Assessment looks at the consultand's motivation for seeking genetic evaluation at a given time, the expectations of what would be gained from a genetics consultation, the personal and family experiences, beliefs and attitudes about the genetic condition as well as standardized psychosocial information.
The consultand is often called by her sister for advice about general pediatric and acute respiratory concerns for her daughter.
With her new recognition and articulation of her unique combination of roles, the consultand recognized that she has the capacity to raise a child with CF and would treasure and love such a child.
Often the adolescent consultand has trouble identifying consequences of her actions, understanding probability, predicting future outcomes, making reasoned decisions, and communicating effectively with the healthcare team.
Psychosocial interventions already identified in the growing literature of cancer risk counseling include: confronting the meaning of one's risk status; venting strong feelings of fear or guilt; helping the consultand to face fears of harm, disfigurement, pain, or death from cancer; managing anxiety, cancer-related worry and intrusive thoughts; coaching in problem solving; facilitating decision-making strategies; and teaching positive, active coping behaviors (Peters & Biesecker, 1997).
The consultands have two young sons and are happy about a current pregnancy in light of their long-standing desire to have a family of four children; however, they are concerned about their risk of having a child with CF.
"We were the western Beltway Bandits," says Carlos, referring to consultands
who thrive in the Washington, DC area enclosed by the freeway system there.