King Kelly M, Wyche Brittany, Umstead Lindsey
Counselor Education Program, California State University, Sacramento, CA, United States.
Wake Forest University, Winston Salem, NC, United States.
Body Image. 2024 Dec;51:101775. doi: 10.1016/j.bodyim.2024.101775. Epub 2024 Aug 7.
Broaching issues of identity and power with clients in the context of their mental health care is affirmed as an effective multicultural and social justice counseling skill by a growing evidence base. Considerations for broaching body size, including size difference and sizeism, with clients has not yet been studied, thus clinicians lack guidelines for facilitating these conversations. In this consensual qualitative research study, we present themes involved in broaching body topics based on our interviews with nine clinicians specialized in treating clients with eating disorders and body-related counseling concerns. Themes addressed counselor development, conceptualization of broaching, clinical-decision-making, practice, and impact of broaching body topics in session. Clinicians identified professional and personal developments they pursued and would advocate for training future clinicians to better serve clients. Descriptions of unique and shared aspects of broaching clients' intersectionality and body-size specifically depict avenues for tailoring broaching conversations. Specific examples of effective and ineffective broaching conversations, including language used and psychoeducational components, provide recommendations for practice and connect to observed impacts on the client, counselor, and counseling process.
在心理健康护理背景下与客户探讨身份认同和权力问题，越来越多的证据表明这是一种有效的多元文化和社会正义咨询技巧。与客户探讨身体尺寸相关问题，包括尺寸差异和体型歧视，目前尚未得到研究，因此临床医生缺乏开展此类对话的指导方针。在这项共识性定性研究中，我们基于对九位专门治疗饮食失调和身体相关咨询问题患者的临床医生的访谈，呈现了探讨身体主题所涉及主题。这些主题涉及咨询师的发展、探讨的概念化、临床决策、实践以及在咨询过程中探讨身体主题的影响。临床医生确定了他们所追求的专业和个人发展，并主张对未来的临床医生进行培训，以便更好地为客户服务。对探讨客户交叉性和身体尺寸的独特和共同方面的描述，具体描绘了定制探讨性对话的途径。有效和无效探讨性对话的具体例子，包括使用的语言和心理教育成分，为实践提供了建议，并与观察到的对客户、咨询师和咨询过程的影响相关联。
