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Tuesday, February 17, 2009

THE USES OF TESTS AND NON-TEST TECHNIQUES IN COUNSELLING


INTRODUCTION

Counsellors use tests generally for assessment, placements, and guidance and appraisals to as assist clients to increase their self-knowledge, practice decision making, and acquire new behaviours. They may be used in a variety of therapies e.g. individual, marital, group, and family and for either gathering of data on clients, assessing the level of some traits, such as stress and anxiety, or measuring clients’ personality types. The purpose of non-informational tests is to stimulate further or more in-depth interaction with the client.

Although the published literature on testing has increased, proper test utilization remains a problematic area. The issue is not whether a counsellor uses tests in counselling practices, but when and to what end tests will be used (Corey, Corey, & Callanan, 1984).

TESTING PROCESS
Steps involved in the process of using tests in counselling include the following: - selecting the test, administering test, scoring the test, interpreting results, communicating the results.

Selecting: Having defined the purpose for testing, the counsellor looks to a variety of sources for information on available tests. Resources include review books, journals, test manuals, and textbooks on testing and measurement (Anastasi, 1988; Cronbach, 1979). The most complete source of information on a particular test is usually the test manual.

Administering:
Test administration is usually standardize by the developers of the test. Manual instructions need to be followed in order to make a valid comparison of an individual’s score with the test’s norm group. Non – Standardization tests used in counselling are best given under controlled circumstances. This allows the counsellor’s experience with the test to become an internal norm. Issues of individual versus group administration need to be considered as well. The clients and the purpose for which they are being tested will contribute to decisions about group testing.

Scoring:
Scoring of tests follows the instructions provided in the test manual, the Counsellor is sometimes given the option of having test machine scored rather than hand scored. Both the positive and negative aspects of this choice need to be considered. It is usually believed that test scoring is best handled by a machine because it is free from bias.

Interpreting:
The interpretation of test results is usually the area which allows for the greatest flexibility within the testing process. Depending upon the Counsellor’s theoretical point of view and the extent of the test manual guidelines, interpretation may be brief and superficial, or detailed and explicity theory based (Tinsley & Bradley, 1986). Because this area allows for the greatest flexibility, it is also the area with the greatest danger of misuse. Whereas scoring is best done by a bias-free machine, interpretation by machine is often too rigid. What is needed is the experience of a skilled test user to individualize the interpretation of results.

Communicating:
Feedback of test results to the client completes the formal process of testing. Here, the therapeutic skills of Counsellors come fully into play (Phelps, 1974). The Counsellor uses verbal and non verbal interaction skills to convey messages to clients and to assess their understanding of it.

ISSUES IN TESTING

Confidentiality:
The ethical and legal restrictions on what may be disclosed from counselling apply to the use of tests as much as to other private information shared between client and counsellor. The trust issue, which is inherent in confidentiality, is relevant to every aspect of testing. No information can be shared outside the relationship without the full consent of the client. Information is provided to someone outside the relationship only after the specifics to be used from the testing are fully disclosed to the client. These specifics include the when, what, and to whom of the disclosure. The purpose of disclosure is also shared with the client and what the information will be used for is clearly spelled out.

Issues of confidentiality are best discussed with the client before conducting any test administration. There should be no surprise when the counsellor asks, at a later time, for permission to share results. Clients who are fully informed, before testing takes place, about the issue of confidentiality in relation to testing are more active participants in the counselling process.

Counsellor Preparation:
Tests are only as good as their construction, proper usage and the preparation of the counsellor intending to use them. The skills and competencies counsellors need or using tests in practice are to:

· Understand clearly the intended purpose of a test.
· Beware of the client’s needs regarding the test to be given.
· Having knowledge about the test, its validity, reliability and the norm group for which it was developed.
· Have personally taken the test before administering it.
· Have been supervised in administering, scoring, interpreting, and communicating results of the tests to be given.
Supervision in the practice of providing testing services ideally encompasses all of the above areas of concern. This supervision needs to be conducted by the knowledgeable practitioner with experience in using tests in clinical practice.

NON-TEST COUNSELLING
While it is most often used by certified counsellors, psychologists and psychiatrists, non-directive counselling provides a number of techniques which can be used effectively by teachers and staff when talking with students about their undesirable behaviour.

Attributed to Carl Rogers, this technique was designed to allow the individual in emotional turmoil to talk out problems and resolved difficulties with a minimum of direction being provided by the person serving as counsellor.
Rogers believed that everyone has the motivation and ability to change in order to become a better, more “self-actualized” person. To help our students to achieve this state, we as teacher- counsellors, act as a sounding board; observing, listening, and deliberately responding according to certain guidelines while the student explores and analyses the problem and devises a personal solution. The teacher-counsellor’s demeanor is ALWAYS accepting and non-punitive. This style encourages the student to feel comfortable in expression of feelings and thus facilitates positive change.

There are five basic responses to student commentary. The first, reflection, is the restating of the student’s comment. This may be done in the exact same terminology used by the student, the repeating of part of the comment, or by rewording the student’s statement. Reflection lets the students know that you are listening and promotes continued commentary.
The second response, a leading statement or question, is designed to encourage the student to elaborate on a topic or devise a solution to a specific problem. Examples of a leading remark include: “I would like to hear your opinion”, “Tell me more about yourself”, and “What happened then”?

The third response, clarification, involves the stating of implied feelings behind a student’s verbal communication. Examples of clarification include: “You sound sad”. Moreover ‘It appears as if you are very angry at James”. Clarification helps the students to deal with the emotions which are present.

The fourth, summarization, is a review of what has been discussed thus far in your counselling session. This summary allows both participants to briefly reflect on what has occurred, view it clearly, and use it as a new starting point from which to build.

The fifth response, questioning, is a review of what has been discussed thus far in your counselling session. This summary allows both participants to briefly reflect on what has occurred, view it clearly, and use it as a new starting point from which to build.

The fifth response, questioning, is comprised of two main types: closed questions which are intended to yield brief, specific information; and open ended questions which are used to encourage the student to talk at greater length on a topic. Examples of closed questioning include: “How old is Mark?” and “Did you complete your homework?” Examples of open questioning include: “How is it going in mathematics class?” and how do you feel about losing recess?”
Rogers believed that this non-opinionated approach helps others to resolve inner conflicts and feelings which manifest themselves in undesirable behaviour. Therefore, the reduction of this inner turmoil can reduce inappropriate behaviour. This technique is useful with students who can be “reasoned with” and are seeking a solution to their problems (or just want to talk). Certainly, the student must be motivated to be involved in a therapeutic discussion. This is not a technique which can be imposed upon the student. Yet, because the student is involved in the programme and chooses the most appropriate solution, she is more likely to follow the proposed solution.

The non-test approach is also useful with students of lower intelligence levels who have accompanying speech and language problems which make their verbalizations difficult to understand. Reflection can be useful in these situations. Repeat the words that are comprehended, continuing the conversation and allowing the students to vent his or her emotions.

How to Use Non-Test Counselling
i) Arrange for a time and place which will provide privacy for your conference.
ii) If the student does not open session, use a leading statement or question to focus him/her on the topic of concern.
iii) Listen to the student in an interested, non-punitive, accepting manner. Make no judgment.
iv) Respond when appropriate, using one of the recommended techniques.
v) After the concerns have been thoroughly voiced by the student, focus him/her on finding solution for the difficulty. (e.g. ‘How will you handle this in the future?”, ‘What do you do now?” and “Have you got any ideas about how you might deal with this issue?”). Allow the student to choose the solution that is best for him or her.

COUNSELLING AND TESTING – testimonies from FHI
FHI is celebrating a great achievement: more than 1 million clients have been counselled, tested and received results from its HIV counselling and testing (CT) programmes in Nigeria. FHI thus achieved one-quarter of the Nigerian government’s target of reaching 4 million people with counselling and testing services by 2009.
Of the 1 million, 47,755 were HIV – positive. Of these, almost two-thirds – 30, 292 or 63.5 percent were females and 17,459 (36.5 percent) were males. In addition, 3,422 children under 14 testing positive – 1,900 males and 1,522 females.

Counselling and testing are critical weapons in the fight against HIV and AIDS. Through these services, people who are HIV positive are identified, counselled and staying on healthy and avoiding transmission to others, and referred to antiretroviral treatment (ART) and other crucial services, including those that effectively prevent mother-to-child transmission of the virus. Currently, FHI/Nigeria has put 23,125 persons on ART in 52 facilities in 22 states.

More about FHI /Nigeria CT Programme
The landmark number of 1 million was achieved in October, 2007, largely due to the Global HIV/AIDS Initiative Nigeria (GHAIN) Project. FHI implements GHAIN’s counselling and testing program, which is now the largest of its kind in the country, operating in 22 of Nigeria’s 36 states and the Federal Capital Territory.
GHAIN operates in support of the Government of Nigeria, and is funded by the US President’s Emergency Plan for AIDS Relief through UNSAID. FHI leads two other smaller counselling and testing Programmes, one funded by the Global Fund to Fight AIDS, Tuberculosis and Malaria and one in the Niger Delta that is funded by the Shell Petroleum Development Company of Nigeria.

Donor support made the achievements and scale-up of the counselling and testing program possible but credit for its success is also due to strong , collaborative partnerships with more than 180 organizations, public, private and faith based, and at community, state and national levels.

SCALDING UP FROM 7,000 TO 1,000,000
In Nigeria, the number of FHI-Supported counselling and testing sites now stands at 185, up from 34 in 2004. The programme is poised to increased coverage to 300 sites and expands to other states by 2009.

Year
FHI-supported sites
Clients receiving results
2004
34
6,839
2005
45
177,846
2006
100
568,693
2007(Oct.)
185
1,237,870

A range of activities contributed to these impressive increases and strengthened services. FHI/Nigeria used realistic and simple strategies to implement counselling and testing programmes – for example, non – laboratory personnel are trained to perform the tests and use rapid kits that are not cold-chain dependent.
The use of mobile units has also contributed significantly to increasing uptake and reducing AIDS related stigma. Though mobile services started barely two years ago, they now enlist about 20 % of all counselling and testing clients. The attractive tents that the units used attract large crowds, as does the convenient of cost-and travel free access to test results.

HOW A LOGO AND A FORMER PRESIDENT INCREASED UPTAKE.
In collaboration with the national government and other stakeholders, FHI/Nigeria developed the heart-to-heart logo that now marks each counselling and testing sites in the country with a “seal of approval”. The logo also appears on national media messages that encourage people to go for counselling and testing.

To foster ownership, coordination and standardization, FHI handed this logo over to the government, which encourages its use by all partners and organizations providing counselling and testing services. The distinctive and instantly recognizable logo not only signals the availability slogan, “we listen, we care,” promises that clients will meet discreet, friendly providers in stigma free setting.

President Olusegun Obasanjo launched the logo at the 2005 World AIDS Day commemoration. The following year, he marked the day by being publicly tested for HIV. That the test was administered by FHI/Nigeria’s Association Director of HIV Counseling and Testing Simon Cartier testifies to the program’s national contributions and technical excellence.

Cartier attests that this singular act increase uptake of counselling and testing services. Policy makers and opinion leaders took note, and governors in different parts of the country took turns being publicly tested.

WORKING WITH THE GOVERNMENT OF NIGERIA.
On a day-to-day basis, FHI/Nigeria’s counselling and testing programme directly supports and works closely with two arms of the government that coordinate and implements HIV/AIDS related activities throughout the country: the National Agency for the Control of AIDS and the National AIDS/STI Control Programme.

Through its work with these bodies, FHI supported Nigeria’s efforts to create national VCT guidelines and a training curriculum, as well as to establish four VCT training centres. FHI/Nigeria later helped the government formulate its scale-up plan, provided technical assistance to provide VCT services at primary health centres, and helped the government develop VCT monitoring and evaluation tools that are now used nationally.

Cartier says that the “good working environment and support from the government” should be credited for the dramatic increase in the number of VCT clients over the past three years. He added, “FHI/Nigeria has enjoyed an excellent relationship with Nigeria, thereby providing better opportunities for the programme to succeed”. In turn, this relationship and the arrival of the million counselling and testing clients in Nigeria would not have occurred without the commitment, unstinting effort, teamwork, resilience and creativity of FHI/Nigerian’s staff.


CONCLUSION
Confidentiality, counsellor preparation, computer testing and client involvement are all issues within the ethical realm. Ultimately, test use by counsellors must be seen as an adjunct to the entire counselling process. Test results provide descriptive and objective data which help the counsellor to assist clients better in making the choices that will positively affect their lives. In order to make the best use of available tests in a counselling relationship, the process of testing and the issues which surround the process must be well examined.

References
Anastasi, A. (1988). Psychological testing 96th Ed.) New York: Macmillan.

Corey, G. Corey, M.S. & Callanan, P. 91984). Issues & Ethics in the helping professions (2bd Ed.) Monterey, CA: Brooks/Cole.

CRONBACH, l. j. (1979). Essentials of psychological testing (4th Ed.)New York: Harper & Row.

Goldman, L. (1971) Using tests in counselling (2nd Ed.) Pacific Palisades, CA: Goodyear Publishing.

Phelps, W. R. (1974). Communicating Test results: A training guide. Final Report. Springfield, VA: National Technical Information Service. (ED 134 853).

Thompson, D. L. (1986). Using microcomputer-based assessment in career counselling. Journal of Employment Counselling, 23 (2), 50 -56. (EJ 333 980).

Tinsley, H.E. A., & Bradley, R. W. (1986). Test interpretation. Journal of Counselling & Development, 64 (7), 462-466. (EJ 333 980).

Underhill, J. (Ed). (1975). Skills for adult guidance educators. Package 11: Selecting assessment instruments. Portland, OR: Northwest Regional Educational Lab. (Ed 192 141).

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