1. IDU TI Counsellor - Roles and Responsibilities

2. 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

3. 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)

4. 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

5. 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.

6. 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

7. 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.

8. 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

9. 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

10. 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

11. 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.

12. 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.

13. 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.

14. 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

15. 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.

16. 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.

17. 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

18. Thank you