The Relationship of Nondirectiveness to Genetic Counseling: Report of a Workshop at the 2003 NSGC Annual Education Conference

Nondirectiveness has been a guiding principle for genetic counseling since the founding of the profession. However, its efficacy and appropriateness in this role have been frequently questioned. A workshop at the 2003 Annual Education Conference of the National Society of Genetic Counselors provided audience participation in a discussion of these issues. Participants presented arguments for and against nondirectiveness as a central ethos. They described complex personal transitions in adapting what they had learned about nondirectiveness during training to the realities of the workplace. There was support for flexible approaches to genetic counseling, with varying adherence to nondirectiveness, based on client and family needs and values, clinical circumstances, and desired counseling outcomes. The discussion supports the use of clinical experience, outcomes research, and the experience of other professions to move beyond nondirectiveness and more accurately identify the theoretical bases that underlie genetic counseling in the variety of circumstances in which it is currently practiced.     

A cognitive behavioral workshop for subclinical obsessions and compulsions

The present study investigates the effectiveness of a 3-h cognitive behavioral workshop for individuals, ages 18-22, with subclinical obsessions and compulsions. It was hypothesized that, compared to individuals in an assessment-only waitlist group (n = 42), individuals assigned to the workshop group (n = 43) would experience a significant decrease in obsessive-compulsive (OC) symptomatology, comorbidity, and thought action fusion endorsement at 1-month and 5-month follow-up assessments. An additional outcome of interest was the number of incident cases of obsessive-compulsive disorder (OCD) over the course of the study. The results indicated that the workshop group reported a significantly fewer number of OC symptoms at 5-month follow-up and endorsed significantly less thought action fusion at both follow-up points. However, there were no differences between groups in severity of OC symptoms and number of comorbid diagnoses endorsed. Only one incident case of OCD was observed during the study, from a participant in the waitlist group. These results are discussed in reference to treatment of subclinical anxiety symptoms.     

Body image and eating disorder symptoms in sexual minority men: A test and extension of objectification theory

On the basis of integrating objectification theory research with research on body image and eating problems among sexual minority men, the present study examined relations among sociocultural and psychological correlates of eating disorder symptoms with a sample of 231 sexual minority men. Results of a path analysis supported tenets of objectification theory with the sample. Specifically, findings were consistent with relations posited in objectification theory among sexual objectification experiences, internalization of cultural standards of attractiveness, body surveillance, body shame, and eating disorder symptoms. Within this set of positive relations, internalization of cultural standards of attractiveness partially mediated the link of sexual objectification experiences with body surveillance; body surveillance partially mediated the relation of internalization with body shame; and body shame partially mediated the relation of body surveillance with eating disorder symptoms. In addition to these relations, internalized homophobia was related to greater eating disorder symptoms through body shame, and recalled childhood harassment for gender nonconformity was linked with eating disorder symptoms through a positive series of relations involving internalization of cultural standards of attractiveness, body surveillance, and body shame.     

Autonomy,Reciprocity, and Responsibility: Darwall and Levinas on the Second Person

Abstract

Stephen Darwall’s The Second‐Person Standpoint converges with Emmanuel Levinas’s concern about the role of the second‐person relationship in ethics. This paper contrasts their methodologies (regressive analysis of presuppositions versus phenomenology) to explain Darwall’s narrower view of ethical experience in terms of expressed reactive attitudes. It delineates Darwall’s overall justificatory strategy and the centrality of autonomy and reciprocity within it, in contrast to Levinas’s emphasis on the experience of responsibility. Asymmetrical responsibility plays a more foundational role as a critical counterpoint to ‘mean‐spirited’ reciprocity than Darwall’s laudable distinction between accountability and revenge, and responsibility even founds this distinction. The experience of being summoned to asymmetrical responsibility amplifies the meaning of ‘authority’, which is a presupposition for Darwall. Finally, asymmetrical responsibility helps develop decentred reasoning, invites risk beyond the boundaries of reciprocity at moments when autonomy appears endangered, reconciles respect and care at the experiential level, and presses to extend the scope of moral obligation.     

Teachers’ creativity,playfulness, and style of interaction with children

Abstract:

This investigation examined the relationships among a teacher's creative thinking, playfulness, and degree of sensitivity in their interactions with preschool children during play. These variables were operationally defined as scores on measures of ideational fluency, playful disposition, and quality of self‐reported play interaction. The Multidimensional Stimulus Fluency Measure, the Adult Behavior Inventory, and the Play Interaction Scale were administered to 46 students and 37 teachers of three‐ and four‐year old children. The Play Interaction Scale, developed for this study, was based on environmental components identified in earlier research as facilitative of play. Subjects indicated the frequency with which they might respond in a structured, elaborative, or unstructured manner to 20 vignettes describing the play of children. Results indicated that the expected positive relationships among creativity, playfulness, and an elaborative teaching style were found only for the students. The predicted negative relationships between creativity and a structured interaction style were found only for the experienced teachers.     

Pragmatic Psychodynamic Psychotherapy—Bridging Contemporary Psychoanalytic Clinical Practice and Evidence-Based Psychodynamic Practice

Pragmatic psychodynamic psychotherapy (PPP; Summers & Barber, 2009 Barber, J. P. 2009. Toward a working through of some core conflicts in psychotherapy research. Psychother. Res, 19(1): 1–12. [Taylor & Francis Online], [Web of Science ®] , [Google Scholar]) describes the therapeutic principles and approaches found in many forms of manualized psychodynamic psychotherapies, which are being used in research studies with the aim of building an evidence-based psychodynamic practice. This article focuses on one such treatment, Supportive-expressive psychotherapy (SEP; Luborsky 1984), which employs the Core Conflictual Relationship Theme (CCRT) method to formulate core interpersonal problems and treatment goals and identify therapeutic interventions. To illustrate SEP, we describe the 40-session treatment of a patient who met diagnostic criteria for several personality disorders. The case illustrates how complex ego-syntonic character pathology is expressed in CCRT terms and worked through in the transference, gradually becoming ego-dystonic and amenable to modification. In this case, the patient became more aware of his interpersonal wishes and vulnerability. Although his anxiety increased somewhat, he had an improvement in psychosocial functioning.     

Embodied Knowing, Embodied Theology: What Happened to the Body?

As part of a larger project on human bodies and theological knowledge, this paper is a preliminary investigation into how biology and physicality shape human knowing. It asks whether, in the frequent use of the phrase embodied knowing or embodied theology, religion scholars have paid sufficient attention to actual bodies. It argues that there has been a lapse of attention to physical dimensions of bodies in the unreflective employment of such phrases, ironically among practical and pastoral theologians who have strong interest in understanding how theology operates on the ground. The paper traces evolving interest in embodiment across several disciplines, including theology, before exploring what might be learned from recent research on evolution, biology, and bodies in anthropology and the biological sciences.     

Traumatic Loss: Conceptual and Empirical Links Between Trauma and Bereavement

Abstract

This article focuses on conceptual issues and empirical studies regarding the topic of traumatic loss (i.e., loss that occurs suddenly and under violent circumstances) as a method for linking the field of trauma, and that of grief and bereavement. Several definitions of trauma are presented that include the concept of loss, and additional concepts are suggested that may be helpful in thinking about the two areas together. Also, modes of death associated with poor recovery are noted, and it is argued that these modes are those that make a bereavement more “traumatic”. Some empirical studies on the psychological outcomes associated with traumatic loss are reviewed, and preliminary findings from a new study of traumatically bereaved women are briefly presented     

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.