The effectiveness of psychiatric genetic counseling training: An analysis of 13 international workshops.

Studies have consistently shown that psychiatric genetic counseling (pGC) helps people with psychiatric conditions by increasing empowerment and self-efficacy, and addressing emotions like guilt. Yet, it is not routinely provided. Genetic counselors and trainees express low confidence in their ability to provide meaningful pGC, especially in the absence of adequate training. Therefore, to address this gap a "Psychiatric Genetic Counseling for Genetic Counselors" (PG4GC) workshop was developed and delivered to 13 groups of participants (primarily qualified genetic counselors and trainees) between 2015 and 2023 (10 workshops were delivered in-person, and three virtually). Participants completed quantitative questionnaires both before and after completing the workshop to assess their comfort, knowledge, behavior, and feeling of being equipped to provide pGC. In total, 232 individuals completed the pre-workshop questionnaire and 154 completed the post-workshop questionnaire. Participants felt more comfortable, knowledgeable, and equipped to provide pGC, and reported being more likely to address psychiatric concerns after the workshop, regardless of whether they were trainees or practicing professionals and whether they completed the workshop in-person or virtually. This study suggests that the PG4GC workshop is an effective educational tool in pGC training that may aid in broader implementation of the service.

Shifts in the genetic counseling workforce highlight a need for laboratory fieldwork experience for genetic counseling trainees.

As the genetic counseling workforce experiences an increase in genetic counselors (GCs) in non-direct patient care roles, it is essential that genetic counseling students are trained in these settings. The Accreditation Council for Genetic Counseling (ACGC) standards regarding laboratory exposure have evolved over time, but laboratory fieldwork experience continues to remain a suggestion for a diversified setting. As more trainees seek laboratory exposure and an increasing number of new graduates opt for laboratory positions, learning firsthand from GCs employed in this setting is a valuable experience that should be available to all trainees. Historically, laboratory educational offerings consisted of onsite rotations for students from local training programs focused on understanding diagnostic testing methodologies and shadowing GCs. Through the years, multiple laboratories have expanded their curriculums to expose students to variant interpretation and report writing, research, client services, marketing, and product development. Alongside the growth of laboratory rotation curriculum grew opportunities for remote rotations. Prior to the COVID-19 pandemic, GeneDx offered remote education options including both individualized rotations and a webinar series. These offerings expanded due to the pandemic coupled with increased demand and have positive implications for future trainees. The evolution of the rotation also included conscious efforts to incorporate diversity, equity, and inclusion into the curriculum, as well as to improved accessibility to laboratory rotations. Notably, there are inconsistencies in laboratory rotation curricula and requirements, and a standardized evaluation and definition of competencies are lacking. ACGC guidelines defining common core concepts required from laboratory rotations would help ensure students receive an equitable minimum skill set, regardless of training site. Stakeholders in GC education should collaborate to enhance the experiences of future trainees and provide the skills needed by a workforce shifting to remote work and increasing numbers of non-direct patient-facing laboratory roles. Drawing upon our years of experience, GeneDx aims to actively contribute to discussions around these questions. Alongside other laboratories and training programs, we hope to foster further innovation surrounding the training needs of our future GC colleagues. This educational innovation illustrates an approach to helping genetic counseling students achieve competencies related to lab-based roles.

Creation and initial validation of a genetic counseling supervisory self-efficacy scale.

Fieldwork supervision is the "signature pedagogy" for training genetic counseling students, ensuring that students have the experience necessary to become minimally competent genetic counselors. According to the National Society of Genetic Counselors 2022 Professional Status Survey, roughly 40% of genetic counselors serve as supervisors for genetic counseling graduate students. Despite fieldwork supervision being essential for training, there are currently no validated supervision skill assessment tools for genetic counseling fieldwork supervisors to use for professional development. While a self-efficacy scale for genetic counselors currently exists, a comprehensive self-efficacy scale for genetic counseling supervision skills does not. The purpose of the study was to develop and validate a genetic counseling supervisory self-efficacy scale (GCSSES). This study was comparative, quantitative, and cross-sectional, with data collected via an online questionnaire which assessed supervision self-efficacy (95 items), derived from 154 published GC supervision competencies, demographics (5), experience (9), and supervisory development (18), using the Psychotherapy Supervisory Development Scale (PSDS). A total of 119 board-certified genetic counselors completed the survey. Factor analysis eliminated 40 items due to insufficient factor loading, and item-item correlation eliminated one item with elevated inter-item correlation, leaving 54 items on the finalized GCSSES. Exploratory factor analysis derived four GCSSES factors, which accounted for 65% of the variance in the scale: (a) Goal Setting, Feedback, and Evaluation; (b) Complex Aspects of Supervision; (c) Conflict Resolution; and (d) Working Alliance. Preliminary analyses show the GCSSES has high reliability and internal consistency (Cronbach's alpha = 0.99). Positive correlations between experience variables and supervisory self-efficacy were identified. A 54 item GCSSES was developed by this study. The GCSSES may serve as a tool for genetic counseling supervisors and graduate programs to assess skills, monitor professional development, and target training. A genetic counseling supervisory self-efficacy scale can also be used in future studies regarding training of genetic counseling supervisors.

Can addiction counselors be trained to deliver Mothering from the Inside Out, a mentalization-based parenting therapy, with fidelity? Results from a community-based randomized efficacy trial.

This study evaluated methods for training community-based clinicians to deliver a mentalization-based parenting intervention in an addiction treatment setting. Mothering from the Inside Out (MIO) targets psychological deficits associated with early stages of addiction recovery by fostering improvement in parental reflective functioning, the capacity to make sense of strong emotions in oneself and the child. Fifteen addiction counselors were randomized to training in MIO versus a Parent Education comparison, and completed eight training sessions and a clinically-supervised 12-session training case. As predicted, MIO and PE counselors demonstrated fidelity to their respective interventions during the training case. At the end of training, MIO counselors showed greater improvement than PE counselors in clinical reflective functioning, the capacity to make sense of a patients' mental and emotional experiences. Implications for training community-based counselors in evidence-based attachment interventions are explored.

Leadership and Peer Counseling Program: Evaluation of Training and Its Impact on Filipino Senior Peer Counselors.

Senior volunteers represented a significant, mostly untapped lay resource of informal social care. In this study, we evaluated the effectiveness of the training program on improving senior volunteers' competency toward peer counseling, and explored its impact on their well-being after three months of the program implementation. We conducted a pre- and post-intervention analysis among 60 senior volunteers aged 60-82 years. They participated in 40 h of training and performed weekly peer counseling home visits for three months. We evaluated the program using survey questionnaires, trainer observation and debriefing, and focus group discussions. After the training, peer counselors showed a significant improvement (p < 0.001) in knowledge (17.1 versus 22.3) and skills (17.0 versus 17.9). All of them met the minimum required passing level of 70% for the knowledge test, and their overall performance was satisfactory as rated by two independent trainers. After three months, peer counselors showed a significant improvement (p < 0.001) in their subjective well-being (d = 0.69) and depressive symptoms (d = -0.67). Filipino senior volunteers could be trained to serve as peer counselors in their communities. This program improved their competency and well-being. Future research is warranted to determine whether the provision of counseling by them will affect the health outcomes of the target population.

Supervision in genetic counselor training in North America: A systematic review.

Genetic counseling has been a profession for over 40 years, and training programs accredited by the Accreditation Council for Genetic Counseling are required to have students supervised in at least 50 patient-facing cases prior to graduation. However, there is no standardized information or training for supervisors of genetic counseling students. As a first step toward creating formal and standardized supervision training, we undertook a systematic review of the genetic counseling student supervision literature. A formal systematic review was conducted including establishing a research question with inclusion and exclusion criteria, establishing search terms, searching databases, reading/screening abstracts, examining full texts for inclusion, assessing for quality, and finally extracting data with a standardized form to provide the basis of the review. In all, 151 papers were screened, of which 19 and two erratum were found to meet inclusion criteria and pass quality measures. Main themes from these papers were as follows: Training Model, Competencies, Investigation of Techniques, Difficulties in Supervision, and Barriers. In total, 19 papers provided evidence for the way that supervision is currently being performed and suggestions for what needs further investigation to direct supervision training. Recommendations for genetic counseling student supervision include the following: provide a review of training models to supervisors; provide a copy of the supervision competencies to supervisors; use competencies with lowest self-efficacy to inform future supervision trainings; and find ways to support genetic counselors in becoming student supervisors.

Addiction counselors and suicide: Education and experience do not improve suicide knowledge, beliefs, or confidence in treating suicidal clients.

Substance use disorders (SUDs) are strongly associated with suicide deaths. However, SUD treatment is associated with lower suicide risk. To this date, we know little about whether SUD counselors are sufficiently knowledgeable about suicide and feel prepared and comfortable with treating and assessing their suicidal clients. This study was designed to characterize SUD counselors' general knowledge and confidence in treating suicidal clients, which was measured by their self-report of general knowledge of suicide prevention and belief in common myths about suicide as well as their self-reported confidence in treating suicidal clients. We hypothesized that confidence would be greater for counselors with more years of education and experience, that degree of education would predict greater knowledge and fewer beliefs in suicide myths, and finally that those counselors with greater knowledge and fewer beliefs in myths would have more confidence when treating suicidal clients. A total of 118 SUD counselors from 15 sites in Western Washington State agreed to participate in the study and completed baseline assessments. They were consented in group setting, usually during a staff meeting, and they were administered surveys on tablet computers. On average, the SUD counselors answered more than half the knowledge questions correctly and disagreed or strongly disagreed with common suicide myths. Their confidence in treating suicidal clients scored across the entire range. Our hypotheses were not supported: Confidence was not greater for those with more education or with more years of experience; degree of education and experience did not predict fewer beliefs in suicide myths; degree of education and experience did not predict greater knowledge; and greater knowledge and fewer beliefs in myths did not predict more confidence. The surprising finding that neither general suicide knowledge nor confidence were associated with the years of their work experience as a SUD counselor nor the level of their education and neither was associated with the other suggests that SUD treatment leadership should not depend on experience, education, general suicide knowledge to assure counselors are confidently able to treat suicidal clients. New or more precise training methods should be considered and evaluated.

Online course on basics of management of behavioral addictions involving use of internet: Observations from the first batch of participants.

Problematic internet use has been reported to be high among school students. An online course was developed with an aim to strengthen the capacity of school teachers and counsellors on early identification, detection and intervention for behavioral addictions involving use of internet. The current report presents the observation from the first batch of participants of this course. Of the 28 teachers and counselors who expressed interest by enrollment in the course, a total of 15 participants provided both the pre and post course evaluation forms. The preliminary findings suggest that the online course is feasible, acceptable and effective in strengthening the capacity of school teachers and counsellors on behavioral addictions involving use of internet.

Genomic education for the next generation of health-care providers.

Historically, medical geneticists and genetic counselors have provided the majority of genetic services. Advances in technology, reduction in testing costs, and increased public awareness have led to a growing demand for genetic services in both clinical and direct-to-consumer spaces. Recent and anticipated changes in the workforce of genetic counselors and medical geneticists require a reexamination of the way we educate health-care providers and the means by which we provide access to genetic services. The time is ripe for rapid growth of genetic and genomic services, but to capitalize on these opportunities, we need to consider a variety of educational mechanisms to reach providers both within and beyond the traditional genetic counseling and medical genetics sectors, including nurses, physician assistants, and nongenetics physicians. This article summarizes the educational efforts underway in each of these professions.

Provider engagement in precision oncology education: an exploratory analysis of online continuing medical education data.

Given the rapid growth in genomic tests and targeted therapeutics, clinicians are likely to benefit from additional precision medicine education. Aim: This study evaluated the engagement and effectiveness of two interactive, case-based educational modules about somatic tumor testing, developed by the Jackson Laboratory, American Medical Association and Scripps Research Translational Institute, titled 'Precision Medicine for Your Practice'. Results: 402 participants enrolled in one or both free online continuing education modules, including physicians, nurses, scientists and genetic counselors and 41% completed module evaluations. Over 90% of respondents reported alignment of program with practice needs and planned to change their practice, including patient communication, identifying candidates for testing and/or interpreting test results. Conclusion: These findings support Precision Medicine for Your Practice as an effective education offering for diverse clinical professionals.

Increasing substance use disorder counselors' self-efficacy and skills in talking to patients about sex and HIV risk: A randomized training trial.

BACKGROUND: People with substance use disorder (SUD) experience increased risk for HIV, Hepatitis C, and sexually transmitted illnesses via risky sex. This high-risk population would benefit from sexual risk reduction interventions integrated into SUD treatment. However, many SUD counselors report lack of skill or confidence in addressing sexual risk with patients. METHODS: This study was part of a larger nested 2 × 2 factorial repeated measures design, which compared two levels of counselor training (Basic-2 h versus Enhanced-10 h plus ongoing coaching). We determined whether counselors receiving Enhanced training addressing their motivation, confidence and skills (a) increased knowledge about sexual issues; (b) increased self-efficacy to discuss sex with patients; and (c) improved skills in discussing sex as part of SUD treatment, compared with those receiving shorter information-based training. Counselors providing individual therapy at two opioid treatment programs (OTP) and two psychosocial outpatient programs in the United States were eligible. Randomization occurred after Basic training. Measures included self-report (self-efficacy and knowledge) and blinded coding of standardized patient interviews (skill). RESULTS: Counselors receiving Enhanced training (n = 28) showed significant improvements compared to their Basic training counterparts (n = 32) in self-efficacy, use of reflections, and use of decision-making and communication strategies with standardized patients. These improvements were maintained from post-training to 3-month follow-up. No adverse effects of study participation were reported. CONCLUSIONS: Results suggest that counselors can improve their knowledge, self-efficacy and skill related to sexual risk conversations with patients based on modest skills-based training.

The impact of motivational interviewing training on rehabilitation counselors: Assessing working alliance and client engagement. A randomized controlled trial.

OBJECTIVE: To determine the impact of a motivational interviewing (MI) training designed to improve rehabilitation counselors' counseling skills to promote clients' engagement in return-to-work behaviors and to establish strong working alliance. PARTICIPANTS: The target population for this study was counselors who work for the state vocational rehabilitation (VR) program and their clients. Data were collected from a total of 347 participants (67 counselors and 280 clients) in the experimental and comparison groups, during the pre-and-posttests. STUDY METHOD: A randomized controlled trial was used in this study. The counselors in the experimental group received a 4-hr standardized MI training and a 4-week follow-up coaching sessions. RESULTS: The counselors in the experimental group demonstrated significant gains in their MI competence scores compared to the comparison group. The clients of the experimental group's counselors improved their engagement in VR services and working alliance with their counselors. CONCLUSIONS: The findings of this research indicated a need for carefully developed counseling trainings and incorporation of the evidence-based practices in the VR programs to provide better quality of rehabilitation services. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Developing a genomics rotation: Practical training around variant interpretation for genetic counseling students.

With the wide adoption of next-generation sequencing (NGS)-based genetic tests, genetic counselors require increased familiarity with NGS technology, variant interpretation concepts, and variant assessment tools. The use of exome and genome sequencing in clinical care has expanded the reach and diversity of genetic testing. Regardless of the setting where genetic counselors are performing variant interpretation or reporting, most of them have learned these skills from colleagues, while on the job. Though traditional, lecture-based learning around these topics is important, there has been growing need for the inclusion of case-based, experiential training of genomics and variant interpretation for genetic counseling students, with the goal of creating a strong foundation in variant interpretation for new genetic counselors, regardless of what area of practice they enter. To address this need, we established a genomics and variant interpretation rotation for Stanford's genetic counseling training program. In response to changes in the genomics landscape, this has now evolved into three unique rotation experiences, each focused on variant interpretation in the context of various genomic settings, including clinical laboratory, research laboratory, and healthy genomic analysis studies. Here, we describe the goals and learning objectives that we have developed for these variant interpretation rotations, and illustrate how these concepts are applied in practice.

The Global State of the Genetic Counseling Profession.

The profession of genetic counseling (also called genetic counselling in many countries) began nearly 50 years ago in the United States, and has grown internationally in the past 30 years. While there have been many papers describing the profession of genetic counseling in individual countries or regions, data remains incomplete and has been published in diverse journals with limited access. As a result of the 2016 Transnational Alliance of Genetic Counseling (TAGC) conference in Barcelona, Spain, and the 2017 World Congress of Genetic Counselling in the UK, we endeavor to describe as fully as possible the global state of genetic counseling as a profession. We estimate that in 2018 there are nearly 7000 genetic counselors with the profession established or developing in no less than 28 countries.

Crisis-counselor perceptions of job training, stress, and satisfaction during disaster recovery.

OBJECTIVE: The United States Crisis Counseling Assistance and Training Program (CCP; authorized by the Robert T. Stafford Disaster Relief and Emergency Assistance Act, 1974/2013) aims to provide disaster-recovery support to communities following natural or human-caused disasters through outreach. Job satisfaction among the crisis counselors the CCP employs may affect the delivery of outreach services to survivors and their communities. The present study was conducted to gain insight into CCP crisis counselors' experiences with job training and work-related stress as predictors of job satisfaction. METHOD: Data was collected from 47 CCP service-provider agencies, including 532 completed service-provider feedback surveys to examine the usefulness of the CCP training they had received, the support and supervision provided by program management, the workload and its duration, resources provided, and the stress experienced. Quantitative and qualitative data were examined, and a multiple linear regression was calculated to predict job satisfaction based on training usefulness, job stress, gender, age, race, full- or part-time status, highest level of education achieved, and supervisory position. RESULTS: The overall regression equation was significant, F(8, 341) = 8.428, p < .000. The regression coefficients indicated that the higher the job training was rated as useful (p < .001), the lower the job stress (p < .01), and the older the age of the respondents (p < .05), the greater the level of job satisfaction. CONCLUSION: Findings suggest that proper training and management of stress among crisis counselors are necessary for influencing levels of staff job satisfaction. Where self-care and stress management were not adequately emphasized, more stress was reported. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Impact of contraceptive counselling training among counsellors participating in the FIGO postpartum intrauterine device initiative in Bangladesh.

OBJECTIVE: To evaluate the impact of structured training given to dedicated family planning counsellors on postpartum intrauterine device (PPIUD) services across six tertiary hospitals in Bangladesh. METHODS: Family planning counsellors underwent structured training on postpartum family planning, PPIUD in particular, over a four-day period. Impact of training was evaluated by comparing PPIUD counselling rates, consent rates, insertion rates, and removal rates five months before and five months after the training, using data from women delivering in the participating facilities. RESULTS: A total of 27 622 women were included in this analysis: 11 263 (40.8%) before the training intervention and 16 359 (59.2%) after it. There was an increase in the proportion of women who were counselled (from 75.3% to 83.8%, P<0.001), and a small decrease in the proportion of women agreeing to have a PPIUD inserted following counselling (13.7% vs 12.9%, P=0.03). Overall insertion rate was similar before and after training (9.5% vs 9.8%, P=0.42), while removal rate reduced from 2.8% to 1.8% (P=0.41). CONCLUSION: Structured training had no impact on overall PPIUD insertion rate. However, it did impact numbers of women receiving counselling, perceived quality of the counselling received, and overall removal rates.

What education, background, and credentials are required to provide genetic counseling?

Technological advances in genetics have resulted in an increase in the number and complexity of screening and diagnostic tests in the prenatal clinical arena. It is critical that patients are provided with appropriate counseling to enable them to make educated decisions. During this workshop session participants discussed the education, background and credentials required to provide counseling regarding prenatal genetic testing options. The participants agreed that prenatal care providers may have limited time and training to adequately address prenatal genetic testing. Telemedicine and online education may help to address this challenge. Workshop participants agreed that educational and certifying organizations should work together to develop standards for the certification and maintenance of certification processes.

Effectiveness of NIMHANS ECHO blended tele-mentoring model on Integrated Mental Health and Addiction for counsellors in rural and underserved districts of Chhattisgarh, India.

The present study was conducted to ascertain the effectiveness of Project ECHO, a Hub and Spokes tele-mentoring model to bridge the urban-rural divide in mental health and addiction care in the context of a developing country like India. The Counsellors from 11 rural and underserved districts of Chhattisgarh were periodically connected to NIMHANS multidisciplinary specialists by smartphone app and underwent virtual mentoring to learn and translate "best practices" in Mental health and Addiction by using "patient-centric learning", a core component of NIMHANS ECHO model. The outcome evaluation was modelled on Moore's evaluation framework focusing on participant engagement, satisfaction, learning, competence and performance. Over the period of 6 months i.e. 12 tele-ECHO clinics, 41 patients case summaries were discussed by the Counsellors with NIMHANS Hub Specialists. Half of the counsellors could join >80% clinics and overall there were no drop-outs. There was a significant increase in learning and self-confidence after six months. The participants liked "relevance of the courses to clinical practices". "group based discussions" and "a reduction in professionals isolation". The results indicate promise of the NIMHANS ECHO tele-mentoring model as one with potential for capacity-building in mental health and addiction for remote and rural areas by leveraging technology.

The Effect of Sexual and Reproductive Health Education on Knowledge and Self-Efficacy of School Counselors.

PURPOSE: Enrichment of school counselors' knowledge would be an effective way to promote sexual and reproductive health (SRH) among adolescents. The present study aims to assess the effect of educational intervention on knowledge and self-efficacy of high school counselors on teenage SRH. METHODS: A randomized controlled trial was conducted between June 2016 and March 2017. One hundred and twelve high school counselors from Tehran were recruited and randomized into two groups. The intervention was comprised of training courses on adolescent SRH as per two educational approaches: the team-based learning (TBL) and lecturing, which consisted of four sessions of 2hours in 2 weeks. The knowledge and feeling of self-efficacy in both groups were assessed at the beginning of the study and 8 weeks after the intervention by researcher-made questionnaires. RESULTS: After intervention, the mean and standard deviation of the knowledge and self-efficacy scores increased significantly in both TBL and lecture groups (p < .001). However, the final mean (standard deviation) of counselors' knowledge and self-efficacy scores in the TBL group were significantly higher than that of those in the lecture group [20.06 (2.74) vs. 18.90 (2.95); p = .03 for knowledge and 43.01 (4.08) versus 41.15 (4.99); p = .03 for self-efficacy] with an almost moderate effect size d = .55 for both outcomes. CONCLUSIONS: The better SRH knowledge and self-efficacy in TBL group can be indicative of the group's effect on making challenges, especially in subjects that are socio-religious by nature. It seems that applying learner-centered educational approaches such as TBL can facilitate achieving pre-assigned SRH goals.