Counseling Customers: Emerging Roles for Genetic Counselors in the Direct-to-Consumer Genetic Testing Market

Individuals now have access to an increasing number of internet resources offering personal genomics services. As the direct-to-consumer genetic testing (DTC GT) industry expands, critics have called for pre- and post-test genetic counseling to be included with the product. Several genetic testing companies offer genetic counseling. There has been no examination to date of this service provision, whether it meets critics’ concerns and implications it may have for the genetic counseling profession. Considering the increasing relevance of genetics in healthcare, the complexity of genetic information provided by DTC GT, the mediating role of the internet in counseling, and potential conflicts of interest, this is a topic which deserves further attention. In this paper we offer a discourse analysis of ways in which genetic counseling is represented on DTC GT websites, blogs and other online material. This analysis identified four types of genetic counseling represented on the websites: the integrated counseling product; discretionary counseling; independent counseling; and product advice. Genetic counselors are represented as having the following roles: genetics educator; mediator; lifestyle advisor; risk interpreter; and entrepreneur. We conclude that genetic counseling as represented on DTC GT websites demonstrates shifting professional roles and forms of expertise in genetic counseling. Genetic counselors are also playing an important part in how the genetic testing market is taking shape. Our analysis offers important and timely insights into recent developments in the genetic counseling profession, which have relevance for practitioners, researchers and policy makers concerned with the evolving field of personal genomics. Keywords Genetic counseling Internet Direct-to-consumer genetic testing Discourse analysis

Screening and Assessment in TANF/Welfare-to-Work: Ten Important Questions TANF Agencies and Their Partners Should Consider

Changes to the welfare system brought about by the Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA), and state and local welfare reform efforts, carry serious implications for Temporary Assistance to Needy Families (TNF) recipients with disabilities and barriers to employment. Specifically, work participation and time limit requirements are two key provisions of the federal welfare law which provided a new sense of urgency encouraging states to develop strategies to assist clients with their transistions from welfare to work. As a first step in this process, TANF agencies are considering strategies to identify the barriers that are inhibiting or prohibiting this transition. PRWORA offers unprecedented flexibility to develop such strategies and design programs and services to assist with the transition from welfare to work. This paper is merely a first step in considering some of the many challenges associated with identifying unobserved barriers to employment

Estimating Public and Private Expenditures on Occupational Training in the United States

[Excerpt] Retraining and upgrading the skills of incumbent workers and providing training to new labor force entrants, dislocated workers, and unemployed persons can help increase the efficiency and effectiveness of the workforce. Funding for occupational training comes from many sources — the federal government, state and local governments, private employers, philanthropic foundations, and individual workers themselves. This report examines occupational training to present a preliminary picture of the total spending on job training in the United States