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101.
This article portrays a model of family therapy clinical supervision using change theory that is most appropriate for use with the videotape, audiotape, case presentation and debriefing from the live session. The most powerful tool during this process is that of communication and assessment of change theorys tools of confidence and conviction. The concepts presented are meant to add an additional dimension to family therapy supervision in cooperation of other theories, not as an end in themselves.Special thanks to Ms. Geri Koncilja of the Informational Technology Center at Colorado State University, Pueblo for illustration and graphic assistance. 相似文献
102.
McConkie-Rosell A Finucane B Cronister A Abrams L Bennett RL Pettersen BJ 《Journal of genetic counseling》2005,14(4):249-270
These recommendations describe the minimum standard criteria for genetic counseling and testing of individuals and families
with fragile X syndrome, as well as carriers and potential carriers of a fragile X mutation. The original guidelines (published
in 2000) have been revised, replacing a stratified pre- and full mutation model of fragile X syndrome with one based on a
continuum of gene effects across the full spectrum of FMR1 CGG trinucleotide repeat expansion. This document reviews the molecular
genetics of fragile X syndrome, clinical phenotype (including the spectrum of premature ovarian failure and fragile X-associated
tremor-ataxia syndrome), indications for genetic testing and interpretation of results, risks of transmission, family planning
options, psychosocial issues, and references for professional and patient resources. These recommendations are the opinions
of a multicenter working group of genetic counselors with expertise in fragile X syndrome genetic counseling, and they are
based on clinical experience, review of pertinent English language articles, and reports of expert committees. These recommendations
should not be construed as dictating an exclusive course of management, nor does use of such recommendations guarantee a particular
outcome. The professional judgment of a health care provider, familiar with the facts and circumstances of a specific case,
will always supersede these recommendations. 相似文献
103.
Axilbund JE Hamby LA Thompson DB Olsen SJ Griffin CA 《Journal of genetic counseling》2005,14(3):235-243
Cancer genetic counselors use a variety of teaching modalities for patient education. This survey of cancer genetic counselors assessed their use of educational videos and their recommendations for content of future videos. Thirty percent of respondents use videos for patient education. Cited benefits included reinforcement of information for clients and increased counselor efficiency. Of the 70% who do not use videos, predominant barriers included the perceived lack of an appropriate video, lack of space and/or equipment, and concern that videos are impersonal. Most respondents desired a video that is representative of the genetic counseling session, but emphasized the importance of using broad information. Content considered critical included the pros and cons of genetic testing, associated psychosocial implications, and genetic discrimination. The results of this exploratory study provide data relevant for the development of a cancer genetics video for patient education, and suggestions are made based on aspects of information processing and communication theories. 相似文献
104.
Doctor's Expertise and Managing Discrepant Information from Other Sources in Genetic Counseling: A Conversation Analytic Perspective 总被引:1,自引:0,他引:1
The study examines a recurrent interactional pattern in genetic counseling. It describes clinical geneticists' responses in
situations in which clients have presented information from other sources that is potentially discrepant with information
given by the doctor. The data consists of 12 video-recorded sessions of genetic counseling in Finland, and the method is conversation
analysis. There are two primary ways the doctors respond: either they accept the client's information as such, but show that
it is not discrepant with the doctor's information, or they reject the client's information. In the latter case they mitigate
the ‘wrongness’ of the client's information. The clinical geneticists seem to be working with a dilemma: they need to find
a balance between ensuring correct understanding of the information and showing respect for the expertise of others. A particularly
complex case is also analyzed and reflected on. 相似文献
105.
Claes E Evers-Kiebooms G Denayer L Decruyenaere M Boogaerts A Philippe K Legius E 《Journal of genetic counseling》2005,14(5):349-363
This prospective study evaluates emotional functioning and illness representations in 68 unaffected women (34 carriers/34
noncarriers) 1 year after predictive testing for BRCA1/2 mutations when offered within a multidisciplinary approach. Carriers had higher subjective risk perception of breast cancer
than noncarriers. Carriers who did not have prophylactic oophorectomy had the highest risk perception of ovarian cancer. No
differences were found between carriers and noncarriers regarding perceived seriousness and perceived control of breast and
ovarian cancer. Mean levels of distress were within normal ranges. Only few women showed an overall pattern of clinically
elevated distress. Cancer-specific distress and state-anxiety significantly decreased in noncarriers from pre- to posttest
while general distress remained about the same. There were no significant changes in distress in the group of carriers except
for ovarian cancer distress which significantly decreased from pre- to posttest. Our study did not reveal adverse effects
of predictive testing when offered in the context of a multidisciplinary approach. 相似文献
106.
Differences in Individual Approaches: Communication in the Familial Breast Cancer Consultation and the Effect on Patient Outcomes 总被引:1,自引:0,他引:1
This multicenter study aimed to assess (i) whether individual clinical geneticists and genetic counselors vary in their communication skills and (ii) whether this variation in communication impacts on patient outcomes, such as anxiety, depression, genetics knowledge, and satisfaction. One hundred and fifty women from high-risk breast cancer families attending their first genetic counseling consultation completed pre and post-consultation self-report questionnaires. The consultations were audiotaped and transcribed verbatim. Univariate analyses showed highly significant differences between individual clinical geneticists and genetic counselors in: facilitating understanding (p 0.001); facilitating active involvement (p 0.001); facilitating partnership building (p = 0.003); addressing emotional concerns (p 0.001); and discussing prophylactic mastectomy (p = 0.017). Multivariate linear regressions showed that this variation in communication resulted in a greater change in patients depression 4 weeks after the counseling session (p = 0.017). These findings suggest clinical geneticists and genetic counselors have achieved some standardization in communicating information, but showed diversity in their facilitation skills. Communication skills may be a useful area to explore further in this field. 相似文献
107.
One measure of the impact of genetic counseling and testing (GCT) is the extent to which it fosters behavioral change that is consistent with mutation status. We describe and illustrate how two different signal detection methods, receiver operating characteristic (ROC) analysis and recursive partitioning, can be used in this context to evaluate the impact of GCT. We analyzed real screening behavior data obtained in the 12 months following GCT for Hereditary Nonpolyposis Colon Cancer (HNPCC) using these two different signal detection approaches. Each approach demonstrated that GCT had an impact on behavioral outcomes, and was effective in fostering behavioral outcomes appropriate to mutation status. The ROC approach demonstrated that GCT was effective because mutation positive and mutation negative individuals could be distinguished on the basis of the number of recommended screening behaviors. The recursive partitioning approach demonstrated that GCT was effective because there were generally high rates of adherence to screening guidelines among subjects. The recursive partitioning technique also identified four subgroups of subjects, each with distinct characteristics, for which tailored interventions could be developed to increase rates of adherence to screening guidelines. Signal detection methods are easily implemented and are useful techniques for evaluating the impact of GCT. 相似文献
108.
Evaluating Genetic Counseling: Client Expectations,Psychological Adjustment and Satisfaction with Service 总被引:1,自引:0,他引:1
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. 相似文献
109.
The present study examined the role played by protective factors in moderating the effects of risk factors over bullying and victimization in a sample of 679 male adolescents recruited in Italian high schools. Boys’ involvement in bullying revealed that one in three students has bullied others at least sometimes in the previous three months, and one in six has been victimized at the same rate; victimization decreases with age. The family related risk factor (conflicting parents) was positively associated with bullying and with victimization (together with punitive parenting); the same applied for risk factor related to the individual ways of dealing with problems (emotionally oriented coping skills). Protective factors related to the family context (supportive and authoritative parents) and to the individual (problem solving coping skills) were negatively associated to bullying and victimization. Hierarchical regression analyses revealed a moderating effect of supportive parenting on punitive parenting and on emotionally oriented coping strategies in predicting victimization. Problem solving coping strategies helped buffer the negative impact of emotionally oriented coping strategies over bullying. Implications of results for practitioners and for future studies are addressed. 相似文献
110.
In light of the evolving roles of parents and the involvement of extended family within Asian cultures, the traditionally Western dyadic coparenting construct must be reconceptualized to include not only the coparenting relationship, but also other caregivers within the coparenting network. Theoretical and empirical evidence on coparental systems are discussed and two studies from South and Southeast Asian cultures are presented to highlight subcultural variations in cocaregiving networks. Results indicated that mothers were the primary caregivers across both cultural contexts. Extended family members assumed important coparental responsibilities in both cultural contexts. These findings highlight the need to reconceptualize and expand the dyadic coparental unit to include extended family members. We also discuss the relevance of the broader coparental network in examining the Asian childs education as well as cognitive and socioemotional development. 相似文献