40
Table 2.1 (continued)
Goala Strategya Behaviora Additional strategiesb
Tenet: Patient autonomy must be supporteda
Establish working
contract
Assess patient
expectations
Provide informed
consent
Establish realistic
agenda
Ask questions
Describe process
State goals
Establish GC goals and
expectations
Information giving
Establish working alliance
Integrate familial
and cultural context
into counseling
relationship and
decisions
Recognize multiple
strategies
Maintain counseling
flexibility
- Use psychosocial
counseling skills/strategies
Information giving
Establish working alliance
Patient feels
empowered and
more in control
Discuss what patient
wants to discuss
Create safe
environment
Respect patient
decision/viewpoint
Enable informed
decisions
- Information giving
Use psychosocial
counseling skills/strategies
Provide care before and
after GC session
Establish working alliance
Facilitate
collaborate
decisions
Ask about options Reflect patient
thoughts and feelings
re: options
Use psychosocial
counseling skills/strategies
Assessment
Information giving
Tenet: Patients are resilienta
Recognize patient
strengths
Identify patient
strengths
Make connections
Anticipatory
guidance
Instill hope
Ask questions about
patient coping skills
Assessment
Use psychosocial skills/
strategies
Information giving
Adaptation Assimilation
Accommodation
- Information giving
Assessment
Use psychosocial
counseling skills/strategies
Empowerment Create safe
environment
Maintain/enhance
patient self-esteem
Identify possible
outcomes - Information giving
Use psychosocial
counseling skills/strategies
Provide care before and
after GC session
Establish working alliance
Tenet: Patient emotions make a differencea
Counselor and
patient know patient
concerns
Recognize ethical
dilemmas in
patient’s life
Anticipate patient
needs
- Use psychosocial skills/
strategies
Information giving
Assessment
2 Overview offiGenetic Counseling