Risky Communication: Pitfalls in Counseling About Risk, and How to Avoid Them
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A genetic counselor is often faced with the difficult task of conveying a set of complex and highly abstract factors associated with the client's risk of developing a familial disorder. The client is faced with the even more difficult task of making significant health-related decisions about an event which may or may not eventuate. Although there is a large corpus of research on this topic, much of the knowledge on risk communication is difficult to apply in a practical context. In this paper we draw together some insights on risk communication and decision-making under conditions of uncertainty, and apply them directly to the problem of communicating familial cancer risk. In particular, we focus on the distinction between individual risk and observed frequencies of adverse events, various framing effects, and contextualizing risk communication. We draw attention to some of the potential pitfalls in counseling about risk and offer avenues for circumventing them.
KEY WORDS:Genetic counseling risk familial cancer risk communication
We thank Debbie Trott, Jacquie Armstrong, Sally Russell, Vanessa Huntley, Nicola Poplawski, and Matthew Welsh for their support, insight, and suggestions. We also acknowledge the valuable critiques provided by two anonymous reviewers.
- Bernstein, P. L. (1996). Against the gods: The remarkable story of risk. New York: John Wiley & Sons.Google Scholar
- Gigerenzer, G. (2002). Reckoning with risk: Learning to live with uncertainty. London: Penguin.Google Scholar
- Hamm, R. M., & Smith, S. L. (1998). The accuracy of patients’ judgments of disease probability and test sensitivity and specificity. J Fam Prac, 47(1), 44–53.Google Scholar
- Kahneman, D., & Tversky, A. (Eds.). (2000). Choices, values, and frames. Cambridge: Cambridge University Press.Google Scholar
- O’Doherty, K. (2005). Risk communication in familial cancer: The discursive management of uncertainty in genetic counseling. Unpublished PhD, The University of Adelaide, Adelaide.Google Scholar
- Slovic, P., Fischhoff, B., & Lichtenstein, S. (1982). Facts versus fears: Understanding perceived risk. In D. Kahneman, P. Slovic & A. Tversky (Eds.), Judgment under uncertainty: Heuristics and biases. Cambridge: Cambridge University Press.Google Scholar
- Yates, F. J. (1990). Judgment and decision making. Englewood Cliffs, New Jersey: Prentice Hall.Google Scholar