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ABGC Boards Exam > Guiding Models In GC and Empathy > Flashcards

Guiding Models In GC and Empathy Flashcards

1
Q

Rogers Person-Centered Counseling

A

-Respect
-Genuineness
+b/c of respect we don’t want to change client, just have to understand where our thoughts and feelings lie
+congruence
-empathy
*Unconditional positive regard

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2
Q

Congruence

A

Agreement between inner thoughts and outward expression of GC

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3
Q

Nondirectiveness

A

Presentation of accurate info in a way that is applicable and comprehendable to them and allows them to make informed decisions

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4
Q

Kessler on non-directiveness

A

Aimed at promoting autonomy and self-directedness in order to build self-esteem and return control to them
-advice giving would undermine this

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5
Q

Advice giving in GC

A
  • standard of care
  • medical recommendations
  • practice guidelines
  • but this isn’t giving our opinion it’s a means of providing tools for decision-making
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6
Q

Value free language

A

Promotes importance of individual above their diagnosis

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7
Q

Narrative medicine

A

Giving patients the time to tell their story and actively listening and engaging, being moved by them

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8
Q

Kessler teaching model

A

Main focus is education, based on assumption clients are coming for new info to make their decisions

  • underestimates reactions, opinions, beliefs, etc and emphasizes cognitive processes
  • still meant to give info in an unbiased manner
  • relationship with client is based on authority not mutuality
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9
Q

Kessler Psychotherapeutic Model

A

Goal is to understand the client, bolster their inner sense of competence, reduce psychological distress, raise self esteem and promote them gaining back control
-also want to help them solve specific problems when possible
-based on assumption/perception that client comes for counseling for complex reasons
-emotions, reactions are factored into how education should be provided
+this is more complex and requires Counselor to use different skills to obtain information about the client, their skills, needs, limitations, etc in order to tailor education and be flexible
+education is used as a means to achieving these goals

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10
Q

Biesecker and Peters Psychoeducation Model of GC

A

GC is a dynamic psycho-educational process based on genetic info

  • within a therapeutic relationship a client helps counselor to tailor technical and probabilistic information to them in a way that promotes their self-determination and adaptation over time
  • goal is to facilitate client ability to use genetic information in a personalized way that increases control and reduces psychological distress
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11
Q

Reciprocal Engagement Model

A
  • Veach et al 2007
  • client and counselor participate in a mutual process of educational exchange of genetic and biomedical information, based on their psychological identities
  • GC-client relationship is a medium in which this can occur
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12
Q

Reciprocal Engagement Model Tenets

A

-education-genetic info is key
+biomedical info is essential, but not sufficient in ensuring patients learning, understanding and application of it to their situation
-relationship and rapport building are critical
-patient autonomy is supported
-patients are resilient
-patient emotions make a difference
+genetic info loaded and can cause cognitive and behavioral reactions in patients and families-emotional impact can make understanding difficult

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13
Q

Genetic Counseling Outcomes

A
  • make a decision
  • manage condition
  • adapt to situation
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14
Q

Transference

A

Unconscious way client relates to GC based on his/her history of relating to others
-sometimes can see overreaction to situation due to this

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15
Q

Countertransferance

A

Unconscious way GC relates to client based on history of relating to others
-could overidentify (more of a concern) or under/deidentify with client which can cause positive or negative interactions with patients due to the level of empathy in response

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16
Q

Kessler and countertransferance

A

No one is immune to suffering, but the GC experience with suffering is what can cause countertransferance

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17
Q

Associative countertransferance

A

Counselor shifts focus from client to their own reaction

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18
Q

Projective Countertransferance

A

When the counselor has the misperception they understand exactly what the patient is going through because they have had similar experiences-does not account for differences in how the same thing may impact someone differently

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19
Q

Rescuer Fantasy

A

Sign of countertransferance where you believe you are the only one who can reach the patient when others have failed

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20
Q

Self-Disclosure

A

Communication about oneself by GC to the client

-rule of thumb is not to do so, but really should be done situationally

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21
Q

Uses of self-disclosure

A

-builds trust in relationship
+by GC sharing it makes client not feel alone and maybe more open to sharing
-reinforces something the client shared
+shows you’re listening and relate
-could generate new perspectives
-could elicit strong emotions that may be important in aiding the GC to delve deeper and help client cope more effectively

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22
Q

Personal self-disclosure

A

Counselor shared something personal about themselves or their experiences in dealing with a situation

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23
Q

Professional disclosure

A

Sharing of experiences with other clients and of working with others to help give the client more info and perspective

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24
Q

Advanced empathy

A

Goes beyond information provided by client and includes new insight into thoughts and behaviors

  • used to help clients express underlying thoughts and feelings
  • can be highly therapeutic and allows for greater expression
  • requires strong foundational rapport to be established
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25
Q

Confrontation

A
  • technique used by GCs to directly challenge client on their view of themselves or their situation differently
  • goal is to help patient understand themselves more deeply
  • can only work when relationship has been established
  • start more tentatively and ease into this gradually to help gauge how patient will feel about it-remember patient may not react as expected
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26
Q

Behaviors to confront

A
  • ambivalence
  • avoidance
  • distortions-twisted or unrealistic thinking
  • evasions
  • discordant non-verbals
  • smoke screens-deflection of topic
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27
Q

Guilt in genetics

A
  • real or imagined internal response to a feeling of responsibility or remorse
  • more frequent in AD or XL conditions because it’s one parent, with AR conditions it still exists, but it’s shared
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28
Q

Defense reactions to guilt

A
  • repression and forgotten personal responsibility
  • intellectualization or rationalization
  • isolation and/or dissociation of feelings
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29
Q

Guilt relieving strategies

A
  • authority-use of knowledge and professional role to explain why they don’t need to have guilt
  • normalization-reducing social and psychological isolation
  • reframing-helping perceptions take on a new less stressful meaning
  • limiting liability-setting boundaries to what an individual can and cannot have a role in
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30
Q

Narcissistic wound

A
  • supplies theory that guilt is actually shame

- particularly with patients who may feel they have failed their child

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31
Q

shame

A

painful feeling arising from the consciousness of something dishonorable, improper or ridiculous done by oneself or another
-external response to your perceptions of how others see you; usually related to self-esteem

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32
Q

shame relieving tactics

A 
-develop working alliance
\+help proactively identify potential issues and aid patients in finding responses
-evoke feelings-using advanced empathy
-accentuate positive
-bolstering ego
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33
Q

Kessler and overcoming shame

A

patient has to express their feelings and confess that they have the belief they are to blame, before they can become receptive to normalizing responses

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34
Q

scaling questions

A

allowing patient to rate or rank their level of feeling about something or how they anticipate an outcome would effect them and why
-allows patients to uncover their emotions and thoughts about different scenarios so as to predict changes in those and help them make decisions

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35
Q

empty chair technique

A

creating imaginative setting for patient to role-play and practice a conversation
-allows for feedback, trouble-shooting from self or counselor

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36
Q

fantasy dialogue

A

individual having an internal conversation
-helps patients predict scenarios with themselves and how they might react or how they want to be told info or how their perspective of themselves might be altered

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37
Q

unconditional positive regard

A
  • part of Rogers client-centered model
  • idea that a person is valued as doing what is best for them to move forward constructively and respecting their self-determination
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38
Q

challenges to giving bad news

A
  • GC feels unprepared or is unprepared

- many clients perceive it to be a poor delivery

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39
Q

breaking bad news

A
  1. planning
  2. assessing what is known
  3. assessing what is wanted from the client
  4. give a warning
  5. share the news
  6. respond to reaction
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40
Q

planning

A
  • place: privacy both physical and emotional
  • time: asking permission, adjusting
  • people involved: patient, supports, who should not be there
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41
Q

assessing what is known and what is wanted

A

simple questions are useful, give them the space to change their minds

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42
Q

give a warning

A

don’t belabor it, inform them to allow them to adjust and ask permission

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43
Q

share the news

A

be kind and be clear, no connotative terms (ex: not positive or negative about a result)

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44
Q

respond to reaction

A

allow time for silence and processing from client because you cannot predict it; reflect what you’re seeing, being empathic, giving space if needed, clarify if needed

  • also assess possible need for further intervention without overdoing it
  • do not try to do too much; make yourself available to client, plan follow-up and discuss immediate next steps to give back control and normalcy
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45
Q

anger response

A
  • apologize
  • give some explanation for your decision
  • may require confrontation or advanced empathy
  • provide space and ensure necessary follow-up will occur
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46
Q

unexpected responses

A
  • place ourselves in the position of client

- provide empathy and aid

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47
Q

theory of chronic sorrow

A

parents of children with ongoing needs may be thrown for a loop when something that happens reminds them of earlier challenges or reminds them of ways their child is different than other children

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48
Q

crisis

A

stressful event that threatens the psychological equilibrium of a client that overwhelms the normal coping response

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49
Q

ACT model of crisis intervention

A

-Acknowledge
+name issue
+acknowledge feelings and normalize
+dispelling false information or beliefs
-Communicate
+demonstrate our versatility in understanding how to manage the situation
+providing confidence in client abilities
+creating a safe space for discussion
-Transition
+breaking down into steps
+providing alternatives and offering continued support

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50
Q

goals in suicidal client management

A
  1. assess adequately regarding suicidal ideation
  2. decrease immediate danger
  3. stabilize and triage
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51
Q

three components of risk

A
  • haplessness: feeling of ill-fatedness
  • hopelessness: feeling that nothing can get better
  • helplessness: nothing can make a difference and no one can help change circumstances
52
Q

assessing ideation

A
  • understanding intent, asking about plans and extent or imminence
  • provide support dependent upon threat level, then discuss alternatives
  • create safety to diminish threat
  • transfer of care can require bringing in additional departments or personnel or feeling as though the client is able to manage independently
53
Q

moral conviction

A

influenced by personal individualized beliefs (cultural, religious, philosophical, etc)

54
Q

ethical convictions

A

driven by deliberate considerations, sometimes professional standards such as those that guide course of action (guidelines, position statements, evidence-based research)

55
Q

Laws and ethics

A

Laws set a minimum standard for conduct of care, so failure to follow is punishable if the clinician does not follow those laws

56
Q

Ethics of care

A

Focuses on the values of interpersonal relationships (ie trust, love, compassion, empathy)
-idea is that genetics professionals act upon their need to care for the patient in the provider-client relationship

57
Q

Principle-based ethics

A

-used by modern medicine in overseeing clinical cases
-emphasis on moral reasoning and analysis
+how would a virtuous person respond?-principles of beneficence, nonmaleficence, autonomy, justice

58
Q

Code of ethics

A

Ideals set forth by professional organizations for clinicians to follow; can be superseded by state and federal laws
-For NSGC it’s based on our relationships and interactions and how we uphold those

59
Q

For themselves in code of ethics

A

Standards we uphold ourselves to (continuing education and staying up to date, yet recognizing our limitations also)

60
Q

GCs and clients in code of ethics

A

Upholding standards of autonomy, beneficence and nonmaleficence with our clients

61
Q

GCs and colleagues in code of ethics

A

Idea is to treat one another with respect and support each other

62
Q

Projection

A

Defense mechanism in which an individual denies the existence of feelings or emotions within themselves by perceiving or attributing them to others

63
Q

Displacement

A

Defense mechanism that involves taking out frustrations, feelings and impulses on less threatening people and objects

64
Q

Reaction-formation

A

Defense mechanism in which a person acts in opposition to their true thoughts or feelings, which may be socially unacceptable
-tends to be exaggerative, impulsive and inflexible

65
Q

ethic boards and committees

A
  • governing bodies without binding laws

- goal and purpose is to aid in the resolution of dilemmas

66
Q

repeating or reflecting

A

use of words or phrases from client in GC response; using part of their statement as yours, sometimes as a question

67
Q

paraphrasing

A

response is a rephrase of what we believe we heard from client
-counselor words capture essence of what was shared

68
Q

summarizing

A

combining thoughts and feelings stated by the client into a clearer, more poignant statement
-longer than paraphrase

69
Q

empathetic breaks

A

change in focus or dynamic of the session

70
Q

empathy

A

understanding someone’s lived experience and sharing in that understanding with them

71
Q

shared language

A

promoting partnership by mirroring the phrasing of the patient
-mirroring, modelling and contracting are all ways of implicating this

72
Q

compassion fatigue

A

lacking emotional strength, loss of energy

  • causes reduced ability to provide empathy
  • function of bearing witness to the suffering of others
73
Q

burnout

A

emotional exhaustion, depersonalization and reduced feeling of personal accomplishment related to prolonged exposure to demanding interpersonal situations
-related to the negative impact of systemic problems over time

74
Q

working alliance

A

stemming from mutually agreed upon goals and tasks

75
Q

redirect

A

refocusing when client has gotten off track

76
Q

riskiness of the gamble

A

risk as a combination of magnitude of uncertainty and level adversity
-factors and the amount, consistency and clarity of information regarding them will influence the judgement of adversity

77
Q

embodied knowledge

A

integration of personal beliefs and experiences into presented biomedical information that has been transformed by identifiable processes in order to make a decision

78
Q

adapting the message

A

requirement of facts to be communicated in a credible, comprehensive way

  • an effective risk formulation and presentation characterizes the needs of the intended audience and their current beliefs
  • ongoing process
79
Q

engagement

A

the cognitive and emotional involvement risk has for the client

  • fluctuates over time in a client
  • level predicts risk perception
  • higher level of this predicts better adaptations to a positive result
80
Q

experiential knowledge

A

derived from empathetic knowledge and connectedness to others experiences
-integral to understanding and risk perception

81
Q

Heuristic systematic model

A

systematic processing of information, beliefs, experiences, etc leads to an effortful tactic of informed decision making and improved understanding of risk over time
-promoting factors: personal relevance and self-affirmation opportunities, lack of time pressure, perceived accountability need, high perceived amount of information, personalized expression of risk and graphical presentation of risk

82
Q

availability heuristic

A

how easily examples of an outcome come to mind, based on “experience” (ex: knowing an affected individual)

83
Q

representative heuristic

A

interpretation of risk, based on prototypes or samples-inferring from a small sample to a large group
-ex: patient feeling as though their risk to have a BRCA mutation is higher than 50% based on family history

84
Q

anchoring heuristic

A

prior beliefs serve as a frame of reference, in which new information and risk figures are evaluated
-bias introduced by the first concept or risk figure discussed

85
Q

cognitive and emotional factors

A
  • optimism v. pessimism
  • attitude towards taking risks
  • preference for numerical format
86
Q

prior beliefs

A

client beliefs about level of risk; may be influenced by information from other providers, research, etc

87
Q

complexity

A

intricacy of risk figures

88
Q

uncertainty

A

associated with perception of the risk figure

89
Q

math ability

A

capability of the client to understand numerical values and probability

90
Q

competing values

A

importance of something else conflicts with the presented risk

91
Q

consequences

A

expected range of outcomes related to the presented risk

92
Q

binarization

A

tendency to view risk in only two categories

-ie risk will occur or not occur

93
Q

need for uncertainty reduction

A

emotional need to reduce uncertainty

94
Q

risk v. burden

A

occurs in light of the concepts of uncertainty and undesirability
-causes competition or weighing of the two in comparison with the other

95
Q

reactions to bad news

A
  • denial
  • anger
  • grief or despair
  • questioning
96
Q

denial

A

inability to acknowledge information, buys time

  • disbelief: heard not accepted
  • deferral: accepted, not implicated
  • dismissal: devalues legitimacy of info
97
Q

anger

A

seeks to blame, GC should help patient elaborate on the underlying feelings

98
Q

grief or despair

A

intense sadness regarding results, GC should discuss this with the patient and why the reaction is so strong

99
Q

questioning

A

asking “why me?”, GC should understand the driving question and address the emotion behind it

100
Q

interventions to patient reactions

A
  • continued support
  • time
  • empathy
  • acknowledgement
  • normalization
101
Q

confronting

A

coping by trying to change opinions of person in charge, combative

102
Q

distancing

A

coping by acting as if nothing happened

103
Q

seeking social support

A

coping by taking news with other people in hopes of learning more, engaging in conversation

104
Q

self-controlling

A

coping by keeping feelings to oneself

105
Q

accepting responsibility

A

coping by criticizing or blaming oneself

106
Q

escape-avoidance

A

coping by hoping for a miracle

107
Q

planning

A

coping by identifying and following next steps of an action plan

108
Q

positive reappraisal

A

coping by identifying an existing or potential positive outcome(s)

109
Q

repression

A

defense mechanism that stops emotions and memories from reaching consciousness

110
Q

denial

A

defense mechanism in which an emotional response is repressed and cannot be consciously expressed or recognized

111
Q

intellectualization

A

emotional response is repressed in this defense mechanism, and situation is attempted to be addressed through cognitive processes

112
Q

sublimation

A

“unacceptable” emotions are redirected into acceptable activities as a defense mechanism

113
Q

projective identification

A

a client’s defense mechanism behavior induces a repressed or unacceptable behavior in another, could be the GC

114
Q

identification

A

assumes the identity or behavior of another person

115
Q

regression

A

reverting to a less mature behavior as a style of defense mechanism

116
Q

undoing

A

defense mechanism that attempts to cancel out a distressing experience by doing something that signifies an opposite feeling

117
Q

Self-Psychology

A

self is dependent on shaping relational experiences

118
Q

relation theory

A

how connections foster coping and relational skills

119
Q

Family systems theory

A
  • adaptation of families as a whole to critical life events

- individuals best understood through family dynamics

120
Q

health belief model

A

fear or threat of a disease will motivate behaviors

121
Q

stages of change model

A
  1. pre contemplation
  2. contemplation
  3. decision
  4. action
  5. maintenance
122
Q

consumer information processing theory

A

patients process and use information in small, manageable chunks

123
Q

social learning theory

A

behaviors and environment are reciprocal systems

124
Q

theory of reasoned action

A

attitudes and social norms are important in behavioral intention

125
Q

common sense model

A

fear control is parallel to decision-making, so coping may interfere with positive behaviors

126
Q

transactional model of stress and coping

A
  • if something feels controllable, action is problem-focused

- if something feels uncontrollable, action is emotion focused

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