Predictive genetic test decisions for Huntington's disease: Elucidating the test/no-test dichotomy

Predictive genetic testing for serious, mature-onset genetic illness represents a unique context in health decision making. This article presents findings from an exploratory qualitative Australian-based study into the decision making of individuals at risk for Huntington's disease (HD) with regard to predictive genetic testing. Sixteen in-depth interviews were conducted with a range of at-risk individuals. Data analysis revealed four discrete decision-making positions rather than a 'to test' or not to test' dichotomy. A conceptual dimension of (non-)openness and (non-)engagement characterized the various decisions. Processes of decision making and a concept of 'test readiness' were identified. Findings from this research, while not generalizable, are discussed in relation to theoretical frameworks and stage models of health decision making, as well as possible clinical implications.

Reflective analysis: Techniques for facilitating reflection

This paper describes a number of techniques for facilitating reflective critical analysis as a means of eliciting in-depth reflections on practice. The authors have previously used similar techniques in the research context, to assist practitioners to identify and analyse the basis of their work with clients. The techniques presented in this paper have been adapted for use in social work education, including in class-based and field education contexts, and to professional supervision.