and 25 enrolled at an eastern Canadian university. At the bivariate level, we found evidence for the importance of sexual consent education by parents, sexual attitudes, and perceptions of social norms with respect to sexual consent attitudes and behaviour. Multiple regression analyses showed that more positive perceptions of social norms, more liberal sexual attitudes, and more sexual consent education from parents were uniquely associated with lower negative attitudes towards sexual consent and more consistent use of explicit sexual consent. More positive perceptions of social norms and less sexual experience were uniquely associated with more positive sexual consent attitudes. Only perception of social norms was uniquely associated with less use of an indirect behavioural approach to establishing consent. The results are interpreted in terms of their implications for enhancing sexual consent attitudes and behaviour among young people.
... They have not focused on sexuality enough in their training for clinicians to feel comfortable discussing all aspects of sexuality with their clients, including sexual pleasure Bachenberg 2015, Tolman andDiamond 2014). Research has repeatedly demonstrated clinicians do not get adequate training in sexuality and are not comfortable discussing sexuality when they do discuss sexuality (Burnes et al. 2017, Hanzlik and Gaubatz 2012, Kelsey et al. 2011, Miller and Byers 2008, Miller and Byers 2009, Miller and Byers 2012, Mollen et al. 2018. Therapists and psychologists are required to understand basic sexual development and are not supposed to discriminate against sexual minorities. ...
Article
Psychological associations require their trainees and professionals to work with diverse issues and diverse clientele, including sexual issues and sexual and gender minorities. While these organizations have been clear on their stance on non-discrimination toward sexual and gender minorities, research has demonstrated that most psychologists are not well trained on sexuality in general, even though educators and trainees believe sexuality is an important topic. Sexuality is a core aspect of human development across the lifespan. Although sexuality may be expressed differently across cultures, sexuality is a part of overall health and wellness for everyone. Sexuality is a broad concept that can include all types of sexual behaviors, sexual and gender orientation, sexual relationships, sexual pleasure, intimacy, attachment, and reproduction. It may be helpful for psychology to adopt a human rights perspective in their sexuality training. This perspective frames sexual rights as human rights and utilizes a sexual health and wellness framework. Utilizing this perspective, psychologists can focus on sexual citizenship from a global, rights-based, positive, and sexual wellness. Keywords: Human Rights, Pedagogy, Psychology, Sexual Rights, Sexual Wellness.
... In general, health service psychologists appear to receive low levels of sexuality education during doctoral training, with few programs offering a course dedicated to sexuality, a finding that has remained consistent over the past three decades (Campos et al., 1989;Lehmiller, 2017;Miller & Byers, 2008, 2010Wiederman & Sansone, 1999). This lack of training reflects a historical context of abstinence-based education programs within the United States that are focused on illness and reproduction rather than pleasure (Donaghue, 2015). ...
Article
Sexuality education positively impacts health service psychologists’ ability to address sexuality, a vital component of overall health and well-being. There is little information about the integration of sexuality into the applied, fieldwork components of psychologists’ training. We surveyed 139 representatives of APA-accredited doctoral internship programs to assess sexuality content during internship training. Participants completed a survey assessing content integration of 12 domains specific to human sexuality. The most endorsed training related to sexual orientation and gender identity; sexual behavior, sexual ethics, and sex therapy were infrequent in internship training curriculum. Implications for research, practice, training, supervision, and advocacy are discussed.
... Training in sexuality can help improve trainee's self-effi cacy in working with issues surrounding sexuality (Blount, Booth, Webb, & Liles, 2017). Researchers have discussed the need to strengthen trainees' sexual intervention self-effi cacy, as graduate students with more sex education and training have been shown to have a greater willingness to treat (rather than refer) clients with sexual problems (Miller & Byers, 2008). ...
Article
There is a growing movement to incorporate sex positivity into clinical and counseling psychology. Although sex positivity has a framework that promotes diversity and inclusion, intersectionality in sex positive research, training, and practice is practically non-existent. The aim of the present paper is to analyze issues related to sex and sexuality from an intersectional sex positive framework. Discussion surrounding intersectional issues among subgroups, sexualities, and relationship structures will be provided. In order to fully adopt an intersectional sex positive approach, recommendations for research, training, and practice will be described.
... We assessed formal sexual health-related midwifery training in two ways based on the Sexual Intervention Education and Training Questionnaire. 14,21 This measure was developed to assess the sexuality-related training of clinical psychologists using somewhat different topics and the authors provided evidence for its reliability and validity. First, participants rated the extent to which each of 10 broad sexual health topics (see Table 1 for the list of topics) had been covered during their formal midwifery education and training. ...
Article
Background: Although promoting sexual health should be an integral part of midwifery practice, little is known about midwives' preparation to address their clients' sexual health concerns. Aims: To assess the formal and self-directed training on sexual health topics relevant to midwifery practice of Canadian midwives as well as the association between training and various practice outcomes. Methods: Forty midwives registered in the Province of Ontario, Canada completed an online survey assessing their formal and self-directed sexual health training, knowledge, comfort, and practice related to 10 sexual health issues. Findings: In terms of formal training, three of the 10 topics were coved in-depth and seven were covered in general terms only or not at all. Participants had received an average of 26.0 hours of formal training related to sexual health. Almost all (90%) participants had engaged in self-directed learning on at least one topic. Participants had asked at least one client about only 5 of the 10 topics and been asked by at least one client about 4.5 of them. Participants who reported more extensive formal training had been asked about more sexual health topics by their clients. More self-directed learning was associated with more positive attitudes toward midwives' role in addressing sexual health concerns, feeling more knowledgeable, and being asked about and asking about more sexual health topics. Conclusion: The midwives in this sample had limited training in some important sexual health issues relevant to midwifery practice. Likely as a result, they often did not address these issues in practice.
... Given that psychologists tend to espouse lower levels of religiously conservative views, and higher levels of politically progressive views compared to the general public (Bilgrave & Deluty, 1998, 2002Inbar & Lammers, 2012), and in light of an established relationship between educa- tion and pro-choice attitudes ( Wiebe et al., 2014), we expected that a majority of participants in our sample would endorse pro-choice attitudes. Conversely, given that misinformation about abortion exists even among healthcare pro- viders ( Coles et al., 2012), including faulty scholarship characterized by methodological problems that lead to erroneous conclusions about abortion and mental health (Charles, Polis, Sridhara, & Blum, 2008;Dadlez & Andrews, 2009;Russo, 2014), and in light of scholarship that shows inade- quate attention to sexuality education among clinical and counseling psy- chologists (Burnes, Singh, & Witherspoon, 2017;Miller & Byers, 2008, 2010, we anticipated finding insufficient knowledge of abortion among our study's participants. ...
Article
Full-text available
Abortion is often misunderstood and steeped in misinformation. Laypeople and medical professionals tend to have limited abortion knowledge. Among the public, individuals who hold accurate information about abortion are more likely to endorse pro-choice attitudes than individuals who are misinformed. We explored knowledge of, and attitudes toward, abortion among 142 psychologists and graduate students. Participants responded accurately, on average, to 68% of the items on a true–false measure of abortion knowledge. In addition, participants with higher levels of accurate knowledge were more likely to endorse pro-choice attitudes. Participants were especially likely to incorrectly answer items related to the prevalence, availability, and current legality of abortion in the United States. Analyzing qualitative interviews with a subset of 13 participants, we generated four themes related to knowledge and attitudes about abortion: Assuming Proficiency Despite Minimal Training, Pursuing Outside Knowledge and Training, Framing Abortion Around Identities, and Perceiving and Experiencing Consequences from Abortion Attitudes. Implications for training are delineated.
... Knowledge and attitudes towards sexuality in later life and the ability and willingness to address sexual concerns of older adults are associated with various factors. Psychology students with more didactic education related to sexuality, more sex therapy experience, and more experience observing a clinician conducting sex therapy, reported stronger sexual intervention self-efficacy beliefs (Miller & Byers, 2008). In a study conducted in Canada and the United States among psychology doctoral students found that participants with more continuing education were more likely to directly ask about clients' sexual concerns/ problems and treat them (Miller & Byers, 2009). ...
Article
Background: Sexuality in later life may be compromised by restrictive attitudes, and lack of knowledge among professionals. This study examined social work students’ attitudes and knowledge towards sexuality and sexual expression in later life and investigated associated factors. Method: Undergraduate social work students from Israel (n = 375) completed the Attitudes and Knowledge towards Older Adult’s Sexuality Scale and questionnaires regarding contacts and exposure to older adults, prior sexual education and sociodemographic. Results: Attitudes and knowledge were correlated. First year students were the most conservative and demonstrated the least knowledge. No differences were found between men and women regarding attitude. However, men and married students had greater knowledge regarding older adults’ sexuality than women or non-married students did. Increased religious observance predicted more conservative attitudes. Age predicted more permissive attitudes and greater knowledge about sexuality in later life. A mediating process examined, suggested knowledge is a mediator variable between age and attitudes towards older adults’ sexuality. Conclusion: As the population in Israel and in Western countries ages, it is important to examine the knowledge and attitudes of social work students regarding older adults’ sexuality and to develop educational and interventional programs aimed at increasing awareness, knowledge, and positive attitudes in this area.
... When clients are treated for sexual concerns, the treatment can be influenced by the clinicians' values and how they perceive certain client characteristics, such as gender or marital status (Hecker et al. 1995;Goldberg et al. 2008;Miller and Byers 2012), and non-monogamy (Hecker et al. 1995;Reddick et al. 2016). Miller and Byers (2008), for example, noted how clinicians-in-training who hold sexually conservative values have difficulty appearing comfortable and remaining unbiased when encountering sexual concerns in therapy, "even when they receive more education in this area than other students" (p 142; see also, Miller and Byers 2012). Some researchers (e.g., Harris and Hays 2008;Priest and Wickel 2011) and theorists (e.g., Schnarch 1991) have suggested that the construct of differentiation of self (DoS; Kerr and Bowen 1988) may be relevant to understanding clinicians' perceptions of clients' sexual behavior, however this has never Abstract Clients regularly come to psychotherapy wanting to discuss sexual concerns. ...
Article
Full-text available
Clients regularly come to psychotherapy wanting to discuss sexual concerns. Clinicians (across mental health professions) often lack training and comfort in addressing sexual concerns. Empirically, it is still unclear how clinicians manage their own level of comfort, values, and implicit beliefs about client characteristics associated with sexuality. Differentiation of self may be a useful construct for understanding the influence of (dis)comfort with sexuality, value commitments, and client characteristics (e.g., gender, marital status, exclusivity) on clinicians’ perceptions of client sexual behavior; though no study to date has empirically explored this possibility. To test the role of differentiation of self, participants, both licensed mental health professionals (n = 89) and clinicians-in-training (n = 109) were recruited from across the United States (M age = 36.40; 83.8% female; 80.3% White). Participants were asked to respond to a vignette about a client presenting with sexual behavior concerns and then completed a series of measures on differentiation of self, comfort with sexuality, personal values, and demographic items. As hypothesized, participants’ level of differentiation had nonlinear and linear conditional effects on how participants rated the client’s sexual behavior described in case vignettes. Implications emphasize the role for differentiation of self in clinicians’ management of sexual comfort, personal values, and client characteristics when encountering clients’ sexual concerns.
... The reasons for this are likely to be historically rooted in the post-World War II development of psychological science (Almaas, 2004;Langfeldt, 2005). One manifestation of this ambivalence is reflected in professional education, where the attention devoted to sexology is limited and does not prepare student psychologists for dealing with the sexual issues of their clients (Miller & Byers, 2008;Reissing & Di Giulio, 2010;Wiederman & Sansone, 1999). To compensate, many psychologists take post-graduation courses in order to increase their sexological competence. ...
... The reasons for this are likely to be historically rooted in the post-World War II development of psychological science (Almaas, 2004;Langfeldt, 2005). One manifestation of this ambivalence is reflected in professional education, where the attention devoted to sexology is limited and does not prepare student psychologists for dealing with the sexual issues of their clients (Miller & Byers, 2008;Reissing & Di Giulio, 2010;Wiederman & Sansone, 1999). To compensate, many psychologists take post-graduation courses in order to increase their sexological competence. ...
Article
The purpose of the present paper is to explore the extent to which different groups of Norwegian psychologists address sexual topics during therapy and clinical work. What is the relationship between the frequency of discussing various aspects of sexuality with clients and the therapists’ social background, training in sexology and beliefs and attitudes about handling sexual issues in therapy? A random sample of 2352 clinical psychologists was invited by email to participate in an online survey. The response rate was 47%. The psychologists reported that, in therapy, they most frequently discussed topics related to negative sexual experiences, sexual problems, sexual function and sexual orientation with their clients. Psychologists who did not believe that sexuality should be communicated on the initiative of the patient did not feel uncertainty about sexuality as a topic, and those who had talked about sexuality during supervision were more likely to communicate with their clients about any sexual topic. Psychologists who are self-confident and who have received supervision regarding sexuality deal with sexual topics more often during therapy.
... In the elderly community, talking about sexual behavior also still seems to be a taboo. The same trend is seen in health care services, as doctors, nurses, and psychologists often leave the topic unaddressed because of personal feelings and/or lack of knowledge (Gott et al., 2004; Bouman et al., 2006: Miller and Byers, 2008; Voermans et al., 2012). However, over the last century, sexual behavior has no longer been considered solely in terms of reproduction. ...
Article
Motivational aspects, emotional factors, and cognition, all of which require intact cognitive functioning may be essential in sexual functioning. However, little is known about the association between cognitive functioning and sexual behavior. The aim of this article is to review the current evidence for the influence of cognitive functioning on sexual behavior in normal aging and dementia. A systematic literature search was conducted in PubMed, Ovid, Cochrane, and PsycINFO databases. The databases were searched for English language papers focusing on human studies published relating cognitive functioning to sexual behavior in the aging population. Keywords included sexual behavior, sexuality, cognitive functioning, healthy elderly, elderly, aging and dementia. Eight studies fulfilled our inclusion criteria. Of these studies, five included dementia patients and/or their partners, whereas only three studies included healthy older persons. Although not consistently, results indicated a trend that older people who are not demented and continue to engage in sexual activity have better overall cognitive functioning. Cognitive decline and dementia seem to be associated with diminished sexual behavior in older persons. The association between cognitive functioning and sexual behavior in the aging population is understudied. The results found are inconclusive. Copyright © 2013 John Wiley & Sons, Ltd.
... Such training has been shown to promote, among medical students and clinical psychology graduate students, confidence in one's ability to discuss sexual issues with clients as well as understanding and acceptance of sexual diversity (Dixon-Woods et al., 2002;W. A. Fisher et al., 1988;Marcotte & Logan, 1977;Miller & Byers, 2008, 2009, 2010. Thus, we expected that, on average, sexuality professionals would Downloaded by [The University of British Columbia] at 12:16 06 January 2013 hold accepting sexual attitudes to a range of consensual sexual expression. ...
Article
Full-text available
This study examined the motivations for entering the field and sexual attitudes, experiences, and behavior of an international group of sexuality professionals. Participants were 252 individuals attending the XVII World Congress of Sexology who completed a questionnaire in English, Spanish or French. Most participants' reported professional rather than personal motivations for entering the field in addition to interest. On average, participants reported little sexual communication with their parents as children. About one-third had experienced unwanted sexual activity as a child. Participants were mostly accepting of a range of sexual activities, although they were less accepting of some behaviors than of others. Twelve of the participants who had engaged in sexual activity with a casual or anonymous partner in the previous 2 years had not used a condom consistently. Participants reported high sexual satisfaction and good sexual communication with their partner. Nevertheless, 45% of the women and 35% of the men reported regularly experiencing one or more sexual problems. Few participants reported that their profession affected their sexual functioning negatively; in contrast most reported that it had positive effects on their sexual functioning. These results suggest that there are few differences between sexuality professionals and the general public.
... Sexual rights include the right to express one's full sexual potential; the right to sexual autonomy, privacy, equity and pleasure; the right to make free and responsible reproductive choices; the right to comprehensive sexual health education; and the right to sexual health care (Pan American Health Organisation and World Health Organisation 2000). Despite writers asserting that practitioners have a professional responsibility to care for the sexual health needs of patients, international research suggests that, irrespective of nationality or patient group, practitioners in every country and every discipline are reluctant to incorporate sexuality into care because of lack of skills, knowledge, or time; fear of causing offence, anxiety or embarrassment; or because they consider patients too ill or unwilling to discuss issues (Guthrie 1999, Sansone & Wiederman 2000, Haboubi & Lincoln 2003, Higgins et al. 2008, Miller & Byers 2008, Akinci et al. 2011, Zeng et al. 2011). As an outcome of these studies, researchers continue to highlight the need for education and research in the area of sexuality, in order that staff may facilitate holistic care. ...
Article
Aim: . To report a study evaluating the effectiveness of a 1-day interdisciplinary sexuality education programme for staff working with people with acquired physical disability. Background: Changes associated with an acquired physical disability can diminish a person's self-esteem, sense of attractiveness, relationships, and sexual functioning. Research suggests that people are dissatisfied with the quality of information and support around sexuality during their rehabilitation. Design: A mixed methods design was used, involving pretest and posttest questionnaires and interviews. Methods: Questionnaire data were analysed using descriptive statistics and paired samples t-tests to evaluate the effects of the programme on knowledge, skills, and comfort. Interview data were analyzed thematically, with particular emphasis on participants' opinions about the application of the course within practice. Participants were working in the area of acquired disability and rehabilitation, and were drawn from a number of disciplines. Data were collected between 2008-2009. Results: Comparison of the pre- and postmeasures, based on paired samples t-tests, showed that the programme statistically significantly increased participants' knowledge, skills, and comfort. Participants felt positive and enthusiastic about the programme and reported numerous incidents where they were more willing to raise issues for discussion and create a supportive listening space for patients to talk about their concerns around sexuality. Conclusion: Providing healthcare practitioners with a 1-day programme leads to positive changes in knowledge, skills, and comfort towards sexuality. Sexuality education may be an ideal topic for bringing practitioners together within an interdisciplinary education context.
... Wylie (44) has reviewed these courses. It has also been reported that in psychology there is little sex education and training during graduate school and internship (45). In an Internet-based study (46), 105 clinical and counseling psychologists responded to a questionnaire on whether they were receiving continuing education that may assist them in providing intervention to clients with sexual issues. ...
Article
The authors outline international training programs in human sexuality. The authors reviewed the international literature and Internet resources to identify key training opportunities and curricula, with particular emphasis on training opportunities for psychiatrists. The authors outline key resources and training courses outside the United States. Training in human sexuality, sexology, and sexual medicine is evolving across many clinical disciplines, but courses remain limited in number and far apart geographically.
... However, most health providers receive little training in their professional programs to prepare them to help clients and patients deal with sexual issues. As a result many are not comfortable discussing sexual issues with their patients/clients and have low self-efficacy for dealing with sexual issues (Arrington, 2004;Kao et al., 2002;Miller & Byers, 2008, 2009Monturo, Rogers, Coleman, Robinson, & Pickett, 2001). Thus, all members of the health care team would benefit from training to enhance their comfort with discussing sexual issues with their patients. ...
Article
The goal of this research was to better understand the impact of prostate cancer and its treatment on a broad range of aspects of men's sexual well-being. Interviews were conducted with 19 men. The men ranged in age from 49 to 74 years and were 1 to 5 years posttreatment. Our results suggest that some but not all aspects of men's sexual well-being are affected by treatment for prostate cancer. Further, the specific aspects that were affected as well as their emotional impact varied considerably from individual to individual. Most of the men reported that, prior to diagnosis and treatment, they engaged in regular sexual activity and that they had been satisfied or very satisfied with their sexual relationship. Following treatment, most (but not all) of the men reported no change in the amount and type of affection expressed, the quality of their romantic relationship, their self-concept as a man, or their sexual desire. In contrast, nearly all of the men described negative changes that were distressing to them in erections, orgasmic consistency, and sexual satisfaction. Further, most of the men believed that their sex life was over due to their erectile difficulties and so had stopped engaging in any sexual activity with their partner, although one third of them continued to masturbate. Five themes emerged with respect to factors that either contributed to or buffered the emotional impact of these changes: partner responses to changes in sexual functioning, effectiveness of medical treatments, communication with their partner about sexual functioning, acceptance of or resignation to sexual changes, and communication with physicians about sexual functioning. Finally, most participants felt that the health care system did not respond adequately to their needs. These results are discussed with respect to the importance of facilitating sexual communication between partners and between patients and health care providers.
Article
Full-text available
Higher education institutions implement purposeful change to improve their performance or impose changes in response to their external environments. To deal with these changes, students are expected to develop their coping capacity – the emotional and cognitive ability to manage the demands of adverse situations. Student coping is composed of four interdependent core elements – self-efficacy, engagement, resilience and anxiety. This article synthesizes the evidence on the effect of higher education changes on student’s ability to cope. Using Polanin et al.’s (2017) overview process, our search generated 551 articles, and after three rounds of screening, the remaining 12 reviews were analyzed using the narrative descriptive synthesis approach. We found that the quality assessment within the included reviews were inconsistent and, sometimes not clearly defined. From the analysis of the reviews, four key themes emerged: (1) change is complex; (2) the nature of change is varied; (3) there is an interdependent relationship between the coping elements; and (4) the measurement of change is not sophisticated. Our findings highlight the need for higher education institutions to adopt a principle-based approach to purposefully develop students’ coping capacity, by improving their self-efficacy, engagement, and resilience, and reducing anxiety. Limitations and future research directions are outlined.
Article
Sexual abuse and dating violence are chronic problems for children and young people in out‐of‐home care. This study explored the impact of a prevention and response programme Power to Kids, which targets harmful sexual behaviour (HSB), child sexual exploitation (CSE) and dating violence (DV) for children and young people in home‐based (foster) care. Twenty‐eight case managers, 25 foster carers and 13 children and young people participated in a mixed methods study in Victoria, Australia informed by the research question: How does the Power to Kids programme impact the sexual health and safety of children and young people in home‐based (foster) care? The data analysis revealed a SAFETY approach whereby the sexual health and safety knowledge of carers and case managers was enhanced, and carers were given permission to have Brave Conversations with children and young people, who could then apply the new knowledge to their lives. Case managers were upskilled in identifying indicators of sexual abuse and empowered to escalate stalled therapeutic and disruption practice when children and young people were identified as experiencing HSB, CSE or DV.
Article
Purpose The purpose of this paper is to develop a measure of practitioner sense of competence when treating children with disruptive behaviours. Design/methodology/approach Two online surveys were conducted with health, social work and psychology practitioners ( n = 113 and n = 239, respectively) working within varied Australian clinical settings. Study 1 developed scale items and conducted an exploratory factor analysis of the initial Professional Sense of Competence Scale (ProSOCS). Study 2 conducted confirmatory factor analysis and tested the construct validity of the scale. Findings Study 1 established a three-factor model, which accounted for 56.9% of variance in the ProSOCS items. Study 2 confirmed the three-factor model and considered an alternative unidimensional model. Study 2 demonstrated good convergent validity with measures of knowledge and general sense of competence. Originality/value The ProSOCS is a valid and reliable way to measure three subscales of a more global composite score of practitioner sense of competence when treating children with disruptive behaviours. Disruptive behaviour represents one of the most common reasons for child presentation in mental health care settings. Understanding how sense of competence among professionals who treat disruptive behaviours in children relates to their level of training, treatment decisions and outcomes could help to enhance use of evidence-based treatment strategies and complement strategies for measuring competence-based training in post-graduate settings.
Article
Children and young people living in residential care are vulnerable to sexual abuse, and there is scant evidence about what sexuality education could help address this vulnerability. This paper explores the impact of the Power to Kids: Respecting Sexual Safety programme, which involved capacity‐building workers to have ‘brave conversations’ with children and young people in residential care. The aim of the study was to capture the perceptions of workers about changes in their skill and confidence levels in relation to having brave conversations with children and young people and the impact of those conversations on children and young people. A mixed‐methods study was undertaken, involving multiple sets of interviews with 27 workers associated with four residential houses. The qualitative and quantitative data analysis showed that workers perceived the impact of the capacity building and brave conversations as strengthening protective factors available to children and young people vulnerable to sexual abuse. The research revealed the ‘LINC model’ as a viable approach to capacity‐building workers to educate children and young people in residential care about sexual health and safety. Workers perceived the enhancement of the following protective factors: stronger safe relationships, greater comfort disclosing abuse and improved knowledge of normal versus harmful sexual behaviour.
Article
Marriage and family therapists and sexual health therapists are likely to receive training in graduate school that prepares them to encounter sexual concerns among clients, but there are few standard ways to assess the efficacy of this training. The Sexual Health Education for Professionals Scale (SHEPS) was developed to address this deficit. In this preliminary study, 163 marriage and family therapy graduate students completed the SHEPS prior to starting a graduate course in assessing and treating sexual concerns. Exploratory factor analyses indicate that the SHEPS subscales have good psychometric properties. The Skills and Knowledge subscales have factors labeled Typical Clients, Special Clients, Conservative Clients, and Ethically Complicated Clients. The Attitudes subscale had factors called General Sexual Attitudes, Valuing Sexual Health Training, Open to Providing Sexual Help, and Conservatism. This new instrument may be used to assess education and training of sexual health and marriage and family therapists. Larger sample sizes and longitudinal studies are needed in future.
Article
Background: People with substance use disorder (SUD) experience increased risk for HIV, Hepatitis C, and sexually transmitted illnesses via risky sex. This high-risk population would benefit from sexual risk reduction interventions integrated into SUD treatment. However, many SUD counselors report lack of skill or confidence in addressing sexual risk with patients. Methods: This study was part of a larger nested 2 × 2 factorial repeated measures design, which compared two levels of counselor training (Basic-2 h versus Enhanced-10 h plus ongoing coaching). We determined whether counselors receiving Enhanced training addressing their motivation, confidence and skills (a) increased knowledge about sexual issues; (b) increased self-efficacy to discuss sex with patients; and (c) improved skills in discussing sex as part of SUD treatment, compared with those receiving shorter information-based training. Counselors providing individual therapy at two opioid treatment programs (OTP) and two psychosocial outpatient programs in the United States were eligible. Randomization occurred after Basic training. Measures included self-report (self-efficacy and knowledge) and blinded coding of standardized patient interviews (skill). Results: Counselors receiving Enhanced training (n = 28) showed significant improvements compared to their Basic training counterparts (n = 32) in self-efficacy, use of reflections, and use of decision-making and communication strategies with standardized patients. These improvements were maintained from post-training to 3-month follow-up. No adverse effects of study participation were reported. Conclusions: Results suggest that counselors can improve their knowledge, self-efficacy and skill related to sexual risk conversations with patients based on modest skills-based training.
Article
Counselor discomfort with sex can impede couple growth during the therapeutic process. As couples address multifaceted problems during therapy, counselors should be prepared to professionally discuss a couple’s sexuality during the therapeutic process. As such, the continued taboo surrounding the discussion of sex may illicit embarrassment or nondisclosure of the sexual difficulties by the individual or couple, or worse, be ignored completely by the counselor. Therefore, counselor self-efficacy of sexual topics requires continued analysis within the literature and clinical practice. Thus, the focus of this article is to bridge the gap between counselor sexual discomfort and building self-efficacy of sexual topics through the use of practical strategies (i.e., assessments and interventions) to use in treatment by (a) presenting an overview of literature on sexual perspectives of counselors that inhibit therapeutic discussion of sexuality in the counseling environment, (b) highlighting therapeutic lenses of sexuality that assist in understanding how sexual problems positively and/or negatively impact clients while promoting healthy communication between the counselor and client, (c) providing evidence for the use of sexually based assessments to assist counselors in the development of sexual conversations in treatment, and (d) presenting a brief overview of treatment methods for sexual problems. Implications for practice and research are discussed.
Article
Full-text available
Objectives Little research has examined the discourses that shape therapists’ sense‐making around heterosex. This paper explores the discourses of sexuality and gender underpinning therapists’ and non‐therapists’ responses to a sexual experimentation scenario in a heterosexual relationship. It also considers the value of the novel technique of story completion (SC), in which participants are asked to write a story in response to a hypothetical scenario, for qualitative psychology and psychotherapy research. Design This research used a comparative SC design (Kitzinger & Powell, 1995). Participants were sequentially presented with and invited to complete two story stems: one in which a male character suggested ‘trying something new’ to his female partner and one in which the female character made the suggestion. The stems were otherwise identical. Methods A total of 100 SCs were written by 49 (28 female; 21 male) therapists and 51 (29 female; 22 male) non‐therapists. Participants were recruited mainly via UK‐based email lists and Facebook groups, and therapeutic training organizations, and the data were analysed using a feminist post‐structuralist thematic analysis (Braun & Clarke, 2006). Results Both groups of participants drew on heteronormative discourses of sexuality and gender to make sense of the stem. Engaging in sexual experimentation was often depicted as a demonstration of being normal. In some stories written by women, sex was framed as a site for negotiating ‘equality’ and reciprocity in relationships. Therapists were more likely than non‐therapists to frame ‘difficulties’ within relationships as opportunities for personal growth and increased emotional depth, and their stories included greater emotional complexity. Conclusion These findings raise questions about practitioner training and whether it results in therapists drawing on narrow and restrictive discourses of heterosex in clinical practice. Practitioner points • Training on sexual issues is largely absent from non‐specialist practitioner training courses, which potentially means therapists are ill‐equipped to respond to clients’ anxiety about sexual issues. Evidence from this and other research indicates that therapists’ sense‐making around heterosexual sexual relationships is underpinned by narrow and restrictive discourses that entrench traditional gender relations and limit sexual agency. • Psychologists are increasingly taking up positions of clinical leadership and are looked to for models of best practice. Drawing on theorizations of sexual difficulties, and of anxieties about sexual practice, that challenge traditional gender and heteronorms, and the commodification and medicalization of sex, is important for effective psychological leadership relating to the treatment of sexual issues and the furthering of social justice agendas.
Article
Full-text available
In this research, it is aimed to determine the relation of school counselors’ counseling self-efficacies’ with life satisfactions and hope levels. It also aims to investigate how school counselors’ counseling self-efficacy levels differentiate by gender, feelings related to occupation, working year, type of worked school and education level. Research model is designed as correlational study. The total 151 sample consists of 99 female (%65.6) and 52 male (%34.4) counselors. Counselors’ ages range from 20 to 52, and the average age of participants is 34.15 (Sd: 7.60). In this study, Demographic Data Form prepared by researchers, Counseling Self-Efficacy Scale developed by Lent and others (2011), Life Satisfaction Scale developed by Diener and others (1985), Dispositional Hope Scale developed by Snyder and others (1991) are used for data collection. Relations between counseling self-efficacy, life satisfaction and hope variables are analyzed with Sperman Brown’s rank correlation coefficient. Differentiation level of school counselors’ counseling self-efficacy level by demographic variables is analyzed with Mann Whitney U test and Kruskal Wallis H test. Results indicated that couselors’ counseling self-efficacy and hope levels (r= .53, p<.01), and life satisfactions (r= .39, p<.01) are positively correlated. Besides, analysis revealed that school counselors’ counseling self-efficacy levels are significantly differentiated by feeling related to occupation and working year. In addition to these, results showed that school counselors’ counseling self-efficacy levels are not significantly differentiated by gender and type of worked school.
Article
Full-text available
This article uses both a case illustration and data from a large-scale survey of outpatient clients (N = 798) to understand the client's perspective about avoiding or being dishonest with his or her therapist about sexual topics. The case study, of a gay young man working with a heterosexual female therapist, explores this client's experience of what happens when it feels impossible to be forthcoming about sex and sexuality. Based on the findings of our study, we note clients’ motives for avoiding these intimate yet important areas (e.g., shame), their perception of how this impacts the therapy process (e.g., impedes clinical progress), and their sense of therapist responses and attitudes that could increase their ability to be more honest (“just ask”). We discuss ways in which therapists can facilitate a more open dialogue about sexual material while attending to clients’ concerns about doing so.
Article
Given the likelihood that marriage and family therapists will encounter clients with sexual concerns, it is important to know how graduate training programs are preparing future clinicians to work with this domain of life. Sixty-nine marriage and family therapy (MFT) program directors completed an online survey to examine how sexual health education is integrated into graduate training programs. Findings indicate that while the majority of program directors value sexuality curriculum, and most programs require at least one course in this area, there are barriers to privileging sex topics in MFT graduate programs. Barriers include few MFT faculties with expertise in human sexuality and marginalized sexual health topics. Implications for training MFT graduate students and their work with future clients are discussed.
Article
Veterans with post-traumatic stress disorder (PTSD) experience high rates of sexual dysfunction. However, the topic of sexual dysfunction is often overlooked clinically and underexamined in the PTSD research literature. Clinician assessment and treatment of sexual dysfunction are particularly important for Veterans, who are at increased risk of exposure to trauma. Review the literature regarding sexual dysfunction among Veterans with PTSD. Review of the literature. Sexual dysfunction, including erectile difficulties in males and vaginal pain in females, is common among Veterans with PTSD. Several underlying mechanisms may account for the overlap between PTSD and sexual dysfunction. Certain barriers may contribute to the reluctance of providers in addressing problems of sexual dysfunction in Veterans with PTSD. With the high likelihood of sexual dysfunction among Veterans with PTSD, it is important to consider the integration of treatment strategies. Efforts to further the research on this important topic are needed. Tran JK, Dunckel G, and Teng EJ. Sexual dysfunction in veterans with post-traumatic stress disorder. J Sex Med **;**:**-**. Published 2015. This article has been contributed to by US Government employees and their work is in the public domain in the USA.
Article
Researchers and theorists have noted that sexuality is an innate element humans possess across the lifespan; however, it remains an uncomfortable area of discussion even among many psychologists-in-training. In this cross-sectional study, 138 Clinical PsyD trainees completed a questionnaire exploring their comfort discussing sexuality with clients. Trainees reported lower comfort appraisals when asked about discussing specific sexual concerns than when asked globally about discussing sexual issues with clients. Additionally, whereas male and female trainees reported similar comfort discussing sexual issues with female clients, female trainees reported significantly less comfort discussing sexual issues with male clients than did male trainees. Participants’ prior sexuality training and sexual attitudes correlated positively with their comfort appraisals, whereas general training or clinical experience did not, highlighting the need to incorporate specific sexuality training into doctoral curricula.
Article
Practicing clinical psychologists are likely to work with sexual health concerns as part of their clinical practice because of high prevalence rates and sexual problems as symptoms of mental or physical health problems and their pharmacological treatment. However, the majority of clinicians do not receive didactic or supervised clinical training. This survey of 188 practicing clinical psychologists in one Canadian city confirmed that, despite lack of training, many clinicians discussed sexual health concerns with their clients and used a variety of sex therapy techniques. This survey also revealed, however, that 60% of clinicians did not ask, or very infrequently asked, clients about sexual health. In general, lack of training affected level of comfort, and both may result in inadequate application of sex therapy techniques and treatment. The results of this survey indicate an ethical imperative to included sexuality training in current graduate curricula to adequately prepare psychologists to assess, refer, and treat sexual health concerns. The inclusion of sexuality-related topics in existing clinical graduate courses, an increase in sexuality-specific courses focused on assessment and intervention in graduate curricula, and broader options for continuing education for practicing clinical psychologists are recommended. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
The current study surveys medical and doctoral psychology students (N = 100) from an urban northeastern university regarding knowledge and attitudes toward elderly sexuality and aging using the Facts on Aging Quiz, the Aging Sexuality Knowledge and Attitudes Scale, and measures of interest in gerontology, academic/clinical exposure to aging and sexuality, and contact with elders. The current study found that psychology students demonstrated greater aging knowledge than medical students; however, both groups showed gaps in knowledge about sexuality. Married students had greater academic/clinical exposure and greater knowledge about aging but less permissive attitudes toward elderly sexuality. Generally, knowledge about aging was the strongest correlate of knowledge about sexuality. Level of knowledge about sexuality was not associated with attitudes. Attitudes toward sexuality and aging may be more strongly tied to demographic variables reflective of religious beliefs or adherence to sociocultural norms.
Article
Full-text available
Despite the existence of Criteria 2 -cultural and individual differences -in the American Psychological Association (APA) accreditation of doctoral training in counseling psychology, few programs offer, much less require, course work on service delivery to or research with ethnic minorities. The goal of this article is to present a model for organizing and evaluating cross-cultural content throughout each phase of clinical and research training during doctoral study in scientist-practitioner programs. First described is an overview of the separate course, area of concentration, interdisciplinary, and integration models for the promotion of cultural understanding in psychology. Then a series of specific recommendations along the lines of the integration model are provided for the development of cross-cultural competence beginning with institutional modifications at the departmental level. Specific additions to research and clinical course work are suggested along with information on available resources for curricular reform in each area. Finally, an apprenticeship continuum from prepracticum to internship is presented as a guide for making more culturally relevant both research and clinical mentoring.
Article
Full-text available
The impact of training on counseling self-efficacy and state and trait anxiety was examined in this study. One hundred and thirteen undergraduate psychology students from United Arab Emirates (UAE) University participated in this investigation. The experimental group consisted of seventy-three students who were taking their first practicum (65 females; 8 males) and the control group was composed of female students who had not yet taken their practicum (n=40). Pre- and posttests were conducted using the Counseling Self-Estimate Inventory (COSE: Larson et al., 1992) and the State-Trait Anxiety Inventory (STAI: Spielberger, Gorsuch, & Lushene, 1970). Significant mean differences were found between the experimental group and the control group in both counseling self-efficacy and anxiety. Analysis of covariance revealed that training increased trainees' counseling self-efficacy and decreased their level of anxiety. These findings are discussed and directions for future research are provided.
Article
Full-text available
Were concerned with the reciprocal, interlocking processes of supervision and counseling. To examine the theoretical model of parallel process, we applied social psychological theories of self-presentation and interpersonal influence in an in-depth case study (1 client, 1 counselor trainee and 1 supervisor) of the naturally developing therapeutic and supervisory relationships. Multiple indexes of the process and outcome (of both treatments) provided self-reported and verbal communication data. Results point to the similar aspects of the two relationships, the possible indicators of parallel process, and an identification of the behavioral features of the supervisor's style. Conclusions provide guidance for more extensive research along these lines. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
Full-text available
These chapters represent [the editors'] conceptualization of a theory of MCT [multicultural counseling and therapy]. The text is divided into 4 major parts. Part I . . . consists of 3 chapters in which we propose and develop a theory of MCT. Parts II [and III] present the contributors' views on our proposed theory, both from a theoretical perspective and from the perspective of how it applies to specific populations. Part IV . . . consists of 1 chapter, which we wrote in response to the contributors' reactions to our original treatise. This graduate-level textbook is geared for courses in psychology, counselor education, and social work, among others. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
Full-text available
Addressing sexuality issues is an inherent part of being a professional psychologist. A survey of training directors revealed that, although about one half of the doctoral programs covered at least some sexuality topics within courses, 19% to 21% of programs did not offer any training with regard to sexual dysfunction, therapy with gay clients, and HIV-AIDS. Sexuality training was even less likely in predoctoral internships. Sexuality training was unrelated to size of the program but was a function of the number of faculty with relevant expertise. Psychologists with adequate knowledge and comfort regarding sexuality will be better able to serve clients and avoid ethical pitfalls. Suggestions for infusing sexuality training into the already-crowded curricula are offered. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
Full-text available
Antidepressants, especially selective serotonin reuptake inhibitors (SSRIs), venlafaxine, and clomipramine, are frequently associated with sexual dysfunction. Other antidepressants (nefazodone, mirtazapine, bupropion, amineptine, and moclobemide) with different mechanisms of action seem to have fewer sexual side effects. The incidence of sexual dysfunction is underestimated, and the use of a specific questionnaire is needed. The authors analyzed the incidence of antidepressant-related sexual dysfunction in a multicenter, prospective, open-label study carried out by the Spanish Working Group for the Study of Psychotropic-Related Sexual Dysfunction. The group collected data from April 1995 to February 2000 on patients with previously normal sexual function who were being treated with antidepressants alone or antidepressants plus benzodiazepines. One thousand twenty-two outpatients (610 women, 412 men; mean age = 39.8 +/- 11.3 years) were interviewed using the Psychotropic-Related Sexual Dysfunction Questionnaire, which includes questions about libido, orgasm, ejaculation, erectile function, and general sexual satisfaction. The overall incidence of sexual dysfunction was 59.1% (604/1022) when all antidepressants were considered as a whole. There were relevant differences when the incidence of any type of sexual dysfunction was compared among different drugs: fluoxetine, 57.7% (161/279); sertraline, 62.9% (100/159); fluvoxamine, 62.3% (48/77); paroxetine, 70.7% (147/208); citalopram, 72.7% (48/66); venlafaxine, 67.3% (37/55); mirtazapine, 24.4% (12/49); nefazodone, 8% (4/50); amineptine, 6.9% (2/29); and moclobemide, 3.9% (1/26). Men had a higher frequency of sexual dysfunction (62.4%) than women (56.9%), although women had higher severity. About 40% of patients showed low tolerance of their sexual dysfunction. The incidence of sexual dysfunction with SSRIs and venlafaxine is high, ranging from 58% to 73%, as compared with serotonin-2 (5-HT2) blockers (nefazodone and mirtazapine), moclobemide, and amineptine.
Article
Were concerned with the reciprocal, interlocking processes of supervision and counseling. To examine the theoretical model of parallel process, we applied social psychological theories of self-presentation and interpersonal influence in an in-depth case study (1 client, 1 counselor trainee and 1 supervisor) of the naturally developing therapeutic and supervisory relationships. Multiple indexes of the process and outcome (of both treatments) provided self-reported and verbal communication data. Results point to the similar aspects of the two relationships, the possible indicators of parallel process, and an identification of the behavioral features of the supervisor's style. Conclusions provide guidance for more extensive research along these lines.
Article
Scores of 297 college students from 3 different courses taught by different instructors on Lief and Reed's Sex Knowledge and Attitude Test and Levenson's Locus of Control test at Weeks 1 and 15 did not change significantly on Levenson's subscales but attitudes of students in the sexuality class changed on masturbation, abortion, and heterosexual relations. No change in knowledge was noted.
Article
The authors studied the effectiveness of the skilled counselor training model (SCTM). Counseling students who completed the SCTM demonstrated greater gains in skills acquisition and counseling self-efficacy than counseling students who did not receive the training. At pretest, the counseling students in both groups, doing self-appraisals, rated their performance of counseling skills significantly higher than trained raters assessed the students' performance of counseling skills. At posttest, members of the control group continued to overestimate their skills levels when compared with the ratings given by the trained raters, whereas, in comparison, students who received SCTM training underestimated their performance.
Article
Prepracticum service-learning is an integral part of the curriculum for counselor education students at a large southwestern university. Service-learning is accomplished by placing novice students in school or community agency settings to acquire early, practical, field-based experience. Activities are more structured and supervised than in an internship or practicum. Analysis indicated that prepracticum service-learning had a positive significant relationship with counselor self-efficacy and a significant negative relationship with student anxiety. However, substantial counseling course work and experience with counseling-related work both had a stronger influence than did prepracticum service-learning, indicating that the latter is more appropriate for novice students.
Article
A brief mock counseling session was potentially more risky but more potent than a brief videotaped counseling session as an intervention for increasing counseling self-efficacy in prepractica trainees.
Article
In recent years, many persons have opposed sex education believing that such courses will lead to increased participation in sexual intercourse by young people, but their fears are not supported by most previous research. The influence of sex education material integrated into functional marriage and family courses, however, has not been the subject of in‐depth, scientific investigations. An anonymous questionnaire was administered to never‐married undergraduate students enrolled in a college‐level marriage and family course at a state university. A pretest and post‐test design was utilized with experimental groups of 50 women and 26 men and comparison groups of 60 women and 28 men. The findings indicate that the sex education content had a significant impact on the experimental groups, especially for women. Substantial increases in knowledge regarding abortion and contraception, more favorable attitudes toward masturbation, and frequency of masturbation were reported by experimental group women as contrasted with comparison group women. Experimental group men indicated increased knowledge about female hygiene and contraception in contrast to comparison group men. From these findings, sex educators should be able to better meet the criticisms of sex education opponents given this greater understanding of the impact of sex education material on the sex lives of their students.
Article
Although the diminishing role of career counseling in the future plans of counseling psychology trainees has been well documented, no empirical data have explained why this phenomenon is occurring. A sample of 290 counseling psychology graduate students was surveyed from 12 American Psychological Association (APA)-approved counseling psychology training programs. Results indicate that trainees' most negative experiences were disparaging remarks about career counseling from faculty and supervisors and their formal course work in career development. Conversely, trainees reported that the most positive influences on their attitudes were experiences obtained by working with career clients. Further, initial regression equations indicate that 45% to 59% of the variance in trainees 'interest and their positive experiences practicing career counseling could be explained by their self-efficacy in career counseling, their training experiences, and their participation in vocational research. Implications for the training of counseling psychologists are provided.
Article
This article describes the development and testing of the Social Work Self-Efficacy Scale, which assesses social workers' confidence regarding a broad range of social work tasks. Pre-post data from two cohorts of social work students are presented showing significant positive change in MSW students' self-efficacy, suggesting a new approach to outcomes assessment in social work education.
Article
Measures of research self-efficacy have the potential to facilitate graduate training and mentoring, but the hypothesized factor structures of these measures have not been confirmed empirically. Moreover, the underlying dimensions of research self-efficacy across multiple measures are unknown. Graduate students in psychology programs (N = 1,004) completed three research self-efficacy instruments via a Web-based survey. Confirmatory factor analyses did not support the hypothesized factor structures. An exploratory factor analysis suggested that four dimensions of research self-efficacy (data analysis, research integration, data collection, and technical writing) underlie responses to items from the three instruments. The authors present possible reasons for the differences in factor structures across instruments and suggest how the assessment of research self-efficacy may facilitate the training and career mentoring of graduate students.
Article
The Multicultural Counseling Competencies (P. Arredondo et al, 1996, D. W. Sue, P. Arredondo, & R. J. McDavis, 1992) provide developmental and evaluative guidelines for enhancing counselor education and practice. A reason for the articulation of the competencies was the need to address racism and other forms of interpersonal and institutional oppression in the profession. The Dimensions of Personal Identity Model is discussed as a reference point to recognize various personal criteria that are often the focal point of discriminatory behavior Specific competencies and explanatory statements provide checkpoints that address racism and other forms of oppression that are part of the human experience, but more particularly so for people of color in the US. Topics discussed include competencies framework; counselor awareness of own assumptions, values, and biases; understanding the worldview of the culturally different client; developing appropriate strategies and techniques; operationalization of the multicultural counseling competencies; counselor awareness of own cultural values and biases; counselor awareness of client's worldview; and culturally appropriate intervention strategies and techniques. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
This investigation examined the role of counselor trainees' self-efficacy on measures of career counseling process, "small o" outcome, and outcome with actual clients. Twenty-four counselor trainees saw 55 clients in 3 to 12 individual sessions. Results indicated that (a) career counseling self-efficacy increased by a standard deviation from prepracticum to postpracticum; (b) client scores significantly improved from pretest to posttest across multiple career outcome measures; (c) clients' working alliance, goal attainment, and decidedness indicated significant growth; (d) the significant growth on the process variable and small o outcome variables did not appear to be related to career counseling self-efficacy; and (e) career counseling self-efficacy apparently related to certain career counseling outcome measures in a manner suggesting much greater complexity than the "more self-efficacy is better" philosophy would imply. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
Do psychology students view their training programs as doing enough to appropriately identify, accommodate, and possibly dismiss students who manifest significant impairment? This study reports the general findings of an exploratory survey distributed to clinical psychology graduate students. Overall, students viewed impairment as a highly sensitive and inadequately addressed issue. Students commonly reported frustration with and concern for impaired colleagues. A few respondents indicated that the terms impaired and problem student were insensitive and that greater attention needed to be given to "impaired" training contexts. Implications regarding formal standards for interpersonal functioning and programmatic supports for students are discussed. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
Surveyed all APA-approved graduate programs in clinical and counseling psychology and predoctoral internship programs to assess the extent of student training in areas related to acquired immune deficiency syndrome (AIDS). The survey found that 75% of graduate programs do not cover AIDS at any point in their curricula and that less than half train students in human sexuality. Other foundation topics pertinent to AIDS prevention and clinical service provision receive little attention in most graduate and internship programs. The authors discuss reasons why greatly increased prevalence of AIDS and human immunodeficiency virus (HIV) conditions will require more substantial training and research among psychologists, and they outline some possible mechanisms to provide this training. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
Describes the development of the Counseling Self-Estimate Inventory through 5 studies. A factor analysis ( N = 213) yielded 5 factors that reflect counselor trainees' confidences in using microskills, attending to process, dealing with difficult client behaviors, behaving in a culturally competent way, and being aware of one's values. Reliability estimates indicate that the items are internally consistent (α = .93) and stable over time. Initial validity estimates show that the instrument is (1) positively related to counselor performance, self-concept, problem-solving appraisal, performance expectations, and class satisfaction; (2) negatively related to state and trait anxiety; (3) minimally related to aptitude, achievement, personality type, and defensiveness; and (4) sensitive to change over the course of master's practicum and across different levels of counselors. Also, trait anxiety and counseling self-efficacy were significant predictors of counselor trainee performance. The development of a reliable and valid counseling self-efficacy instrument has training and research implications. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
Addresses the centrality of the self-efficacy mechanism (SEM) in human agency. SEM precepts influence thought patterns, actions, and emotional arousal. In causal tests, the higher the level of induced self-efficacy, the higher the performance accomplishments and the lower the emotional arousal. The different lines of research reviewed show that the SEM may have wide explanatory power. Perceived self-efficacy helps to account for such diverse phenomena as changes in coping behavior produced by different modes of influence, level of physiological stress reactions, self-regulation of refractory behavior, resignation and despondency to failure experiences, self-debilitating effects of proxy control and illusory inefficaciousness, achievement strivings, growth of intrinsic interest, and career pursuits. The influential role of perceived collective efficacy in social change and the social conditions conducive to development of collective inefficacy are analyzed. (21/2 p ref) (PsycINFO Database Record (c) 2006 APA, all rights reserved). © 1982 American Psychological Association.
Article
Thesis (M.S.)--Ball State University, 1990. Includes bibliographical references (leaves 73-78).
Article
Thesis (Ph. D.)--University of Nebraska--Lincoln, 1997. Includes bibliographical references.
Article
The present experiment was designed to test the theory that psychological procedures achieve changes in behavior by altering the level and strength of self-efficacy. In this formulation, perceived self-efficacy. In this formulation, perceived self-efficacy influences level of performance by enhancing intensity and persistence of effort. Adult phobics were administered treatments based upon either performance mastery experiences, vicarious experiences., or they received no treatment. Their efficacy expectations and approach behavior toward threats differing on a similarity dimension were measured before and after treatment. In accord with our prediction, the mastery-based treatment produced higher, stronger, and more generalized expectations of personal efficacy than did the treatment relying solely upon vicarious experiences. Results of a microanalysis further confirm the hypothesized relationship between self-efficacy and behavioral change. Self-efficacy was a uniformly accurate predictor of performance on tasks of varying difficulty with different threats regardless of whether the changes in self-efficacy were produced through enactive mastery or by vicarious experience alone.
Article
This study provides additional information on the psychometric properties of the Sexual Aversion Scale (SAS). Results suggest a positive relationship between sexual aversion, generalized anxiety, and history of sexual victimization. Variables such as age and religiosity were unrelated to scores on the SAS, although females reported significantly more sexual anxiety than males. The factor structure of the SAS is described and suggests that sexual aversion is a multifaceted problem with at least three and possibly four different dimensions.
Article
The outcome of an independent sexology course for Colombian medical students was evaluated by means of the Sex Knowledge and Attitude Test (SKAT), stressing the 'material' or 'substantial', rather than statistical, significance of changes after instruction. The results indicate that the course was as effective in producing increases in the students' sexual knowledge as previous non-independent courses, and as effective as them, or more, in modifying positively the students' sexual attitudes. These results are at variance with those of most sex education programmes described so far in the literature, whose effectiveness is in doubt due to the small magnitude of changes after instruction.
Article
This study describes a 30-item questionnaire, the Sexual Aversion Scale, that was used to assess sexual fears and avoidance in college students. The construct of sexual aversion was based on the newly listed DSM-III-R criteria for sexual aversion disorder. Results were obtained from 382 college students. The questionnaire was shown to have good internal consistency and test-retest reliability. Female students reported significantly more sexual anxiety. They expressed more fear of intercourse and the negative social consequences of their sexual behavior. They were also more inclined to avoid situations where they might become sexually involved. Conversely, males appeared to be more sexually frustrated and said they would become more sexually active were it not for fear of catching a sexually transmitted disease. It is concluded that sexual fears are fairly widespread among college students and are being fueled by the current AIDS crisis. One implication of these findings is that sexual aversion disorder may become a prevalent problem, especially if the AIDS epidemic continues to spread to the heterosexual population.
Article
This article describes the "rape myth" and tests hypotheses derived from social psychological and feminist theory that acceptance of rape myths can be predicted from attitudes such as sex role stereotyping, adversarial sexual beliefs, sexual conservatism, and acceptance of interpersonal violence. Personality characteristics, background characteristics, and personal exposure to rape, rape victims, and rapists are other factors used in predictions. Results from regression analysis of interview data indicate that the higher the sex role stereotyping, adversarial sexual beliefs, and acceptance of interpersonal violence, the greater a respondent's acceptance of rape myths. In addition, younger and better educated people reveal less stereotypic, adversarial, and proviolence attitudes and less rape myth acceptance. Discussion focuses on the implications of these results for understanding and changing this cultural orientation toward sexual assault.
Article
Two nursing self-efficacy scales (academic and clinical) were developed and refined for use in identifying problems in progress in undergraduate nurses. Emergent factors within each scale contained items representing important aspects of nursing education. Both measures showed good internal consistency, test-retest reliability, and construct validity. Sensitivity to content and focus of tuition at time of completion was shown with some changes in factor structure over samples of first year nursing students. Academic self-efficacy (but not clinical self-efficacy) was predictive of course withdrawal. Applications to nursing education, progress in pursuing a nursing career and attrition are discussed.
Article
In the research reported here, the authors examined the relation of 82 medical students' feelings about sex to their level of sexual knowledge, willingness to treat patients with sexual concerns, and participation in an elective sex education course. The results showed that the erotophobic students (those with negative feelings about sexuality) had significantly lower levels of sexual knowledge and were significantly less likely to participate in an elective human sexuality course than the erotophilic students (those with positive feelings about sexuality). Moreover, the erotophobic students who took part in the sexuality course benefited from it less than did the erotophilic students as measured by their willingness to treat patients with sexual concerns. Finally, although the students overall were relatively knowledgeable about sex and were relatively willing to treat patients with sexual concerns, troubling gaps in specific sexual knowledge and in willingness to treat patients with certain sexual concerns (such as acquired immune deficiency syndrome) were identified. Medical schools need to structure sex education in ways that take account of students' ambivalent feelings about sex and need to provide sex education that increases both sexual knowledge and willingness to treat patients with sexual concerns.
A study of the influence of sexuality education experiences, sexual comfort, and agency support on social workers' willingness to address client sexual concerns
  • B Berman
Berman, B. (1996). A study of the influence of sexuality education experiences, sexual comfort, and agency support on social workers' willingness to address client sexual concerns. Dissertation Abstracts International, 58, 0100.
2006 APPIC Match: Survey of Applicants from APPIC Web site
  • G Keilin
Keilin, G. (2006). 2006 APPIC Match: Survey of Applicants. Retrieved November, 2007 from APPIC Web site: Http://www.appic.org.
Training potential therapeutic recreators for self-efficacy and competence in interpersonal skills
  • W W Munson
  • D A Zoerink
  • R E Stadulis
Munson, W. W., Zoerink, D. A., & Stadulis, R. E. (1986). Training potential therapeutic recreators for self-efficacy and competence in interpersonal skills. Therapeutic Recreation Journal, 20, 53-62.
Promoting Sexual Health. Progress in Reproductive Health Research
World Health Organization. (2004). Promoting Sexual Health. Progress in Reproductive Health Research, 67, 4.
Understanding the relationship among counseling, self-efficacy, anxiety, developmental level, coursework, experience and counsellor performance
  • C E Kocarek
Kocarek, C. E. (2002). Understanding the relationship among counseling, self-efficacy, anxiety, developmental level, coursework, experience and counsellor performance. Dissertation Abstracts International, 62, 3381.
Enhancing competence and self-efficacy of potential therapeutic recreators in decision making counseling
  • W W Munson
  • R E Stadulis
  • D G Munson
Munson, W. W., Stadulis, R. E., & Munson, D. G. (1986). Enhancing competence and self-efficacy of potential therapeutic recreators in decision making counseling. Therapeutic Recreation Journal, 20, 85-93.
Profile of psychology graduate students
  • P O'neill
O'Neill, P. (2005). Profile of psychology graduate students: 2003-2004. Psynopsis, 27, 20.
September) Evaluation of Clinical Psychologists' Provision of Sexual Health Care Needs. Paper presented at the Canadian Sex Research Forum
  • G Di Giulio
  • E Reissing
Di Giulio, G., & Reissing, E. (2004, September) Evaluation of Clinical Psychologists' Provision of Sexual Health Care Needs. Paper presented at the Canadian Sex Research Forum, Fredericton, NB.
Perceptions of fraudulence, counseling self-efficacy, and satisfaction with work. Unpublished doctoral dissertation
  • A Alvarez
Alvarez, A. (1995). Perceptions of fraudulence, counseling self-efficacy, and satisfaction with work. Unpublished doctoral dissertation, State University of New York, Albany.
  • G Keilin
Keilin, G. (2006). 2006 APPIC Match: Survey of Applicants. Retrieved November, 2007 from APPIC Web site: Http://www.appic.org.
Sexual dysfunction: A guide for assessment and treatment
  • J P Wincze
  • M P Carey
Wincze, J. P., & Carey, M. P. (2001). Sexual dysfunction: A guide for assessment and treatment. New York: Guilford Press.