Variables in the outcome of genetic counseling

Genetic counseling is defined as a communication process which has as its goal the provision of information and support for the alleviation of human suffering. Review of the literature indicates that educational, reproductive, and psychological outcomes vary and that reproductive behavior is dependent upon stage in the life cycle, the mother's religion, and the family's attitude toward children. The degree of handicap of the affected, improvement with treatment, recurrence risk, and mode of inheritance may be important determinants within certain groups. Psychological outcome is harder to assess. Both clinical observations and objective measures have indicated a high degree of emotional upset in counselees at the time of genetic counseling. Causes for this upset are hypothesized and related to the grief model. It is suggested that these psychological variables have significant impact upon the learning, decision making, and behavior of counselees. It is postulated that these affective effects are operating for periods of three or more years after counseling. Thus, it is proposed that aspects of genetic counseling related to adjustment be increased and lengthened.