Background: As genetic counseling is incorporated into settings where genetic results influence health recommendations, the traditional ethos of “non-directiveness” becomes increasingly inadequate to address the range of clinical uses of genetic information. Whether, when, and to what extent deliberate influence and persuasion have a role to play in genetic counseling has been largely unexplored. Genetics professionals have struggled to define contexts within which influential communication can be an ethically justifiable component of genetic counseling and to balance patient autonomy with professional obligations to act in patients’ best interests. While most agree that persuasive communication should be ethically justified, patient-centered, and equitable, there has been limited conceptual and empirical investigation into what this looks like in clinical communication.
Objective: The objective of our project is to develop a framework and coding system to describe and evaluate providers’ and patients’ uses of influential communication in genetic counseling sessions.
Methods: Work is underway to create a framework for identifying influential communication strategies based on a review of empirical studies and conceptual literature. We will develop a coding system to apply this framework to transcripts from 45 standardized genetic counseling encounters. In this session, we will describe the findings from this analysis and discuss their normative implications. Implications: This work is an initial step towards developing an evidence-based approach to describe uses of influence reliably and consistently in genetic counseling. We intend for our approach to be applicable to empirical and normative clinical communication research in genetic counseling and other clinical settings.
