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(Mis)alignments in counseling for Huntington's Disease predictive testing: clients' responses to reflective frames
Srikant Sarangi1, Kristina Bennert, Lucy Howell
1Health Communication Research Centre, Cardiff University, Cardiff, Wales, United Kingdom. sarangi@cardiff.ac.uk
Journal of Genetic Counseling
|March 25, 2005
Summary
Clients respond variably to genetic counseling reflective questions. Some engage in self-reflection, while others challenge its relevance, often to display readiness for predictive genetic testing.
Area of Science:
- Medical Genetics
- Clinical Psychology
- Sociolinguistics
Background:
- Genetic counseling involves reflective frames to explore client perspectives.
- Previous research examined counselors' initiation of these frames.
- This study analyzes client responses to reflective questioning in genetic counseling.
Purpose of the Study:
- To analyze client responses to reflective frames in genetic counseling.
- To investigate mismatches between discussing disease risk and knowing test results.
- To explore the concept of alignment between counselor and client agendas.
Main Methods:
- Discourse analysis of 119 counselor-client question-response sequences.
- Data from 24 Huntington's Disease counseling consultations in South Wales.
- Focus on two types of reflective questions: testing decisions and impact of results.
Main Results:
- Identified three client response themes: knowledge for action, subjective need to know, and downplaying knowledge.
- Observed varying client engagement with self-reflection, from endorsement to challenge.
- Client responses linked to perceived need to display readiness for predictive testing.
Conclusions:
- Client responses to reflective frames are diverse and context-dependent.
- Alignment between counselor and client agendas influences response patterns.
- Understanding these responses is crucial for effective genetic counseling, particularly for predictive testing.