1. Types of Counseling Algorithms. Session 17 Presentation 17

2. In previous sessions: Types of questions: open, closed, qualifying. Analysis of mistakes during counseling. How to behave during counseling. Characteristics of a counselor: – Qualities – Skills – Knowledge – Resources Presentation 17

3. During this session: Types of counseling algorithms Importance of understanding different approaches Multiple use and overlap of counseling algorithms Practicing different approaches Presentation 17

4. Levels of counseling Macro Medium Micro Presentation 17

5. Levels of counseling Macro – Case-management – Pre-post test counseling (various kinds of tests) Medium – Subject of counseling: HIV test, STI – test, drug use, reproductive health of IDUs, etc. Micro – Specified subject of counseling (topic focus): what exactly about drug use are you going to talk? Presentation 17

6. Levels of counseling: time frame Macro – Up to several month Medium – Up to several hours Micro – From several hours to several seconds Presentation 17

7. Levels of counseling graphically Levels do not exclude each other. Some level may overlap. Macro level will always overlap with medium and micro level. Medium level will always overlap with micro level. Only micro level can be used individually. Presentation 17 Macro level Medium micro

8. Which levels in you work do you use most often? Presentation 17

9. Medium Level RequestHistory Risk AssessmentIEC Solution/decision making Client’s question Collecting data/information about client Collecting data on risksProvision of specific information Next steps development or back to client’s request (different request) Presentation 17

10. Micro Level Consider Handout 17.1. Micro counseling algorithm Presentation 17

11. Micro Level Algorithm provides with the information necessary to cover in order to highlight the topic. Algorithm is a structure to give a structured answer, however, it does not mean you have to go through all the steps of the algorithm! One algorithm can easily overflow into the other. The main rule is not to stop in the middle of the block! Presentation 17

12. Risk Assessment RA is common for all levels of counseling. Risk Assessment is a part of counseling process that is designed to help clients to estimate their risk or the risk of their partners associated with injecting and sexual practices, as well as possibilities of increasing/reducing those risks. Presentation 17

13. How to do Risk Assessment? Situation analysis – asking questions about – Practices of using drugs/alcohol – Sexual behavior – Relationship with partners – Other factors Presentation 17

14. How to find solutions? Provide a client with information that will help him/her to make a decision with respect to risk reduction. Provide a client with possible solutions, available services. Presentation 17

15. Implementation phase Make a plan together with the client. Do not scare a client away with too ambitious goals. Presentation 17

16. Difficulties of risk assessment for a client Usually all people underestimate their risks Illusion of being lucky Fatalism Problems/tasks that are of high priority Falls understanding/myths about certain risks Traditional gender roles and expectations Impact of drugs/alcohol Presentation 17

17. Counseling Instruments Questions Reassurance Paraphrasing and generalizing Empathy Pauses, silence Information provision Interpretation to make unclear - clear Confrontation – do not use if not sure how! Feelings of a counselor and being open – but be careful to be too open! Structuring counseling - make sure your plan coincides with the client’ expectations. Ongoing process through the hole counseling. Finishing counseling – usually happens naturally; if not – use techniques to finish it. Presentation 17

18. Exercise A group of three: One “counselor” One “client” One observer Task: Consult your partner on the topic indicated in the handout. “Client” must not agree or disagree for the sake of the game but using logical arguments Observer uses “observation form” to evaluate the counseling process of a colleague. Presentation 17