Practice-based competencies for accreditation of and training in graduate programs in genetic counseling

In January 1996, the American Board of Genetic Counseling (ABGC) adopted 27 practice-based competencies as a standard for assessing the training of graduate students in genetic counseling. These competencies were identified and refined through a collective, narrative process that took place from January through November 1994, and included directors of graduate programs in genetic counseling, ABGC board members and expert consultants. These competencies now form the basis of the document Requirements for Graduate Programs in Genetic Counseling Seeking Accreditation by the American Board of Genetic Counseling (American Board of Genetic Counseling, 1996). The competencies are organized into four domains and are presented and discussed in this article.The Consortium includes Directors of established graduate programs in genetic counseling and members of the ABGC Board of Directors who participated in the Consensus Development Conference held in January, 1994: Diane Baker (University of Michigan/ABGC); Bonnie Baty (ABGC); Joan Burns (University of Wisconsin); Debra Collins (ABGC); Virginia Corson (ABGC); Beth Fine (Northwestern University/ABGC); Elizabeth Gettig (University of Pittsburgh); Verle Headings (Howard University); Jacqueline Hecht (University of Texas); Carl Huether (University of Cincinnati); Bonnie LeRoy (University of Minnesota); Joan Marks (Sarah Lawrence College); Anne Matthews (University of Colorado); Roberta Palmour (McGill University); Lorna Phelps (Medical College of Virginia); Kimberly Quaid (Indiana University); Joan Scott (ABGC); Ann Smith (ABGC); Helen Travers (ABGC); Judith Tsipis (Brandeis University); Ann Walker (University of California-Irvine/ABGC); Jon Weil (University of California-Berkeley); S. Robert Young (University of South Carolina); Randi Zinberg (Mount Sinai School of Medicine, New York).     

Pre-screening education in multiple marker screening programs: The effect on patient anxiety and knowledge

Previous studies have shown that unexplained deviations in maternal serum multiple marker screening (MMS) generate considerable anxiety during the remainder of pregnancy. While the role of education in decreasing anxiety is documented, to date there has been no prospective evaluation of which educational practices might minimize this emotional stress. In a pilot study, we prospectively examined the effects on anxiety and knowledge by providing information about MMS (1) by genetic counselor, (2) by pamphlet, and (3) by primary physician. Women randomized to one of these three modalities were administered the Spielberger State- Trait Anxiety Inventory [STAI] and knowledge questionnaires at their initial obstetrics visit, at their second visit after educational intervention and 1–2 weeks after MMS results were provided to patients. Education resulted in an increase in knowledge and post-education knowledge was different between educational modalities. Anxiety declined in patients educated through genetic counseling or a pamphlet.     

A case-based approach to the development of practice-based competencies for accreditation of and training in graduate programs in genetic counseling

The American Board of Genetic Counseling (ABGC) sponsored a consensus development conference with participation from directors of graduate programs in genetic counseling, board members, and expert consultants. Using a collective, narrative, and case-based approach, 27 competencies were identified as embedded in the practice of genetic counseling. These competencies were organized into four domains of skills: Communication; Critical Thinking; Interpersonal, Counseling, and Psychosocial Assessment; and Professional Ethics and Values. The adoption of a competency framework for accreditation has a variety of implications for curriculum design and implementation. We report here the process by which a set of practice-based genetic counseling competencies have been derived; and in an accompanying article, the competencies themselves are provided. We also discuss the application of the competencies to graduate program accreditation as well as some of the implications competency-based standards may have for education and the genetic counseling profession. These guidelines may also serve as a basis for the continuing education of practicing genetic counselors and a performance evaluation tool in the workplace.The Consortium includes Directors of established graduate programs in genetic counseling and members of the ABGC Board of Directors who participated in the Consensus Development Conference held in January 1994: Diane Baker (University of Michigan/ABGC); Bonnie Baty (ABGC); Joan Burns (University of Wisconsin); Debra Collins (ABGC); Virginia Corson (ABGC); Beth Fine (Northwestern University/ABGC); Elizabeth Gettig (University of Pittsburgh); Verle Headings (Howard University); Jacqueline Hecht (University of Texas); Carl Huether (University of Cincinnati); Bonnie LeRoy (University of Minnesota); Joan Marks (Sarah Lawrence College); Anne Matthews (University of Colorado); Roberta Palmour (McGill University); Lorna Phelps (Medical College of Virginia); Kimberly Quaid (Indiana University); Joan Scott (ABGC); Ann Smith (ABGC); Helen Travers (ABGC); Judith Tsipis (Brandeis University); Ann Walker (University of California-Irvine/ABGC); Jon Weil (University of California-Berkeley); S. Robert Young (University of South Carolina); Randi Zinberg (Mount Sinai School of Medicine, New York).     

Varieties of positive and negative priming

Numerous recent investigations have focused on a particular relation between the roles a stimulus plays in successive displays: when a stimulus ignored by a subject on one occasion is to be attended on a succeeding occasion, reaction time to that stimulus is slowed relative to a control condition. But this is but one possible case ofnegative priming. There are other ways in which negative priming might occur, and there are several varieties of positive priming as well. All these possibilities were explored in the present experiment.     

Family-centered intensive case management: A step toward understanding individualized care

New York State's initial attempt at individualizing services occurred within the context of an experiment. We randomly assigned children 5–12 years old who were referred for out-of-home placement in treatment foster care to either treatment foster care, Family-Based Treatment (n=15), or to Family-Centered Intensive Case Management (FCICM) (n=27). FCICM used teams of case managers and parent advocates to provide in-home services. Flexible service dollars, respite care, and behavior management skills training were available to assist teams in individualizing care. Preliminary outcomes indicate that children in FCICM are doing as well or better than children assigned to FBT in their functioning and symptom reduction. Parents of children in FCICM have made gains, although not at a statistically significant level, in behavior management skills and family strengths that allow them to provide care for their children at home.     

Gravitational acceleration as a cue for absolute size and distance?

When an object’s motion is influenced by gravity, as in the rise and fall of a thrown ball, the vertical component of acceleration is roughly constant at 9.8 m/sec². In principle, an observer could use this information to estimate the absolute size and distance of the object (Saxberg, 1987a; Watson, Banks, von Hofsten, & Royden, 1992). In five experiments, we examined people’s ability to utilize the size and distance information provided by gravitational acceleration. Observers viewed computer simulations of an object rising and falling on a trajectory aligned with the gravitational vector. The simulated objects were balls of different diameters presented across a wide range of simulated distances. Observers were asked to identify the ball that was presented and to estimate its distance. The results showed that observers were much more sensitive to average velocity than to the gravitational acceleration pattern. Likewise, verticality of the motion and visibility of the trajectory’s apex had negligible effects on the accuracy of size and distance judgments.     

Nonstranger sexual aggression: A discriminant analysis of the psychological characteristics of undetected offenders

Sex Roles - Rape is an underreported and underconvicted crime. Therefore, many highly sexually aggressive men are missed by research employing judicial identification for sample selection. The...     

Death of a Salesman: A clinical look at the Willy Loman family

A separation-individuation model is used to explore the dynamics of the Willy Loman family as depicted in the play,Death of a Salesman. The concept of differentiation is discussed, with examples from the play used to magnify the applicability of this construct. The family is viewed in three-generational context, using Erickson's definition of identity as it relates to the continuity between the past, present and future. The low level of differentiation inexorably leads to a void of intimacy, reflected in the form of emotional isolation, inability to tolerate differences and lack of problem solving skills. Finally, the discussion accents the difficulties experienced by the Loman children to separate and in individuation.     

Sexual responding of “nonrapists” to aggressive sexual themes: Normative data

The present study presents data relevant to the sexual responding to aggressive cues of a large sample of nonrapist males recruited from the community. Two hundred three subjects received physiological assessment of sexual arousal to heterosexual and rape stimuli. Results indicated that under instructions not to interfere with sexual responding, approximately 80% of the nonrapists would be correctly classified, which was significantly different from chance. However, under instructions to suppress arousal, classification was no better than chance. The rape index was not related to age, socioeconomic status, sexual experience, or amount of arousal shown in the laboratory. However, there was a small but significant relationship to IQ. Overall, the data suggest that for instructions not to interfere with responding, the error rate seen in this larger-scale sample was equivalent to that in previous studies using smaller normative samples and that classification in general is not biased by the subject characteristics measured in this study.Portions of this project were supported by USPHS Grant MH-34030-02 from the Center for the Studies of Crime and Delinquency and by Tennessee Department of Mental Health and Mental Retardation Research Contract ID-0783 to the Department of Psychiatry.