Practising genetic counsellors in Perth join the Sydney team
Helen Mountain and Sarah Long are highly experienced clinical genetic counsellors based in Perth, Western Australia (WA). They have joined the Genetic Counselling team, each working one day a week, providing clinical supervision and teaching support to students.
Helen reflects that after 22 years as a genetic counsellor her “circuitous path towards genetic counselling is not what you would call a typical one!”
Sarah, a genetic counsellor for 12 years, has worked in prenatal, adult and familial cancer genetics with experience in paediatric genetics as well.
Tell us about your journey into genetic counselling.
Helen: My love of genetics started as a rural science undergraduate and postgraduate student. Later I worked in medical research and as a scientist in a molecular diagnostic laboratory where I was first introduced to the genetic counselling profession.
By then I had research and diagnostic experience and had gathered some life experience and was beginning to feel a pull towards the people behind the specimens.
A move from Brisbane to Perth enabled me to make the switch from the lab into the clinical setting. There were no Master’s courses then so I approached the Director of Genetic Services and he took me on as a locum genetic counsellor. I had amazing on-the-job training and completed counselling training and courses. After gaining experience through contract work I secured a permanent position and completed my certification with the Human Genetics Society of Australia (HGSA) Board of Censors. I have never looked back!
Sarah: I first heard of genetic counselling in third year biomedical science. At the time I was fascinated by the idea but didn’t know how to do the course while in WA. I later found that there was a distance education Graduate Diploma of Genetic Counselling so I studied and completed that, alongside working as a research assistant in a laboratory for a year, and then a year in oncology as a research data manager. I started at the Genetic Services of WA in a clinic coordinator role while I finished my practical. After several years I achieved Board Certification and look forward to taking my career to the next level by becoming a part of UTS.
How did you come to work in the Genetic Counselling Discipline at UTS?
Helen: I was involved in the initial consultation process for the development of the UTS course and was captivated by the philosophy behind it. I thought being in WA meant being involved in teaching was beyond my reach as my family’s roots are firmly planted in Perth for now. I became aware of the ‘live and online’ teaching methods and responded to a call for expressions of interest. I was pleased that I could offer what was needed, so with a bit of shuffling of other commitments and with support from my team at GSWA I joined the GSH in July 2019.
Sarah: I had been lecturing students occasionally and really enjoyed the teaching aspect. However being based in Perth where there is no genetic counselling course I didn’t see there was much opportunity to be able to teach on a more permanent basis. When I was offered the opportunity to teach and develop course content part time I was very excited to take up a new role as Associate Lecturer and the challenges it provides.
What do you enjoy most about your role, in one of the newest disciplines being established at the Graduate School of Health?
Helen: I really enjoy connecting with the students and watching their transition from the classroom into the clinical setting and developing their confidence and skills. I love that in my role as a genetic counsellor I am always learning and discovering new things. My GSH role takes this to another level where I am learning from the next generation of genetic counsellors! The technology and learning systems allow me to feel connected even though I am 3940 km away.
Sarah: Being part of developing the new course gives me a chance to share my experience and knowledge with the next generation of genetic counsellors. I love being able to work in an enthusiastic and knowledgeable team and reinforce my own learning and skills.
In your opinion, what do you think are the big or ‘wicked’ questions facing the genetic counselling profession at the moment? How do you think the profession can respond?
Helen: I question how we will remain connected to what drew me into the profession – the people. Explaining complex and challenging information to people who are in crisis or a heightened emotional state is difficult but this will becoming even harder in the genomic era. The information and need for informed consent can overwhelm both clients and counsellors and we can sometimes forget, or avoid, the more challenging emotions. I also wonder how these aspects will be addressed as genetic testing moves into mainstream medical practice. Genetic counsellors have a distinct skill set which makes us uniquely placed to adapt to new technologies whilst maintaining the underlying tenets of genetic counselling.
Sarah: I think the rise of direct to consumer testing and programs that claim to ‘interpret’ the data are very dangerous. A recent study showed around 50% of 'pathogenic' variants reported by these companies were false positives. People had already made decisions to have prophylactic surgery in some cases, so educating the general public about this issues is vital.
Also with the advent of panel testing (testing for many genes at once) interpreting results and whether the client would want to know about incidental findings keeps us on our toes. A good way to manage this is by having a very clear consent form outlining what will and won’t be communicated to the client is vital, but providers outside genetics who order online genetic tests may not know this is important. So educating medical professionals as well as the public has to be a priority.
I also think the need for reflective practice is extremely important and an aspect all genetic counsellors need to be focused on throughout their career.