Barriers Impacting the Utilization of Supervision Techniques in Genetic Counseling

Clinical supervision is an essential element in training genetic counselors. Although live supervision has been identified as the most common supervision technique utilized in genetic counseling, there is limited information on factors influencing its use as well as the use of other techniques. The purpose of this study was to identify barriers supervisors face when implementing supervision techniques. All participants (N?=?141) reported utilizing co-counseling. This was most used with novice students (96.1 %) and intermediate students (93.7 %). Other commonly used techniques included live supervision where the supervisor is silent during session (98.6 %) which was used most frequently with advanced students (94.0 %), and student self-report (64.7 %) used most often with advanced students (61.2 %). Though no barrier to these commonly used techniques was identified by a majority of participants, the most frequently reported barriers included time and concern about patient’s welfare. The remaining supervision techniques (live remote observation, video, and audio recording) were each used by less than 10 % of participants. Barriers that significantly influenced use of these techniques included lack of facilities/equipment and concern about patient reactions to technique. Understanding barriers to implementation of supervisory techniques may allow students to be efficiently trained in the future by reducing supervisor burnout and increasing the diversity of techniques used.     

Hazard function effects on promoting self-control in variable interval time-based interventions in rats

The present experiments investigated properties of time-based interventions used to increase self-control. Rats received impulsive-choice assessments before and after interventions that consisted of different distributions of delays to reinforcement. In Experiment 1, rats received an intervention with an increasing hazard function where delays were more evenly distributed, a decreasing hazard function where delays were mostly short, or a constant hazard function where delays were exponentially distributed. Surprisingly, rats that received the decreasing hazard function made the most self-controlled choices. Response rates during intervention trials showed that rats anticipated reinforcement based on the shape of the distributions they received. In Experiment 2, rats received an intervention with a decreasing hazard function with a steep slope or a shallow slope. Both time-based interventions increased self-control and produced similar response-rate patterns, indicating that the slope of the decreasing hazard function may not play a strong role in intervention efficacy. While this research aligns with previous literature showing that time-based interventions improved self-control, exposure to short delays produced the biggest improvements. Ultimately, exposure to short delays may increase the subjective value of the larger–later choice while occasional long delays may promote the ability to wait, which may have important implications for translational applications.     

Identifying and Treating Race‐Based Trauma in Counseling

This study investigated 106 counseling professionals’ experiences with identifying and treating race‐based trauma and the relationship between training and treatment. Competency was assessed with the Race‐Based Trauma Survey for Counselors. Although most participants reported working with clients who had symptoms associated with race‐based trauma, many had not received training in identifying and treating race‐based trauma among individuals of color. This finding highlights the disparities between health care and the provision of related services. Recommendations for counseling professionals and researchers are included. Este estudio investigó las experiencias de 106 profesionales en consejería con la identificación y el tratamiento de traumas basados en la raza, así como la relación entre la capacitación y el tratamiento. La competencia se evaluó usando la Encuesta para Consejeros sobre Traumas Basados en la Raza. A pesar de que la mayoría de participantes informó que había trabajado con clientes que tenían síntomas asociados con traumas basados en la raza, muchos no habían recibido capacitación para identificar y tratar traumas basados en la raza en personas de color. Este hallazgo resalta las disparidades entre la atención sanitaria y la provisión de servicios relacionados. Se incluyen recomendaciones para profesionales en consejería e investigadores.     

An evaluation of the reliability and construct validity of eating disorder measures in White and Black women

Most measures of eating disorder symptoms and risk factors were developed in predominantly White female samples. Yet eating disorders affect individuals of all racial and ethnic backgrounds. Black women appear more vulnerable to certain forms of eating pathology, such as binge eating, and less susceptible to other eating disorder symptoms and risk factors, such as body dissatisfaction, compared with their White peers. Despite concern that extant measures do not adequately assess eating concerns among Black women, the construct validity of scores on most of these measures has not been adequately examined within this population. This study included 2,208 Black and White women who completed the following: the Binge Eating Scale (BES), the Eating Disorder Diagnostic Scale (EDDS), the Eating Attitudes Test-26 (EAT-26), the Eating Disorder Inventory Body Dissatisfaction and Drive for Thinness subscales, the Bulimia Test-Revised (BULIT-R), the Multidimensional Body-Self Relations Questionnaire-Appearance Evaluation subscale (MBSRQ-AE), and the Objectified Body Consciousness Scale (OBCS). Most measures yielded internally consistent scores in both races. Confirmatory factor analyses indicated that loadings for some measures, including the EAT-26 and EDDS, were not invariant across groups and thus do not assess equivalent constructs in White and Black women. However, others, including the BULIT-R, BES, OBCS, and MBSRQ-AE, exhibited factorial invariance in both races. Results suggest scores are likely not equivalent across races for several popular measures of eating disorder symptoms and risk factors. Thus, it is recommended that researchers and clinicians obtain additional information regarding racial/cultural factors when using these instruments with Black women.     

Barriers to and Motivations for Physician Referral of Patients to Cancer Genetics Clinics

Although it is well known that under-referral of colon cancer patients to cancer genetics clinics is a chronic problem, no study has yet examined why physicians may be ordering testing independently rather than referring patients to cancer genetics clinics. The current study explored variables which may impact a physician’s preference for ordering testing independently or referring patients to outside cancer genetics experts. An online questionnaire, distributed to the membership of the American College of Gastroenterology and the American Society of Colorectal Surgeons, yielded responses from 298 physicians. Motivations to refer to cancer genetics clinics rather than order testing independently included fear of genetic discrimination and a belief that patients benefit from genetic counseling about the risks, benefits and consequences of testing. These results suggest that in order to increase referrals, genetic counselors must educate physicians about the unique benefits patients receive from participating in genetic counseling.     

Cues To Consumer Susceptibility To Salesperson Influence: Implications For Adaptive Retail Selling

Consumer susceptibility to salesperson influence (CSSI) is developed as a multidimensional construct and segmentation base for adaptive retail selling strategies. Differences in informational, recommendational and relational CSSI by gender, age, and purchase pal utilization are investigated in a stratified national random sample of new vehicle purchasers. Specific retail and salesperson strategies are discussed.     

Motivated Suspicion: Asymmetrical Attributions of the Behavior of Political Ingroup and Outgroup Members

Suspicious attributional thought was assessed in the context of the political behavior of ingroup and outgroup politicians. Strong Democrats and Republicans read a newspaper article describing a Democratic or Republican politician's support of a bill. Half the participants read that the politician may have been motivated by an ulterior motive, obtaining campaign support from companies that benefited from the bill. In two studies, interaction effects revealed that participants discounted the behavior of an outgroup politician when an ulterior motive was salient. In contrast, they failed to discount the behavior of an ingroup politician when an ulterior motive was salient or either politician when no ulterior motive was salient. Study 2 also revealed evidence that negative, other-directed affect mediated the bias in attributional judgments.     

A COMPARISON OF TWO PHYSICAL GUIDANCE PROCEDURES IN THE TREATMENT OF PEDIATRIC FOOD REFUSAL

Physical guidance procedures can be effective in the treatment of severe pediatric food refusal. Researchers evaluating the use of physical guidance procedures often include a procedure referred to as a jaw prompt, but other variations of physical guidance may also be effective. An additional form of physical guidance, the finger prompt, might increase food acceptance. We evaluated nonremoval of the spoon and physical guidance (jaw prompt or finger prompt) in a reversal design. Results showed treatment packages including both procedures were effective in increasing food acceptance and decreasing inappropriate mealtime behavior. Copyright © 2013 John Wiley & Sons, Ltd.     

AN INDIVIDUALIZED LEVELS SYSTEM TO INCREASE INDEPENDENT MEALTIME BEHAVIOR IN CHILDREN WITH FOOD REFUSAL

An individualized levels system was implemented to increase independent eating in two children with food refusal. Participants earned access to different status levels associated with varying availability of preferred items/activities outside of meals according to criteria based on low levels of prompting throughout the meal. A reversal design was implemented to evaluate the effects of the intervention on independent mealtime behavior. Results demonstrated that the levels system was effective in increasing independent eating and in decreasing prompted bites for both participants. Although the effectiveness of an individualized levels system has been previously demonstrated in the treatment of severe problem behavior, it has not been empirically evaluated in the context of increasing appropriate behavior or with children with food refusal. These findings provide support for such a treatment to promote mealtime independence during an intensive feeding program and at two months follow‐up. Copyright © 2013 John Wiley & Sons, Ltd.     

Taking Stock of Behavioral Measures of Adolescent Dating Violence

The past 2 decades have witnessed an increase in dating violence awareness and research. As the field evolves, it is critical to examine the definition and measurement of adolescent dating violence. This article summarizes the behavioral measures of adolescent dating violence used in the field. Based on a review of the literature and federally funded studies, we identified 48 different measures. The most commonly used measures were the Conflict Tactics Scale–2, the Safe Dates Scale, and the Conflict in Adolescent Dating Relationship Inventory, which all examine aspects of psychological, physical, and sexual violence. Researchers also adapted or created their own measures. This article concludes with a discussion of developments for consideration as the field moves forward.