1. Diagnosis - verify psychiatric diagnoses in affected individuals.

2. Family History - obtain complete and accurate family history.

3. Risk of Recurrence - in the absence of a clear mode of transmission, refer to established empirical risks for specific disorders.

4. Evaluation of the Consultand - assess consultand’s emotional and intellectual capacity prior to proceeding with counseling. 

5. The Risk/Burden Ratio - assess consultand’s understanding and willingness to negotiate various risks and burdens.

6. Forming a Plan of Action - help consultand to arrive at a decision most consistent with his/her priorities and world-view.

7. Follow-up - continued assessment of the consultand’s understanding of pertinent information and follow-up of life events.

(Adapted from Tsuang MT.  Genetic counseling for psychiatric patients and their families.  Am J Psychiatry 1978;135:1465-1475.)