2. What is Counselling ?
HIV/AIDS Counselling is defined by
WHO as a dialogue between a client and
a care provider aimed at enabling the
client to cope with stress and to take
personal decisions relating to
HIV/AIDS.The Counselling process
includes the evaluation of personal risk
of HIV transmission and the facilitation of
preventive behaviour
3. Who is a Counsellor ?
• The individual person who provides
support and guidance is known as the
Counsellor and the individual who recieves
the support & guidance is known as the
Client
4. COUNSELING & PSYCHOSOCIAL SUPPORT:
Counseling is a face to face communication in which one
person helps another make decisions and act on them.
Counseling can be defined primarily a confidential dialogue
between a person in need and a case provider in an effort to
reduce the stressful impact of HIV/AIDS on the individuals.
The goal of this dialogue as part of the treatment plan is to
promote and maintain the maximum possible level of
psychological and physical well being.
The process of counseling includes providing information
that allows individuals to make decisions that reduce the risk
of transmitting the infection.
The counseling may also involve the spouse, family friends
and other who take care of HIV infected person and who see
themselves as being at risk of HIV infection.
5. QUALITIES OF AN EFFECTIVE COUNSELLOR.
1) Positive regard or respect for people.
2) Open, non judgmental and high level of
acceptance
3) Caring and empathetic.
4) Self-aware and self-disciplined.
5) Knowledgable/informed about subject and
awareness of resources available within the
community.
6) Culturally sensitive.
7) Patient and good listener.
8) Ability to maintain confidentiality.
9) Objective and having clarity.
6. COUNSELLING IS A TOOL, WHICH NEEDS TO BE USED VERY CAREFULLY AND
ACCURATELY. A LITTLE MISTAKE MAY DEFEAT ITS PURPOSE.
Hence the Counsellor : Should Do
VERBAL NON-VERBAL
Use language that the client understands Use a tone of voice similar to the clients
Repeat in other words and clarifies client’s
statements
Nod occasionally, uses facial
expressions
Explains clearly and sufficiently Use occasional gestures
Summarize Keep suitable conversational distance
Respond to primary message Not to speak too quickly or too slowly
Encourage, ‘yes, go on’
Address appropriately to the clients age
Give needed information
Use humor or other means of reducing
tension
Not to criticize or censure the client
7. Should not do
Verbal Non-Verbal
Advising Looking away frequently
Preaching and moralizing Keeping an inappropriate distance
Blaming, judging or labeling Sneering
Cajoling(persuading by flattery or
deceit)
Frowning, scowling and yawning
‘why’ questions. Interrogating Using an unpleasant tone of speech
Directing, demanding Speaking too quickly or too slowly
Excessive reassuring Moving around to much. Fidgeting
Straying from the topic Having a blank facial expression or staring
Encouraging dependence
Patronizing(condescending) attitude
8. Why is counseling Important?
In the context of the HIV/AIDS pandemic the goals of
counseling are
a) To support the ability of infected persons and those who
care for them.
b) To prevent the transmission to others. The trauma of the
disease of HIV infection or AIDS comes not only from the fact
that the disease is known to be fatal, but also that it is often
accompanied by social stigma and rejection. It is normal for
the patient to experience anger, fear and sadness when
confronted with a diagnosis of a terminal illness. These
patients are compounded with extreme feelings of guilt and
isolation. The fact that there is no cure means, the infected
person is confronted with fear, resentment and normal
coordination from family. Counseling is the main strategy for
dealing with the psychosocial consequences of AIDS
pandemic.
9. Why counseling is necessary:
The unexpected disclosures of HIV positive status may
precipitate various psychological reactions in a person
such as denial, guilt, anger, violent behaviour depression
and suicidal tendencies.
The patients relatives and family members may have
many questions to ask about when confronted with a
peculiar situation. The truth is to be reveled, information
is to be given, anxieties are to be alleviated a dialogue is
to be established and a patient is to be supported
psycologically. The patient during the course of the
disease may also develop neuropsychiatric problems.
This is why counseling is necessary in HIV infected
individual. Counseling cannot be done haphazardly
rapport has to be built between the patient and the
counselor.
10. Who can give counseling?
Any one who works with patient and families
can provide counseling. All health care
provider have the opportunity and
responsibility to provide psychosocial support
of this kind almost every time they talk to
clients.
Physicians are in a unique position to provide
such support in the form of basic counseling,
because they have already establish a
relationship with the patient and are usually
trusted.
11. When is counseling necessary?
Counseling is necessary before and after HIV
testing pretest counseling includes the
dialogues needed to obtain consent from the
individual for the test. After the test
counseling is indicated both for those who
are sero negative and for those with +ve test
result. HIV infected person who already have
AIDS , their families and friends will also need
counseling, prior to breaking the news. Those
with negative test result need counseling on
how to remain negative test result need
counseling on how to remain negative
through safer sexual behaviour.
12. How to counsel:-
Depending on the persons situation and
needs physician must be able to discuss the
following aspects of the HIV/AIDS.
a) the diagnosis
b) How HIV is transmitted
c) How to prevent HIV transmission
d) How to maintain the best state of health in
the face of HIV infection
e) How to take care of common HIV/AIDS
related problems.
13. Basic counseling skills.
a) Using the time & resource available
b) listening carefully & activity
c) Questioning effectively
d) Providing accurate information which is
complete
e) Respecting patients rights and
confidentiality.
f) Maintaining constant eye contact.
14. During counseling:
1) Listen to your client attentively
2) Be attentive to what he/she says
3) Maintain eye contact
4) Be non-judgmental
5) show genuine concern
6) Be patient
7) Maintain confidentiality
8) Explore High Risk Behaviour- IDUs, Blood
transfusion receives.
9) Explore test Implication – Explore test for
antibodies of HIV not AIDS
10) It the test positive?
