Genetic counselor as a member of an outreach education team

As part of a program to improve maternal and infant health in New Jersey, the Robert Wood Johnson Foundation has funded seven regional consortia throughout the State. One of the goals of the Northern New Jersey Regional Consortium is to provide a comprehensive educational program for ambulatory care staff. An outreach education team was established that includes a perinatal nurse educator, a neonatal nurse educator, a nutritional counselor and a genetic counselor. Many issues in genetics can be initially addressed by the ambulatory care provider. A good understanding and awareness of the impact of genetic issues in patient care is needed to enhance the ability to recognize patients needing special services. Early assessment of possible risk for developmental disabilities can lead to appropriate comprehensive care and improved pregnancy outcome. Regular in-service programs, addressing the way heredity contributes to developmental disorders, the latest techniques used in genetics and the available management programs, can be provided. The present study is an evaluation of the effectiveness of the program.     

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     

Collaboration of Churches and Service Providers: Meeting the Needs of Older African Americans

ABSTRACT

This article describes a community outreach volunteer project designed to reach frail community-based older adults. The project is an example of church and secular agency collaboration in which the church provides leadership in volunteer recruitment and the agency provides training and outreach activity monitoring. The church's role in this project illustrates that small and medium-size African American churches can play an important role in mobilizing volunteer resources and can perform a linking role in helping secular agencies to gain access to frail, hard-to-reach, low-income older adults.     

Transforming school ensemble instruction through spiritually informed teaching practices

The transformative experiences that could be central to learning are curiously absent from American school music education. Students are motivated through competition and the goal of most programmes is flawless large ensemble performance. This paper describes a music programme in which the daily instructional practices have been modified and influenced by an outreach programme in which the students taught socially and economically challenged children of similar age. This programme was developed by a teacher with a deep sense of faith. His spiritually informed teaching practices emphasise the same principles of social justice espoused by secular educational philosophers. Parallels between spiritual and educational philosophies and a discussion of the transformations experienced by students conclude the paper.     

Seeking help for non-suicidal self-injury: A social network analysis approach

Individuals who self-injure have consistently reported less perceived social support; yet, little is actually known about the support they seek out from others specifically for non-suicidal self-injury. The goal of this study was to explore characteristics of support networks of those who self-injure. Twenty-three percent reported not seeking support for self-injury, while the remaining reported smaller social networks than typical. Most participants sought help infrequently, and when they did, found supporters to be only moderately helpful. Network characteristics were found to relate to self-injury behavior and patterns emerged regarding supporters in the networks. Implications for advocacy and education are provided.     

Training and Mobilizing Volunteers for Emergency Response and Long-Term Support

Abstract

This article offers guidelines for the screening, assignment, and ongoing training of volunteers for active outreach, which are based on the experience of the Israel Crisis Management Center's countrywide volunteer network. Given ongoing support, volunteers can provide the vital immediate and long-term support that is particularly important to vulnerable populations. Issues in training include: (a) responding to loss and trauma, (b) collaboration, and (c) cultural sensitivity. Ways to minimize burnout through nurturing a sense of belonging, connectedness, and meaning are discussed. The unique contribution and need for special support of volunteer trauma survivors who are models of post-traumatic growth is described.     

A crisis mental health intervention service: an innovative model for working intensively with young people on the edge of care

This paper describes the setting up and the first year of running of an innovative outreach service for adolescents on the edge of care that aimed at redressing family breakdown and preventing placements in the care system. It was a collaborative endeavour between social services and a child and adolescent mental health provision to facilitate the engagement of hard to reach young people and families that often presented high levels of risk. This article describes a distinctive model of applied psychoanalytic work with individuals, families and the networks of practitioners and agencies around the case. It focuses on the integration of two perspectives: the individual and the family on the one hand and the organisation on the other. Case examples illustrate how our psychoanalytic and developmental framework illuminated our understanding of frequently extreme acting out behaviour and parental difficulties in terms of underlying intergenerational trauma, which was often re-enacted. This framework also helped in understanding the difficulties that practitioners experienced and how these related to individual and family dynamics. The article describes the significance of containment in the treatment of adolescents and families in crisis as well as in supporting the professional network.     

Same-Sex Intimate Partner Violence: Lesbian,Gay, and Bisexual Affirmative Outreach and Advocacy

Intimate partner violence (IPV) is pervasive and crosses all boundaries of sexual orientation, race, and class. Scholars contend that the intimidation of another person through abusive acts and words is not a gender issue. Organizations seeking to offer equitable services to survivors of IPV must intentionally establish themselves as inclusive agencies. This article presents a review of common societal myths and barriers to help-seeking for survivors of same-sex partner violence and offers program guidelines for lesbian, gay, and bisexual affirmative outreach services and advocate training.     

Recruiting Anxious Older Adults for a Psychotherapy Outcome Study

Although anxiety is a serious problem among the elderly, very little research has been conducted with anxious older adults. One reason is that although anxiety disorders overall are more common than depression in older community samples, many specific anxiety disorders are relatively rare. Furthermore, anxious older adults often do not seek treatment or otherwise come to the attention of mental health researchers. This paper describes the first year of recruitment efforts for a treatment outcome study of psychotherapy for generalized anxiety disorder in adults at least 55 years old. Successful methods included collaborations with hospital-based health education programs and senior centers, as well as notices in local and senior newspapers. Less successful methods included radio public service announcements and mailings to residential facilities, churches and synagogues, and physicians. Recommendations for recruitment of anxious older adults into research projects are discussed.     

A virtual training institute in Eastern Europe

This is a short outline of the development of psychoanalysis and of analytic training in Eastern Europe after the fall of the Iron Curtain. The Han Groen Prakken Psychoanalytic Institute for Eastern Europe was founded by the IPA and the EPF in 2002 to organize and coordinate this. The activity of such an unusual training institute, virtual and time-limited up to the birth of new IPA study groups, is described with the problems it has had to face, from shuttle analysis to research of this unusual training, from initial outreach activity to formation of new analytic groups, from unavoidable plurality of analytic approaches of an international staff to the need for systematic teaching, from criteria for selection of candidates in such a large area with many languages, cultures and histories, to the integration of new analysts and groups in the international analytic community. These problems are part of the challenge implicit in the globalization, with its unavoidable push to enlarge to the whole humanity the psychoanalytic theory and praxis. Such an experience is now used in Latin America, but may also soon have its application in other continents. Freedom of mind is a basic need of all humans and psychoanalysis still has much to say about this.