The second edition of Genetic Counseling Practice: Advanced Concepts and Skills, provides in-depth content regarding the advanced competencies for meeting patient needs across the changing landscape of genetic counseling practice. The content aligns with the Reciprocal Engagement Model (REM) of practice which integrates the biomedical knowledge and psychosocial aspects of genetic counseling.
This edition has been revised and expanded to reflect advances made in the present-day field. Edited by a team two genetic counselors and a psychologist, the chapters offer a holistic picture of genetic counseling. Chapter authors are all recognized experts in the profession. The chapters are grounded in evidence-based practice and research. Each chapter includes learning activities to help readers apply concepts and skills. Featured topic areas include:
- Meeting the needs of culturally diverse patients
- Addressing challenging patient dynamics
- Working with children, adolescents and families
- Using emerging service delivery models for genetic counseling
- Engaging in self-reflective, deliberate practice
- Promoting genetic counselor professional development
Genetic Counseling Practice is an indispensable guide to the complex and evolving field of genetic counseling, and this updated second edition will help practitioners and trainees alike navigate its most pressing and practical challenges with skill and care.
Table of Contents
Preface x
About the Authors xi
Acknowledgments xvii
1 Introduction 1
Bonnie S. LeRoy, Patricia McCarthy Veach, and Nancy P. Callanan
Development of the 2nd Edition 2
References 7
2 Complicated Shadows: The Limitations of Autonomy in Genetic Counseling Practice 9
Robert G. Resta
Objectives 9
Definition and Focus 10
Seven Limitations of Autonomy 11
Summary 18
Learning Activities 19
References 21
3 Actively Engaging with Patients in Decision-Making 25
Andrea Shugar and Cheryl Shuman
Objectives 25
A Brief History of the Medical Encounter: From Paternalism to Shared Decision-Making 25
Psychological Aspects of Decision-Making 26
Informed Decision-Making 30
Summary 41
Learning Activities 41
Acknowledgment 48
References 48
4 Risk Assessment and Communication: A Complex Process 53
Shannan Delany Dixon, MaryAnn W. Campion, and Claire N. Singletary
Objectives 53
Introduction 53
Risk Assessment in Genetic Counseling 54
Risk Communication 61
Influences on Risk Perception 65
Summary 70
Learning Activities 70
References 73
5 A Genetic Counselor’s Guide to Understanding Grief 79
Nadia Ali and Cecelia Bellcross
Objectives 79
Introduction 80
The Grief Process 82
Types of Grief 89
Conclusion 101
Learning Activities 102
References 105
6 Patient Anger: Insights and Strategies 109
Lynn Schema
Objectives 109
Introduction 109
Challenges Posed by Patient Anger 116
Practice Applications 118
Conclusion 123
Summary Points 123
Learning Activities 124
References 127
7 Resistance and Adherence: Understanding the Patient’s Perspective 131
Krista Redlinger-Grosse
Objectives 131
Definition and Concepts 132
Resistance 133
Adherence and Non-adherence 140
Summary 144
Learning Activities 145
References 148
8 Countertransference: Making the Unconscious Conscious 153
Krista Redlinger-Grosse
Objectives 153
Definitions and Concepts 154
The Countertransference Process 155
Manifestations and Effects of Countertransference 161
Management of Countertransference 166
Summary 169
Learning Activities 169
References 171
9 Supporting Family Communication About Genetic Conditions 177
Marion Mcallister, Rhona Macleod, and Alison Metcalfe
Objectives 177
Introduction 177
Literature Review 178
Application of Select Family Systems Theory Interventions Adapted to Genetic Counseling 180
Summary 186
Learning Activities 187
Acknowledgments 188
References 188
10 Developmentally Based Approaches for Counseling Children and Adolescents 191
Stephanie Austin and Kelly Schoch
Objectives 191
Introduction 191
Child and Adolescent Development 192
Theoretical Framework 195
Chronic Illness and Children 197
Strategies for Genetic Counseling with Children and Adolescents 199
Conclusion 212
Summary Points 212
Learning Activities 212
References 214
11 Cultural Competency and Genetic Counseling: Key Concepts 219
Nancy Steinberg Warren
Objectives 219
Introduction 219
Definitions and Key Concepts 220
Health Disparities 226
Conceptualizing Cultural Competence 230
Developing Cultural Competency 231
Summary 236
Learning Activities 236
Resources for Cultural Knowledge, Cases, Teaching, and Learning Exercises 239
References 240
12 Cultural Competency: Application to Genetic Counseling 247
Nancy Steinberg Warren
Objectives 247
Introduction 247
Cultural Competency and the Genetic Counseling Process 248
Explanatory Models of Health and Well-being 253
Health Literacy 259
Working with Interpreters and Translators 260
Summary 263
Learning Activities 264
Resources for Cultural Knowledge, Cases, Teaching, and Learning Exercises 265
References 266
13 Education in Genetic Counseling: The Impacts of Genetic Literacy and Adult Learning 271
Andrea L. Durst and Rachel Mills
Objectives 271
Introduction 271
General Literacy in the United States 273
Health Literacy 274
Genetic Literacy 276
Genetic Literacy Considerations for Genetic Counselors 280
Adult Education Theory in Practice 294
Summary Points 301
Learning Activities 302
References 304
14 Adapting Genetic Counseling Practice to Different Models of Service Delivery 317
Angela Trepanier and Dawn C. Allain
Objectives 317
Introduction 317
Defining Service Delivery Models 318
Attributes of Alternative Service Delivery Models 319
Putting it all Together - Practice Implications 329
Conclusions 333
Learning Activities 333
References 335
15 “Oh The Places You’ll Go!” The Genetic Counselor Professional Development Journey 341
Catherine A. Reiser
Objectives 341
Introduction 341
Literature Review 343
Reflective Practice 347
Optimizing Self-Reflection 352
Leadership 354
Summary Points 356
Acknowledgments 356
Learning Activities 357
References 360
16 Development of the Genetic Counseling Profession: A Professionalization Process 365
Bonnie Jeanne Baty
Objectives 365
What Makes a Field of Practice a Profession? 365
How Does Genetic Counseling Measure Up to the Characteristics of a Profession? 366
Milestones in the Development of the Genetic Counseling Profession 366
Genetic Counseling and the General Model of Professionalization 369
Looking to the Future: Milestones that Need Further Development to Advance the Professionalization of Genetic Counseling 370
How is Professionalization of Genetic Counseling Relevant to Genetic Counseling Practitioners? 375
Summary 376
Learning Activities 377
References 378
Index 383