IDU TI Counsellor - Roles and Responsibilities

Introduction Working in an IDU TI is a multi-disciplinary approach Different cadre of staff Multiple functions are required to be fulfilled A given staff has to perform multiple roles The role of each cadre of staff should be clearly delineated and discussed to prevent confusion/conflict in execution of work 2Before initiating the session, the facilitator will ask the counsellors to enumerate the major services and activities required to be provided by the IDU TI. A two column table will be drawn on a chart paper, and the responses on services/activities will be noted down in the left column. The facilitator will then ask the participants on who can be the appropriate staff to conduct each of the activity, and note down the responses against each of the activity/services. Pl. note that a given activity will be carried out by more than one staff. After this is noted down, the facilitator will proceed to present the slide, by stating that as discussed now, an IDU TI has multiple responsibilities as well as different cadre of staff. One cadre of staff will perform multiple activities, and hence a co-ordinated response is required for smooth functioning, and the roles and responsibilities should be clearly delineated from the beginning to avoid confusion/conflict

Who can be a counsellor? - NACO guideline The counsellor should preferably be a post graduate in Psychology, MSW or Graduate with minimum two years experience in counselling or working with HRG (Revised TI costing guidelines, NACO, 2009) The counsellor should have a Bachelor’s degree in psychology/social science/humanities. If the counsellor is from drug using background, he / she should have completed higher secondary education with training in counselling. Those who have received training in counselling and prior experience of working with drug users are preferred (Standard Operating Procedure for OST implementation, NACO, 2008)

Counsellor – Roles & Responsibilities Broad areas of activities Counselling both in DIC & in outreach setting Referrals and networking Advocacy Manage DIC Conduct training & capacity building Record maintenance

Roles/Responsibilities – Counselling in DIC Baseline assessment of an individual client Emphasis on psychosocial functioning Ensure that the client is screened for STIs & general medical conditions by medical staff Provide different forms of counselling: Motivational counselling, Risk reduction counselling – injecting & sexual HIV related counselling Drug related counselling – detoxification, OST, Relapse prevention, etc.

Roles/Responsibilities – Counselling in DIC Counsel spouse/family members of IDU clients & provide family counselling Rule out co-morbidity among IDUs and counsel for co-morbidity, including appropriate referrals

Roles/Responsibilities – Counselling in outreach setting Accompany the outreach staff in the field and provide counselling as required Carry out home visits, as and when required Link the spouses and family members of the IDU clients to the IDU TI programme The facilitator should generate a discussion on how is outreach conducted in the IDU TI. After eliciting responses from a couple of participants, the facilitator should proceed to the next slide.

Roles/Responsibilities – Counselling in outreach setting Conducting outreach: steps – Involves outreach planning by the TI team Mapping of places/spots where IDUs are likely to be found – social mapping Visiting the spots and contacting the IDUs Analyse the hotspots to know the injecting/sexual practices of IDUs – spot analysis

Roles/Responsibilities – Counselling in outreach setting Determining the number of IDUs known to the project staff – contact mapping Deploying outreach staff in accordance with the number of IDUs and hotspots – work plan Service delivery by outreach team Needle/syringe exchange Risk reduction materials, including condoms Referrals Counselling

Roles/Responsibilities – Counselling in outreach setting Outreach by counsellor Plan outreach services along with the outreach team and PM Aim to cover all hotspots in a given time frame (e.g. one month period) Prioritise those hotspots which are more ‘hot’ i.e. more risky practices are encountered Convey the dates and timings to the outreach team which covers the particular hotspot

Roles/Responsibilities – Counselling in outreach setting Outreach by counsellor Provide services in outreach Conduct group counselling Build motivation of those IDUs who are not ready to avail services Motivate to seek services in DIC Motivate for other services, e.g. testing, ART services, etc.

Roles/Responsibilities – Referrals and networking Referrals for STI check up, ICTC, ART and other relevant services Link up with the services/service providers in the vicinity for vocational training, night shelter, detoxification and rehabilitation centres, etc.

Roles/Responsibilities – Entities for networking Health care providers ICTC ART STI DOTS for TB CCC Detoxification/rehabilitation centres Diagnostic labs Hospitals Other services Agencies implementing income generation programmes Agencies providing nutrition, educational and vocational support Agencies/charities providing food, shelter, clothing, etc.

Roles/Responsibilities – Steps in Referrals/networking Map service agencies Prepare a simple database Meet the key person in each agency Inform about the TI work, advocate for humane services for IDUs Display the service map & directory in the DIC Establish a system of referrals

Roles/Responsibilities – Referrals/networking Role of counsellor Accompany the PM in meeting the key person Assist in preparing database of referral agency Regular meeting with the referral agency Personally F/U with the counsellors of the following agencies ICTC, ART, Detoxification/rehabilitation centres, TB centre, OST centre, etc.

Roles & Responsibilities Manage DIC – usually managed by counsellor / programme manager Ensure systems are established in DIC functioning, e.g. where will the IDU be registered, who will the IDU interact with first, cleaning of the DIC, etc. Ensure enough commodities are available for the IDUs Ensure rules and regulations are established in DIC prepared in consultation with the clients Ensure staff are oriented on their roles Ensure help is available in case of emergency, e.g. emergency health problem among IDU clients, unruly behaviour of an IDU, etc.

Roles & Responsibilities Advocacy Assist the programme manager in conducting advocacy programmes Conduct training & capacity building Train the outreach staff on basic issues related to counselling of IDUs in the field Record maintenance Maintain records as required by the SACS and NACO

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