Psychological aspects of genetic counseling. XIV. Nondirectiveness and counseling skills.

The difficulties some professionals have in achieving nondirective goals is largely due to the inadequate and ineffective application of basic counseling skills. The "new genetics," with its emphasis on decision-making in association with genetic testing, is among the most demanding forms of personal counseling, the effectiveness of which depends largely on the professional's human experience and counseling abilities. Examples are given showing inadequacies in professional responses to clients in genetic counseling which, in turn, defeat the achievement of a nondirectiveness that is helpful to clients, supports their self-directedness, and leaves them more psychologically prepared for quality decision making. Other models of counseling (e.g., shared decision making) will not fare any better than the nondirective one unless counseling skills of professionals in genetic services are upgraded in a significant way. Professional organizations need to give greater attention to the training and postgraduate supervision of all personnel involved in genetics services.