Risky communication: pitfalls in counseling about risk, and how to avoid them.
A genetic counselor is often faced with the difficult task of conveying a set of complex and highly abstract factors associated with the client's risk of developing a familial disorder. The client is faced with the even more difficult task of making significant health-related decisions about an event which may or may not eventuate. Although there is a large corpus of research on this topic, much of the knowledge on risk communication is difficult to apply in a practical context. In this paper we draw together some insights on risk communication and decision-making under conditions of uncertainty, and apply them directly to the problem of communicating familial cancer risk. In particular, we focus on the distinction between individual risk and observed frequencies of adverse events, various framing effects, and contextualizing risk communication. We draw attention to some of the potential pitfalls in counseling about risk and offer avenues for circumventing them.
O'Doherty
K
K
School of Psychology, University of Adelaide, Adelaide, 5005, South Australia, Australia. kieran.odoherty@psychology.adelaide.edu.au
Suthers
G K
GK
D019313:BRCA1 Protein / Q000235:genetics; D001943:Breast Neoplasms / Q000235:genetics / Q000517:prevention & control / Q000523:psychology; D003142:Communication; D005260:Female; D006580:Genetic Carrier Screening; D005817:Genetic Counseling / Q000379:methods*; D005819:Genetic Markers / Q000235:genetics*; D020022:Genetic Predisposition to Disease / Q000235:genetics / Q000523:psychology*; D005820:Genetic Testing / Q000523:psychology; D006801:Humans; D016013:Likelihood Functions; D009369:Neoplasms / Q000235:genetics* / Q000517:prevention & control / Q000523:psychology; D010051:Ovarian Neoplasms / Q000235:genetics / Q000517:prevention & control / Q000523:psychology; D011336:Probability; D011369:Professional-Patient Relations; D011379:Prognosis; D012306:Risk
D019313:BRCA1 Protein; C492913:BRCA1 protein, human; D005819:Genetic Markers