Abstract:Metaphors are figures of speech used extremely frequently in everyday language, thoughts, and actions (Lakoff & Johnson, 1980).Metaphors appear simple but are fundamental schemata allowing expression and processing of complex emotions and information.Metaphorical language, including simile as a more explicit form, is recognized as having an important role in communication, learning, and understanding the world (Lakoff & Johnson, 1980;Ricoeur, 2003).Although metaphor is so embedded in language and thinking that… Show more
“…To reassure patients in their consultations, many genetic counsellors mentioned using the analogy of the ‘ innocent typo ’ to distinguish a VUS from a true pathogenic result (Sexton & James, 2022):I say we did a spell check and they found something there that’s a little bit different than what we would typically see, but we don’t know right now, if it actually means anything. Is it actually changing the meaning of the word or not?…”
Genomic tests regularly produce Variants of UncertainSignificance (VUS), mutations of which currently little is known but may turn out to be disease-causing. The communication of such variants in the United States is typically delegated to genetic counsellors. Based on
“…To reassure patients in their consultations, many genetic counsellors mentioned using the analogy of the ‘ innocent typo ’ to distinguish a VUS from a true pathogenic result (Sexton & James, 2022):I say we did a spell check and they found something there that’s a little bit different than what we would typically see, but we don’t know right now, if it actually means anything. Is it actually changing the meaning of the word or not?…”
Genomic tests regularly produce Variants of UncertainSignificance (VUS), mutations of which currently little is known but may turn out to be disease-causing. The communication of such variants in the United States is typically delegated to genetic counsellors. Based on
“…A recent paper has advocated a more comprehensive use of metaphor within all aspects of genetic counseling (Sexton & James, 2022). They argue that working with client‐generated and counselor‐generated metaphors has great potential for making complex genetics meaningful within the reciprocally engaged client–counselor relationship.…”
Section: Working With Metaphormentioning
confidence: 99%
“…An example of working with metaphor within genetic counseling is provided in the Sexton & James paper (Sexton & James, 2022, p. 36) where a patient with a 50% risk of Huntingdon disease (HD) who was now considering testing expressed “I've been in the tall grass for a long time.” Ideas that could be developed from this metaphor included past ambivalence, uncertainty and feeling overwhelmed, being stuck/lost/alone, and being unable to think about the future or to find a clear way out. These concepts could well be challenging to express directly but are clearly of relevance to the exploratory nature of genetic counseling and in helping the patient toward informed decision making.…”
Counseling techniques are an important component of genetic counseling training and are focused on the person‐centered counseling philosophy. While this has a long tradition within the profession and underpins the empowerment goal, it should not limit consideration of the potential benefits of education on other psychotherapeutic approaches such as the cognitive philosophy. The goal of empowerment in genetic counseling requires patients to receive information in a way that is accessible to them and to make sense of it in relation to their own health, lifestyle, and family information. This assimilation of new information is a complex cognitive process, and yet it is one that genetic counselors do not routinely actively facilitate. Rather the counseling component of genetic counseling has traditionally focused on emotionally supporting the patient which is driven by the person‐centered philosophy that is covered in genetic counseling training. This paper argues for the potential for adopting more cognitive approaches informed by cognitive–behavioral therapy (CBT) and acceptance and commitment therapy (ACT), as these short interventions can have wide impact, including engaging patients who do not want to discuss feelings, helping people to make sense of information (not just gain knowledge), and helping people to change the relationship they have with their thoughts. This paper advocates for an introduction to CBT and ACT to be incorporated into prequalification training and for more advanced training to be available to postqualification genetic counselors.
“…The importance of metaphors to genetic counseling has been articulated by A. Sexton and James (2021) including research applications which seek to evaluate the impact of genetic counseling as well as effective communication and counseling strategies. Other uses of metaphor in qualitative research may be in asking participants to explain something using a metaphor, or to use a researcher-constructed metaphor that articulates a theme or idea representing the data (Tracy, 2020).…”
Section: Metaphor Analysismentioning
confidence: 99%
“…Searching for and analyzing metaphors that have arisen organically in the participants' interviews can be an excellent way of gaining insight regarding cognitive thinking as well as meaning or sensemaking, especially when they are unable to do so consciously (Tracy, 2020). The importance of metaphors to genetic counseling has been articulated by A. Sexton and James (2021) including research applications which seek to evaluate the impact of genetic counseling as well as effective communication and counseling strategies. Other uses of metaphor in qualitative research may be in asking participants to explain something using a metaphor, or to use a researcher‐constructed metaphor that articulates a theme or idea representing the data (Tracy, 2020).…”
Section: Additional Steps Towards Nuanced Interpretive Storiesmentioning
All genetic counselors interact with research, whether through conducting studies, participating in them, or applying results to their practice. Research is also integrated at the trainee level, with all accredited genetic counseling training programs requiring a research output for the purposes of accreditation (Accreditation Council for Genetic Counseling (ACGC), 2019). Reckoning with research methods is therefore an activity that all genetic counselors are likely to undertake in some form. A recent content analysis of the Journal of Genetic Counseling revealed "research methodology" was the least common topic of articles published over the analysis period (2011-2017) with only nine articles (1.9%) addressing this area (Wallgren et al., 2021). More than a third (34.4%) of all the publications
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