September 2006 — FHI 360 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:
- Assess the emotional state and general condition of the client
- Identify key issues or problems and assess their importance
- Explore options to address these issues
- Agree on a plan of action
- 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, health care 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.
