Counselor–counselee interaction in reproductive genetic counseling: Does a pregnancy in the counselee make a difference?

ObjectiveTo investigate the influence of a pregnancy and other counselee characteristics on several aspects of counselor–counselee interaction during the initial clinical genetic consultation.MethodsThe consultations, of a group of pregnant women (n = 82) and of a control group of non-pregnant women (n = 58), were compared specifically with regard to differences in global affective tone, extent of psychosocial exchange and women's participation in the decision-making process. Consultations were recorded, and subsequently coded from audiotape by 10 raters.ResultsOnly two differences in outcome measures were found between the two study groups: the counselor was rated as slightly more nervous in consultations with pregnant women, and in consultations with non-pregnant women fewer decisions were taken. The length of the consultation, the contribution of a counselee's companion to the consultation and counselee characteristics (age, level of education, initiation of referral, affected person, degree of worry and preferred participation in decision-making) were more important in explaining the nature of the interaction.ConclusionOur study yielded no important differences in counselor–counselee interaction during the initial clinical genetic consultation of pregnant versus non-pregnant women regarding the affective tone of the consultation, the degree to which psychosocial issues were discussed and the women's participation in the decision-making process.Practice implicationsOur findings suggest that a negatively affected counselor–counselee interaction is not an important disadvantage in consultations with pregnant women. Given the limitations of our study, however, we advocate further studies on counselor–counselee interaction in reproductive genetic counseling, in order to improve the quality of reproductive genetic counseling.