FHI - FHI/Namibia Publishes Community Counselor Training Toolkit

OCTOBER 2007 — FHI/Namibia has developed a novel, client-centered approach to training community counselors that enables them to focus on the whole person. This means that counselors put HIV infection in the context of clients' lives, rather than isolating their sexual behaviors, risk patterns, or treatment needs.

This approach provides a universal framework that is applicable to a wide range of HIV services, from counseling and testing through prevention of mother-to-child transmission and adherence. For each type of service, counselors follow five steps:

1) assess the emotional state and general condition of the client
2) identify key issues or problems and assess their importance
3) explore options to address these issues
4) agree on a plan of action
5) organize follow-up to continue the process

To build essential counseling skills, the training uses a wide range of experiential and participatory learning exercises, discussion, practical examples, and role plays. The course also strengthens the capacity of providers to deliver comprehensive services within an interdisciplinary team that optimizes the contribution of all members. Within this context, healthcare providers primarily focus on medical options, providing specific factual health information at appropriate times and diagnosing and treating medical problems. Community or lay counselors focus on emotional and psychosocial support and ensure that clients understand important health-related issues. Counselors thus support their clients in any targeted behavior change, such as risk reduction, adherence to antiretroviral therapy, safe infant feeding, and positive living.

Download PDFs below.

Community counselor training toolkit: a facilitator guide and six modules

Facilitator guide. This guide introduces the entire training toolkit, and contains information on the methodology, philosophy, and focus of the curriculum. The guide should be read prior to facilitating any of the toolkit modules.

Module 1: Personal growth. This module helps participants explore their own thoughts, feelings, values, and attitudes, and walks them through the process of understanding and accepting themselves, since self-acceptance provided the basis for developing empathy and accepting others. By reflecting on and analyzing their own experiences, participants not only develop important counseling skills, but facilitators can assess whether participants are capable of becoming good counselors. Experiential learning from this module is continually referenced in the other sections. Facilitator Guide. Participant guide.

Module 2: Basic counseling skills. This module focuses on essential counseling skills required for all types of counseling, particularly those using a client-centered approach. The emphasis is on practicing the fundamentals, including listening, reflecting, probing/action, and problem-management skills. These are used to build trust, develop empathy, assess the emotional state and general condition of the client, identify and assess the importance of key issues or problems, explore options to address these issues, agree on a plan of action with achievable objectives, and organize follow-up sessions to continue the counseling process. Facilitator guide. Participant guide.

Module 3: General HIV, including sex education and sexuality. This module lays out important topics and general information related to HIV, such as prevalence, transmission, prevention, and the natural course of the disease. Some sessions focus on emotional aspects of the disease, which are then integrated into a counseling framework. The emphasis on sexuality and relationships is required, since sex is the most common mode of transmission in Africa, and counselors must be comfortable discussing issues related to sex and sexuality. Trainees need to explore their personal values related to sexuality and sexual behaviors before working with clients with different values and sexual behaviors.
Facilitator guide. Participant guide.

Module 4: HIV counseling and testing. This module incorporates client-centered counseling into general voluntary counseling and testing topics. Community counselors are encouraged to use the existing counseling and testing outline as a starting point, rather than a fixed protocol. Participants apply skills acquired during previous modules to the specific settings of HIV counseling, testing, and follow-up.
Facilitator guide. Participant guide.

Module 5: Adherence counseling for HIV treatment. This module applies basic counseling skills to help clients manage HIV at different stages of the disease. The counseling includes preparing clients for prophylaxis, treatment of opportunistic infections, and antiretroviral treatments, as well as working to achieve and maintain optimal adherence with clients who return for follow-up visits. Facilitator guide. Participant guide.

Module 6: Counseling and prevention of mother-to-child transmission. Preventing mother-to-child transmission involves infant-feeding counseling, counseling and testing, and counseling that supports mothers to make realistic choices about positive living, HIV prevention, and family planning. Facilitator guide. Participant guide.