Commentary on “Conceptualizing Genetic Counseling as Psychotherapy in the era of Genomic Medicine”

Before commenting directly on the article by Austin, Semaka, and Hadjipavlou (2014), I need to state my bias on this issue very clearly: As a counselor educator, counseling psychologist, and professional clinical counselor who has taught counseling techniques to genetic counseling students for more than 30 years, I have always strongly endorsed Kessler’s (1997) perspective that genetic counseling incorporates two core functions. The first function is the effective communication of information related to the genetic aspects of a wide variety of medical conditions. This information needs to be accurate, current, and expressed in a way that is understandable to patients who may have no medical or scientific background. The information-giving (teaching) part of genetic counseling is a complex and difficult task in that it not only requires a depth of knowledge but also a high level of interpersonal skill (e.g., reading a patient’s nonverbal confusion after an attempted explanation or recognizing that sometimes a carefully placed question may reveal what the patient is not understanding). The second core function of the genetic counselor task is to serve as a counselor (or psychotherapist), aiding the patient’s exploration of his/her emotional reactions and psychosocial concerns related to the genetic information presented. This second component of a genetic counselor’s work is emphasized in the Accreditation Council for Genetic Counseling (Accreditation Council for Genetic Counseling 2013 ,p p. 3–4) Practice-Based Competencies under Domain II: Interpersonal, Psychosocial and Counseling Skills. This section of the document includes core competencies clearly reflective of psychotherapy skills: