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Importantly, however, you should always consider individual differences in patient
needs and preferences and proceed accordingly.
6.2.2 Setting Genetic Counseling Session Goals
Goals are the road maps that bring focus and direction to the session and help to
structure the relationship. Setting genetic counseling session goals is part of the
contracting process. Goals are “...mental representations of desired outcomes to
which people are committed...” (Mann et al. 2013 , p. 488). They help counselors
and patients identify precisely what they can and cannot achieve in genetic counsel-
ing (Hackney and Bernard 2017 ). Goals help you determine what information to
present, how to structure the session, and the types of interventions to use. Goal
setting encourages patients to be clear about what they want to accomplish in a
genetic counseling session. Furthermore, goals can help patients feel motivated to
take action, and they allow both you and your patients to evaluate the effectiveness
of the genetic counseling session and relationship.
The importance of explicitly stated and agreed-upon goals is illustrated in a
study of concordance between genetic counselors’ and patients’ views of the nature/
type of patient concerns and the level/severity of their concerns. Michie et al. ( 1998 )
found that genetic counselors were sometimes inaccurate in judging patient con-
cerns: “When there was not concordance, counselors were more likely than patients
to think the patients’ main concern was to get information or to find out about their
risk status” (p. 228). Concordant sessions tended to emphasize more emotional
issues and resulted in greater patient satisfaction with the information received and
greater satisfaction with the extent to which their expectations were met.
6.2.3 Goals of Genetic Counseling
Genetic counseling is “the process of helping people understand and adapt to the
medical, psychological and familial implications of genetic contributions to dis-
ease” (Resta et al. 2006 , p. 77). Consistent with this definition, the Reciprocal-
Engagement Model (REM) of genetic counseling practice (McCarthy Veach et al.
2007 ) identifies three overarching outcome goals. Specifically, the patient under-
stands and applies information in order to make decisions, manage conditions, and
adapt to her or his situation. To achieve these broad outcomes, there are 16 goals for
genetic counseling sessions that reflect 4 major factors: Understanding and
Appreciation, Support and Guidance, Facilitative Decision- Making, and Patient-
Centered Education (Hartmann et al. 2015 ). The following list displays the REM
goals associated with each factor (Hartmann et al. 2015 ):
6 Structuring Genetic Counseling Sessions: Initiating, Contracting, Ending, and Referral