Interview with a Genetic Counselor – NPE & Ancestry Testing

Interview with Brianne Kirkpatrick – Founder of Watershed DNA

“The DNA in your body is 99.9 percent identical to 99.9 percent of other people’s DNA. What about the other 0.1 percent? Variations in this tiny portion of our DNA explain why individuals have different health risks, resemble relatives and can sometimes be identified as belonging to particular ethnic groups.” “Ancestry testing” is a category of DNA testing that has grown in popularity in recent years. People order this type of at-home DNA testing to answer questions like: “Where did my ancestors originate?” and “Can I find relatives using DNA testing?” Many people are interested in answering both of these questions. – As described by Brianne Kirkpatrick

Brianne Kirkpatrick is a Genetic Counselor, DNA coach, author, and founder of Watershed DNA. Brianne’s combination of skill and compassion enable her to support people in the aftermath of a surprise DNA discovery. She guides people uncovering a situation of NPE (not parent expected), coaches those preparing to share a DNA secret, and assists those attempting to search for biological family find the right path forward. An alumnus of Indiana University and Northwestern University, Brianne is a member of the National Society of Genetic Counselors, American Board of Genetic Counseling, American Counseling Association, and International Society of Genetic Genealogy.

As the home DNA test marketplace continues to grow, the role of the genetic counselor is likely to evolve dramatically to include assisting clients with the interpretation of and adaptation to these results, as well as advising the companies involved in this sector on the ethical, legal, and social issues associated with this testing. The value of having genetic counselors involved in the home DNA testing setting has been identified by a number of professional societies (NSGC 2015a; ACMG Board of Directors 2016). (find links to more such articles by Brianne at the bottom of this blog post)

Relevance of Ancestry Testing to Genetic Counselors

Ancestry testing lies at the intersection of genealogy and genetics. Genealogy, the tracking of familial lines through documentation of marriages, births, and adoptions, is the second most common hobby in the United States (Farnham 2012). The value of integrating genealogy studies for health and genetic studies is growing in recognition, as demonstrated by a growing list of scientific publications (Cannon‐Albright et al. 2013; Carbone et al. 2015; Daya et al. 2013; Norton et al. 2013; Scholand et al. 2013; Stefansdottir et al. 2013; Zaitlen et al. 2013).

Below I am including information from an article where Brianne Kirkpatrick states some important notes for genetic counseling and the future for Genetic counselors in Ancestry testing. I believe this will be of key relevance along with the interview session to get a good overview of the relation between genealogy and Genetics, of Genetic counseling to Ancestry and how this could also be a potential area in Genetic Counseling:

Guidance for Genetic Counseling in Scenarios Involving Ancestry Testing

Practice guidelines for genetic counselors do not yet exist for ancestry testing. Until guidelines are available, we offer some thoughts for best practices.

  • Support and validate the client’s desire to understand more about genetics and the implications of DNA discoveries for themselves and their family members.
  • Consider your responsibility as the Genetic Counselor – determine is this inside of my specialty or not? Recall that discussing the benefits, limitations, and residual risk associated with genetic testing is within the competencies of all counselors.
  • Ancestry testing is a significant part of the home DNA testing market and as such, genetic counselors have a responsibility to learn about the testing; when someone has questions, listen, validate, support them, and seek additional resources and information.
  • Acknowledge the value of ancestry testing as a tool for exploring identity, ethnicity, family, relationships, and how they can connect to health. Do not fall into the trap of seeming dismissive of someone’s choice to pursue testing.
  • Briefly inquire into the goals of the person ‐ could the information be obtained another way? Is the answer they are seeking available from ancestry or other DNA testing?
  • Ask, will you know where to go if you have questions or need support after testing?
  • Answer the questions you can, and refer if the client desires additional genetic counseling beyond your scope of practice; search the “Find a Genetic Counselor” tool for GC’s who list Personalized Medicine and/or ancestry testing as a specialty.
  • Understand and point out benefits of genetic counseling services, such as the provision of information, supporting improved communication between family members, and enhancing psychological well‐being.

Future Directions of Ancestry Testing and Paths for Genetic Counselors

There is a tremendous amount of work already in function and progress on relating Genealogy to Genetics considering the large amount of genomic databases coming from customers from a precedent setting and a place not described before in medical research.

From what we’ve learnt through the interview and the growing cases and interests in Ancestry testing, in NPE people, it is highly evident that there will be growing opportunities for the integration of genealogical research and ancestry testing, genetics research, and healthcare. There are many possible roles for genetic counselors in an expanded future of genetic genealogy. Genetic counselors have already begun to serve in roles for research groups in this niche. 

 Just as genetic counselors are employed at increasing numbers by commercial laboratories, a future with genetic counselors employed at genealogy firms, ancestry companies or startups entering this sphere is likely. The value of the genetic counselor’s skills are clearly evident.Communication of complex information for a variety of audiences is a core feature of the successful graduate from a genetic counseling training program. Project management and leadership, provision of psycho-social support, research and writing skills, case development and follow‐through, and resource identification for customers are a few of the many other skills of a genetic counselor that fit with the needs of companies in this market.

Related publications:

DNA, Ancestry Testing and You – Brianne E. Kirkpatrick

Ancestry Testing and the Practice of Genetic Counseling – Brianne E. Kirkpatrick, Misha D. Rashkin

Meet Brianne Kirkpatrick, Watershed DNA Founder

When the DNA Test Reveals Too Much

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