Empathic connection with one's patients is essential to genetic counselor clinical practice. However, repeatedly engaging with distressed patients may cause compassion fatigue, a phenomenon characterized as feeling overwhelmed by experiencing patients' suffering. In order to extend findings of an initial qualitative study, we surveyed 222 genetic counselors about their compassion fatigue and factors that predict its occurrence. Multiple regression analysis identified seven significant predictors accounting for 53.7% of the variance in compassion fatigue. Respondents at higher risk of compassion fatigue were more likely to report being burned out, using self-criticism and giving up to manage stress, experiencing a greater variety of distressing clinical events, having larger patient caseloads, relying on religion as a coping strategy, having no children, and seeking support to manage stress. Respondents also provided critical incidents regarding their compassion fatigue and themes in these incidents are described. Practice and research recommendations are provided.

Personal values are motivational sources for an individual's actions [Hitlin and Piliavin (Annual Review of Sociology 30:359-393, 2004)]. Genetic counselors' values may influence their behaviors in clinical practice, but a profile of their personal values has not been identified empirically. In this study, 292 genetic counselors completed the Schwartz Universal Values Questionnaire (SUVQ; Schwartz, S. H. (1992). Universals in the content and structure of values: Theoretical advances and empirical tests in 20 countries. In M. Zanna (Ed.), Advances in experimental social psychology (pp. 1-65). Boston, MA: Academic.), a widely used measure of value types, and provided information about their demographic characteristics. Results indicate that respondents highly valued benevolence, self-direction, achievement, and universalism indicating a strong pattern of concern for the welfare of others. They placed considerably less value on stimulation, tradition, and power, which reflect personal interests. Respondents who reported practicing a religion scored significantly lower on stimulation and hedonism and higher on tradition and spirituality than those not practicing; married respondents and parents scored significantly lower on stimulation and achievement; and males scored higher on power than females. The value types are described, and training and research recommendations are provided.

Heuristics are mental shortcuts that aid people in everyday problem-solving and decision-making. Although numerous studies have demonstrated their use in contexts ranging from consumers' shopping decisions to experts' estimations of experimental validity, virtually no published research has addressed heuristics use in problems involving genetic conditions and associated risk probabilities. The present research consists of two studies. In the first study, 220 undergraduates attempted to solve four genetic problems--two common heuristic problems modified to focus on genetic likelihood, and two created to study heuristics and probability rule application. Results revealed that the vast majority of undergraduates used heuristics and also demonstrated a complete misuse of probability rules. In the second study, 156 practicing genetic counselors and 89 genetic counseling students solved slightly modified versions of the genetic problems used in Study 1. Results indicated that a large percentage of both genetic counselors and students used heuristics, but the counselors demonstrated superior problem-solving performance compared to both the genetic counseling students and the undergraduates from Study 1. Research, training, and practice recommendations are presented.