Psychosocial Flashcards
Define Transference
transference – unconscious way that a client relates to the genetic counselor based on his or her history of relating to others; how the client perceives the counselor and how the client behaviors toward the counselor
clients project attitudes, roles, and expectations onto the counselor based on their previous encounters with others
result of misperception of the counselor leading to overreaction to the reality of the situation
may be positive or negative
What are the five transference reactions a client may have?
Counselor as an ideal – client views the counselor as perfect
Behaviors: excessive compliments, agreeing with everything said
Counselor as seer – client believes the counselor has all the right answers
Behaviors: repeatedly asking what the counselor would do
Counselor as nurturer – client views the counselor as a source of strength
Behaviors: acting helpless, excessive crying, urgent demands
Counselor as frustrator – client views the counselor as spoiling their experience
Behaviors: excessively defensive, blaming the counselor
Counselor as nonentity – client views the counselor as an inanimate figure with no feelings, wishes, or needs
Behaviors: topic shifting, dismissing counselor’s interpretation
Define Countertransference
countertransference – unconscious way that a genetic counselor relates to the client based on his or her history of relating to others
can include emotional reactions and projections toward clients that may not be particularly appropriate to the current relationship
involves misperceptions and overreactions
may be positive or negative
can occur due to overidentification or disidentification with a client
Define projective identification.
projective identification – the genetic counselor mistakenly believes that their feelings are the client’s feelings; misperception that one understands exactly what a client is going through because the counselor has had the same or a similar experience
results in shallow empathy because the counselor will not go deeply into feelings that are upsetting to them
Define Associative Countertransference
associative countertransference – the client’s experience taps into the genetic counselor’s inner self, and the counselor begins to focus on their own thoughts, feelings, and sensations
results in loss of focus during a session because attention shifts from the client to oneself
may be triggered by past or current problems or situations that are similar to the client’s
counselor does not believe that their feelings are the client’s feelings
Define overprotective countertransference.
overprotective countertransference – the genetic counselor regards clients as childlike and in great need of care and protection, so the information given to a client is cushioned (ex. “This risk isn’t really so bad.”), qualified (ex. “It was just a guess.”), or protects clients from experiencing and expressing their painful feelings (ex. “It will be fine.”)
Identify signs of an overprotective GC
- Talking in a low voice
- Using physical gestures that are infantilizing to a client
- examples: patting on the back, hugging, patting on the hand
- Excessively worrying about a client, possibly to the point of obsession
Define Benign Transference
benign countertransference – the genetic counselor has an intense need to be liked by clients or has a fear of strong client affect, especially anger
- Results in a shallow exploration of emotions or a preponderance of optimistic information or issues
- Session may be full of extraneous small talk or personal chatting, as the genetic counselor is trying to be more like a friend to the patient
Define Rejecting Countertransference
Rejecting countertransference – the genetic counselor acts aloof or cold and behaves in ways that create distance in the relationship, such as use of blunt language (ex. “Your risk of having a child with a birth defect is high because you drank during your pregnancy.”) or being dismissive of clients (ex. “That’s your decision, I’m not you.”)
-perceive clients as needy or dependent, resulting in the counselor feeling personally responsible for the client’s welfare or fearing that the client may have excessive demands
Define Hostile Countertransference
hostile countertransference – the genetic counselor dislikes something about the client, and in an attempt to be as unlike the client as possible, the counselor distances themselves in both overt and covert ways, such as making harsh statements (ex. “You sure have gotten yourself into a mess with this nonpaternity situation.”)
- reasons for disliking the client may include: mannerisms, beliefs, values, attitudes, or physical characteristics
- counselor’s attitude is that the client is getting what he or she deserved
What is morality
morality – a common code of conduct or an agreed-on view of what behavior is acceptable and what behavior is not acceptable by a society or a community of people
- in certain situations, society can justify immoral actions
- moral convictions provide a stand by which to evaluate one’s own and other people’s conduct and character
- goal of moral behavior is to decrease the harms suffered by members of that society
What are the four principles of principle-based ethics?
Beneficence
Nonmaleficence
Autonomy
Justice
Define Beneficence
beneficence – promotion of personal well-being in others; when benefits have been balanced against harms and costs, the outcome should be of net benefit
- health care providers should be acting as advocates for the patient and acting in good faith for the benefit of that patient
- interpreted as paternalism when a provider’s view of benefit does not agree with the views of a patient
-refusal to acquiesce in the patient’s wishes, choices, or actions can result in neglect and violation of patient autonomy
Define nonmaleficence.
nonmalficence – involves restrictions on behavior as opposed to actions that promote behavior; duty not to inflict harm
duty to remain the protector of the life and health of a patient
frequently an issue surrounding medical research or vulnerable populations
Define autonomy.
autonomy – represents an individual’s personal rule of self, remaining free form controlling interferences that prevent the making of meaningful choices
-truth telling, confidentiality, and informed consent are all obligations applied to an individual
