Communication in Genetic Counseling: Cognitive and Emotional Processing

The profession of genetic counseling has received limited guidance from theoretical models in how to communicate complex health information so that clients can actively use the information. In this study of a national sample of 145 genetic counselors conducting sessions with simulated clients, we ap...

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Bibliographic Details
Published in:Health communication 2011-10, Vol.26 (7), p.667-675
Main Authors: Ellington, Lee, Kelly, Kimberly M., Reblin, Maija, Latimer, Seth, Roter, Debra
Format: Article
Language:English
Subjects:
Adult
Aged
Amniocentesis - psychology
Breast Neoplasms - genetics
Breast Neoplasms - psychology
Cognition
Cognition & reasoning
Cognitive processing
Communication
Emotion recognition
Emotions
Facilitation
Female
Genetic counseling
Genetic Counseling - psychology
Genetic counselling
Health information
Humans
Language
Male
Middle Aged
Ovarian Neoplasms - genetics
Ovarian Neoplasms - psychology
Patient Simulation
Pregnancy
Simulated clients
Time Factors
Verbal communication
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Summary:The profession of genetic counseling has received limited guidance from theoretical models in how to communicate complex health information so that clients can actively use the information. In this study of a national sample of 145 genetic counselors conducting sessions with simulated clients, we apply two different approaches for analyzing and describing verbal health communication. The Roter interaction analysis system (RIAS) and linguistic inquiry word count (LIWC) were used to identify evidence of communication behaviors consistent with tenets of the social cognitive processing model (SCPM). These tools revealed descriptive evidence of counselor facilitation of client emotional processing and, to a lesser extent, facilitation of client cognitive processing and understanding. Conversely, descriptive analysis of client communication revealed evidence of cognitive processing, but less affective processing. Second, we assessed whether genetic counselor facilitative communication predicted simulated client responses consistent with the cognitive and emotional processing inherent in SCPM. These analyses revealed that counselor attempts to promote emotional expression and client insight were positively associated with client word usage indicative of expression of negative affect and cognitive processing. This study is the first to our knowledge to apply RIAS and LIWC in tandem and gives us a description of current practices within genetic counseling within a theoretical framework. Additionally, it provides suggestions for education and communication goals to improve providers' responses to patient emotions as well as skills to engender patient understanding and personal meaning-making of complex medical information.
ISSN:1041-0236
1532-7027
DOI:10.1080/10410236.2011.561921