Honoring and Privileging Personal Experience and Knowledge: Ideas for a Narrative Therapy Approach to the Training and Supervision of New Therapists

This article discusses an approach for the training and supervision of new therapists built around social constructionist and poststructuralist ideas from a narrative therapy perspective. We briefly discuss some of the pitfalls of current training/supervision in marriage and family therapy (MFT) that are deficit based and/or that disproportionately grant privilege to expert knowledge. We articulate this emerging training approach which utilizes the rite of passage metaphor, centers relationalism, and incorporates the honoring and privileging of new therapists' lived experience, knowledges, skills, talents, ideas, morals, personal ethics, values, beliefs. Concrete practices of experience privileging, re-membering, and creating communities of concern are detailed, and illustrative examples from our supervision work are given.     

Why older adults make more immediate treatment decisions about cancer than younger adults

Literature relevant to medical decision making was reviewed, and a model was outlined for testing. Two studies examined whether older adults make more immediate decisions than younger adults about treatments for prostate or breast cancer in authentic scenarios. Findings clearly showed that older adults were more likely to make immediate decisions than younger adults. The research is important because it not only demonstrates the consistency of this age-related effect across disease domains, gender, ethnic groups, and prevalent education levels but begins to investigate a model to explain the effect. Major reasons for the effect focus on treatment knowledge, interest and engagement, and cognitive resources. Treatment knowledge, general cancer knowledge, interest, and cognitive resources relate to different ways of processing treatment information and preferences for immediate versus delayed decision making. Adults with high knowledge of treatments on a reliable test tended to make immediate treatment decisions, which supports the knowledge explanation. Adults with more cognitive resources and more interest tended to delay their treatment decisions. Little support was found for a cohort explanation for the relationship between age and preference for immediate medical decision making.     

Coming Full Circle: A Reciprocal-Engagement Model of Genetic Counseling Practice

As genetic health care and genetic testing expand from primarily addressing conditions that are exclusively genetic in nature to common diseases with both genetic and environmental components, the scope of genetic counseling has grown. Identification and utilization of a normative model of practice defined by members of the profession is critical as genetic services become more commonplace in medical care. The purpose of this paper is to describe the results of a consensus conference convened to define a model of genetic counseling practice based on the guidance of educators and leaders in the profession. Twenty-three program directors or their representatives from 20 genetic counseling graduate programs in North America listened to presentations and participated in group discussions aimed at determining the elements of a model of practice, including tenets, goals, strategies, and behaviors for addressing patients’ genetic concerns. Their discussion is summarized, training implications and research recommendations are presented, and a model of practice that extends their ideas is proposed.     

Congruence in Satir's Model: Its Spiritual and Religious Significance

This article casts into relief the essentialist-existential philosophy implicit in Satir's model of healing using Paul Tillich's systematic philosophical framework. Parallels between Satir's model of the person are drawn with Tillich's ontological categories of essence and existence, individualization and participation, and destiny and freedom. Congruence as the integration of elements in three vital human dimensions: the interpersonal, intrapsychic, and spiritual-universal, is correlated with Tillich's philosophical understanding of salvation. The religious quest is understood as a systemic, multidimensional process that brings the interactive and interdependent personal, interpersonal and spiritual dimensions into a restored unity. Thus Satir's rehumanization project and Tillich's religious quest are shown to coincide.