Health Education in Primary Care

- Counseling

Counseling is a direct communication process through which one or more persons provide guidance and support to an individual or group in identifying needs and making appropriate decisions, according to their circumstances and needs, that support the adoption of healthy behaviors.

Objectives of Counseling

• Clarify the options available to users of different health services.
• Deliver the intended messages to the target audience.
• Encourage individuals and groups to think about their problems.
• Help individuals and groups understand the causes of a problem and the factors that influence it.
• Help individuals and groups propose appropriate solutions.
• Enable service users to make sound, informed decisions that are appropriate for the family.
• Support individuals and groups in taking the necessary actions to solve their problems.

Basic Steps of Counseling

• Good interview (establishing a positive relationship with the woman).
• Questioning (collecting information and listening).
• Education (presenting and explaining information).
• Selecting the most appropriate alternatives (supporting decision-making).
• Implementation guidance (explaining how to carry out the decision).
• Counseling follow-up (planning the next steps).

 

Characteristics of an Excellent Counselor:

• Believes in the importance of health messages for all members of the community.
• Has knowledge of reproductive health, family planning, and sexually transmitted infections, as well as current trends and changes affecting families' needs for reproductive-health and family-planning services.
• Has the willingness and enthusiasm to help the client.
• Possesses communication skills, including active listening, non-verbal communication (body language), effective questioning, and clear presentation of information.
• Demonstrates appropriate attitudes and behaviors, including avoidance of premature judgments, patience, open-mindedness, suitable respect, and concern for the client's best interests.
• Maintains an ongoing commitment to self-directed learning, particularly learning from mistakes, and continually develops professional skills.
• Is open to different cultures and ways of life.
• Understands the culture, customs, and values of the populations targeted by the service.

Appropriate Environment for Conducting a Counseling Session in the Clinic:

The service provider should make the client feel comfortable and cared for and should provide an environment that ensures privacy. This allows the client to feel safe and discuss needs openly and comfortably.

• Counseling may be conducted in the medical examination room or in a designated counseling room, provided that sufficient privacy is available to ensure confidentiality for the woman or the couple.
• Ensure that the room contains adequate seating for the client, her husband, or a companion if requested, and arrange the furniture to facilitate communication between the counselor and the client.

 

Procedures for Conducting a Counseling Session:

·       When meeting the client, show interest, offer an appropriate greeting, and introduce yourself by name and professional title.

·       Reassure the client that all information disclosed will be treated as strictly confidential.

·       Ask the client about the reason for the visit and identify her needs.

·       Explain that the questions are being asked to help meet her needs.

·       Focus the discussion only on the client's needs and avoid unrelated topics that are not important to her.

·       Use clear language and words that the woman can understand easily.

·       Use the educational aids available in the clinic, such as the educational-aids display, flip chart, and brochures.

·       Encourage the client to speak freely and ask questions. Listen carefully and demonstrate attentiveness through positive body language.

·       Maintain effective eye contact, while recognizing that direct eye contact may not be acceptable in some communities.

·       Allow the client sufficient time to express her ideas and make her own decision.

·       Respect periods of silence when the client is thinking deeply, and respond supportively.

·       Be aware of known or possible cultural differences between you and the clients, and ask for clarification when additional information is required.

·       Do not write and listen at the same time. Give full attention to listening, then record your notes.

·       Answer clients' questions objectively.