Evaluating Genetic Counseling: Client Expectations,Psychological Adjustment and Satisfaction with Service

Periodic evaluations of genetic counseling services are useful for determining the effectiveness of counseling in meetings its psycho-educational aims, as well as identifying where improvements to the service may be made. This study aimed to evaluate the genetic counseling services provided by Genetic Services of Western Australia (GSWA) to determine the impact of counseling on client expectations, satisfaction with the service, and psychological adjustment, defined as wellbeing and perceived personal control (PPC). A total of 122 clients participated in a self-administered survey conducted pre- and post-counseling. Client expectations of the service as a means of providing information were met, and opportunities for counselors to meet client’s expectations of psychological support were identified. Furthermore, counseling was found to maintain and enhance psychological wellbeing of clients. The role of counseling in facilitating the development of PPC was a key contributor to a high sense of satisfaction in clients.     

From philosopher to psychologist: the early career of Edwin Ray Guthrie, Jr

Edwin R. Guthrie rose to prominence as a psychologist in the 1930s. His theoretical outlook was behavioristic. This approach came from his conviction that an objective method could be applied to a scientific treatment of mind. Prior to becoming a psychologist, he was a philosopher of mathematics. Guthrie was initiated into psychology by Stevenson Smith, from whom he learned a psychology of adjustment informed by comparative research, Columbia functionalism, and clinical psychology. Guthrie's first step into psychology was in collaboration with Smith on Chapters in General Psychology (S. Smith & E.R. Guthrie, 1921). To synthesize their own unique position on learning from the contemporary theory and research, they used the principle of association. This articles focuses on Guthrie's origin and his development into a learning theorist.     

On the contribution of perceptual fluency and priming to recognition memory

Repetition priming has been shown to be independent of recognition memory. Thus, the severely amnesic patient E.P. has demonstrated intact stem completion priming and perceptual identification priming, despite at-chance performance on recognition memory tasks. It has also been shown that perceptual fluency can influence feelings of familiarity, in the sense that items perceived more quickly tend to be identified as familiar. If studied items are identified more fluently, due to perceptual priming, and fluency leads to familiarity, why do severely amnesic patients perform no better than chance on recognition memory tasks? One possibility is that severely amnesic patients do not exhibit normal fluency. Another possibility is that fluency is not a sufficiently strong cue for familiarity. In two experiments, 2 severely amnesic patients, 3 moderately amnesic patients, and 8 controls saw words slowly clearing from a mask. The participants identified each word as quickly as possible and then made a recognition (old/new) judgment. All the participants exhibited fluency, in that old responses were associated with shorter identification times than new responses were. In addition, for the severely amnesic patients, priming was intact, and recognition memory performance was at chance. We next calculated how much priming and fluency should elevate the probability of accurate recognition. The tendency to identify studied words rapidly (.6) and the tendency to label these rapidly identified words old (.6) would result in 36% of the studied words being labeled old. Other studied words were identified slowly (.4) but were still labeled old (.4), resulting in an additional 16% of studied words labeled old. Thus, the presence of fluency increases the probability of accurate recognition judgments to only 52% (chance = 50%). This finding explains why amnesic patients can exhibit both priming and fluency yet still perform at chance on recognition tests.     

Microswitch programs for persons with multiple disabilities: an overview of the responses adopted for microswitch activation

Background: To introduce a person with multiple disabilities to a microswitch-aided program, one has to select a plausible response(s), that is, a response(s) that can be performed reliably and without excessive effort by the person and can successfully activate the microswitch(es) available (producing preferred stimuli). This paper provides an overview of the responses adopted for microswitch activation in research studies during the last 20 years. Method: Computerized and manual searches were carried out to identify the studies published between 1986 and 2005. Forty-eight research studies were identified. They concerned the use of (1) a single (typical) response, (2) a single (non-typical) response, (3) multiple (typical and non-typical) responses, and (4) multiple (vocal) responses. Results and discussion: The results showed that 151 of the 190 participants involved in the studies had a positive outcome (i.e., clear increases in their responding, which suggested that they had learned the association between responding and consequent preferred stimuli). Failures were largely concentrated in the first group of studies. The discussion focused on (a) the importance of selecting plausible responses for increasing the chances of success, (b) the need of non-typical responses for persons with minimal motor behavior, (c) implications of programs with multiple responses on engagement and choice, and (d) relevance of using vocal utterances. Some suggestions for future research concerning these points were also examined.     

Genetic Cancer Risk Assessment and Counseling: Recommendations of the National Society of Genetic Counselors

These cancer genetic counseling recommendations describe the medical, psychosocial, and ethical ramifications of identifying at-risk individuals through cancer risk assessment with or without genetic testing. They were developed by members of the Practice Issues Subcommittee of the National Society of Genetic Counselors Cancer Genetic Counseling Special Interest Group. The information contained in this document is derived from extensive review of the current literature on cancer genetic risk assessment and counseling as well as the personal expertise of genetic counselors specializing in cancer genetics. The recommendations are intended to provide information about the process of genetic counseling and risk assessment for hereditary cancer disorders rather than specific information about individual syndromes. Key components include the intake (medical and family histories), psychosocial assessment (assessment of risk perception), cancer risk assessment (determination and communication of risk), molecular testing for hereditary cancer syndromes (regulations, informed consent, and counseling process), and follow-up considerations. These recommendations should not be construed as dictating an exclusive course of management, nor does use of such recommendations guarantee a particular outcome. These recommendations do not displace a health care provider's professional judgment based on the clinical circumstances of a client.     

The Parents Matter! Program Interventions: Content and the Facilitation Process

The Parents Matter! Program (PMP) has developed three interventions for parents of 4th and 5th grade African-American children (9–12 years old). The overarching goal of all three interventions is to provide parents with knowledge, skills, and support for enhancing their efforts to raise healthy children. The interventions are: (1) Enhanced Communication and Parenting (five 2 -hour sessions), (2) Brief Communication and Parenting (single 2 -hour session), and (3) General Health (single 2 -hour session). This article discusses the development of these interventions, presents an overview of the content of each intervention, and discusses issues related to the facilitation/presentation of these interventions.     

Impaired odor recognition memory in patients with hippocampal lesions

In humans, impaired recognition memory following lesions thought to be limited to the hippocampal region has been demonstrated for a wide variety of tasks. However, the importance of the human hippocampus for olfactory recognition memory has scarcely been explored. We evaluated the ability of memory-impaired patients with damage thought to be limited to the hippocampal region to recognize a list of odors. The patients were significantly impaired after a retention delay of 1 h. Olfactory sensitivity was intact. This finding is in agreement with earlier reports that rats with hippocampal lesions exhibited memory impairment on an odor delayed nonmatching to sample task (after 30 min and 1 h) and that patients with damage thought to be limited to the hippocampal region were impaired on an odor span memory task. Olfactory recognition memory, similar to recognition memory in other sensory modalities, depends on the integrity of the hippocampal region.