275logical functioning (e.g., cognitive impairment, mental illness), challenging life
events (e.g., divorce, job loss), and/or lack of resources (e.g., poor or no social sup-
port, isolation). Be careful not to take too much of the responsibility onto yourself
for a “lack of success.” Moreover, even when you do not have an obvious and
immediate effect, if you behave in a caring and professional manner, you may “plant
a seed” for later thought and action by some patients.
10.4 Class Activities
Activity 1: Res (Triad Role-Plays)
Students work in triads, each taking a turn being the genetic counselor, patient, and
observer. They should engage in 10-min role-plays in which the patient presents a
very specific issue (e.g., sharing relevant genetic risk/testing information with sib-
lings). The patient and counselor should act out this issue using one of the following
resistance role-plays:
Role-Play 1
When the genetic counselor provides some information about the patient’s options,
the patient should respond to all counselor’s suggestions with “Yes, but.. .” In other
words, the patient should refute, counter, and find fault with all counselor’s options.
Role-Play 2
The patient should be silent, giving one- or two-word answers, refusing to answer,
and trailing off in her responses. The patient is making it evident that nothing is
going to happen until the counselor addresses her resistance (which was caused by
the genetic counselor telling the patient that she should share information with her
siblings; the patient thinks the counselor does not understand her family
situation.).
Role-Play 3
The patient should get angry in response to the first question the genetic counselor
asks.
Process
Discuss with the counselor how it felt to be resisted in this way. What did the coun-
selor do to respond to the patient’s resistance? Why might patients use these types
of resistance?
Estimated time: 60 min.
Instructor Note
To make this activity more challenging, the student playing the patient could select
the role-play without telling the individual playing the counselor which role she/
he selected.
9.7 Class Activities