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Related Experiment Videos

The Genetic Counseling Video Project (GCVP): models of practice.

D Roter1, L Ellington, L Hamby Erby

  • 1Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Baltimore, MD 21205, USA. droter@jhsph.edu

American Journal of Medical Genetics. Part C, Seminars in Medical Genetics
|August 31, 2006
PubMed
Summary

Genetic counselors (GCs) utilize distinct teaching and counseling approaches in practice. Counseling models, emphasizing emotional support, led to higher client satisfaction and perceived counselor effectiveness.

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Area of Science:

  • Medical Genetics
  • Communication in Healthcare
  • Psychosocial Support

Background:

  • Genetic counseling integrates both educational ('teaching') and supportive ('counseling') functions.
  • Limited understanding exists regarding how these dual functions are implemented in routine genetic counseling practice.
  • This gap necessitates empirical investigation into the practical application of genetic counseling models.

Purpose of the Study:

  • To document and analyze the communication patterns of genetic counselors (GCs) during routine pre-test counseling sessions.
  • To identify distinct practice models employed by GCs in both prenatal and cancer genetics.
  • To evaluate the impact of different practice models on simulated client (SC) satisfaction and perceived counselor effectiveness.

Main Methods:

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  • A national sample of 177 genetic counselors (GCs) provided pre-test counseling to 6 simulated clients (SCs) in a controlled setting.
  • Counseling sessions were videotaped and analyzed using the Roter Interaction Analysis System (RIAS) for communication patterns.
  • Both GCs and SCs completed post-session questionnaires assessing satisfaction, communication, and counselor demeanor.

Main Results:

  • Cluster analysis revealed four distinct practice patterns: 'clinical teaching,' 'psycho-educational teaching,' 'supportive counseling,' and 'psychosocial counseling.'
  • Counseling models (supportive and psychosocial) were characterized by higher emotional and facilitative talk, and lower verbal dominance.
  • Simulated clients reported higher satisfaction with communication, counselor affective demeanor, and non-verbal skills during counseling model sessions.

Conclusions:

  • Both teaching and counseling approaches are evident in the routine practice of genetic counselors.
  • Counseling-focused models appear to enhance client satisfaction and perceptions of counselor effectiveness.
  • Understanding these practice variations is crucial for optimizing genetic counseling delivery and client outcomes.