test interpretation in counseling

> ` +V bjbjss 9 M / ^ ^ ^ ^ ^ ^ ^ r 6# 6# 6# 8 n# t # \ r $A p J$ : $ ( $ $ $ &. PDF 1995 EDO-CG-95-26 ERIC Digest - American Counseling Association This is especially relevant given the low response rate. The cases submitted provided additional, nuanced descriptions of the circumstances that can surround errors in genetic test interpretation compared to the survey data, as case submitters were not limited to specific response options. PDF Assessment Skills for School Counselors - American Counseling Association A total of 416 individuals opened the survey and 360 individuals fully completed it, giving a response rate of 7.2%. Maiese DR, Keehn A, Lyon M, Flannery D, Watson M. Working groups of the National Coordinating Center for seven regional genetics service Collaboratives. This process helps reduce the chance of a client misunderstanding the test results or recalling them inaccurately. From genetics to genomics: facing the liability implications in clinical care, Personalized medicine and genetic malpractice, A review of medical malpractice claims related to clinical genetic testing, Stemming overtreatment in U.S. Healthcare may cut costs of care, Case Study Research and Applications: Design and Methods, A general inductive approach for analyzing qualitative evaluation data. The interpretation of genetic testing results is subject to error. (B) Perceived consequences of the genetic report misinterpretation for all three potential variant misinterpretations types. From helices to health: undergraduate medical education in genetics and genomics, Pitfalls in the interpretation of molecular diagnostic tests, Performance of ACMG-AMP variant-interpretation guidelines among nine Laboratories in the Clinical Sequencing Exploratory Research Consortium. A counselor is obliged to do everything possible to effectively solve the problem and avoid any mental, moral or physical harm. Includes surveys of vocational personality, and aptitude tests and structured experience in administration and scoring. These activi-ties include interpreting test scores and non-test data.Pupil assessment includes scheduling and preparingfor testing, scoring them or sending them out for scoring,recording results, and scheduling for interpretation.Counselors are also responsible for assisting students inevaluating their aptitudes and abilities through interpret-i. Also explored are techniques, materials and ideas to assist school counselors and related practitioners at all levels in their professional development. Case series focused on errors in genetic testing, especially in the realm of hereditary cancer risk, have been key in providing awareness to the consequences of improper management of genetic testing and report interpretation.16,21,22,58 Experiences of misinterpretation in pediatric, prenatal, and even direct-to-consumer genetic testing have also been reported by genetic professionals.5962 Continued identification of pitfalls in the ordering and interpretation of genetic resultsand the identification of these errors in a robust, quantitative manneris necessary in order to realize the extent to which errors in genetic interpretation occur so that they may be adequately addressed. (Contains 20 references.) Abstract and Figures. FOIA Schmidlen T, Schwartz M, DiLoreto K, Kirchner HL, Sturm AC. These challenges can occur for both genetics and non-genetics trained professionals who are providing the results to patients and their families. DeepDyve's default query mode: search by keyword or DOI. Genetic counselor perceptions of adverse effects of genetics service provision by non-genetics professionals, All along the watchtower: a case of long QT syndrome misdiagnosis secondary to genetic testing misinterpretation. The therapist then interprets the person's answers. More information about CSER can be found at https://cser-consortium.org/. Communicating Assessment Results in the Counseling Interview. These include factors such as emotional stability, perfectionism, reasoning, and warmth. Given the complexity of the psychological problems faced by many people around the world for several reasons (problems in family life, at school, at work, in relationships with friends, etc. Request Permissions. To assist students with formulating goals commensurate with their interests and abilities, a study incorporating planned testing and group counseling was conducted at a community college in the West. oldman (1972) characterized the relationship between tests and counseling as the marriage that failed. 2023 DeepDyve, Inc. All rights reserved. Ordering of the incorrect genetic test was not mentioned in these cases, as testing options were predetermined for all study sites in the CSER consortium. The goal of the survey was to identify instances of genetic result misinterpretation and to assess the clinicians' experience in how those cases affected patient care. Using various approaches in career counselling for traditionally disadvantaged (and other) learners: some limitations of a new frontier. Submitted cases show that pitfalls in misinterpretation of genetic results extend beyond perceived errors in variant classification. A counselor should be able to select a test based on its task and the features of a counselee correctly. Case studies were then collected from a select group to further explore potential causes of misunderstanding. Respondents were allowed to select more than one answer to account for the involvement of different types of healthcare professionals for respondents who had experienced multiple examples of result misconception. McClaren BJ, King EA, Crellin E, Gaff C, Metcalfe SA. 2023 DeepDyve, Inc. All rights reserved. This study is an initial exploration of perceived instances of misinterpretation described by genetics professionals, including geneticists and genetic counselors, using self-reported data. Genetic testing is increasingly employed in the evaluation of medical conditions, ranging from neurocognitive disorders with childhood onset to the development of cancer in adults.1 The involvement of all age groups and expansive clinical indications for genetic testing have led to an increased demand for genetic tests and ordering of these tests by health professionals without formal training in genetics.2 Coupled with this increase demand for testing is the rapid advancement of genomic technology, resulting in an increased complexity of genetic testing options to clinicians who may need to order and interpret genetic tests as a part of patient care.3 These advances in the genomic era have been swift, and medical schools may not be able to cover the nuances of genomic test interpretation in a traditional course schedule.48 Nevertheless, there is a recognized shortage of trained medical geneticists and genetic counselors, so health professionals without formal training in genetics have increasingly been involved in ordering and interpreting genetic testing especially as the enthusiasm for genomic medicine continues to rise.912, Despite the spread of genomic medicine throughout the US healthcare system, its benefits cannot be fully realizedand perhaps, may be negatedif genetic testing results are misinterpreted. The communication of probabilistic information through test A study by Makhoon et al. Karyotype, single gene sequencing, and del/dup studies were ordered for a patient from the same laboratory. The survey respondents highlighted that variant misclassification was common and interpretation of a VUS as a benign or pathogenic variant was the most frequently observed form of variant misinterpretation. Future research regarding frequency of instances of misinterpretation among clinicians using a more structured approach with piloting and validation of survey questions is an important next step to this work. Test interpretation: Talking with people about their test results. The authors address this oversight, identifying and explaining principles and procedures for counselors to follow in interpreting tests to clients. As for parents, the professional school counselor: a. Topics you will need to know to pass the quiz include understanding and identifying different assessments. TINSLEY, HOWARD E.A. ), the services of practicing psychologists are becoming more popular every day. Interpretation and Use of Tests in Counseling Adults The survey was distributed to the three groups, totaling approximately 5000 members. The qualifications of counselors should match the type of the tests since they should use those testing and assessment for which they have been trained and are competent (ACA Code of Ethics, 2014). Only two cases classified the reported error as a misinterpretation in variant classification ('benign' interpreted as 'pathogenic', and 'VUS' interpreted as 'pathogenic'). The data that support the findings of this study are available from the corresponding author upon reasonable request. Analysis, synthesis and utilization of assessment data for counseling and service planning are emphasized. Rubanovich CK, Cheung C, Mandel J, Bloss CS. To get new article updates from a journal on your personalized homepage, please log in first, or sign up for a DeepDyve account if you dont already have one. Test interpretation. Test Interpretation - TINSLEY - 1986 - Journal of Counseling & Development - Wiley Online Library Test Interpretation HOWARD E.A. Accessibility Nazareth S, Nussbaum RL, Siglen E, Wicklund CA. In practice, counseling psychologists try to gain an understanding of how each individual thinks, feels, and acts, and their assessment practices cover the entire range of human cognitive, conative, and affective attributes. Enhancing human development throughout the life span; Honoring diversity and embracing a multicultural approach in support of the worth, dignity, potential, and uniqueness of people within their social and cultural contexts; Safeguarding the integrity of the counselorclient relationship; and. Differential effects of two test-interpretation styles in counseling: A field study. Reanalysis concluded variant was likely diagnostic in this case. The effects of two styles of test interpretation, namely directive and collaborative, and clients' perceptions of the technical status of tests, namely high and low, were compared for 32 . During the feedback session John inquires about Jessica's values, interests, expectations, and goals, and also examines Jessica's performance on previous tests . National Human Genome Research Institute (NHGRI) with co-funding from the National Institute on Minority Health and Health Disparities (NIMHD) and the National Cancer Institute (NCI), Grant/Award Numbers: U01HG007301, U01HG009599, U01HG009610, U24HG007307. We designed a survey in which we asked respondents about examples of experienced genetic test misinterpretation (Appendix S1). For example, 23andMe only tests for three mutations of the BRCA1 and BRCA2 . The effects of test interpretation styles and the status of tests in Genetic education and nongenetic health professionals: educational providers and curricula in Europe. Select data courtesy of the U.S. National Library of Medicine. Abstract The interpretation of genetic testing results is subject to error. It was concluded that the study of integrated group counseling and testing produced no significant changes in student interests. Improving molecular genetic test utilization through order restriction, test review, and guidance, Errors in genetic testing: common causes and strategies for prevention. 8600 Rockville Pike Greenberg SE, Boothe E, Delaney CL, Noss R, Cohen SA. Two hundred and twenty reported cases of misinterpretation involved a Specialist Physician, followed by 182 reported cases involved a Primary Care Physician, and 110 with a Nurse or Mid-Level Provider. One caveat to the distribution method was that survey recipients may have been members of two or even all three of the groups, making the actual number of recipients likely to be below the estimated 5000. Furthermore, case submitters noted that there are gray areas in the interpretation of genetic results and that perceived errors may not be easily identified. As regards to the assessment of the tests, regardless of a counselees age, it must comply with the principles of accuracy, reliability and scientific validity, corresponding to the objective data obtained by research and proven methods. Provider not familiar with the case called it VUS. Participants were aware that their responses were being used as part of a study by investigators at the University of Alabama at Birmingham. In his/her activities, a counselor should always keep in mind the principle of no harm. Pade, Wright and other clinicians provide more guidance on how to take your reports to the next level. Note: Summary of the cases submitted by the CSER Education & Return of Results Working Group, highlighting perceived pitfalls in interpretation of genomic test results among providers. Table 2 briefly describes each case as well as the (1) perceived consequence of the reported error and (2) perceived contributing factors to the reported error. All other trademarks and copyrights are the property of their respective owners. The assessment technique most widely used by counseling psychologists is the clinical interview. For example, for the proper application of individual intelligence tests and most of personality tests a relatively long period of intensive training and supervision of the testing process is required, while testing of educational achievements needs minimal professional preparation. Lastly, respondents were asked how long, on average, did patients have to wait before they were provided with the correct interpretation of their genetic testing result following prior misinterpretation of the result. A total of 40/242 (16%) of surveyed individuals had encountered at least one case of a pathogenic result being interpreted as benign. TINSLEY and RICHARD W. BRADLEY It has been argued that tests contribute little to the counseling process. While this is helpful from an anecdotal standpoint, the data we collected are not intended to identify ways to fix pitfalls and challenges in providing results. Upon WES, a non-fatal diagnosis was found., A patients breast and ovarian cancer result was interpreted as negative by her oncologist, when the result was positive. Both professionals with and without formal training in genetics were challenged by test reports, and variants of unknown significance were most frequently involved. Research on the Effects of Test Interpretation: A Review Greb AE, Brennan S, McParlane L, Page R, Bridge PD. A qualitative case-based approach was then used to explore experiences with perceived misinterpretation of genetic testing results among genetics professionals who were members of the CSER consortiums Education and Return of Results (E-ROR) working group, which consists of about 65 members.29 This approach allowed for a more nuanced exploration of instances of perceived misinterpretation, as our survey only allowed participants to respond with yes or no, with an optional open-ended response to share anecdotes. A growing selection of library products includes archives, data, case studies and video. Case submitter #9, for example, cited the need for caution when interpreting results and the necessity of investigating the limitations of a testing modality. Respondents were asked to judge the factors that contributed to misinterpretation, shown in Figure 2(C). Secondly, incorrect counseling of patients despite correct classification of the variant can also occur. Determined whether the estimation accuracy of 120 undergraduates engaged in individual counseling, group counseling, or control conditions would improve more on test scales of high than of low or . The genomics era has brought with it liabilities that are unique and it is likely that some misinterpretation lawsuits will set legal precedent.2527 The ramifications of genetic test result misinterpretations can also lead to the misuse of healthcare dollars, costing families, payers, and the entire healthcare system.21,28. CH. 12 & 13 Flashcards | Quizlet Time frame is off; testing takes more than a day, Assessments are arbitrary and don't mean anything without a comparison, Create your account to access this entire worksheet, A Premium account gives you access to all lesson, practice exams, quizzes & worksheets. Next, survey respondents reported the types of variant classifications that were most prone to misconception. In doubtful and controversial cases, a psychologist is obliged to consult with an expert in the relevant field and objectively consider the recommendations received. Twenty-four cases of misinterpretation by a medical professional not listed above were also reported. - Definition & Characteristics, What Is the DSM? No significant change was detected in certain student interests at P .05 level. The most common is a VUS interpreted as pathogenic or benign, followed by misinterpretation of a benign variant interpreted as pathogenic. This observational study illustrates examples of pitfalls and challenges in interpretation of genetic testing results as reported by genetics professionals. - Definition & Characteristics Quiz, The Middle Stages: Working Within The Counseling Relationship Quiz, Termination During the Counseling Process: Function, Timing & Related Issues Quiz, Psychological Research & Experimental Design, All Teacher Certification Test Prep Courses, The History of Counseling and Psychotherapy, Human Growth and Development in Counseling, Mental Health, Substance Abuse & Rehabilitation Counseling, Social and Cultural Elements of Counseling, Working Scholars Bringing Tuition-Free College to the Community, Circumstances where it's unnecessary to give an assessment to patients, Determine circumstances that would require assessments, Learn when personality assessments are given. Pitfalls and challenges in genetic test interpretation: An exploration I was eventually consulted and the patient was a beautiful infant, with no features of the condition. Search introductory-and-advanced-courses; 12. . Test results in counseling constitute interventions that can facilitate change and lead to greater awareness, knowledge, and self understanding. As the survey was not designed to determine the frequency of misinterpretation, our results are not amenable to quantitative analyses. It can only be broken if keeping the confidentiality might cause serious injury or even death of a counselee as well as other people, including the counselor. Contributing factors are listed in Figure 2(C). Introduction to formal assessment. We also recognize that there may have been ascertainment bias in the responses received, wherein practitioners who had encountered an instance of results misinterpretation may have been more likely to respond to the survey or provide a case study. Enrolling in a course lets you earn progress by passing quizzes and exams. Test Interpretation - an overview | ScienceDirect Topics Test interpretation. - APA PsycNet As such, the survey questions were written by study authors and not subject to review of validity or reliability of the data that were generated. Case submissions revealed that interpretation pitfalls extend beyond variant classification analyses. The number of misinterpreted genetic testing cases reported by respondents varied, with the majority having experienced 25 cases (55%), 21% experienced 10 or more, 13% experienced 610 cases, and 11% experienced just one. Introduction to formal assessment. This site, and all its contents, are Copyright 2023 by New York University. Anecdotes are paraphrased to avoid unintentional reidentification of patients. Of 360 valid responses, 61 people responded that they had not been involved in a case in which a genetic test result was misinterpreted by another provider which terminated the survey, leaving 299 surveys for further study. However, psychometric assessment procedures have numerous advantages over the interview. Test Development 38 . People have long been interested in understanding human personality. Generation and implementation of a patient-centered and patient-facing genomic test report in the EHR. The goal of this study was primarily descriptive: to identify and highlight instances in which these genetic professionals have encountered situations where they consider that medical professionals have misunderstood a genetic test result. De novo variant of uncertain significance in found in a premature infant: provider reported that the variant wasnt paternally or maternally inherited without discussing the mechanism of de novo variants. This requirement enables professional counselors to provide consultation and training to others who assist with test administration and scoring. Both the survey and case analyses revealed that the most commonly reported consequence of result misconception was perceived patient stress, though other outcomes included incorrect management or treatment decisions and increases in medical care cost through ordering of unnecessary follow-up tests. This document presents a client centered approach to testing and interpretation. Results were reported to family as causative before del/dup studies completed, which were negative. However, this type of work has its own characteristics, which lies in the fact that a psychologist having an ability to influence the psychological state of a client, as well as his/her later life, performs primarily ethical responsibility towards his/her counselee. Professor of Educational Psychology. An official website of the United States government. In order to ensure comprehensive analysis of the data, the perceived consequence of and contributing factors to these misinterpretation cases, as well as the observed themes in the cases, were refined through iterative processes and discussion with all study authors. Bookmark this article. For example, therapists gain experience one client at a time, but tests provide information based on large numbers of people in the form of norm groups. Differences in the meanings attributed to the probabilitistic words/expressions were found among the three samples (training programs), suggesting possible "training program differences " in the way that counseling psychologists may be taught to understand the language of test interpretation reports. Note: Select examples of the 160 anecdotes submitted by survey respondents, each representing a different type of perceived variant misinterpretation. The most frequent reported consequence was perceived patient stress. ; BRADLEY, RICHARD W. 1986-03-01 00:00:00 HOWARD E.A. (C) Perceived factors contributing to reported misinterpretations for all three potential variant types. In case #1, for example, the provider disclosed a VUS that was neither maternally or paternally inherited to the mother of an infant without explaining the concept of de novo inheritance. The Rorschach inkblot test is a type of projective assessment in which subjects look at 10 ambiguous inkblot images and describe what they see in each one. The breakdown of types of health professionals involved in misinterpretation events is shown in Figure 1. All cases, however, cited incorrect application of genetic concepts by the referring provider as the perceived cause of misinterpretation. In turn, the interpretation of test results is directly related to the liability for the psychological state and health of the client. A high level of professionalism of a counselor implies respect for his/her counselee as a unique and unrepeatable person. The activity of psychological counselors has a special significance in the modern world. Competent test users implement appropriate and standardized administration procedures. Other publications have discussed ways to reduce the likelihood of misinterpretation, and improved education of medical professionals has emerged as a common theme.3235 While the need for increased education of non-genetics professionals in clinical genetics has long been appreciated, it is clear that pitfalls in interpretation can still occur with formal genetics training. Which . Patients mother assumed non-paternity given the variant was not inherited from either parent. The Qualtrics platform was used to send the survey to three groups of genetics professionals: (1) medical geneticists certified by the American Board of Medical Genetics and Genomics, (2) genetic counselors who are members of the National Society of Genetic Counselors (NSGC), and (3) members of the Clinical Sequencing Evidence-Generating Research (CSER) Consortium, which includes medical geneticists, laboratory geneticists, and genetic counselors. Individuals should not be told the results of testing without their interpretation. TEST INTERPRETATION - Psychology Dictionary Without access to patient records and test reports, collecting instances of misinterpretation can be subjective and influenced by ascertainment bias. Participants completed the survey in January and February in 2019 and did not receive compensation. - Definition & Purpose Quiz, The Counseling Intake Process & Initial Interview, The Counseling Intake Process & Initial Interview Quiz, Testing and Assessment in Counseling: Types & Uses Quiz, What Is the DSM? Sign up today, get DeepDyve free for 14 days. Wiley. While results were negative, the ordering provider stated that the test had ruled out all genetic causes of the infans phenotype and informed the family that there was no recurrence risk in future children. The survey did not address complications arising from amended reports or discordant variant calling among labs. Counselor John is discussing test results with examinee Jessica. The gene however is not definitively associated with IUGR, microcephaly, and brain abnormalities. The values were chi-squared for ten interest areas; social service, outdoor, mechanical, clerical, computational, persuasive, scientific, artistic, literary, and musical. In particular, testing should be only performed by qualified personnel intended to protect an individual against misuse of the test. Chatbots & artificial intelligence to scale genetic information delivery, The counselor will videoconference you now: addressing opportunities and challenges with patient-clinician communication in the telemedicine era. The marriage between tests and career counseling: An intimate report, Discrepancy identification: A model for the interpretation of the Kuder DD and other interest inventories. Information recall . Case-based reports from genetic professionals were also collected to further explore the circumstances surrounding perceived examples of genetic test misinterpretation. Art and challenges of precision medicine: interpreting and integrating genomic data into clinical practice. Link/Page Citation Psychological tests are used frequently in counseling. One explanation for the argument that tests contribute little to the counseling process, may be that counselor training has focused on technical aspects of testing rather than application. TINSLEY, RICHARD W. BRADLEY First published: March 1986 https://doi.org/10.1002/j.1556-6676.1986.tb01166.x Citations: 13 PDF Tools Share Get access to the full version of this article. Interpreting test scores to clients: What scores should one use? All DeepDyve websites use cookies to improve your online experience. Communicating Assessment Results in the Counseling Interview. Respondents were asked if they had experienced each of the following cases: (1) a benign or likely benign variant interpreted as pathogenic, (2) a variant of unknown significance (VUS) interpreted as benign or pathogenic, and (3) a pathogenic variant interpreted as benign If respondents experienced a perceived misinterpretation in more than one scenario, they were able to respond appropriately. Select data courtesy of the U.S. National Library of Medicine. At least one case of a benign variant being interpreted as pathogenic by a non-genetics professional was reported by 141/261 (54%) surveyed respondents who answered this question, shown in Figure 2(A). Responds to comments by L. E. Tyler (1959) on the authors' original article on test interpretation in counseling (see record 1961-03939-001).
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