Genetic counseling: provision and reception of information

To explore verbal communication between family and counselor, transcripts of 30 tape-recorded or observed genetic counseling sessions are analyzed qualitatively. In half the cases, available data did not allow counselors to give parents a single estimate of the recurrence rate. Moreover, limits on the language available for communicating small probabilities made common the use of nonnumerical statements about a family's chance of having an abnormal child. Counselees processed the factual information they were given, most commonly translating recurrence rates in ways that emphasized the uncertainties associated with them. They tended to view these rates in binary form and requested guidelines for their behavior, indicating uncertainty about how to proceed with reproductive decision-making. The findings suggest that strategies for processing information are an important element influencing parental perspectives on and approaches to the problems created by being at-risk and to possible courses of action.