Elaboration of the Reciprocal-Engagement Model of Genetic Counseling Practice: a Qualitative Investigation of Goals and Strategies
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As the genetic counseling field evolves, a comprehensive model of practice is critical. The Reciprocal-Engagement Model (REM) consists of 5 tenets and 17 goals. Lacking in the REM, however, are well-articulated counselor strategies and behaviors. The purpose of the present study was to further elaborate and provide supporting evidence for the REM by identifying and mapping genetic counseling strategies to the REM goals. A secondary, qualitative analysis was conducted on data from two prior studies: 1) focus group results of genetic counseling outcomes (Redlinger-Grosse et al., Journal of Genetic Counseling, 2015); and 2) genetic counselors’ examples of successful and unsuccessful genetic counseling sessions (Geiser et al. 2009). Using directed content analysis, 337 unique strategies were extracted from focus group data. A Q-sort of the 337 strategies yielded 15 broader strategy domains that were then mapped to the successful and unsuccessful session examples. Differing prevalence of strategy domains identified in successful sessions versus the prevalence of domains identified as lacking in unsuccessful sessions provide further support for the REM goals. The most prevalent domains for successful sessions were Information Giving and Use Psychosocial Skills and Strategies; and for unsuccessful sessions, Information Giving and Establish Working Alliance. Identified strategies support the REM’s reciprocal nature, especially with regard to addressing patients’ informational and psychosocial needs. Patients’ contributions to success (or lack thereof) of sessions was also noted, supporting a REM tenet that individual characteristics and the counselor-patient relationship are central to processes and outcomes. The elaborated REM could be used as a framework for certain graduate curricular objectives, and REM components could also inform process and outcomes research studies to document and further characterize genetic counselor strategies.
KeywordsReciprocal-engagement model Genetic counseling models Genetic counseling strategies Genetic counseling goals
This study was completed in partial fulfillment of the requirements for the first author’s Doctor of Philosophy degree from the University of Minnesota. The authors would like to thank Yu Huang, MA for her time and dedication in the qualitative coding process.
Dr. Christina Palmer served as Action Editor on the manuscript review process and publication decision.
Compliance with Ethical Standards
Conflict of Interest
Krista Redlinger-Grosse, Patricia McCarthy Veach, Bonnie S. LeRoy, and Heather Zierhut declare they have no conflict of interest.
Human Studies and Informed Consent
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. This study was approved by the University of Minnesota IRB. Informed consent was obtained from all individual participants included in the study.
This article does not contain any studies with animals performed by any of the authors.
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