Journal of Genetic Counseling

, Volume 27, Issue 5, pp 1275–1290 | Cite as

Managing Couple Conflict During Prenatal Counseling Sessions: An Investigation of Genetic Counselor Experiences and Perceptions

  • Kara SchoeffelEmail author
  • Patricia McCarthy Veach
  • Karol Rubin
  • Bonnie LeRoy
Original Research


Research shows couple conflict occurring during prenatal genetic counseling sessions may be challenging for some genetic counselors. Yet, no study has explored couple conflict in depth. The current study investigated genetic counselors’ experiences and perceptions of the nature and context of couple conflict in prenatal sessions and counselor conflict management strategies. Sixteen prenatal genetic counselors recruited through the National Society of Genetic Counselors participated in semi-structured phone interviews asking about how they recognize couple conflict; topics that trigger conflict and when it occurs; individual, cultural, and situational factors associated with conflict; conflict management strategies; and specific examples from their practice. Inductive and cross-case comparison methods revealed a number of themes. Genetic counselors recognize couple conflict through non-verbal and verbal cues, and conflict can occur at any time, particularly during decision-making about testing and test results and during results review of an affected pregnancy. Factors associated with conflict include cultural customs, age, emotional state, religious beliefs, and being forced to attend counseling. Participants identified 23 conflict management strategies classified into five themes: facilitate decision-making, encourage couple expression, act within one’s scope of practice, provide psychosocial support, and support the identified patient. Counselors emphasized that their strategies are couple dependent. Patients may benefit from genetic counselors assessing couple conflict and intervening when it impedes genetic counseling goals. Clinical examples from this study may contribute to informing genetic counselor practice, program curricula, and continuing education workshops.


Prenatal Genetic counseling Genetic screening Genetic testing Couple conflict Decision-making Conflict management Strategies 



This study was completed in partial fulfillment of the requirements of the first author’s Masters of Science degree from the University of Minnesota. We would like to thank the genetic counselors who participated in this study.

Dr. Christina Palmer served as Action Editor on the manuscript review process and publication decision.

Compliance with Ethical Standards

Conflict of Interest

Kara Schoeffel, Patricia McCarthy Veach, Karol Rubin, and Bonnie LeRoy 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 (5). Informed consent was obtained from all participants for being included in the study.

Animal Studies

No animal studies were carried out by the authors for this article.


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Copyright information

© National Society of Genetic Counselors, Inc. 2018

Authors and Affiliations

  1. 1.Genomic MedicineAurora Health CareMilwaukeeUSA
  2. 2.Department of Genetics, Cell Biology, and DevelopmentUniversity of MinnesotaMinneapolisUSA
  3. 3.Genetic CounselingCounsyl, Inc.South San FranciscoUSA

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