What leads to good counselling?

ABSTRACT

PIP Human immunodeficiency virus (HIV) counseling involves advising those who are facing an incurable, stigmatizing disease. The counselor needs to be emotionally stable and have respect for the patient's rights and dignity. The abilities to listen, communicate, keep confidentiality, and maintain a nonjudgemental attitude are all necessary. Institutions need to provide privacy and time for such counseling. Practical items (condoms, soap, bleach, plastic sheets, home care visits, and travel expenses) should also be provided. Training in counseling is useful for anyone involved in the care and support of HIV patients. Skills include the ability to 1) explain HIV testing, prevention of sexually transmitted disease (STD), and family planning methods clearly, simply, and appropriately; 2) speak openly and frankly, encouraging the same in the patient, about sex; 3) listen and to allow time for the patient to talk; 4) ask nonleading questions that encourage patients to express feelings and to think about their life and personal relationships; 5) empathize; 6) give psychological support; 7) assist someone in making realistic decisions and in adjusting to change by drawing upon their resources; and 8) establish trust and to keep confidentiality. A training course should be limited to 20 participants who attend several workshops conducted over a few months. Group exercises, demonstrations, role plays, short talks, and videos should be mixed to allow participants to learn and practice skills. This should include an exercise allowing them to discover their own values, fears, and prejudices. Supervision by an experienced counselor is necessary during and after training. This includes dealing with the counselor's emotional reactions to counseling. A follow up workshop should be held a few months later, where difficult situations could be role played. Regular meetings with colleagues, supervision, and further training should be continued. Training courses should be evaluated through discussion, supervision, and questionnaires.^ieng