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

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their medical care; (3) change in patient’s ability to engage in the genetic counseling
process; (4) change in patient’s genetic knowledge; (5) patient is empowered; and
(6) patient receives short-term counseling. These studies demonstrate the dynamic
interaction of the tenets and goals of the model and their relationship to desired
outcomes and, thus, reflect the complex nature of genetic counseling.

2.3 Carl Rogers’ Person-Centered Counseling

Prior to the development of the REM, the profession looked to Carl Rogers’ theory
of Person-Centered Counseling as the basis for the genetic counseling approach to
patient care. A closer look at Rogers’ Person-Centered Counseling provides some

Table 2.2 Reciprocal-Engagement Model (REM) goals and corresponding factors

REM goal Factor

The counselor knows what information to impart to each patient Facilitative

decision-making

Counselor presents genetic information in a way that the patient can

understand

Patient-centered

education

Counselor helps the patient to feel informed Facilitative

decision-making

Counselor helps the patient to gain new perspectives Support and guidance

Counselor and patient establish a bond Support and guidance

Good counselor-patient communication occurs Patient-centered

education

Counselor’s characteristics positively influence the process of

relationship-building and communication between counselor and

patient

Support and guidance

Counselor establishes a working contract with a patient Understanding and

appreciation

Counselor integrates the patient’s familial and cultural context into the

counseling relationship and decision-making

Understanding and

appreciation

Counselor helps the patient to feel in control Support and guidance

Counselor facilitates collaborative decisions with the patient Facilitative

decision-making

Counselor recognizes patient strengths Support and guidance

Counselor helps patient to adapt to his or her situation Support and guidance

Counselor facilitates the patient’s feelings of empowerment Understanding and

appreciation

Counselor works with patient to recognize concerns that are triggering

the patient’s emotions

Understanding and

appreciation

Counselor and patient reach an understanding of patient’s family

dynamics and their effects on the patient’s situation

Understanding and
appreciation
Counselor promotes maintenance of or increase in patient self-esteem Understanding and
appreciation
Adapted from Hartmann et al. ( 2015 )

2.3 Carl Rogers’ Person-Centered Counseling