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Genetic counselling for hereditary cancer providing counsellors with feedback on their communicative behaviour.

Pieterse, A., Dulmen, S. van, Ausems, M., Beemer, F., Bensing, J. Genetic counselling for hereditary cancer providing counsellors with feedback on their communicative behaviour. Psycho-Oncology: 2004, 13(8 suppl.) S 37. Abstract. 7Th World Congress of Psycho-Oncology, August 25th-28th, 2004, Copenhagen, Denmark.
Background: The uncovering of cancer susceptibility genes has allowed personalized risk assessment through genetic counselling and genetic testing. Testing, however, has a number of limitations and genetic counselling may not provide counselees with the certainty they expected. A correct estimation of counselees' prior needs may be critical for effective counselling, yet it is a difficult task. More attention is needed in finding ways how to improve this. Purpose: Assessing the influence of providing counselors with feedback on their communicative behaviour on counsellor's capacity to better tune in to counselees' needs. Methods: Counsellors (N=6) at the Departmenty of Medical Genetics in Utrecht were randomly assigned to an experimental and a control condition. Counsellors in the experimental condition received a feedback training halfway the study period. All initial consultations counsellors conducted with new counselees (N=128) were videotaped, both before (all counsellors, N. consultations=94) and after (experimental condition only, N consultations=34) feedback. Videotaped consultations were analyzed using an adaptation of the RIAS and these data were related to counselees' needs as measured prior to the counselee's visit, and to outcome measures of the consultation in terms of counselees' conditions and anxiety. Results: Preliminary results suggest that after feedback, counselllors provide more medical information and advice, and ask less medical questions. Counselees seen by a counsellor who received feedback perceived a lower risk of carrying a cancer gene. Feedback did not affect the extent to which psycho-social issues were discussed, nor counselees' anxiety. (aut.ref.)