Walking in your patient‘s shoes: an investigation of genetic counselor empathy in clinical practice.

Abstract

Empathy is defined as "... [the ability] to perceive the internal frame of reference of another with accuracy and with the emotional components and meanings which pertain thereto as if one were the person, but without ever losing the `as if' condition" (Rogers, 1957, p.210). It is an important genetic counselor attitude and skill that is effective in establishing rapport with patients and providing them with psychosocial support (Kessler, 1999; McCarthy Veach, Bartels & LeRoy, 2007). Yet there is a dearth of empirical studies concerning how genetic counselors conceptualize and use empathy in their clinical practice. Furthermore, genetic counselors' empathy tendency, or ability to experience empathy, has not been examined. Accordingly the present study investigated genetic counselors' empathy tendency, their empathic responses to patient statements in five hypothetical genetic counseling scenarios (cancer, cleft palate, Fabry disease, Long QT syndrome, and Huntington Disease), and their personal successes and challenges in engaging empathically with their patients. Two hundred ten genetic counselors responded to an anonymous online survey posted to the National Society of Genetic Counseling (NSGC) listserv, and of these respondents, 143 completed the entire survey. Their empathy tendency was assessed with the Interpersonal Reactivity Index (Davis, 1983). Results indicated that participants had the highest mean empathy scores on the Empathic Concern Scale, followed by the Perspective-Taking Scale, Fantasy Scale, and Personal Distress Scale. Content analysis of written responses to the five genetic counseling scenarios revealed that, within and across scenarios, participants' responses to patient statements varied markedly. They included concise summaries of content and reflections of patient feelings, and lengthy, complex responses containing open and closed questions, information, self-disclosure, advice, counselor opinions, and/or nonverbal behaviors. Participants' use of empathy in their responses to the patients were not significantly related to their scores on any of the four empathy tendency scales. Analysis of empathy successes revealed three major themes: Exploring Psychosocial Issues and Providing Psychosocial Support, Information Provision, and Facilitating Patient Coping. Analysis of empathy challenges also revealed three major themes: Counselor Factors, Nature of Genetic Counseling Sessions, and Patient Factors. Implications for practice and research are presented.