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that nondisclosure responses to patient requests were successful when they included
an explanation of the reason they did not disclose. So, for example, in response to
the question “Did you have prenatal testing?,” a genetic counselor might say, “The
decision I made about testing may not apply to your situation, but some of the things
I thought about were...”.
11.1.6 Examples of Self-Disclosure Topics and Genetic
Counselor Self-Disclosures
Topics genetic counselors have reported disclosing include whether they had
children, if they had received genetic counseling services, common life experi-
ences, and religious/spiritual beliefs (Thomas et al. 2006 ); sexual orientation
(Glessner et al. 2012 ); and, in prenatal genetic counseling, responses to patient
questions about counselor demographics (e.g., “How many children do you
have?”), personal opinions regarding patient decisions (e.g., “What would you do
in my situation?”), genetic counselor’s personal pregnancy experiences/decisions
(e.g., “Have you ever been pregnant? and “Did you have amniocentesis during
your pregnancy?”), and professional experiences/opinions regarding patient
decisions (e.g., “Do you see lots of other people with this result/situation?”)
(Balcom et al. 2013 ).
In Balcom et al.’s ( 2013 ) study of genetic counselor responses to prenatal
patients’ disclosure requests, counselors either typically responded with: (1) per-
sonal self-disclosure (e.g., “If people ask me if I have children I will say, ‘Yeah, I
have a little girl,’ or I’ll say, ‘Yeah, I have a baby’.” (p. 364), (2) professional self-
disclosure (e.g., “Typically when [patients] ask about what I have done when I was
pregnant I will give sort of a group disclosure... Like if we’re talking about the first
trimester screen, [I’ll tell patients], ‘There are four groups of people...One group
never wants the amnio and this might not be the best test for them. Some people
want the diagnostic information; they don’t want a new number. And, the screen
may not be right for them either; they go straight to the amnio. Or the middle two
groups kind of want to avoid it or kind of want it but want more information. And
after talking to you, I’m really getting the feeling that you are in blank group. Is that
a fair assessment’?” (p. 364), and (3) redirection (e.g., “There have been times when
[patients] have asked me [‘What did you do during your pregnancy?’] and I’ve said,
‘Let’s really focus on what’s most important for you’.” (p. 364), or they (4) decline
to answer the question” (e.g., “When I’m asked what I would do...I usually just tell
them that my circumstances would be different from [theirs], and that they know
themselves and what they can handle much better than I can after a 1 h. consulta-
tion” (p. 364).
Redlinger-Grosse et al. ( 2013 ) studied genetic counseling students’ and genetic
counselors’ responses to a hypothetical prenatal patient’s request for self- disclosure.
Survey participants read a scenario about a patient who was referred for prenatal
counseling due to advanced maternal age. She was hesitant about having an
11 Counselor Self-Reference: Self-Disclosure andfiSelf-Involving Skills