The role of the genetic counsellor in this setting is to provide information regarding the genetics of HBOCS and the risks of carrying and passing on a mutation, and to assist the counsellee in making informed decisions about genetic testing.
Once the appropriate analyses and risk assessments have been undertaken, the counsellee may be offered a molecular genetic test, including testing for the Afrikaner founder mutations as a first-line testing option (prices range from approximately ZAR1 600 to ZAR3 500).
The counsellee's family history and demographic information was recorded and analysed.
A BOADICEA risk score and a Manchester score were calculated for each counsellee, based on personal and family history alone; molecular results were excluded from these calculations so that a pretest prediction of identifying a pathogenic BRCA mutation could be performed.
No formal guidelines currently exist to assist genetic counsellors or their counsellees in determining whether founder mutation analysis is sufficient or whether additional testing should be pursued following a negative result for the founder mutations identified in this population group.
This would be done by bringing to the attention of the counsellee
conditions and experiences that would encourage the individual to develop desirable behaviour in order to modify undesirable behaviour (Allen, 1990; Essuman, in Achebe 1988).
The major skills required for effective counselling were: (i) adequate knowledge on HIV/AIDS and of its testing; (ii) ability to listen and infuse confidence in counsellee
; (iii) ability to identify and understand critical personal issues to counsel; (iv) plan necessary interventions to strengthen family ties; and (v) build motivation to continue counselling.
is faced with negative information, and it may be difficult for her to consider her prenatal diagnosis options optimally.
' view of an unclassified variant in BRCA1/2: recall, interpretation, and impact on life.
Part 4, "Personal Liabilities," also has five chapters, on "defamatory speech on computer bulletin boards," "expectations of privacy," "junk e-mail," "ethical issues for a virtual self," and "ethical and legal issues in e-mail therapy." The authors of this latter chapter, on psychological and psychiatric counseling via the Internet, say that while it offers attractions to therapists and counsellees
, alike, it also poses huge problems and dangers, among them questions of confidentiality, responsibility, and the ability of the patient to assess the competence of the therapist (pp.