Elaboration of the definition of genetic counseling into a model for counselee decision‐making

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Abstract
Genetic counseling has evolved from a eugenic orientation to an orientation concerned with the physical and mental well-being of counselees. This change in genetic counseling, which has received formal recognition in a new definition of genetic counseling, requires collateral development of the processes and evaluation of the outcomes of counseling. This paper offers a theory of genetic counseling which interrelates genetic information, psychological responses, learning theory, and decision-making. The theory presented for genetic counseling is based on the more general theories of learning, decision-making and adaptation to psychological stress. This theory is extended into a practical model that provides a comprehensive explanation of the relationships between the activities of genetic counseling and informed decision-making, which is assumed to be a major element of healthy counselee adjustment. Implications of this theory for the genetic counselor, the counselee and the assessment of clinical and program success are discussed.