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Compare the previous example to this more appropriate interchange:
Cl: I don’t want to have a baby with Down syndrome.
Co: Tell me more about that.
Cl: I just don’t think I could handle it.
Co: You’re afraid that you couldn’t manage?
Cl: Right...I have to work fulltime, and I’d have no one to watch the baby. And
I’m not sure I could give it all of the special care it would need.
Co: What are your impressions of what a child with Down syndrome is like?
Cl: [Patient describes her perceptions]
Co: [Counselor affirms or correct patient perceptions, including a discussion of
different levels of severity and then says] What options have you considered
if the test results indicate Down syndrome?
Wubbolding ( 1996 ) cautions against the use of questions that “mask” the coun-
selor’s opinions. For example, “Do you think you should be making this decision
alone?” “Do you think you should talk to your mother and find out more about her
health history before having this test?” “Have you tried talking with your child
about the importance of following the recommended diet for PKU?”
Although it may be appropriate at times to express your opinions and offer advice
(see Chap. 10), you should not disguise them as requests for more information.
5.1.5 Questions You Generally Should or Should Not Ask
Questions to Ask
Although every patient and genetic counseling situation differs, there are a few critical
questions you should consider asking most patients early in the session: “What brought
you to genetic counseling?” and “What’s brought you here now?,” as well as either
“How can I be helpful to you?” or “Can you tell me what you’re hoping to get out of
genetic counseling?” Patients’ responses to these questions can indicate their major
goals for the genetic counseling session as well as give you some idea about how much
they understand about genetic counseling. There can be risks with these questions,
however. Some patients may be overwhelmed if you ask these questions right away.
They are not always sure of what they want, and they may not even know why they are
seeking genetic counseling (especially likely if they were referred). So, these ques-
tions will not be a magical way to get patients to open up to you. You may need to first
spend time describing what genetic counseling is and what they might be able to get
from the session, and then ask your question again in a different way. For example:
Co: What brought you to genetic counseling?
Pt: I really don’t know. Dr. Smith told me I should come.
Co: Well, I see you have some family history of...We can discuss your risks
for...and options for...Would you like to do that?5 Gathering Information: Asking Questions