16-Counseling-for-FP-lecture note Use.ppt

Imarisha Maisha
Counseling for FP Use

Specific Objectives
1. Demonstrate basic communication skills
necessary for effective counseling in FP
2. Demonstrate counseling that is required in
FP services
2

Objective
 By the end of the module, participants will be
able to demonstrate the basic counseling
skills for FP use
3

Definition
 It is a person to person interaction in
which the counselor provides adequate
information to enable the client to;
• work through particular problems conflicts, feelings
and helps find ways to resolve or cope with them
• make informed choice and guidance on making the
choice that best meets client’s needs and concerns
4

Purpose of FP Counseling
 To support a client and her/his partner in
choosing the method of FP that suits them
best and support them in solving any problem
that may arise in the process of selecting or
using the chosen method
 Counseling provides information,
clarifications, and opportunity to make a
choice

Qualities of a Good FP Counselor
 Personal qualities and attitudes
• Empathetic, genuine, respectful (unconditional positive regard)
 Knowledge about counseling
 Communication skills
 Knowledge related to the clients
 Knowledge and abilities related to contraception
 Knowledge related to the country’s systems of service
delivery
6

Principles of counseling
 Respect each client to create trust
 Interact
 Tailor information to the client
 Avoid too much information
 Provide the service that the client
needs/wants
 Help the client understand and remember
7

Communication skills
 Ability to:
 Create an atmosphere comfortable to the
client
 Present information clearly
 Encourage questions
 Listen and observe attentively
8

Communication Skills Cont……
 Guide counselor- client interactions
 Speak the client’s “language”
 Ask questions effectively to encourage the
client to share information and feelings
9

Counseling Skills
 Active listening
 Positive body language
 Constructive feedback
 Paraphrasing
 Seeking clarification
10

Counseling Skills- 2
 Appropriate/effective questioning
techniques
 Use non technical and simple
language
 Verbal and non-verbal
encouragement

What is Active Listening?
 Listening to another
person in a way that
communicates
understanding,
empathy and interest
 It is different from hearing
 Requires energy, skill and
commitment
 Makes the client feel
important, acknowledged and
empowered
12

Active Listening : The Do’s (Tips)
 Do’s
 Allow client to express himself/ herself
 Concentrate on what client is saying
 Allow client to control conversation
 Accept client’s opinion as valid for
himself/herself
13

Do’s Cont………….
 Pay attention to not only words but also client's
gestures and behaviors
 Prevent emotions from inhibiting active listening
no matter what the client is saying
14

Active Listening: Don’ts
 Do other things (e.g., look through papers)
when the client is talking.
 Daydream or get distracted by surrounding
events
 Interrupt/Finish the clients sentences
 Ask questions that change the subject.
15

Don’t Cont…………………..
 Rebut, criticize, or judge.
 Anticipate what the speaker is going to
say next.
 Ignore the emotional context.
 Become angry, defensive, or upset
16

Positive Body Language
 Body language includes:
 Body posture
 Position of body parts(arms, legs, eyes)
 Gestures
 Space
 Seating
 Active listeners use body language to
indicate respect, interest and empathy
 Body language may have different
meanings in different communities or
cultures 17

What impressions do these body languages
suggest to the client?
18

What impressions do these body languages
suggest to the client?
19

Verbal and Nonverbal Encouragement
 Definition:
 This involve the use of words, phrases
and gestures that indicate attention and
the wish for the person to continue
speaking.
20

Examples of Verbal Encouragement
 I see
 I understand
 I get it
 That’s clear
 Uh-huh
 I hear you
21
Any other examples?

Examples of Non-verbal Encouragement
 Nodding the head
 Mirroring the client’s
facial expression e.g.
 Smiling
 Laughing
 Frowning
 Showing surprise
 Others (in participants’
countries/communities)
22

Use of simple language and visual aids
 Female anatomy :
 What is the simple language for:
 Cervix
 Clitoris
 Fallopian tubes
 Ovaries
 Uterus
 Vagina
23

Use of simple language and visual aids cont..
 Male anatomy: What is the simple language
for:
• Penis
• Prostate gland
• Scrotum
• Semen
• Testis
• Vas deferens
24

Use of simple language and visual aids cont..
 What is the simple language for:
 Menstruation
• Fertilization
• Pregnancy
• Abortion
• Miscarriage
25

Paraphrasing: Definition
 Paraphrasing is “restating what the
speaker said in different words in
order to demonstrate attention and
encourage the speaker to continue”
26

Examples of Paraphrasing
 STATEMENT
 I want to use IUCD but my
sister says that it can travel
round the body and stick to
the baby’s head.
 Why do we have to collect
these statistics? we never
seem to do any thing with
them.
 PARAPHRASE
 You want to use IUCD but
you are not sure of its
effects on the body
 You are questioning the
need for collecting data
because you don’t see how
they are used. is that right?
27

Guidelines for use of Clarification
 Admit that you don’t understand exactly what
the person is telling you.
 Restate the message as you understand it,
asking if your interpretation is correct.
 Use phrases such as “do you mean…”, “are you
saying that…..”.
 Do not use clarification excessively.
28

Definition of Open-Ended and
Closed-Ended Questions
 Open-ended questions are:
 questions that cannot be answered by a yes or no.
 Begin with interrogative words e.g. who , what,
where, why and how.
 Closed questions are those that can be
answered by a yes or no
29

Appropriate Questioning
Techniques: Examples
 Closed questions:
 “Did you solve the
problem of the stock
out of the pill?”
 “Did you organize that
training course?”
 Open-Ended questions
 “What has been done
about the stock out of
pill?”
 “How are you going to
organize the training
course?”
30

Guidelines for Paraphrasing
 Listen for the client’s basic message
 Give the client a simple summary (do not add
new ideas)
 Observe a cue or ask for a response that
confirms or denies the accuracy of the
paraphrase
 Do not restate negative statements that the
client may have made about herself/himself
 Use paraphrasing sparingly (usually use when
client hesitates or stops talking)
31

Clarification : Definition
 Clarification is “asking questions in order to
better understand what the client said”.
 Similar to paraphrasing, but its purpose is to
ensure understanding rather than to motivate
the client to continue speaking.
32

Examples of Clarification
 STATEMENT
 We have traditional vasectomy
services here, but our caseload
is low. And they say that this
new NSV has fewer
complications.

 The majority of our clients use
the pill and seem to like it. But
with Norplant implants they
wouldn’t have to remember to
take anything .
 CLARIFYING QUESTION
 Are you saying that you believe
your vasectomy caseload will
increase if you introduce NSV
because the complication rate is
lower?
 Let me see if I understand you.
Do you mean that you are
thinking of trying to change your
method mix by adding Norplant
implants because your clients
might prefer a method that’s
more convenient for them?
33

Constructive Feedback
 Feedback can be:
• Negative- (overly critical,
causing hurt feelings)
• Positive- (supportive, causing
good feelings)
• Punitive -(focusing on
assigning blame)
• Constructive- (focusing on
solutions to the problem)
34

Counseling Approaches
 GATHER is an acronym used to remember the essential steps
of counseling
G - Greet in a culturally acceptable way
A - Ask about the client and her RH needs
T - Tell client about FP methods/RH services
H - Help client choose a method/service
E - Explain how to use the method
R - Return visit, schedule an appointment for routine follow-
up,what to do incase of side effects or any concerns
35

REDI Approach
 REDI Approach
 R -Rapport building
 E -Exploration
 D -Decision making
 I -Implementing the decision
36

Steps of REDI
 Step one: Rapport building
 Welcome the client
 Make introductions
 Ensure confidentiality
 Help the client to relax and feel
comfortable
37

Steps of REDI Cont..
 Step two. Exploration
 Introduce the subject of family planning
 Explore the clients’ needs, risks, sexual lives,
social context and circumstances
 Provide information about family planning,
dual protection, and HIV/STI transmission
 Assure confidentiality
38

 Step three. Decision making
 Identify decisions the client needs to make
 Discuss FP options, HIV/STI prevention and
dual protection for each decision made
 Weigh the benefits, disadvantages and
consequences of each.
 Assist the clients to make decisions that are
realistic for them to carry out
39

 Step four. Implementing the decision
 Make concrete, specific plan for carrying out the
decision
 Identify the skills that the client will need to
carry out the decision
 Practice the skills as needed with the provider’s
help
 Make a plan for follow up
40

Clients Rights
 Clients have a right to:
 Information
 Access to services
 Informed choice
 Safe services
 Privacy and confidentiality
 Dignity comfort and expression of opinion
 Continuity of care
41

Barriers to Effective Counseling
 Assignment :Brainstorm
 1.Factors that affect counseling process
 2.How to overcome these barriers.
42

Barriers to effective Counseling
 Age differences
 Language differences
 Education levels
 Values/beliefs relating to culture/Gender biasness
 Lack of privacy/ confidentiality
 Inappropriate non verbal behaviors
 Judgmental attitude
 Religious differences
43

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