309- Pt: “What would you do if you were me?”
- Co: “I’m not sure, but when I’ve had a big decision to make, I think things over
for a while and talk with my family. I try not to rush into a decision before I feel
ready. How would that work for you?”
Elicits Strong Feelings
Patients may become sad, angry, and/or frightened during the session. You may
need to give them permission to express their feelings. One way to do this is with
self-disclosure. For example:
- Co: “As a parent too, I know I would be very anxious if someone told me my
baby’s newborn screening test was abnormal. Is that how you’re feeling?” - Co: “It looks like you want to cry and that you’re holding yourself back.
Sometimes I feel uncomfortable crying, but it helps me to let it out.”
Provides Education
Self-disclosure can be educational when done hypothetically. For example, a clini-
cian might say, “I can’t tell you what you should do, but here is what I would be
thinking about if I were you... (McCarthy Veach 2011 , p. 353).
Paine et al. ( 2010 ) surveyed 151 undergraduate and graduate students who com-
pleted surveys describing a hypothetical genetic counseling session with a patient at
risk for FAP who was deciding to pursue testing or surveillance procedures. The
patient asked, “What would you do if you were me?” The counselor either shared
what she would do (Personal Disclosure) or what other patients have done
(Professional Disclosure), or she deflected the question (No Disclosure). Participants
rated the non-disclosing counselor significantly lower in social attractiveness
(warmth, likeability) than either of the disclosing counselors, and less satisfying
than the professional disclosing counselor. Ratings of satisfaction with the informa-
tion provided in the genetic counseling session were higher for the professionally
disclosing genetic counselor than for the non-disclosing counselor. The findings
suggest self-disclosure may enhance perceptions of the counselor, and sharing one’s
clinical experience (e.g., what other patients have done) provides useful
information.
11.1.5 Guidelines for Using Self-Disclosure
Several authors offer suggestions for using self-disclosure:
Examine your reasons for disclosing. Self-disclosure should help patients
accomplish their goals for genetic counseling and should not be for reasons such as