Validity of the Butcher Treatment Planning Inventory as a measure of negative treatment attitudes.

This study evaluated the validity of the Butcher Treatment Planning Inventory (BTPI) as a measure of negative expectations and attitudes toward counseling. Undergraduate students completed the BTPI, the Attitudes Toward Seeking Professional Psychological Help Scale-Abbreviated Version, and the Expectations About Counseling-Brief Form during one administration period. Higher scores on the BTPI Closed-Mindedness and Low Expectation of Benefit scales were associated with more negative attitudes toward counseling. Furthermore, higher scores on Closed-Mindedness, Problems in Relationship Formation, and the Treatment Difficulty Composite were associated with lower expectations to become actively involved in counseling. Participants reporting higher levels of psychological distress on the BTPI were less likely to expect warm therapeutic relationships and to take active roles in treatment. Relationships between attitudes and expectations about counseling were also evaluated. Participants reporting more positive attitudes toward counseling reported higher expectations to work with warm, empathic counselors and to take active roles in counseling and lower expectations for prescriptive, doctor-patient relationships with counselors.

Additional validation of the attitudes toward Seeking Professional Psychological Help Scale.

To provide information on the construct validity of the Attitudes Toward Seeking Professional Psychological Help scale, relationships between prior treatment experiences and scores on the scale were evaluated. Participants were 270 students recruited from undergraduate psychology courses at a medium-sized university in the midwestern USA. 79% were women: their ages ranged from 18 to 53 years (M= 19.0, SD=4.4). In addition to completing the scale, the subset of 76 participants who reported prior mental health care treatment also evaluated these experiences using a rating scale anchored by 0: very dissatisfied and 4: very satisfied. For the total sample, prior experience with the mental health care delivery system was associated with higher scores on the scale, denoting more positive attitudes. In the subgroup with prior treatment experience, evaluation ratings were also associated with treatment attitudes, accounting for 17% of the variance in their scale score. These results provide additional support for the construct validity of this scale.

Revisiting relationships between sex-related variables and continuation in counseling.

This study examined the relationships between three sex-related variables (client sex, therapist sex, and dyad matching on sex) and continuation in counseling. 245 college students who were clients at three university counseling centers participated. Consistent with previous studies, women comprised 68.2% of the clients seeking services at these counseling centers. Clients' sex was significantly related to counseling duration, explaining 2.2% of the common variance. Female clients, on the average, attended 1.8 more sessions than male clients. However, neither the therapists' sex nor dyad matching on sex was significantly related to the duration of counseling. None of the sex-related variables correlated with premature termination of counseling. The results have implications for providing counseling and outreach services to male students. Despite relatively equivalent rates in the incidence of mental health problems, female students continue to comprise the majority of clients. Therefore, university counseling centers need to communicate their services better to male students in need of mental health services.

Does psychopathology predict counseling duration?

Many university counseling centers have adopted case management policies in an effort to conserve limited resources. Fearing that students with more severe problems will consume too many clinical resources, many counseling centers have decided to refer such students to external agencies or providers for mental health services. However, this fear might be unwarranted because empirical research has not shown a substantial relationship between psychopathology and counseling duration. This investigation examined whether a new treatment-planning inventory, the Butcher Treatment Planning Inventory, might be useful for better understanding the relationships between various problem areas and counseling duration. Participants were new clients (students and staff members) at a university counseling center in the southeastern USA. Professional staff members and graduate students in counselor education, clinical psychology, and clinical social work provided counseling services to the participants. Lower scores on several scales predicted counseling duration. In other words, clients with lower scores on these scales (representing less psychopathology) attended more counseling sessions than clients with greater psychopathology. Therapists' background also predicted counseling duration; clients who worked with either a professional staff member or graduate student in counselor education attended more sessions than clients who worked with a graduate student in clinical psychology. The results of this study, combined with previous research, suggest that measures of psychopathology are not very useful for identifying which clients will complete long-term counseling. Until better information becomes available, actuarial tables remain the most efficient means for predicting counseling duration.

Predicting premature termination from counseling using the Butcher Treatment Planning Inventory.

This investigation examined the extent to which premature termination from counseling could be predicted from selected scales on the Butcher Treatment Planning Inventory (BTPI). Ninety-five new clients at a university counseling center agreed to participate in the study and completed the BTPI as part of the intake evaluation. Premature termination occurred when a participant missed a scheduled appointment and unilaterally dropped out of counseling. Higher scores on Closed-Mindedness, Problems in Relationship Formation, Somatization of Conflict, Self-Oriented/Narcissism, Perceived Lack of Environmental Support, and the Treatment Difficulty Composite were associated with premature termination. The General Pathology Composite, a general index of symptomatic distress, also enhanced the prediction of premature termination by suppressing irrelevant variance in other BTPI scales. The results provide support for the validity of the BTPI in identifying clients at risk for premature termination from counseling.