Conceptualizing Genetic Counseling as Psychotherapy in the Era of Genomic Medicine
Conceptualizing Genetic Counseling as Psychotherapy in the Era of Genomic Medicine
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DOI：
10.1007/s10897-014-9728-1
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发表时间：
2014-12-01
影响因子：
1.9
通讯作者：
Hadjipavlou, George
中科院分区：
文献类型：
--
作者：
Austin, Jehannine;Semaka, Alicia;Hadjipavlou, George
关于遗传对医学疾病的贡献的讨论已经变得越来越普遍。从肿瘤学到精神病学，所有医学领域的医生和其他卫生保健提供者都经常回答有关他们治疗的疾病的遗传基础的问题。关于基因检测和风险的交流也进入这些对话，因为越来越多的人希望所有医学专家了解遗传学知识。伴随着这一不断发展的医学景观是一些关于遗传咨询专业的未来的不确定性，与遗传咨询师的需求增加和减少的可能性是可能的结果。这种新出现的不确定性提供了机会，明确概念化的潜在独特的价值和贡献的遗传咨询师以上的教育遗传学和风险，可能由其他卫生专业人员提供。在本文中，我们建议将遗传咨询概念化为一种高度限定的心理治疗形式，其中遗传信息的有效交流是一个中心治疗目标。虽然这样的方法绝不是新的-在1979年Seymour Kessler明确描述了遗传咨询作为一种“心理治疗的遭遇”，一个“与心理治疗潜力的互动“，我们扩展了他的观点，并提供了支持我们的立场的研究证据。我们回顾了过程和结果研究中的现有证据，这些证据表明遗传咨询是一种治疗性接触，不能简化为咨询师执行简单的“信息管道”功能，而不会失去有效性。然后，我们讨论了潜在的障碍，可能会阻碍更大的吸收实践的心理治疗模式，并通过讨论实践的影响关闭。
Discussions about genetic contributions to medical illness have become increasingly commonplace. Physicians and other health-care providers in all quarters of medicine, from oncology to psychiatry, routinely field questions about the genetic basis of the medical conditions they treat. Communication about genetic testing and risk also enter into these conversations, as knowledge about genetics is increasingly expected of all medical specialists. Attendant to this evolving medical landscape is some uncertainty regarding the future of the genetic counseling profession, with the potential for both increases and decreases in demand for genetic counselors being possible outcomes. This emerging uncertainty provides the opportunity to explicitly conceptualize the potentially distinct value and contributions of the genetic counselor over and above education about genetics and risk that may be provided by other health professionals. In this paper we suggest conceptualizing genetic counseling as a highly circumscribed form of psychotherapy in which effective communication of genetic information is a central therapeutic goal. While such an approach is by no means new-in 1979 Seymour Kessler explicitly described genetic counseling as a "kind of psychotherapeutic encounter," an "interaction with a psychotherapeutic potential"aEuro"we expand on his view, and provide research evidence in support of our position. We review available evidence from process and outcome studies showing that genetic counseling is a therapeutic encounter that cannot be reduced to one where the counselor performs a simple "conduit for information" function, without losing effectiveness. We then discuss potential barriers that may have impeded greater uptake of a psychotherapeutic model of practice, and close by discussing implications for practice.