Specific Objectives
1.Demonstrate basic communication skills
necessary for effective counseling in FP
2.Demonstrate counseling that is required in
FP services
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Objective
By the end of the module, participants will be
able to demonstrate the basic counseling
skills for FP use
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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
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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
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Communication skills
Ability to:
Create an atmosphere comfortable to the
client
Present information clearly
Encourage questions
Listen and observe attentively
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Communication Skills Cont……
Guide counselor-client interactions
Speak the client’s “language”
Ask questions effectively to encourage the
client to share information and feelings
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Counseling Skills
Active listening
Positive body language
Constructive feedback
Paraphrasing
Seeking clarification
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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
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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
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Do’sCont………….
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
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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.
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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
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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
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What impressions do these body languages
suggest to the client?
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What impressions do these body languages
suggest to the client?
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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.
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Examples of Verbal Encouragement
I see
I understand
I get it
That’s clear
Uh-huh
I hear you
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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)
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Use of simple language and visual aids
Female anatomy:
What is the simple language for:
Cervix
Clitoris
Fallopian tubes
Ovaries
Uterus
Vagina
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Use of simple language and visual aids cont..
Male anatomy: What is the simple language
for:
•Penis
•Prostate gland
•Scrotum
•Semen
•Testis
•Vas deferens
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Use of simple language and visual aids cont..
What is the simple language for:
Menstruation
•Fertilization
•Pregnancy
•Abortion
•Miscarriage
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Paraphrasing: Definition
Paraphrasing is “restating what the
speaker said in different words in
order to demonstrate attention and
encourage the speaker to continue”
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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?
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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.
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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
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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?”
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Guidelines for Paraphrasing
Listenfor 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 statementsthat the
client may have made about herself/himself
Use paraphrasing sparingly(usually use when
client hesitates or stops talking)
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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.
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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?
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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)
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Counseling Approaches
GATHERis 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
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REDI Approach
REDI Approach
R -Rapport building
E -Exploration
D -Decision making
I -Implementing the decision
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Steps of REDI
Step one: Rapport building
Welcome the client
Make introductions
Ensure confidentiality
Help the client to relax and feel
comfortable
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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
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Steps of REDI Cont..
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
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Steps of REDI Cont..
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
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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
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Barriers to Effective Counseling
Assignment :Brainstorm
1.Factors that affect counseling process
2.How to overcome these barriers.
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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
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