This study will examine the process of prenatal genetic counseling to determine how various
client and counselor factors affect the communication process in a counseling session. The
specific aims of the study are to:
- Provide information on prenatal genetic counselors' interactions with clients for the
basis of a future larger study of the genetic counseling process.
- Determine the average length and the range of length of prenatal genetic counselors'
interactions with clients when family history information has already been provided.
- Document on videotape the communication content and interaction dynamics of prenatal
genetic counselors interacting with clients in order to:
- Characterize different models of prenatal genetic counseling
- Determine the nature of discussions concerning cystic fibrosis carrier testing within
the context of prenatal genetic counseling.
- Examine the impact of prenatal genetic counselors' characteristics (years of
experience, training and background, age, clinical setting, anxiety) on the
communication content and interaction dynamics of sessions with clients.
- Examine the impact of the presence of a spouse on the communication content and
interaction dynamics of prenatal genetic counseling sessions with clients.
- Examine the impact of client verbal emotional cues on the communication content and
interaction dynamics of prenatal genetic counseling sessions.
Counselors will be recruited for this study from among practicing prenatal genetic
counselors at regional meetings and a national meeting of the National Society of Genetic
Counselors. They will perform prenatal genetic counseling sessions with actors in the roles
of client and client's spouse. The sessions will be videotaped, and the counselor and
actors will fill out questionnaires regarding the characteristics of the counselor and the
Counselors may be contacted later to request permission to use segments of their videotaped
sessions for creating a video teaching tool for counseling professionals that illustrates
different ways to practice the genetic counseling.
The main objective of this pilot study is to provide insight into the process of prenatal
genetic counseling that can both inform the practice of prenatal genetic counseling and
serve as the springboard to a later, more comprehensive study. The research participants
will all be practicing prenatal genetic counselors recruited from regional meetings and a
national meeting of the National Society of Genetic Counselors. Participating genetic
counselors will be asked to perform a prenatal genetic counseling session with a simulated
client (an actor) or simulated clients (actor and actor posing as spouse) presenting with
the indication of advanced maternal age. The participating genetic counselors will also be
asked to address cystic fibrosis carrier testing within the course of this session. This
session will be videotaped. In addition, both the genetic counselor and simulated client
will be asked to fill out questionnaires related to characteristics of the counselor and the
session itself. The process and content of the genetic counseling communication will be
analyzed qualitatively and quantitatively (using Roter Interaction Analysis System). Through
these analyses, we hope to both describe the nature of prenatal genetic counseling
communication in a relatively large sample and to determine the ways in which a variety of
client and counselor factors affect the communication process itself (determined through
changes in the RIAS communication codes). In addition, we hope to provide information on the
logistics of data collection in order to inform a similar larger study planned to look at
the impact of communication on client outcomes.
Any master's trained genetic counselors attending the 2002 regional meetings and/or a
national meeting of the National Society of Genetic Counselors who currently provide
prenatal genetic counseling services as part of their professional practices will be
included in the study. In addition, any prenatal genetic counselors referred by these
individuals, but who did not attend these meetings, will also be eligible to participate.
Genetic counselors who do not practice prenatal counseling training programs will be
excluded In addition, master's level students currently in genetic counseling training
programs will be excluded from the study because differences in their stages of training
and practice development would introduce additional variability into the data set.