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- The counselor helps patients understand and integrate their experiences.
- The counselor functions as facilitator, guide, and model.
- The approach fosters counselor involvement with the patient’s emotional issues.
2.5 The Teaching Versus Counseling Approach to Genetic
Counseling
Kessler ( 1997 ) later describes two basic approaches to genetic counseling: teaching
and counseling. Although he names these models, they are, in fact, approaches to
genetic counseling patient care. These approaches dovetail well with the descrip-
tions of the two basic orientations of the genetic counselor (content orientation and
person orientation) that Kessler described 18 years earlier.
2.5.1 The Teaching Model of Genetic Counseling
- The major outcome goal is educated patients.
- A premise is that patients come to genetic counseling for information.
- An assumption is that informed patients are able to make autonomous decisions.
- Cognitive and rational processes form the foundation of the approach; psycho-
logical aspects are minimized. - The counseling process involves providing all-inclusive, accurate information in
an impartial manner; the counselor does not become involved. - Teaching is the only means to meet the end goal: an educated patient.
- The counselor-patient relationship is based on counselor authority.
2.5.2 The Counseling Model of Genetic Counseling
- The major outcome goals are to understand the patient, advance the patient’s
sense of self-competence, help the patient gain a sense of control, alleviate some
psychological stress, provide support, and help the patient with problem solving. - A premise is that patients come to genetic counseling for complicated reasons
such as needing information, wishing for validation, wanting support, and look-
ing for a way to reduce their anxiety. - Human behavior and psychological aspects of genetic counseling are complex.
- The counseling process is multifaceted, involving the psychological assessment of
patient strengths, limitations, needs, values, and decision-making styles; a range
of counseling skills are needed for a positive outcome; counseling must be specific
to the patient and flexible; and the counselor must attend to his or her inner self. - Education is only one means that is used to meet the end goals described above.
- The counselor-patient relationship is mutual.
2 Overview offiGenetic Counseling