The Genetic Counsellor:

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The Genetic Counsellor Sue Kenwrick
PhD Genetic Counsellor Department of Medical
GeneticsAddenbrookes Hospital sue.kenwrick_at_adden
brookes.nhs.ukTel 01223 216446
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Genetic Counselling
'a communication process which deals with human
problems associated with the occurrence, or the
risk of occurrence, of a genetic disorder in a
family. .
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Content

• My career path
• What genetic counselling involves
• Skills and qaulifications required

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The Journey
B.Sc. Genetics Ph.D. Cancer Postdoctoral
research molecular biology and human
genetics PI/Lecturer - finding genes for
human disease 20 years as a scientist, I
wanted a change
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Requirements of a new job
Genetics Global view, not specific Team
work Impact of genetics on health, mental and
physical ?Could I become a genetic counsellor?
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Where is Genetic Counselling Done?
Clinical Genetics Service East Anglian
Regional Genetics Service Addenbrookes
Hospital. The Team Medical Genetics
Consultants and Registrars Genetic Counsellors
-nursing or academic background with
genetic counselling training Molecular
diagnostic and cytogenetic laboratories.
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Skills attained Skills required Genetic
knowledge Counselling patients Teaching Health
service Supervision Solution Obtained
Certificate in counselling (general) Obtained a
Genetic counsellor training position M.Sc. in
Genetic counselling -GOAL
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Genetics is a Family Affair
Affected individuals Diagnosis and Clinical
Care Affected and unaffected individuals
Genetic Counselling
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Genetic Counselling 1
Information gathering

• Developing a family tree inc. ethnicity
• Finding out how much people understand
• Experiences within the family
• Finding out what they need or expect
• Getting a view of family relations and culture

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Genetic Counselling 2
Information giving -

• the clinical aspects of the condition
• the inheritance pattern
• implications for other family members
• the chance of recurrence
• the tests/options available to them

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Genetic Counselling 3
Support

• Information not advice
• Empowering individuals so that they can
• -Make informed choices that are right for
• them and their family
• -Adjust to having a genetic condition in the
  family

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Example 1 - Cystic fibrosis

• Counselling
• Affect of the diagnosis
• Chance of recurrence
• Prenatal genetic
• testing/PGD
• Implications for other family members

Amy 10y
Charles 2m Cystic fibrosis
Autosomal recessive, 1/2500 births
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Example 2 - Breast cancer
?
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Monica 30y

• Counselling
• Affect of the diagnosis
• Risk assessment
• Genetic testing
• Managing risk
• surveillance
• surgery
• Implications for wider family
• Family dynamics

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Skills Required

• Good understanding of clinical and genetic
  issues
• Good communication skills
• translating genetics into lay language
• Sensitivity to a patients circumstances
• Good listening and observation (picking up
  cues)
• Ability to help patients explore their options
  and choices
• without being judgmental
• Dealing with emotional reaction

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Emotional Reactions
Shame
Anxiety
Anger
Sorrow
Low self esteem
numbness
Blame
confusion
Denial
Guilt
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Becoming a Genetic Counsellor

• AGNC website www.agnc.co.uk
• Nursing or caring services
• - then specialise
• Academic background
• MSc in Genetic Counselling
• Experience in a caring service