What Would You Say? Genetic Counseling Graduate Students’ and Counselors’ Hypothetical Responses to Patient Requested Self-Disclosure

Genetic counselor self-disclosure is a complex behavior that lacks extensive characterization. In particular, data are limited about genetic counselors’ responses when patients ask them to self-disclose. Accordingly, this study investigated genetic counseling students’ (n = 114) and practicing genetic counselors’ (n = 123) responses to two hypothetical scenarios in which a female prenatal patient requests self-disclosure. Scenarios were identical except for a final patient question: “Have you ever had an amniocentesis?” or “What would you do if you were me?” Imagining themselves as the counselor, participants wrote a response for each scenario and then explained their response. Differences in disclosure frequency for students vs. counselors and disclosure question were assessed, and themes in participant responses and explanations were extracted via content and thematic analysis methods. Chi-square analyses indicated no significant differences in frequency of student versus counselor disclosure. Self-disclosure was significantly higher for, “Have you ever had an amniocentesis?” (78.5 %) than for, “What would you do if you were me?” (53.2 %) (p < .001). Types of self-disclosures included personal, professional, and mixed disclosures. Prevalent explanations for disclosure and non-disclosure responses included: remain patient focused and support/empower the patient. Additional findings, practice and training implications, and research recommendations are presented.