Psychosocial care in a medical genetics clinic

In the process of genetic counseling, many patients and their families need psychosocial evaluation and care to help them cope with the genetic information and its implications. Such psychosocial work may be routine or extended. For two years we assessed the actual psychosocial evaluation and care provided by us in a medical genetics clinic, using six categories to classify the nature of a patient's need for extended psychosocial work. Of 138 new patients, 82 (59%) required extended psychosocial evaluation and care. In particular, young patients, seen with many family members, and requiring multiple medical consultations, were found to need the most extensive psychosocial care. Ongoing clinic patients (N = 35) referred for psychosocial care were used as a comparison group. We concluded that a significant number of patients and their families receiving genetic counseling also require extended psychosocial evaluation and care, and that these patients may be identifiable early in the counseling procedure.