Response to Costa, Lemos, and Paneque Letter to the Editor
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We are gratified to learn that the Reciprocal-Engagement Model (REM; McCarthy Veach et al., 2007) is the theoretical-practical basis of a quality assessment measure of genetic counseling in Portugal. Measures with demonstrated strong psychometric properties are valuable tools for research, training/supervision, and practice. Paneque et al.’s (2018) measure shows promise as a reliable and valid instrument for assessing genetic counseling practice. Their instrument adds to a growing body of research concerning the tenets, goals, and strategies that comprise the REM (e.g., Hartmann et al., 2015; Redlinger-Grosse et al., 2016; Redlinger-Grosse et al., 2017).
Many theories, models, and measures pertinent to genetic counseling lack empirical evidence regarding their cross-cultural validity. Indeed, the REM is grounded in the experiences and perceptions of predominantly White, Western practitioners, educators, and researchers. Paneque et al.’s (2018) work provides initial evidence that the elements of the REM extend across some cultures. The dimensions comprising their measure correspond to the REM elements of education, individual attributes, and relationship; and to REM tenets (fundamental assumptions of genetic counseling practice), namely, genetic information is key, patient autonomy must be supported, patients are resilient, patient emotions matter, and relationship is integral to genetic counseling.
Paneque et al.’s (2018) measure highlights the centrality of the genetic counselor-patient relationship. Relationship or “working alliance,” as it is known in psychological counseling fields, has been shown to be a powerful predictor of outcome (cf. Wampold, 2010). We expect that future research using Paneque et al.’s (2018) measure will show the quality of the genetic counselor-patient relationship significantly affects genetic counseling outcomes.
We wish Milena Paneque and her colleagues, and other researchers in Europe who have expressed interest in the REM, much success in their endeavors. We look forward to seeing what they discover along the way.
Pat McCarthy Veach and Bonnie S. LeRoy.
Conflicts of Interest
Patricia McCarthy Veach and Bonnie S. LeRoy declare that they have no conflicts of interest.
- Paneque, M., Costa, C., Lemos, C., Alves-Ferreira, M., Sequeiros, J., & Lemos, M. S. (2018). Portuguese tool for quality assessment of GC. Acta Médica Portuguesa, 31. https://doi.org/10.20344/amp.9997.
- Redlinger-Grosse, K., McCarthy Veach, P., Cohen, S., LeRoy, B. S., MacFarlane, I. M., & Zierhut, H. (2016). Defining our clinical practice: The identification of genetic counselor outcomes utilizing the Reciprocal Engagement Model. Journal of Genetic Counseling, 25, 239–257.CrossRefPubMedGoogle Scholar
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