Nondirectiveness: Genetic Counselors Perceptions, Practice and Purpose. By Sarah Von Schuch
Introduction: Nondirectiveness is a central tenet of genetic counseling and its purpose is commonly defined as “supporting client autonomy and promoting active, self-confident decision making” (Kessler, 1997, p. 166). Despite being well espoused, however, nondirectiveness has been an area of controversy. In the last few years many different perspectives of nondirectiveness have surfaced, yet trends in genetic counselors’ perceptions, beliefs, and use had not been assessed since 1993. The purpose of this study was to investigate genetic counselors’ perceptions, beliefs, and practice of nondirectiveness, as well as identify trends in its use. Methods: The study employed web-based questionnaires open to all working master’s level genetic counselors who were members of the National Society of Genetic Counselors. Results: The study found that genetic counselors today feel less strongly about the importance of nondirectiveness in clinical practice than did counselors in 1993. It also found that the overwhelming majority of counselors (95%) believed it was appropriate to be directive at times. Still, despite this, the majority of genetic counselors also believed there is not a better approach or philosophy that fits their practice today. In addition we found that while genetic counselors differ in how they choose to describe/define nondirectiveness, these differences did not appear to impact how counselors incorporate nondirectiveness into their clinical practice.