Counselling issues

 

  1. Individuals often have emotional reactions to their genetic situation that cannot be resolved by simply
    providing them with information and facts. Addressing these reactions can require the use of counselling
    skills such as active listening and a non-judgemental approach.
  2. As with all counselling, avoid stereotyping or making assumptions about the people’s level of understanding or emotional ability to deal with the situation.
  3. Counselling in consultations about genetics may address breaking difficult or bad news, anxiety, uncertainty, grief, guilt and blame. Counselling can assist individuals to adjust to their situation; however, in some instances people may have unresolved issues. Referral for specialist counselling may be appropriate (see Contacts, support and testing).
  4. Difficult or bad news in genetics can include:
  5. A higher than anticipated risk shown by screening or clinical assessment
  6. Diagnosis of a genetic condition, by testing or clinical assessment
  7. Lack of a definitive diagnosis
  8. Uncertainty regarding prognosis
  9. Uninterpretable test results (eg no mutation/gene alteration found in cancer genetic testing)
  10. News that is different from anticipated
  11. Identification of carrier status
  12. Breaking difficult/bad news is complex due to:
  13. The practitioner’s own emotional state
  14. The degree of identification with the individual
  15. Acceptance of the practitioner’s own mortality
  16. The burden of truth telling
  17. Continuing commitment to the individual
  18. Uncertainty
  19. It is never easy to break difficult or bad news; however, there are sensitive ways to break such news that
    facilitate coming to terms with the news over time. A caring and empathic manner is important.
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