Culturally Appropriate Career Counseling With Gay and Lesbian Clients

This article details the current knowledge regarding the provision of culturally appropriate career services to gay and lesbian clients. It is divided into 5 parts: history and context for the delivery of career counseling services to gay and lesbian clients, counselor self‐preparation for working with gay and lesbian clients, client‐focused interventions useful for counseling with gay and lesbian clients, program‐focused interventions useful for addressing the special issues that this group presents, and appropriate advocacy or social action interventions. Issues of multiple cultural identities and the intersection of lesbian and gay issues with race and ethnicity are also addressed.     

Genetics After the Act: A Specialist Health Service Amid NHS Reform

This article considers the impact of the recent reform of the National Health Service (NHS) on specialist regional health services. A case study of medical genetic services is presented to highlight some problems arising from the implementation of the 1990 NHS and Community Care Act. New financial arrangements introduced by the Act have led many regional health authorities to devolve the finance and organization of specialist health services to districts. The introduction of competition and devolved budgets may pose especial problems for some specialist health services. In the case of genetic services these difficulties are exacerbated by new pricing rules. The paper explores these issues and suggests that the imposition of the market model on health care overlooks some vital, human elements which do not fit neatly into such a model.