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This study examined therapist differences in their clients' ratings of their therapists' multicultural competencies (MCCs) as well as tested whether therapists' who were rated as exhibiting more MCCs also had clients who had better therapy outcomes (N = 143 clients and 31 therapists). All clients completed at least 3 sessions. Results demonstrated that therapists accounted for less than 1% of the variance in their clients' Cross-Cultural Counseling Inventory-Revised (CCCI-R; T. D. LaFromboise, H. L. K. Coleman, & A. Hernandez, 1991) scores, suggesting that therapists did not differ in terms of how clients rated their MCCs. Therapists accounted for approximately 8.5% of the variance in therapy outcomes. For each therapist, their clients' CCCI-R scores were aggregated to provide an estimate of therapists' MCCs. Therapists' MCCs, based on aggregate CCCI-R scores, did not account for the variability in therapy outcomes that were attributed to them. Additionally, clients' race/ethnicity, therapists' race/ethnicity, or the interaction of clients'-therapists' race/ethnicity were not significantly associated with clients' perceptions of their therapists' MCCs. (Contains 3 tables and 2 footnotes.)

Objective: The purpose of this study was to explore the relationship between the alliance and outcome in couple therapy and examine whether the alliance predicted outcomes over and above early change. The authors also investigated partner influence and gender and sought to identify couple alliance patterns that predicted couple outcomes. Method: The authors examined the alliances and outcomes at posttreatment and follow-up of 250 couples seeking treatment for marital distress in a naturalistic setting. The Session Rating Scale was used to measure the alliance; the Outcome Rating Scale and Locke Wallace Marital Adjustment Scale were used to measure outcomes. Couples were White, Euro-Scandinavian, and heterosexual, with a mean age of 38.5 years and average number of years together of 11.8. On a subsample (n = 118) that included couples with 4 or more sessions, the authors investigated the relationship between the alliance and outcome controlling for early change, and patterns of alliance development were delineated. Results: In the full sample, first-session alliances were not predictive of outcomes, but last-session alliances were predictive for both individuals and their partners. In the subsample, third-session alliances predicted outcome significantly above early change (d = 0.25) that exceeded the reliable change index. Couple alliances that started over the mean and increased were associated with significantly more couples achieving reliable or clinically significant change. Gender influences were mixed. Conclusions: Given the current findings suggesting a potential alliance impact over and above symptom relief as well as the importance of ascending alliance scores, continuous assessment of the alliance appears warranted. (Contains 6 tables and 4 footnotes.)

The current study retrospectively examined the relationship between female clients' perceptions of microaggressions directed toward women, working alliance, and therapeutic outcomes (N = 121). A measure, the Microaggressions Against Women Scale (MAWS), was developed specifically for this study, based on a content review of the literature, focus group, and a panel of seven female psychologists. A latent class factor analysis (returning one factor) and internal consistency estimates supported the measure. Clients' MAWS scores were negatively correlated with working alliance and therapy outcomes, suggesting that clients' perceptions of microaggressions can influence the process and outcome of therapy. Last, working alliance mediated the negative relationship between microaggressions and therapy outcomes. Implications for practice and further research are provided. (Contains 3 tables and 1 figure.)

T. J. G. Tracey et al.'s (2003) common factors model derived from therapists and psychotherapy researchers has provided a parsimonious structure to inform research and practice. Accordingly, the current authors used the 14 common factor categories identified in Tracey et al.'s model as a guide to code clients' perceptions of helpful therapist actions (e.g., intervention, way of being) in short-term psychotherapy. Next, they conducted a cluster analysis to establish meaningful subgroups of clients based on clients' perceptions of helpful therapist actions. Finally, they explored if clients in these subgroups differed in their report of conformity to masculine norms. Clients (N = 161) from a university counseling center were recruited for the current study. Results revealed 3 clusters of clients based on their perceptions of helpful therapist actions: Insight (44%), Relationship (30%), and Information (26%). In contrast, Tracey et al. found 3 clusters: Bond (which includes Insight and Relationship), Information, and Structure of therapy (not found in the current study). Clients in the Insight and Relationship clusters reported more conformity to masculine norms as compared with clients in the Information cluster. There were no sex differences across clusters. (Contains 5 tables, 1 figure and 1 footnote.)

College campuses across the United States are increasingly challenged to educate psychologically distressed students and to recognize that college student mental health is not only a counseling center issue, but also a campus issue. As such, many colleges and universities are moving toward campuswide prevention efforts designed to help identify and support students who need to manage their distress. Prior research has highlighted these issues and described ways to involve campus units in initiating campuswide prevention efforts. This article focuses on the key elements necessary to successfully foster prevention efforts and includes practical suggestions to improve prevention protocols on campus. (Contains 1 figure.)

Many counseling centers have session limits to accommodate the increasing number of clients who seek treatment. The current study explored clients' expectations for the number of sessions over the course of one year at a large university counseling center. In contrast to previous research that has suggested clients want ten or fewer sessions, our results suggest that over 60% of clients wanted 20 or more sessions. Moreover, clients who expected 20 or more sessions reported therapy was less effective than clients who expected less than 20 sessions. While actual number of sessions was related to expected number of sessions, termination status appeared to be related to clinical factors and not clients' expected number of sessions. Implications for clinical practice and agency session limit policies are discussed. (Contains 3 tables.)

University counseling centers (UCC) must rely on referrals to off-campus providers, due to limited staffing, severity of clients' issues, and ethical treatment considerations. In a mixed method design, this study found that 42% of clients were unsuccessful in connecting with an off-campus provider when referred by a university counseling center therapist. Clients of color were more unsuccessful in connecting with an off-campus provider than Caucasian clients. Regardless of ethnicity, clients reported that therapist follow up, accessible referral sources, and high personal motivation assisted in a successful referral process. Financial issues were the primary inhibitory factor for the referral process. Suggestions for clinical practice and university counseling center policies are provided. (Contains 3 tables and 1 note.)

The role of Evidence-Based Practice (EBP) is increasing in importance for professional psychologists working in university counseling center contexts. As a result, providing training and supervision in EBP will be essential to the ability of college-based counselors to meet minimal standards of care. The focus of this paper is to provide a framework to foster critical thinking, to discuss the pedagogical assumptions of supervisors, and to provide suggestions for college counseling center supervisors to incorporate training in EBP into the expected competencies to be gained by interns and other trainees.

Client perceptions of their therapists' cultural humility have been associated with positive therapy outcomes; however, it is unclear whether these positive effects are consistent across clients. In particular, this study [...]

Sexual activity occurs among a large portion of young adults and adolescents, including high school students. While about 40% of high school students nationwide have engaged in sexual intercourse, more information is needed about how individual characteristics may relate to larger patterns of adolescent sexual behavior. This exploratory study utilized a latent class analysis (LCA) to identify clusters of high school students (N = 801) based on demographic characteristics, sexual refusal skills, healthy relationship skills, sociosexuality, internalizing symptoms, alcohol use, various forms of social support (i.e., parents, friends, teachers), and sexual activity at baseline to predict their sexual behavior at a 6-month follow-up. Four unique latent classes were identified based on these baseline predictors. Distinctions in the profiles of high schoolers varied significantly by internalizing symptoms, race/ethnicity, sexually conservative attitudes, and social support in the prediction of adolescent sexual activity at 6-months. This study contributes to the investigation of demographic, social, psychological, attitudinal, and behavioral factors that may distinguish high school students from one another in terms of their longitudinal rates of sexual activity. [ABSTRACT FROM AUTHOR]

The current study presents implementation and impact data from a cluster randomized trial of a youth relationship education curriculum. High school students (n = 1,135) were randomized at the school level to receive curricula‐as‐usual or a healthy relationships program delivered by facilitators who were not employed by the high schools. Program evaluators reported high engagement and students indicated high satisfaction with the program, but multilevel models showed no statistically significant impacts on healthy relationship skills, attitudes, and behaviors at three and nine months post‐intervention. Strengths and limitations of the research design and program implementation, as well as implications for evaluating youth relationship education more broadly, are discussed. [ABSTRACT FROM AUTHOR]

Cultural humility, first introduced a quarter century ago, has increasingly emerged over the last decade as a concept of considerable importance: it has been touted as playing a crucial role in potentially enhancing the relationship in both psychotherapy and supervision, its practice being heartily embraced and roundly recommended. But are those recommendations and that hearty embrace justified? What do the empirical data say? We address those questions subsequently, taking a granular look at studies in which cultural humility vis‐à‐vis psychotherapy and supervision have been examined. Based on our review of 21 psychotherapy/cultural humility studies and seven supervision/cultural humility studies, we offer critique of the research work done thus far (e.g., it being decade delimited and landlocked) and propose recommendations for future treatment and supervision investigations (e.g., internationalising cultural humility research). Because cultural humility appears to be a durable and enduring concept, appears practically beneficial for both the therapy and supervision situations and is increasingly being pursued empirically, such a research report would seem particularly timely and potentially helpful in advancing research. [ABSTRACT FROM AUTHOR]