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An Evaluation of Prepracticum Helping Skills Training for Graduate Social Work Students

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Title: An Evaluation of Prepracticum Helping Skills Training for Graduate Social Work Students
Language: English
Authors: Gockel, Annemarie, Burton, David L.
Source: Journal of Social Work Education. 2014 50(1):101-119.
Availability: Routledge. Available from: Taylor & Francis, Ltd. 325 Chestnut Street Suite 800, Philadelphia, PA 19106. Tel: 800-354-1420; Fax: 215-625-2940; Web site: http://www.tandf.co.uk/journals
Peer Reviewed: Y
Page Count: 19
Publication Date: 2014
Document Type: Journal Articles
Reports - Research
Education Level: Postsecondary Education
Higher Education
Descriptors: Graduate Students, Practicums, Helping Relationship, Social Work, Counseling Techniques, Skill Development, Skill Analysis, Self Efficacy, Empathy, Anxiety, Metacognition, Followup Studies, Educational Strategies, Teaching Methods, Questionnaires, Outcome Measures, Likert Scales, Pretests Posttests, Achievement Gains, Student Attitudes, Instructional Effectiveness, Introductory Courses
DOI: 10.1080/10437797.2014.856234#.U6Hcn_ldVPo
ISSN: 1043-7797
Abstract: Although foundational practice classes play a key role in helping prepracticum students develop counseling skills, we know little about the effectiveness of this form of helping skills training. This study assessed the effect of helping skills training delivered in foundational practice classes on proximal indicators of counseling skills acquisition, including measures of counseling self-efficacy, empathy, anxiety, and hindering self-awareness or rumination. Participating students made significant gains in counseling self-efficacy that were maintained at 3-month follow-up. Reductions in anxiety, rumination, and personal distress in interpersonally challenging situations were observed at follow-up, indicating that students made a successful transition to the field following training. The frequency of large-group role plays in particular was related to gains in students' counseling self-efficacy.
Abstractor: As Provided
Number of References: 45
Entry Date: 2014
Accession Number: EJ1029628
Database: ERIC
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  Value: <anid>AN0094614373;swe01jan.14;2019Apr02.13:44;v2.2.500</anid> <title id="AN0094614373-1">An Evaluation of Prepracticum Helping Skills Training for Graduate Social Work Students. </title> <p>Although foundational practice classes play a key role in helping prepracticum students develop counseling skills, we know little about the effectiveness of this form of helping skills training. This study assessed the effect of helping skills training delivered in foundational practice classes on proximal indicators of counseling skills acquisition, including measures of counseling self-efficacy, empathy, anxiety, and hindering self-awareness or rumination. Participating students made significant gains in counseling self-efficacy that were maintained at 3-month follow-up. Reductions in anxiety, rumination, and personal distress in interpersonally challenging situations were observed at follow-up, indicating that students made a successful transition to the field following training. The frequency of large-group role plays in particular was related to gains in students' counseling self-efficacy.</p> <p>Helping skills training, also known as counseling skills training or communication skills training, is central to the development of an effective social worker. Helping and communication skills enable social workers to understand and address individual and group problems and build the kinds of relationships that get the job done, whether that job is helping a client face a particular challenge, bringing a community together to address a common issue, or building policies that can change lives. Training in the helping professions is theoretically divided into the acquisition of knowledge, skills, and self-awareness; however, critics have suggested that the major focus of professional training is too often placed on knowledge, leaving skills training a distant second and self-awareness a dismal third in line ([<reflink idref="bib23" id="ref1">23</reflink>]).</p> <p>The foundational practice course is often the first place that students receive direct instruction in helping and communication skills. This course is considered the linchpin of the training process because it helps students apply the knowledge learned in other classes to real-life challenges drawn from the field, while fostering the self-awareness that facilitates further skill development. Despite the centrality of the foundational practice course, we know very little about the effectiveness of these courses in providing students with the skills and attributes needed to succeed in their field placements and their subsequent careers ([<reflink idref="bib10" id="ref2">10</reflink>]; [<reflink idref="bib12" id="ref3">12</reflink>]; [<reflink idref="bib31" id="ref4">31</reflink>]; [<reflink idref="bib40" id="ref5">40</reflink>]). The Council on Social Work Education's (CSWE; 2008) accreditation standards mandate an active assessment of students' learning outcomes to respond to just such gaps in our knowledge of the social work training process.</p> <p>Clinical social workers make up the majority of practitioners in the field ([<reflink idref="bib32" id="ref6">32</reflink>]). Consequently, existing research on communication skills training has focused on helping social work students build counseling and interpersonal skills that may later be applied to tasks at the mezzo and macro levels of practice. The majority of this research was conducted in the 1970s and 1980s. These findings validated the effectiveness of professional training over practice experience alone ([<reflink idref="bib40" id="ref7">40</reflink>]). Behavioral training models that combined direct instruction, modeling, and feedback with the opportunity to practice target skills such as active listening proved to be more effective than classroom teaching alone and remain the standard in the field ([<reflink idref="bib31" id="ref8">31</reflink>]; [<reflink idref="bib40" id="ref9">40</reflink>]; [<reflink idref="bib45" id="ref10">45</reflink>]). Unfortunately, the "internal validity" of these studies as a whole is "quite low" ([<reflink idref="bib45" id="ref11">45</reflink>], p. 109). They contain numerous methodological flaws, including small and self-selected samples, inadequate measures and rating protocols, limited designs that used posttest-only measures or failed to include follow-up assessments, and a lack of detail regarding the training strategies assessed ([<reflink idref="bib31" id="ref12">31</reflink>]; [<reflink idref="bib40" id="ref13">40</reflink>]; [<reflink idref="bib45" id="ref14">45</reflink>]).</p> <p>Current training models for social workers also draw heavily on the more substantial body of training literature to be found in counseling psychology ([<reflink idref="bib10" id="ref15">10</reflink>]; [<reflink idref="bib40" id="ref16">40</reflink>]). However, many of these studies suffer from some of the same methodological flaws ([<reflink idref="bib18" id="ref17">18</reflink>]), and counseling theory may not be directly applicable to social work practice ([<reflink idref="bib40" id="ref18">40</reflink>]). Many of the original studies focused on the instruction of a single skill in isolation, such as reflective listening, and involved brief instructional interventions (5 minutes to 1 hour) and brief overall training programs of, for example, 10 hours in length ([<reflink idref="bib18" id="ref19">18</reflink>]; [<reflink idref="bib31" id="ref20">31</reflink>]). Yet most novice trainees in social work programs now attend semester-long practice courses that offer instruction in a range of helping skills and provide an opportunity for the repeated practice of any single skill. Thus the early research does not necessarily reflect the current context of social work training.</p> <p>Alarmingly, several of the more methodologically sound studies from this period either found no training effects or determined that students actually decreased in helping skills over the course of professional training ([<reflink idref="bib45" id="ref21">45</reflink>]). Two studies that did include a follow-up component found that students who were able to successfully demonstrate helping skills after a course of training did not effectively apply these skills to their experience with clients in the field, identifying a critical gap in the transfer of training ([<reflink idref="bib5" id="ref22">5</reflink>]; [<reflink idref="bib22" id="ref23">22</reflink>]). As a result of these limitations, recent reviews have called for a renewal of research in this area ([<reflink idref="bib10" id="ref24">10</reflink>]; [<reflink idref="bib18" id="ref25">18</reflink>]; [<reflink idref="bib40" id="ref26">40</reflink>]). The reviewers' recommendations include evaluating forms of helping skills training that better represent the breadth, intensity, and context of current training protocols, investigating a wider range of training strategies, broadening outcome measures, which have too often focused primarily on assessing empathic responses, enhancing methodological rigor, and including follow-up measures to evaluate the transfer of training from the classroom to the field ([<reflink idref="bib18" id="ref27">18</reflink>]; [<reflink idref="bib40" id="ref28">40</reflink>]).</p> <p>Although research in the field has slowed considerably in the last 3 decades, a number of other variables, in addition to empathic responding, have since been linked to the process of helping skills acquisition. Counseling self-efficacy, which is a student's belief in his or her ability to effectively execute counseling tasks, has been identified as a key variable in the skill development process ([<reflink idref="bib27" id="ref29">27</reflink>]). Counseling self-efficacy is viewed as "a primary mechanism between simply knowing how to help in a counseling situation and actually executing effective counseling actions" ([<reflink idref="bib14" id="ref30">14</reflink>], p. 49). Counseling self-efficacy has been positively related to counseling performance, and higher levels of counseling self-efficacy have been shown to help students to manage anxiety, persevere in the face of challenging counseling tasks, focus on the positive and changeable aspects of their performance, and make use of feedback ([<reflink idref="bib15" id="ref31">15</reflink>]; [<reflink idref="bib14" id="ref32">14</reflink>]; [<reflink idref="bib27" id="ref33">27</reflink>]). Counseling self-efficacy is hypothesized to be most important as a factor in skill development for beginning students in pre-practicum or early practicum training as trainees in advanced practicum placements show fewer changes in counseling self-efficacy ([<reflink idref="bib27" id="ref34">27</reflink>]).</p> <p>Anxiety has been identified as another key factor in training, and one that can interfere with counseling skill development, particularly among novice trainees ([<reflink idref="bib11" id="ref35">11</reflink>]; [<reflink idref="bib15" id="ref36">15</reflink>]; [<reflink idref="bib17" id="ref37">17</reflink>]). A pervasive sense of anxiety appears to be a hallmark of early clinical training experiences: trainees commonly fear performing counseling tasks poorly, being negatively evaluated, and being judged as unhelpful or unskilled by clients or supervisors ([<reflink idref="bib3" id="ref38">3</reflink>]; [<reflink idref="bib15" id="ref39">15</reflink>]). Excessive anxiety is thought to interfere with the trainee's ability to take in new information, to accurately observe and assess his or her counseling interactions, and to be open to learning in supervision ([<reflink idref="bib15" id="ref40">15</reflink>]). In prior studies, trainee anxiety has been negatively associated with counseling self-efficacy, counseling skills acquisition, and counseling performance ([<reflink idref="bib11" id="ref41">11</reflink>]; [<reflink idref="bib17" id="ref42">17</reflink>]; [<reflink idref="bib21" id="ref43">21</reflink>]).</p> <p>Hindering self-awareness is one of the most recent variables that has been identified as interfering with counseling performance ([<reflink idref="bib20" id="ref44">20</reflink>]; [<reflink idref="bib44" id="ref45">44</reflink>]; [<reflink idref="bib43" id="ref46">43</reflink>]). Hindering self-awareness involves being distracted by an awareness of one's thoughts, feelings, physiological sensations, or behaviors ([<reflink idref="bib44" id="ref47">44</reflink>]). As trainees begin to enact the counseling skills they have been learning, they may be more self-conscious, more aware of each gesture or verbalization, and more critical about the extent to which they are successfully implementing desired skills ([<reflink idref="bib20" id="ref48">20</reflink>]; [<reflink idref="bib44" id="ref49">44</reflink>]). This excessive self-consciousness can, in turn, hinder their ability to respond fully to the client in the moment ([<reflink idref="bib44" id="ref50">44</reflink>]; [<reflink idref="bib43" id="ref51">43</reflink>]), particularly when it involves critical self-talk ([<reflink idref="bib17" id="ref52">17</reflink>]). The frequency of hindering self-awareness has been related to client perceptions of the trainee as being less helpful, and to negative assessments by trainees of their own performance and of their clients' reactions to them ([<reflink idref="bib44" id="ref53">44</reflink>]). Helping skills training programs may serve to increase counseling self-efficacy ([<reflink idref="bib17" id="ref54">17</reflink>]) and ameliorate anxiety and hindering self-awareness ([<reflink idref="bib20" id="ref55">20</reflink>]), and these variables should also be considered in helping skills research ([<reflink idref="bib18" id="ref56">18</reflink>]).</p> <p>Questions regarding the effect of particular training strategies also require attention. Although the combination of didactic instruction, modeling, and feedback are supported by existing evidence, there are few studies comparing the effects of different types of modeling or feedback. For example, is live demonstration by the instructor more effective than videotaped role plays by experts? Although we know that immediate feedback has a more profound effect than delayed feedback, what is the effect of feedback from different sources? For example, does receiving feedback from your instructor versus your peers have a different effect? In addition, modeling works best when the model appears to accomplish a skill through effort versus effortlessness ([<reflink idref="bib15" id="ref57">15</reflink>]). Does that mean that watching peer models who necessarily expend more effort is more effective than watching expert models?</p> <p>Although the necessity of practice is often taken for granted in the field, the effects of practice have seldom been investigated as a distinct instructional strategy ([<reflink idref="bib18" id="ref58">18</reflink>]). The most common form of practice is role-playing, and a number of early studies linked role-playing to increases in counseling skill development ([<reflink idref="bib31" id="ref59">31</reflink>]). More recently, Larsen and colleagues (1999) found that role-playing may facilitate skill development if the role play is successful but interfere with skill development if the role play is unsuccessful. This finding led them to conclude that role-play practice is a higher-risk instructional strategy that may be more appropriate once students have begun to master individual counseling microskills in isolation and their counseling self-efficacy has started to build. Role-play practice is one of a number of strategies, including videotape review, that require further research ([<reflink idref="bib19" id="ref60">19</reflink>]; [<reflink idref="bib26" id="ref61">26</reflink>]).</p> <p>Similarly, most existing studies investigated the presence or absence of a particular educational strategy, but few have investigated the frequency of a given strategy. It is possible that the effect of potentially high-impact strategies such as role-play practice may change with their frequency of use. For example, students who dread potentially unsuccessful role plays may learn to relax over time as they see that their peers make similar errors and discover that they can learn and grow from their mistakes. Thus the frequency and not just the presence of particular instructional strategies may be another fruitful topic of study, particularly when exploring the effect of a broad variety of training strategies in concert.</p> <p>The current study was designed to respond to existing calls for a renewal of research on helping skills training for prepracticum students and to address the particular gap in recent research on helping skills training in social work. In order to respond to these gaps, we evaluated the effectiveness of a foundational practice course as a model of helping skills training that uses a wide variety of instructional strategies to help students develop an interrelated series of beginning counseling skills. Because it is not possible to evaluate distal changes in actual counseling performance with prepracticum trainees who have yet to encounter a client, in this study we assessed changes that students experienced on a broad variety of proximal measures of counseling skills acquisition and development appropriate to prepracticum trainees, including empathy, counseling self-efficacy, anxiety, and hindering self-awareness. The research questions guiding this study were:</p> <p></p> <ulist> <item> 1. Do prepracticum students benefit from the helping skills training they receive in foundational practice courses that integrate a variety of instructional methods and teach a combination of beginning counseling skills?</item> <p></p> <item> 2. Are training gains maintained at 3 month follow-up?</item> <p></p> <item> 3. Is the frequency of particular instructional strategies related to training outcomes?</item> </ulist> <p>Based on the existing literature, our hypotheses were (a) that students would benefit from the helping skills training programs nested within foundational practice courses as demonstrated by increases in empathy and counseling self-efficacy and declines in anxiety and hindering self-awareness over the course of training; (b) that training outcomes would be maintained at follow-up; and (c) that the frequency of use of the instructional strategies of modeling, feedback, and role-play practice would have a positive relationship to training outcomes.</p> <hd id="AN0094614373-2">METHOD</hd> <p></p> <hd id="AN0094614373-3">Description of the Sample</hd> <p>A total of 137 students were registered in the incoming class of a graduate school for social work in New England in 2010, and 132 of those students agreed to participate in our evaluation study. On average, incoming students were 30.02 years of age (<emph>SD</emph> = 9.0 years; <emph>Mdn</emph> = 26.5), ranging from 21–62 years. The sample was primarily female, as is not uncommon in social work schools, with 111 (84.1%) indicating female sex, 19 (14.4%) indicating male sex, and 2 (1.5%) who did not respond to this question. The participants primarily selected Caucasian as their race (74%), with 11% indicating mixed race, 5% Black, 5% Latino, and 5% Other. As is typical for social work programs, the students were required to possess the equivalent of a 4-year degree in a liberal arts college prior to entry. In terms of counseling experience prior to entering the MSW program, 32% of students had no previous counseling experience, and the remaining students reported an average of 1 year of experience as a volunteer, intern, or paid staff person before beginning graduate school.</p> <hd id="AN0094614373-4">Research Design</hd> <p>Quantitative measures were gathered from all first-year students who chose to participate at the beginning of clinical practice instruction (Week 1) and were repeated at the end of clinical practice instruction (Week 10) using a pre–posttest questionnaire. Participating students were also asked to complete a follow-up questionnaire 3 months after completing the class to evaluate whether any changes that were found were maintained after they transitioned to their placements.</p> <hd id="AN0094614373-5">Recruitment and Data Collection Process</hd> <p>Entering first-year students received a brief introduction to the study near the end of their first foundational practice class to solicit their participation. Teachers left the class as soon as they introduced the researchers, so that they remained blind to their students' participation. To minimize confusion, the study package (consent, questionnaire, and envelope) was distributed to all students at the beginning of the introduction so that they could review the materials and ask questions as the study was being described. Students were advised that their decision to participate in the study would have no effect whatsoever on their grade.</p> <p>Students who wished to participate were asked to fill out the consent and begin the questionnaire. Students who preferred not to participate were asked to return the consent and questionnaire to the envelope and hand the package back to the researcher as they left the class. Participating students were asked to return the completed questionnaire to the envelope and seal the envelope, and they received a coupon for coffee as an honorarium for their participation. The posttest was administered in the second to last class in a similar fashion. A number of students did not complete the posttest survey (<emph>n</emph> = 6, 4.5%) and no further data are available on those students, resulting in an <emph>n</emph> = 126 for the posttest sample. Follow-up surveys were mailed to all students who had completed a posttest measure and indicated their willingness to be contacted for follow-up (<emph>n</emph> = 122) in December of 2010. The completed follow-up surveys (<emph>n</emph> = 81) were returned by mid-February 2011. A number of students did not choose to participate in the follow-up survey (<emph>n</emph> = 45, 35.7 % of the posttest sample) and no further data are available on those students, resulting in a follow-up <emph>n</emph> = 81. Data were not manipulated, substituted, or imputed to address attrition in any analysis.</p> <hd id="AN0094614373-6">Foundational Practice Course</hd> <p>The course itself focused on teaching students a progressive series of basic counseling interviewing skills including reflecting, asking questions, exploring presenting concerns, empathic responding, and so forth in the context of relevant information about assessment, psychopathology, counseling theory, and ethics that would help students more effectively integrate and apply these skills. The course was united by a joint syllabus and taught by seven different instructors. As might be expected, the techniques employed to teach clinical practice skills included a combination of educational strategies that have previously been empirically validated, including didactic instruction, modeling, and feedback ([<reflink idref="bib18" id="ref62">18</reflink>]; [<reflink idref="bib24" id="ref63">24</reflink>]). In this case, modeling encompassed both the live demonstration of skills by the instructor and the use of videotapes where expert counselors demonstrated target skills in live client interviews. Feedback included both direct feedback from the instructor and peer feedback offered after role-play exercises, which were the central strategy to allow students to practice and develop their counseling skills. Three forms of role-play practice were used: standard two-person role plays, small-group role plays where one or two observers commented on a role play between two students, and large-group role plays, where two or more students engaged in a role play in front of the class at large and received feedback from peers and from the instructor.</p> <p>The use of case study, in which students learned about counseling through analyzing a specific case example of therapy was also incorporated, and instances of instructors providing specific examples from their own practice of clinical social work was isolated as another educational strategy. Finally, the course also drew on videotape review, a strategy that is recommended but that as yet has not been well tested ([<reflink idref="bib19" id="ref64">19</reflink>]). Videotape review involved having students videotape a role play where they acted as the social worker, then review and transcribe a segment of the videotape and analyze the segment with regard to their developing counseling skills, reactions to the client, and observations about the dynamics of the interaction.</p> <hd id="AN0094614373-7">Measures</hd> <p>We selected standardized measures of a broad range of skills or traits that have been associated with counseling skill acquisition and counseling performance among novice trainees as proximal measures of training effectiveness. Each measure had demonstrated reliability and validity in prior studies. The Interpersonal Reactivity Index (IRI), is currently one of the most widely used individual difference measures of empathy ([<reflink idref="bib1" id="ref65">1</reflink>]; [<reflink idref="bib4" id="ref66">4</reflink>]). The IRI was selected because critics of the literature have suggested that the behavioral measures of empathic responding that are typically used do not adequately capture the attitudinal dimension of empathy, which may take longer to internalize and to generalize to practice contexts ([<reflink idref="bib14" id="ref67">14</reflink>]; [<reflink idref="bib24" id="ref68">24</reflink>]).</p> <p>The IRI has 28 items divided into four separate scales (Perspective Taking, Empathic Concern, Fantasy Scale, Personal Distress), which can be totaled. Each subscale measures a distinct feature of empathy. Participants indicate the extent to which the items describe their thoughts and feelings on a 5-point scale ranging from A (<emph>does not describe me well</emph>) to E (<emph>describes me very well</emph>), with higher scores indicating a greater degree of empathy. An example of a typical item is "When I see someone being taken advantage of I feel kind of protective towards them." [<reflink idref="bib8" id="ref69">8</reflink>] reports an internal consistency (coefficient alpha) across the four scales ranging from.70 to.78 in the development sample, and test–retest reliabilities between.61 and.81 for a 2-month period. Inter-item reliabilities as determined by Cronbach's alpha in this study were acceptable: Perspective Taking, α = .75; Empathic Concern, α = .65; Fantasy Scale, α = .81; Personal Distress, α = .65; and for the Total Score, α = .75. Davis' (1983) validation study showed that IRI subscales correlated in the expected directions with other measures of empathy, and with measures of interpersonal functioning, sensitivity, emotionality, and self-esteem.</p> <p>The Counselor Activity Self-Efficacy Scales (CASES) is a 41-item instrument with three subscales (Helping Skills Self-Efficacy, Session Management Self-Efficacy, and Counseling Challenges Self-Efficacy) that can be summed for a total score ([<reflink idref="bib28" id="ref70">28</reflink>]). Participants rate their confidence in their ability to perform particular counseling tasks with most clients over the next week on a scale ranging from 0 (<emph>no confidence at all</emph>) to 9 (<emph>complete confidence</emph>). The items are reflective of generic skills that any clinical social worker would need to become proficient in over time, such as asking open-ended questions, listening, attending to nonverbal communication, and providing information. Typical item tasks include the ability to "use silence to allow clients to get in touch with their thoughts and feelings" and to "help your client set realistic counseling goals."</p> <p>Following the CASES authors' model, we omitted the Counseling Challenges subscale, which is more appropriate for advanced trainees ([<reflink idref="bib29" id="ref71">29</reflink>]), and combined the first two subscales (Helping Skills Self-Efficacy and Session Management Self-Efficacy) for an overall score. The scale developers reported inter-item reliabilities ranging from.79 to.94 for these subscales, and an inter-item reliability of.97 for the overall scale. In the validation study ([<reflink idref="bib28" id="ref72">28</reflink>]), the CASES was strongly related to other measures of counseling self-efficacy, while not being significantly related to measures of social desirability. It also distinguished between less and more experienced trainees and was effective in capturing significant changes in students' self-efficacy over a semester-long training course. The CASES has been used in a number of counselor training studies (e.g., [<reflink idref="bib14" id="ref73">14</reflink>]; [<reflink idref="bib15" id="ref74">15</reflink>]). Internal reliability was robust in the current sample: Helping Skills Self-Efficacy, α = 92; Session Management Self-Efficacy, α = .96; and Total Score, α = .96.</p> <p>Anxiety was measured by the State subscale of the State-Trait Anxiety Inventory (STAI), a 20-item inventory that captures self-reports of current moment anxiety ([<reflink idref="bib9" id="ref75">9</reflink>]). Participants rate their agreement with a series of statements such as "I feel nervous" on a scale ranging from a low of 1 (<emph>not at all</emph>) to a high of 4 (<emph>very much so</emph>), with higher scores indicating greater anxiety. Spielberger and colleagues reported an inter-item reliability ranging from α = .91 to α = .93 for a sample of college students, and we found similar results with α = .90. The STAI has been highly correlated with other measures of anxiety ([<reflink idref="bib16" id="ref76">16</reflink>]), and it is routinely used in counseling skills training research (e.g., [<reflink idref="bib16" id="ref77">16</reflink>]; [<reflink idref="bib27" id="ref78">27</reflink>]).</p> <p>The only existing measure of hindering self-awareness per se, the Self-Awareness and Management Strategies Scales (SAMS), focuses on measuring hindering self-awareness in session ([<reflink idref="bib42" id="ref79">42</reflink>]). Since we were working with pre-practicum trainees, who were not yet meeting with clients, we selected the Rumination subscale of the Reflection Rumination Questionnaire as a measure of hindering self-awareness instead. This scale encompasses both the key elements of excessive self-focus and negative self-focus that appear to be most likely to interfere with counseling skill development ([<reflink idref="bib44" id="ref80">44</reflink>]).</p> <p>The Rumination subscale of the Reflection Rumination Questionnaire (RRQ) measures neurotic rather than reflective self-attention and has been correlated with measures of neuroticism, self-consciousness, anxiety, and depression ([<reflink idref="bib39" id="ref81">39</reflink>]). Participants circle a number from 1 (<emph>strongly disagree</emph>) to 5 (<emph>strongly agree</emph>) to indicate the extent of their agreement with a series of 12 statements such as "Sometimes it is hard for me to shut off thoughts about myself," with higher scores indicating higher levels of rumination. The authors reported an inter-item reliability of.90 in the development sample. In the current study, α = .92. The Rumination subscale of the RRQ has been used to measure ruminative self-attention in a number of recent studies with college students ([<reflink idref="bib34" id="ref82">34</reflink>]; [<reflink idref="bib35" id="ref83">35</reflink>]).</p> <p>In addition to standardized measures, an educational strategies survey was designed by the first author to measure students' evaluations of the helpfulness of different instructional strategies using a scale ranging from a 1 (the strategy was <emph>not at all helpful</emph>) to a 5 (the strategy was <emph>essential</emph> to their learning and development of clinical skills). It also measured their overall satisfaction with the instruction they received, which ranged from a possible 0 (<emph>very unsatisfied</emph>) to a 4 (<emph>very satisfied</emph>), as well as their ratings of the frequency with which different instructional strategies were used in their practice classes, which ranged from a 0 (<emph>strategy not used in this class</emph>) to a 5 (<emph>strategy was used three times per week</emph>).</p> <hd id="AN0094614373-8">RESULTS</hd> <p></p> <hd id="AN0094614373-9">Student Changes at Posttest and Follow-Up</hd> <p>A one-way ANOVA[<reflink idref="bib1" id="ref84">1</reflink>] was used to assess differences in each scale across the three points of data collection. The most significant changes that students experienced over the course of instruction were increases in overall counseling self-efficacy at posttest, which reflects students' beliefs about their ability to effectively implement their developing counseling skills (Table 1). These changes reflect gains in both students' perceived ability to use particular counseling skills as well as their perceived ability to manage the flow of a counseling session at posttest. Gains students made in counseling self-efficacy at the conclusion of instruction were further enhanced once they transitioned to the field at follow-up. Although students exhibited no significant changes in anxiety, hindering self-awareness, or empathy following training, they did experience a significant drop in anxiety and hindering self-awareness at follow-up. The results are summarized in Table 1.</p> <p>TABLE 1 ANOVA of Pretest to Follow-Up Mean Differences in Proximal Indicators of Counseling Skill Acquisition</p> <p> <ephtml> <table><thead valign="bottom"><tr><td>Variable<xref ref-type="fn" rid="TFN1001" /></td><td>Pre</td><td>Post</td><td>Follow-Up</td><td><italic>F</italic></td></tr></thead><tbody><tr><td>Interpersonal Reactivity Index (Empathy)</td></tr><tr><td>Perspective taking</td><td char=".">24.10(3.81)</td><td char=".">23.39(3.78)</td><td char=".">23.19(4.06)</td><td char=".">1.75</td></tr><tr><td>Fantasy scale</td><td char=".">20.91(4.50)</td><td char=".">20.92(4.96)</td><td char=".">20.27(5.29)</td><td char=".">.50</td></tr><tr><td>Empathic concern</td><td char=".">23.60(3.46)</td><td char=".">23.25(3.35)</td><td char=".">23.09(4.15)</td><td char=".">.60</td></tr><tr><td>Personal distress<xref ref-type="fn" rid="TFN1002" /><sup>,</sup><xref ref-type="fn" rid="TFN1002" /></td><td char=".">12.45(4.02)</td><td char=".">12.62(4.07)</td><td char=".">10.94(3.56)</td><td char=".">5.11 <xref ref-type="fn" rid="TFN1003" /></td></tr><tr><td>Total<xref ref-type="fn" rid="TFN1002" /></td><td char=".">81.06(9.27)</td><td char=".">80.18(10.19)</td><td char=".">77.48(10.87)</td><td char=".">3.30 <xref ref-type="fn" rid="TFN1003" /></td></tr><tr><td>Counseling Activity Self-Efficacy Scales</td></tr><tr><td>Helping skills<xref ref-type="fn" rid="TFN1002" /><sup>,</sup><xref ref-type="fn" rid="TFN1002" /></td><td char=".">5.26(1.40)</td><td char=".">6.05(1.04)</td><td char=".">6.34(1.12)</td><td char=".">23.60<xref ref-type="fn" rid="TFN1003" /></td></tr><tr><td>Session management<xref ref-type="fn" rid="TFN1002" /><sup>,</sup><xref ref-type="fn" rid="TFN1002" /></td><td char=".">4.50(1.72)</td><td char=".">6.02(1.07)</td><td char=".">6.28(1.15)</td><td char=".">56.88<xref ref-type="fn" rid="TFN1003" /></td></tr><tr><td>Total<xref ref-type="fn" rid="TFN1002" /><sup>,</sup><xref ref-type="fn" rid="TFN1002" /></td><td char=".">4.96(1.46)</td><td char=".">6.04(0.99)</td><td char=".">6.30(1.08)</td><td char=".">39.73<xref ref-type="fn" rid="TFN1003" /></td></tr><tr><td>State Anxiety Scale</td></tr><tr><td>State anxiety<xref ref-type="fn" rid="TFN1002" /><sup>,</sup><xref ref-type="fn" rid="TFN1002" /></td><td char=".">43.41(10.40)</td><td char=".">42.17(10.54)</td><td char=".">37.10(9.39)</td><td char=".">10.10<xref ref-type="fn" rid="TFN1003" /></td></tr><tr><td>Rumination Questionnaire</td></tr><tr><td>Rumination<xref ref-type="fn" rid="TFN1002" /><sup>,</sup><xref ref-type="fn" rid="TFN1002" /></td><td char=".">3.37(0.74)</td><td char=".">3.39(0.77)</td><td char=".">3.07(0.78)</td><td char=".">5.28<xref ref-type="fn" rid="TFN1003" /></td></tr><tr><td><ext-link id="TFN1001" /><sup>†</sup>Higher scores on each scale indicate more of that characteristic or skill.</td></tr><tr><td><ext-link id="TFN1002" /><sup>1</sup>Significant pre to post difference; <sup>2</sup>significant post to follow-up difference; <sup>3</sup>significant pre to follow-up difference.</td></tr><tr><td><ext-link id="TFN1003" />*<italic>p</italic> < .05; **<italic>p</italic> < .01; ***<italic>p</italic> < .001.</td></tr></tbody></table> </ephtml> </p> <p>Perhaps the most surprising change was that students appeared to actually decline in overall empathy at follow-up. This decline was due largely to a decrease in the personal distress subscale of the Interpersonal Reactivity Index. We interpret this result as evidence of a possible gain in counseling skill acquisition in keeping with reported increases in counseling self-efficacy. Recent investigations of the factor structure of the Interpersonal Reactivity Index suggest that the personal distress subscale measures quite a different construct than empathy ([<reflink idref="bib1" id="ref85">1</reflink>]; [<reflink idref="bib33" id="ref86">33</reflink>]). The personal distress subscale measures one's own feelings of discomfort in the face of emotionally challenging interpersonal situations. According to the scale's author ([<reflink idref="bib9" id="ref87">9</reflink>]), scores on the personal distress subscale have been negatively correlated with social competence and positively correlated with social dysfunction on eight different measures of social functioning. Thus the decrease in students' scores on the personal distress subscale actually represent an increase in their comfort with handling the interpersonally challenging situations that are intrinsic to the day-to-day practice of social work.</p> <p>Scores on the remaining three scales of the Interpersonal Reactivity Index, which more closely represent the traditional construct of empathy ([<reflink idref="bib33" id="ref88">33</reflink>]), did not change significantly at posttest or follow-up. This may have been due to relatively high levels of empathy at program entry. Using <emph>t</emph> tests, mean scores for the total current, predominantly female, sample were compared to norms for female undergraduates in the development sample, who reported higher levels of empathy than male undergraduates, to conservatively estimate potential differences. Table 2 demonstrates that the current sample reported significantly higher levels of empathy than the original sample on all subscales but personal distress, where their means were comparable to the development sample.</p> <p>TABLE 2 Mean Comparisons of Current Sample With IRI Normative Female Sample</p> <p> <ephtml> <table><thead valign="bottom"><tr><td>Scale</td><td>Sample Mean (<italic>N</italic> = 132)</td><td>Norm Sample Mean (Females) (<italic>N</italic> = 582)</td><td><italic>t</italic></td></tr></thead><tbody><tr><td>Perspective taking</td><td char=".">24.10</td><td char=".">17.96</td><td char=".">18.50<xref ref-type="fn" rid="TFN2001" /></td></tr><tr><td>Fantasy scale</td><td char=".">20.91</td><td char=".">18.75</td><td char=".">4.97<xref ref-type="fn" rid="TFN2001" /></td></tr><tr><td>Empathic concern</td><td char=".">23.60</td><td char=".">21.67</td><td char=".">6.43<xref ref-type="fn" rid="TFN2001" /></td></tr><tr><td>Personal distress</td><td char=".">12.45</td><td char=".">12.28</td><td char=".">.47</td></tr><tr><td>Total</td><td char=".">81.06</td><td char=".">70.66</td><td char=".">12.89<xref ref-type="fn" rid="TFN2001" /></td></tr><tr><td><ext-link id="TFN2001" />*<italic>p</italic> < .001.</td></tr></tbody></table> </ephtml> </p> <hd id="AN0094614373-10">Student Evaluations of Pedagogical Strategies</hd> <p>Student evaluations provide an overall picture of the diverse instructional strategies used in the foundational practice class and offer some feedback on students' perceptions of their effectiveness. Table 3 summarizes the frequency with which different instructional strategies were employed in the classroom across all instructors, demonstrating that traditional methods of instruction such as lecture and large- and small-group discussion remained the most frequently used instructional strategies in this sample.</p> <p>TABLE 3 Rank Order of Educational Strategies by Frequency of Use</p> <p> <ephtml> <table><thead valign="bottom"><tr><td /><td>Frequency<xref ref-type="fn" rid="TFN3001" /></td><td /></tr><tr><td /><td>Mean<xref ref-type="fn" rid="TFN3002" /></td><td><italic>SD</italic></td></tr></thead><tbody><tr><td>Large-group discussion</td><td char=".">4.64</td><td char=".">.853</td></tr><tr><td>Lecture</td><td char=".">3.60</td><td char=".">1.465</td></tr><tr><td>Small-group discussion</td><td char=".">3.56</td><td char=".">1.176</td></tr><tr><td>Instructor practice examples</td><td char=".">3.44</td><td char=".">1.208</td></tr><tr><td>Two-person role plays</td><td char=".">3.16</td><td char=".">1.059</td></tr><tr><td>Peer feedback</td><td char=".">2.99</td><td char=".">1.599</td></tr><tr><td>Case study</td><td char=".">2.98</td><td char=".">.860</td></tr><tr><td>Instructor feedback</td><td char=".">2.72</td><td char=".">1.660</td></tr><tr><td>Live demonstration</td><td char=".">2.35</td><td char=".">1.530</td></tr><tr><td>Video demonstration</td><td char=".">2.09</td><td char=".">.971</td></tr><tr><td>Small-group role plays</td><td char=".">1.85</td><td char=".">1.220</td></tr><tr><td>Large-group role plays</td><td char=".">1.69</td><td char=".">1.007</td></tr><tr><td>Videotape review</td><td char=".">1.06</td><td char=".">.425</td></tr><tr><td><ext-link id="TFN3001" />*Sorted by frequency.</td></tr><tr><td><ext-link id="TFN3002" /><sup>†</sup>Scale: 0 = not used, 1 = used once or twice in the course, 2 = used every other week, 3 = used one time per week, 4 = used two times per week, 5 = used three times per week.</td></tr></tbody></table> </ephtml> </p> <p>Students' ratings of the helpfulness of the instructional strategies used to teach the foundational practice course indicated that they considered all of the educational strategies to be helpful to their learning and skill development, and that assessment remained consistent once they transitioned to their work in the field at follow-up. Although exposure to the field shifted their rankings of the helpfulness of various strategies, students consistently ranked videotape review, instructor practice examples, and live demonstrations as the most helpful educational strategies. Table 4 details their rankings of the helpfulness of various educational strategies at posttest and follow-up.</p> <p>TABLE 4 Student Rankings of the Helpfulness of Educational Strategies Used in the Foundational Practice Course</p> <p> <ephtml> <table><thead valign="bottom"><tr><td><italic>How helpful were each of the following strategies in promoting your learning and development of clinical or counseling skills?</italic></td></tr><tr><td>Post<xref ref-type="fn" rid="TFN4001" /></td><td>Follow-Up<xref ref-type="fn" rid="TFN4001" /></td></tr><tr><td /><td>Mean<xref ref-type="fn" rid="TFN4002" /></td><td><italic>SD</italic></td><td /><td>Mean<xref ref-type="fn" rid="TFN4002" /></td><td><italic>SD</italic></td></tr></thead><tbody><tr><td>Student videotape review</td><td char=".">4.21</td><td char=".">.97</td><td>Instructor practice examples</td><td char=".">4.31</td><td char=".">.89</td></tr><tr><td>Instructor practice examples</td><td char=".">4.17</td><td char=".">.92</td><td>Live demonstration</td><td char=".">4.30</td><td char=".">.83</td></tr><tr><td>Live demonstration</td><td char=".">4.10</td><td char=".">.95</td><td>Student videotape review</td><td char=".">4.13</td><td char=".">1.02</td></tr><tr><td>Case study</td><td char=".">4.02</td><td char=".">.96</td><td>Instructor feedback</td><td char=".">4.10</td><td char=".">.96</td></tr><tr><td>Two-person role play</td><td char=".">3.91</td><td char=".">.93</td><td>Case study</td><td char=".">3.96</td><td char=".">.97</td></tr><tr><td>Instructor feedback</td><td char=".">3.90</td><td char=".">1.08</td><td>Video demonstration</td><td char=".">3.84</td><td char=".">1.00</td></tr><tr><td>Video demonstration</td><td char=".">3.81</td><td char=".">1.01</td><td>Two-person role play</td><td char=".">3.80</td><td char=".">1.05</td></tr><tr><td>Small-group role play</td><td char=".">3.69</td><td char=".">.93</td><td>Small-group role play</td><td char=".">3.68</td><td char=".">1.04</td></tr><tr><td>Large-group role play</td><td char=".">3.68</td><td char=".">.94</td><td>Peer feedback</td><td char=".">3.68</td><td char=".">.95</td></tr><tr><td>Small-group discussion</td><td char=".">3.65</td><td char=".">1.05</td><td>Large-group role play</td><td char=".">3.49</td><td char=".">1.14</td></tr><tr><td>Peer feedback</td><td char=".">3.54</td><td char=".">.96</td><td>Small-group discussion</td><td char=".">3.46</td><td char=".">1.00</td></tr><tr><td>Large-group discussion</td><td char=".">3.36</td><td char=".">1.11</td><td>Lecture</td><td char=".">3.08</td><td char=".">1.02</td></tr><tr><td>Lecture</td><td char=".">3.26</td><td char=".">1.06</td><td>Large-group discussion</td><td char=".">3.02</td><td char=".">1.01</td></tr><tr><td><ext-link id="TFN4001" />*Sorted by mean.</td></tr><tr><td><ext-link id="TFN4002" /><sup>†</sup>Scale: 1 = not at all helpful, 2 = somewhat helpful, 3 = helpful, 4 = very helpful, 5 = essential.</td></tr></tbody></table> </ephtml> </p> <hd id="AN0094614373-11">Course Satisfaction</hd> <p>Students were also asked to rank their satisfaction with the instruction they received in the foundational practice course, and there was very little variability in their responses. The average level of satisfaction with instruction for the participants = 3.59 (mostly satisfied to very satisfied) (<emph>SD</emph> = 1.58), with 58.9% of the sample choosing the highest possible rating of very satisfied.</p> <p>TABLE 5 Hierarchical Linear Regression of the Frequency of Educational Strategies on Pre–Post Changes in Counseling Self-Efficacy</p> <p> <ephtml> <table><thead valign="bottom"><tr><td /><td>CSE Helping Skills<xref ref-type="fn" rid="TFN5002" /></td><td>CSE Session Management<xref ref-type="fn" rid="TFN5003" /></td><td>CSE Total<xref ref-type="fn" rid="TFN5004" /></td></tr><tr><td /><td><italic>b</italic></td><td>Standard Error</td><td>β</td><td><italic>b</italic></td><td>Standard Error</td><td>β</td><td><italic>b</italic></td><td>Standard Error</td><td>β</td></tr></thead><tbody><tr><td>Case study</td><td char=".">−.005</td><td char=".">.145</td><td char=".">−.004</td><td char=".">−.093</td><td char=".">.160</td><td char=".">−.059</td><td char=".">−.041</td><td char=".">.137</td><td char=".">−.030</td></tr><tr><td>Instructor practice examples</td><td char=".">−.168</td><td char=".">.114</td><td char=".">−.168</td><td char=".">−.302</td><td char=".">.126</td><td char=".">−<bold>.270</bold><xref ref-type="fn" rid="TFN5001" /></td><td char=".">−.222</td><td char=".">.108</td><td char=".">−<bold>.230</bold><xref ref-type="fn" rid="TFN5001" /></td></tr><tr><td>Instructor feedback</td><td char=".">.004</td><td char=".">.088</td><td char=".">.006</td><td char=".">.059</td><td char=".">.097</td><td char=".">.072</td><td char=".">.027</td><td char=".">.083</td><td char=".">.038</td></tr><tr><td>Peer feedback</td><td char=".">.012</td><td char=".">.088</td><td char=".">.016</td><td char=".">.038</td><td char=".">.098</td><td char=".">.044</td><td char=".">.023</td><td char=".">.084</td><td char=".">.031</td></tr><tr><td>Large-group discussion</td><td char=".">−.243</td><td char=".">.139</td><td char=".">−.164</td><td char=".">−.333</td><td char=".">.153</td><td char="."><bold>−.201</bold><xref ref-type="fn" rid="TFN5001" /></td><td char=".">−.278</td><td char=".">.131</td><td char="."><bold>−.195</bold><xref ref-type="fn" rid="TFN5001" /></td></tr><tr><td>Small-group discussion</td><td char=".">.011</td><td char=".">.099</td><td char=".">.011</td><td char=".">.037</td><td char=".">.109</td><td char=".">.032</td><td char=".">.021</td><td char=".">.093</td><td char=".">.021</td></tr><tr><td>Lecture</td><td char=".">−.044</td><td char=".">.084</td><td char=".">−.051</td><td char=".">.050</td><td char=".">.092</td><td char=".">.052</td><td char=".">−.007</td><td char=".">.079</td><td char=".">−.009</td></tr><tr><td>Live demonstration</td><td char=".">.158</td><td char=".">.091</td><td char=".">.197</td><td char=".">.049</td><td char=".">.101</td><td char=".">.054</td><td char=".">.113</td><td char=".">.086</td><td char=".">.147</td></tr><tr><td>Video demonstration</td><td char=".">.080</td><td char=".">.130</td><td char=".">.065</td><td char=".">−.002</td><td char=".">.144</td><td char=".">−.002</td><td char=".">.047</td><td char=".">.123</td><td char=".">.039</td></tr><tr><td>Two-person role play</td><td char=".">−.115</td><td char=".">.122</td><td char=".">−.096</td><td char=".">−.245</td><td char=".">.135</td><td char=".">−.185</td><td char=".">−.166</td><td char=".">.115</td><td char=".">−.145</td></tr><tr><td>Large-group role play</td><td char=".">.380</td><td char=".">.120</td><td char="."><bold>.315</bold><xref ref-type="fn" rid="TFN5001" /></td><td char=".">.326</td><td char=".">.133</td><td char="."><bold>.243</bold><xref ref-type="fn" rid="TFN5001" /></td><td char=".">.358</td><td char=".">.114</td><td char="."><bold>.309</bold><xref ref-type="fn" rid="TFN5001" /></td></tr><tr><td>Small-group role play</td><td char=".">−.007</td><td char=".">.108</td><td char=".">−.007</td><td char=".">.090</td><td char=".">.119</td><td char=".">.080</td><td char=".">.034</td><td char=".">.102</td><td char=".">.035</td></tr><tr><td>Student videotape review</td><td char=".">.268</td><td char=".">.295</td><td char=".">.090</td><td char=".">.381</td><td char=".">.326</td><td char=".">.115</td><td char=".">.313</td><td char=".">.279</td><td char=".">.109</td></tr><tr><td><ext-link id="TFN5001" />*<italic>p</italic> < .05; **<italic>p</italic> < .01.</td></tr><tr><td><ext-link id="TFN5002" /><sup>1</sup><italic>F</italic>(13, 99) = 1.8, <italic>p</italic> = .054, <italic>R</italic><italic><sup>2</sup></italic> = .19.</td></tr><tr><td><ext-link id="TFN5003" /><sup>2</sup><italic>F</italic>(13, 99) = 2.0, <italic>p</italic> = .027, <italic>R</italic><italic><sup>2</sup></italic> = .21.</td></tr><tr><td><ext-link id="TFN5004" /><sup>3</sup><italic>F</italic>(13, 99) = 2.1, <italic>p</italic> = .018, <italic>R</italic><italic><sup>2</sup></italic> = .22.</td></tr></tbody></table> </ephtml> </p> <hd id="AN0094614373-12">Effect of Particular Educational Strategies</hd> <p>Next, the frequency of all of the educational strategies were regressed onto the pre- to posttest change scores for all three of the counseling self-efficacy measure's scales using standard hierarchical regression. The results were similar to one another, with large-group role plays predicting change scores for Session Management Self-Efficacy and Overall Counseling Self-Efficacy (see Table 5). The first hierarchical regression model approached but did not reach significance, so as a group increases in the frequency of these instructional strategies were unrelated to changes in helping skills self-efficacy (<emph>F</emph>(<reflink idref="bib13" id="ref89">13</reflink>, 99) = 1.8, <emph>p</emph> = .054). Given the number of variables in the model, we also used a stepwise regression. In this case <emph>F</emph>(<reflink idref="bib13" id="ref90">13</reflink>, 99) = 13.30, <emph>p</emph> < .001, with the large-group role plays the only remaining variable in the equation (<emph>b</emph> = .394, <emph>b (SE)</emph> = .108, β = .327, <emph>p</emph> < .001). The more the large-group role plays were used in classes, the more helping skills self-efficacy improved, and this was not the case for other strategies. The presence of other instructional strategies may be critical or important to reported changes in helping skills self-efficacy but not the frequency of their use in this sample. Because all classes used all strategies at least once as indicated by student frequency ratings, we cannot assess to what degree the presence or absence of a particular instructional strategy affected changes in helping skills self-efficacy.</p> <p>The second regression model was significant (<emph>F</emph>(<reflink idref="bib13" id="ref91">13</reflink>, 99) = 2.0, <emph>p</emph> = .027), and increases in the frequency of instructor practice examples, large-group role play, and large-group discussion predicted 21.2% of the change in the Session Management Self-Efficacy Subscale. The frequency of instructor practice examples and large-group discussion predicted decreases in session management self-efficacy, and the frequency of large-group role plays predicted gains in session management self-efficacy. The final regression model was also significant (<emph>F</emph>(<reflink idref="bib13" id="ref92">13</reflink>, 99) = 2.1, <emph>p</emph> = .018), with the frequency of large-group role plays and instructor practice examples predicting 22.4% of the variance in total counseling self-efficacy. Thus the more often large-group role plays were employed, the greater students' degree of pre- to posttest change in counseling self-efficacy, and the more instructor practice examples were employed, the smaller the change in students' overall counseling self-efficacy. All three models were negative in terms of multicollinearity diagnostics.</p> <hd id="AN0094614373-13">DISCUSSION</hd> <p>In response to our primary research question, our hypotheses were only partially supported. Students reported significant increases in counseling skills self-efficacy over the course of training but no changes in anxiety, hindering self-awareness, or empathy. Given that counseling self-efficacy is regarded as a key ingredient in counseling skill acquisition and has been empirically related to counseling skill development and counseling performance ([<reflink idref="bib14" id="ref93">14</reflink>]; [<reflink idref="bib17" id="ref94">17</reflink>]), this result demonstrates that students in this sample did indeed benefit from helping skills training. The type of helping skills training that is embedded in typical social work foundational practice classes, which draws on multiple educational strategies and targets a series of interrelated beginning counseling skills does appear to support the process of counseling skills acquisition. Unfortunately, these benefits were not as robust as anticipated, or perhaps took longer to mature.</p> <p>In response to our second research question, our hypotheses were supported. As expected, students not only maintained their gains in counseling self-efficacy but actually increased slightly in this trait at follow-up. Students also exhibited decreases in personal distress, anxiety, and hindering self-awareness at follow-up. Decreases on the Personal Distress subscale of the Interpersonal Reactivity Index signaled gains in feeling comfortable and competent in responding to the stressful interpersonal situations, such as witnessing others in distress, that are part and parcel of the clinical social work role. Taken as a whole, these results indicate that foundational practice training adequately prepared students in this sample to accomplish a successful transition to their field placements.</p> <p>Students' decreases in anxiety and hindering self-awareness further indicated that students had more learning resources freed up by the transition to field. It is possible that these changes were not observed at the end of training because students cannot fully accomplish them until they confront their fears about beginning to work with clients in the field. Authors who observed changes in trainee anxiety and hindering self-awareness over the course of helping skills instruction worked in a structure where students started to see clients during the prepracticum phase of instruction ([<reflink idref="bib20" id="ref95">20</reflink>]; [<reflink idref="bib43" id="ref96">43</reflink>]). These findings further support the notion that counseling self-efficacy is a particularly relevant measure for students who are at the beginning stage of counseling skills acquisition ([<reflink idref="bib17" id="ref97">17</reflink>]). Changes in counseling self-efficacy preceded changes in other variables, which may suggest that increases in counseling self-efficacy need to occur before declines in anxiety and hindering self-awareness can be observed. Although prior researchers have demonstrated a negative relationship between counseling self-efficacy and anxiety ([<reflink idref="bib11" id="ref98">11</reflink>]; [<reflink idref="bib17" id="ref99">17</reflink>]), the sequencing of training effects remains an open question.</p> <p>Students did not report significant changes in empathy following training or after their transition to field. Based on recent investigations of the factor structure of the Interpersonal Reactivity Index ([<reflink idref="bib1" id="ref100">1</reflink>]; [<reflink idref="bib33" id="ref101">33</reflink>]), we separated the results on the Personal Distress subscale from the results on the remaining three subscales, which more accurately represent changes in overall empathy. The lack of significant change in empathy on these subscales may have been due to a combination of factors. Students began training with higher than average levels of empathy and so had less room to improve as the result of training. The Interpersonal Reactivity Index may not be the best measure to assess changes in empathy with professional helpers. Other researchers working with trainees in the helping professions have linked nonsignificant effects on the Interpersonal Reactivity Index to the scale's lack of sensitivity ([<reflink idref="bib14" id="ref102">14</reflink>]).</p> <p>However, empathy may also be more resistant to the effect of training than other traits. The findings of prior researchers suggest that empathy remains constant or decreases over the course of formal counseling training ([<reflink idref="bib36" id="ref103">36</reflink>]), and that students value it less as they advance in their studies ([<reflink idref="bib41" id="ref104">41</reflink>]). Even studies that explored only the behavioral aspects of empathic responding have found that students do not often generalize gains made in training to their practice with clients in the field ([<reflink idref="bib5" id="ref105">5</reflink>]; [<reflink idref="bib22" id="ref106">22</reflink>][<reflink idref="bib24" id="ref107">24</reflink>]). Thus new strategies may be needed to cultivate changes in the attitudinal dimensions of empathy to help students further internalize and maintain gains that prior researchers have reported in the behavioral aspects of empathic responding.</p> <p>In response to the final research question, our hypotheses were partially supported. The results of regression analyses demonstrated that large-group role plays, but not modeling or feedback, predicted gains in counseling self-efficacy across both subscales as well as on the measure overall. This is one of the few studies to compare the effect of the frequency of a broad range of educational strategies at one time. The results highlight the importance of the frequency of role-play practice in comparison to other validated strategies such as modeling and feedback. Because we could not assess the effects of the presence or absence of each strategy, only its frequency, it may be that the effect of other strategies are not as tied to frequency. Although other researchers have suggested that the effect of role-play practice may vary with the trainee's interpretation of the outcome ([<reflink idref="bib26" id="ref108">26</reflink>]), these findings indicate that simply engaging in large-group role plays had a beneficial effect on students' counseling self-efficacy in this sample. These results are consistent with self-efficacy theory, which suggests that experiences such as role plays that allow for the practice and mastery of a skill will have the most significant effect on self-efficacy ([<reflink idref="bib2" id="ref109">2</reflink>]).</p> <p>The current study also provided an opportunity to compare the effect of different types of role-play practice. Most prior studies have assessed the presence or absence of role plays as an instructional technique ([<reflink idref="bib17" id="ref110">17</reflink>][<reflink idref="bib31" id="ref111">31</reflink>]). Yet the effectiveness of role-play practice may shift over time. Beginning students may be anxious about trying new skills with their peers and often complain that the role play initially feels stilted or unnatural ([<reflink idref="bib25" id="ref112">25</reflink>]; [<reflink idref="bib30" id="ref113">30</reflink>]). However, as they persist and begin to see the benefits of the process, they may become more relaxed with the strategy, and it may feel more natural over time. Thus frequency may be an important consideration in assessing the effects of role-play practice. Most existing studies have also concentrated on assessing the effect of role plays done in dyads or triads ([<reflink idref="bib22" id="ref114">22</reflink>]; [<reflink idref="bib30" id="ref115">30</reflink>]; [<reflink idref="bib31" id="ref116">31</reflink>]). Yet, in comparing the frequency of different types of role play practice in this study, the frequency of large-group role plays clearly had a larger effect on students' change scores.</p> <p>Some of the key mechanisms that have been hypothesized to increase self-efficacy include mastery experiences, observing models, receiving feedback reflecting one's efficacy, and regulating emotional arousal ([<reflink idref="bib2" id="ref117">2</reflink>]). Modeling is thought to be particularly effective when the model is clearly expending effort to perform as opposed to seeming to achieve effortlessly. Large-group role plays may be a particularly powerful strategy for developing self-efficacy because it combines an opportunity for practice for some students, with modeling for other students, while providing the students doing the role play with feedback from both the instructor and their peers.</p> <p>Large-group role plays involved having a group of students enact a clinical role-play scenario spontaneously in front of the class. Either a specific student or a group of students would volunteer to take turns enacting the role of the clinical social worker. The performance aspect of the exercise called on students to begin mastering the increased arousal that often accompanies initial meetings with clients while developing their skills through practice. Observers were tasked with noting places where peers used their skills to good effect, as well as offering an alternative perspective about other possible interventions. Receiving supportive feedback from the instructor and their peers alike could increase self-efficacy for the student playing the social worker. Each person engaged in the role play debriefed his or her experience, providing an opportunity for students to understand the dynamics of the intervention from multiple perspectives. Observers could benefit from watching their peers work at implementing the skills they were learning while they prepared themselves for the task. Thus large-group role plays may be a particularly effective instructional strategy because they engage all the central mechanisms for fostering self-efficacy and allow more reticent students to titrate the challenge involved by gradually progressing from the role of observer to the role of social worker.</p> <p>The results of the regression analyses also demonstrated that the frequency of instructor practice examples and large-group discussions actually detracted from student gains either in session management self-efficacy or overall counseling self-efficacy. These findings are also consistent with self-efficacy theory ([<reflink idref="bib2" id="ref118">2</reflink>]), which suggests that gains in self-efficacy are particularly related to direct experience in mastering a specific skill. Time spent in class discussion or in listening to an instructor's practice example is time not spent in the kind of direct practice exercises that promote mastery experiences. However, instructor practice examples were an educational strategy that students ranked as particularly helpful to his or her overall learning. Student rankings may point to a need to situate generic skills within specific contexts and to link them to broader concepts in the field. Although equally important, this need is not adequately assessed by the counseling self-efficacy measure, which focuses on the direct application of particular counseling skills. Hill, Stahl, et al. (2007) have argued that helping skills training may be more effective if it is situated within a coherent conceptual framework.</p> <p>The three instructional strategies that students most preferred helped them to link specific counseling skills to a broader conceptual framework, while incorporating the elements of didactic instruction, modeling, and feedback. Instructor practice examples are a form of didactic instruction that help to clarify how a skill can be applied in different situations, enabling a student to understand how that application changes based on contextual factors. Live demonstration involves having the instructor directly model a challenging skill that needs more illustration and provides students with the opportunity to ask the instructor about how and why particular responses were given. The videotape review asked students to assess their own practice, linking it to their developing conceptual understanding about which skills should be applied and how they should be applied in a given context. Thus, the strategies students preferred may highlight their need to link skill development to a larger conceptual framework that allows them to understand and deploy new skills in a flexible way.</p> <p>Student rankings may also highlight the importance of the instructor as a model in the learning process. All of the preferred instructional strategies highlighted the role of the instructor in an overt or covert way. Live demonstration involved direct modeling by the instructor. Instructor practice examples involved covert modeling, where students learned about the instructor's application of particular skills or concepts to his or her own work in the field. Videotape review represented the first opportunity for students to receive extensive feedback on both their skills and their understanding of the counseling process from the instructor. [<reflink idref="bib18" id="ref119">18</reflink>] argue that both the person of the trainer and the nature of his or her relationship with the trainee are likely to have a significant effect on the process and outcome of training. However, this effect has only rarely been examined in helping skills training research.</p> <p>Students may rely on their instructor, in particular, as a model for their developing identity as a clinical social worker. In this sample, they clearly preferred instructor modeling and instructor practice examples to expert models on videotape. A student's ongoing exposure to the instructor over time may make it easier to see both his strengths and weaknesses, as well as witnessing the effort he puts into live demonstrations, perhaps making the instructor a more accessible model than video experts. Because instructors have the benefit of developing an ongoing relationship with students, they may be more likely to share examples of mistakes as well as successes from their own practice. Expert models, by definition, are focused on accurately demonstrating a particular skill at a particular point in time. One of the key functions that instructors serve is to help students connect specific skills to an overall framework that can serve to organize intervention and guide clinical practice. Thus, the ongoing relationship with their instructor may lead students to value and draw on their instructor as a specific model for their own broader development as a clinical social worker.</p> <hd id="AN0094614373-14">Limitations</hd> <p>This evaluation is limited in that it reports on changes in a single group following instruction and therefore cannot account for other intervening variables that may have influenced the changes reported by students. It assessed students' changes on a range of variables that have been related to counseling performance but does not measure counseling performance itself. Students' perceptions of change on the self-report instruments used may not be related to their actual changes in counseling skills. Although the frequency of one instructional strategy emerged as being particularly helpful, the contribution of each individual instructional strategy to the whole cannot be assessed with this design. In addition, the study investigates the experiences of students at one institution only. Different schools may have different approaches to helping skills training that are not accounted for by the current study.</p> <hd id="AN0094614373-15">CONCLUSION</hd> <p>In responding to recent calls for evaluating our educational strategies ([<reflink idref="bib6" id="ref120">6</reflink>]), this study adds to the literature by providing some evidence to suggest that standard models of helping skills training commonly delivered through foundational practice courses may facilitate the counseling skills acquisition process by fostering counseling self-efficacy. Furthermore, the current study highlights large-group role plays as an instructional strategy that warrants more research, particularly regarding the conditions under which this strategy may increase counseling self-efficacy. It also raises potentially rich questions for future investigations including: Do gains in counseling self-efficacy precede declines in factors that interfere with counseling skills acquisition such as anxiety and hindering self-awareness? Can helping skills training effectively increase empathy itself as well as increasing empathic response behaviors? Does the effect of modeling differ according to the trainee's relationship to the model? How do instructor practice examples shape trainee learning?</p> <p>There are many other relevant questions that we did not consider. Mindfulness is increasingly recommended as a strategy for enhancing the effectiveness of clinical training (Gockel, 2010; [<reflink idref="bib24" id="ref121">24</reflink>]). In particular, mindfulness has been identified as a means of enhancing empathy ([<reflink idref="bib37" id="ref122">37</reflink>]) and as a potential antidote to hindering self-awareness including anxiety and rumination for novice trainees ([<reflink idref="bib34" id="ref123">34</reflink>]). Future studies could investigate the effect of mindfulness in enhancing helping skills training. In addition, the training model of the institution itself may have affected the current findings. The study was conducted in a context in which students received helping skills training prior to engaging with clients in their practica. Comparing the effects of using the same strategies at an institution that offers helping skills training in conjunction with students' field experience may further clarify whether particular strategies are more or less important in different training contexts.</p> <hd id="AN0094614373-16">FUNDING</hd> <p>This research was completed with the support of an award from the Smith College School for Social Work Clinical Research Institute and the Brown Foundation.</p> <ref id="AN0094614373-17"> <title> REFERENCES </title> <blist> <bibl id="bib1" idref="ref65" type="bt">1</bibl> <bibtext> Alterman, A. I., McDermott, P. A., Cacciola, J. S. and Rutherford, M. J.2003. Latent structure of the Davis Interpersonal Reactivity Index. Journal of Psychopathology and Behavioral Assessment, 25: 257–265. doi:10.1023/A:1025936213110</bibtext> </blist> <blist> <bibl id="bib2" idref="ref109" type="bt">2</bibl> <bibtext> Bandura, A.1986. Social foundations of thought and action: A social cognitive theory, Englewood Cliffs, NJ: Prentice Hall.</bibtext> </blist> <blist> <bibl id="bib3" idref="ref38" type="bt">3</bibl> <bibtext> Bischoff, R. J. and Barton, M.2002. The pathway toward clinical self confidence. American Journal of Family Therapy, 30: 231–242. doi:10.1080/019261802753577557</bibtext> </blist> <blist> <bibl id="bib4" idref="ref66" type="bt">4</bibl> <bibtext> Cliffordson, C.2001. Parents' judgments and students' self-judgments of empathy: The structure of empathy and agreement of judgments based on the Interpersonal Reactivity Index (IRI). European Journal of Psychological Assessment, 17: 36–47. doi:10.1027/1015-5759.17.1.36</bibtext> </blist> <blist> <bibl id="bib5" idref="ref22" type="bt">5</bibl> <bibtext> Collins, D. and Bogo, M.1986. Competency-based field instruction: Bridging the gap between laboratory and field learning. Clinical Supervisor, 4(3): 39–52.</bibtext> </blist> <blist> <bibl id="bib6" idref="ref120" type="bt">6</bibl> <bibtext> Council on Social Work Education2008Handbook of social work education policies and procedures for the 2008 educational policy and accreditation standards (EPAS). Retrieved fromhttp://<ulink href="http://www.cswe.org/Accreditation/Handbook/Overview14745.aspx">www.cswe.org/Accreditation/Handbook/Overview14745.aspx</ulink> (<ulink href="http://www.cswe.org/Accreditation/Handbook/Overview14745.aspx">http://www.cswe.org/Accreditation/Handbook/Overview14745.aspx</ulink>)</bibtext> </blist> <blist> <bibl id="bib7" type="bt">7</bibl> <bibtext> Daniels, J. A. and Larson, L. M.2001. The impact of performance feedback on counseling self-efficacy and counselor anxiety. Counselor Education and Supervision, 41: 120–130. doi:10.1002/j.1556-6978.2001.tb01276.x</bibtext> </blist> <blist> <bibl id="bib8" idref="ref69" type="bt">8</bibl> <bibtext> Davis, M. H.1980. A multidimensional approach to individual differences in empathy. JSAS Catalog of Selected Documents in Psychology, 10: 85</bibtext> </blist> <blist> <bibl id="bib9" idref="ref75" type="bt">9</bibl> <bibtext> Davis, M. H.1983. Measuring individual differences in empathy: Evidence for a multidimensional approach. Journal of Personality and Social Psychology, 44: 113–126. doi:10.1037/0022-3514.44.1.113</bibtext> </blist> <blist> <bibtext> Dinham, A.2006. A review of practice of teaching and learning of communication skills in social work education in England. Social Work Education, 25: 838–850. doi:10.1080/02615470600915894</bibtext> </blist> <blist> <bibtext> Friedlander, M. L., Keller, K. E., Peca-Baker, T. and Olk, M. E.1986. Effects of role conflict on counselor trainees' self-statements, anxiety level, and performance. Journal of Counseling Psychology, 33: 73–77. doi:10.1037/0022-0167.33.1.73</bibtext> </blist> <blist> <bibtext> Gillingham, P.2008. Designing, implementing and evaluating a social work practice skills course: A case example. Social Work Education, 27: 474–488. doi:10.1080/02615470701380089</bibtext> </blist> <blist> <bibtext> Gockel, A.2010. The promise of mindfulness for clinical education. Smith College Studies in Social Work, 80: 248–268. doi:10.1080/00377311003784184</bibtext> </blist> <blist> <bibtext> Greason, P. B. and Cashwell, C. S.2009. Mindfulness and counseling self-efficacy: The mediating role of attention and empathy. Counselor Education & Supervision, 49: 2–19. doi:10.1002/j.1556-6978.2009.tb00083.x</bibtext> </blist> <blist> <bibtext> Hall, K. E.2009. Anxiety and counseling self-efficacy among counseling students: The moderating role of mindfulness and alexithymia(Doctoral dissertation). Available from ProQuest Dissertations and Theses database. (UMI No. 3356126)</bibtext> </blist> <blist> <bibtext> Hess, S. A., Knox, S. and Hill, C. E.2006. Teaching graduate trainees how to manage anger: A comparison of three types of training. Psychotherapy Research, 16: 282–292. doi:10.1080/10503300500264838</bibtext> </blist> <blist> <bibtext> Hiebert, B., Uhlemann, M. R., Marshall, A. and Lee, D. Y.1998. The relationship between self-talk, anxiety, and counselling skill. Canadian Journal of Counselling, 32: 163–171.</bibtext> </blist> <blist> <bibtext> Hill, C. E. and Lent, R. W.2006. A narrative and meta-analytic review of helping skills training: Time to revive a dormant area of inquiry. Psychotherapy: Theory, Research, Practice, Training, 43: 154–172. doi:10.1037/0033-3204.43.2.154</bibtext> </blist> <blist> <bibtext> Hill, C. E., Stahl, J. and Roffman, M.2007. Training novice psychotherapists: Helping skills and beyond. Psychotherapy: Theory, Research, Practice, Training, 44: 364–370. doi:10.1037/0033-3204.44.4.364</bibtext> </blist> <blist> <bibtext> Hill, C. E., Sullivan, C., Knox, S. and Schlosser, L. Z.2007. Becoming psychotherapists: Experiences of novice trainees in a beginning graduate class. Psychotherapy: Theory, Research, Practice, Training, 44: 434–449. doi:10.1037/0033-3204.44.4.434</bibtext> </blist> <blist> <bibtext> Ho, P., Hosford, R. and Johnson, M.1985. The effects of anxiety on recall in self versus other-model observation. Counselor Education and Supervision, 25: 48–55.</bibtext> </blist> <blist> <bibtext> Kopp, J. and Butterfield, W.1986. Changes in graduate students' use of interviewing skills from classroom to the field. Journal of Social Service Research, 9: 65–88.</bibtext> </blist> <blist> <bibtext> Ladany, N.2007. Does psychotherapy training matter? Maybe not. Psychotherapy: Theory, Research, Practice, Training, 44: 392–396. doi:10.1037/0033-3204.44.4.392</bibtext> </blist> <blist> <bibtext> Lambert, M. J. and Simon, W.2008. "The therapeutic relationship". In Mindfulness and the therapeutic relationship, Edited by: Hick, S. F. and Bien, T.19–33. New York, NY: Guilford.</bibtext> </blist> <blist> <bibtext> Lane, C. and Rollnick, S.2007. The use of simulated patients and role-play in communication skills training: A review of the literature to August 2005. Patient Education and Counseling, 67: 13–20. doi:10.1016/j.pec.2007.02.011</bibtext> </blist> <blist> <bibtext> Larson, L. M., Clark, M. P., Wesely, L. H., Koraleski, S. F., Daniels, J. A. and Smith, P. L.1999. Videos versus role plays to increase counseling self-efficacy in prepractica trainees. Counselor Education & Supervision, 38: 237–248. doi:10.1002/j.1556-6978.1999.tb00574.x</bibtext> </blist> <blist> <bibtext> Larson, L. M. and Daniels, J. A.1998. Review of the counseling self-efficacy literature. The Counseling Psychologist, 26: 179–218. doi:10.1177/0011000098262001</bibtext> </blist> <blist> <bibtext> Lent, R. W., Hill, C. E. and Hoffman, M. A.2003. Development and validation of the counselor activity self-efficacy scales. Journal of Counseling Psychology, 50: 97–108. doi:10.1037/0022-0167.50.1.97</bibtext> </blist> <blist> <bibtext> Lent, R. W., Hoffman, M. A., Hill, C. E., Treistman, D., Mount, M. and Singley, D.2006. Client-specific counselor self-efficacy in novice counselors: Relation to perceptions of session quality. Journal of Counseling Psychology, 53: 453–463. doi:10.1037/0022-0167.53.4.453</bibtext> </blist> <blist> <bibtext> Moss, B.2000. The use of large-group role-play techniques in social work education. Social Work Education, 19: 471–483. doi:10.1080/026154700435995</bibtext> </blist> <blist> <bibtext> Mumm, A.2006. Teaching social work students practice skills. Journal of Teaching in Social Work, 26: 71–89. doi:10.1300/J067v26n03_05</bibtext> </blist> <blist> <bibtext> National Association of Social Workers2012Fact sheet: Who are social workers? Retrieved fromhttp://<ulink href="http://www.naswdc.org/pressroom/2011/HSH-FactSheet2011.pdf">www.naswdc.org/pressroom/2011/HSH-FactSheet2011.pdf</ulink> (<ulink href="http://www.naswdc.org/pressroom/2011/HSH-FactSheet2011.pdf">http://www.naswdc.org/pressroom/2011/HSH-FactSheet2011.pdf</ulink>)</bibtext> </blist> <blist> <bibtext> Pulos, S., Elison, J. and Lennon, R.2004. The hierarchical structure of the Interpersonal Reactivity Index. Social Behavior and Personality, 32: 355–360. doi:10.2224/sbp.2004.32.4.355</bibtext> </blist> <blist> <bibtext> Shapiro, S. L., Brown, K. W. and Biegel, G. M.2007. Teaching self-care to caregivers: Effects of mindfulness-based stress reduction on the mental health of therapists in training. Training and Education in Professional Psychology, 1: 105–115. doi:10.1037/1931-3918.1.2.105</bibtext> </blist> <blist> <bibtext> Shapiro, S. L., Brown, K. W., Thoresen, C. and Plante, T. G.2011. The moderation of mindfulness-based stress reduction effects by trait mindfulness: Results from a randomized controlled trial. Journal of Clinical Psychology, 67: 267–277. doi:10.1002/jclp.20761</bibtext> </blist> <blist> <bibtext> Shapiro, S. L. and Izett, C. D.2008. "Meditation. A universal tool for cultivating empathy". In Mindfulness and the therapeutic relationship, Edited by: Hick, S. F. and Bien, T.161–175. New York, NY: Guilford.</bibtext> </blist> <blist> <bibtext> Shapiro, S. L., Schwartz, G. E. and Bonner, G.1998. Effects of mindfulness-based stress reduction on medical and premedical students. Journal of Behavioral Medicine, 21: 581–599.</bibtext> </blist> <blist> <bibtext> Spielberger, C. D., Gorsuch, R. L., Lushene, R., Vagg, P. R. and Jacobs, G. A.1983. State-Trait Anxiety Inventory, CA: Mind Garden. Menlo Park</bibtext> </blist> <blist> <bibtext> Trapnell, P. D. and Campbell, J. D.1999. Private self-consciousness and the five-factor model of personality: Distinguishing rumination from reflection. Journal of Personality and Social Psychology, 76: 284–304. doi:10.1037/0022-3514.76.2.284</bibtext> </blist> <blist> <bibtext> Trevithick, P., Richards, S., Ruch, G. and Moss, B.2004. "learning communication skills in social work education". In Teaching and, London, UK: Social Care Institute for Excellence.</bibtext> </blist> <blist> <bibtext> Walsh, R. A., Perrucci, A. and Severns, J.1999. What's in a good moment: Hermeneutic study of psychotherapy values across levels of psychotherapy training. Psychotherapy Research, 9: 304–326. doi:10.1080/10503309912331332781</bibtext> </blist> <blist> <bibtext> Williams, E. N., Hurley, K., O'Brien, K. and DeGregorio, A.2003. Development and validation of the self-awareness and management strategies (SAMS) scales for therapists. Psychotherapy: Theory, Research, Practice, Training, 40: 278–288. doi:10.1037/0033-3204.40.4.278</bibtext> </blist> <blist> <bibtext> Williams, E. N., Judge, A. B., Hill, C. E. and Hoffman, M. A.1997. Experiences of novice therapists in prepracticum: Trainees', clients', and supervisors' perceptions of therapists' personal reactions and management strategies. Journal of Counseling Psychology, 44: 390–399. doi:doi;10.1037/0022-0167.44.4.390</bibtext> </blist> <blist> <bibtext> Williams, E. N., Polster, D., Grizzard, M. B., Rockenbaugh, J. and Judge, A. B.2003. What happens when therapists feel bored or anxious? A qualitative study of distracting self-awareness and therapists' management strategies. Journal of Contemporary Psychotherapy, 33: 5–18. doi:10.1023/A:1021499526052</bibtext> </blist> <blist> <bibtext> Wodarski, J. S., Feit, M. D. and Green, R. K.1995. Graduate social work education: A review of 2 decades of empirical research and considerations for the future. Social Service Review, 69: 108–130.</bibtext> </blist> </ref> <ref id="AN0094614373-18"> <title> Footnotes </title> <blist> <bibtext> <sups>1</sups>Statistical Package for the Social Sciences version 14 was used for all analyses.</bibtext> </blist> </ref> <aug> <p>By Annemarie Gockel and DavidL. Burton</p> <p>Reported by Author; Author</p> <p></p> <p>Annemarie Gockel is assistant professor and David L. Burton is associate professor at Smith College.</p> </aug> <nolink nlid="nl1" bibid="bib23" firstref="ref1"></nolink> <nolink nlid="nl2" bibid="bib10" firstref="ref2"></nolink> <nolink nlid="nl3" bibid="bib12" firstref="ref3"></nolink> <nolink nlid="nl4" bibid="bib31" firstref="ref4"></nolink> <nolink nlid="nl5" bibid="bib40" firstref="ref5"></nolink> <nolink nlid="nl6" bibid="bib32" firstref="ref6"></nolink> <nolink nlid="nl7" bibid="bib45" firstref="ref10"></nolink> <nolink nlid="nl8" bibid="bib18" firstref="ref17"></nolink> <nolink nlid="nl9" bibid="bib22" firstref="ref23"></nolink> <nolink nlid="nl10" bibid="bib27" firstref="ref29"></nolink> <nolink nlid="nl11" bibid="bib14" firstref="ref30"></nolink> <nolink nlid="nl12" bibid="bib15" firstref="ref31"></nolink> <nolink nlid="nl13" bibid="bib11" firstref="ref35"></nolink> <nolink nlid="nl14" bibid="bib17" firstref="ref37"></nolink> <nolink nlid="nl15" bibid="bib21" firstref="ref43"></nolink> <nolink nlid="nl16" bibid="bib20" firstref="ref44"></nolink> <nolink nlid="nl17" bibid="bib44" firstref="ref45"></nolink> <nolink nlid="nl18" bibid="bib43" firstref="ref46"></nolink> <nolink nlid="nl19" bibid="bib19" firstref="ref60"></nolink> <nolink nlid="nl20" bibid="bib26" firstref="ref61"></nolink> <nolink nlid="nl21" bibid="bib24" firstref="ref63"></nolink> <nolink nlid="nl22" bibid="bib28" firstref="ref70"></nolink> <nolink nlid="nl23" bibid="bib29" firstref="ref71"></nolink> <nolink nlid="nl24" bibid="bib16" firstref="ref76"></nolink> <nolink nlid="nl25" bibid="bib42" firstref="ref79"></nolink> <nolink nlid="nl26" bibid="bib39" firstref="ref81"></nolink> <nolink nlid="nl27" bibid="bib34" firstref="ref82"></nolink> <nolink nlid="nl28" bibid="bib35" firstref="ref83"></nolink> <nolink nlid="nl29" bibid="bib33" firstref="ref86"></nolink> <nolink nlid="nl30" bibid="bib13" firstref="ref89"></nolink> <nolink nlid="nl31" bibid="bib36" firstref="ref103"></nolink> <nolink nlid="nl32" bibid="bib41" firstref="ref104"></nolink> <nolink nlid="nl33" bibid="bib25" firstref="ref112"></nolink> <nolink nlid="nl34" bibid="bib30" firstref="ref113"></nolink> <nolink nlid="nl35" bibid="bib37" firstref="ref122"></nolink>
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PubType: Academic Journal
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PreciseRelevancyScore: 0
IllustrationInfo
Items – Name: Title
  Label: Title
  Group: Ti
  Data: An Evaluation of Prepracticum Helping Skills Training for Graduate Social Work Students
– Name: Language
  Label: Language
  Group: Lang
  Data: English
– Name: Author
  Label: Authors
  Group: Au
  Data: <searchLink fieldCode="AR" term="%22Gockel%2C+Annemarie%22">Gockel, Annemarie</searchLink><br /><searchLink fieldCode="AR" term="%22Burton%2C+David+L%2E%22">Burton, David L.</searchLink>
– Name: TitleSource
  Label: Source
  Group: Src
  Data: <searchLink fieldCode="SO" term="%22Journal+of+Social+Work+Education%22"><i>Journal of Social Work Education</i></searchLink>. 2014 50(1):101-119.
– Name: Avail
  Label: Availability
  Group: Avail
  Data: Routledge. Available from: Taylor & Francis, Ltd. 325 Chestnut Street Suite 800, Philadelphia, PA 19106. Tel: 800-354-1420; Fax: 215-625-2940; Web site: http://www.tandf.co.uk/journals
– Name: PeerReviewed
  Label: Peer Reviewed
  Group: SrcInfo
  Data: Y
– Name: Pages
  Label: Page Count
  Group: Src
  Data: 19
– Name: DatePubCY
  Label: Publication Date
  Group: Date
  Data: 2014
– Name: TypeDocument
  Label: Document Type
  Group: TypDoc
  Data: Journal Articles<br />Reports - Research
– Name: Audience
  Label: Education Level
  Group: Audnce
  Data: <searchLink fieldCode="EL" term="%22Postsecondary+Education%22">Postsecondary Education</searchLink><br /><searchLink fieldCode="EL" term="%22Higher+Education%22">Higher Education</searchLink>
– Name: Subject
  Label: Descriptors
  Group: Su
  Data: <searchLink fieldCode="DE" term="%22Graduate+Students%22">Graduate Students</searchLink><br /><searchLink fieldCode="DE" term="%22Practicums%22">Practicums</searchLink><br /><searchLink fieldCode="DE" term="%22Helping+Relationship%22">Helping Relationship</searchLink><br /><searchLink fieldCode="DE" term="%22Social+Work%22">Social Work</searchLink><br /><searchLink fieldCode="DE" term="%22Counseling+Techniques%22">Counseling Techniques</searchLink><br /><searchLink fieldCode="DE" term="%22Skill+Development%22">Skill Development</searchLink><br /><searchLink fieldCode="DE" term="%22Skill+Analysis%22">Skill Analysis</searchLink><br /><searchLink fieldCode="DE" term="%22Self+Efficacy%22">Self Efficacy</searchLink><br /><searchLink fieldCode="DE" term="%22Empathy%22">Empathy</searchLink><br /><searchLink fieldCode="DE" term="%22Anxiety%22">Anxiety</searchLink><br /><searchLink fieldCode="DE" term="%22Metacognition%22">Metacognition</searchLink><br /><searchLink fieldCode="DE" term="%22Followup+Studies%22">Followup Studies</searchLink><br /><searchLink fieldCode="DE" term="%22Educational+Strategies%22">Educational Strategies</searchLink><br /><searchLink fieldCode="DE" term="%22Teaching+Methods%22">Teaching Methods</searchLink><br /><searchLink fieldCode="DE" term="%22Questionnaires%22">Questionnaires</searchLink><br /><searchLink fieldCode="DE" term="%22Outcome+Measures%22">Outcome Measures</searchLink><br /><searchLink fieldCode="DE" term="%22Likert+Scales%22">Likert Scales</searchLink><br /><searchLink fieldCode="DE" term="%22Pretests+Posttests%22">Pretests Posttests</searchLink><br /><searchLink fieldCode="DE" term="%22Achievement+Gains%22">Achievement Gains</searchLink><br /><searchLink fieldCode="DE" term="%22Student+Attitudes%22">Student Attitudes</searchLink><br /><searchLink fieldCode="DE" term="%22Instructional+Effectiveness%22">Instructional Effectiveness</searchLink><br /><searchLink fieldCode="DE" term="%22Introductory+Courses%22">Introductory Courses</searchLink>
– Name: DOI
  Label: DOI
  Group: ID
  Data: 10.1080/10437797.2014.856234#.U6Hcn_ldVPo
– Name: ISSN
  Label: ISSN
  Group: ISSN
  Data: 1043-7797
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Although foundational practice classes play a key role in helping prepracticum students develop counseling skills, we know little about the effectiveness of this form of helping skills training. This study assessed the effect of helping skills training delivered in foundational practice classes on proximal indicators of counseling skills acquisition, including measures of counseling self-efficacy, empathy, anxiety, and hindering self-awareness or rumination. Participating students made significant gains in counseling self-efficacy that were maintained at 3-month follow-up. Reductions in anxiety, rumination, and personal distress in interpersonally challenging situations were observed at follow-up, indicating that students made a successful transition to the field following training. The frequency of large-group role plays in particular was related to gains in students' counseling self-efficacy.
– Name: AbstractInfo
  Label: Abstractor
  Group: Ab
  Data: As Provided
– Name: Ref
  Label: Number of References
  Group: RefInfo
  Data: 45
– Name: DateEntry
  Label: Entry Date
  Group: Date
  Data: 2014
– Name: AN
  Label: Accession Number
  Group: ID
  Data: EJ1029628
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=eric&AN=EJ1029628
RecordInfo BibRecord:
  BibEntity:
    Identifiers:
      – Type: doi
        Value: 10.1080/10437797.2014.856234#.U6Hcn_ldVPo
    Languages:
      – Text: English
    PhysicalDescription:
      Pagination:
        PageCount: 19
        StartPage: 101
    Subjects:
      – SubjectFull: Graduate Students
        Type: general
      – SubjectFull: Practicums
        Type: general
      – SubjectFull: Helping Relationship
        Type: general
      – SubjectFull: Social Work
        Type: general
      – SubjectFull: Counseling Techniques
        Type: general
      – SubjectFull: Skill Development
        Type: general
      – SubjectFull: Skill Analysis
        Type: general
      – SubjectFull: Self Efficacy
        Type: general
      – SubjectFull: Empathy
        Type: general
      – SubjectFull: Anxiety
        Type: general
      – SubjectFull: Metacognition
        Type: general
      – SubjectFull: Followup Studies
        Type: general
      – SubjectFull: Educational Strategies
        Type: general
      – SubjectFull: Teaching Methods
        Type: general
      – SubjectFull: Questionnaires
        Type: general
      – SubjectFull: Outcome Measures
        Type: general
      – SubjectFull: Likert Scales
        Type: general
      – SubjectFull: Pretests Posttests
        Type: general
      – SubjectFull: Achievement Gains
        Type: general
      – SubjectFull: Student Attitudes
        Type: general
      – SubjectFull: Instructional Effectiveness
        Type: general
      – SubjectFull: Introductory Courses
        Type: general
    Titles:
      – TitleFull: An Evaluation of Prepracticum Helping Skills Training for Graduate Social Work Students
        Type: main
  BibRelationships:
    HasContributorRelationships:
      – PersonEntity:
          Name:
            NameFull: Gockel, Annemarie
      – PersonEntity:
          Name:
            NameFull: Burton, David L.
    IsPartOfRelationships:
      – BibEntity:
          Dates:
            – D: 01
              M: 01
              Type: published
              Y: 2014
          Identifiers:
            – Type: issn-print
              Value: 1043-7797
          Numbering:
            – Type: volume
              Value: 50
            – Type: issue
              Value: 1
          Titles:
            – TitleFull: Journal of Social Work Education
              Type: main
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