The use of the thematic apperception test in the study of Native American psychological characteristics: a review and archival study of Navaho men

The present study was designed as a "snapshot in time"--an archival analysis of the psychological characteristics of four Navaho men taken from Navaho Veterans--A Study of Changing Values (E. Z. Vogt, 1951). From a sample of 15 men, Vogt judged 2 as "most acculturated" and 2 as "most unacculturated." The present study was an attempt to examine the Thematic Apperception Test (TAT) protocols of these men on the basis of any recurring and psychologically significant thematic patterns, shared and unshared by the "acculturated" and "unacculturated" subjects. Vogt administered cards from the original TAT set created by H. A. Murray (1943). In this article, a section concerning the definitional use of the term acculturation is provided, followed by a discussion of the limitations inherent in the analysis of TAT protocols. A general survey of psychological and cultural studies of Native Americans using the TAT or TAT modifications is also provided. The examination of the protocol sets resulted in the identification of four themes or approaches to the TAT cards that were thought to be most pervasive and significant across both levels of acculturation: economic deprivation and physical suffering, loneliness/isolation, interpersonal conflict/violence, and individualistic vs. familial orientations. These themes and approaches are illustrated with quotations from the original protocols and are later summarized as the first four categories of a table comparing the psychological characteristics of the most acculturated men with the most unacculturated men. Results of the thematic analyses are discussed within the framework of economic and social pressures traditionally experienced by Native Americans.     

Expansion of Genetic Services Utilizing a General Genetic Counseling Clinic

We established a general genetic counseling clinic (GCC) to help reduce long wait times for new patient appointments and to enhance services for a subset of patients. Genetic counselors, who are licensed in Tennessee, were the primary providers and MD geneticists served as medical advisors. This article describes the clinic referral sources, reasons for referral and patient dispositions following their GCC visit(s). We obtained patients by triaging referrals made to our medical genetics division. Over 24 months, our GCC provided timely visits for 321 patients, allowing the MD geneticists to focus on patients needing a clinical exam and/or complex medical management. Following their GCC visit(s), over 80 % of patients did not need additional appointments with an MD geneticist. The GCC allowed the genetic counselor to spend more time with patients than is possible in our traditional medical genetics clinic. Patient satisfaction surveys (n?=?30) were very positive overall concerning the care provided. Added benefits for the genetic counselors were increased professional responsibility, autonomy and visibility as health care providers. We conclude that genetic counselors are accepted as health care providers by patients and referring providers for a subset of clinical genetics cases. A GCC can expand genetic services, complement more traditional genetic clinic models and utilize the strengths of the genetic counselor health care provider.