Psychosocial

Question 1

Stages of Coping

Answer 1

• Denial
• Guilt
• Depression
• Anger
• Acceptance

Question 2

Obstacles to Coping

Answer 2

• medical costs
• cosmetic significance
• frequency of acute episodes
• chronicity of the problem
• life span
• recurrence risk
• family dynamics
• availability of support system
• biological clock?
• religion
• quality of life
• educational background
• cultural practices

Question 3

Attending

Answer 3

observing a clients verbal and nonverbal behaviors as a way of understanding what the clients are experiencing, and displaying effective nonverbal behaviors to clients during genetic counseling sessions

Question 4

Coping mechanisms

Answer 4

• strategies for solving problems or for modifying the meaning of an experience
• some may be problematic if engaged in intensely and for very long periods of time
• all defense mechanisms are attempts to cope, but not all coping strategies are defense mechanisms

Question 5

Accepting Responsibility

Answer 5

coping mechanism in which patient criticizes or blames oneself

Question 6

Confrontative

Answer 6

coping mechanism in which the patient tries to change the opinions of the person who is in charge (genetic counselor, physician, etc.)

Question 7

Distancing

Answer 7

coping mechanism in which the patient acts as if nothing happened (tells children after appointment that they didn’t learn anything, when really they found out about a high risk for cancer)

Question 8

Escape-avoidance

Answer 8

coping mechanism in which patient hopes for a miracle

Question 9

Planning

Answer 9

coping mechanism in which patient identifies next steps and follows through

Question 10

Positive Appraisal

Answer 10

coping mechanism in which the patient tries to see any possible positive results or outcomes (rather have a child with Down syndrome than no child at all)

Question 11

Seeking Social Support

Answer 11

WHAT A DIFFICULT FLASHCARD
coping mechanism in which the patient talks with others in hope of learning more. For example, attending support groups for people with similar genetic conditions

Question 12

Self-controlling

Answer 12

coping mechanism in which patient keeps to him or herself (short answers, “I’m fine”)

Question 13

Countertransference

Answer 13

redirection of a psychotherapist’s feelings toward a client—or, more generally, as a therapist’s emotional entanglement with a client

Question 14

Associative Countertranseference

Answer 14

• your client’s experiences taps into your inner self and you begin to focus on your own thoughts, feelings, and sensations
• triggered by your own past or current problems or situations that are similar to your client’s

Question 15

Benign Countertranseference

Answer 15

• to prevent being disliked to avoid strong affect, you create an atmosphere that is the same among all clients and situations,
• due to an intense need to be liked by clients to fear of a strong client affect, especially anger.
• optimistic, cheerful interchanges, and by limited consideration of negative information or issues
• attempting to be more of a friend than a GC

Question 16

Hostile Countertranseference

Answer 16

• when you dislike something about your client (e.g. mannerism, physical characteristic, attitude, value), and in an attempt to be unlike the client as possible, you try to distance yourself in overt and covert ways
• more common in GCs experiencing burnout

Question 17

Overprotective Countertranseference

Answer 17

you regard some or most clients as childlike and in need of great care and protection, so you cushion the information you give, or you qualify your interpretations, or you don’t allow your clients to experience and express their painful feelings

Question 18

Projective Identification

Answer 18

misperception that you understand exactly what a client is going through because you have had the same or similar experience

Question 19

Rejecting Countertranseference

Answer 19

you may regard some or most clients as dependent and needy, but you react punitively, becoming aloof or cold, and behaving in ways that create distance between you, either because you fear the demands clients might place on you

Question 20

Defense Mechanism

Answer 20

• unconscious responses to real or perceived threat

- attempt to maintain some measure of personal control and reduce painful emotions

Question 21

Denial

Answer 21

defense mechanism in which the reality of a situation or perception is not consciously experienced or recognized

Question 22

Displacement

Answer 22

defense mechanism in which the patient shifts their emotional response from original aim to a vulnerable target (mad at PCP or spouse, etc but yells at genetic counselor)

Question 23

Identification

Answer 23

defense mechanism in which the patient assumes the behavior or opinion of someone else they look up to (my sister says if I have an amnio I will miscarry)

Question 24

Intellectualization

Answer 24

defense mechanism in which the patient the represses emotional response and addresses the situation through rational, cognitive processes

Question 25

Projection

Answer 25

defense mechanism in which the patient perceives their own feelings in others (a patient is feeling shame, but thinks his/her partner is ashamed)

Question 26

Projective identification

Answer 26

defense mechanism in which the patient causes an unacceptable emotion in someone else (represses anger but acts in a way that makes the GC angry)

Question 27

Rationalization

Answer 27

defense mechanism in which the patient justifies objectionable information with plausible statements (but I take my prenatal vitamin every day!)

Question 28

Reaction formation

Answer 28

wut

Question 29

Regression

Answer 29

defense mechanism in which the patient reverts to developmentally less mature behavior

Question 30

Repression

Answer 30

defense mechanism in which feelings, perceptions, or memories are lost to consciousness or put out of mind

Question 31

Sublimation

Answer 31

defense mechanism in which the patient channels unacceptable wishes into more socially acceptable activities (pain and anger toward diagnosis fuels advocacy work in an organization)

Question 32

Undoing

Answer 32

defense mechanism in which the patient cancels out a distressing experience through a reverse reaction (an obsessive need for prenatal testing after having a child with Down syndrome)

Question 33

Transference

Answer 33

An unconscious way that a client relates to the genetic counselor based on her or his history of relating to others

Question 34

Five elements for true informed consent to be met

Answer 34

competence, amount and accuracy of information, patients understanding, voluntariness, authorization

Question 35

Four principles of medical ethics

Answer 35

beneficence, non-maleficence, autonomy, justice

Question 36

ABCs of psychiatric assessment

Answer 36

Affect and Appearance

• Appearance: Hair, eyes, stature, dress, grooming, appropriateness, attractiveness
• Affect/mood: Anxious, depressed, sad, worried, belligerent, etc.

Behavior
- By report/by observation of movement, body position, speech, bizarre, self-abusive, hyperactive/agitated, psychomotor retardation, impulsive, unstable, dramatic gestures, altered sleep, eating, intoxicated, or sexual patterns

Cognition and Coping

• Cognitive thinking: Disorganized, distorted, irrational, defensive, memory, concentration, attention, distractibility, delusions, hallucinations
• Coping style: Intellectualize, concrete, problem solving, diffuse

Suicide risk
- Present ideation, plans, actions