This review of family communication of genetic risk information addresses questions of what the functions and influences on communication are; what, who and how family members are told about genetic risk information; what the impact for counsellee, relative and relationships are; whether there are differences by gender and condition; and what theories and methodologies are used. A systematic search strategy identified peer-reviewed journal articles published 1985-2009 using a mixture of methodologies. A Narrative Synthesis was used to extract and summarise data relevant to the research questions. This review identified 33 articles which found a consistent pattern of findings that communication about genetic risk within families is influenced by individual beliefs about the desirability of communicating genetic risk and by closeness of relationships within the family. None of the studies directly investigated the impact of communication on counsellees or their families, differences according to gender of counsellee or by condition nor alternative methods of communication with relatives. The findings mainly apply to late onset conditions such as Hereditary Breast and Ovarian Cancer. The most frequently used theory was Family Systems Theory and methods were generally qualitative. This review points to multifactorial influences on who is communicated with in families and what they are told about genetic risk information. Further research is required to investigate the impact of genetic risk information on family systems and differences between genders and conditions.

Genetic testing for BRCA1/2 mutations associated with hereditary breast and ovarian cancer reveals significant risk information about one's chances of developing cancer. It is important to study communication processes in families where members are undergoing genetic testing because the information received is crucial not just to the individual concerned but also to other members of the biological family. This study investigates family communication of BRCA1/2 test results from both the informants' and recipients' perspectives. A total of 10 female patients and 22 of their relatives were interviewed. Patients' and their relatives described feelings of responsibility for sharing genetic information within the family to enable others to reduce their risks of developing cancer. However, there were limits to an individuals' responsibility once key family members had been informed, who then had to take responsibility for continuing dissemination of information. Whilst there was an implicit responsibility to inform the family of a mutation, information was edited or withheld in the best interest of relatives, dependent upon their perceived emotional readiness, resilience and current life stage and circumstances. The pre-existing family culture and the impact previous cancer diagnoses had upon the family also influenced the process of communication. Findings are discussed in relation to extant literature and implications for clinical practice are considered.

Western society recognises male and female sex from physiological attributes, such as genitals and chromosomes. 'Gender' is the social and cultural expectation of how males and females should think, behave and how they should be treated by others (Diamond, 2002). Some children and adolescents experience distress, marginalization, and abuse associated with their gender identifications, preferences and behaviours, which are inconsistent with those expected of their biological sex. Often their families and society find gender non-conformity at best difficult, at worst offensive, distressing and intolerable. There is increasing focus on how mental health professionals work with difference in gender and sexual identity and recent publications highlight the shift from pathologizing transgender to a more 'identity-based' perspective, focussing more on the stigmatizing affects of the environment and the impact on the individual (Bockting, 2009). This article describes the challenges of binary gender discourse for young people and their wider contexts and considers how clinicians may more helpfully respond to avoid unhelpful binaries and so keep the young person in mind. The therapeutic aims of the UK Gender Identity Development Service (GIDS) for children and young people are considered and examples of our work provided.

The Young People's Consultation Service (YPCS) is a four‐session, self‐referral, psychodynamically‐oriented psychotherapeutic consultation service for young people aged between 16 and 30, at the Tavistock and Portman NHS Foundation Trust in London. Aim: It was hypothesized that clients would show an improvement on outcome measures at the end of the four sessions. It was also hoped that the data would identify characteristics of the clients who show the most benefit. Method: A review of the case‐notes of all clients attending the service between January 2003 to April 2006 was carried out, and details were entered into a database, including demographic information, presenting issues and attendance. Clients were given the Youth Self‐Report form (YSR) (Achenbach, 1991) or the Young Adult Self Report form (YASR) (Achenbach, 1997), according to age, before the start of the intervention and at the end of the four sessions. Outcome data were analysed, comparing pre‐ and post‐treatment scores on the YSR/YASR. Results: A total of 236 clients attended the service during the study period. Pre‐ to post‐comparison data on the YSR/YASR was available for 24 clients. Of those, YSR/YASR scores reduced significantly on all subscales and severity reduced over time in all cases. In addition, there was a trend towards moving from the clinical to the non‐clinical range, reaching statistical significance on the Internalizing and Total subscales. A number of YPCS clients showed both statistically significant and clinical improvement on the Internalizing and Externalizing scales of the YSR/YASR, with a greater number showing improvement on the Internalizing scale. Conclusions: Improvements were found on all subscales of the YSR/YASR at the end of the four session intervention. A greater number of clients showed improvement on the Internalizing subscale, suggesting that this form of very brief psychotherapy is most effective for clients with emotional problems.