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for genetic counselors to have established a safe environment and supportive
relationship. Further, inquiring in such a way that a person could decline disclos-
ing if he or she does not feel safe or comfortable may be an effective strategy”
(p. 746). They further recommended asking questions with gender-neutral lan-
guage. For example, some genetic counselors have told us that when patients
bring people to the session, they begin by asking the patient “And who have you
brought with you today?” This neutral question avoids stereotypic assumptions
about relationship status based on peoples’ apparent gender identity, age, and
so forth.
The results of Glessner et al. ( 2012 ) and VandenLangenberg et al. ( 2012 ) pro-
vide excellent examples of “culturally educated questioning” skills, as described
in Rodriguez and Walls ( 2000 ). Rodriguez and Walls ( 2000 ) advocate that coun-
selors conduct cultural assessments to gather “clinically relevant cultural data”
(p. 89). Culturally educated questioning is based on four assumptions; “First, the
client, the counselor, and the counseling process all exist within a multicultural
context. It is widely accepted that culture is inseparable from human experi-
ence...and, therefore, from counseling interactions. Second, client cultural iden-
tification or experience may or may not relate significantly to presenting
problems. Indeed, the challenge for counselors...is to consider cultural influ-
ences without unduly emphasizing their importance...[Third,] effective multi-
cultural counseling requires that the salience of the cultural context within which
the presenting problem exists be assessed, not assumed...Finally, client self-
report is the most reliable source of information regarding relevance of cultural
factors” (pp. 92–93).
5.4 Closing Comments
Questions are the most direct way to elicit information from patients. They are use-
ful throughout genetic counseling sessions as they assist in rapport building, goal-
setting, exploration of the patient’s situation, decision-making, and follow-up.
Questioning requires a great deal of skill in order to ask the correct questions and to
actively listen to what patients are telling you about themselves and their families.
Skillful questioning requires you to be aware of what you want to know and why
you want to know it, and to anticipate when and how best to ask each question to
obtain desired information without unduly stressing patients or causing them to feel
judged. We caution you to only ask questions as necessary and to follow up with
reflections/summaries of what you hear to ensure that you and the patient are “on
the same page.”
Questions can be particularly useful for gathering relevant family and medical
histories. As the family history is often one of the first activities to take place in a
genetic counseling session, it provides an excellent opportunity to learn more about
5 Gathering Information: Asking Questions