Billing for Medical Genetics and Genetic Counseling Services: A National Survey

In January 2007 the American Medical Association added a new Current Procedural Terminology® (CPT) code, 96040, for “Medical Genetics and Genetic Counseling Services.” In order to identify the impact of having this new code and to identify issues with implementation of the code, the National Society of Genetic Counselors (NSGC) CPT® Working Group surveyed NSGC members using an internet-based survey tool. The majority of respondents (94%) reported being aware of the new code and over half of the respondents (69%) said they were billing for genetic counseling. Approximately 24% of those billing reported using 96040. Many facilities are not using this code and the reported success of billing using 96040 is highly varied. Continued education may be beneficial to encourage reimbursement for 96040 and follow up is needed to assess the ongoing implementation and impact of the new CPT® code.     

Self-Concept and Stress: A Study of a Group of Southern Baptist Ministers

In this study the authors found that trait anxiety has a negative relationship with self-concept and a positive relationship with self-criticism and several life changes.     

Counseling Counselors: A Survey of Values

This study surveyed counselors' rates of involvement in counseling, explored whether counselors value seeing therapists of a similar theoretical orientation to their own, and examined which characteristics were important in choosing one's therapist. Of 2,000 randomly selected ACA members, with a 38% return rate, 80% were found to have attended counseling, with women seeking counseling at significantly higher rates than men. Having been in counseling varied as a function of division affiliation as well as counselor's theoretical orientation. Finally, this study also explored the characteristics deemed important in choosing one's counselor and the values counselors hold regarding involvement in their own therapy.     

A Survey of College Counseling Facilities

Of 1,136 senior colleges surveyed in the United States, 71 per cent of the 415 responding reported that they had student counseling facilities. The median ratio was 1 counselor per 770 students; 18 per cent make use of graduate students as assistants; 8 per cent exclude certain groups of students from these facilities. The majority of counseling services are connected with student personnel divisions, and more than half routinely test entering freshmen for academic aptitudes or achievement, personality factors, or vocational interests. Over three-quarters offer optional testing of intelligence, personality factors, vocational and academic aptitudes, and vocational interests. Over half limit counseling to “normal” problems, and the largest specific orientation is Rogerian; most, however, consider their approach “eclectic.”     

A Survey of Ethical and Professional Challenges Experienced by Spanish Health-Care Professionals that Provide Genetic Counseling Services

Genetic testing is increasingly applied for diagnosis and clinical treatment. In some countries, genetic counseling services are provided by professionals with specific training in this discipline, whereas other countries have no teaching programs and counseling is offered by physicians, nurses, pharmacists or biochemists. This counseling raises more and more ethical dilemmas for health professionals at their clinics. The purpose of this study was to analyze the characteristics of Spanish professionals devoted to providing genetic counseling services and to investigate the frequency of the ethical dilemmas they face. Results from 72 survey respondents revealed this counseling is provided by an almost even number of male and female professionals, mostly physicians with many years of professional experience. The overall frequency of the ethical dilemmas encountered was not high. The most frequent dilemmas corresponded to emotional responses by patients, informed consent, uncertainty about test results, and limitations on health-care resources. The frequency of dilemmas involving discrimination and provider directiveness was very low. Additional findings, practice implications, and research recommendations are presented.     

Employee Counseling Services: Ethical Dilemmas

Issues surrounding the definition, identification, and handling of emotional problems in the work environment are presented. Strategies for dealing with these dilemmas are provided.     

Interpersonal, Intragroup Conflict between Southern Baptist Pastors: A Qualitative Inquiry Examining Contributing Factors

This ethnographic examination examines interpersonal, intragroup conflict between Southern Baptist pastors in the USA with a focus on the factors that contribute to such conflict. First, literature is provided to demonstrate the history of the denomination, reasons for relational intragroup conflict between pastors working together in the same churches, and information on the prevalence and instances of interpersonal conflict. Second, this study employs qualitative research methods, namely in-depth interviewing and participant observation. Through engaging in interviews with the participants, statements were elicited from six Southern Baptist pastors (Pastors #1, #2, and #3, and Outside Baptist Pastors #1, #2, and #3) on the nature, reasons, and prevalence of such conflict between Southern Baptist pastoral leaders. As the sources of such conflict are diverse (i.e., historical events, spiritual reasons, organizational conflict, interpersonal differences, etc.), I argue that qualitatively analyzing and reporting on this subject is of value to scholars of ethnographic research and interpersonal communication in the religious and spiritual realms. Furthermore, since the consequences of conflict can be severe (i.e., forced pastoral terminations, damaged churches, failed spiritual missions, etc.), this study is important as it examines matters that give rise to conflicts. Finally, areas for future research are addressed.     

Writing and Publishing Books in Counseling: A Survey of Authors

This article presents data and ideas from 74 authors who published books in the field of counseling. The process of writing and publishing books is reviewed, and information is provided on typical timetables, book contracts, and remuneration. Suggestions are provided for selecting publishers and obtaining and negotiating contracts. Authors were generally very satisfied with the experience of writing a book.     

Pastoral Counseling Down Under: A Survey of Australian Clergy

This survey research describes the attitudes and practices of Australian Christian clergy regarding counseling in their pastoral care roles. Data has been collected by use of a mail survey of 1954 Australian clergy residing in the state of Queensland from Dec 2007 until March 2008. 758 useable surveys were returned resulting in a return rate of 40.1%. The clergy’s (a) confidence in handling seven different counseling situations, (b) counseling preparation, (c) professional knowledge about counseling, (d) counseling modality, and (e) demographics were assessed. Australian Christian clergy are thus described with a discussion of a number of implications for training organisations such as Bible Colleges and Seminaries.     

Combining Counseling and Career Services: Conflicts and Choices

This article describes some of the administrative issues in merging counseling and career services in institutions of higher education. Discussion focuses on the major kinds of problems that can be anticipated and the eventual choices that administrators must make.     

Guidance and Counseling Services in Nigeria

This article focuses on the major factors responsible for the recognition of the need for guidance. It reviews the historical development, philosophical bases, and trends.     

The Ethics of Counseling: A National Survey of Certified Counselors

National survey data were collected from 579 counselors certified by the National Board for Certified Counselors (NBCC). Participants indicated their beliefs about whether each of 88 behaviors was ethical and also the degree to which they were confident of their judgment about the behavior. Systematic patterns in responding emerged in regard to age, sex, primary work setting, and degree. Participants also indicated their evaluation of 16 sources of ethical information or guidance. Highest ratings were given to American Association for Counseling and Development (AACD; now the American Counseling Association [ACA]) Ethical Standards, AACD ethics committee, the Journal of Counseling & Development, state licensing boards, and colleagues. The lowest ratings were given to local ethics committees, published clinical and theoretical work, court decisions, state and federal laws, and agencies for which participants had worked.     

A Survey of Clinical Supervision in Genetic Counseling

Three hundred and thirty-five full members of the National Society of Genetic Counselors completed a survey concerning the nature of clinical supervision for genetic counseling students. Slightly over half (54.3%, n = 182) had provided clinical supervision within the past 5 years. Of those who supervised, 66.7% had 5 years or less supervision experience, and 55% had supervised 10 or fewer students. The majority became supervisors because they enjoy teaching and contributing to the profession. Common reasons for not supervising include no local graduate program, and had never been asked to supervise. Live supervision is the most prevalent student evaluation method: every supervisor reported providing one-on-one oral feedback, and 47.3% indicated that they always provide feedback immediately following a counseling session. The most frequent challenges involve students who lack technical knowledge and who fail to incorporate feedback. Training, policy, and research implications are discussed.     

Billing and Record-Keeping for Familial Cancer Risk Counseling: A National Survey

We surveyed 111 genetic counselors providing cancer risk counseling (CRC) in order to document their billing and record-keeping practices. Of the 75 respondents, billing was generally done under the supervising physician with a wide variation in charges. Follow-up telephone interviews with 28 counselors who charge patients revealed that billing was usually done using the CPT codes for consultations, and the ICD-9 diagnostic codes for cancer (if applicable), a medical complaint, or a family history of cancer code. Most counselors exclude some clinical information from the patient's medical record. In consultation notes, 81% of counselors document a discussion of genetic testing, but only 37% document the patient's actual testing decision, and only 19% document test results. In anticipation of increased referrals for CRC, data are needed on the components of a CRC visit, the amount of time required to provide CRC, patient outcomes measures, and charges and reimbursement. The feasibility and advisability of keeping results separate from the patient's medical record also needs to be addressed.     

A Developmental Approach to Outreach Services for Counseling Centers

Economics, pressure for accountability and changing student needs are forcing counseling centers to evaluate their services and methods of delivery. This article illustrates how a developmental, proactive, outreach approach can be an alternative to the traditional medical model.