Browsing by Subject "Genetic Counseling"
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Item From graduate to seasoned practitioner: a qualitative investigation of genetic counselor professional development.(2009-07) Zahm, Kimberly WehnerResearch on professional development processes can contribute to individuals' anticipation and normalization of developmental processes, to improved training and supervision, and to the creation of a wider breadth and depth of professional development opportunities and support in the field. Presently, no comprehensive studies of genetic counselor professional development have been conducted. In the present study 34 post-degree genetic counselors from all six National Society of Genetic Counselors practice regions in the United States and Canada participated in a semi-structured telephone interview about their professional development experiences. Five major research questions were investigated: (1) What constitutes professional development for genetic counselors? (2) How do these professional development processes occur for genetic counselors? (3) What facilitates and/or impedes professional development? 4) How does genetic counselor professional development vary as a function of experience level? and 5) How does genetic counselor professional development compare/contrast to psychotherapist development described by Skovholt and Ronnestad (1992a)/Ronnestad and Skovholt (2003) and Orlinsky et al. (2005)? Participants were purposefully sampled from three levels of post-degree genetic counseling experience: novice (0-5 years), experienced (6-14 years), and seasoned (> 15 years). Using a modified version of Consensual Qualitative Research (Hill et al., 2005; 1997), three themes, 12 domains, and 47 categories were extracted from data. The themes are: 1) Being a clinician: Genetic counselors' evolving perceptions of and relationships to their clinical work; 2) The field itself: Genetic counselors' evolving perceptions of and relationships to the field of genetic counseling; and 3) Being a clinician in the field: Genetic counselors' evolving perceptions of and relationships to their role as a genetic counselor A preliminary model of genetic counselor professional development is proposed. The model suggests development processes occur throughout the professional lifespan, each component of professional development mutually influences the others, and there are both positive and negative avenues of development. For instance, personal life and professional life mutually influence each in important ways. Participants rated 15 influences on their professional development (adapted from Orlinsky et al., 2005). Within and across experience levels, and consistent with Orlinsky et al.'s (2005) findings, sources of interpersonal influence ("experiences in genetic counseling with patients" and "working with genetic counseling colleagues") were rated as highly important. The findings also were largely consistent with Skovholt & Ronnestad's (1992a / 2003) therapist model (anxiety in early practice dissipating over time, personal life affecting professional development, etc.), with a few notable differences (including unique challenges of frequently delivering "bad news" to patients, and the parallel process between individual counselors' professional development experiences and genetic counseling's development as a relatively young field. Major findings, study strengths and limitations, and practice, training, and research implications are discussed.Item Validation and Extension of the Reciprocal-Engagement Model of Genetic Counseling Practice: A Qualitative Investigation of Genetic Counselor Goals, Strategies, and Behaviors(2016-08) Redlinger-Grosse, KristaAs the genetic counseling profession steadily evolves, in part due to continual advances in genetic technology, there is a growing need to establish a validated model of practice. The Reciprocal-Engagement Model (REM; McCarthy Veach et al., 2007) is a recently proposed model comprised of five tenets and 17 corresponding goals. Two studies to date provide evidence of its validity (Hartmann et al., 2015; Redlinger-Grosse et al., 2015); thus, the REM remains a "work in progress." The purpose of the present study was to further develop and validate the REM by identifying genetic counselors' and genetic counseling researchers’ perceptions of strategies and behaviors that occur in genetic counseling sessions and mapping said strategies and behaviors to the 17 REM goals. A secondary, qualitative analysis was conducted on data obtained in two prior studies: 1) focus group results of genetic counselors’ and researchers’ perceptions of genetic counseling outcomes (Redlinger-Grosse et al. 2015); and 2) genetic counselor practitioners’ examples of their successful and unsuccessful genetic counseling sessions (Geiser, 2009). Using directed content analysis methods, the focus group data were further analyzed to yield 337 strategies and 140 behaviors. A Q-sort performed on the 337 strategies yielded 15 broader strategy domains. These domains were then used in a second directed content analysis to map REM goals and corresponding strategy domains onto examples of 67 successful and 63 unsuccessful genetic counseling sessions. Additional validation of the REM goals was noted based on differing proportions of strategy domains identified in successful sessions versus the proportions not present in unsuccessful sessions. For successful sessions, the most frequent domains were "Information Giving" and "Use Psychosocial Counseling Skills and Strategies." For unsuccessful sessions, the most frequent domains that were not present were "Information Giving" and "Working Alliance." These results support the reciprocal nature of the REM, especially with respect to addressing patients’ informational and psychosocial needs. Data analysis further revealed patients' characteristics and/or behaviors contributed either to success (or lack thereof) of the genetic counseling sessions, supporting a REM tenet that the genetic counselor-patient relationship is central to processes and outcomes. The present results have implications for training and research. For example, the elaborated REM could be incorporated into training program curricula and used to demonstrate how the Accreditation Council for Genetic Counseling (ACGC) practice based competencies are accomplished. REM components could inform studies of genetic counseling processes and outcomes. Further empirical validation of the REM is warranted, including documenting genetic counseling strategies and behaviors in observational or analogue studies.