Genetic Counsellors and Private Practice: Professional Turbulence and Common Values

Genetic counsellors face tensions between past and future identities: between established values and goals, and a broadening scope of settings and activities. This study examines the advent of genetic counsellors in private practice in Australia and New Zealand from the perspectives of the small numbers working in this sector and those who have only worked in public practice. Semi-structured interviews were conducted with 16 genetic counsellors who had experience in private practice, and 14 genetic counsellors without private sector experience. Results demonstrated that circumstantial and personal factors can mitigate the challenges experienced and the amount of support desired by those who had established a private practice, and those who were employed by private companies. Notably, most participants with private sector experience perceived themselves to be viewed negatively by other genetic counsellors. Most participants without private sector experience expressed concern that the challenges they believed genetic counsellors face in private practice may impact service quality, but wished to address such concerns by providing appropriate support. Together, our results reinforce that participants in private and public sectors are strong advocates for peer support, multidisciplinary team work, and professional development. These core values, and seeking understanding of different circumstances and support needs, will enable genetic counsellors in different sectors to move forward together. Our results suggest supports that may be acted upon by members of the profession, professional groups, and training programs, in Australia, New Zealand, and overseas.     

Medical Family Therapy: Charting a Course in Competencies

The skills and training medical family therapists need to be effective in their work is an underdeveloped area in the literature. Training programs in Medical Family Therapy (MedFT) currently vary in duration, intensity, and focus of material and most of this is due to the minimal research done on what core competencies are needed. The results presented in this paper are the product of a larger modified Delphi (Dalkey in Studies in the quality of life, Lexington Books, Lexinton, MA, 1972) study designed to reach consensus regarding the current definition, scope, and practice of MedFT. Thirty-seven experts in MedFT participated in this two-phase investigation. What resulted and will be reported on in this article are the training requirements and recommended core competencies for the practice of MedFT. Participants indicated that 12 academic course content areas and 13 core competencies should be required of those seeking training in MedFT. Recommendations for MedFT core competencies at the master??s, post master??s, and doctoral levels, as well as advancements for future research, are described in detail.     

Multicultural Counseling Competencies as Tools to Address Oppression and Racism

The Multicultural Counseling Competencies (Arredondo et al., 1996; Sue, Arredondo, & McDavis, 1992) provide developmental and evaluative guidelines for enhancing counselor education and practice. A reason for the articulation of the competencies was the need to address racism and other forms of interpersonal and institutional oppression in the profession. The Dimensions of Personal Identity Model is discussed as a reference point to recognize various personal criteria that are often the focal point of discriminatory behavior. Specific competencies and explanatory statements provide checkpoints that address racism and other forms of oppression that are part of the human experience, but more particularly so for people of color in the United States.     

Counsellors' self-perceived multicultural competencies model

This study aimed to develop a UK instrument measure of counsellors’ multicultural competencies. Also, it intended to analyse to what extent multicultural competencies have an influence in counselling practice in terms of processes and interventions.

The study was an expansion of the American multicultural competencies model, which related cultural competence to a combination of three factors: cultural beliefs, cultural knowledge and cultural skills. Results partially supported the hypothesis, which predicted that counsellors would present high correlation rates between cultural skills, cultural knowledge and cultural beliefs when self-evaluating their levels of multicultural competence.

The study's findings present alternative three-dimensional multicultural models that indicated how counsellors perceived multicultural competence based on both societal (e.g. race, class, patriotism) and functional (e.g. family, social norms and groups). It also discusses the correlations between cultural skills, cultural knowledge and cultural beliefs and how they played a part in helping counsellors to further understand their multicultural competencies and limitations. Finally, it is proposed that future research should investigate the possibility of developing multidimensional or multi-axial models as an alternative way of further developing the counsellors’ multicultural competencies models which emerged from this study.     

Competencies of Process: Toward a Relational Framework for Integrated Care

As integrated care (IC) has gained more traction within both the psychosocial and medical fields, the need to train medical family therapy students and established professionals in this care typology has increased in tandem. To address this stated need, there is a large body of literature pertaining to models of care, typologies of intervention, clinical and financial effectiveness, and now a burgeoning discussion related to the academic and practice-based competencies necessary for IC practice. While the ability of the medical family therapist as behavioral health provider (MedFT/BHP) to practice in integrated settings may rely on an understanding of population-based medicine, disease etiology, medication and psychopharmacology, as well as augmentations to patient conceptualization and practice, all of the specifics related to that care are ultimately leveraged on the relationships formed by the MedFT/BHP with their healthcare colleagues. What this means is while we have attempted to distill the gestalt of integrated care into its major practice-based parts (e.g., model development and implementation, competencies, financial viability, efficacy/effectiveness, mechanisms of activation, and marketing), we have not adequately described the competencies necessary to set the stage for these types of close working relationships: relationships that make integration, of any kind, a possibility. The following paper was written to discuss three competencies related to the relational process of integration: (a) conceptual flexibility, (b) understanding and acceptance, and (c) acknowledgment and appreciation, as well as how these competencies provide the backdrop against which integrated care, as a practice, can emerge.     

国外心理健康服务人员胜任特征

什么样的人具有资格担当心理健康服务人员, 这方面的研究属于心理健康服务人员胜任特征的问题。国外有关心理健康服务人员胜任特征的研究主要涉及: 核心胜任特征与特殊胜任特征、能力与胜任特征评估、胜任特征模型及其开发、心理健康服务不同具体领域的胜任特征研究, 这些研究对于改进心理健康服务人员的教育与培训、录用与管理有着重要指导作用。目前该领域研究的局限在于很少关注如何运用已确认的胜任特征去评价心理健康服务领域的学生以及从业人员。     

Identifying and Integrating Individual Level and Organizational Level Core Competencies

The current use of the term core competencies in business and industry results in confusion since the term is utilized in a variety of different manners. Through a review of business and psychology literature combined with the benchmarking of companies and consulting firms, this article defines two levels of core competencies. These two levels are organizational level core competencies and individual level core competencies. Additionally, this article addresses approaches for identifying, integrating and validating these two levels of core competencies and is intended to serve as a foundation for future research and discussion in relation to core competencies.     

Multicultural Counseling Competencies and Standards: A Call to the Profession

In April 1991, the Association for Multicultural Counseling and Development (AMCD) approved a document outlining the need and rationale for a multicultural perspective in counseling. The work of the Professional Standards committee went much further in proposing 31 multicultural counseling competencies and strongly encouraged the American Association for Counseling and Development (AACD) and the counseling profession to adopt these competencies in accreditation criteria. The hope was to have the competencies eventually become a standard for curriculum reform and training of helping professionals.     

Resourceful Dialogues: Eliciting and Mobilizing Client Competencies and Resources

Within the social constructionist (narrative, solution-focused and collaborative language systems) therapies, therapists have increasingly focused on identifying and mobilizing clients’ resources and competencies. How such client resources and competencies are identified and elaborated can be considered empirical matters for analysts of therapeutic discourse. The present paper examines resourceful sequences of dialogue in 12 single session lifestyle consultations for how counsellors conversationally engaged consultees, and for what transpired within these sequences of dialogue. These sequences were micro-analyzed using conversation analysis and retrospective comments from consultees and therapists involved in these sequences were solicited using a videotaped replay procedure known as comprehensive process analysis [Elliott (1989). In M. Packer & R. B. Addison (Eds.), Entering the circle: Hermeneutic investigation in psychology (pp. 165–184). Albany, NY: SUNY Press]. The combined conversation analyses and related comments for three of the 23 videotaped passages analyzed are reported with the aim of enhancing therapists’ conversational practices in hosting resourceful dialogues with clients.

Educating Genetic Counselors in Australia: Developing an International Perspective

The demand for genetic counseling services is increasing worldwide. This paper highlights the Australian experience of genetic counselor education and the history of the profession. The relevance of local factors, including the healthcare system, the education system and the small population in the evolution of the 1-year training programs are considered as an alternative model for emerging programs. The development of the education and training processes compared to that of other countries namely the United States of America (USA), the United Kingdom (UK) and Canada is discussed. The importance of international collaborations between the programs, to facilitate academic discussion and possible curriculum innovations, and to maintain professional understanding between genetic counselors is emphasized. Core genetic counseling competencies have been published for the UK and USA and an Australian set is proposed. In conclusion future directions are considered, including international issues around genetic counseling certification, reciprocity, and the potential for an Australian role in training genetic counselors in South East Asia.     

The Application of Community Psychology Practice Competencies to Reduce Health Disparities

This article demonstrates the application of community psychology practice competencies to health disparities reduction. It begins with a discussion of changes and evolution of the maternal child health field over nearly three decades, then describes implications for community psychology practice and the application of practice competencies.     

The responsibilities of counsellor supervisors: A qualitative study

A study was carried out to investigate whether supervisors of counsellors considered themselves to be clinically responsible for the work of their supervisees, what responsibilities they considered themselves to have for the counsellors' work, and how they managed their responsibilities. The purpose of the study was to enhance the counselling profession's understanding of the responsibility of supervisors and of the supervisory relationship. The study was confined to supervisors working in private practice. Ten experts in the field of counselling and supervision were interviewed, using a semi-structured questionnaire. The interviews were analysed using the 'constant comparative method'. They revealed that the participants would not use the term 'clinical responsibility' to describe their responsibilities. There were mixed views about the nature of the responsibility of the supervisor when supervising counsellors practising independently. The participants indicated a preference to supervise only the most experienced counsellors, with whose practice they were already familiar and in whose work they already had considerable confidence. None of the supervisors interviewed considered themselves to be legally responsible for the counsellors' work. All the participants were aware that the risks associated with counselling in private practice could be considerable and had an acute sense of responsibility for the content of the work. Reluctance to take action against supervisees who were in breach of the code of ethics was expressed. There was scepticism about the requirement for them to have supervision for their supervisory work. Implications for the practice of counselling supervision and for the profession are discussed.     

Couple and Family Therapy Within the Current Pan-Canadian Context

Canadians take numerous approaches to couple and family therapy due in part to Canada’s diversity of people and geography, as well as the influence of the health care context, a central facet of our national identity. Tracing back to Nathan Epstein, the founder of family therapy in Canada, there continues to be a strong tradition of couple and family therapy within Canada which has international reach. Formal training in family therapy, as well as couple/marital therapy occurs largely outside of the scope of degree granting programs and university settings. The American Association for Marriage and Family Therapy has a strong presence in Canada, with six divisions across the country. Popular models of practice for Canada’s couple and family therapists include cognitive-behavioral therapy, solution-focused therapy, narrative therapy, emotionally-focused therapy, and Bowenian/intergenerational therapy. A growing number of training opportunities are becoming available across Canada, and the practice of couple and family therapy is becoming institutionalized as one of the core competencies for professions such as psychiatry. In this article, we examine the context of family therapy in Canada by examining its history, the unique accreditation standards, qualifications and organizations associated with family therapy, the relationship between couple and family therapy, and future directions for this field of practice.     

Is Student Counselling a Profession?

Moves towards professionalisation within student counselling are discussed as a case-study which may have wider applicability within counselling as a whole. The main approaches to defining a profession are described, and eight criteria are distinguished and applied to student counselling. It is concluded that student counsellors are some way from the 'ideal-type' profession. Account also needs to be taken, how ever, of moves towards some forms of deprofessionalisation' within the traditional professions. Current moves towards accreditation of individuals and courses within the Association for Student Counselling are welcomed.     

Genetic Counseling Supervisor Competencies: Results of a Delphi Study

Clinical supervision is a critical component of genetic counseling student preparation, yet empirically-determined competencies for genetic counseling supervisors are lacking. In this study a modified, two-round Delphi method was used to gain consensus about important genetic counseling supervisor knowledge, characteristics, and skills. Program directors and assistant directors of American Board of Genetic Counseling accredited genetic counseling programs in North America (N?=?33) were invited to participate and to recruit three experienced supervisors. Seventy-four individuals completed Round 1 and, of these, 61 completed Round 2. Approximately two-thirds were clinical supervisors from prenatal, pediatrics, cancer, and adult clinics; one-third were program directors. Participants rated the importance for genetic counseling supervisors of 158 items derived from supervision literature in allied health professions. They rated 142 items (89.9 %) as highly important. Content analysis of these items yielded six supervisor competency domains: Personal traits and characteristics; relationship building and maintenance; student evaluation; student centered supervision; guidance and monitoring of patient care; and ethical and legal aspects of supervision. The results provide a basis for training genetic counseling supervisors and for further research to refine and validate supervisor competencies.     

Identifying Competencies with Behavioral-Event Interviews

Coding competencies from behavioral-event interviews according to the principles of a new approach to assessment (McClelland, 1973) produces assessments that are reliable and validly associated with success as an executive. These assessments are not influenced by length of protocol or by performance in the preceding year. Bias is not a problem if both the interviewer and the coder are blind to executive success. In contrast to a traditional psychometric approach based on regression analysis, an algorithm based on competency scores predicted managerial success and improved performance across a number of samples. This algorithm identified potential outstanding performers as individuals whose scores reached designated tipping points within clusters of substitutable competencies. Experts' judgments of competencies needed or shown by executives in various positions agreed only moderately with competencies shown to be important by the data from behavioral-event interviews.     

Counselor Preparation and the Association for Spiritual,Ethical, and Religious Values in Counseling Competencies: An Exploratory Study

A national study of American Counseling Association members (N = 230) examined perceptions of the importance of the 14 Association for Spiritual, Ethical, and Religious Values in Counseling (ASERVIC) Spiritual Competencies and perceived ability to practice those competencies. Learning pathways to achieve knowledge of the ASERVIC Competencies were explored. Participants viewed the competencies as important but felt less able to consistently practice them. Prior exposure to the content of the competencies through spiritual topics covered in graduate school was positively correlated to perceived ability to practice the competencies. Recommendations were made for strengthening teaching of spirituality in counselor education.     

A Model of Therapist Competencies for the Empirically Supported Interpersonal Psychotherapy for Adolescent Depression

In order to treat adolescent depression, a number of empirically supported treatments (ESTs) have been developed from both the cognitive behavioral therapy (CBT) and interpersonal psychotherapy (IPT-A) frameworks. Research has shown that in order for these treatments to be implemented in routine clinical practice (RCP), effective therapist training must be generated and provided. However, before such training can be developed, a good understanding of the therapist competencies needed to implement these ESTs is required. Sburlati et al. (Clin Child Fam Psychol Rev 14:89–109, 2011) developed a model of therapist competencies for implementing CBT using the well-established Delphi technique. Given that IPT-A differs considerably to CBT, the current study aims to develop a model of therapist competencies for the implementation of IPT-A using a similar procedure as that applied in Sburlati et al. (Clin Child Fam Psychol Rev 14:89–109, 2011). This method involved: (1) identifying and reviewing an empirically supported IPT-A approach, (2) extracting therapist competencies required for the implementation of IPT-A, (3) consulting with a panel of IPT-A experts to generate an overall model of therapist competencies, and (4) validating the overall model with the IPT-A manual author. The resultant model offers an empirically derived set of competencies necessary for effectively treating adolescent depression using IPT-A and has wide implications for the development of therapist training, competence assessment measures, and evidence-based practice guidelines. This model, therefore, provides an empirical framework for the development of dissemination and implementation programs aimed at ensuring that adolescents with depression receive effective care in RCP settings. Key similarities and differences between CBT and IPT-A, and the therapist competencies required for implementing these treatments, are also highlighted throughout this article.