Preferences of Individuals in Committed Relationships About Premarital Counseling

Premarital educational and counseling programs provide one way of addressing many of the risk factors associated with couple distress and divorce. Unfortunately, few couples who are offered premarital programming engage in the programs offered. This study examined preferences for premarital programming in a sample of individuals in committed relationships who intended to marry the current partner. Results suggested that premarital counseling conducted by a therapist and of short duration, following engagement, was most preferred. The most preferred topics/contents were related to communication and conflict resolution.     

Genetic Counseling for the Orthodox Jewish Couple Undergoing Preimplantation Genetic Diagnosis

Orthodox Jewish patients who seek genetic counseling are often placed in a difficult position of having to choose between their desire to follow Jewish religious instruction (halacha) and following the advice of the genetic counselor. In this article we will present the work of the Puah Institute based in Jerusalem that is dedicated to assisting and guiding such couples to navigate through the medical system and medical recommendations and create a harmony between modern genetic counseling and the Orthodox Jewish tradition. In light of the expanding use of preimplantation genetic diagnosis (PGD) for a variety of medical and non-medical conditions, this dilemma is even more poignant. There is an ethical debate regarding PGD and the correct parameters for its use. Here we present the Orthodox Jewish view of the use and abuse of PGD. We present three case studies that sought the assistance and guidance of the Puah Institute. Each of these cases raises ethical dilemmas for the genetic counselor and for the rabbinic counselor. We discuss; the status of the embryo, the status of a carrier of a genetic abnormality and whether PGD is an obligation or good practice. In addition we deal with whether PGD and the search for the desired traits can be defined as eugenics or not.     

Multicultural Counseling and the Orthodox Jew

The cultural diversity literature largely ignores the effects of religion, and especially Judaism, on counseling and psychotherapy. The author reviews the meager and mostly anecdotal accounts relating to Orthodox Jews in the literature of several related disciplines, including counseling, social work, psychology, and psychiatry. The objective is to identify the barriers, institutional and personal, that must be overcome before the Orthodox Jew can receive adequate mental health care and to suggest recommendations for clinical practice.     

Genetic Counseling for Personal Genomic Testing: Optimizing Client Uptake of Post-Test Telephonic Counseling Services

The field of genetic counseling faces a broad challenge: many potential clients may not be aware of the value and benefit of genetic counseling services, and therefore may not utilize those services. Navigenics is a personal genomic testing company that provides telephonic genetic counseling services for multifactorial diseases and pharmacogenetics. When first offered in 2008, utilization of the Navigenics genetic counseling service was less than expected. To explore the basis for under-utilization and potential mechanisms for increasing uptake, Navigenics initiated a quality improvement study, in which three different methods of engaging clients in the uptake of genetic counseling services were assessed over the course of 1 year. Outcomes showed significant differences in uptake rates between methodologies (7.5%, 24.6%, and 60.1%), yielding an 8-fold increase in service utilization when post-test telephonic outreach to all clients was performed. Further, utilization spanned all risk levels based on client results, evidence that not only clients with high-risk results were motivated to engage in the genetic counseling service. This research indicates that implementing strategies to educate clients about genetic counseling can positively impact client engagement and utilization of available services.     

A New Model for Premarital Counseling Within the Church

The divorce rate among Christians is higher than that of the average population. This statistic is cause for concern and change in church preparation for marriage. Although instruction for pastoral premarital counseling exists, most churches do not follow the minimum guidelines. Churches need a new proactive model for building good marriages rather than mending broken ones. This article presents one such model for marriage preparedness. A graduate of Southwestern Baptist Theological Seminary     

Family size and psychological functioning in the Orthodox Jewish community

Caring for children is a known psychosocial stressor; however, its effects on psychological functioning may have substantial cross-cultural variance. We explored relationships between family size and a variety of psychological outcomes among Orthodox Jews in four separate studies: (1) an international treatment-seeking sample (n?=?82), (2) a community sample from Canada (n?=?226), (3) an out-patient clinical sample from greater New York (n?=?82), and (4) a large dyadic sample of Israeli couples (n?=?789). Surprisingly, results suggested that family size was not associated with greater stress, anxiety, depression, global functioning, family functioning, family communication, family satisfaction, or even parenting stress. It is possible that the high religious value placed on family life as well as structural adaptions in families buffer against potential stressors associated with child rearing, and further research on these potential effects is warranted.     

Counseling Adolescents and the Challenges for Genetic Counselors

Genetic counselors may have an important role in helping the adolescent make an informed decision with regard to genetic testing and in helping them to adjust to genetic risk information. However, counseling techniques that are used with adults may not be always be suited to the adolescent population. Adolescence is a time of development during which separation from the family and formation of identity is achieved. The process of this development may impact the genetic counseling relationship. Family relationships may have a strong influence on the client's decision to have genetic testing. Additionally, it may be difficult to engage the client as adolescents may not have the ability to think abstractly and consider the short and long term consequences of genetic testing. It is helpful therefore to discuss the counseling process and techniques that may be useful when counseling these clients. This paper presents two case studies that illustrate some of the difficulties that may occur when counseling adolescents for genetic testing. The authors' have reflected on their clinical experience with these clients and this is presented here to add to the growing literature on this subject.     

Correlates of Genetic Counseling and Testing Among Orthodox Jews

One hundred and thirty-six Orthodox Jews responded to questions about their family background, disability attitudes, and their participation in genetic counseling and testing. Findings showed that only birth order and the presence of a disabled family member correlated with increased chances of an individual going for genetic counseling/testing. Results are discussed in the context of the contemporary sociology of Orthodox Judaism, with a particular focus on better understanding the experience of having a disabled family member.     

Providing Counseling for Individuals With Alzheimer's Disease and Their Caregivers

Alzheimer's disease is a progressive condition that results in brain wasting and eventual death. With its increasing diagnosis rate, counselors will likely acquire clients with Alzheimer's disease or their caregivers. Important background information and several practical counseling methods are provided that may assist counselors working with this population.     

The Perspectives and Challenges of Primacy and Synodality in the Orthodox Church Today

The Holy and Great Council of the Orthodox Church in 2016 should be perceived and received as a genuine manifestation of synodality at the beginning of the 21st century. It has reminded us that it is within the exercise of primacy and synodality at the universal level that the unity and the orthodoxy of the church is guaranteed. Its message referred to the proposal for the Holy and Great Council to become a regular institution to be convened every seven or ten years. By saying this, the Holy and Great Council has perhaps inaugurated a new era of synodality in the Orthodox Church on the universal level. This is perhaps the greatest contribution of the Holy and Great Council in an era of globalization, when the pastoral problems encountered by each local autocephalous church, due to a growing secularization of the world, are very similar and need a common synodal response.     

A Comparative Study of the Intelligence of Jewish Preschool Boys and Girls of Orthodox Parentage

Children aged 2-51/2 to 5-1/2 were pretrained on two three-choice simple discrimination problems presented consecutively, which were followed by training on 10 unique oddity sets. Transfer data were obtained from those Ss who learned the oddity problems by presenting five new oddity sets.

All three Groups learned the second pretraining problem more quickly than the first, although on both problems the two older Groups learned faster than the youngest Group. Nearly all the Ss learned to select the correct stimuli on the 10 three-choice oddity sets. Sixty-four percent of the children between 2-1/2 and 4-1/2 evidenced transfer to the five new oddity sets, indicating comprehension of the oddity relationship and the ability to respond on the basis of this higher-order solution. This finding is contrary to that predicted by contemporary theories of cognitive development (e.g., 3, 8).

The remaining Ss had either learned to choose the odd stimulus, but were unable to maintain a relational choice when presented with new sets, or solved the original discrimination by applying specific solutions to a 10-problem simultaneous three-choice discrimination problem.     

Grandparents and Stepgrandparents: Challenges in Counseling the Extended-Blended Family

Remarriage of parents may bring new grandparents and stepgrandparents into the lives of children, creating new family structures and needs for adjustment. The extended-blended family may benefit from specific counseling interventions.     

An Assessment of Genetic Counseling Services for Individuals with Multiple Sclerosis

Multiple sclerosis (MS) affects up to 1/500 Canadians. The University of British Columbia MS Clinic (UBC Clinic) is the only MS clinic in Canada (and likely internationally) that routinely offers genetic counseling to patients and their families. A typical session includes the collection of family history and demographic data, discussion of the inheritance of MS, interpretation of family-specific recurrence risks and psychosocial counseling. The aims of this study were to explore patients’: 1) expectations of the genetic counseling session; 2) understanding of the etiology of MS (both pre and post-session); and 3) post-session perceptions of genetic counseling. A two-part questionnaire to assess genetic counseling services was distributed before and after sessions to all consenting patients seen during the period October 1, 2008 to February 28, 2009 inclusive. Sixty-two completed questionnaires were analysed. Genetic counseling was found to significantly increase the number of individuals who were able to correctly identify the etiology of MS (p?<?0.001). Patient satisfaction with genetic counseling was high, with an average satisfaction score of 32.4/35 (92.6 %). Of those who provided comments (n?=?42/60) regarding the usefulness of the genetic counseling session, 95.2 % reported it useful (n?=?40/42). Findings suggest that genetic counseling is effective in increasing patients’ knowledge of the etiology of MS and is viewed by patients as a useful service. Based on the high level of positive feedback regarding genetic counseling by the study sample, this study suggests that the services provided by genetic counselors may be beneficial for patients with MS seen in other centers.     

Satisfaction and Stressors in a Religious Minority: A National Study of Orthodox Jewish Marriage

The paucity of mental health studies with Orthodox Jews makes culturally competent counseling care unlikely. In this large‐scale investigation of marriage among Orthodox Jews, most respondents reported satisfaction with marriage and spouse, although satisfaction was highest among recently married couples. The most significant stressors were finances, communication, physical intimacy/sexuality, time pressures, and in‐law conflicts. Counseling interventions are discussed. La escasez de estudios sobre salud mental en poblaciones de judíos ortodoxos limita la posibilidad de ofrecer un cuidado de consejería culturalmente competente. En esta investigación a gran escala sobre el matrimonio entre judíos ortodoxos, la mayoría de los participantes indicaron satisfacción con su matrimonio y esposo/a, aunque la satisfacción fue mayor entre las parejas recién casadas. Los elementos estresantes más significativos fueron las finanzas, la comunicación, el contacto íntimo/sexualidad, la falta de tiempo, y los conflictos con la familia política. Se discuten intervenciones para la consejería.     

Ethical Challenges in the Treatment of Individuals With Intellectual Disabilities

The effective provision of psychotherapy services to individuals with intellectual disability requires consideration of ethical issues related to clinical competence, access to services, obligations to multiple parties, guardianship, and appropriate assessment practices. This article provides an overview of major ethical considerations with guidance for clarifying and resolving common ethical concerns. Psychologists are encouraged to expand access to psychotherapy services for this population while maintaining awareness of potential modifications, training needs, and boundaries of professional competence. The authors provide recommendations and resources for effective and ethical treatment of psychotherapy clients with intellectual disabilities.     

Assessing and treating sexual dysfunctions in Orthodox Jewish couples: a summary of 41 consecutive cases

ABSTRACT

Orthodox Jews are a distinct subgroup with specific beliefs and values towards sexuality, reproduction, modesty, and openness to mental health treatment. This paper reviews the treatment of 41 Orthodox Jewish couples who presented for sex therapy. Most couples were referred by a rabbinical leader. The most common presenting problem was an unconsummated relationship; present in 27 couples. In 34 couples the initial presenting complaint was a male sexual problem yet in 20 of 41 couples both partners described having some sexual problem. Almost 50 per cent of both men and women were also diagnosed with a comorbid psychiatric disorder, which was almost always previously undiagnosed. The most common presenting problems were vaginismus, male inhibited arousal, and/or inhibited male orgasm. Two case examples illustrate some adaptations to assessment and treatment that can be helpful in treating sexual problems in Orthodox Jewish couples.     

Using REBT in Jewish, Christian, and Muslim Couples Counseling in the United States

This article addresses how marriage functions within Judaism, Christianity, and Islam. Case studies of couples within these three religions are used to demonstrate how rational emotive behavior therapy (REBT) can help address marital issues within couples counseling of religious individuals in a manner that supports the couples’ religious values but decreases disturbance associated with religious issues within marriage.