How Might the Genetics Profession Better Utilize Social Media

Social media is a common method of communication in people’s personal lives and professional settings. Gallagher et al. (2016) recommended, “it is time for genetic counselors to embrace social media as a means of communicating with patients or other healthcare professionals.” Full members of the National Society of Genetic Counselors (NSGC) in the USA and Canada and genetics patients in Cleveland, OH, were surveyed to determine interest in using social media for patient-provider interactions. Both cohorts indicated that patient privacy and confidentiality would be a concern; however, survey results indicated patients would be interested in using social media to receive general information about genetic counseling and to learn about genetics services. Genetic counselors indicated privacy issues were not concerning if social media were to be used in this capacity. The majority of genetic counselor participants (88.7%) indicated they would welcome national guidelines for patient-provider social media use. Data from this study demonstrated that sharing what to expect at a genetic counseling appointment, defining genetic counseling, and announcing community outreach events are possible ways genetic counselors could utilize social media to communicate with and educate patients.     

Role conflict for school counselors: training versus job demands

Principals' expectations on six counselor role dimensions were compared with ideal counselor roles as seen by counselor educators. The relationship of principals' training and practice in counseling to appropriate counselor role perceptions was also studied. Disagreement was found between principals and counselor educators on the role of the counselor in situations involving clerical tasks, confidentiality, personal-emotional counseling, and non-related counseling functions. Principals with some counseling training or experience were more similar to counselor educators in expectations concerning discipline, confidentiality, and clerical activity than those principals without counseling training experience. Yet all principals differed markedly from the ideal role as viewed by counselor educators.     

Nonsectarian Counseling in Churches: A Delicate Balance

This account of the author's 2 contrasting experiences as a church counselor raises awareness regarding counseling in new venues and in response to congregational and community needs. Church members responded to the invitation to come to counseling before problems became crises; the majority of the members explored midlife and other developmental issues. Specific concerns related to confidentiality and privacy, counselor values and attitudes, the extent of pro bono services, the counselor's relationship with clerics, counseling of clerics, church membership, outreach, and boundaries are addressed, as well as the effective use of discussion groups for youth, men, women, and parents in building a sense of community.     

Do pastoral counselors have a duty to report clergy sexual abuse done by their clergy clients?

What does a pastoral counselor do when a clergy client reveals that he or she has been sleeping with a parishioner? Does the counselor have an ecclesiastical duty to report this offense to a church official; or does the pledge of confidentiality trump any disclosure? Some ecclesiastical bodies require their clergy to bring knowledge of these offenses to church authorities. Does this requirement apply to pastoral counselors? The authors have been confronted with these questions in their ministry of pastoral counseling and have struggled with producing a faithful, professional response. Along the way they have not received clear direction from judicatories or professional organizations. This article is the authors' attempt to answer the questions raised above as well as to challenge professional and ecclesiastical bodies to confront more forthrightly the dilemmas these situations cause for pastoral counselors who seek to protect the welfare of the Church as well as protect the pledge to maintain confidentiality.     

Problems in privileged communication

Although most counselors offer their clients confidentiality as a condition of the counseling relationship, they are unable to guarantee the protection of privileged communication. Even when protected by statutory provision, counselors do not have total immunity from appearance in court and disclosure of confidential information. There are exceptions to privileged communications statutes that could produce severe conflicts between a counselor's ethical and legal duties, and similar problems can occur if the counselor is faced with a defamation or malpractice suit.     

Client Perceptions of the Impact of Genetic Counseling: An Exploratory Study

Twenty-eight former genetic counseling clients seen at a major Midwestern university were recruited to be interviewed about their genetic counseling experiences, including most and least helpful aspects, what they learned, how this information impacted their decision-making, and their perceptions of their genetic counselors' behaviors. Responses were inductively analyzed, and several themes were identified, including: Clients sought genetic counseling to obtain genetic-medical information; a majority accurately recalled this information; genetic counseling influenced decisions for about 50% of the sample; decision-making was affected by several extra-session factors; a majority experienced distress during the session; most perceived genetic counselor responses as nondirective and liked this approach; counselor behaviors regarded as directive involved discussion of pregnancy termination; participants disagreed about the need for and provision of genetic counselor support; most regarded the session as helpful and stated that they would seek genetic counseling again. Suggestions for addressing these issues in practice and research are given.     

Counseling black college students in special programs

The black college student's encounter with special programs gives rise to special counseling needs which this article describes. In effect, the counselor's task is to assist the student to cope with institutional demands and overcome the alienating effect of the impersonal, white, middle class institution. To do this, the counselor must establish a unique relationship with the student at a critical moment through an outreach approach. Subsequently, the counselor will also be called upon to assist the student in the resolution of an identity crisis. White counselors are not disqualified, but they may need to modify their style of counseling.     

Legal concerns of the pastoral counselor

The United States is increasingly becoming a legalized society wherein laws are determining what a pastor providing counseling can and cannot do. The pastoral counselor needs to be cognizant of which laws are helpful and which are restrictive in the counseling which he/she provides. This article was written to provide a beginning understanding of the following issues: confidentiality, privileged communications, clergy privilege, state licsensing and tax-exempt status. The issues of malpractice insurance and third party payments are also touched upon briefly.He is a minister of the United Church of Christ and a Diplomat of the American Association of Pastoral Counselors. His article is based on a lecture at the Denver meeting of the AAPC and is reprinted with his permission.     

“What Would You Do if You Were Me?” Effects of Counselor Self-Disclosure Versus Non-disclosure in a Hypothetical Genetic Counseling Session

Two prior studies suggest genetic counselors self-disclose primarily because patients ask them to do so (Peters et al., 2004; Thomas et al., 2006). However, scant research has investigated effects of counselor disclosure on genetic counseling processes and outcomes. In this study, 151 students (98 undergraduates, 53 graduates) completed one of three surveys describing a hypothetical genetic counseling session in which a patient at risk for FAP was considering whether to pursue testing or surveillance procedures. Dialogue was identical in all surveys, except for a final response to the question: “What would you do if you were me?” The counselor either revealed what she would do (Personal Disclosure), what other patients have done (Professional Disclosure), or deflected the question (No Disclosure). Imagining themselves as the patient, participants wrote a response to the counselor and indicated their perceptions of her. Participants rated the non-disclosing counselor significantly lower in social attractiveness than either disclosing counselor, and less satisfying than the professional disclosing counselor. Analysis of written responses yielded four themes: Made Decision, Sought Information, Expressed Thoughts/Feelings, and No Decision. Practice implications and research recommendations are provided.     

a bill of client rights and responsibilities

Little has been written about client rights except on the issue of confidentiality. The authors of this article propose a bill of rights for the client in the counseling relationship. With each right there is a corresponding responsibility. The authors suggest that if clients wish to exercise their rights, they must also be prepared to assume a greater degree of responsibility. Such a change in the counseling relationship may bring about greater involvement on the part of both client and counselor.     

Counselor Empathy or “Having a Heart to Help”? An Ethnographic Investigation of Chinese Clients' Experience of Counseling

Current understanding of counselor empathy is almost entirely based on Western culture. Clients'; perceptions of counselor empathy are scarcely investigated within any non-Western group. Using ethnographic interviews, this study explored the concept of counselor empathy from Chinese counseling clients'; perspectives by exploring their experiences of therapeutic relationships. Although informants did not commonly and explicitly consider counselor empathy as a priority in counseling, preliminary results suggest that they may perceive it in Chinese counseling relationships as a different phenomenon linguistically and conceptually.     

Cross-cultural pastoral counseling: Method or hermeneutic?

This article explores some of the meta-questions that emerge when talking about “cross-cultural pastoral counseling.” Is it a distinct counseling method or a practical hermeneutic that prompts the counselor to examine his or her therapeutic approach? The author argues that “cross-cultural pastoral counseling” is really a hermeneutic that challenges the pastoral counselor to an ongoing evaluation of how and to what extent his or her approach to pastoral counseling may be guided by dominant social convention versus the gospel mandate of Matthew 25: 31–46 [RSV]. The article reviews relevant literature, discusses three fundamental changes (“conversions”) that are necessary for the pastoral counselor in order to do cross-cultural pastoral counseling, and presents a case illustration involving a multi-cultural pastoral counseling intervention.     

Are Genetic Counselors and GLBT Patients “on the Same Page”? an Investigation of Attitudes, Practices, and Genetic Counseling Experiences

Gay, lesbian, bisexual, and transgender (GLBT) individuals comprise a growing patient population in genetic counseling, yet literature on working with this population is scarce. This study sought to investigate GLBT patient experiences in genetic counseling and genetic counselor attitudes and practices when counseling GLBT patients. Twenty-nine GLB individuals who had previously participated in genetic counseling, and 213 genetic counselors completed online surveys. No individuals identifying as transgender participated. The patient survey assessed disclosure of orientation, discrimination in genetic counseling, and quality of services received. The counselor survey assessed comfort with and attitudes about counseling GLBT patients, disclosure of counselor orientation, and whether they counsel differently with this population. Every patient denied experiencing discrimination during their session, but 17% reported their genetic counselor assumed they were heterosexual, and 45% indicated intake forms were not GLBT-inclusive. A majority of counselors (91%) reported having counseled GLBT patients and indicated they were comfortable doing so (86%), and 72% indicated no differences in their counseling approaches with GLBT patients. Few counselors (17%) received training in GLBT issues, and most (61%) desired such education. Additional findings and practice and research recommendations are presented.     

Significant Content of Group Counseling Sessions with Culturally Deprived Ninth Grade Students

Some examples are presented of the problems and concerns that were verbalized and discussed during group counseling sessions with 4 groups (36 students) of culturally deprived white ninth grade boys and girls. The examples cited indicate that among these culturally deprived students there is a general lack of identification with school, a pattern of employing inappropriate means to gain acceptance and recognition, a philosophy of life geared toward immediate material gratification, and parental models that do not result in positive parental identification. There seems to be little hope for these students in their present situation unless they receive some help and support from interested others outside their group. It is suggested that group counseling, for considerably more than the 15 sessions given these students, may afford a means by which the school and the counselor can help the culturally deprived find an effective way to deal with the dilemma in which they find themselves.     

Program Evaluation and Counseling: Yesterday,Today, and Tomorrow

Spawned by intensified demands for accountability, expanding counselor roles and functions, and increased counselor attention both in the counseling literature and in counseling practice, program evaluation has emerged as a vital aspect of counselor functioning in recent years. This article highlights the differences between program evaluation and research, a long-standing source of confusion; presents major issues in the practice of counseling program evaluation; and identifies current trends in program evaluation.     

Group counseling in a different cultural context: Several primary issues in dealing with Chinese clients

To apply group therapy or counseling, a branch of helping methodology rooted in modern Western psychology, to a culturally different context, such as the Chinese cultural environment, group counselors need to increase their awareness, knowledge, and skills that are compatible with the group climate they encounter. A group counselor needs to understand the general characteristics of the culture. The counselor should use his or her leadership quality to deal appropriately with group clients' psychological dynamics, which bear unique cultural preferences with respect to thinking, feeling, and doing. While many group counseling communication skills from a Western theoretical framework can be helpful and applicable to the Chinese group clientele, some of these skills need to be contextually modified. The counseling goal is to properly integrate Chinese cultural and therapeutic norms into the group process.He also teaches as a Sessional-Instructor in the same department.     

The State of Community Counseling: A Survey of Directors of CACREP‐Accredited Programs

Directors of CACREP‐accredited community counseling programs were surveyed on plans for their programs, needed curricular changes, professional organization and publications desired, and what makes community counseling distinct as a counseling specialization. Respondents were evenly divided between those who seem to see community counseling as generic counselor preparation for nonschool settings and those who seem to see it as a community‐oriented specialization in its own right. This division of opinion suggests a need to resolve this issue.     

Evaluation of a Clinical Genetics Service – A Quality Initiative

Paper-based surveys are an effective means of evaluating the quality of a clinical service. As part of ongoing quality improvement initiatives within our Genetics Program, new patients were invited to participate in a paper-based survey. Issues related to the quality of counseling based on educational/informational aspects (e.g. whether testing was explained fully, testing options, the meaning of normal/abnormal testing), competency, respect and nondirectiveness of counseling in addition to clinical environment/setting were evaluated. Data related to demographics, discipline seen within the program and whether the patient was seen by a physician or genetic counselor were also captured. Five hundred questionnaires were distributed. One hundred and forty-seven questionnaires were returned, with a response rate of 29.4 %. The majority of patients seen were prenatal (pregnant) patients and comprised a heterogeneous group including those seen for advanced maternal age and abnormal maternal serum screening. Overall, 98.6 % of respondents felt their appointment in genetics was a positive experience. Issues related to confidentiality, pros and cons of testing, meaning of an abnormal test result and time allotted for decision making were significantly different in some disciplines between genetic counselor and geneticist. However, when controlling for referral indication, these differences lost significance with the exception of issues relating to confidentiality and perceived time allotted to organize thoughts and questions. This survey provided valuable information to allow for improvement in the quality of the provision of service.     

Paperwork,Pressure, and Discouragement: Student Attitudes Toward Guidance Services and Implications for the Profession

This article goes beyond the traditional survey of student attitudes toward the school guidance service. The student data are used as a springboard to the broader issues affecting the counseling profession. The focus is on counselor discouragement and what all concerned practitioners can do to revitalize the profession.     

Client Reaction to Counselor's Use of Self-Experience

This study sought to determine if counselor use of self-experience may be useful in increasing self-confidence, self-disclosure, perceived genuineness, and empathic understanding. Volunteer graduate students in education interested in participating in a series of group counseling sessions structured to deal with problems of the graduate student were used in this study. 30 graduate students were divided into 6 groups of 5 each. 3 groups were experimental groups and 3 groups were control groups. In the control groups self-experience examples were not used by the counselor, but in the experimental groups they were used extensively. Questionnaires, taped sessions, and post-counseling interviews were used in evaluation of results. The experimental groups perceived the counseling relationship as less genuine than the control groups. The results of the study did not support the use of counselor self-experience examples in group counseling.