Facilitating the Genetic Counseling Process Practice-Based Skills, Second Edition

(vip2019) #1

120


Know What Type of Question to Ask



  • Use both open and closed questions. Open-ended questions allow patients to
    express themselves more autonomously. As mentioned earlier, patients can
    choose to express things that are most important to them. Open questions can
    be especially effective when first introducing a topic (Spitzer Kim 2009 ).
    Closed questions, as stated earlier, allow you to gather precise information
    (e.g., details about family history), and they can keep the session from wander-
    ing off-track.

  • Be sure to ask the type of question you intended to ask. It’s generally a mistake to
    ask closed questions when you want extended answers and to ask open questions
    when you want precise answers. Also, you need to clearly understand the differ-
    ence between open and closed questions.

  • Use follow-up questions. If a patient provides little or no response to your
    question, consider saying “Tell me more about that.” If a patient is unable or
    unwilling to answer an open question, you can ask a closed question as a way
    of drawing the patient out. For example, if in response to the question “How
    is your pregnancy going,” a patient says “Fine,” a genetic counselor may fol-
    low up with some closed-ended questions, such as “Have you had any bleed-
    ing or cramping?” Or, if in response to the question “How do you feel about
    having this test?,” the patient says “OK, I guess,” the counselor might say, “Do
    you think you want to proceed with this test today, or do you need time to talk
    with your family first?” (forced choice). Or, if in response to the question
    “How do you feel about pursuing another pregnancy,” the patient says, “I want
    to have another child, but I worry about having yet another miscarriage,” the
    genetic counselor might respond “Tell me how your fear of another miscar-
    riage compares to your desire of adding a child to your family?” (ranking
    question).


Additional Guidelines for Effective Questioning



  • Listen to determine whether the patient answers your question and what the
    answer is. Ask again later or in a different way if the patient does not answer.
    Questioning skills take time and practice to develop. Initially you will learn how
    to ask questions (question format) and then learn what topics to focus on in your
    questions (content and context). Next you will learn to concentrate on listening
    to the answer, and then you will gain further skills for determining where to go
    next based on the patient’s answer.

  • Avoid interrupting. Unless patients ramble excessively, allow them to finish their
    sentences and thoughts. Ask patients to complete unfinished sentences.
    Sternlight and Robbennolt ( 2008 ) provide similar recommendations for lawyers:
    “In order to both listen effectively and appear to clients to be listening effec-
    tively, lawyers should typically let their clients tell their initial stories without
    interruptions...follow up their accounts with clarifying questions...and then


5 Gathering Information: Asking Questions
Free download pdf