Types of Counselling and Guidance at VCT and PITC
PST 06102
:
Counselling and Guidance
Session
11
: Types of Counseling and Guidance provided
at VCT
, and PITC
1
Learning tasks
By the end of this session students are expected to be able to:
Describe
HIV Testing and Counseling Approaches in Tanzania
Explain
pre and post test counseling
Explain
prevention and disclosure counseling
Describe
bereavement counseling
2
HIV Testing and Counseling Approaches in
Tanzania
Different approaches to HIV testing and counseling exist in Tanzania as follow;
Client-Initiated
Counseling and Testing (VCT);
client voluntarily makes the decision
to learn
his/her HIV status and seeks for counseling and testing services out of his/her
own will
for the purpose of prevention of HIV infection and personal life decision making
Provider-Initiated
HIV Testing and Counseling (PITC);
HIV testing and
counseling which
is recommended by health care provider to person attending Health Care Facilities
as standard
component of medical care
3
Activity:
Buzzing
What are the
types of counselling and guidance provided at CTC?
4
Pre and Post Test Counseling
There are several types of counseling in relation to HIV Counselling and guidance. The
essence of
the different types of counseling and guidance is to provide guidance and counseling
in different
stages of HIV infection that the infected person and the relations go through.
The types
include: Pre-test counselling, post-test counselling, prevention counseling,
bereavement counseling
and disclosure Counseling
5
Pre-test counseling
Pre-test
counselling simply refers to counseling given to an individual prior to taking
an HIV
test.
It
is given to prepare the person for the HIV test and the implications of taking the test.
Post
Test Counselling
Post
test counseling simply refers to counselling given to an individual after an HIV test
is conducted
and is given irrespective of what the HIV test result is.
The
main goal is to help the client to understand and come to terms with his/her test
results and
to initiate adaptation to their seropositive or
seronegative
status.
6
Prevention and Disclosure
Counselling
Prevention Counselling
Prevention
counselling is similar to pre-test counseling as it provides an opportunity for
the counsellor/client
to negotiate and reinforce a plan to reduce or eliminate the risk of
HIV transmission
.
Prevention
counseling can also be given to relatives and significant others of an
infected person
so as to protect them from contacting the infection in the process of caring for
the PLWHA
.
7
Prevention and Disclosure Counselling
Disclosure Counselling;
Disclosure
of HIV status is advocated to reduce stigma among PLWHA.
Clients
prepared emotionally for the outcome of disclosing, they are helped to identify
who the
disclosure might be affect (e.g. spouse, children) and to be aware of potential
negative consequences
.
Health
workers must ensure that there is adequate support and preparation before and
after disclosing
PLWHA
may need support to disclose their status to loved ones and their loved ones
may need
support to cope with their feelings about the information.
8
Bereavement
counselling
Bereavement counseling
Bereavement
is a term that can be used to describe any event that includes loss, so this
could mean
losing a job or the death of someone you know. Bereavement can also be termed
as grief
.
Bereavement
in relation to HIV/AIDS could be grief over the loss of a dear one or
grief upon
learning one or a partner or a friend is HIV positive
9
Normal Grief Reactions
The normal grief reactions can include:
Feelings
: This can be expressed in the form of shock, anger, Sadness, guilt,
self reproach
, loneliness, helplessness, hopelessness, depression, numbness and feelings
of unreality
Physical
symptoms: Such as tightness in throat and chest, excessive sensitivity
to noise
, irritability, weakness, loss of appetite, insomnia, weight loss.
Behavior
: This can be manifested in the form of confusion, hallucination (seeing
or hearing
the deceased person), tearfulness, Absentmindedness, obsession to
belongings of
deceased person, irrational behavior
10
Potential Danger Signs in Grief Reactions
When
someone feels he/she is no longer of value as a person
Behavior
or personality changes that are inconsistent with clients normally
behavior pattern
.
When
client makes threats of self-destruction
Excessive
hostility
Complete
withdrawal and unwillingness to interact with other people
Appearance
of fleeing from reality
11
Stages of bereavement are;
Denial
:
first reaction that people have to the loss of a loved one or a diagnosis of
HIV, tend
to deny and may withdraw from usual social contacts.
Anger
;
There is the stage of anger at self, loved one, God, the world, the HIV
virus and
the world in general. Questions such as ―Why me?‖, ―Why did it happen
to him/her
?‘ are asked over and over again.
Bargaining;
At
this stage the grieving person may make bargains with God, asking, "If I
do such
and such, will you take away the loss?", ―I promise I'll be a better
person if
….‖ Hoping that the loss will disappear or magically be made right.
12
Depression;
At
this stage the person feels numb, although anger and sadness may
remain underneath
but the person feels tired and doesn‘t care any longer about
what happens
.
A
sense of hopelessness and helplessness washes over the person and leaves
him or
her unable to muster energy to do anything and everyday functioning may
also be
a problem.
Acceptance
;
At
this stage there is a sense of resignation, when anger, sadness and
mourning have
tapered off.
The
person simply accepts the reality of the loss and lets‘ go, but memories
still remain
.
It is not a pleasant feeling but rather a feeling of being ready for whatever may come.
13
Key Points
There are several types of counseling in relation to HIV Counselling and guidance, The
essence of
the different types of counseling and guidance is to provide guidance and counseling
in different
stages of HIV infection that the infected person and the relations go through.
Counsellors should counsel and guide the client by listen actively without judging or trying
to guide
the person on how to grieve, showing compassion and empathy should be the
counsellors primary
tool in helping client as well as to guide client to be able to adjust to life after loss
14
Evaluation
What are the types of counseling and guidance provided at CTC?
What
are stages of HIV positive bereavement?
15
Reference
MOHSW (2008). HIV and AIDS Voluntary Counselling and Testing: Participant Manual. Dar
es
Salaam
, Tanzania: National AIDS Control Programme.
World Health Organization, (2007) Guidance on provider-initiated HIV testing and counselling
in health
facilities. Geneva,
United Republic of Tanzania, MOHSW, AIDS Control Programme, ( 2007) Guidelines on
HIV Testing
and
Counseling
in Clinical Settings. Dar
es
Salaam,Tanzania
:
16
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