An Effective Counsellor

• Believes in and is committed to the basic values and principles of family planning and client rights.
  
• Is accepting, respectful, non-judgmental, and objective when dealing with clients.
  
• Is aware of her/his values and biases and does not impose them on clients understands and
  
• Is sensitive to cultural and psychological factors (such as family or community pressures) that may affect a client's decision to adopt family planning always maintains clients' privacy and confidentiality.
  

Counsellor Skills and Techniques

An effective counsellor knows and possesses all technical aspects of family planning methods and can apply good interpersonal communication skills, and counselling techniques:

• A) Praise
  • Praise is the expression of approval or admiration.
  • Praising reinforces good behaviour by identifying and supporting the right things a client has done. For example, praising clients:
    • Shows that you respect their concern for their health
    • Acknowledges difficulties they might have overcome to come to the health care facility
    • Expresses approval for positive choices and actions
• B) Encouragement

  Encouragement means giving support, courage, confidence, and hope. In the health care setting, giving encouragement means letting clients or patients know that you believe they can overcome their problems and helping them find ways to do so. For example, encouraging clients:

  • Points out hopeful possibilities.
  • Focuses on what is good about what they have done and urges them to continue.
  • Tells them that they are already helping themselves by coming to the health facility.
• C) Asking questions during counselling - Why do we ask questions during FP counselling?
  • To assess the client's FP needs and knowledge.
  • To learn about the client's medical status, previous contraceptive use, personal circumstances, preferences, and concerns.
  • To actively engage the client and elicit information about his or her needs, interests, and preferences.
  • To establish a good relationship by showing concern and interest.
  • To prioritise the key issues to target during the time available for counselling.
  • To determine the educational or language level that will be best understood by the client.
  • To avoid repeating information that the client already knows.
  • To identify areas of misinformation, that needs to be corrected

  Closed-ended questions usually will be answered with a very short response, often just one word. A closed question calls for a brief, exact reply, such a yes or no or a number. Closed questions are valuable for quickly getting necessary information about the client's background, condition, and medical history. For example:

  • How old are you?.
  • How many children do you have?.
  • Do you have a method in mind?.
  • Are you confident that you can remember to take a pill every day?.
  • Is your house far from this clinic?.
  • When was your last menstrual period?.
  • Are you currently using an FP method?.

  Open-ended questions are useful for exploring more in-depth information as well as the client's opinions and feelings. They usually require longer responses and so are more effective in determining what the client needs (regarding information and emotional support) and what he or she already knows. Such questions often start with the words "How","What", or "Why." Examples of open-ended question include:

  • How can we help you today?.
  • What do you like about the method you want to use?.
  • What have you heard about the method?.
  • How would you feel if you experienced changes in your monthly bleeding?.
  • What do you think could have caused this problem?.
• D) Listening - Tips for active listening:
  • Establish and maintain eye contact.
    
  • Demonstrate interest by nodding, leaning toward the client, and smiling.
  • Sit comfortably and avoid distracting movements.
  • Pay attention to the client (e.g., do not engage in other tasks while you are meeting with the client, do not talk to other people, do not interrupt the client, and do not allow others to interrupt).
  • Listen to the client carefully. Do not become distracted and think about other things or about what you are going to say next.
  • Listen both to what your clients say and to how they say it, and make note of the tone of voice, choice of words, facial expressions, and gestures.
  • Imagine yourself in your client's situation as you listen.
  • Allow for pauses of silence at times during your interaction so that the client has time to think, ask questions, and talk.
  • Encourage the client to ask questions. Help the client to continue talking by using expressions like "yes", "hmm", and "and then what?"
  • Repeat what the client has said. (Note, however, that exact repetition of what the client has said should be used sparingly. Instead, counsellors should use paraphrasing or reflect, as discussed below).
• E) Reflecting Is recognising and interpreting the client's feelings and integrating what has been said in the further discussion.

• F) Clarification Is asking questions to understand better what the client has said. These techniques convey to the client that the provider is listening to what she or he is saying, help the provider understand what the client has said, and encourage the client to continue talking.

• G) Paraphrasing Is restating what the speaker has said in your words to demonstrate attention and understanding, and to encourage the speaker to continue. The paraphrasing guidelines are as follows:
  • Listen to the speaker's primary message.
  • Give the speaker a simple summary of what you believe is the message. Do not add any new ideas.
  • Observe the client's response and use it as a cue that confirms or denies the accuracy of your paraphrasing, or asks the client to let you know whether you have correctly understood what he or she has said.
  • Do not restate negative statements that people might have made about themselves in a way that confirms this perception. If someone says, "I acted foolishly in this situation," it is not appropriate to say, "So, you feel foolish." Instead, you can try to understand the situation better by asking questions.
  • Do not overuse paraphrasing.
  • Your objective is to encourage the person to continue speaking.