The Experience of Genetic Counselors Working with Patients Facing the Decision of Pregnancy Termination after 24 Weeks Gestation

Prenatal genetic counselors are health care professionals who counsel women making reproductive decisions which include decisions such as terminating pregnancies due to fetal anomalies. Little is known about the experiences and practices of prenatal genetic counselors working with women who have the option of termination after 24 weeks gestation. In this national survey of 168 genetic counselors who have practiced prenatal genetic counseling, we asked about their general practice patterns, including indications for which termination is offered and types of abortion care services that are coordinated by genetic counselors. We report respondents’ self-assessments of level of understanding of federal abortion law and abortion procedures. Seventy-six percent of respondents have offered and counseled on termination after 24 weeks and 93% of respondents believe it is the responsibility of the counselor to discuss this option with patients. However, one-third report that they have some or no understanding of the procedures and three-quarters report that they have some or no understanding of federal abortion law. The results of this study provide insight into knowledge and experiences of genetic counselors working with these patients, allowing for improved genetic counselor training and continuing education to provide better guidance and develop more effective means of assisting patients.     

Women and AIDS: Implications for Counseling

Women's concerns regarding AIDS have been ignored or minimized by most writers and AIDS educators. Although women may share many similarities with men in their reactions to AIDS, they have unique concerns that must be recognized. Understanding these concerns is essential for counselors in order to give quality care to women at risk for infection. This article describes women at risk and offers suggestions for counselors in working with such women.     

Language About People with Disabilities

A decade of rehabilitation literature (a) calls attention to imprecise, stereotypical, and devaluing language that is often used to discuss people with disabilities and (b) offers more appropriate alternatives. Because professional counselors sometimes commit these language abuses, and counselors of all specialities can expect to see some clients who have disabilities, this article seeks to bring these issues to the attention of the counseling profession at large.     

Counseling in Zimbabwe: History,Current Status,and Future Trends

Counseling in Zimbabwe has a long tradition, dating back to pre‐Colonial times. In the modern context, counseling has evolved through the educational and health care sectors. Since the 1990s, Zimbabwean counselors have advocated for professional recognition, a struggle similar to that of counselors in the United States. In this article, the authors provide a historical view of counseling in Zimbabwe, discuss the current status of and future trends in counseling, and make recommendations for the advancement of the profession.     

Worldviews of Women: Comparisons Between White American Clients,White American Counselors,and Chinese International Students

Worldviews of White American women clients, White American women counselors, and Chinese international women students were surveyed. Multivariate planned comparisons showed significant differences between (a) White American clients and White American counselors and (b) Chinese international students and White American counselors. Income was a significant predictor of worldviews for White American clients. Age and marital status contributed strongly to the worldviews of White American counselors. Among the Chinese students, the Taiwanese and the Mainland Chinese held significantly different worldviews. Worldviews of women are discussed from feminist as well as cross-cultural perspectives. Future directions for practice, research. and theory are suggested regarding the multicultural counseling process with clients of different worldview orientations.     

The Need for an Awareness of Specialized Issues in Counseling Alcoholic Women

Because of the increase in the number of women seeking treatment for alcoholism in recent years, it is essential that counselors give careful consideration to how this client population can most effectively be helped. Three counselors from the Alcohol Institute of the Eastern Maine Medical Center, Bangor, were interviewed for this article. Their perceptions and experiences as alcoholism counselors are integrated with some of the current research on alcoholic women to provide a framework for professionals in a variety of settings to develop an awareness of the specific issues affecting alcoholic women and to begin to address these issues with their clients.     

Socialization of sex roles in the counseling setting: Differential counselor behavioral and attitudinal responses to typical and atypical female sex roles

Counseling and therapy have frequently been attacked by feminists for the role they play in socializing women to a limited and ultimately untenable sex role. Male counselors in particular have been singled out as special oppressors of women. This study attempted to determine whether, in fact, counselor behavior and attitudes operated as a means of sex-role socialization, and whether male counselors tended to be more biased than female counselors when interacting with female clients. Subjects were eight male and eight female graduate students in counseling psychology who conducted initial interview sessions with two client-confederates, volunteer graduate students trained in role-playing situations representing a typical and an atypical sex-role condition. Videotapes of the interviews were subsequently analyzed to assess counselor reinforcement patterns of specific client cue sentences. In addition to these behavioral data, paper-and-pencil inventories were used to determine counselors' perception of clients, counselors' degree of attitudinal sex-stereotyping, and client-confederates' subjective evaluation of counselors. Contrary to expectations, results indicated that counselors as a whole exhibited more behavioral bias with typical than with atypical clients. Further, counselors reacted more positively toward the atypical than toward the typical clients, and counselor response to a global sex-role inventory indicated that counselors described the healthy, well-adjusted female as significantly more instrumental than the healthy, well-adjusted male. Female counselors appeared to be both more reinforcing and less punishing than male counselors with female clients in both roles, as well as less behaviorally biased than the male counselors. Female counselors also evaluated the atypical clients more positively than did the male counselors, and were in turn evaluated more positively than were the male counselors by clients in both roles. The study concludes with a discussion of implications for counselor training.     

Sexuality and Perimenopause: What Counselors Need to Know

Perimenopause, which recently has been recognized as separate from menopause, affects approximately 22 million U.S. women. It is a time when women are at greater risk for emotional, relationship, and sexual problems. The authors describe the symptoms of perimenopause, discuss the resulting psychosocial and sexual impact, and present treatment implications for counselors.     

Exemplary Counseling Strategies for Developmental Transitions of Young Women With Attention Deficit/Hyperactivity Disorder

This article is intended to provide rehabilitation, career, and mental health counselors with an understanding of how attentional impairments are manifested in young women and how professional counselors may help them most effectively. Treatment guidelines and recommendations are presented for working with these young women through the developmental transition years of adolescence and young adulthood.     

Archetypes and Gender: Goddesses,Warriors, and Psychological Health

This article describes the principles and assumptions of Jung's archetypal psychology and how they have been adopted and modified by feminist counselors and the mythopoetic men's movement. It critiques each of these revisions of Jungian archetypal psychology and provides suggestions to counselors for modifying and implementing concepts and techniques that are based in archetypal psychology.     

Women,Human Rights,and Counseling: Crossing International Boundaries

As the world becomes more globalized, psychological and counseling issues have become more pronounced. As social justice issues become illuminated on a global scale, there is increased attention to women as identified victims of social injustices and human rights violations. This article examines the role of professional counselors working with women from an international perspective with the intention to heighten awareness and understanding of the interrelationship of global women's issues and effective counseling interventions.     

New Directions in Counseling Women

A revolution in counseling women is one logical outcome of recent changes in the social, political, and economic movements that have predisposed individuals to modify their life-styles and value systems. This article discusses four facets of that revolution and concludes that new counselor training programs are required to meet the needs of emerging client populations. The conclusions are supported by research that indicates (a) new sources of knowledge about the development and functioning of women clients; (b) new groups of client populations whose needs are not being met by traditional counseling strategies; (c) innovative procedures specifically tailored to the unique characteristics of these client groups; and (d) revised standards of ethical practice to ensure competent and appropriate services for all client populations. Training programs are outlined that provide guidelines for sex-fair education for all counselors and more intensively focused training for counselors who select the counseling of women clients as a career specialty.     

Manifest needs of prospective counselors: a comparative study

Mean performances of 81 prospective counselors on each of the Edwards Personal Preference Schedule (EPPS; Edwards, 1959) needs were analyzed and statistically compared with performances of elementary school counselors, other school counselors, urban college students, professional women, Roman Catholic sisters, and the 1959 EPPS norm samples. Performances of the men and women in the prospective counselor group were similar. Men had a significantly higher need for achievement and dominance, but the significance did not reach .01. Two EPPS needs, intraception and nurturance, consistently differentiated the prospective counselor group. Comparisons across samples indicated that prospective counselors were most similar to the two counseling samples and, for the female subgroup of prospective counselors, to the sample of professional women. Largest across-sample differences were found between the female prospective counselors and the Roman Catholic sisters, between the female prospective counselors and norm samples of female college students and female adults, and between the male prospective counselors and the male adult norm sample.     

Once-Married Lesbians: Facilitating Changing Life Patterns

Many women have undergone a significant life transition from a heterosexual marriage to a lesbian life pattern. As facilitators of life transitions, counselors can play an important role in minimizing the pain and maximizing the growth involved in such a change. This article provides counselors with information about the diversity of this life transition and then discusses three areas in which counselors may facilitate this process by helping clients to (a) develop a positive identity as a lesbian, (b) adapt to their relationships with women partners, and (c) deal with work-related issues arising from the changed life pattern.     

A Model for Building School–Family–Community Partnerships: Principles and Process

The extant literature documents the importance of school counselors’ roles in school–family–community partnerships, yet no model exists to guide school counselors through the process of building partnerships. The authors propose a model to help school counselors navigate the process and principles of partnerships. They define partnerships; discuss the principles of democratic collaboration, empowerment, social justice, and strengths focus that should infuse partnerships; enumerate a partnership process model; and discuss implications for practice and research.     

Women and Work—Rights,Realities, and Prospects

Women's place as a permanent part of the work force has been established, but the question now is whether women will continue to be the majority of low-skilled, low-paid workers or will share equally in opportunities in all fields of employment. The economic needs of most women workers are approximately the same as those of male workers. With 6.6 million women heads of families in 1973, nearly one out of three such families was poor according to Department of Labor criteria. Professional job counselors have a responsibility to support women who make nontraditional career choices. Counselors and others must also be aware of the rights and resources available to each woman in pursuing her career goals.     

“Testing Times,Challenging Choices”: An Australian Study of Prenatal Genetic Counseling

In many countries pregnant women deemed to be at increased risk for fetal anomaly following a screening test may attend a genetic counseling session to receive information and support in decision-making about subsequent diagnostic testing. This paper presents findings from an Australian study that explored 21 prenatal genetic counseling sessions conducted by five different genetic counselors. All were attended by pregnant women who had received an increased risk result from a maternal serum screening (MSS) test and who were offered a diagnostic test. Qualitative methods were used to analyze the content and structure of sessions and explore the counseling interactions. Findings from this cohort demonstrate that, within these prenatal genetic counseling sessions, counselor dialogue predominated. Overall the sessions were characterized by: a) an emphasis on information-giving b) a lack of dialogue about relevant sensitive topics such as disability and abortion. Arguably, this resulted in missed opportunities for client deliberation and informed decision-making. These findings have implications for the training and practice of genetic counselors and all healthcare professionals who communicate with women about prenatal testing.     

Spirituality and Religiosity: Factors Affecting Wellness Among Low‐Income,Rural Women

A study including measures of spirituality, religiosity, and wellness was conducted to identify coping strategies for the multiple challenges to wellness faced by low‐income, rural women. Total spirituality and religiosity accounted for 39% of the variance in wellness, with purpose and meaning in life, unifying interconnectedness, and private religious practices composing the main contributions. Implications for counselors working with these women are discussed, as is the need for further research.     

Managing Variant Interpretation Discrepancies in Hereditary Cancer: Clinical Practice,Concerns, and Desired Resources

Variant interpretation is a complex process, and classification may vary between sources. This study aimed to determine the practice of cancer genetic counselors regarding discrepancies in variant interpretation and to identify concerns when counseling these discrepancies. An electronic survey was sent to genetic counselors in the NSGC Cancer Special Interest Group. The vast majority of counselors (93%) had seen a variant interpretation discrepancy in practice. A large majority (96%) of respondents indicated that they conducted their own research on reported variants. Most respondents cited variant databases as the most common resource utilized in researching variants. Approximately 33% of counselors spent 45 min or more of extra time researching a discrepancy compared to researching a variant with a single classification. When asked how they approached counseling sessions involving variant interpretation discrepancies, the free responses emphasized that counselors considered family history, clinical information, and psychosocial concerns, showing that genetic counselors tailored the session to each individual. Discrepancies in variant interpretation are an ongoing concern for clinical cancer genetic counselors, as demonstrated by the fact that counselors desired further resources to aid in addressing these discrepancies, including a centralized database (89%), guidelines from a major organization (88%), continuing education about the issue (74%), and functional studies (58%). Additionally, most respondents reported that the ideal database would be owned by a non-profit organization (59%) and obtain information directly from laboratories (91%). This investigation was the first to address these discrepancies from a clinical point of view. The study demonstrates that discrepancies in variant interpretation are a concern for clinical cancer genetic counselors and outlines the need for additional support.