What Do Genetic Counselors Learn on the Job? A Qualitative Assessment of Professional Development Outcomes

Professional development is an important goal for professionals in human service fields such as counseling, teaching, and nursing. However, there are relatively few published papers on this topic specific to genetic counselors, and no studies systematically examine the outcomes of their professional development. This study was designed to investigate genetic counselors’ perceptions of their post-degree learning and to compare themes in their learning to those of psychotherapist professional development models. Two hundred ninety-three genetic counselors completed the demographics portion of an anonymous online survey, and of these, 185 also responded to at least one of two open-ended items: What is the most important thing you have learned about yourself in your practice as a genetic counselor? and What advice would you give to genetic counseling students just starting their career? An interpretative content-analysis method was used to extract three major themes: Intrapersonal lessons, Interpersonal lessons, and Professional lessons. Training and practice implications and research recommendations are provided.     

Walking the yellow brick road

This article uses the story of The Wonderful Wizard of Oz (L. F. Baum, 1900) as a metaphor for exploring career counseling issues related to self‐deception, loss, and the search for the “all‐knowing” expert. The dynamics of the story can be applied to both counseling practice and counselor training. Cross‐cultural issues are also considered.     

Client Perceptions of the Impact of Genetic Counseling: An Exploratory Study

Twenty-eight former genetic counseling clients seen at a major Midwestern university were recruited to be interviewed about their genetic counseling experiences, including most and least helpful aspects, what they learned, how this information impacted their decision-making, and their perceptions of their genetic counselors' behaviors. Responses were inductively analyzed, and several themes were identified, including: Clients sought genetic counseling to obtain genetic-medical information; a majority accurately recalled this information; genetic counseling influenced decisions for about 50% of the sample; decision-making was affected by several extra-session factors; a majority experienced distress during the session; most perceived genetic counselor responses as nondirective and liked this approach; counselor behaviors regarded as directive involved discussion of pregnancy termination; participants disagreed about the need for and provision of genetic counselor support; most regarded the session as helpful and stated that they would seek genetic counseling again. Suggestions for addressing these issues in practice and research are given.     

Are Genetic Counselors and GLBT Patients “on the Same Page”? an Investigation of Attitudes, Practices, and Genetic Counseling Experiences

Gay, lesbian, bisexual, and transgender (GLBT) individuals comprise a growing patient population in genetic counseling, yet literature on working with this population is scarce. This study sought to investigate GLBT patient experiences in genetic counseling and genetic counselor attitudes and practices when counseling GLBT patients. Twenty-nine GLB individuals who had previously participated in genetic counseling, and 213 genetic counselors completed online surveys. No individuals identifying as transgender participated. The patient survey assessed disclosure of orientation, discrimination in genetic counseling, and quality of services received. The counselor survey assessed comfort with and attitudes about counseling GLBT patients, disclosure of counselor orientation, and whether they counsel differently with this population. Every patient denied experiencing discrimination during their session, but 17% reported their genetic counselor assumed they were heterosexual, and 45% indicated intake forms were not GLBT-inclusive. A majority of counselors (91%) reported having counseled GLBT patients and indicated they were comfortable doing so (86%), and 72% indicated no differences in their counseling approaches with GLBT patients. Few counselors (17%) received training in GLBT issues, and most (61%) desired such education. Additional findings and practice and research recommendations are presented.     

Web‐Assisted Career Counseling

For the past 20 years counselors have used computer‐based career information systems to assist clients with career planning and job hunting. Much of the same this information is now available on the Internet and can be accessed without the aid of a counselor. Such developments are likely to have a major impact on employment counseling practices. This article outlines selected Web‐assisted counseling issues that are likely to affect counselors over the next few years and summarizes the career services currently available on the World Wide Web.     

Lesbians With Physical Disabilities: A Qualitative Study of Their Experiences With Counseling

The authors interviewed 25 lesbians with physical disabilities about their counseling experiences. Using a phenomenological qualitative approach, the authors identified 9 themes. Five themes addressed participants' perceptions of their counselors: general satisfaction or dissatisfaction, counselors' general effectiveness, counselors' awareness and education regarding sexual orientation and/or disability, discrimination and bias, and counselor identity. Three themes related to the participants' attempts to negotiate the counseling process: coming out or self‐disclosure, self‐advocacy, and accessibility/accommodations. The final theme related to depression.     

“I Didn’t Know It Existed Before You Called”: Protestant Clergy Experience, Education and Perceptions Regarding Genetics

Despite the intrinsic role religious/spiritual (hereafter, R/S) beliefs have in patient clinical decision-making and crisis coping, there is little research exploring the relationship that exists between clergy (professionals who provide R/S counsel and guidance) and genetic counseling patients. This qualitative, exploratory study was designed to explore Protestant clergy (N?=?8) perceptions of and experience with genetics-related issues. Data analysis revealed that a wide range of R/S perceptions regarding genetics-related issues exist within Protestantism, Protestant clergy have a basic understanding of genetic testing and conditions, and while directive counseling is inherent to Protestant clergy counseling, there appears to exist two opposing styles: unbiased and biased. Based on this information, there are two main implications for genetic counseling clinical practice. First, R/S assessments need to be increasingly implemented into genetic counseling sessions, so that the psychosocial needs of patients with specific R/S beliefs can be identified and addressed. An increase in R/S assessments may be accomplished by increased exposure in genetic counselor training, continuing education opportunities, and by establishing relationships with board-certified, professional chaplains. Second, genetic counselors can influence the genetic education and experience of clergy by raising awareness within their own R/S assemblies. Doing so can also serve to further educate genetic counselors in the R/S beliefs of their own traditions, thus increasing sensitivity, empathy and the quality of care provided.     

An empirical examination of client attitudes towards online counseling.

Trends over the past decade have shown that online counseling has grown in terms of popularity among consumers and clinicians alike; however, little, if any empirical evidence exists that examines client attitudes towards online counseling as alternative to traditional face-to-face therapy. Therefore, this study investigated client attitudes towards online counseling. Data was collected from 48 e-clients who received online counseling at the Center for Online Addiction. Variables such as client perceptions and concerns about using online counseling, clients' reasons for seeking online counseling over in-office treatment, and demographic profiles of e-clients were assessed. Results suggested that Caucasian, middle-aged males, with at least a four-year bachelors degree were most likely to use online counseling and anonymity, convenience, and counselor credentials were the most cited reasons they sought online counseling over in-office treatment. The lack of perceived privacy and security during online chat sessions and the fear of being caught while conducting online sessions were the main concerns reported by e-clients. A better understanding of client motives and perceptions towards online counseling helps to guide treatment in using the Internet as a clinical tool, especially as the Internet becomes increasingly more available in previously remote markets and the field of online counseling continues to grow.     

Integrating Personal and Career Counseling: A Challenge for Counselors

In recent years career counseling has often been viewed as separate and distinct from personal counseling, ignoring a long tradition in the career development field that has consistently recognized the importance of personality factors in the process of choosing and maintaining a career. This paper argues for the use of an eclectic career counseling model that embraces both personality and career development theories. The model requires the counselor to be able to move back and forth between the active and directive role of the career counselor and the facilitative and exploratory role of the personal counselor. A case is presented to demonstrate its application and implications for counseling and training are discussed.     

Genetic Counseling Supervisors’ Self-Efficacy for Select Clinical Supervision Competencies

Supervision is a primary instructional vehicle for genetic counseling student clinical training. Approximately two-thirds of genetic counselors report teaching and education roles, which include supervisory roles. Recently, Eubanks Higgins and colleagues published the first comprehensive list of empirically-derived genetic counseling supervisor competencies. Studies have yet to evaluate whether supervisors possess these competencies and whether their competencies differ as a function of experience. This study investigated three research questions: (1) What are genetic counselor supervisors’ perceptions of their capabilities (self-efficacy) for a select group of supervisor competencies?, (2) Are there differences in self-efficacy as a function of their supervision experience or their genetic counseling experience, and 3) What training methods do they use and prefer to develop supervision skills? One-hundred thirty-one genetic counselor supervisors completed an anonymous online survey assessing demographics, self-efficacy (self-perceived capability) for 12 goal setting and 16 feedback competencies (Scale: 0–100), competencies that are personally challenging, and supervision training experiences and preferences (open-ended). A MANOVA revealed significant positive effects of supervision experience but not genetic counseling experience on participants’ self-efficacy. Although mean self-efficacy ratings were high (>83.7), participant comments revealed several challenging competencies (e.g., incorporating student’s report of feedback from previous supervisors into goal setting, and providing feedback about student behavior rather than personal traits). Commonly preferred supervision training methods included consultation with colleagues, peer discussion, and workshops/seminars.     

The Association Between Implicit Racial Bias and Mindfulness in Mental Health Practitioners

The mental health research literature on implicit bias is limited (Boysen, 2009), and little is known about how factors that are associated with self‐perceived multicultural counseling awareness, such as mindfulness, relate to implicit racial bias in practicing mental health professionals. Using a correlational research design, we examined the association between mental health practitioners' implicit bias, self‐perceived multicultural counseling competence, facets of dispositional mindfulness, and mindfulness practices. A total of 137 mental health professionals completed an online questionnaire. Results revealed a negative relationship between the observing component of dispositional mindfulness and the implicit racial preference associating White and “good” words. In addition, results indicated that the frequency of engaging in mindfulness practices negatively predicted implicit racial preference associating White and good. Implications for counselor training, practice, and future research are discussed.     

The School Change Feedback Process: Creating a New Role for Counselors in Education Reform

The authors present the results of a multiyear collaborative research project that involved a counselor educator, graduate‐level school counseling students, and school personnel in defining a new role for counselors in education reform. This collaborative effort was based on an innovative conceptual framework that informs school counselors about specific schooling processes that can either enhance or hinder student academic, personal/social, and career development.     

Who Are the Next Generation of Genetic Counselors? A Survey of Students

Genetic counseling students were surveyed about their backgrounds, application process to genetic counseling programs, and career motivations and plans. Program directors from 27 accredited programs were asked to distribute 362 surveys to students. Fifty-two survey items assess demographics; sources of support for pursuing a genetic counseling career (information about genetic counseling, encouragement/discouragement from others); career motivations (reasons for applying and for becoming a genetic counselor); and career certainty. Two hundred and thirty-five usable surveys were returned (64.9% usable return rate). Most respondents were Caucasian females (mean age = 25.4 years). About 13% identified as ethnic minorities, and about one-third reported family histories of a genetic condition(s). Most respondents learned about the field in classes, and most were strongly encouraged by family and friends to pursue genetic counseling. Reasons rated as most important for becoming a genetic counselor included helping others and intellectual stimulation. Recruitment, training, and research recommendations are given.     

Professional Counseling in Hong Kong

The authors provide an overview of recent developments in professional counseling as related to schools, career counseling, and community services in Hong Kong. The strategic position of counseling professionals, counseling associations, and counselor certification is discussed. The future development of counseling in Hong Kong is also considered.     

An Interview With Sunny Hansen: Pioneer and Innovator in Counseling and Career Development

During her 45‐year career, Sunny Hansen was a pioneer and innovator in counseling and career development. She has lived the holistic life about which she writes and teaches. In this interview, she discussed the major influences on her life, the evolution of her professional career from English and journalism teacher to counselor and counselor educator, and her teaching and scholarship. She also shared her insights on balancing life roles, holistic life planning, and the counselor as a change agent.     

Assessment Use by Counselors in the United States: Implications for Policy and Practice

Although assessment use is a professional activity recognized by every major counseling organization, little is known about which assessments are used in counseling. In this study, 926 respondents from a random national sample of counselors reported their use of personality, projective, career, intelligence/cognitive, educational/achievement, clinical/behavioral, and environmental/interpersonal tests. Test rankings by frequency of use and comparisons by type of counselor and type of test are reported. Implications for policy and practice are discussed.     

A National Survey of AIDS Training in Counselor Education Programs

A review of the literature suggests that counseling professionals may not be receiving substantive training related to AIDS. In this article, all U.S. counselor education programs were surveyed to determine the extent of such training. The responding programs (N = 243) identified AIDS as a high priority for inclusion in curricular programming, yet nearly 40% of the responding programs did not include any AIDS training in their curricula. Implications for counselor education and the counseling profession are discussed, and suggestions are made for including AIDS-related training in programs.     

social network sites: a starting point for career development practitioners

This action research study explores the career influence of social network sites (SNSs) by examining 14 web‐based articles that consider the risks and opportunities of SNSs from a job search perspective. Three themes are discussed: user visibility, self‐presentation, and network connections. Practical strategies are identified to help career development professionals update their counseling approaches and engage clients in conversations concerning privacy issues, negotiating public and private boundaries on the web, self‐presentation, and applying networking best practices to SNSs.