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- “I know how hard it can be to deal with insurance companies, too. I’ve run into
roadblocks with them myself. I can help you make some progress in getting this
procedure/test covered.” - “My mother had breast cancer, and I remember how difficult it was to live with
uncertainty. How is it for you?” - “I understand that considering religious beliefs is an extremely important part of
this process for you. My religion is important to me as well. So, tell me more
about what you’re thinking.” - Regarding cancer testing: “...I assure you that I’ll do everything I can to make
the process go as quickly and smoothly as possible...” (Kao 2010, p. 54). - Regarding a cleft palate scenario in which a mother described the traumatic
experience of finding out at birth that her baby was diagnosed with clefting: “...
I can imagine that I would feel the same way...” (p. 68); and “From what you
shared, it sounds like everyone else in the room was surprised and concerned and
you didn’t know what was going on [primary empathy]. In this type of situation,
my imagination always works overtime [self-disclosure]. Do you think that is
what you were doing? [question]” (Kao 2010, p. 69). - Regarding a patient with Fabry disease: “...I know a little about this kind of pain,
from knowing people with sickle cell...” (p. 77); and “I can’t imagine dealing
with that. It sounds like it affects every part of your life. I would be so afraid and
worried about when it was going to happen” (Kao 2010, p. 77). - Regarding a patient with Long QT: “...Hopefully I can help in any way that I can
with your decision and if possible put you in contact with other women with
Long QT who have had successful pregnancies” (Kao 2010, p. 87). - Regarding a patient who is at risk for Huntington disease: “Whenever I see
someone to talk about HD, the difficult decision about how and when to tell
children is one of the greatest struggles they face ...” (p. 100); and “...I would
think that if so many people in my family were affected with Huntington’s dis-
ease that I would be a little afraid to talk about it, too...” (Kao 2010, p. 100).
11.2 Self-Involving Responses
As we said earlier, self-involving responses are direct communications of the genetic
counselor’s feelings about and reactions to the patient and the counselor-patient rela-
tionship in the here-and-now situation. Self-involving responses deal with the imme-
diate counselor/patient relationship, and they are a type of communication about how
the relationship is personally affecting either or both the counselor and patient(s). As
such, they are more intimate responses. Self-involving responses can be particularly
helpful when there are issues preventing the patient from disclosing deeper feelings
and thoughts (Hill et al. 2008 ; Hill et al. 2014 ; Novotney 2008 ); they can reduce
patient anxiety (McCarthy Veach 2011 ; Shafran et al. 2017 ) and help the patient feel
cared for (Hill et al. 2014 ); they are an effective way to enhance your genuineness,
likability, and trustworthiness; and they can enhance the relationship (Dewane 2006 ).
11 Counselor Self-Reference: Self-Disclosure andfiSelf-Involving Skills