How to Talk with Families About Genetics and Psychiatric Illness
Language: English
Pages: 280
ISBN: 0393705498
Format: PDF / Kindle (mobi) / ePub
Addressing clients’ questions and concerns about the role of genetics in mental illness.
As we learn more about how our biology and genes can play into the development of a mental health disorder, patients and their families are increasingly seeking answers to tough questions about common risk factors, the likelihood of recurrence, the need for genetic testing, and implications for future generations.
A practical, go-to resource for all mental health clinicians, this guide explains just how to address these questions and concerns in a way that’s comprehensible and compassionate. Filled with case studies, sample dialogues, and question-and-answer examples, it is an essential roadmap for practitioners, helping them to demystify a complex issue for their clients and equip them with the accurate, reassuring information they need.
comfortable about their ability to support the principles of autonomy and beneficence when discussing causes of psychiatric illness and risks for family members. At present there is no genetic testing for psychiatric illness that is of sufficient clinical utility to warrant widespread use (Mitchell et al., 2010), so genetic discrimination against at-risk individuals based on genetic test results is not yet of concern. Close relatives of individuals with psychiatric disorders may still face
family). Consider using an analogy like the jar model to reinforce where the risk came from—for example, “Based on your family history, we can see that it is likely that your ‘jar’ is probably already partly filled with genetic vulnerability.” Finally, reassure clients that you understand how complex this information is and that you are willing to explain things several times and answer any questions. We encourage you to provide the client or family member with a written summary of the risk
them about the etiology and the likely risk based on their personal and family histories, taking care to ask each to verbalize how he or she perceived the risk. I stated that the issue of risk to their children was clearly important to both of them but that they were far from finding common ground, or even seeing merits in each other’s positions. Thus I suggested a referral to a marriage counselor to help the couple deal with the issue and invited them to re-contact me for additional education
Genetics, 149(3), 364–71 Parry, B. L. (2009) Assessing risk and benefit: To treat or not to treat major depression during pregnancy with antidepressant medication. American Journal of Psychiatry, 166, 512–14. Pedersen, C. B., & Mortensen, P. B. (2001). Evidence of a dose-response relationship between urbanicity during upbringing and schizophrenia risk. Archives of General Psychiatry, 58, 1039–46. Pfeffer, N. L., Veach, P. M., & LeRoy, B. S. (2003). An investigation of genetic counselors’
illnesses do not track predictably through the family, and multiple related disorders manifest. Table 1.1 provides several examples of such genetic syndromes. Even taken together, these syndromes account for only a very small proportion of all psychiatric illnesses. Strong scientific data support the idea that psychiatric illnesses are typically caused by the combined influences of both genetic and environmental contributions. The full range of, and exact mechanisms by which, genetic factors