The Effect of Ego Assessment Training for School Counselors on the Outcome of Cognitive Behavioral Counseling for Female Adolescents Diagnosed as Clinically Depressed

Abstract

The purpose of the present study was to examine the relevance of ego development training for school counselors who integrated the knowledge acquired from the training into their treatment plans for female adolescent clients diagnosed as being clinically depressed. The participants were five female middle school counselors who volunteered to participate in the study and their five female middle school student clients diagnosed as clinically depressed who agreed, with the permission of their parents/guardians, to have the data associated with their treatments analyzed. The counselors were employed in several middle schools within a large metropolitan county school system in a southeastern state. The investigator selected the participating school counselors from a pool of volunteers based on their motivation to participate and level of counseling competence. The counselors ranged in age from 30 to 50 years, and all were White. The ages of the student clients covered a range of 11 to 14 years with two being White, two African Americans, and one Central American. An intensive single-subject quantitative design replicated five times was employed in the present study. Following the selection process, the investigator conducted a formal standardized three-session training program for the five counselors. The training included learning how to integrate the results of the Beck Depression Inventory (BDI) and the Sentence Completion Test (SCT) into treatment plans for counseling clinically depressed clients that addressed symptoms of depression and ego development levels of the clients based on Loevinger's theory. Each of the five counselors passed a knowledge test developed by the investigator at the close of the training and rated the training program high on a measure of confidence in the training itself. Thereafter, the five counselors worked independently in dyads, each matched with one clinically depressed client for five counseling sessions lasting approximately 40 to 45 minutes. The investigator served as a mentor⁄coach to the counselors and monitored their adherence to the treatment plans. During the first counseling sessions, each of the five school counselors administered the BDI and SCT instruments. Thereafter, the BDI was used as a posttest measure of change in depressive symptoms over time, and the SCT data were used to determine if there were issues in the development of the adolescent clients that caused arrested ego development and integrated that information into a variety of cognitive-behavioral counseling strategies chosen to address the clients' presenting symptoms. Each of the clients tracked their symptoms of depression in journals and on weekly self-monitoring forms, providing continuous behavior observation data over the duration of the treatments and the study. Across the five replications, pre-to-posttest BDI data indicated decreases in symptoms of depression for all the clients; behavioral observation data indicated decreases in depressive thoughts and occurrences of presented symptoms; and the school counselors submitted favorable reports about the usefulness of the ego development training in their treatment planning and counseling techniques. Internal validity for the findings was enhanced by the components of the research design that included a standardized training program for the counselors; supervision of the experimental process by the investigator; repeated observations that were planned before the beginning of the data collection; assessment of clearly defined cognitive, behavioral, and affective process and outcome variables, and comparisons across the five replications of the design. Generalization may seem to be restricted to middle school-aged female clients treated by middle-aged female White counselors in large southeastern metropolitan school districts. On the other hand, external validity was enhanced by the five replications of the intensive single-subject design.

Description

Keywords

school counselors, depression, Ego

Citation

Degree

PhD

Discipline

Counselor Education

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