Empathy training in genetic counseling: an investigation of how genetic counselors learn to "walk in their patients' shoes".

Abstract

Empathy is a fundamental component of genetic counseling, but empirical data regarding the nature of genetic counselor empathy and empathy training methods are lacking. In this descriptive study, 60 genetic counselors, recruited through an online survey sent via the NSGC listserv, provided written definitions of empathy and responded to demographic questions. Additionally, genetic counselor program training directors nominated genetic counseling supervisors they perceived as focusing on empathy development when training students. Seventeen supervisors subsequently completed a similar online survey. Eleven genetic counselors and 16 supervisors completed follow a semi-structured, audio recorded phone interview to further investigate how genetic counselors define their professional use of empathy, to clarify training methods used to build empathy skills, and (for supervisors only) to determine methods supervisors use to evaluate empathy development. Inductive analysis of written definitions from the survey yielded themes consistent with Barrett-Lennard's (1981) 3-component model of empathy, namely, that genetic counselor's perceive empathy as: (1) the ability to understand another person's experience; (2) communicating that understanding; and (3) the other person's perception of being understood. Modified Consensual Qualitative Research (CQR; Hill, Thompson, & Williams, 1997; Hill, Knox, Thompson, Williams, & Hess, 2005) methods were used to analyze interview transcripts of genetic counselors and supervisors. Findings from this analysis showed that, similar to other health professions, genetic counselors and supervisors are more cognizant of Barrett-Lennard's (1981) Components 1 and 2. Genetic counselors reported learning their definition of empathy in their training program but honing their empathy skills primarily through clinical experience. Supervisors reported training and experience were equally important in their both their own and their student supervisees' learning of empathy and skill development. Supervisors experienced increased comfort using empathy in clinical practice as they became more familiar with the concept and reported emphasizing empathy more with their students as they gained clinical and supervisory experience. Genetic counselors reported that with experience empathy became a tangible skill and a process used throughout the session. Both groups of interviewees described empathy as an evolving process. While some participants believed empathy might be innate, most reported empathy is something one is continuously learning and it is refined through training and experience. Post-genetic counseling session reflection and anticipatory guidance were most frequently mentioned by both groups as supervisory methods used to promote empathy development. Findings from this study were congruent with the Reciprocal Engagement Model (REM) of Genetic Counseling (McCarthy Veach, Bartels, & LeRoy, 2007), a published model of the genetic counseling process. A model of empathy in genetic counseling, the Reciprocal Engagement Model of Empathy (REM-E), is proposed to describe how empathy can be infused into genetic counseling practice. Additional findings, practice implications and research recommendations are presented.