Empathetic communication of test results to a patient is critical. Testing may be useless unless the resulting communication and counseling are effective. The goal is to ensure that the test information is appropriately enrolled in both the care of the patient and the patient's perception of health. Practical techniques for ensuring effective counseling are provided, together with descriptions of resources available to the health care professional. A detailed discussion of counseling and health care objectives in testing for cancer syndromes is presented. © 2006 John Wiley & Sons, Inc.