There is a growing body of literature considering genetic counselling services in a variety of clinical settings. This literature encompasses both predictive and diagnostic testing, from the viewpoints of service providers and recipients. It also embraces a wide range of conceptions of the nature and goals of genetic counselling. However, research in this area has been criticised for a focus on outcome rather than process, and it has been suggested that this focus limits its practical use. The purpose of this review is twofold: (1) to describe the varying concepts of counselling which appear to be utilised in published work and (2) to discuss the possible applications of this work to practice.