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34 Cards in this Set
- Front
- Back
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types of unresolved grief reactions
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chronic and prolonged - intense grief reactions triggered by events through the person's life
delayed - initial absence of grief often w numbness, followed by an intense reaction weeks, months, years later exaggerated - overly excessive grief reaction, can be disabling masked - denied grief, manifests as physical or other emotional symptoms |
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displacement
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-maladaptive coping
-feelings toward one perosn or situation are directed toward another individual -ex. client who is angry about cancer rissk may diret anger to a relative or health care provider -ex. client not booking own surveillance appts but nagging relative's to book theirs |
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distancing
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-maladaptive coping strategy
-shiled themselves from carring too much about people -especially after many losses -interferes with maintenance of romantic r'ships, friendships, etc. |
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projection
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-maladaptive coping strategy
-ascribe one of own undesirable traits or feelings to another person -allows individual to distance self from issues that are hard to deal with -ex. guilt - pt says it's the OB"s fault. anxious - pt perceives the GC as anxious |
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goals of GC session (Kessler)
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-understand the other person
-bolster their inner sense of control over their lives/promote a greater sense of control over their lives -relieve psychological distress, if possible -support and possibly raise self esteem -help them find solutions to specific problems |
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associative countertransference
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-arises in an empathically attuned moment in a session when the patient shares an experience, loss, wish, or tory that carries the counselor (usually for a short time) into his inner self
-remembered emotions, review of mental images, recall of conversations - |
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projective countertransference
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-counselor makes assumption of experince of patient based on counselor's own parallel life experience (loss, suffering, fear, panic)
-session may go in direction of counselor's reaction instead of patient's |
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denial
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-'inability to acknowledge to onself certain inforamtion or news'
-common resonse when info elicits shock and fear -usually short term -don't intervene too soon, may be adaptive for a short period at the right tiem |
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anger
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-useful interventions
-- invite them to discuss anger - "you sound angry, tell me more" --witnessing the feeling, honoring its role, empathic attunement lifts anger ---manage own reactions, get supervision -may take different shapes - blame, crying (esp women) |
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guilt, shame
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-esp, in parents of affected children
-use denial or withdrawl to cope with guilt and shame -witness the guilt and shame, give it a space, help them then come to greater self-empathy -don't offer rapid reassurances |
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NSGC code of ethics
Section I: GCs themselves |
-value: competence, integrity, veracity, dignity, self-respect in selves and others
strive to: -seek out and acquire sufficient and relevant information required for situation -continue educ'n, train'g -keep abreast current standards of practice -recognize own limits in situation -accurately represent themselves, training, competence, etc. -acnkowldege and disclose conflicts of interest -avoid r'ships and activites that interfere w professional judgement or objectivity -responsible for own physical and emtional health as it influences professional performance |
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NSGC code of ethics
Section II: GCs and their clients |
-values: care and respect for autonomy, individuality, welfare, freedom
strive to: -serve those who seek services regardless of personal or external interests or biases -clarify and define their roles and r'ships w patients, accurately describe their services -respect clients' beliefs, inclinations, circumstances, feelings, family r'ships, cultural traditions -enable clients to make informed decisions -refer clients to other qualified pofressionals as needed -maintian info received from client as confidential unless released by client or required by law -avoid exploitation of clients for personal advantage, profit, interest |
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NSGC code of ethics
Section III: GCs and their colleagues |
-values: mutual respect, caring, cooperation, support
strive to: -share knowledge and provider mentorship and guidance for prof'l dev't of other GCs, students, colleagues -respect and value the knowledge, perspective, contributions, areas of competence of colleagues and students -collaborate to provide the highest quality service -encourage ethical behavior in colleagues -assure that individuals under their supervision undertake responsibliities that are commensurate with their knowledge, experience, and training -maintain appropriate limits to avoid tthe potential for exploitation in their r'ships with students and colleagues |
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NSGC code of ethics
section IV: GCs and society |
-interest and particiation in activities that have the purose of promoting the well being of society and access to health care
strive to: -keep abreast of societal developments that may endanger the physical or psychological health of individuals -promote policies that aim to prevent discrimination -oppose the use of genetic information as the basis for discrimintation -participate in activities necessary to bring about socially responsible change -serve as a asources of reliable info and expert opinion for policymakers -keep public informed and educated about impact on society of new technological ans scientific advances and possible changes in society that may result from the application of these findings -support policies that assure ethically responsible research -adhere to laws and regulations of society. however, when laws are in conflict with the principles of the profession, GCs work toward change that will benefit the public interest |
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ADA
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-prohibits employment discrimination on basis of disability
-protects indivdiuals with genetic etiolgy same as non-genteic etiology |
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executive order 2000
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-Clinton
-prohibits the US government from using genetic info in hiring, promotion, discharge, and all other employment decisions |
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HIPAA (1996)
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-only covers employer-based and commercially issued group health insurance
-limits to what extent insurers can discriminate based on pre-existing conditions -explicitly states that genetic inforamtion in absence of current diagnosis cannot be considered a pre-existing condition -BUT can still exclude if received treatment/care/etc within 6 months prior to enrolling in new group/employer plan -also increases access to insurance if lose insurance |
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HIPAA 2002
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-protect medical records and other personal health info
-limit nonconsenual use and release of PHI -give patients new rights to access their medicla records and know who else has accessed them -restrict disclosure of PHI to min. needed for intended purpose -establish new criminal and civial sanctions for vioaltions -new requirements for access to records by researchers and others |
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GINA
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title I - health insurance
-can't reject coverage or raise premiums based on genetic info -no protection for symptoms or diagnosis of genetic disorder -prohibits requiring genetic info for ass't/enrol't/etc -takes effect between may 22/09 and may 21/10 as plans roll over title II - employment -takes effect nov 21 2009 -prohibits employer, employment agency, labor org'n from discriminating against an employee based on genetic info "genetic information" -own genetic tests (including as part of a research study) -family members' genetic tests -genetic tests of embryo or fetus -family history of disease -any request for or receipt of genetic services or participation in research that includes genetic services by and individual or family member -genetic tests = analysis of DNA, RNA, chromosomes, protiens, metabolites. |
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limitations of GINA
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-no protection for life insurance, disability insurance, long-term care insurance
-doesn't mandate coverage for any test or treatment -employment provisions don't apply to employers <15 employees -doesn't prohibit health insurers from obtaining and using genetic tests in making payment determinations |
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NSGC policy statements w ethica relevance
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-support reproductive freedom
-support access to care regardless of race, ethnicity, SES, etc. -support genetic nondiscrimintatin -suppor right to privacy and confidentiality re: genetic info -support right to informed consent including full disclosure of all options -support fetal tissue research -support national health care reform that pormotes universal access -discourage prenatal and childhood predictive testing for adult-onset disorders -supports research or therapeutic cloning, not reproductive cloning -DTC - recommends list of issues for customers to assess in DTC company |
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ACMG ethics guidelines
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-DTC - outlines min. requirements for DTC protocol
-adoption - joint ASHG/ACMG, endorsed by NSGC - only genetic testing to help child, same as anoy other child, not testing for traits w/i normal range -against gene patents, for maximum accessiblity and open licensing -duty to recontact - genetics professional shoudl recommend pt and referring recontact; but geneticist resposnbile for updating pt they follow on ongoing basis -testing minors - |
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what is sublimation?
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defense mechanism
Sublimation is a defense mechanism that allows us to act out unacceptable impulses by converting these behaviors into a more acceptable form. For example, a person experiencing extreme anger might take up kick boxing as a means of venting frustration. Freud believed that sublimation was a sign of maturity that allows people to function normally in socially acceptable ways. |
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what is displacement?
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defense mechanism
Displacement involves taking out our frustrations, feelings, and impulses on people or objects that are less threatening. Displaced aggression is a common example of this defense mechanism. Rather than express our anger in ways that could lead to negative consequences (like arguing with our boss), we instead express our anger towards a person or object that poses no threat (such as our spouses, children, or pets). |
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what is reaction formation?
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defense mechanism
Reaction formation reduces anxiety by taking up the opposite feeling, impulse, or behavior. An example of reaction formation would be treating someone you strongly dislike in an excessively friendly manner in order to hide your true feelings. Why do people behave this way? According to Freud, they are using reaction formation as a defense mechanism to hide their true feelings by behaving in the exact opposite manner. |
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what is isolation of affect?
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a defense mechanism in which you "think the feeling" instead of feeling it.
ex. "i guess i'm angry at him" vs. expressed and experienced anger |
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What is a heuristic? What are some examples?
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* Anchoring and adjustment
* Availability heuristic * Representativeness heuristic * Naïve diversification * Escalation of commitment |
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basic skills and attitudes needed for multicultural competancy
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-understanding of your own cultural code, how it shapes how you act, think, relate, communicate, perceive reality and judge others. awareness of your own biases and blinders
-knowledge of clients' ways of perceiving reality, how they interpret illness and disorders, experience and express pain, view sex, marriage, family, kinship -attitude of humility re: diversity of human cultures and value of each of them -ability to use other people's cultural code as a counseling resources, not just viewd a s abarrier or obstacle |
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denial
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-normal part of grieving
-can be adaptive -respond with empathy and understanding NOT confrontation -work with it, not against it |
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undoing
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-defense mechanism
-try to reverse or undo feeling by doing something that indicates the opposite feeling (ex. angry at a professor, give the professor an apple) |
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sublimation
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direct feelign into a socially acceptable outlet - boxing, writing poetry, etc.
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representativeness
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-heuristic
-degree to with A is representative or similar to B, if similar, then attribute many features of one to the other -ex. - judge amnio as unsafe b/c of one friend's story -ex. consider all gov't agencies untrustworthy b/c of bad experience iwth one -i.e. generalizing from one to others |
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availability
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-frequency or probablity of aevent by ease with which instances or occurences coem to mind
-overestimate risks of SCD b/c of high profile news cases on athletes -think flying is more risky thatn driving b/c of dramatic plane crashes |
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adjustmetn and anchoring
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-make estimates from starting form initial values (anchor) and then adjsuting them
-ex. |
