Abstract
Psychiatric genetic counseling (PGC) is an emerging specialty discipline within the genetic counseling profession. A specialist PGC service was founded in 2012 in Vancouver, Canada, and though patient benefits have been demonstrated, many physicians do not regularly refer patients to the service despite awareness of its availability. We conducted a qualitative study involving semi-structured telephone interviews with Vancouver-based physicians who were aware of the PGC service to explore this phenomenon. Interviews were audio-recorded, transcribed verbatim, coded, and analysed for emergent themes. Consistent with a grounded theory approach, constant comparison was employed throughout data collection and analysis. Analyses of interviews conducted with 12 physicians revealed that referral practices were informed by perceptions about the purpose of PGC and interpretation of patient cues. Physicians perceived PGC as an information-focused intervention, and considered referral when patients explicitly expressed desire for information about recurrence risk or etiology that they felt unable to adequately address themselves. Even when physicians identified psychotherapeutic benefits of PGC, patient needs of this nature were not perceived as cues prompting referral to PGC. These data suggest that further work is necessary to position PGC in physicians’ minds as a service that could potentially benefit most individuals with psychiatric disorders and their families, and that it encompasses more than information provision. It is important to increase physicians’ awareness of the complementary role that genetic counselors can play to that of the physician in providing psychotherapeutically oriented counselling about illness etiology.
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Acknowledgments
The authors were grateful to receive funding support for this study through the National Society of Genetic Counselors (NSGC) Research Special Interest Group and the University of British Columbia Genetic Counselling Training Program. Interview transcription was performed by: Mingshu Dong, Vicky Hsieh, and Sarah Gerrard. JA was supported by the Canada Research Chairs program and BC Mental Health and Substance Use Services.
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EL, AI, EM, HW, AL and JA declare that they have no conflict of interest.
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All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000 (5). Informed consent was obtained from all individual participants included in the study. The study was approved by the University of British Columbia Ethics Review Board (H13-03175).
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No animal studies were carried out by the authors for this article.
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Leach, E., Morris, E., White, H.J. et al. How do Physicians Decide to Refer Their Patients for Psychiatric Genetic Counseling? A Qualitative Study of Physicians’ Practice. J Genet Counsel 25, 1235–1242 (2016). https://doi.org/10.1007/s10897-016-9961-x
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DOI: https://doi.org/10.1007/s10897-016-9961-x