Two vignettes of adolescent sexual disclosure: guidance for HIV clinical practice.

HIV-positive adolescents are required by law to notify sexual partners, but can find it difficult to achieve this goal. This article offers practice guidance for counselling HIV-positive adolescents about sexual disclosure in clinical settings and for building confidence in managing sexual lives with HIV. We use two vignettes to illustrate key differences between perinatally and sexually infected adolescents in terms of readiness to disclose, and include a set of strategies for both groups that can be tailored to individual circumstances and contexts. The toolbox of strategies we describe include pre-counselling, focused counselling, social support groups and technical support. Pre-counselling helps to identify barriers and motivations to sexual disclosure and is followed by counselling sessions in which the focus is on role playing and sexual scripts for disclosure. Peer-led support groups are designed to boost adolescent confidence, and pre-paid cell phones, text messaging, ready-dial phone numbers and a private Facebook page provide back-up support and out-of-hours contact. Since sexual disclosure can be a risky proposition, safety plans, such as having an emergency contact person, should always be in place. These strategies are designed to empower vulnerable adolescents, foster trust between patient and provider, and reduce HIV transmission to sexual partners.

Developing a Peer Mentorship Program to Increase Competence in Clinical Supervision in Clinical Psychology Doctoral Training Programs.

OBJECTIVES: Supervision has recently been recognized as a core competency for clinical psychologists. This recognition of supervision as a distinct competency has evolved in the context of an overall focus on competency-based education and training in health service psychology, and has recently gained momentum. Few clinical psychology doctoral programs offer formal training experiences in providing supervision. METHODS: A pilot peer mentorship program (PMP) where graduate students were trained in the knowledge and practice of supervision was developed. The focus of the PMP was to develop basic supervision skills in advanced clinical psychology graduate students, as well as to train junior doctoral students in fundamental clinical and practical skills. Advanced doctoral students were matched to junior doctoral students to gain experience in and increase knowledge base in best practices of supervision skills. The 9-month program consisted of monthly mentorship meetings and three training sessions. RESULTS: The results suggested that mentors reported a 30% or more shift from the category of not competent to needs improvement or competent, in the following supervision competencies: theories of supervision, improved skill in supervision modalities, acquired knowledge in supervision, and supervision experience. Furthermore, 50% of the mentors reported that they were not competent in supervision experience at baseline and only 10% reported that they were not competent at the end of the program. Satisfaction data suggested that satisfaction with the program was high, with 75% of participants indicating increased knowledge base in supervision, and 90% indicating that it was a positive addition to their training program. CONCLUSIONS: This program was feasible and acceptable and appears to have had a positive impact on the graduate students who participated. Students reported both high satisfaction with the program as well as an increase in knowledge base and experience in supervision skills.