Counselling and Communication Skills for Genetic Counsellors

Module details

Title

Counselling and Communication Skills for Genetic Counsellors

Type

Specialist

Module code

SLS424

Credits

10

Requirement

Compulsory

Aim of this module

This module will provide the trainee with an introduction to counselling theories relevant to the practice of genetic and genomic counselling, in addition to training in counselling skills. Trainees will understand the process of psychological adaptation  to a genetic or genomic diagnosis in the family, including the range of coping responses to deal with uncertainty and potential future loss. In the work-based module they will be expected to observe and participate in patient-centred genetic and genomic counselling consultations, practising and applying effective counselling and communication skills to meet the psychological, social and cultural needs of individuals and their families.

Competencies

#	Learning outcome	Competency	Action
# 1	Learning outcome 1,2	Competency Identify the patient’s agenda for three trainee led genetic counselling consultations taking into account the concerns and priorities for the individual/couple and/or family.	Action View
# 2	Learning outcome 1,2	Competency Interpret the medical, family and psychological history provided by an individual.	Action View
# 3	Learning outcome 1	Competency Recognise the adaptation process individuals and families may go through as they adjust to their genetic situation.	Action View
# 4	Learning outcome 1	Competency Reflect on the use of a range of communication and counselling skills through audio and/or video, recording two consultations, with patient’s consent, with a GCRB Registered Genetic counsellor.	Action View
# 5	Learning outcome 1	Competency Reflect and prepare two cases for discussion at supervision and/or mentor meetings and develop an action plan for future patient interaction.	Action View
# 6	Learning outcome 1,3	Competency Provide non-directive genetic and genomic counselling in a supportive manner, in a case where pre- conceptual choices are being discussed with an individual or couple at increased risk of having a pregnancy affected with a genetic condition.	Action View
# 7	Learning outcome 1	Competency Critically reflect on a case in supervision that focuses on the counselling relationship in a trainee- led consultation.	Action View
# 8	Learning outcome 1	Competency In a trainee led consultation, identify and respond to the emerging needs of the patient or family within the consultation.	Action View
# 9	Learning outcome 2	Competency In a trainee-led consultation, provide information using a different mode of communication, taking into account any language or cultural differences (e.g. interpreter, use of counselling aids).	Action View
# 10	Learning outcome 3	Competency Use counselling strategies to facilitate patients' decision-making when considering whether to have a predictive/pre-symptomatic genetic test in a trainee-led consultation.	Action View
# 11	Learning outcome 1	Competency Observe a result giving genetic counselling appointment and reflect on the appointment with respect to the SPIKES framework.	Action View
# 12	Learning outcome 1	Competency Deliver a bad news result following an adult carrier test under direct supervision by a GCRB Registered Genetic Counsellor.	Action View
# 13	Learning outcome 4	Competency Assist in the referral of an individual and/or family to other health or social care professionals.	Action View

Assessments

You must complete:

• 2 case-based discussion(s)
• 2 of the following DOPS/ OCEs:

Draw and interpret a three generation family tree for a paediatric case	DOPS
Give a carrier test result either by telephone or face to face consultation	DOPS
Provide information during a consultation about either a patient organisation or relevant support agency	DOPS
Respond appropriately to an individual or couple following a bereavement or loss could be a new diagnosis in a relative	DOPS
Discuss with parents the option of testing following identification of a duplication or deletion mircoarray result in a child	DOPS
Summarise at the end of a consultation the plans for follow up	DOPS
Reflect on learning from a case discussed at supervision	OCE
Observe a bad news result consultation reflect on process with reference to SPIKES and role play delivering bad news result	OCE
Provide genetic counselling to a patient or family where English is not the first language	OCE
Reflect and identify coping strategies adoped by an individual or family in response to a genetic genomic issue	OCE

Learning outcomes

1. Apply core and advanced counselling skills within genetic and genomic counselling consultations under supervision.
2. Elicit and interpret appropriate medical, family and psychological history in a sensitive and culturally appropriate manner.
3. Facilitate individual/couple and family decision-making under direct supervision.
4. Refer individuals and/or families to other support agencies when required.

Learning outcomes

1. Recognise the appropriate use of counselling skills in the context of genetic and genomic counselling.
2. Describe relevant counselling theories and how these relate to the genetic and genomic counselling context.
3. Define and evaluate the counselling skills integral to conducting an effective genetic or genomic counselling session.
4. Describe and evaluate the range of potential psychological and emotional reactions to living with a genetic or genomic condition in the family or living at risk.
5. Explain the ethical concepts underpinning genetic and genomic counselling, including preserving confidentiality and enabling autonomous choice.
6. Identify the scope of a ‘normal’ response to bereavement and loss, drawing on current literature and contemporary models of grief and loss.
7. Describe the range of support agencies that may be used by patients and evaluate the effectiveness of these support structures from a patient  perspective.
8. Discuss the role of critical reflection and use of supervision to support the development of counselling skills.
9. Develop and reflect on the importance of the therapeutic relationship in genetic and genomic practice, having positive regard and respect for the autonomy of the individual.
10. Practise and use a range of counselling skills to enable individuals to express their beliefs, values and emotions.
11. Learn to recognise their own professional strengths and limitations, whilst developing and implementing action plans to support professional development.

 

Indicative content

Introduction to counselling theory

• Counselling theory as applied to practice, for example:
  • Person-centred counselling
  • Egan’s Skilled Helper model
  • Family Systems theory
  • Attachment theory
  • Psychodynamic theory
• Introduction to models of loss and grief
• Introduction to the tasks of mourning
• Responses to loss associated with genetic diagnosis or risk
• Psychological responses to genetic risk (e.g. monitoring, blunting)
• Individual and cultural influences on decision-making in a genetic counselling context
• Ethical approaches to genetic counselling and professional guidance (e.g. Association of Genetic Nurses and Counsellors (AGNC) Code of Ethics, The Genetic Counsellor Registration Board (GCRB) Code of Conduct, HCPC and their standards of proficiency for clinical practice)

 Counselling skills

• Core skills (empathy, congruence, warmth)
• Advanced skills (advanced empathy, concreteness, challenge)
• How communication skills affect assessment of, and engagement with, individuals
  • Non-verbal communication, such as body language
  • Language, the use and interpretation of words
• How to modify means of communication to address and take account of factors such as age, capacity, learning ability and physical ability
• The characteristics and consequences of verbal and non-verbal communication and how this can be affected by factors such as age, culture, ethnicity, gender, socio-economic status and spiritual or religious beliefs
• How and when to assist the communication needs of patients and their families, including the use of an appropriate interpreter or advocate, where appropriate and taking into account different communication preferences/styles
• Skills development and assessment through use of role-play and video- recorded sessions
• Brief psychotherapy interventions for application in clinical practice
• Ways of enhancing positive coping and resilience

 Reflective practice

• Continual development of counselling skills through the cycle of reflective practice
• Tools for reflective practice (e.g. use of KIDS framework/ Johns model of structured reflection)
• The role   of   transference   and   counter-transference   in   the   counselling relationship
• Becoming a reflective practitioner
• The use of supervision in a genetic counselling context
• The code of professional conduct for Genetic Counsellors

 Support networks and other agencies

• The use of psychological support networks to help patients
• The role of lay organisations for patient information and support

Activities

• Prepare for and participate in counselling supervision and reflect on this experience.
• Audio or video record two consultations for review of counselling competencies, discussing the consultations with your supervisor.
• Observe and participate in, and describe the breadth of practice, in a range of genetic counselling consultations.
• Participate in CPPD activity and reflect on learning, e.g. attendance at psychosocial meeting such as the European Meeting on Psychosocial Aspects of Genetics (EMPAG, the Association of Genetic Nurses and Counsellors (AGNC) annual meeting, International meeting on the psychosocial aspects of hereditary cancer (IMPahcc), Antenatal Results and Choices (ARC) workshops).