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.     

Spiritual coaching in cancer patients: treating the spirit as well as the disease

Interest in the exploration of spirituality in medical practice has been growing recently due to some studies suggesting its role in the improvement of patient well-being and quality of life. This project examined the feasibility of providing spiritual coaching with patients in an outpatient Radiation Oncology clinic setting. The purpose of spiritual coaching was to provide patients with opportunities to explore their current spiritual lives, increase their involvement in spiritually enhancing activities, and expand their spiritual opportunities. Quality-of-life measurements focused on feelings of hopefulness and distress were used in patients undergoing radiation treatment for cancer. This study suggests that there is a potential benefit for spiritual coaching in the care of cancer patients, and future studies will be done to further el ucidate the ationship of spirituality and quality of life in this population.     

HOMELESSNESS AND CONTAINMENT – A PSYCHOTHERAPY PROJECT WITH HOMELESS PEOPLE AND WORKERS IN THE HOMELESS FIELD

A high percentage of homeless people suffer from a severe degree of personality disorder that causes them to fall through the net of psychiatric and caring services. Their persistent inability to maintain an actual dwelling‐place as a location of stability and meaning, is also reflected in an inner state of fragility, and in relationship difficulties that lead to destructive behaviours that inevitably alienate others. In this paper, the relationship between homelessness, the maternal body, buildings and containment is explored, using clinical material which illustrates how the claustro‐agoraphobic dilemma (Henri Rey 1994 Rey, H. 1994. Universals of Psychoanalysis in the Treatment of Psychotic and Borderline States, Edited by: Magagna, J. London: Free Association Books.  [Google Scholar]), intrinsic to the state of homelessness and to borderline conditions, impacts on vulnerable individuals and on care workers in this field. Examples drawn from staff consultations demonstrate how psychodynamic thinking can help to provide containment within systems of care.     

Impulsive responses to positive mood and reward are related to mania risk

Bipolar disorder is characterised by impulsivity, and recent research suggests it is important to consider more specific forms of impulsivity. In two student samples, we examined associations of self-reported impulsivity with mania risk (Hypomanic Personality Scale, HPS). We hypothesised that mania risk would relate to impulsivity in the context of opportunities for rewarding activities (Delaying Gratification Inventory, DGI), reward pursuit (Fun-Seeking subscale of the Behavioural Activation Scale, BAS), and when experiencing positive affect (Positive Urgency Measure, PUM). In Study 1 (N=823), the HPS was uniquely related to Fun-Seeking and PUM scores. Study 2 (N=482) replicated the correlation of HPS scores with PUM while documenting positive associations between PUM and trait-like responses to positive affect. Findings across both studies stress the importance of considering the role of positive emotion in driving the impulsivity among persons at risk for mania. These findings have implications for refining our understanding of the aetiology of bipolar disorder and for treatment development.     

When I grow down – music,spirituality and memory loss: A performative lecture on aging

This article uses a postmodern methodology to set out a model of life which consists of a time of growing up and learning to speak, and of growing down when the power of speech and cognition gradually disintegrates. It describes how this was presented at a conference partly by means of drama (including movement and music) at the beginning and ending of a lecture which was designed to show the important role of music at the beginning and end of life. The centre of the presentation sets out the research into the role of music in personhood, wellbeing and health. It examines the role of music in connectedness, community and identity. There is much evidence for the relationship between music and health which is leading to the possibility of doctors prescribing music. The growth of community choirs has seen the growth of a musical aesthetic which values wellbeing highly. A phenomenography of the musical experience clarifies the relationship between music and wellbeing and the potentially transformative effects of the liminal space created by the four domains of musicking – Materials, Expression, Construction and Values. It also sets out a way of presenting research that engages the mind, body, emotions and spirituality of the audience.     

Upward intergenerational influences on parents' innovativeness and innovation adoption: A comparative study of single‐ and multiple‐child families

In the marketing and consumer behavior literature, there has been a growing attention on upward intergenerational influences, or reverse socialization, which is largely because of children's increasing influences on family decisions. This paper hypothesizes different patterns of upward intergenerational influences in single versus multiple‐child families, controlling for peer and spousal influences. We found that young adult single children had a direct positive influence on their parents' innovation adoption behavior, but not a significant influence on their parents' overall innovativeness, whereas young adult children with siblings had a different effect: Their innovativeness had a significant positive influence on their parents' overall innovativeness, but not a direct impact on their parents' innovation adoption.     

Aging and Alcohol Abuse: Increasing Counselor Awareness

Alcohol abuse in older adulthood is a rapidly growing but often hidden problem. The authors provide an overview of the issues related to older adult alcohol abuse through a discussion of physiological, psychological, and social risk factors; an examination of appropriate assessment procedures; and an overview of factors related to treatment.