Renegotiating Sexuality Following an Acquired Disability: Best Practices for Counselors

Acquired physical disabilities are a critical issue that confronts many adults today, and they are projected to continue to increase over the next several years. For many individuals with acquired physical disabilities, the disabilities affect sexuality, thus requiring a renegotiation of disability and sexuality. This article reviews the extant literature on physical disabilities and sexuality and provides best practices for counselors to effectively address the needs of this growing population.     

Current Lynch Syndrome Tumor Screening Practices: A Survey of Genetic Counselors

An electronic survey of the National Society of Genetic Counselors Cancer Special Interest Group was conducted in July 2011 to assess Lynch syndrome tumor screening programs and identify barriers to implementation. Over half of respondents (52.8 %) reported having a routine Lynch syndrome tumor screening protocol for newly diagnosed colon and/or endometrial cancers, and approximately half of these used a universal approach. There was an increase in the number of those screening over time, especially in the past 3 years. Tumor screening methods varied; 34/53 (64.2 %) started with immunohistochemistry, 11/53 (20.8 %) started with microsatellite instability testing and 8/53 (15.1 %) performed both on newly diagnosed colorectal tumors. Just 21.7 % (23/106) of respondents indicated they have a tumor screening program in place for newly diagnosed endometrial cancers. Written consent is rarely obtained (7.1 %) and the method of how results were returned to the patient was variable among respondents. Prevalent barriers to implementation were concern about cost, bringing key players together and convincing medical staff of the necessity. Use of Lynch syndrome tumor screening is in clinical practice, but protocols vary widely. This survey provides a glimpse of current practices and common barriers, and identifies the need for tumor screening algorithms with outcomes data.     

Sex,Education, Age,and Cautiousness: Implications for Counselors

A cross‐sectional study of educated men and women showed that cautiousness, as measured by perceived problem‐solving ability, does not increase with age. Sex differences were nonsignificant. The results are discussed in terms of R. Schultz and J. Heckhausen's (1996) Life Span Model of Successful Aging.     

Disability and Family Intervention: A Perspective for Counselors

Thomas H. Hohenshil and Rodney K. Goodyear , Special Assignment Editors Disability and Family Intervention: A Perspective for Counselors Hilda P. Versluys, Physical Rehabilitation and Family Dynamics. Rehabilitation Literature, March-April, 1980, 41 (3–4), 58–65.     

Genetic Disorders of Intellectual Disability: Expanding our Concepts of Phenotypes and of Family Outcomes

Over the past two decades, great strides have been made in our understandings of how genetic conditions influence behavior and how such so-called “behavioral phenotypes” influence parent and family stress and coping. In this paper, we call for expansions in two directions. First, as a field we need to go beyond behavior in our concepts of phenotypes, to also include the many medical, physical, and other “non-behavioral” phenotypes that influence children’s everyday lives. Second, in examining how etiology-related phenotypes affect others, we need to go beyond the outcome of parental stress. In this regard, we focus on parental health, well-being, and various life choices, as well as how parenting children with specific genetic disorders can often lead to positive perceptions and outcomes. We end by discussing remaining research issues and how these two expansions relate to clinical practice.     

Employment and Compensation Practices For Counselors

A study was conducted concerning counselor employment and compensation practices in 115 public school districts, selected by criteria of relatively high salaries offered at various stages of education and experience. It was found that counselors had high levels of training in the districts investigated; that the bulk of districts offering relatively superior salaries sought and obtained the services of highly qualified persons; that inbreeding of counselors in such districts is rare; that the services of experienced counselors are sought by approximately half of the systems sampled; and that teacher training and/or experience are not necessarily prerequisite to employment in some one third of better paying districts. Involvement of practicing counselors in the screening of applicants for counseling positions was found to be uncommon.     

Review of Spinal Muscular Atrophy (SMA) for Prenatal and Pediatric Genetic Counselors

Spinal muscular atrophy (SMA) is an autosomal recessive neuromuscular condition with degeneration of the anterior horn cells in the spinal column. Five SMA subtypes exist with classification dependent upon the motor milestones achieved. Study of the SMN1 (survival motor neuron) and SMN2 genes as well as the concepts of the “2?+?0” carriers, gene conversion, de novo mutations and intragenic mutations allow for a better understanding of SMA. Detailing the carrier and diagnostic testing options further deepens the genetic counselor’s knowledge of SMA. A review of care guidelines and research options is included as this information gives a patient a well-rounded view of SMA. Although SMA is most commonly associated with the SMN1 gene, a number of spinal muscular atrophies not caused by genetic changes in this gene may be included as differential diagnoses until confirmatory testing can be completed. SMA is a complex condition requiring a detailed knowledge on the genetic counselor’s part in order to explain the disorder to the patient with clarity thus facilitating increased communication and decision making guidance with the patient.     

Elucidating Genetic Counseling Outcomes from the Perspective of Genetic Counselors

Outcomes in the field of genetic counseling have not been well-defined or categorized, despite pressures to provide evidence-based measures in all areas of healthcare. This study describes a process to elucidate and categorize a wide-ranging set of outcomes as characterized by diverse groups of practicing genetic counselors. Semi-structured focus groups were conducted at the National Society of Genetic Counselors 2013 NSGC Annual Education Conference during an educational breakout session. A general inductive qualitative research approach was utilized to code focus group notes, categorize them into themes, and compare them across specialty groups. A total of 107 individuals participated in 14 focus groups, consisting of specialists in cancer (n = 20), general genetics (n = 40), prenatal genetics (n = 11), and “other” (n = 36). Of the twelve genetic counseling outcomes themes identified, the most common across focus groups included: 1) appropriateness of testing and accuracy of results interpretation; 2) psychosocial outcomes; 3) adherence to or receipt of appropriate medical management; and 4) patient and provider knowledge. Data assessed by specialty demonstrated similarities in outcomes themes, suggesting that a common set of genetic counseling outcomes would likely be appropriate to cover the majority of needs for the profession. Results can serve as a platform from which to build a more well-defined and comprehensive set of outcomes.     

Accountability Practices of School Counselors: A National Survey

A national survey of practicing school counselors was conducted to obtain information regarding (a) their accountability practices, (b) barriers to the collection of accountability data, (c) the relationship between involvement in accountability efforts and demographic variables, and (d) strategies for increasing activity in the area of accountability. Results indicated that 55% of the 239 respondents were collecting accountability data, often for the purpose of enhancing their professional growth and development. The 108 school counselors not involved in the collection of such data identified lack of familiarity with procedures and time constraints as major barriers. Respondents indicated a need for additional preservice and in-service training, as well as for dissemination of exemplary procedures.     

Psychosocial Adaptation to Chronic Illness and Disability: A Primer for Counselors

In this article, the authors discuss 3 broad domains of psychosocial adaptation to chronic illness and disability. These include the dynamics (basic concepts, psychosocial responses, and coping strategies) typically associated with the process of adaptation to disabling conditions, assessment of adaptation as evidenced by 6 commonly used measures, and intervention strategies applied to facilitating coping with and adaptation to chronic illness and disability.     

Clinical Supervision of Substance Abuse Counselors: Current and Preferred Practices

A national survey of substance abuse counselors (N = 134) was conducted to learn their current and preferred supervision practices. Results are presented for the entire sample, as well as within-group comparisons based on counselor recovery status and education level.     

Meditation and Appropriation: Best Practices for Counselors Who Utilize Meditation

Support for meditation is found across academic communities and popular culture. Although the application of meditative practices has yielded positive treatment outcomes, larger purposes of the practice are perhaps lost in the empirically driven West, thus driving a risk of appropriation. In response, the authors outline 4 implications for best practice for counselors who aspire to engage in the culturally responsible use of meditative practices.     

The Logic of Deferral: Educational Aims and Intellectual Disability

The educational aims described by educational philosophers rarely embrace the full range of differences in intellectual ability, adaptive behavior, or communication that children exhibit. Because envisioned educational aims have significant consequences for how educational practices, pedagogy, and curricula are conceptualized, the failure to acknowledge and embrace differences in ability leaves open the question of the extent to which students with intellectual disabilities are subject to the same aims as their “typically-developing” peers. In articulating and defending valued aims of education, educational philosophers tacitly or expressly concede that particular aims will be ill suited to many children with intellectual disabilities, and that separate aims will therefore apply to them. This paper evaluates the philosophical reasoning behind this conclusion that some people, by necessity, must be governed by separate educational aims, to be decided separately and secondarily. The author calls this the “deferral stance.” First, the paper outlines concerns about a particular ability-biased social and epistemic context in which theorizing about educational aims takes place. The author then examines assumptions that underpin the logic of deferral, arguing that the logic proves flawed when subjected to conceptual and empirical scrutiny. The paper concludes by outlining an inclusive approach—the affirmative stance—to theorizing about educational aims that resists the logic of exclusion and deferral.     

Genetic Counseling: Implications for Community Counselors

A special issue of the Journal of Health Psychology (Vol. 7, No. 2, 2002) was reviewed. The articles covered a variety of qualitative studies conducted using an interpretive phenomenological analysis method to examine the interviews with people who had received genetic testing and counseling. Implications for the broader counseling field were also presented.