45- Counselor genuineness: the counselor establishes an open relationship with the
client, is open to his or her own emotional reactions to the client, and establishes
a safe setting where clients are free to self-actualize.
Upon examination of Rogers’ theory, one can see how the basic foundations of
this approach are a good fit with the REM of genetic counseling practice. Both
Person-Centered Counseling and the REM empower the patient, value the patient’s
belief system, and strive to understand the patient’s experiences.
2.4 Person-Oriented Versus Content-Oriented Genetic
Counseling
We only need to look at the work of Seymour Kessler to better understand two other
tenets of the REM: Relationship is integral to genetic counseling and Patient emo-
tions make a difference. No one individual has examined the complex psychological
dimensions of genetic counseling in more detail than has Kessler. His work in this
area reaches back to the time when genetic counseling was first establishing itself as
a health-care service in major medical settings. Kessler was tireless in his efforts to
examine the psychological issues associated with the provision of this service and
to teach genetic counselors about the skills they need to enhance their practice as the
profession has advanced over the years.
In 1979, Kessler discusses the emergence of a more psychologically or person-
oriented genetic counseling in contrast to the previous content-oriented genetic
counseling. He states that the person orientation “...starts with the premise that
genetic counseling deals with human behaviors, important ones at that; health and
illness, procreation, parenthood, and sometimes life and death. It views the prob-
lems posed by a genetic disorder as being intimately related to the overall situation
of the persons, their ways of solving problems, making decisions and adapting to
life crises. Whereas the content oriented approach emphasizes facts, the person ori-
ented approach places the focus on the various meanings that facts have for the
counselees as well as on the intrapsychic and interpersonal consequences of these
meanings” [p. 19].
In the content orientation:
- The counselor believes that objective facts and figures are the basis on which
decisions are made and actions proceed. - The counselor gives high priority to providing information.
- The counselor functions as authority, educator, and advisor.
- The approach fosters emotional distancing on the part of the counselor.
In the person orientation:- The counselor believes decisions and actions are based on the subjective under-
standing and varied meanings of the facts and figures.
2.4 Person-Oriented Versus Content-Oriented Genetic Counseling