THE FATHER,THE FATHER FUNCTION,THE FATHER PRINCIPLE: SOME CONTEMPORARY PSYCHOANALYTIC DEVELOPMENTS

The author discusses Freud's thinking on the role of the father, as well as that of later French theoreticians. To illustrate his remarks, he draws on the poetry of Carlos Drummond de Andrade (1912–1987), a Brazilian poet whose work often dealt with themes of the father, the family, and his own paternal relationship. The author also discusses the psychic formation of the father principle and how this may be evident in the clinical analytic setting, even when the analyst's approach privileges field theory, intersubjectivity, or other concepts emphasizing the relationship between analyst and patient.     

Barriers Impacting the Utilization of Supervision Techniques in Genetic Counseling

Clinical supervision is an essential element in training genetic counselors. Although live supervision has been identified as the most common supervision technique utilized in genetic counseling, there is limited information on factors influencing its use as well as the use of other techniques. The purpose of this study was to identify barriers supervisors face when implementing supervision techniques. All participants (N?=?141) reported utilizing co-counseling. This was most used with novice students (96.1 %) and intermediate students (93.7 %). Other commonly used techniques included live supervision where the supervisor is silent during session (98.6 %) which was used most frequently with advanced students (94.0 %), and student self-report (64.7 %) used most often with advanced students (61.2 %). Though no barrier to these commonly used techniques was identified by a majority of participants, the most frequently reported barriers included time and concern about patient’s welfare. The remaining supervision techniques (live remote observation, video, and audio recording) were each used by less than 10 % of participants. Barriers that significantly influenced use of these techniques included lack of facilities/equipment and concern about patient reactions to technique. Understanding barriers to implementation of supervisory techniques may allow students to be efficiently trained in the future by reducing supervisor burnout and increasing the diversity of techniques used.     

Measuring the Effectiveness of a Genetic Counseling Supervision Training Conference

Genetic counselors who receive formal training report increased confidence and competence in their supervisory roles. The effectiveness of specific formal supervision training has not been assessed previously. A day-long GC supervision conference was designed based on published supervision competencies and was attended by 37 genetic counselors. Linear Mixed Model and post-hoc paired t-test was used to compare Psychotherapy Supervisor Development Scale (PSDS) scores among/between individuals pre and post conference. Generalized Estimating Equation (GEE) model and post-hoc McNemar’s test was used to determine if the conference had an effect on GC supervision competencies. PSDS scores were significantly increased 1 week (p < 0.001) and 6 months (p < 0.001) following the conference. For three supervision competencies, attendees were more likely to agree they were able to perform them after the conference than before. These effects remained significant 6 months later. For the three remaining competencies, the majority of supervisors agreed they could perform these before the conference; therefore, no change was found. This exploratory study showed this conference increased the perceived confidence and competence of the supervisors who attended and increased their self-reported ability to perform certain supervision competencies. While still preliminary, this supports the idea that a one day conference on supervision has the potential to impact supervisor development.     

The Relationship between the Supervision Role and Compassion Fatigue and Burnout in Genetic Counseling

Many genetic counselors provide supervision to students during their career. Previous studies have shown genetic counselors, in general, are at increased risk for developing compassion fatigue. The purpose of this study was to determine if there was a difference in compassion fatigue and burnout levels in genetic counselors who currently supervise compared to genetic counselors who do not. Genetic counselors who currently practice in a clinical setting (N = 391) completed an online survey containing demographic questions, the Professional Quality of Life Scale, the State-Trait Anxiety Inventory, and questions specific to the genetic counselor’s experiences with supervision. Overall, when controlling for trait-anxiety, the supervision role by itself was not independently associated with the risk for compassion fatigue and burnout among genetic counselors. Within supervisors, however, there were several factors which were associated with this risk. Those with less supervision experience reported more secondary traumatic stress. Those supervisors reporting less confidence had decreased compassion satisfaction. Those with less experience or less confidence in their supervision role were most likely to be at increased risk for developing compassion fatigue. Training in supervision and support for dealing with compassion fatigue and burnout may be beneficial to supervisors with less experience.     

Characterization of the Practice and Attitudes of Genetic Counselors with Doctoral Degrees

Potential advantages and disadvantages of doctoral training in genetic counseling have been debated. In this study, individual interviews were conducted to characterize the practice and attitudes of genetic counselors who have achieved doctoral degrees in any field. Participants (N=31) were more likely to spend time in research and less likely to spend time in clinic than genetic counselors in general. Advantages identified by participants were consistent with theorized advantages, and included increased knowledge, wider research roles, additional opportunities and greater respect. Disadvantages identified by participants focused more on individual perspectives than previously theorized profession-wide disadvantages. These included increased time commitment and decreased patient contact. The attitudes of participants towards the development of doctoral training in genetic counseling were generally positive. The results suggest that doctoral training in genetic counseling would have more benefits than drawbacks for individuals pursuing this degree.     

The Relationship Between the Supervisory Working Alliance and Student Self-Efficacy in Genetic Counseling Training

The purpose of this study was to determine if a genetic counseling student’s perception of the supervisory working alliance (SWA) is related to their self-efficacy on select clinical practice-based competencies (PBCs), evaluating the second tenet of the Reciprocal Engagement Model of Supervision (REM-S) from a student perspective. Second year genetic counseling students (N?=?168) completed a survey containing demographic and clinical rotation experience questions, the Supervisory Working Alliance Inventory-Trainee Form (SWAI-T), and the Genetic Counseling Self-Efficacy Scale (GCSES). Overall, the SWAI-T was significantly associated with all factors of the GCSES. Additionally, the relationship between the SWAI-T and self-efficacy was specific to those who had only one supervisor, thus highlighting the SWA may be most important under these circumstances. This serves as an important step in being able to guide supervisors toward effective methods in supervision, which may include encouraging supervisors to build a strong relationship with their supervisee in order to help strengthen the student’s confidence in their clinical skills.