Elucidating Genetic Counseling Outcomes from the Perspective of Genetic Counselors

Outcomes in the field of genetic counseling have not been well-defined or categorized, despite pressures to provide evidence-based measures in all areas of healthcare. This study describes a process to elucidate and categorize a wide-ranging set of outcomes as characterized by diverse groups of practicing genetic counselors. Semi-structured focus groups were conducted at the National Society of Genetic Counselors 2013 NSGC Annual Education Conference during an educational breakout session. A general inductive qualitative research approach was utilized to code focus group notes, categorize them into themes, and compare them across specialty groups. A total of 107 individuals participated in 14 focus groups, consisting of specialists in cancer (n = 20), general genetics (n = 40), prenatal genetics (n = 11), and “other” (n = 36). Of the twelve genetic counseling outcomes themes identified, the most common across focus groups included: 1) appropriateness of testing and accuracy of results interpretation; 2) psychosocial outcomes; 3) adherence to or receipt of appropriate medical management; and 4) patient and provider knowledge. Data assessed by specialty demonstrated similarities in outcomes themes, suggesting that a common set of genetic counseling outcomes would likely be appropriate to cover the majority of needs for the profession. Results can serve as a platform from which to build a more well-defined and comprehensive set of outcomes.     

Newborns’ attention is driven by the translational movement

The present study investigated whether 2-day-old newborns are able to discriminate two translating meaningless Point-Light Displays (PLD) videos, in which the shape of one of them changes compared to that of the other along the trajectory, independently from movement kinematics, and if this ability is present both when stimuli differed at the end or at the beginning of the movement. To manipulate the instant in which along the movement the difference between stimuli was evident, and to maintain every unspecific dissimilarity possibly determining the preference, videos were played in a loop either forward or backwards. In Experiment 1, PLD stimuli moved with natural accelerated-decelerated kinematics; in Experiment 2 they moved at constant velocity. Four groups of newborns were submitted to the preferential looking technique experiments. Results showed that newborns looked longer at natural kinematics and that, irrespective of the type of kinematics, they discriminated the two stimuli only when videos were played forward, that is, only when stimuli differed at the end of the movement. These data suggest that, independently from kinematics, movement translational components induce newborns to allocate attention at the end of the observed movement. Given the strict link between attention and eye movements, we suggest that this effect may bootstrap the system and give rise to proactive gaze, the typical gaze behaviour present during executed and observed goal-directed actions.     

Assessment of acquired capability for suicide in clinical practice

The Interpersonal Psychological Theory of suicide proposes that the interaction between Thwarted Belongingness, Perceived Burdensomeness, and Acquired Capability for Suicide (ACS) predicts proximal risk of death by suicide. Instruments to assess all three constructs are available. However, research on the validity of one of them, the acquired capability for suicide scale (ACSS), has been limited, especially in terms of its clinical relevance. This study aimed to explore the utility of the different versions of the ACSS in clinical assessment. Three versions of the scale were investigated, the full 20-item version, a 7-item version and a single item version representing self-perceived capability for suicide. In a sample of patients recruited from a clinic specialising in the treatment of suicidality and in a community sample, all versions of the ACSS were found to show reasonable levels of reliability and to correlate as expected with reports of suicidal ideation, self-harm, and attempted suicide. The item assessing self-perceived acquired capacity for suicide showed highest correlations with all levels of suicidal behaviour. However, no version of the ACSS on its own showed a capacity to indicate suicide attempts in the combined sample. It is concluded that the versions of the scale have construct validity, but their clinical utility is limited. An assessment using a single item on self-perceived ACS outperforms the full and shortened versions of ACSS in clinical settings and can be recommended with caution for clinicians interested in assessing this characteristic.     

Timelines for difficult times: use of visual timelines in interviewing suicide attempters

The stories of people who attempt suicide are insufficiently reflected in suicide research in psychology. This article outlines a method using a visual timeline during the interviews to explore the narratives of suicide attempts. The method was successfully employed in two studies to collect data on the suicidal process from people with prior experience of suicide attempts. The advantages of the method in collecting comprehensive data, building rapport, and fostering participants’ insight are outlined. Strategies that were used to ensure safety of participants are described in addition to the requirements for interviewers seeking to apply this method.     

Promoting Attachment and Mentalization for Parents and Young Children in the Foster Care System: Implementing a New Training and Treatment Approach in an Agency

The Building Blocks Program is an innovative psychodynamic treatment approach that was designed to fit within a social service agency structure. It is based on concepts of attachment, attunement, and mentalization and builds on the research of Beatrice Beebe (2003), Peter Fonagy and colleagues (2002), Arietta Slade (2005), Howard and Miriam Steele (2008), and Dan Stern (1985). The Building Blocks Program targets birth mothers and their young children under age 5 who have been or are in danger of being removed from their families. In the beginning of the program, the Building Blocks therapists faced many challenges. As noted (Remez, this issue), many of the therapists were unfamiliar with a Reflective Supervision model of learning. They were accustomed to a more traditional pedagogical approach that emphasized critiquing their work, with a focus on their clients’ pathology. The Building Blocks model focuses on therapist and client safety and support, prompting a paradigm shift in the therapists’ thinking about supervision and how to conduct therapy.     

Explicit vs. implicit emotional processing: The interaction between processing type and executive control

The current study examined whether the interaction between emotion and executive control (EC) is modulated by the processing type of the emotional information. Namely, whether the emotional information is explicitly processed, implicitly processed or passively viewed. In each trial, a negative or neutral picture preceded an arrow-flanker stimulus that was congruent or incongruent. Incongruent stimuli are known to recruit EC. Explicit processing of the pictures (Experiment 1a), which required responding to their emotional content, resulted in emotional interference for congruent but not for incongruent stimuli. Similar effects were shown for the passive viewing condition (Experiment 2). In contrast, implicit processing (Experiment 1b), which required responding to non-emotional content, resulted in emotional interference for both congruent and incongruent stimuli. Thus, our findings indicate that implicit emotional processing affects performance independently of EC recruitment. In contrast, explicit emotional processing and passive viewing of emotional pictures lead to reduced emotional interference when EC is recruited.