International Exchange Training in Genetic Counseling: An Exploration of the Value in Exchange Experiences

International exchange training in genetic counseling is increasing, but research examining these experiences is lacking. In this study 309 genetic counseling students and genetic counselors completed an anonymous survey investigating six major research questions: (1) How prevalent are international genetic counseling experiences? (2) What types are pursued and why? (3) What supports and barriers exist? 3) What are the demographic characteristics of individuals accruing international experience? (5) Does international experience promote professional development? and (6) Do genetic counseling students and professionals perceive international experiences as beneficial? Most respondents were Caucasian females born in one of 25 countries. The most prevalent experiences involved either clinical observation or clinical training. Common motivations for pursuing international experience were personal growth, exposure to a different healthcare system, and travel opportunities. Outcomes included professionally-relevant experience and personal growth. Barriers included finances, limited availability of opportunities, and for those without international experience, family responsibilities. Additional findings, practice and training implications, and research recommendations are provided.     

Characterizing Clinical Genetic Counselors’ Countertransference Experiences: an Exploratory Study

Countertransference (CT) refers to conscious and unconscious emotions, fantasies, behaviors, perceptions, and psychological defenses genetic counselors experience in response to any aspect of genetic counseling situations (Weil 2010). Some authors theorize about the importance of recognizing and managing CT, but no studies solely aim to explore genetic counselors’ experiences of the phenomenon. This study examined the extent to which clinical genetic counselors’ perceive themselves as inclined to experience CT, gathered examples of CT encountered in clinical situations, and assessed their CT management strategies. An anonymous online survey, sent to NSGC members, yielded 127 usable responses. Participants completed Likert-type items rating their CT propensities; 57 of these individuals also provided examples of CT they experienced in their practice. Factor analysis of CT propensities tentatively suggested four factors: Control, Conflict Avoidance, Directiveness, and Self-Regulation, accounting for 38.5% of response variance. Thematic analysis of CT examples yielded five common triggers: general similarity to patient, medical/genetic similarity, angry patients, patient behaves differently from counselor expectations, and disclosing bad news; six common manifestations: being self-focused, projecting feelings onto the patient, intense emotional reaction to patient, being overly invested, disengagement, and physical reaction; five CT effects: disruption in rapport building, repaired empathy, over-identification, conversation does not reach fullest potential, and counselor is drained emotionally; and three management strategies: recognizing CT as it occurs, self-reflection, and consultation. Results suggest CT is a common experience, occurring in both “routine” and emotionally complex cases. Training programs, continuing education, and peer supervision might include discussion of CT, informed by examples from the present study, to increase genetic counselor awareness and skills for managing the phenomenon.     

Illustrating a mixed-method approach for validating culturally specific constructs

The purpose of this article is to illustrate a mixed-method approach (i.e., combining qualitative and quantitative methods) for advancing the study of construct validation in cross-cultural research. The article offers a detailed illustration of the approach using the responses 612 Sri Lankan adolescents provided to an ethnographic survey. Such surveys offer a connection between the primary methodologies used (i.e., ethnographic and factor analytic approaches) as they are predicated on qualitative inquiry and allow for the application of factor analysis. If the qualitatively derived constructs are comparable to factor analytic results, then triangulation across methods is achieved and a survey can be developed that is sensitive to culturally specific phenomena. The illustration of this approach uses data from an ethnographic survey of self-concept, as defined by Harter (1999) [Harter, S. (1999). The construction of the self: A developmental perspective. New York: The Guilford Press]. The construction of the self: A developmental perspective. New York: The Guilford Press]. The overall finding is that three constructs emerged from the factor analysis and were reconciled with the ethnographic data.     

An Investigation of Genetic Counselor Experiences in Peer Group Supervision

Peer supervision groups have been studied in counseling fields including psychotherapy and social work. However, limited research exists regarding genetic counselor peer supervision groups. In the present study five major research questions were investigated: (1) How prevalent is peer group supervision among genetic counselors? (2) What motivates genetic counselors to join and continue to seek peer group supervision? (3) What comprises the content, agenda, and structure of group meetings? (4) What are participants’ perceptions of group dynamics, including conflicts, cohesion, and leadership? and (5) What are the perceived benefits and limitations of participating in peer group supervision? A total of 214 genetic counselors completed an online survey, and 70 (34.8%) reported being involved currently in peer group supervision. Fifteen of these 70 respondents were interviewed regarding their experiences in peer group supervision. Inductive analysis of their responses yielded 11 domains and 37 categories. Practice implications and research recommendations are discussed.     

The visual metacognition questionnaire: a measure of intuitions about vision

Recent research has revealed a series of striking limits to visual perception. One important aspect of these demonstrations is the degree to which they conflict with intuition; people often believe that they will be able to see things that experiments demonstrate they cannot see. This metacognitive error has been explored with reference to a few specific visual limits, but no study has yet explored people's intuitions about vision more generally. In this article we present the results of a broad survey of these intuitions. Results replicate previous overestimates and underestimates of visual performance and document new misestimates of performance in tasks that assess inattention blindness and visual knowledge. We also completed an initial exploratory factor analysis of the items and found that estimates of visual performance for well-structured information tend to covary. These results represent an important initial step in organizing the intuitions that may prove important in a variety of settings, including performance of complex visual tasks, evaluation of others people's visual experience, and even the teaching of psychology.     

A Survey of Clinical Supervision in Genetic Counseling

Three hundred and thirty-five full members of the National Society of Genetic Counselors completed a survey concerning the nature of clinical supervision for genetic counseling students. Slightly over half (54.3%, n = 182) had provided clinical supervision within the past 5 years. Of those who supervised, 66.7% had 5 years or less supervision experience, and 55% had supervised 10 or fewer students. The majority became supervisors because they enjoy teaching and contributing to the profession. Common reasons for not supervising include no local graduate program, and had never been asked to supervise. Live supervision is the most prevalent student evaluation method: every supervisor reported providing one-on-one oral feedback, and 47.3% indicated that they always provide feedback immediately following a counseling session. The most frequent challenges involve students who lack technical knowledge and who fail to incorporate feedback. Training, policy, and research implications are discussed.     

Development of a Congruence Scale Based on the Satir Model

The Congruence Scale derives from the construct of congruence, the goal of therapeutic change in the Satir model. Congruence is conceptualized as a state of awareness, openness, and connection in three human dimensions: the Intrapsychic, Interpersonal, and Universal-Spiritual. Procedures in developing the Congruence Scale are described. Results provide evidence of concurrent validity with the Satisfaction With Life Scale and the Outcome Questionnaire. Four factors of the Congruence Scale are extracted from factor analysis: Intrapsychic-Interpersonal, Spiritual, Creative, and Communal. Further research to confirm the reliability and validity of the congruent construct is recommended.     

Fetal testosterone and autistic traits

Studies of amniotic testosterone in humans suggest that fetal testosterone (fT) is related to specific (but not all) sexually dimorphic aspects of cognition and behaviour. It has also been suggested that autism may be an extreme manifestation of some male‐typical traits, both in terms of cognition and neuroanatomy. In this paper, we examine the possibility of a link between autistic traits and fT levels measured in amniotic fluid during routine amniocentesis. Two instruments measuring number of autistic traits (the Childhood Autism Spectrum Test (CAST) and the Child Autism Spectrum Quotient (AQ‐Child)) were completed by these women about their children (N=235), ages 6–10 years. Intelligence Quotient (IQ) was measured in a subset of these children (N=74). fT levels were positively associated with higher scores on the CAST and AQ‐Child. This relationship was seen within sex as well as when the sexes were combined, suggesting this is an effect of fT rather than of sex per se. No relationships were found between overall IQ and the predictor variables, or between IQ and CAST or AQ‐Child. These findings are consistent with the hypothesis that prenatal androgen exposure is related to children exhibiting more autistic traits. These results need to be followed up in a much larger sample to test if clinical cases of ASC have elevated fT.     

Gay, Lesbian, and Bisexual Patients’ Recommendations for Genetic Counselors: A Qualitative Investigation

Gay, lesbian, and bisexual (GLB) individuals comprise a growing patient population in genetic counseling. However, only one article from a genetic counseling journal provides empirical data on GLB patients' genetic counseling experiences and genetic counselor attitudes and practices regarding GLB patients. The present study, an extension of the aforementioned article, gathered further information about patients' genetic counseling experiences through semi-structured telephone interviews. Twelve of the previous study's 29 patient respondents (n?=?10 lesbian women, n?=?1 gay man, n?=?1 bisexual woman) participated. Interview questions concerned the use of medically inclusive forms, factors influencing patient disclosure, counselors' ability to relate to them, and their expectations of genetic counselors. Inductive analysis of the interviews yielded seven themes: 1) Medically inclusive forms with gender neutral terms are important; 2) Genetic counselor ability to relate to a GLB person depends more on the relationship established during the session and less on external symbols; 3) The presence of GLB-friendly symbols increases comfort when disclosing one's orientation; 4) Inclusion of the patient's partner is important and best done by encouraging their active participation in sessions; 5) When GLB patients disclose their orientation, they expect to be treated like any other patient; 6) Providers should ask about orientation if medically pertinent and the remaining discussion should take orientation into consideration; and 7) When a provider inquires about orientation it should be done in a safe and appropriate way. Illustrative quotations, genetic counseling practice implications, and research recommendations are presented.