Psychological aspects of genetic counselling / edited by Alan E.H. Emery, Ian M. Pullen.

Date:
1984
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Licence: Attribution-NonCommercial 4.0 International (CC BY-NC 4.0)

Credit: Psychological aspects of genetic counselling / edited by Alan E.H. Emery, Ian M. Pullen. Source: Wellcome Collection.

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    TRAINING IN GENETIC COUNSELLING 227 such as 'responding to verbal cues' are probably the most useful (Maguire et al., 1978). This feedback teaching is as effective when given within small groups providing the teacher observes certain rules. He should focus both on the data to be covered and the skills which are to be used. Strengths should be highlighted before weaknesses are exposed and the 'hot seat' approach should be avoided where one doctor is criticised by the remainder. The doctors should also be encouraged to say how they felt about being observed and the task that they were given. The willingness to practise three or four times and receive feedback should result in considerable learning for most doctors. However, there will be a few who fail to learn. They might respond to training which focuses on the areas they find most difficult and includes feedback from the patient about what it was like to be counselled in that way. The use of a third person who asks the doctor and patient to discuss step by step how the session went has also been advocated (Kagan et al., 1969). Training the tutors A key question is who should carry out this training and how should they be trained? A recent study has suggested that a doctor, psychologist or nurse can do it effectively provided they have watched demonstration tapes and are clear about the principles to be followed and the skills that are to be taught (Fairbairn et al., 1983). What is not clear is whether or not they should have first been trained in counselling skills in exactly the same way as the doctors they are going to teach. Evolving the methods The methods of counselling discussed so far have appeared acceptable and effective when carried out in clinical practice (Maguire et al., 1980). In the specific area of genetic counselling some skills might prove to be of more value than others. This will only become clear if vigorous attempts are made to link the use of specified skills to both short and longer term outcomes in those counselled, particularly the patients' psychological and social adjust¬ ment. The training methods can then be modified to take account of such findings. Conclusions Genetic counselling requires that the doctor possess certain key skills. Unfortunately, he is not as likely to have acquired them as he might think.