Module 2: Lesson 7 – Basic Genetic Counselling Skills

Name: Tina Wessels
Affiliation: University of Cape Town
Location: Cape Town, South Africa

 

I obtained my undergrad degree in Genetics (BSc(Agric)Animal Genetics) from the University of Pretoria.  I went on and did an Honours in Genetics also at the University of Pretoria. As I was always interested in working with people I enrolled for the Masters degree in Genetic Counselling offered at the University of the Witwatersrand.  I obtained my MSc(Med) in Genetic Counselling in 1997 and worked as a genetic counsellor in the department of Human Genetics at Wits. I then briefly joined the National department of Health (1998 to 2000) but missed the clinical contact with patients and returned to Wits.  In 2001, I was appointed Manager Clinical Genetics in the Division Human Genetics at the National Health Laboratory Service and the University of the Witwatersrand.  My duties included providing a genetic counselling service to private and state patients, co-facilitating the MSc (Med) genetic counselling course, teaching and research. I obtained my PhD from the University of the Witwatersrand in 2013.  My PhD was conducted in association with the Health Communications Project and examined the communication aspects of the Genetic Counselling process in our antenatal multicultural context.  I joined the Division of Human Genetics at UCT on 1 April 2014 as senior lecturer in Genetic Counselling.  Together with Prof Jacquie Greenberg, we run the Masters programme in Genetic Counselling and I am involved in other undergrad and postgraduate teaching.  In addition to my academic role, I am involved in clinical service and counsel patients from Groote Schuur and Red Cross Children’s Hospital – See more at: http://www.humangenetics.uct.ac.za/hg/division/staff/clinical/med_ounsellors/wessels#sthash.42FOH9uz.dpuf

Summary

The aim of this component is to provide the trainees with the basic genetic counselling communication skills to allow them to effective translate and communicate genetic and genomics information to patients and their families. The Basic Genetic counselling skills component will focus on the process of communicating the medical and scientific concepts to patients and their families, taking the psychological aspects associated with the condition or risks, into consideration. The communication process is centred on a framework of nondirective counselling, informed decision making and patient autonomy. The goal is to help the individuals and their families to adapt to the psychological, personal and familial implications of the condition and the associated risks.

Learning Outcomes

  • Describe the impact of genetic/genomic information on the individual and the family;
  • Describe the structure of a genetic counselling session;
    Communicate genetic/genomic information to individuals and their families
  • Facilitate information decision making
  • Use basic counselling skills in the genetic counselling sessions
  • Provide individuals and their families with appropriate support and referrals

Class Videos & Slides
Example: Counselling Session

Please note this is an example of a counselling session within a South African context.

Video 1

Video 2

Slides 1

Slides 2

Assessments: Pre-Class Exercise

Question 1: Read the following article.
How many Genetic Counsellors do you know in your community? Any other thoughts?

What it takes to be a Genetic Counsellor in South Africa: Interview with Frieda Loubser

Question 2: Read the following story and reflect on the impact an inherited disease/condition could have on an individual, their family and friends?
http://www.tellingstories.nhs.uk/index.php/joys-story

Assessments: Class Exercise
Please select one of the cases described below and role play as part of the exercise. Take turns to be the counsellor versus the patient. Give each other feedback on the role plays.

Case 1 – Cancer family history

A 35 year old woman presents at clinic. Her mother and a maternal aunt was diagnosed breast cancer in their 40s and a cousin was diagnosed with ovarian cancer at 50. Issues to think through and answer:

Is the woman at increased risk of developing breast cancer?
Is the cancer genetic?
What are the risks to her son and daughter of developing cancer?
What genetic testing should be offered?
Founders, BRCA1/2 screening, panels?
Result interpretation

Case 2 – Sickle cell anaemia

A couple in their late 20s presents at clinic. They have a healthy 5 year old son and a 2 year old daughter who was recently diagnosed with sickle cell anaemia. The women are currently 12 weeks pregnant. No family history. Issues to think through and answer:

Impact of the diagnosis on the couple?

Living with a child with sickle cell disease

Explaining recessive inheritance

What are the risks to the unborn baby?

What are the options available to the couple?

Emotional issues related to the pregnancy

Risks to other family members

Quiz

Class Evaluation
See course evaluations section.

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Extra Reading