Journal of Genetic Counseling

, Volume 2, Issue 3, pp 159–169 | Cite as

A teaching framework for cross-cultural genetic counseling

  • Jon Weil
  • Ilana Mittman


The increasing diversity of American society has brought growing recognition of the need to bridge cultures in the delivery of genetic counseling services. New immigrants and members of diverse ethnic groups face multiple barriers to genetic counseling services. The need to train genetic counselors to deal with cultural diversity is especially crucial in the new genetic era, given the rapid expansion of available technology, with the resulting social and ethical ramifications. A framework for teaching cross-cultural issues in genetic counseling training programs is presented that can be implemented in step-wise fashion, consistent with available resources. Cross-cultural issues can be incorporated into existing teaching and training modalities by expanding the orientation from monocultural to multicultural. Relevant clinical experience, exploration of students' preconceptions and biases, reading materials, and lectures by invited speakers can all enhance students' knowledge and sensitivity. It is critically important that training programs furnish students with the basic tools necessary for the ongoing process of learning about cultural diversity.

Key words

genetic counseling genetics training programs education ethnocultural cross-cultural cultural diversity 


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  1. Anderson JN (1983) Health and illness in Pilipino immigrants.West J Med 139:811–819.Google Scholar
  2. Barker JC (1992) Cultural diversity — Changing the context of medical practice. In: Cross-cultural medicine — A decade later (Special Issue).West J Med 157:248–254.Google Scholar
  3. Bouvier LF, Gardner R (1986) Immigration to the U.S.: The unfinished story.Population Bull 41(4).Google Scholar
  4. Comas-Diaz L, Griffith EEH (eds) 1988Clinical Guidelines in Cross-Cultural Mental Health. New York: Wiley.Google Scholar
  5. Crocker AC (1992) The challenge of “Healthy People 2000.”J Genet Couns 1:123–133.Google Scholar
  6. Espenshade TJ (June 1987) Population replacement and immigrants' adaptation: New issues facing the West.Family Planning Perspectives 19(3):115–118.Google Scholar
  7. Gonzalez V, Gonzales J, Freeman V, Howard-Pitney B (1991)Health Promotion in Diverse Cultural Communities. Palo Alto: Health Promotion Resource Center, Stanford Center for Research in Disease Prevention.Google Scholar
  8. Hartog J, Hartog EA (1983) Cultural aspects of health and illness behavior in hospitals.West J Med 139:910–916.Google Scholar
  9. Hauck L, Punales-Morejon D, Smith S, Timko-Schere A (1990) Outreach — Counseling the new and old Americans. National Society of Genetic Counselors Tenth Annual Educational Conference Program Book, pp. 31–32.Google Scholar
  10. Hutchins V, Walch C (1989) Meeting minority health needs through special MCH projects.Public Health Rep 104:621–626.Google Scholar
  11. Jones A, Seagull AA (1989) Dimensions of the relationship between the Black client and the White therapist: A theoretical overview. In: Atkinson DR, Morten G, Sue DW (eds) Counseling American Minorities: A Cross Cultural Perspective (3rd Ed). Dubuque IA: Wm. C. Brown.Google Scholar
  12. Kellogg Foundation (1988)Health of the Uninsured and Underinsured: Developing a System to Monitor Trends. Battle Creek, MI: W. K. Kellogg Foundation.Google Scholar
  13. Kessler S (1979) The genetic counselor as psychotherapist.BD: OAS XV(2):187–200.Google Scholar
  14. Kessler S (1980) The psychological paradigm shift in genetic counseling.Soc Biol 27:167–185.Google Scholar
  15. Kessler S (1992) Psychological aspects of genetic counseling. VIII. Suffering and countertransference.J Genet Couns 1:303–308.Google Scholar
  16. Lamm RD, Imhoff G (1985)The Immigration Time Bomb. New York: Truman Talley Books.Google Scholar
  17. Lew L (1990) Understanding the Southeast Asian health care consumer: Bridges and barriers. In: Paul N, Kavanagh L (eds)Genetic Services for Underserved Populations. BD: OAS 26(2):147–154.Google Scholar
  18. Lin-Fu J (1990a) Response to the keynote address. In: Paul N, Kavanagh L (eds)Genetic Services for Underserved Populations. BD: OAS 26(2):21–24.Google Scholar
  19. Lin-Fu J (1990b) The Federal Office of Maternal and Child Health's role. In: Paul N, Kavanagh L (eds)Genetic Services for Underserved Populations. BD: OAS 26(2):185–188.Google Scholar
  20. Lin-Fu JS (1988) Population characteristics and health care needs of Asian Pacific Americans.Public Health Rep 103:18–27.Google Scholar
  21. Marfatia L, Punales-Morejon D, Rapp R (1990) Counseling the underserved: When an old reproductive technology becomes a new reproductive technology. In: Fine B, Gettig B, Greendale K, Leopold B, Paul NW (eds)Strategies in Genetic Counseling: Reproductive Genetics and New Technologies. BD: OAS 26(3):109–126.Google Scholar
  22. McGoldrick M, Pearce JK, Giordano J (eds) (1982)Ethnicity and Family Therapy. New York: Guilford Press.Google Scholar
  23. Mirsky J, Kaushinsky F (1988) Psychological processes in immigration and absorption.J Am College Health 36:329–334.Google Scholar
  24. Mittman I (1990a) Immigration and the provision of genetic services. In: Paul N, Kavanagh L (eds)Genetic Services for Underserved Populations. BD: OAS 26(2):139–146.Google Scholar
  25. Mittman I (1990b) A model perinatal genetics program. In: Paul N, Kavanagh L (eds)Genetic Services for Underserved Populations. BD: OAS 26(2):93–100.Google Scholar
  26. National Conference (1990) Overcoming Cultural Barriers to Genetic Counseling. Tucson, AZ, April 18–20.Google Scholar
  27. Paul N, Kavanagh L (eds) (1990)Genetic Services for Underserved Populations. BD: OAS 26(2). Washington, DC: National Center for Education in Maternal and Child Health.Google Scholar
  28. Perez-Stable E (1987) Issues in Latino Health Care.West J Med 146:213–218.Google Scholar
  29. Randall-David E (1989)Strategies for Working with Culturally Diverse Communities and Clients. Washington DC: The Association for the Care of Children's Health.Google Scholar
  30. Rauch J (1992)Taking a Family Health/Genetic History: An Ethnocultural Learning Guide and Handbook. Arlington VA: MCH Clearing House.Google Scholar
  31. Sue DW, Sue D (1990)Counseling the Culturally Different: Theory and Practice (2nd Ed). New York: J Wiley.Google Scholar
  32. Thorngren M (1990) Health care concerns of Hispanic populations. In: Paul N, Kavanagh L (eds)Genetic Services for Underserved Populations. BD: OAS 26(2):39–45.Google Scholar
  33. US Census (1990a) Data obtained from the US 1990 Census of Population and Housing, Summary Tape file 1A.Google Scholar
  34. US Census (1990b) Data obtained from the US 1990 Census of Population and Housing, Summary Tape file 3A.Google Scholar
  35. US Congress, Office of Technology Assessment (1992) Counseling and Cystic Fibrosis Carrier Screening: Results of a Survey — Background Paper OTA-BP-BA-97. Washington DC: US Government Printing Office.Google Scholar
  36. Walker AP, Scott JA, Biesecker BB, Conover B, Blake W, Djurdjinovic L (1990) Report of the 1989 Asilomar meeting on education in genetic counseling.Am J Hum Genet 46:1223–1230.Google Scholar
  37. Wang V, Marsh FH (1992) Ethical principles and cultural integrity in health care delivery: Asian ethnocultural perspectives in genetic services.J Genet Couns 1:81–92.Google Scholar
  38. Wang V, Punales-Morejon D (1992) Evaluating cultural awareness, knowledge, and skills: A prototype for the development of multiculturalism in genetic counseling.J Genet Couns 1:340–341.Google Scholar

Copyright information

© National Society of Genetic Counselors, Inc. 1993

Authors and Affiliations

  • Jon Weil
    • 1
  • Ilana Mittman
    • 2
  1. 1.Program in Genetic CounselingUniversity of CaliforniaBerkeley
  2. 2.Women and Children's ServicesSinai Hospital of BaltimoreBaltimore

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