Counseling Issues Research Articles

K02 How To Improve Young People's Experiences Of Predictive Testing For Huntington's Disease

Background A growing number of young people are requesting predictive testing for Huntington’s disease (HD). However, little research has explored whether they have different information and support needs from adults. We have previously described the experiences of young people (YP) undergoing predictive testing using rigorous qualitative methodology. Aim To identify key aspects of good counselling practice required to meet young people’s specific information and support needs. Methods Thematic analysis of interviews with 12 young people (aged 17–26) undergoing predictive testing for HD in Scotland. Results Key points for practice were: (1) Provide clear and engaging written and verbal information about the PT protocol, especially number of pre-test appointments and time span between each - signpost to resources such as HDYO www.hdyo.org; (2) YP may also be seeking support to deal with anger, intrusive thoughts or grief and loss - refer elsewhere if necessary; (3) Explore potential impact of results on family dynamics and family communication; (4) YP may have strong beliefs about their genetic status, discuss potential impact upon self-esteem and self-identity, especially of an unexpected result; (5) Encourage use of available family support before and after testing – this may not be through the direct family line; (6) Be clear about whose responsibility it is to make further appointments and (7) YP may require additional support or intervention between venepuncture and result. Conclusion Attention to these issues in genetic counselling could improve YP’s experiences of predictive testing for HD.

Next-generation carrier screening: are we ready?

Editorial summaryNext-generation sequencing (NGS) methodology allows for a major expansion in current carrier screening tests. NGS testing has been shown to be analytically accurate and cost-effective, but major challenges include educational and counseling issues.

Epicurean Ethics in the Pragmatist Philosophical Counsel

The paper explores the extent to which Epicurean ethics as a general philosophy of life can be integrated in a composite pragmatist approach to philosophical counseling. Epicureanism emerged in a historical era that was very different from the modern time and addressed a different philosophical ethos of the time. This alone makes it difficult for Epicureanism to satisfy all of the normative criteria for a modern ethics. On the other hand, the paper discusses aspects of the modern ‘external’, duty- and demand-driven ethics that may contribute to the emergence of some of the main issues for modern philosophical counseling. The author points out aspects of Epicurean ethics that are potentially powerful tools to address the issues of mood and meaning in philosophical counseling, and thus serve as a contemporary complement to a complex duty-bound, yet pragmatist view of ethics.

Counseling for non-invasive prenatal testing (NIPT): what pregnant women may want to know

Counseling for non-invasive prenatal testing (NIPT): what pregnant women may want to know

Pregnancy complicated by valvular heart disease: an update.

Cardiovascular disease complicates ≈1% to 3% of all pregnancies and is responsible for 10% to 15% of maternal mortality. Although its prevalence is considered relatively low in pregnant women, heart disease is the most common cause of maternal mortality. Because more women with congenital or

Next generation genetic counseling: introduction to the special issue.

The genesis of the idea for thisspecial issue,as well as its title, “Next Generation Genetic Counseling,” originated in January 2012. As the newly hired project manager for the University of North Carolina-Chapel Hill’s Clinical Sequencing Exploratory Research (CSER) consortium project, NCGENES, Myra had begun speculating just how the adaptation of Next Generation Sequencing (NGS) would affect genetic counseling practice (Roche 2012). Later that spring, at the American College of Medical Genetics meeting, the message that NGS would have an unprecedented impact on genetic counseling was delivered loudly and clearly but it seemed that too few of the voices sending that message belonged to genetic counselors. The idea behind this Special Issue is simply this: tap into the collective wisdom of the genetic counseling community to explore how NGS’s clinical application would impact current genetic counseling practices and ponder future implications by providing a platform on which the voices of genetic counselors could be heard. Since it was still early in the adaptation phase,wesuspectedthatfew empiricalstudiesanalyzingNGS and genetic counseling would be completed in time for our submission deadline. Therefore, we decided to cast a wide net in order to capture a broader swath of the early adaptation experiences of genetic counselors as they transitioned from traditional approaches in testing, counseling, and training to what promised to be an exciting, if uncertain, future. We challenged our colleagues to think, discuss, and write about what they saw as the critical emerging issues facing our profession. We wanted to “crowd source” their ideas and hear about strategiestocombine the essence ofwhatour profession has always contributed with new, best practices for the future as we moved together towards Next Generation Genetic Counseling (NGGC). Our call for papers invited submissions describing the evolution of genetic counseling and education strategies relevant to whole genome or whole exome sequencing; counseling and ELSI issues specifically related to return of diagnostic and incidental results; and the role of the genetic counselor on multidisciplinary teams offering this testing. The diverse submissions in this issue successfully answered our call. They range from empirical studies analyzing such bread and butter topics as informed consent and return of results to case studies describing how practicing genetic counselors are grappling with these same issues in their clinics. Throughout, we have kept the focus on the genetic counselors themselves as they adapt to expanded niches and actively create new ones.

It is time: a commentary on "An exploration of genetic counselors' needs and experiences with prenatal chromosomal microarray testing".

It is time: a commentary on "An exploration of genetic counselors' needs and experiences with prenatal chromosomal microarray testing".

Periviable Birth

This is an executive summary of a workshop on the management and counseling issues of women anticipated to deliver at a periviable gestation (broadly defined as 20 0/7 through 25 6/7 weeks of gestation), and the treatment options for the newborn. Upon review of the available literature, the workshop panel noted that the rates of neonatal survival and neurodevelopmental disabilities among the survivors vary greatly across the periviable gestations and are significantly influenced by the obstetric and neonatal management practices (eg, antenatal steroid, tocolytic agents, and antibiotic administration; cesarean birth; and local protocols for perinatal care, neonatal resuscitation, and intensive care support). These are, in turn, influenced by the variations in local and regional definitions of limits of viability. Because of the complexities in making difficult management decisions, obstetric and neonatal teams should confer prior to meeting with the family, when feasible. Family counseling should be coordinated with the goal of creating mutual trust, respect, and understanding and should incorporate evidence-based counseling methods. Since clinical circumstances can change rapidly with increasing gestational age, counseling should include discussion of the benefits and risks of various maternal and neonatal interventions at the time of counseling. There should be a plan for follow-up counseling as clinical circumstances evolve. The panel proposed a research agenda and recommended developing educational curricula on the care and counseling of families facing the birth of a periviable infant.

Periviable birth: executive summary of a joint workshop by the Eunice Kennedy Shriver National Institute of Child Health and Human Development, Society for Maternal-Fetal Medicine, American Academy of Pediatrics, and American College of Obstetricians and Gynecologists

This is an executive summary of a workshop on the management and counseling issues of women anticipated to deliver at a periviable gestation (broadly defined as 20 0/7 through 25 6/7 weeks of gestation) and the treatment options for the newborn infant. Upon review of the available literature, the workshop panel noted that the rates of neonatal survival and neurodevelopmental disabilities among the survivors vary greatly across the periviable gestations and are significantly influenced by the obstetric and neonatal management practices (eg, antenatal steroid, tocolytic agents, and antibiotic administration; cesarean birth; and local protocols for perinatal care, neonatal resuscitation, and intensive care support). These are, in turn, influenced by the variations in local and regional definitions of limits of viability. Because of the complexities in making difficult management decisions, obstetric and neonatal teams should confer prior to meeting with the family, when feasible. Family counseling should be coordinated with the goal of creating mutual trust, respect, and understanding and should incorporate evidence-based counseling methods. Since clinical circumstances can change rapidly with increasing gestational age, counseling should include discussion of the benefits and risks of various maternal and neonatal interventions at the time of counseling. There should be a plan for follow-up counseling as clinical circumstances evolve. The panel proposed a research agenda and recommended developing educational curricula on the care and counseling of families facing the birth of a periviable infant.

Periviable birth: executive summary of a Joint Workshop by the Eunice Kennedy Shriver National Institute of Child Health and Human Development, Society for Maternal-Fetal Medicine, American Academy of Pediatrics, and American College of Obstetricians and Gynecologists.

This is an executive summary of a workshop on the management and counseling issues of women anticipated to deliver at a periviable gestation (broadly defined as 20 0/7 through 25 6/7 weeks of gestation), and the treatment options for the newborn. Upon review of the available literature, the workshop panel noted that the rates of neonatal survival and neurodevelopmental disabilities among the survivors vary greatly across the periviable gestations and are significantly influenced by the obstetric and neonatal management practices (for example, antenatal steroid, tocolytic agents and antibiotic administration; cesarean birth; and local protocols for perinatal care, neonatal resuscitation and intensive care support). These are, in turn, influenced by the variations in local and regional definitions of limits of viability. Because of the complexities in making difficult management decisions, obstetric and neonatal teams should confer prior to meeting with the family, when feasible. Family counseling should be coordinated with the goal of creating mutual trust, respect and understanding, and should incorporate evidence-based counseling methods. Since clinical circumstances can change rapidly with increasing gestational age, counseling should include discussion of the benefits and risks of various maternal and neonatal interventions at the time of counseling. There should be a plan for follow-up counseling as clinical circumstances evolve. The panel proposed a research agenda and recommended developing educational curricula on the care and counseling of families facing the birth of a periviable infant.

Young People’s Perceptions of a Group Home’s Efficacy: A Retrospective Study

There are many young people from troubled backgrounds today in residential treatment care facilities. However, the majority of the residential care facilities do not offer the type of services required to have the desired impact on young people. In an attempt to contribute to this gap this study used a qualitative methodology to explore the retrospective experiences of youths who attended a faith-based residential treatment facility in the southern region of the United States. Findings suggest that program atmosphere, staff, punishment practices, counseling, spiritual development, and re-entry issues are important elements of the efficacy of residential care facilities.

Entering the Sacred: Using Motivational Interviewing to Address Spirituality in Counseling

Despite the salience of spirituality in the lives of many clients, counselors are often hesitant to explore spiritual issues in counseling, largely out of a valid concern of imposing values on the client. Motivational interviewing provides a framework within which a counselor can both assess spirituality and facilitate client exploration of spiritual issues without fear of imposing values.

Ethical Issues in Coparent Counseling

Coparent counseling is a method of helping moderate- and high-conflict divorced or separated parents improve their shared caretaking of their children. Because it is a relatively new modality, its practitioners face ambiguity and uncertainty in their efforts to practice ethically. In the present article, information and recommendations are provided regarding confidentiality, separate meetings with parents, interactions with attorneys and the court, meetings with the children, insurance billing, competence, and informed consent.

Relationship Between Nature Relatedness and Holistic Wellness: An Exploratory Study

Nature relatedness has been explored from interdisciplinary perspectives and found to be related to greater well‐being. However, nature relatedness has not been incorporated into counseling‐based holistic wellness models. This study of the relationship between nature relatedness and wellness provides implications for wellness theory, counseling practice, and research.

Mission for the Journal of Multicultural Counseling and Development Special Issue

Journal of Multicultural Counseling and DevelopmentVolume 42, Issue 2 p. 66-68 original articles Mission for the Journal of Multicultural Counseling and Development Special Issue Caroline S. Clauss-Ehlers Editor, Caroline S. Clauss-Ehlers EditorSearch for more papers by this author Caroline S. Clauss-Ehlers Editor, Caroline S. Clauss-Ehlers EditorSearch for more papers by this author First published: 02 April 2014 https://doi.org/10.1002/j.2161-1912.2014.00044.xRead the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article. Volume42, Issue2Special Issue: DIVERSITY IN HIGHER EDUCATIONApril 2014Pages 66-68 RelatedInformation

A Race Still Unfinished

[Breast Cancer Special Issue Index][1] Few scientific endeavors captured as much public interest as the race to identify BRCA1 , a gene responsible for inherited predisposition to breast and ovarian cancers. The search culminated in a 1994 Science paper reporting the isolation of BRCA1 by positional cloning.[*][2] Isolation of the related cancer predisposition gene BRCA2 followed soon after.[†][3] Twenty years later, the BRCA genes continue to make headlines, sparking a Supreme Court decision on the legality of gene patenting and intense debates on the ethics of genetic testing. ![Figure][4] CREDIT: ANNE WESTON/CANCER RESEARCH UK/VISUALS UNLIMITED INC. In this special section of Science , expert contributors retrace the long and tortuous path leading to the mapping and identification of the BRCA1 gene; discuss the ways in which BRCA mutation status has been integrated into the clinical management of patients in high-risk families; and highlight the role of the BRCA proteins in preserving the structural and numerical integrity of chromosomes throughout the cell cycle, a function that may explain their tumor suppressor activity. Science 's News team explores many of the issues that have arisen since the discovery of the BRCA genes. Advances in molecular medicine have brought new options for treatment and prevention, driving down mortality rates in wealthy countries. But in poor countries, shut out from these advances, mortality rates remain disproportionately high. Widespread breast screening has led to early detection and a new dilemma: whether to aggressively treat noncancerous lesions that may never become invasive or whether to “watch and wait.” Since 1994, dozens more genes have been found that increase a woman's risk of hereditary breast cancer, but by how much is uncertain, confounding already complicated issues in genetic testing and counseling. Throughout this explosion of research, advocacy groups have been a powerful force in boosting funding and shaping the agenda, and they continue pushing for increasingly ambitious, some say unrealistic, goals. Clearly much more needs to be done—both more research and better ways to get existing treatments to women who need them. The discovery of the BRCA genes was transformative. More than a million women and men have been tested for BRCA1 and BRCA2 mutations in the past 20 years, and there is no doubt that the test has saved lives. But mutations in these two genes account for only 5 to 10% of breast cancer cases in the general population, and worldwide, breast cancer remains the most common and most deadly cancer in women. Is it time to start a new race? [1]: http://www.sciencemag.org/site/special/breastcancer/index.xhtml [2]: #fn-1 [3]: #fn-2 [4]: pending:yes

Microscopic chromosome Xp distal deletions – a challenging issue in prenatal genetic counseling

A prenatal diagnosis of chromosome X short arm deletions may present a challenge in prenatal genetic counseling. We present clinical and molecular data of carriers of Xp distal deletions. We assessed prenatal and postnatal phenotypes of individuals from three families with large Xp distal deletions and from a fourth family with a small Xp distal deletion. The work-up included karyotyping, chromosomal microarray analysis, and assessment of the X inactivation pattern. Five out of eight women with large deletions had a short stature (<3rd percentile). Subjects from one family had developmental and emotional problems. All female carriers with small deletions had markedly short stature, whereas the men had mildly short stature. Chromosomal microarray analysis revealed 11.7-19.3 Mb deletions in three families and a small ~1 Mb deletion in the fourth. The pseudoautosomal region 1 of the X chromosome was deleted in two families with large deletions. X inactivation was skewed in all tested cases with large deletions. Xp distal deletions are mainly associated with short stature. Skewing of the abnormal X chromosome may attenuate the phenotype in cases with large deletions. We suggest that prenatal evaluation in such cases should include sonographic follow-up and assessment of the X inactivation pattern.

Mark Pope: Counseling's Sacred Weaver

Transformative cultural agent, networker and collaborator, professional leader, advocate for social justice, mentor, and scholar all describe roles that have defined the career of Mark Pope. Sacred weaver is a term that captures the essence of his unique place in the history of the professions of counseling and psychology. The authors use information from interviews with 6 widely recognized leaders in the fields of counseling and psychology and an interview with Pope himself to capture the essence of counseling's sacred weaver.

Personal and Professional Discord: Examining Religious Conservatism and Lesbian‐, Gay‐, and Bisexual‐Affirmative Counselor Competence

Lesbian, gay, and bisexual (LGB) orientations can evoke strong reactions that are often based on personal beliefs that seemingly conflict with professional standards calling for LGB‐affirmative counseling. This study examined the relationship between religious conservatism and LGB‐affirmative counselor competence. Controlling for education level, political conservatism, and LGB interpersonal contact, the results indicate that, as religious conservatism increased, LGB competency significantly decreased. The strongest predictor of LGB‐affirmative counselor competency was religious fundamentalism, whereas multicultural course work was not a significant predictor.

A Conversation About the Intersection of Faith, Sexual Orientation, and Gender: Jewish, Christian, and Muslim Perspectives

Recent challenges to counselor education and the ACA Code of Ethics (American Counseling Association, ) provided impetus for this article, which is focused on how 3 major Western religions address counseling and counselor training with diverse clients. Jewish, Christian, and Muslim perspectives are highlighted as related to counseling and training issues across faith, sexual orientation, and gender issues.