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Genetic testing

Genetic counselling: what happens

What a genetic counselling appointment actually involves - and why it surrounds every serious genetic test.

Key facts

At a glance

  • What it is: a structured conversation with a genetic counsellor or clinical geneticist - information and decision support, never persuasion.

  • Before testing: your family tree is mapped, the right test identified, and every possible category of result talked through in advance.

  • The decision is yours: declining or deferring a test is a respected outcome of counselling, not a failure of it.

  • After testing: results are explained in context - including uncertain variants - with a written summary and a plan for relatives.

  • Practical ground covered: insurance rules under the UK code, how to tell family members, and implications for children and pregnancies.

The full picture

What this test involves, and how to get it

Genetic counselling is decision support, not gatekeeping - and emphatically not persuasion in either direction. A first appointment typically maps a detailed three-generation family tree, establishes what question genuinely needs answering, and identifies which test (if any) can answer it. The heart of pre-test counselling is rehearsing the future: what a positive result would open and close, what a negative result would and would not guarantee, and how to hold an uncertain variant - because tests return three kinds of answer, not two. Time, family logistics, children’s interests, and the distinct UK insurance rules for predictive testing all get airtime. People regularly conclude that testing is not right for them, or not yet; counselling counts that as success.

Post-test counselling turns a result into a plan: surveillance or prevention where findings are actionable, cascade testing for relatives (with practical help on how to tell them - a harder task than most anticipate), reproductive options where relevant, and written summaries you can share with GPs and family. Counsellors are specifically trained for the emotional terrain - guilt about what has been passed on, relief with survivor’s edge, family friction over who wants to know. NHS genetic counselling accompanies testing through regional genetics services, with waits varying by urgency and region; private genetics clinics offer counsellor- and consultant-led appointments within weeks, and any private test worth taking for a serious condition should come wrapped in exactly this structure - if a provider offers sequencing without counselling, that is a reason to choose a different provider.

A quiet reminder

This guide is for information, not medical advice.

Your own clinician knows your history and can tell you which parts apply to you. Next review of this page: 2027-09-27.

Frequently asked

Common questions about Genetic counselling: what happens.

Quick, plain-English answers to what people ask us most.

  • What is genetic counselling?

    Genetic counselling is a conversation with a specially trained healthcare professional to discuss your personal or family history of a genetic condition, explore what genetic testing can and can't tell you, and understand what any results might mean. It combines medical information with emotional and practical support.

  • Why would someone have genetic counselling?

    People seek genetic counselling for many reasons: a family history of a hereditary condition, planning a pregnancy, considering genetic testing, or trying to make sense of a result they've already received. It helps you make informed, personal decisions rather than facing complex information alone.

  • Do I need to prepare for it?

    It helps to gather as much family medical history as you can beforehand, including which relatives have been affected by particular conditions and roughly at what age. Your counsellor may also send you a form to complete in advance to make the best use of your appointment time.

  • What happens during a session?

    You'll talk through your family and personal medical history in detail, and the counsellor will explain relevant genetic concepts, testing options, and what results could mean for you and your relatives. Sessions are conversational and paced around your understanding and questions, often lasting 45 minutes to an hour.

  • Does it have any risks?

    There's no physical risk, as genetic counselling itself doesn't involve any procedures. Some people find it emotionally challenging to discuss family history or the possibility of certain conditions, which is exactly why counselling support is built into the process.

  • How long does it take to get through the process?

    The counselling session itself is usually a single appointment, though if testing is arranged afterwards, that will have its own separate timeframe for results, often a few weeks.

  • What happens after the consultation?

    You and your counsellor will decide together whether testing is appropriate, and if so, what type. If you decide not to test, you'll still leave with a clearer understanding of your risk and options for the future.

  • How much does it cost privately, and is it available on the NHS?

    Genetic counselling is available on the NHS through regional genetics services, usually via referral, though waiting times can be considerable depending on your area. Private genetic counselling can typically be arranged much more quickly, with cost varying by provider.

  • How reliable is the advice given?

    Genetic counsellors are highly trained specialists who base their guidance on established genetic and family risk assessment methods. That said, genetics is complex and risk estimates are often probabilities rather than certainties, which your counsellor will explain clearly.

  • How do I book it privately, and how quickly can I be seen?

    You can book a private genetic counselling appointment directly, often within one to two weeks.