‘There are no rights and wrongs in these situations’: identifying interactional difficulties in genetic counselling

TLDR: In this article, the authors present extracts from a body of data collected at a regional genetic counselling centre, and analyse using a conversation analytic approach, focusing on the communication of genetic information by counsellors and the ways in which this is received by clients, and how this impacts upon the way in which topics for discussion are arrived at.

Abstract: The rapid scientific and technological advances in the field of human genetics have created an ever-widening gap in knowledge and understanding between those specialists who are involved with them and the general public who are the intended beneficiaries. Genetic counselling is seen as an important way of addressing this gap. Whilst there is a growing literature on genetic counselling, this has tended to focus on quantitative measures of outcome. However, there is a growing recognition that genetic counselling is a communicative process, and needs to be studied as such. This paper presents extracts from a body of data collected at a regional genetic counselling centre, and analysed using a conversation analytic approach. A particular emphasis is placed upon the communication of genetic information by counsellors and the ways in which this is received by clients, and how this impacts upon the ways in which topics for discussion are arrived at. Four areas around which interactional difficulties arise are identified: achieving a client-led agenda; knowing what is relevant for a particular client; managing different activities within counselling; and managing the multiple perspectives of clients.