Counseling Skills and Behaviors of Genetic Counselors: A Qualitative Study

Research is needed to ensure the frameworks created to ensure best clinical practice for the genetic counseling (GC) profession align with current GC clinical practice. Nineteen practicing genetic counselors in prenatal, pediatric, or cancer specialties were interviewed to elicit their session goals and the counseling skills utilized within sessions and to determine how closely responses align with the Framework for Outcomes in Clinical Communication Services (FOCUS) and Reciprocal Engagement Model (REM). As part of a qualitative content analysis guided by FOCUS, quotes extracted and coded into key themes using RQDA software demonstrated consistency with REM goals and categories within the FOCUS communication skills domain. All GC goal were found to overlap with the goals of the REM and several additional GC goals not reflective of the REM were reported. Although counseling skills varied, several patterns were identified with regard to what skills are employed to achieve certain goals or to complete certain components of the GC session. Our data support the FOCUS framework and the REM and provide additional insight regarding clinical GC practice. Given that GCs struggled to find terms for the reported skills, the GC profession could use this taxonomy of possible terms as a starting point for discussions that may eventually lead to a consensus on shared terminology used in teaching, supervision, practice and research on genetic counseling processes