The Genetic Counseling Video Project (GCVP): models of practice
The Genetic Counseling Video Project (GCVP): models of practice
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DOI：
10.1002/ajmg.c.30094
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发表时间：
2006-11-15
影响因子：
3.1
通讯作者：
Dudley, W.
中科院分区：
文献类型：
--
作者：
Roter, D.;Ellington, L.;Dudley, W.
遗传咨询被定义为同时具有“教学”和“咨询”功能；然而，对于这些功能在日常实践中是如何表达的，我们知之甚少。本研究通过录像记录了全国产前和癌症遗传咨询师（GCs）为模拟客户（SCs）提供常规测试前咨询的做法，从而解决了这个问题。在全国遗传咨询师协会（NSGC）的两次年度会议上招募的177名遗传咨询师被随机分配到6名不同种族的女性遗传咨询师中，有或没有配偶，为他们的专业提供咨询。采用Roter交互作用分析系统（RIAS）对152盘录像带进行编码，gc和sc分别完成评价问卷。聚类分析产生了两种教学模式和两种咨询模式。教学模式包括：(1)临床教学（31%），以低心理社会、情感和促进性谈话为特点，高临床交流水平，高语言优势；(2)心理教育教学（27%）的特点是高水平的临床和社会心理交流，低水平的情感和促进性谈话，较高的言语支配。咨询模式包括：(1)支持性咨询（33%），其特点是低心理社会和临床交流，高水平的情感和促进性谈话，低语言支配；(2)心理咨询（9%）表现为高情绪性和促进性谈话，低临床和高心理社会交流，最低言语支配。SCs对沟通、咨询师的情感举止和咨询师使用非语言技能的满意度评分在咨询模型会议中最高。教学和咨询模式似乎都体现在日常实践中，并预测了客户满意度、情感行为和非语言有效性的变化。(c) 2006 Wiley-Liss, Inc。
Genetic counseling is conceptualized as having both "teaching" and "counseling" functions; however, little is known about how these functions are articulated in routine practice. This study addresses the question by documenting, on videotape, the practices of a national sample of prenatal and cancer genetic counselors (GCs) providing routine pre-test counseling to simulated clients (SCs). One hundred and seventy-seven GCs recruited at two annual conferences of the National Society of Genetic Counselors (NSGC) were randomly assigned to counsel one of six female SCs of varying ethnicity, with or without a spouse, in their specialty. One hundred and fifty-two videotapes were coded with the Roter Interaction Analysis System (RIAS) and both GCs and SCs completed evaluative questionnaires. Two teaching and two counseling patterns of practice emerged from cluster analysis. The teaching patterns included: (1) clinical teaching (31%) characterized by low psychosocial, emotional and facilitative talk, high levels of clinical exchange, and high verbal dominance; and (2) psycho-educational teaching (27%) characterized by high levels of both clinical and psychosocial exchange, low levels of emotional and facilitative talk, and higher verbal dominance. The counseling patterns included: (1) supportive counseling (33%) characterized by low psychosocial and clinical exchange, high levels of emotional and facilitative talk, and low verbal dominance; and (2) psychosocial counseling (9%) with high emotional and facilitative talk, low clinical and high psychosocial exchange, and the lowest verbal dominance. SCs ratings of satisfaction with communication, the counselor's affective demeanor, and the counselor's use of non-verbal skills were highest for the counseling model sessions. Both the teaching and counseling models seem to be represented in routine practice and predict variation in client satisfaction, affective demeanor, and nonverbal effectiveness. (c) 2006 Wiley-Liss, Inc.