287that no “recipe” suffices to answer all parents’ questions about how this important
task should be approached in their family. Successful consultation to parents requires
true counseling, matching parents’ fears and questions with information, explora-
tion and advice specific to their concerns, circumstances and strengths” (p. 259).
Examples of advice genetic counselors might give to patients are as follows:
- Some patients say they wish they had taken more time to make the decision to
terminate a pregnancy. So, when counseling a patient(s) who is at the decision-
making stage, the genetic counselor says, “I know it’s natural to want to decide
quickly and move on, but I would encourage you to take a few days.” - “Consider the issues very carefully. Take as much time as you need.”
- A couple whose first child was affected with spinal muscular atrophy (SMA) was
in conflict over whether to have preimplantation genetic diagnosis for a future
pregnancy. After discussing the issue in the genetic counseling session, the coun-
selor said, “I would encourage you to continue this conversation at home, and
take some time to make the decision.” - “I think we should wait until your husband gets here and then maybe you will
feel more comfortable about making a decision.” - Women who carry the gene for fragile X syndrome often feel alone, guilty, and
burdened. Recognizing this, the counselor said: “I would encourage you to
include your husband in decisions about having more children.” - “I think it’s important that you know about all of the options available to you.”
- “It sounds to me like you would prefer to have the ultrasound before we discuss
prenatal testing options any further. So, I think it’s a good idea to do that.” - “In making a decision about carrier testing, it’s important to think about whether
the information will be useful to you. If you know your child were at risk for
cystic fibrosis (CF), would you do anything or plan anything differently?” - “One thing you might consider is having an autopsy done to help you assess the
risks of this happening again.” - The patient stated that she wanted predictive testing for early-onset Alzheimer
disease because her doctor told her to have the test. The counselor said, “Perhaps
you should focus on what is best for you and your family. Let’s talk about that.” - “Many of my patients have found it very helpful to talk to other parents of chil-
dren who have ___.” - “I recommend that you contact the national parent support organization for... to
stay current about new developments, changes in health care management, etc.
They have a great website.”
10.1.4 Consequences of Advice Giving
Advice may have both positive and negative consequences within interpersonal
relationships: “Advice may be seen as helpful and caring or as butting in; advice
may be experienced as honest or supportive; and seeking and taking advice may
10.1 Advice Giving