The stability of aspect-based career preferences and of the recommended list of occupations derived from them

Career-related preferences (e.g., team work, independence, length of training, income), which are an elaboration and extension of vocational interests, are one of the cornerstones that guide individuals to promising occupations recommended for further exploration. These preferences are informative and can serve individuals and their career counselors only if they are reliable and stable. Study 1 tested the two-week reliability of 31 career-related preferences of 213 freshman students and the two-year stability of the preferences of 132 of these students. Both the within-aspect preferred levels (e.g., only indoors most preferred, but mostly indoors also acceptable) and the importance of the aspects were elicited. The median within-participant two-week reliability was .85 for preferred levels and .64 for aspect importance; the median two-year stabilities were .75 and .51, respectively. In Study 2, the preferences elicited in Study 1 were used to derive a list of recommended occupations compatible with each participant's preferences at Time 1, Time 2 (2 weeks later), and Time 3 (2 years later), using a compensatory-model-based fit index. The percentage of identical occupations in the lists of the top ten recommended occupations was quite high — 62% for Time 1 and Time 2, and 54% for Time 1 and Time 3. The theoretical and practical implications of the reliability and stability of recommendations based on aspect-based career preferences are discussed.     

Constructionist career counseling of undergraduate students: An experimental evaluation

This study used a pretest–posttest control group design to examine the effectiveness of a six-session constructionist career counseling intervention (Savickas, 2011). It was hypothesized that relative to pre-intervention scores, the participants would demonstrate decreases in their indecision, anxiety, uncertainty, and insecurity about their career choices. Participants consisted of 50 undergraduates ranging in age from 19 to 25. They completed the Undergraduate Career Choice Survey (UCCS) and then were evenly divided into an intervention group and a control group. The intervention group received six sessions of constructionist career counseling. Each session was approximately 45 min with a total of 4 h, 30 min approximately for the six sessions. Both groups then took the UCCS again. Analyses of the data using t-tests revealed significant reductions in indecision, anxiety, uncertainty, and insecurity for the intervention group but not for the control group. The intervention group took the UCCS again eight weeks later. An ANOVA indicated that the reductions in indecision, anxiety, uncertainty, and insecurity were slightly yet significantly greater. Limitations and directions for further research were pointed out.     

Lost in (cyber)space: finding two adolescent boys hiding from their own humanity

This article explores the intense psychological effects of compulsive Internet use, which has become increasingly common among adolescent boys and young men. Two cases are presented and discussed to illustrate some of the psychic distortions around thinking and feeling, as these occurred in the analysis of a mid‐adolescent boy and of another patient in later adolescence. A kind of narcissistic omnipotence grounded in magical thinking appeared to take root in their minds, and it led to an avoidant pattern in relationships because of such strong wishes for both distance and control. A short review of the conceptual origins of magical thinking underscores its continued relevance because so many now engage with the Internet. In addition, Anzieu's idea of the ‘skin ego’ is applied to the clinical case material to provide a theoretical framework for the developmental challenges that can appear in adolescent boys who seek to use the Internet as a form of psychic container. Emerging problems that immersion in the Internet might bring into our practices, for example the depleting effects of massive projective identification, are considered and discussed, along with the obvious ways in which using the Internet can be beneficial for connecting with others, for creating new platforms of expression, and for education.     

If We Build It … Will They Come? – Establishing a Cancer Genetics Services Clinic for an Underserved Predominantly Latina Cohort

Background: Cancer genetic counseling and testing is a standard of care option for appropriate families and can identify individuals at increased risk prior to diagnosis, when prevention or detection strategies are most effective. Despite documented efficacy of cancer risk reduction in high-risk individuals, underserved and minority individuals have a disproportionate cancer burden and limited access to genetic counseling. Methods: A needs assessment survey documented gaps in knowledge and interest in prevention. Satellite clinics were established at two indigent healthcare systems. Cancer genetics CME lectures were conducted and referral guidelines disseminated to clinicians who referred patients for counseling. Results: An increase in clinician knowledge was demonstrated post-CME and reflected by quality referrals. Eighty-eight percent of patients kept their appointments. In the predominantly Latina⁶ (n=77) clinic population, 71.4% were affected with cancer, and 17 mutation positive families were identified. Preliminary data shows a positive impact on patients' motivation and behavior. The majority has expressed satisfaction and reduction in anxiety. Conclusions: This study demonstrates feasibility and acceptability of cancer genetics services in this population, suggesting the potential to reduce cancer morbidity in underserved, high-risk families.“Latino” is the most common census term for individuals of Spanish, Mexican, Central and South American, Cuban, or Puerto Rican descent, referring to ethnicity, and is generally considered a more ethnically/culturally based term for individuals of the aforementioned groups. As this cohort is female the feminine noun “Latina” is used     

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.     

A Qualitative Study of Health Professionals' Views Regarding Provision of Information About Health-Protective Behaviors During Genetic Consultation for Breast Cancer

This study aimed to explore health professionals' views and practice regarding the provision of information about health-protective behaviors (e.g., exercise, alcohol consumption, diet) during genetic consultation for breast cancer. Ten genetic counselors participated in three focus groups, and seven medical specialists were interviewed in a focus group or individually. Data was analyzed using the constant comparative method. Findings suggested that health professionals held differing, often opposing, views about the value of health-protective behaviors for women at increased risk of breast cancer. The content and extent of information provided about health-protective behaviors varied widely, and participants expressed a need to form consensus regarding information provision both within and across clinics. The main barriers to providing information regarding health-protective behaviors included the lack of research evidence regarding the impact of these factors and higher priority of other information need to be provided in the limited consultation time. Participants generally did not consider it their role to promote health-protective behaviors, and were concerned about the psychological impact of providing information about behavioral risk factors during genetic consultations.     

A Survey of Patients’ Experiences with the Cancer Genetic Counseling Process: Recommendations for Cancer Genetics Programs

In order to promote ongoing quality improvement of not only the Penn State Cancer Genetics Program, but also other cancer risk assessment programs throughout the country, we developed, piloted and conducted a survey to explore patient expectations, experiences, and satisfaction with the cancer genetic counseling process. The comprehensive survey was mailed to 340 eligible patients, 156 (45.9%) of whom returned the completed survey within the allotted time. Responses to closed-ended questions were tallied and open-ended questions were content analyzed. Major findings show that: (1) Patients were seeking cancer-related information and support throughout the cancer risk assessment process and were interested in participating in available research studies; (2) The setting in which patients are seen for cancer risk assessment may pose potential emotional ramifications; (3) Misperceptions regarding insurance discrimination and lack of insurance coverage persist; (4) Patients view the genetic counselor as responsible for updating them about new discoveries. Specific recommendations for cancer genetics programs are included.     

Transdiagnostic Internet treatment for anxiety disorders: A randomized controlled trial

Clinician-guided Internet-based cognitive behavioural therapy (iCBT) programs are clinically effective at treating specific anxiety disorders. The present study examined the efficacy of a transdiagnostic Internet-based cognitive behavioural treatment (iCBT) program to treat more than one anxiety disorder within the same program (the Anxiety Program). Eighty six individuals meeting diagnostic criteria for generalized anxiety disorder (GAD), panic disorder, and/or social phobia were randomly assigned to a treatment group, or to a waitlist control group. Treatment consisted of CBT based online educational lessons and homework assignments, weekly email or telephone contact from a clinical psychologist, access to a moderated online discussion forum, and automated emails. An intention-to-treat model using the baseline-observation-carried-forward principle was employed for data analyses. Seventy-five percent of treatment group participants completed all 6 lessons within the 8 week program. Post-treatment data was collected from 38/40 treatment group and 38/38 control group participants, and 3-month follow-up data was collected from 32/40 treatment group participants. Relative to controls, treatment group participants reported significantly reduced symptoms of anxiety as measured by the Generalized Anxiety Disorder - 7 Item, Social Phobia Screening Questionnaire, and the Panic Disorder Severity Rating Scale - Self Report Scale, but not on the Penn State Worry Questionnaire, with corresponding between-groups effect sizes (Cohen’s d) at post-treatment of 0.78, 0.43, 0.43, and 0.20, respectively. The clinician spent a total mean time of 46 min per person over the program, participants rated the procedure as moderately acceptable, and gains were sustained at follow-up. Modifications to the Anxiety program, based on post-treatment feedback from treatment group participants, were associated with improved outcomes in the control group. These results indicate that transdiagnostic programs for anxiety disorders may be successfully administered via the Internet.     

Internet administered guided self-help versus individualized e-mail therapy: A randomized trial of two versions of CBT for major depression

Internet-delivered psychological treatment of major depression has been investigated in several trials, but the role of personalized treatment is less investigated. Studies suggest that guidance is important and that automated computerized programmes without therapist support are less effective. Individualized e-mail therapy for depression has not been studied in a controlled trial. Eighty-eight individuals with major depression were randomized to two different forms of Internet-delivered cognitive behaviour therapy (CBT), or to a waiting-list control group. One form of Internet treatment consisted of guided self-help, with weekly modules and homework assignments. Standard CBT components were presented and brief support was provided during the treatment. The other group received e-mail therapy, which was tailored and did not use the self-help texts i.e., all e-mails were written for the unique patient. Both treatments lasted for 8 weeks. In the guided self-help 93% completed (27/29) and in the e-mail therapy 96% (29/30) completed the posttreatment assessment. Results showed significant symptom reductions in both treatment groups with moderate to large effect sizes. At posttreatment 34.5% of the guided self-help group and 30% of the e-mail therapy group reached the criteria of high-end-state functioning (Beck Depression Inventory score below 9). At six-month follow-up the corresponding figures were 47.4% and 43.3%. Overall, the difference between guided self-help and e-mail therapy was small, but in favour of the latter. These findings indicate that both guided self-help and individualized e-mail therapy can be effective.