Is it Feasible?: Self-Affirmation for Hereditary Breast and Ovarian Cancer Genetic Counseling

Background: Some women have a high chance of developing breast and ovarian cancer because of a change in a gene that is passed within a family from one generation to the next. These women with hereditary breast and ovarian cancer (HBOC) have to make hard choices about tests and treatments. Researchers want to study how to help women to feel ready to make those choices. A kind of writing exercise might help if it is done before genetic counseling. This writing exercise is called a self-affirmation (SA) exercise. It may lead to better communication during counseling and better behavioral outcomes. Objective: To see if an SA exercise done before HBOC genetic counseling could improve client communication and behavior. Eligibility: * Clients: Adult female \>=18 years of age with initial appointment for HBOC risk with genetic counselor at St. Luke's Health System * Genetic Counselors: Genetic counselors \>=18 years of age providing genetic counseling to clients at risk for HBOC Design: Clients will be screened by phone prior to their genetic counseling appointment. They will arrive 15 minutes early to their appointment. They will do a 10 to 15 minute survey and writing exercise. This includes questions about: * Things that are important to them * How they are feeling prior to the appointment After their genetic counseling appointment, they will take a 10- to 15-minute follow-up survey. It can be in the office or online. It will include questions about: * How they felt about the writing exercise * How they felt about their genetic counseling * If they had cancer * If they were offered and had genetic testing Genetic counselor participants will take a 2 to 5 minute survey after each session with a client in the study. This will include questions about how the client was in the session. They also will take a 10 to 15 minute survey at the end of the study. It will be about their opinions on the process of having their clients complete the writing exercise.

Sex

Female

Minimum age

18 Years

INCLUSION CRITERIA:

Client Participants:

* Must be female, at least 18 years old
* Have an initial appointment for genetic counseling for HBOC risk at St. Luke's Health System
* Must be able to read and write in English to participate
* Pregnant women will be included

Genetic Counselor (GC) Participants:

-Must be certified GCs who see clients with an indication for HBOC related genetic counseling at St. Luke's Health System

EXCLUSION CRITERIA:

* Non-English speakers and illiterate subjects will be excluded
* Clients who are unable to provide consent will be excluded

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