Counseling style or counseling skill?
Today I saw a patient whose brother has DS. When I prepared this case last night, I thought about counseling issues in addition talking about causes of DS and recurrence risk. The counseling questions that I could think of include asking the patient what the life has been like growing up with a brother who has DS, and what the patient would feel and do if she had a baby has DS. However, when the session got started, I changed my mind. As usual, I asked what concerns or questions they had. I was expecting them to say they are worrying about the baby’s risk of having DS. Unfortunately, they said nothing related DS. So we brought up DS and I asked how her brother’s doing. From their attitude, I convinced myself that they knew DS, they had no problem to raise a baby with DS. But I still introduced the causes of DS including trisomy 21 and translocation as well as recommending her to have chromosome analysis to rule out translocation. Then she brought up that her doctor introduced sequential screening for DS. Certainly, I discussed SS with them in detail.
When XXX commented on my session, she advised me to explore more about her thoughts in terms of DS by asking the questions I mentioned above even they behaved to defend her brother. It appears that they don’t have concerns. But as a GC, we should explore more to make sure they have been thinking it through. I agree with Tracy. If the patient expressed lots of concerns, I would certainly explore more. In this case, I thought I tailored the session based upon the reaction of the patient. Well, this is my first ever DS case. Is it a question of counseling skill vs. counseling style? Of course, different GC has different counseling styles. But counseling skill can be helpful to distinguish better GCs from good GCs, whereas counseling style can’t.
