In the role play video that you watched, comment on the:
1. The attending skills that the genetic counselor employed. Identify the skills that you saw and explain how these contribute to the overall counseling session.
The genetic counsellor not only listened to what patient was saying. She was able to read non-verbal cues and was able to help the patient open up and comfortable. Another important thing I observed was the genetic counselor maintained eye contact throughout the whole time she was with the patient. During the whole interview, the setting was formal yet warm. The tone of the interview was that the counselor cared for the patient. There was sensitivity in her voice. She was able to elicit answers from the patient without being very intrusive. She pauses every so often, to allow the patient to talk, especially on several topics she doesn’t want to share, in this case, her father and their relationship.
The whole session will depend on how the counselor impresses on the patient. If the counselor seems very stern and upfront, the patient might close up and not share important details.
2. The primary empathy skills that the genetic counselor employed. Identify the empathy responses of the counselor and explain how these contributed in further elucidating the thoughts and emotions of the client.
Empathy is of understanding what another person is experiencing. It is putting yourself in someone else's shoes to understand what she or he is going through. By supporting and allowing the patient to vent her view point, we will able to find out her emotional and psychological state.
Once the patient states what she feels, the counselor paraphrased what the patient said. After this, she was able to summarize what the patient disclosed.
From the lecture given to us, having empathy is helpful but we should not give so much empathy that genetic counselor over identifies with the patient. Also, we should note that not all patients react the same way. Each patient's need for empathy is different. It is part of our responsibility to gauge every patient's needs. Silence is a strong tool to allow the patient to open up. We should not try so hard, but let counseling come naturally, so the patient may be able to open up. The steps to achieving proper primary empathy are: identification of feelings, giving proper content responses, making feeling responses.
3. The effectiveness of the questions the genetic counselor asked.
Getting information about the patient and her family can be done by asking appropriate questions. We can both use open or closed-ended questions during the interview based on how the patient reacts. During the interview video, more open-ended questions were used. This allowed sharing of feelings and thoughts of the patient. Her beliefs regarding her condition was opened up when the counselor asked how she feels.
The goal of asking questions should be kept in mind but there should be fluidity and flow during the conversation, as was observed in the video. The function of asking questions during counseling are: to get an accurate family history, to encourage reflection, to explore views of the patient regarding the disease. It is not a simple run down of questions as what we do in our first consultations with the patient where we fill-up a form from past medical, family, social, sexual history of the patient. Counseling is so much more than that. It is a must to know when and how to ask relevant questions and not just shot-gun type of history taking.
Taking information in genetic counseling needs to be systematic. The questions are simple, understandable, yet comprehensive. What the counselor in the video did was she mixed information questions with empathy skills.
This skill of involving and engaging the patient through proper communication is a must-have for counselors. I pray that in the correct time, with proper training, I would be able to do this also.