A Counseling Paradox: Do Preservice Counselors Need Employment Counseling?

Data from this study identified a significant discrepancy between preservice counselors' perceptions of their career opportunities and actual placement data.     

Iceland—Genetic Counseling Services

This brief report aims to give an overview of the history and current status of clinical genetics services in Iceland and specific genetic counseling considerations for Iceland’s population. Presently, there are two part time medical geneticists and one full time genetic counselor with an MSc education from Cardiff, within the Department of Genetic and Molecular Medicine, based in Iceland’s only tertiary healthcare facility, Landspitali, the National University Hospital. An oncologist (20 %) also contributes to the cancer genetic counseling service. In addition, a pediatric medical geneticist has a 25 % appointment at the Children’s Hospital. No other health care organization offers genetic counseling, and there are no private genetic counseling services.     

Does Counseling Need the Mind?

In this article, the author argues that the language used in counseling practice is largely a common sense language using mentalistic words. Basic mentalistic assumptions and challenges to those assumptions are outlined. The practical consequences of retaining or discarding mentalism in counseling are discussed. The author concludes that mentalistic language persists in counseling practice because it offers a useful vocabulary, but that the counseling field could benefit from adopting a path similar to that used in the cognitive sciences.     

Disciplinary Counseling: A Contradiction?

Many counselors appear to be operating on false assumptions (shibboleths) regarding counseling. The removal of these shibboleths leaves one more receptive to examining the basic assumptions underlying the linkage of discipline and counseling. Discipline and counseling may be seen as similar in terms of their educational goals, and counseling is used as a tool for the disciplinary counselor to implement the attainment of these common goals. Unresolved problems remain, however. Counseling is used during only a portion of disciplinary activities; thus there seems to be a misplaced emphasis on counseling in the title of the disciplinary counselor. Such inaccuracy may have unfortunate implications. Because of the usually accepted meaning of “discipline,” the title of disciplinary counselor is confusing and possibly damaging to both the profession and the students it intends to serve.     

Who Benefits From Computerized Career Counseling?

The Adaptive Counseling and Therapy (ACT: Howard, Nance, & Myers, 1986) model was used to predict who would benefit from computerized career counseling. Specifically, clients who had more stable goals and aspirations and more defensive independence were expected to derive more benefit from computerized career counseling, an intervention that provides low levels of direction and support. A total of 54 clients who came to the Career Planning and Placement Center seeking career assistance were referred to the System for Interactive Guidance and Information PLUS (SIGI-PLUS). As hypothesized, clients with more stable goals had the greatest gains in vocational identity. Additionally, clients who showed more defensive independence were more satisfied with the SIGI-PLUS treatment. Implications, limitations, and suggestions for future research are discussed.     

Androgyny: A Goal for Counseling?

Although psychological androgyny is a useful and attractive concept for many counselors, a review of the literature suggests that androgyny cannot now serve as a concrete goal for sex-role counseling. It may also pose its own problems for individuals.     

A Comparison of Telephone Genetic Counseling and In-Person Genetic Counseling from the Genetic Counselor’s Perspective

Growing demand for and limited geographic access to genetic counseling services is increasing the need for alternative service delivery models (SDM) like telephone genetic counseling (TGC). Little research has been done on genetic counselors’ perspectives of the practice of TGC. We created an anonymous online survey to assess whether telephone genetic counselors believed the tasks identified in the ABGC (American Board of Genetic Counseling) Practice Analysis were performed similarly or differently in TGC compared to in person genetic counseling (IPGC). If there were differences noted, we sought to determine the nature of the differences and if additional training might be needed to address them. Eighty eight genetic counselors with experience in TGC completed some or all of the survey. Respondents identified differences in 13 (14.8 %) of the 88 tasks studied. The tasks identified as most different in TGC were: “establishing rapport through verbal and nonverbal interactions” (60.2 %; 50/83 respondents identified the task as different), “recognizing factors affecting the counseling interaction” (47.8 %; 32/67), “assessing client/family emotions, support, etc.” (40.1 %; 27/66) and “educating clients about basic genetic concepts” (35.6 %; 26/73). A slight majority (53.8 %; 35/65) felt additional training was needed to communicate information without visual aids and more effectively perform psychosocial assessments. In summary, although a majority of genetic counseling tasks are performed similarly between TGC and IPGC, TGC counselors recognize that specific training in the TGC model may be needed to address the key differences.     

Do Common Factors Account for Counseling Outcome?

This study drew from common factors as an explanatory model for how counseling produces client change. Client self‐report measures for 3 common factors—client factors, client–counselor relationship factors, and client expectancy factors—were examined at a counseling training clinic. Regression analyses revealed that 2 factors significantly predicted treatment outcome: client expectancy and the therapeutic alliance. One variable from client factors—abuse history—had a nonsignificant but modest relationship with outcome.     

Should Universalism Trump Cultural Relativism in Counseling?

Certain cultural customs and practices are viewed as abhorrent by many people, yet contemporary American counselors rarely criticize any specific culture. In this article, the authors explore why counselors abstain from such criticism. Furthermore, the authors demonstrate that universalism, often regarded as a politically incorrect and an academically archaic philosophy, is manifestly prevalent within the world's religious and political realms, as well as within the counseling profession. The authors assert that universalism should be prevalent within the counseling profession and that it can be integrated with multicultural principles. Finally, the authors suggest a procedure for identifying universal principles and practices.     

Rehabilitation Counseling: A Profession or a Trade?

The problem of the shortage of counselors is examined and the various possible solutions considered. A solution that appears to be developing in many state rehabilitation agencies is the employment of college graduates with no preparation in counseling. These employees are designated as counselors, counselor aides, or counselor trainees, and given in-service training. Such persons, it appears, will eventually be considered counselors without any further educational preparation. It is questioned whether they are, in fact, counselors, but if they are able to perform all the functions of those designated as counselors (excluding professional counseling), then counseling is not a profession, but a trade, for which adequate preparation can be obtained through on-the-job training.     

Strange Bedfellows?: Rational-Emotive Therapy and Pastoral Counseling

Integrating Rational-Emotive Therapy with biblical precepts is discussed as a basis for pastoral counselors to bridge the gap between religion and psychotherapy.     

Cancer Risk Counseling: How Is It Different?

Fifty-six of 80 (70%) full members of the National Society of Genetic Counselors with interest in cancer genetics responded to a 1994 survey regarding their cancer risk counseling practices. This study was undertaken to describe cancer risk counselors and the services they provide and to identify possible differences from general genetic counseling that warrant further study. Of 56 respondents, 41 (75%) were providing CRC. The components of CRC programs are described. Our results found significant differences between CRC and general genetic counseling in terms of training and experience of genetic counselors providing CRC and length and number of counseling sessions per consultand. 51% of respondents had 1–2 years of working in CRC, compared to 17% with 1–2 years experience in genetic counseling (p<0.05). Over one-third had 10 or more years genetic counseling experience. Counselors were more likely to see individuals at risk for cancer for longer counseling sessions (p<0.05) and for additional sessions (p<0.05).     

Does Receiving Genetic Counseling Impact Genetic Counselor Practice?

This study was an investigation of whether genetic counselors have received genetic counseling and if so, how they believe it affects their practice. One thousand genetic counselors were mailed surveys about the nature of genetic counseling services received, impact on their clinical practice, frequency and reasons for disclosing about their receipt of counseling to their clients, and demographics. Ninety-three of the 510 respondents reported receiving genetic counseling. Of these, almost three-fourths were practicing genetic counselors while receiving services. Reasons for services include prenatal concerns, family history of cancer, and history/risk of other genetic conditions. Frequently endorsed effects on practice include increased empathy and understanding of client decisions, feeling more connected with clients, greater emphasis on psychosocial support, and sympathy. Forty-six respondents disclosed to clients about their receipt of genetic counseling. Prevalent reasons include client asked, help clients feel they are not alone, demonstrate counselor understanding, decrease client anxiety, build rapport, and normalize client feelings. Practice and research recommendations are given.     

Women’s Experience of Telehealth Cancer Genetic Counseling

Telegenetics offers an alternative model of delivering genetic counseling to rural and outreach areas; however there is a dearth of qualitative research into the patient’s experience. Twelve women who had received telemedicine genetic counseling for hereditary breast and/or ovarian cancer (HBOC) within the previous 12 months participated in a semi-structured telephone interview. The interview explored women’s experience with telegenetics, satisfaction, perceived advantages and disadvantages and quality of the interaction with their genetic professionals. Overall women were highly satisfied with telegenetics. Telegenetics offered them convenience and reduced travel and associated costs. The majority of women described feeling a high degree of social presence, or rapport, with the off-site genetic clinician. One woman with a recent cancer diagnosis, reported that telemedicine was unable to meet her needs for psychosocial support. This finding highlights the need to be mindful of the psychosocial support needs of women with a recent diagnosis being seen via telegenetics. Patients attending for HBOC genetic counseling are generally highly satisfied with the technology and the interaction. Care should be taken, however, with patients with more complex psychosocial needs.