Genetic Counselling Communication: A Discourse-Analytical Approach
Published Online: 19 SEP 2013
Copyright © 2001 John Wiley & Sons, Ltd. All rights reserved.
How to Cite
Sarangi, S. 2013. Genetic Counselling Communication: A Discourse-Analytical Approach. eLS. .
- Published Online: 19 SEP 2013
For a long time, the genetic counselling process had remained a blackbox, especially from a discourse-analytical perspective. Over the last two decades, the rich and complex communication process that constitutes the ‘hybrid’ activity of genetic counselling has been a focus of study using discourse analysis methodology. Thematically, genetic counselling encompasses topics as diverse as the natural history of a genetic disorder, aspects of (non)diagnosis and prognosis, (non)treatability, lay genetic awareness, future risks for a client and other family members, reproduction choices, psychosocial aspects of coping, the ethical and legal consequences of decisions and privacy issues concerning the disclosure/circulation of genetic information. This range of topics does not follow neat and parallel interactional trajectories; instead the topics become interweaved in an overlapping manner and are managed interactionally under given conditions, including the multiparty nature of participation in the counselling encounter. A discourse-analytical approach is an attempt to uncover the structural, interactional and thematic organisation of genetic counselling as a situated activity.
Genetic counselling as a communicative activity is complex and hybrid, which does not follow a simple ritual interactional routine.
The notion of ‘activity type’ (forms of setting) to characterise communicative events with component ‘discourse types’ (forms of talk) is a useful way to capture the dynamic and variable nature of genetic counselling across modes (face-to-face versus telephone-mediated), disease conditions as well as sociocultural settings.
The activity of genetic counselling can be mapped structurally, interactionally and thematically to illustrate the unique nature of the counselling process.
Concepts such as directiveness and nondirectiveness are part of a continuum and are manifest differently at the interactional level.
At a thematic level, risk and uncertainty are two sides of the same coin and the language of probability assumes significance in terms of risk explanation and risk perception.
The concept of risk is far more complex in genetic counselling than in other disease settings as it includes the associated ‘risk of knowing’ and the ‘risk of (non)disclosure’.
Negotiation of what is normal and what is abnormal can be mapped on to risk/uncertainty trajectories in genetic counselling.
The management of ethical and moral issues in genetic counselling requires an interaction-based situated approach in preference to the principle-based guidelines.
In discourse analytic terms, it is possible to distinguish between psychological and sociomoral dimensions of genetic counselling, which underpin clients' decision-making.
The self-other orientations (e.g. self versus other; self and other and self-as-other) are a key feature of genetic counselling.
- discourse analysis;
- activity type;
- risk explanation;
- risk of knowing;
- professional neutrality