Counseling issues: The role of the genetic counselor

The definition of genetic counseling was established by an ad hoc committee of the American Society of Human Genetics in 1974 and has survived without revision over two decades (1). The application of genetic counseling practices to the needs of persons at risk of cancer is a constructive development in medical care. The model of genetic counseling is well suited to deliver to families highly charged information that is medically, genetically and emotionally complex. Genetic counselors assist families in understanding both the medical and emotional aspects of disease while providing a connection to support services. The elements of the basic definition of genetic counseling-explaining medical facts, hereditary concepts, and recurrence risk information; working within the context of family decision making; and providing support and options for care and surveillance-are readily applied to the challenges that a diagnosis of cancer or a discovery of cancer gene brings to an individual or family. Training of nonphysician genetic counselors was initiated at Sarah Lawrence College in 1969. Standards for accreditation have recently been set by the American Board of Genetic Counseling and certification of genetic counselors has been available since 1980. Training consists of two years of graduate work in medical genetics and related sciences and counseling plus at least 400 hours of supervised clinical experience counseling patients and families.