239Then the student speculates on what issues s/he might need to confront the
patient about during genetic counseling.
Students are NOT to give advice or solve the patient’s problem. Other group
members can add their ideas to the student’s speculations.
Patient Statements
- “I’m 39 and this is my first pregnancy. I had prenatal testing and just learned that
there is something wrong with my baby. They say there’s a chance my child could
have a lot of behavior problems in school and may not be able to learn. Oh, and I
remember they also said he would be really tall. But they aren’t real sure, because
hardly any research has been done on people with this condition. What should I do?” - “I’ve just found out that my brother is gay. I already know that two of my cousins
on my dad’s side are gay. I’ve read that homosexuality may be inherited. Are my
wife and I more likely to have a gay child if she ever gets pregnant?” - “I asked to see you first before my husband comes in because I’m not sure I want
to go through with this NIPT test. He knows I was pretty wild in my younger days,
and I did a lot of partying, including smoking pot and using other drugs a few
times. What if the results come back and there’s something wrong with the baby?” - “I’ve just tested positive for Huntington’s disease. I’m not symptomatic yet, but
I want to know exactly what to expect. How do other people deal with this? Have
you ever heard of people with Huntington’s committing suicide?” - “My husband and I want to have a baby. I believe my health is good and there are
no genetic problems in my family. However, my husband is an active alcoholic.
I’m concerned about fetal alcohol syndrome.” - “I came here today for prenatal testing. This is my second pregnancy. My first
child has a severe form of autism, which means that he will be completely depen-
dent on my husband and me for the rest of our lives. I’m afraid this might happen
again, but I don’t believe in having an abortion. If our next child does not have
autism, I will feel better that this is not my fault.” - “This is my fourth pregnancy. I have three sons. My husband and I really want a
girl this time. We have heard that some prenatal testing could determine the sex
of the child. I’d like to get that testing done here.” - “I was diagnosed with breast cancer a few weeks ago. Because my mother died
of breast cancer in her 40s, my doctor said I should have genetic testing. I know
it will help to have this test. But, I have two teenage daughters. I’m so worried
that I might find out that they will get breast cancer, too.”
Estimated time: 60–75 min.
Activity 3a: Low-Level Advanced Empathy and Confrontation Skills Model
The instructor and a volunteer genetic counseling patient engage in a role-play in
which the counselor demonstrates poor advanced empathy and confrontation behav-
iors (e.g., overanalyzes patient motives and feelings; confronts the patient in
8.4 Class Activities