It is tempting to begin this book about the psychological aspects of the speciality of medical genetics by focusing on the individuals and families concerned and to explore the effect or the personal meaning of having a genetic consultation. However, good medical training and, in particular, training in psychological principles begin with a wider view. It uses a wide-angled lens, rather than a more detailed focus, to explore and define genetic counselling. This means beginning by addressing how genetic counselling has developed into its present shape and looking at the context of its evolution. This sets the scene which is the context of the question of the nature of genetic counselling and how is it defined. This can be followed by looking at the range of the speciality and the motivation for seeking genetic counselling. With that back-drop, it is then possible to analyse the component parts of a typical genetic counselling encounter, discuss the function of the interview and ask why it takes its present form.

The context

Genetic counselling has evolved in the context of three different areas: advances in medical knowledge, changes in society and the basic human desire to have knowledge, to understand and to learn.

Advances in medicine and the study of diseases have progressed by refinements in clinical diagnosis and special investigations. The richness of knowledge about the factors involved in the development of diseases has necessitated divisions into specialities, which all come under the umbrella of medicine.