273groups regarding their genetic status and genetic testing were related to their rela-
tionship with God. Their beliefs and religious/spiritual connection served as an
“anchor” (p. 318) in these stressful situations.
Quillin et al. ( 2006 ) investigated perceived risk for breast cancer and use of spiri-
tual coping mechanisms in a sample of at-risk women. While they found no signifi-
cant relationship for women with negative family histories, there was an inverse
relationship for women with positive family histories. Specifically, use of spiritual
coping was related to lower perceived risk of breast cancer for those women. The
authors speculated that “Frequent spiritual coping may be a manifestation of one’s
spiritual locus of control, the belief that God empowers the faithful to prevent dis-
ease, or God can be consulted to actively interfere with a disease process, in this
case genetic susceptibility for cancer...” (p. 455).
Williams et al. ( 2017 ) interviewed genetic counselors and former patients who
had maintained a long-term professional relationship after a life-limiting prenatal
diagnosis. One effect of the relationship on the counselors was their recognition of
the “strength that faith can have in a patient’s life” (p. 350).
9.5.1 Strategies for Addressing Religious/Spiritual Issues
in Genetic Counseling
“...As a new genetic counselor, I was often unsure how to proceed when families turned the
discussion towards religion and spiritual issues. I’m still not sure I’m very accomplished in
this realm, but I’ve learned to be more comfortable with these discussions and I’ve found
that this theme works well for me. I’ve had the good fortune of having one of our hospital
chaplains (who also happens to be the mother of a young boy with Down syndrome) partner
with me in discussions with families who were having a difficult time resolving their spiri-
tual beliefs with the birth of their baby with Down syndrome. Your hospital chaplains are an
underutilized resource! It is interesting that it is in these discussions with families, where we
are talking about how to find meaning in the birth of this child with Down syndrome, where
I feel I am making the most difference with my families. This is the heart of genetic counsel-
ing to me, not the review of chromosomes and recurrence risks and features, but the relation-
ship between human beings and the discussion of what it means to be human” (Brasington
2007, p. 733, reflecting on her experiences counseling about Down syndrome).
You should consider the possibility that spiritual issues are relevant to some
extent for most of your patients even those patients who do not mention them.
Research suggests “Unless invited patients may assume these topics are ‘off limits’
or that care providers are indifferent to their beliefs” (Anderson 2009 , p. 52). You do
not need to be of the same faith or have the same belief system as your patients in
order to consider religious/spiritual issues. It’s not necessary to share the same reli-
gious faith any more than you need to share the same sex, race, or background. What
matters is that you convey openness and nonjudgmentalness and connect empathi-
cally with patients’ worldviews (Cheston 1991 ).
Some authors advocate the use of limited spiritual assessment to determine the
relevance of religious and spiritual beliefs for genetic counseling patients (D’Souza
2007 ; Peters et al. 2016; Seth et al. 2011 ; Sheets et al. 2012 ; White 2009 ). D’Souza
9.5 Religious/Spiritual Dimensions