The Field Of Genetic Counselling Psychology Essay

The Field Of Genetic Counselling Psychology Essay Over the past fifty years, the field of genetic counselling has been constantly evolving, often changing the roles and adjusting the values of genetic counsellors within the field. This progress can be monitored by looking at the genetic counselling literature from various decades and comparing fundamental values of the profession at a certain time period. In this paper, an evaluation of genetic counselling services is based on four studies conducted in 1970s and 2000s. These studies were on genetic counselling provided for neural-tube malformations by Morris and Laurence (1976), Duchenne muscular dystrophy by Emery et al. (1972), the role of genetic counselling in multidisciplinary metabolic clinic by Hartley et al. (2010), as well as on the genetic counselling for patients with psychiatric disorders (Hill and Sahhar 2006). The main focus of Morris and Laurence (1976) research was to assess the value of genetic counselling provided to couples who had a child with neural-tube malformations, an affected relative, or themselves had been suffering from these defects over the period of 8 years. The success of 160 genetic counselling sessions was measured by the clients reaction to counselling, accurate recollection of risks, and the appropriateness of the actions taken as a result of the risk numbers provided. In this study, genetic counselling consisted of two consultations. During the initial consultation, information on the origin, possible causes of the neural-tube malformation, and risk figures was given. In addition, the counsellor addressed the couples concerns and discussed the potential means of solving them using a nondirective approach (Morris and Laurence 1976). After the session, none of the couples had received the letter with the details of the consultation, it was only sent to their general p ractitioner. A two-hour follow-up consultation was arranged at the couples home, with a previous consent of the couple via a formal letter and the general practitioner. During this visit, a genetic counsellor had focused on the couples reactions to counselling, accurate recollection of risk information, and their decision on further pregnancy (Morris and Laurence 1976). The main purpose of Emery et al. (1972) study was to evaluate the effectiveness of genetic consultations given to women with confirmed diagnosis of Duchenne muscular dystrophy over the period of 4 years. The effectiveness of genetic counselling was measured in a similar way to the previously mentioned study, in addition to the influence of consultations on womens marital status. In contrast with the findings on neural-tube malformations (Morris and Laurence 1976), genetic counselling in this study consisted of two sessions and one follow-up visit. All three consultations differed in nature. Women referred to genetic counselling in this study were not aware of the exact risk numbers of them being a carrier for the X-linked Duchenne muscular dystrophy; therefore, the point of the first visit was to conduct a predictive test based on the serum levels of creatine kinase. As soon as the results were obtained, women came for the second consultation, where the information on the character o f the disease, their carrier status and risk figures was given. Similar to the study done on neural-tube malformations, Emery et al. (1972) implemented a nondirective approach into the genetic counseling sessions, with a slight emphasis on the importance of the risk figures given to women who were in the high risk group only. During a follow-up visit, a questionnaire was used to assess womens reactions to counselling and their views on future pregnancies. Neither counselled women nor their general practitioners received a detailed letter of the consultation. pg. 2 Both of the studies showed that the majority of clients seemed to have a fairly good apprehension of the disease nature and recall of the risk numbers, with the outstanding memory of clients falling into groups of very high and low risk. However, Morris and Laurence (1976) found that 23% of their clients had a very poor recall due to various reasons. It was quite surprising to see that nearly one-fifth of the couples were disappointed with the nondirectiveness of genetic counselling mostly because they were looking for someone to make decisions for them. The question that immediately comes to mind is: What are the reasons for disliking the nondirective approach? Was it because the counsellor did not provide enough psychological support? If the counsellor was concentrating on being nondirective and let clients be completely responsible for their own decisions, then the counsellor might have missed the opportunity to emotionally connect with the clients and give them enough confidence to make the decisions of their own. The evaluation of the effectiveness of genetic counselling in these two studies was mainly measured by the clients ability to retain information on risks, their attitude towards advice given, and their future decision making (Emery et al 1972; Morris and Laurence 1976). However, both of these studies had no emphasis on feelings of other family members about the disease, financial burden associated with the disease, and the social aspects of it. It was quite surprising to see that in the attempt to evaluate the effects of genetic counselling in Duchenne muscular dystrophy (Emery et al. 1972), there was no record of the actual feelings of the clients towards genetic counselling and the nondirective approach used. In my opinion, one cannot fully assess the attitude towards genetic counselling if it is measured through comprehension of the nature and risks of the disease, and not the emotional responses to the counselling process. It can be seen from both of the studies, that nondirective approach was used as a method for conducting genetic counselling. Over the past three decades, nondirectiveness was an integral part of genetic counselling (Kessler 1997). As a result, the information given to families had an emphasis on the genetic aspect of the disease, the risks associated with it and the importance of those risks. Genetic counsellors restrained themselves from participating in active discussion, giving advice or making any decision for the client. The study on Duchenne muscular dystrophy (Emery et al. 1972) clearly shows that the decisions associated with future pregnancies regardless of the risks were left entirely to the woman. Looking through the literature on genetic counselling, there seems to be a lot of criticism of nondirective approach and dissatisfaction of many genetic counsellors that have recently entered the field with it (Kessler 1997; Weil 2003; Weil et al. 2006). A high rate of dissatisfa ction with nondirective approach in the field could be well due to the fact that nondirectiveness was initially implemented in reproductive genetic counselling era, when genetic counsellors could only provide information on risks and prenatal testing, and left the decisions on family planning up to the clients (Weil 2003). This is well illustrated by the studies on neural-tube malformations (Morris and Laurence 1976) and Duchenne muscular dystrophy (Emery et al. 1972). The study done by Hartley et al. (2010) vividly shows how different the role of genetic counsellor is these days. It looks at a genetic counsellor as a part of one complex multidisciplinary environment providing a wide variety of health services to children with metabolic disorders. The distinct feature of the genetic counselling in such clinics is pg. 3 that the counselling sessions are provided continuously over the life span of a patient. In contrast with the genetic counselling services in 1970s, the counsellors in this type of clinical environment have an opportunity to fully engage with the client, an advantage of addressing every concern the patients family has, as well as providing a continuing emotional support (Hartley et al. 2010). The consultations themselves differ quite significantly from those taken place in reproductive genetic counselling era. During the first consultation, genetic counsellors do realize that the stress of recently diagnosed child with metabolic disorder often overrides the familys ability to take in the information on the disorder and risks associated with it. Keeping this in mind, genetic counsellors do not go into the genetic aspect of the disorder, but rather provide immediate psychosocial support and give an idea of what it means to live with a metabolic condition on the day-to-day basis (Hartle y et al. 2010). Looking back at the studies done by Morris and Laurence (1976) and Emery et al. (1972), one could see a possible downside of giving a whole lot of information in a single counselling session, which could be the underlying reason for clients poor recall of information when in distress. Therefore, the second consultation is usually held at least four months after the metabolic disorder is diagnosed. And it is during this session that the extensive information on the inheritance and nature of the condition, and the available community support groups (Hartley et al. 2010). The study done by Hill and Sahhar (2006) also shows a newly developing role of a genetic counsellor in the field of psychiatric genetics. Due to the current limitations in the knowledge of psychiatric genetics, most of the genetic counsellors work is devoted to providing helpful resources to the family, connecting them with support groups, emphasizing the importance of family support and helping to deal with the stigma associated with psychiatric disorders, however, the risks of recurrence are also explained. The counselling sessions also tend to be held over a long period of time, which gives clients more time to adapt to a genetic side of mental illness. The two recent studies are similar in a way that there was a detailed summary letter written to the clients with the information covered during the counselling session (Hartley et al. 2010; Hill and Sahhar 2006). In studies done by Morris and Laurence (1976) and Emery et al. (1972), it is quite understandable that if someone wants to measure the ability of a client to remember the information given, then no summary letter should be sent. However, such letter tends to be crucial with helping clients to fully understand and retain the information on the disorder if they were not able to concentrate on it during the counselling session (Hill and Sahhar 2006). These letters also serve as important starting point for sharing information within the family or with a general practitioner. Both of the recently done studies on the genetic counselling emphasize a psychosocial approach to genetic counselling rather than nondirective approach. It is quite interesting, because few years before these papers came out, Weil (2003) did raise a question of whether nondirective approach should continue to be recognized as the main ethos for genetic counselling, or whether a new approach, emphasizing psychosocial direction, should be developed. As Weil (2003) suggested, some crucial values of nondirectiveness, such as providing balanced information, not imposing the genetic counselors values on the counselee, and supporting counselee autonomy should be included in the central ethos of the genetic counselling practice in general, regardless of the approach used.

The Characteristics of Adolescents Essay -- Papers Young Adults Teenag

The Characteristics of Adolescents Works Cited Not Included Adolescence, the period of life between childhood and maturity, may be regarded as one of the most crucial stages through which the human individual passes in his journey from conception to death. For many, it is seen as the key stage in development. Changes in physique and the maturation of the reproductive system bring with them associated changes in emotions and the whole pattern of psychological characteristics is restructured as the individual strives to attain a sense of identity. Development in intellectual functioning provides the adolescent with the ability to question himself, his family, his world, and his values (Garrod, Smulyan, Powers, and Kilkenny, 1992). Adolescents begin to develop principles- not necessarily those that adults would like to have them develop- but nevertheless principles of conduct. They are deeply influenced by "what is done" among their peers or among people slightly older than themselves, whom they respect. Adolescents tend to revolt against whatever code of morals may be in vogue in their corner of the world, and they can become completely obsessed by almost any moral problem. They are normally prejudiced and uncompromising in whatever attitude they adopt. This stage of growth is a difficult one for them and for everyone else, but perhaps it is necessary as a step from the unthinking acceptance of childhood to the independent thinking of an adult. During this period, the adolescent is an unreasonable creature. He does a good deal of hard thinking, accompanied by endless hours of talking with his peers, about his philosophy of life. Int... ...cult to engage in discussions about problems that affect them, and less likely to respond on a feeling level than young women. Being the mother of two children, aged twenty-one and nineteen years of age, I am aware of how a youth's characteristics would impact on our session. I have never had a problem dealing with adolescents, as I am consistently interacting with teenagers on a regular basis. Therefore, I am familiar with the problems that might be addressed during therapy; such as the fear of disclosure, inability to see problem behaviours, and their view that counselling is punitive. As a result, I would use various micro skills that I have acquired over numerous years to make sure the counselling environment was as comfortable for the adolescent as possible, therefore allowing them to discuss their problems.

How Did the Constitution Guard Against Tyranny Essay

Have you ever wondered what the US would be like if our government was a tyranny? Well, thanks to our founding fathers for creating a strong constitution, we don’t have to worry about that. The constitution was written in 1787 in Philadelphia. The problem was that the existing government that was under the Articles Of Confederation wasn’t very successful. Therefore, the fifty-five delegates representing twelve out of the thirteen states came together to tweak our constitution to create a strong government without allowing one person, or group of people to have too much power. The framers used the Constitution to protect against Tyranny in three ways federalism, separation of powers, and checks and balances. One way that the framers protected against Tyranny was through federalism. â€Å"The different governments will each control each other, at the same time will be controlled by itself. † (Document A) By separating the two different governments ,it creates a double security to the rights of the people Commentary, and the two control each other and itself. Read more: Tyranny constitution essay This guards from a tyranny because it keeps the power completely separated between central and state government but keeping the power even at the same time, so that one doesn’t inherit too much. Document A states that powers given to the central government include: regulate trade, conduct foreign relations, provide an army and navy, declare war, print and coin money, set up post offices, and make immigration laws. Powers given to the states include: set up local governments, hold elections, establish schools, pass marriage and divorce laws, and regulate in-state business. The two different parts government hold their own different powers and responsibilities that are both limited and shared to keep it fair. This guards from tyranny because it splits up the rolls between the central and state government but still keeps them even. Federalism is one of the main ways framers used to protect against tyranny. Another way the framers used the Constitution to protect against tyranny was separation of powers. â€Å"(L)iberty requires that the three great departments of power should be separate and distinct. (Document B) For our government to be successful we much create three main levels of government where powers are distributed. This guards from tyranny because it makes sure that no branch has more power than one another because they check each other. Document B states that in the Constitution article 1 section 1, article 2 section 1 clause 1, and article 3 section are about the three separate branches in our government and what responsibilities that each o ne holds. With our government having three different branches each one has its own limited powers that make a democracy possible. This guards against tyranny because no branch overpowers each other, nobody gets too much power, and the powers are evenly distributed. Separation of powers is one of the main things framers used to protect against tyranny. A third way that the framers used the Constitution protects against tyranny was checks and balances. â€Å"†¦ The constant aim is to divide and arrange the several offices in such a manner as that they check on the other†¦ The main goal is to make sure that each of the three branches have control over each other but still separated. This protects against tyranny because each branch has powers the control one another. In document C it states how each level of government limits and balances each other out to keep the powers even, and how our government is constitutional. Each different part of the government has three separate branches t he uses the Method checks and balances to keep power even and to have control over each other. This guards from tyranny because by keeping all of them limited with what they can do and in control of each other keeps it from one branch getting more power than another. Checks and balances is one of the main things the framers used to protect against tyranny. Federalism, Separation of powers, and checks and balances were the three ways that the framers used the constitution to protects our government against a tyranny. Paragraph 1 came from document A stating how federalism played a part in protecting against tyranny by creating double security for the people. Paragraph 2 came from document B stating how the separation of powers played a part in protecting against tyranny by creating three branches of government with separate powers. Paragraph 3 came from document c stating how checks and balances played a part in protecting against tyranny by making sure each branch had certain powers and also controlled each other at the same time. The founding fathers took advantage of the holes in the Articles of Confederation and used their knowledge to create a stronger constitution that today still guards from tyranny affecting our government.

A Brief Note On M Northwest Assistance Ministries, A Non...

N.A.M Northwest Assistance Ministries is a non-profit, community-based, multi-program social service agency. The mission statement is to strive to meet basic human needs through neighbors helping neighbors. Basic services are provided by The Emergency Basic Needs Program offering a variety of emergency services including shelter, food, energy bills, prescriptions (non-narcotic), gasoline vouchers, transportation, bus tokens, clothing, financial help with rent/mortgage, school supplies, referrals, and holiday food and toys. Northwest Assistance Ministries values are maintaining a strong commitment to their mission of meeting basic human needs through Neighbors helping Neighbors; fostering a spirit of respect and charity; striving for excellence in all that they do; and strengthening connections with their spiritual, funding, and volunteer partners. NASW Code of Ethics took after by the office staff were: service with the essential objective of helping individuals in need and to address social issues. Dignity and worth of the individual was an alternate code of morals; treating every individual in a minding and aware style, while staying aware of individual contrasts and social and ethnic assorted qualities. To wrap things up, informed consent giving administrations to customers just in the connection of an expert relationship based, when suitable, on substantial educated assent. The organizational structures of NAM are as includes the Board of Trustee along with the ExecutiveShow MoreRelatedExploring Corporate Strategy - Case164366 Words   |  658 Pagescapture the richness and complexity of real-life management situations and we would also encourage readers and tutors to take every possible opportunity to explore the live strategic issues of organisations – both their own and others. 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