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.     

最大信息量法在CCSPC评分中应用的效度证据

采用基于最大信息量法的多维项目反应理论模型估计计算机模拟心理咨询病例系统（CCSPC）的合成分数及四个模块分数,并收集效标效度证据、成长变化效度证据和内容效度证据,结果表明：五个指标与心理咨询师考试三级技能成绩的相关均达到显著,且高于其与三级理论成绩的相关;所有指标得分均随着心理学学历升高而升高;多数指标分数随心理学本科年级提高而提高;获得心理咨询师资格认证的被试在CCSPC上有更高的得分.     

A Review of “The Reformation. A Brief History”

Scholars researching the varieties of Orthodox Judaism have different types of primary and secondary resources available to them electronically. Books and journals are available digitally. Web sites emanate from institutions, organizations, and individuals that have clear ideological and political preferences. There is increasing use of the Internet by Orthodox and Haredi Jews for a variety of religious, communal, personal, and educational purposes. Religious Jewish residents of the West Bank maintain community Web sites that provide historical, theological, institutional, and communal information. This article describes some of the Web-based resources and tools that reflect the wide range of Orthodox thought, activity, and practices.     

Terrorism in the Age of the Internet: The Case of Muslim Arab Foreign Terrorist Organizations

This study focuses on Muslim Arab extremism online. It specifically looks at the case of Muslim Arab organizations identified by the U.S. Department of State as Foreign Terrorist Organizations. The use of the Internet to communicate extremist rhetoric is not a new phenomenon nor is it one that is particular to Muslims or Arabs. This study simply focuses on this specific subgroup, partially due to the increased scholarly attention to the topic of terrorism and to the public's heightened interest in the Muslim and the Arab world since 9/11.     

Barriers and Supports to Substance Abuse Service Use Among Homeless Adults

Although there is a great need for substance abuse services among the homeless, many homeless individuals do not use those services. This study examined barriers and supports related to service use. Participants recognized a need for treatment and significant barriers to accessing care.     

Sequential Aiming with Two Limbs and the One-Target Advantage

Movement times to the first target in a 2-target sequence are typically slower than in 1-target aiming tasks. The 1-target movement time advantage has been shown to emerge regardless of hand preference, the hand used, the amount of practice, and the availability of visual feedback. The authors tested central and peripheral explanations of the 1-target advantage, as postulated by the movement integration hypothesis, by asking participants to perform single-target movements, 2-target movements with 1 limb, and 2-target movements in which they switched limbs at the first target. Reaction time and movement time data showed a 1-target advantage that was similar for both 1- and 2-limb sequential aiming movements. This outcome demonstrates that the processes underlying the increase in movement time to the 1st target in 2-target sequences are not specific to the limb, suggesting that the 1-target advantage originates at a central rather than a peripheral level.     

Between Midlife and Old Age:

This article is based on taped interviews with 56 women, individually and in groups, between the ages of 60 and 70, as well as my own experience as a woman past 65. Discussions with my friends and colleagues in this age group also contributed to my thinking. My sense is that the seventh decade is one of numerous transitions in the lives of women, and that these transitions require extensive, varied, and often painful opportunities for learning. Furthermore, the proximity to life's ending also acts as a strong motivator for engaging in activities that had previously been put off; these include a variety of self-selected and often pleasurable learning experiences. The learning that takes place at this age is rarely acknowledged; it is more likely to be overshadowed by the ageist assumption that old people lost their ability to learn or even to comprehend new information, and by the sexist assumption that women are incapable of making intelligent and practical decisions. These interviews and informal discussion contradict such stereotypical misinformation about old women, showing instead a high level of personal and interpersonal learning, as well as the development of extensive and creative new coping strategies.     

The Diagnostic Approach

No abstract available for this article.