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NTA Level 6 • Semester 1 • PST06102 Care and Treatment Clinic (CTC) Counselling and Guidance • Source Session/Topic 10 Full source-text version: all educational wording from the extracted learning source is retained; only presenter/tutor metadata and web-layout noise are removed, while formatting is improved for readability. PST 06102 : Counselling and Guidance Session 10 : Care and treatment Clinic (CTC) 1 Learning tasks By the end of this session students are expected to be able to: Explain Concept of care and treatment Clinic (CTC) Identify core elements of HIV preventions, treatment and support at CTC Explain organization of care and treatment services 2 Introduction to Care and Treatment Clinic (CTC) Is a National Plan which was launched in 2004 for Tanzania mainland , with the aim of providing quality care, Education, Counseling and guidance and treatment for all people living with HIV/AIDS ( PLHIV). CTC have been set up, in both public and private hospitals, and in referral hospitals down to health centers and dispensaries, throughout Tanzania. Standard Operating Procedures (SOP) for Care and Treatment Clinics (CTC) in hospitals have been developed based upon various National Guidelines, the SOP outline the procedures in a standardized manner on how to operate the set down objectives of the programme. 3 CTC is an integral part of the delivery of care and treatment made to ensure that effective monitoring and evaluation of the stated programme takes place in one roof, Data collected from CTC , as well as data from other sources of the programme like Inpatient, are made useful to inform about progress in delivering the services to Patient Living with HIV (PLHIV), and on the impact these services have on the lives of patients that access them. Core goals for management of HIV in CTC are ; maximal suppression of viral replication and promotion of immune reconstitution through combination antiretroviral therapy and promoting long-term adherence, avoiding drug interactions, minimizing toxic effects, simplifying treatment regimens , decreasing drug costs, managing comorbid conditions, and preventing transmission of HIV by achieving undetectable viral load WHO promotes a comprehensive approach to the management of people living with HIV that addresses the individual‘s full range of health related needs, many of which may change during his or her lifetime. 4 What are the core elements of HIV prevention, treatment and support at CTC? 5 Core Elements of HIV Prevention, Treatment and Support at CTC The core elements of HIV prevention, treatment and support that need to be available within CTC services at any level include This includes the following : Education about behavioral risks and condom use for infected people Orientation on care and treatment services available in hospital and district Education and regular counselling on life-long disease management, and in particular on treatment adherence Education and counselling on actions that may delay progression of disease and reduce comorbidities; for example, addressing nutrition, food safety, clean water and use of insecticide treated bed-nets 6 Early identification and management of co-morbidities such as TB Prophylaxis for OIs and cancers including Cotrimoxazole , TB preventive therapy and cervical screening Assessing eligibility for ART i.e. clinical staging, social eligibility and CD4 counts Effective referrals to essential hospital services such as antenatal clinics for MTCT, family planning advice before and while on ART, STI or other specialized clinics Recording and reporting according to the established electronic and paper based system Registration and appointment systems for effective treatment continuation and preventing missed appointments Referral to community services such as HBC, social welfare and legal support 7 Prophylaxis for OIs and cancers including Co- trimoxazole , TB preventive therapy and cervical screening Assessing eligibility for ART i.e. clinical staging, social eligibility and CD4 counts Effective referrals to essential hospital services such as antenatal clinics for MTCT, family planning advice before and while on ART, STI or other specialized clinics Recording and reporting according to the established electronic and paper based system Registration and appointment systems for effective treatment continuation and preventing missed appointments Referral to community services such as HBC, social welfare and legal support In order to provide effective and quality HIV and AIDS Care and Treatment, service delivery needs to be organized in a manner to ensure efficiency, user friendliness, and regular, standardized follow up. Quality Improvement (QI) initiatives are a helpful tool in this regard 8 Organization of Care and Treatment Services The organization of care and treatment services at (CTC) is, patient visit plan, adherence management and life style counseling, medical record system and reporting 1. Patient visit plan At the initial clinic visit, a triage nurse will assess patient‘s needs, register basic information on reliable patient demographics and contact information, issue relevant forms such as CTC1 , CTC2 and the TB screening tool, weigh the patient, and direct her/him to relevant sites . o Patients who are recommended for and agree to initiate therapy will meet with pharmaceutical personnel for counseling and guidance on ARVs and other related medicines ; they will discuss adherence, medication dosages and adverse reaction management . o Patients will be scheduled for a follow-up appointment in two weeks, then monthly for the first six months, depending on assessment by the clinician and pharmaceutical personnel on the status of a patient on ART o When patient is clinically stable, with good adherence for at least the first six months or more to ART regimen, and no history of drug toxicity or recurrent OI, s/he may be given an appointment of two months hence or more, as agreed between the clinician, pharmaceutical personnel and the patient. o All patients are advised to come into the CTC immediately before their condition deteriorates prior to their next scheduled visit. 9 2. Adherence Management and Lifestyle Counselling; Adherence to preventive therapies, TB treatment and ARVs are important factors in ensuring better health outcomes. Patients in long term therapy or prophylaxis, including ARV treatment, are strongly encouraged to identify an adherence/treatment assistant. This can be any person (e.g. a family member, friend, colleague, or community member)

NTA Level 6 • Semester 1 • PST06102 Counselling and Guidance in Promoting Rational Use of Medicines Counselling and Guidance • Source Session/Topic 9 Full source-text version: all educational wording from the extracted learning source is retained; only presenter/tutor metadata and web-layout noise are removed, while formatting is improved for readability. PST 06102 : Counselling and Guidance Session 9 : Counseling and Guidance in promoting Rational Use of Medicine 1 Learning tasks By the end of this session students are expected to be able to: Explain concept of counseling and guidance in promoting rational use of medicines Describe Role of counseling and guidance in promoting rational use of medicines Describe Counseling and guidance matters to improve rational use of medicines 2 How counselling and guidance promot e rational use of medicines ? 3 Introduction to Counselling and Guidance in Promoting Rational Use of Medicines Counselling and Guidance in Promoting Rational Use of Medicines is mandated since medicines are weapons used by man to fight against diseases therefore patient should be counselled and guided on the proper use of medicines. Pharmaceutical personnel can set up a different counselling space for guiding patients, he can keep up points of interest of patient history, hypersensitivities and other vital information for the treatment , and in addition, he/she encourages the patients to take the measurements in appropriate time in order to keep any antagonistic results. 4 The amount and type of counselling and guidance required to be provided to patients by pharmaceutical personnel varies depending on the patient‘s individual needs, and the individual situation in question. Pharmaceutical personnel are reminded that they have a duty of care to their patients, and must at all times act in the best interests of their patients, exercising due diligence and his/her own professional judgment to ensure rational use of medicines. 5 What are the role of counselling and guidance in promoting rational use of medicines? 6 Role of Counselling and Guidance in Promoting Rational Use of Medicines Help patients to get correct information and advice regarding their medicine therapy to improve rational use of medicines. Counselling and guidance process if properly implemented and consistently maintained result in the safe supply of prescribed medicinal products and ensure that they are used rationally and appropriately . 7 Adequate Counselling and guidance provided to patient by pharmaceutical personnel must be satisfied that, patient has sufficient information to take their medicinal product safely and as prescribed , and that they know how to store the medicinal product to ensure rational use of medicines . When pharmaceutical personnel ensure that the patients provided with appropriate counselling and guidance are the right patient, or approved representative it will avoid any unintentional breaches of patient confidentiality hence increase rational use of medicines. When medicinal product is substituted, the Pharmaceutical personnel must take the necessary steps to ensure that patient is aware of the substitution and is fully counselled and guided on the change , as is the case with the initiation of any new medication to improve rational use of medicines The Pharmaceutical personnel should ensure that patient get sufficient counselling and guidance on the active ingredient in the medicinal product and is aware of how to use their medicinal product safely to improve rational use of medicines 8 Counselling and Guidance Matters to improve rational use of medicines A im of effective patient counselling and guidance is to enable and encourage the safe and proper use of medications by patients in order to achieve the required therapeutic outcomes . To achieve such positive results, a pharmaceutical personnel may undertake to counsel and guide patient or his/ her representative on the following matters, as deemed appropriate: The nature and use of the medicinal product, the directions for use; how to take/administer it and duration of treatment The therapeutic benefit which may be expected from the use of the medicinal product and potential side effects that are likely to be experienced and how to deal with them 9 Any special precautions to be taken while using the medication; special regard for food or drink like which foods to avoid, which drinks to avoid, take with(out) food, take with(out) drink and which other medicinal products to avoid The importance of the need for compliance with the directions for use, where a medicinal product has been interchanged in line with prescriber‘s , instruction/consent, or in accordance with the HPRA interchangeable list, to avoid confusion for patients and to ensure that the risk of duplication of therapy is avoided Storage of the medicinal product, what to do if they think the medicinal product is not working , what to do in the event of a missed dose, what to do in the event of an overdose, the correct use of therapeutic devices (including demonstration, if applicable) 10 If the patient is using the medication long term, whether they are experiencing any difficulties with it, counselling and guidance on change to medication or any new medications being introduced Any other matters which may be included or referred to in the Summary of Product Characteristics ( SmPC ) for the medicinal product concerned, what to do with any previously dispensed medicinal product(s), no longer required (i.e. disposal of medicinal product) The pharmaceutical personnel should aim to confirm patient understanding at regular intervals in the counselling process, assessing whether or not the information was understood as intended. The pharmaceutical personnel should ensure that the patient understands how to use the information furnished to them in order to improve the probability of positive therapeutic outcomes . 11 Key points The main aim of effective patient counselling and guidance is to enable and encourage the safe and proper use of medications by patients in order to achieve the required therapeutic outcomes. The Pharmaceutical personnel must be satisfied that the patient has sufficient information to take their medicinal product safely and as prescribed, and that they know how to store the medicinal product . Patient counselling and guidance is a key component of

NTA Level 6 • Semester 1 • PST06102 Counselling and Guidance Process Counselling and Guidance • Source Session/Topic 8 Full source-text version: all educational wording from the extracted learning source is retained; only presenter/tutor metadata and web-layout noise are removed, while formatting is improved for readability. PST 06102 : Counselling and Guidance Session 8 : Counselling and Guidance Process 1 Learning Tasks By the end of this session students are expected to be able to: Define counselling and guidance process Explain stages of counselling process Identify factors that hinder effective counselling 2 What is counseling and guidance process? 3 Definition of Counselling and Guidance Process The counseling process often takes time, it is probably not realistic to expect that clients‘ problems will be solved after one or two sessions, because counseling is a process, it is wise to give it a few weeks before you decide it is not working for a client . There are time when a client may have a very specific questions or concern that can be resolved quickly in one or two sessions, something may have been troubling client for months or even for years , in that case, it may take a longer time to build a trusting relationship with counsellor and to resolve problem, client and counsellor can talk over what client‘s goals for counseling are and how long it will take client to achieve these goals 4 Definition of Counselling and Guidance Process Guidance is the process of assisting the individual to choose, to prepare, to enter upon and progress in course of action pertaining to the educational, vocational, health, recreational and community services, it is a process of helping individuals through their own efforts to discover and develop their potentialities both for personal happiness and social usefulness. Guidance as a concept guidance is concerned with the optimal development of the individual and guidance as a process guidance helps the individual in self- understanding ones strengths and limitations and in self-direction (ability to solve problems, make choices and decision on ones own. 5 What are the stages of counseling process? 6 Stages of the Counselling Process In order to counsel a patient effectively, the counsellor needs to have a variety of skills and work with the patient through different steps. Most of these steps and skills fall under the umbrella of four main stages in the counseling process. These four stages are detailed below. 1. Relationship Building Rather than telling patients about a subject, counsellors first ask patients what they know or what they have heard, and correct their misperceptions through discussion. Establishes rapport Establishing rapport should be the very first step in starting a relationship. If the patient does not trust the counsellor, s/he may be reluctant to discuss lifestyle issues or behaviours . Establishing rapport serves to open communication between the counsellor and the patient. 7 1. Relationship Building Greets the patient and makes him or her feel welcome Establishes the reason the patient has come Confirms what the counsellor can and cannot do Assures the patient of confidentiality Sets the rules for the session (e.g. time) Uses language at a level that the patient can understand 8 2. Exploration The patient shares his or her own feelings and views about the problem at hand. The counsellor listens , encouraging the patient to express his or her main concerns. The counsellor gives time for the patient to tell their stories, so the counsellor can understand the issues and see things the way the patient sees things. The counsellor listens carefully The counsellor asks questions so the patient will provide more information The patient leads the discussion, and not the counselor 9 3. Understanding The counsellor helps the patient to understand some of the concerns that patient has discussed . The counsellor helps to draw conclusions, and to interpret the information. The counsellor listens to the patient and interprets some of the information the patient has given The counsellor might help the patient to understand some of the patient‘s attitudes or actions that could be creating challenges The counsellor also sees how ready or able the patient is to change those attitudes and actions 10 3. Action Plan Counsello r uses information the patient has provided, and information about what the patient is able and willing to do about the issue of concern to talk about concrete steps the patient will take The pair collaborates in creating a plan for action The pair discusses available resources to support the plan and can plan for the next session 11 The Outcomes of Counselling The results or resolutions of a counselling process aim to enable the patient to: Make some of the changes that he/she wants in life Develop positive relationships and explore his or her potential Cope with painful situations, like death, terminal illness and disability Outcomes of Effective Counseling ; When counseling is effective, patients: Develop a greater awareness of their problems Create new responses to old issues Develop a relationship with the person providing the counselling Are more likely to return to the clinic for additional care and treatment 12 Factors that Hinder Effective Counselling Language barrier Lack of counseling skills Personality/attitude of counselor Cultural relationship and social economic differences Lack of trust and confidence between counselor and counselee Unrealistic expectations of patients/clients 13 Key points The counseling process often takes time, it is probably not realistic to expect that clients‘ problems will be solved after one or two sessions, because counseling is a process, it is wise to give it a few weeks before you decide it is not working for client. Effective Counselling , is private, confidential, and respectful, views the patient as the expert on his or her own life, respects that patients come to counselling with great, strengths and knowledge upon, which to build, doesn‘t tell the patient what to do, and never forces the patient to do something • The Outcomes of Counselling, the results or resolutions of a counselling process aim to enable

NTA Level 6 • Semester 1 • PST06102 Situations Requiring Guidance Counselling and Guidance • Source Session/Topic 7 Full source-text version: all educational wording from the extracted learning source is retained; only presenter/tutor metadata and web-layout noise are removed, while formatting is improved for readability. PST 06102 : Counselling and Guidance Session 7: Situations Require Guidance 1 Learning tasks By the end of this session students are expected to be able to: Define situations require guidance Explain situations require guidance List principles of direct and indirect guidance 2 Definition of the Situations Required Guidance Guidance as a process, developmental in nature, by which an individual is assisted to understand , accepts and use his/her abilities, aptitudes and interests and attitudinal patterns in relation to his/her aspirations. It is a process of helping or assisting an individual to solve their problems, it help them to identify where to go, what to do and how to do for post accomplishment of their goals. Guidance as an educational construct involves those experiences that assist each learner to understand him/herself, accept him/herself, and live effectively in his/her society, this is in addition to the learner‘s experiences in the world of work 3 Definition of the Situations Required Guidance Guidance can also be looked at as a programme or services to individuals based upon the need of each individual, an understanding of his/her immediate environment, the influence of environmental factors on the individual Guidance is designed to help each individual adjust to his/her environment, develop the ability to set realistic goals for him/herself, and improve his/her knowledge. As a process, guidance is not a simple matter, but involves a series of actions or progressive steps which move towards a goal, as a service, we can isolate four major services, those of educational , vocational, personal and social guidance . Situations that require counselling are educational guidance, vocational guidance, career guidance , avocational guidance and personal and Social Guidance 4 What are the situations required guidance ? 5 Situations Require Guidance 1. Educational Guidance Educational guidance is, essential in the counselling service, guiding and educating patients to take right treatment and adhere to the medications, guiding young people to pursue the right type of education, while ensuring that the right balance is kept in order to meet the human resource needs of a nation Helping an individual to reflect on personal educational issues and experiences and to make appropriate educational choices and appropriate treatment choice. 6 2. Vocational Guidance Vocational guidance is a process for helping individuals to choose an occupation, prepare for it, enter it and develop in it. Vocational happiness requires that a person‘s interests, aptitudes and personality, be suitable for his/her work. It plays its part by providing individuals with an understanding of the world of work and essential human needs, and familiarizing individuals with such terms as the dignity of ‘labor ‘ and ‘work value‘. It based on psychological tests and interviews to find out what career or occupation may best suit a person, it is the process of assisting a student to choose, prepare for and enter an occupation for which he or she shows aptitude. 7 3. Personal and Social Guidance Personal and social guidance is the process of helping an individual to know how to behave with consideration towards other people. Primarily , personal and social guidance helps the individual to understand himself, know how to get on with others, learn manners and etiquette, pursue leisure time activities, practice social skills, develop family and family relationships, and understand social roles and responsibilities 8 4. Career guidance Career guidance includes a wide variety of professional activities which help people deal with career-related challenges. Career counselors work with adolescents seeking to explore career options, experienced professionals contemplating a career change, parents who want to return to the world of work after taking time to raise their child, or people seeking employment. Career guidance is also offered in various settings, including in groups and individually, in person or by means of digital communication, several approaches have been undertaken to systemize the variety of professional activities related to career guidance and counseling such as: The Career Educator "supports people in developing their own career management competences" The Career Information & Assessment Expert "supports people in assessing their personal characteristics and needs, then connecting them with the labour market and education systems" The Career Counsellor "supports individuals in understanding their situations, so as to work through issues towards solutions“ The Programme & Service Manager "ensures the quality and delivery of career guidance and counselling organisations' services" 9 5. Avocational guidance An avocation is an activity that someone engages in as a hobby outside their main occupation . There are many examples of people whose professions were the ways that they made their livings, but for whom their activities outside their workplaces were their true passions in life. It assist individual with leisure attitudinal or behavior problem with choosing and effectively participating in an avocation, as a newly emerging independent profession, a vocational guidance has the task of developing theory, techniques and tools for doing the job with greater precision. 10 What are the Principles of direct and indirect guidance? 11 Principles of Direct Guidance The followings are the principles of direct guidance Use simple language Speak in a relaxed voice Be positive Offer choices with care Encourage independence and cooperation Be firm Be consistent Provide time for change Consider feelings Intervene when necessary 12 Key Point Guidance as an educational construct involves those experiences that assist each learner to understand him/herself, accept him/herself, and live effectively in his/her society, this is in addition to the learner‘s experiences in the world of work and the people found there, Guidance can also be looked at as a programme or services to individuals based Up on the need of each individual, an understanding of his/her immediate environment, the influence of environmental factors on the individual Situations require guidance are; educational guidance, vocational guidance, career guidance, a

NTA Level 6 • Semester 1 • PST06102 Situations Requiring Counselling Counselling and Guidance • Source Session/Topic 6 Full source-text version: all educational wording from the extracted learning source is retained; only presenter/tutor metadata and web-layout noise are removed, while formatting is improved for readability. PST 06102 : Counselling and Guidance Session 6 : Situations Require Counselling 1 Learning tasks By the end of this session students are expected to be able to: Define situation require counseling Explain situations require counseling Explain crisis counseling Explain genetic counseling 2 Definition of Situations Requiring Counselling can be useful in a number of different life situations, it help with all sorts of different issues, it can help with positive events such as choosing a direction in life or reaching your full potential. When a person feeling a bit stuck‘ and would value the viewpoint of a counsellor, it can be things from his/her past that s/he would like to tackle or there may be things in the present that s/he want to try and change. Situations that require counseling are, psychotherapeutic counselling, health counselling, personal counseling , crisis counselling, genetic counselling, and marriage counselling 3 What are the situations required counseling? 4 Situations Required Counselling Psychotherapy Counselling: Is defined as a form of therapy in which a trained professional uses method based on psychological theories to help a person with psychological problems. It refer to almost any kind of human interaction such as talking or demonstrating that is based on a psychological theory of the problem but it does not include medical treatment such as medication. It is the use of psychological methods, particularly when based on regular personal interaction , to help a person change and overcome problems in desired ways. Psychotherapy aims to improve an individual's well-being and mental health, to resolve or mitigate troublesome behaviors, beliefs, compulsions, thoughts, or emotions, and to improve relationships and social skills. Certain psychotherapies are considered evidence-based for treating some diagnosed mental disorders . 5 Situations Required Counselling Health counseling Health "health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity Health counseling: define as the process where by an individual or group mental, spiritual or physical health is being counsel by a professional counselor and provide support to sustain them . Patient Counselling is defined as "an individualized process involving guidance and collaborative problem solving to help the patient to better manage the health problem" 6 Situations Required Counselling P urpose of patient education and counselling: To help patients manage their chronic disease by using available health, social and economic resources . Assist Patients to develop their own understanding of the problem and what can be done about it. To provide appropriate training to patient so that they can obtains a higher quality of life, the disease remains under control, the treatment is consistent and hospital costs are smaller for both the individual and the state. 7 Situations Required Counselling The benefits of patient education counseling (PEC) for hospitals are: Shortening the length of stay Decreasing medical, personal and social costs Increasing patient satisfaction Improving quality and effectiveness of health care 8 B enefits of counseling for people with chronic diseases are : Improving the quality of life Fostering independence for the patient Improving the control over disease Emphasizing the importance of prevention and early recognition of the disease Personal Counselling A confidential meeting between yourself and a professional counsellor. Often the purpose is to solve one or more problems or to give you information 9 Goals and values of Counselling What goals and values does Counselling hold? It encourage healthy independence, being yourself, self-confidence, honesty about who you are and how you feel, It encourage clients to face the world and to take appropriate risks in order to grow and change Expressing emotion (feelings) is preferable to repressing them; Choosing your own way in life instead of living by the standards of others; o Self-discovery through self-disclosure. 10 Marriage Counseling Marriage , is also called matrimony or wedlock, is a socially or ritually recognized union between spouses that establishes rights and obligations between those spouses, as well as between them and any resulting biological or adopted children and affinity (in-laws and other family through marriage) Individuals may marry for several reasons, including legal, social, libidinal, emotional, financial , spiritual, and religious purposes. Marriage counseling/ couples therapy: Is a type of psychotherapy, it helps couples of all types recognize and resolve conflicts and improve their relationships. Through marriage counseling, you can make thoughtful decisions about rebuilding your relationship or going your separate ways . Marriage counseling typically includes both partners, but sometimes one partner chooses to work with a therapist alone. . The specific treatment plan depends on the situation. 11 Marriage Counseling Couples seek marriage counseling to improve a troubled relationship. I ssues which can be addressed by marriage counseling includes: Communication problems, Sexual difficulties Conflicts about child rearing or blended families Substance abuse, Financial problems Anger , Infidelity and health problems Marriage counseling might also be helpful in cases of domestic abuse, if violence has escalated to the point that you're afraid, however, counseling alone isn't adequate, contact the police or a local shelter or crisis center for emergency support. 12 Crisis Counselling Crisis is any event that is going to lead to an unstable and dangerous situation affecting an individual, group, community, or whole society. Crises are deemed to be negative changes in the security, economic, political, social, or environmental affairs, especially when they occur abruptly with little or no warning. Eight Categories of crises Natural disaster: eg , earthquakes, volcanic, floods, tsunamis and storms Technological crises: eg , software failures, industrial accidents, and oil spills ( human manipulation) Confrontation : eg , individuals and/or groups fight businesses, government, and various interest groups to win acceptance of their demands and expectations. 13 Eight Categories of crises Malevolence: eg , tampering, kidnapping, malicious rumors and terrorism Organizational Misdeeds: eg , crisis

NTA Level 6 • Semester 1 • PST06102 Guidance Techniques Counselling and Guidance • Source Session/Topic 5 Full source-text version: all educational wording from the extracted learning source is retained; only presenter/tutor metadata and web-layout noise are removed, while formatting is improved for readability. PST 06102 : Counselling and Guidance Session 5: Guidance Techniques 1 Learning tasks At the end of this session, students are expected to be able to : Define guidance techniques Explain guidance techniques Describe characteristics of a good guidance services Identify quality of effective guidance counselors 2 Definition of Guidance Techniques It is the assistance or help rendered by a more experienced person to a less experiences person to solve certain major problems i.e. educational, vocational, personal etc. They help the individual to become increasingly competent in self-direction and self-help; it is a continuous process of service to individuals They are designed to help one individual or group of individuals in making necessary adjustment to environment whether that be health problems or outside it 3 Activity: Buzzing What are the techniques for effective guidance ? 4 Guidance Techniques The following are the techniques for effective guidance Positive verbal environment, positive reinforcement, using consequences, warning, effective praise, suggesting, persuading, redirecting, listening, ignoring and encouraging 5 Techniques for effective guidance Positive reinforcement Positive verbal environment Using consequences Warning Effective praise Persuading Redirecting Listening Encouraging Ignoring 6 a. Positive reinforcement : Involves the addition of a reinforcing stimulus following a behavior that makes it more likely that the behavior will occur again in the future. When a favorable outcome, event, or reward occurs after an action, that particular response or behavior will be strengthened . 7 b. Positive verbal environment: Means establishing Positive Verbal Environments that is strategies for promoting social development through positive guidance. As social creatures, we all interact with each other in an environment that we create together through our communication, positive, nurturing interactions over time lead to a more positive self-esteem to client Negative verbal environments are ones in which clients feel unworthy, unlovable, insignificant, or incompetent because of what counselor say or do 8 c. Using consequences letting client experience the natural or logical consequences of their actions is one way to teach responsibility, natural consequences are the inevitable result of a client’s own actions d. Warning The act of warning, the state of being warned he had warning of his illness, something that warns or serves to warn especially a notice or bulletin that alerts the public to an imminent hazard (such as a tornado, thunderstorm, or flood) warning 9 d. Effective praise Effective Praise can increase your client’s positive behaviors while decreasing negative behaviors. Effective Praise also builds confidence and creates greater family harmony. It is a four-step teaching process that is planned and pur – poseful . It is specific, genuine, and contingent on positive behavior e. Persuading To make someone do or believe something by giving them a good reason to do it or by talking to that person and making them believe it 10 f. Redirecting To direct (someone or something) to a different place or by a different route. E.g., If you redirect your energy, resources, or ability, you begin doing something different or trying to achieve something different g. Listening It i s giving one's attention to sound, Eg ; speech, music or natural sounds. Listening involves complex affective, cognitive, and behavioral processes 11 h. Encouraging The act of making something more appealing or more likely to happen. something that makes someone more determined, hopeful, or confident. Something that makes someone more likely to do something. i . Ignoring Do not encourage inappropriate behavior, if not dangerous, avoid giving them attention and do not look directly at them Ignoring is inappropriate if the behavior is harmful or damaging property, tell the client what behavior you are ignoring and what behavior you desire 12 Characteristics of a Good Guidance Service Identifiable aids to assist individuals. Involved in achieving goals of treatment. Provide for competent pharmaceutical personnel or other health workers. Supported by functional preparations for pharmaceutical personnel in guidance services. 13 Based on the knowledge of the needs of the clients and upon competencies of other health workers. Services made available to clients. Needs the cooperation of family members and community. More preventive than curative. Founded on the concept of the totality of the individual. Should be evaluated constantly 14 Quality of effective guidance counselors Detail oriented, Discreet and trustworthy, Problem solver, Compassionate. Great manager of time, Great communication skills in order to talk to patients and relatives. Tolerant and understanding of clients situations Motivational and enthusiastic for clients success Belief in the ability of all clients to succeed 15 Key points Techniques for effective guidance are; Positive verbal environment, positive reinforcement, using consequences, warning, effective praise, suggesting, persuading, redirecting, listening, ignoring and encouraging Characteristics of a good guidance service: identifiable aids to assist individuals, involved in achieving goals of treatment, 16 Review questions What are the techniques for effective guidance? What are the characteristics of a good guidance service? 17 References MoHSW (2005) National guidelines for the clinical management of HIV and AIDS , Dar es Salaam . Hubley , J. (1993). Communicating Health. An action and guide to health and health Promotion. 1st Edition. British Angotti N, et al. (2009) Increasing the acceptability of HIV counseling and testing with three C’s: convenience, confidentiality and credibility. Thailand MM, Ostermann J, Crump JA, (2010). Characteristics of HIV voluntary counseling and testing clients before and during care and treatment scale-up .Moshi, Tanzania. Jones A. J (1951), Principles of Guidance and Pupil Personal work . New York. McGraw Hill 18 ← Previous TopicNext Topic →View all Counselling and Guidance topicsOpen Complete Full Notes PDF / OFFLINE NOTES Unataka kutumiwa notes hizi kupitia WhatsApp?Kwa notes zilizopangiliwa vizuri kwa kusoma offline au PDF, bonyeza kitufe hapa chini. Ujumbe wenye Level, Semester, Module na Topic utaandaliwa moja kwa moja.TUMIWA NOTES WHATSAPP WhatsApp: 255620339260

NTA Level 6 • Semester 1 • PST06102 Counselling Techniques Counselling and Guidance • Source Session/Topic 4 Full source-text version: all educational wording from the extracted learning source is retained; only presenter/tutor metadata and web-layout noise are removed, while formatting is improved for readability. PST 06102 : Counselling and Guidance Session 4: Counselling Techniques 1 Learning tasks At the end of this session, students are expected to be able to : Define counseling technique Explain counseling techniques Identify qualities and values of effective counsellors 2 Activity: Buzzing What is counseling technique?? 3 Counseling technique They are tools a counsellor/healthcare provider uses in order to get information from a patient/client in order to build a relationship, assess the presenting problem , understand the problem and be able to lead a patient/client reach a solution . It is an art that requires practice counsellor should adequately possessed basic counseling skills so that he/she can recognize and handle most barriers and end up with successful counselling sessions 4 Activity: Buzzing What are the techniques for effective Counseling??? 5 Counseling Techniques Greetings, The greeting must reflect warmth not only in the spoken words but also in the tone of voice as well as the facial features of the client. Empathizing , empathy means feeling with a person, understanding why the person is in pain while sympathy means feeling sorry for a person and putting oneself in the others shoe Accepting, Means valuing another person unconditionally as a human being, when a counsellor shows disrespect or contempt for the client’s values and way of life the client would assume that the counsellor does not respect him/her and this will affect the rapport building between them. 6 Affirming , this means congratulating or complimenting clients on the positive actions that they have been able to take whether it is the decision to come for counseling. Using silence; silence is sometimes necessary if a client becomes upset and needs a few minutes to calm down or collect his thoughts. Active listening; a ctive listening by the counsellor encourages the client to share information by providing verbal and nonverbal expressions of interest. 7 Attending behaviours, is expressing awareness and interest in what the client is communicating both verbally and nonverbally. Paraphrasing, m eans repeating the key points of what a client has said. This skill serves many purposes Reflection of feelings, the counsellor tries to perceive the emotional state of the client and respond in a way that demonstrates an understanding of the client’s emotional stat 8 Summarizing Means Summing up the main points of a person’s story and eliminating the less relevant details. The counselor takes the main points of the conversation and presents them to the client in a succinct manner that touches all that was covered during the session. 9 Questioning and probing, t his skill is the primary tool that a counselor uses to obtain information or seek clarifications from clients. Speaking simply, t his means making use of language that is easy enough for a person to understand. Focusing, is a skill which enables the counsellor help, the client prioritize and choose the most pressing problem that they would like to resolve. Correcting misperceptions, t his means providing accurate information to a client and correcting any misinformation that the client has expressed during the session. Supporting, t he counselor offers encouragement and help clients in order to give them confidence for taking action, the counselor has to be sure that he/she does not sound patronizing to the client 10 Self – disclosing , 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. 11 Qualities and Values of Effective Counsellors Counselor: where clients/patients explore and understand their worlds and so discover better ways of thinking and living. A counselor must attempt to facilitate a client to solve their own problems, yet demonstrate a genuine concern and compassion for the client's dilemmas, the rapport of the client and counselor is an important factor in counseling. 12 Possible Qualities Competence Maintains confidentiality Trustworthiness Demonstrate self-awareness and understanding Good psychological health Can build good rapport Show warmth and sensitivity Show empathy Remain objective and open minded Active listener Be able to reflect and clarify their needs Patience Be non-judgmental 13 Effective Counselling Is private, confidential, and respectful Views the patient as the expert on his or her own life Respects that patients come to counselling with great strengths and knowledge upon which to build Doesn’t tell the patient what to do, and never forces the patient to do something Understands that the patient lives in a social setting that influences choices Views social relationships as a resource for improving health Is developed through training and practice 14 Values Values guide the beliefs and opinions that you stand for. Because values guide what you stand for and what you do not want, you cannot assign them any monetary value. Your values determine who you are, what you decide and how you behave. Proper application of your values results in respect, love, good health and good habits. Values are developed during growth. Therefore, the family and environment contribute alot to the development of an individual values. It is important to respect values of others because we all have different values . 15 Values of an Effective Counselor Social values : These are some standards of behaviors determined by society (e.g. good manners) Moral values : Objective and unchangeable, and are a born knowledge of what is right and wrong (e.g. telling lies) Religious values : Based on a particular faith or creed in a society 16 Key points Counselor should adequately possessed basic counseling skills for successful counseling sessions Counselor needs to help clients focus on the issues that are most important to them at the time of the session and it is important to respect the client’s feelings, and address the issues that they feel are

NTA Level 6 • Semester 1 • PST06102 General Types of Counselling Counselling and Guidance • Source Session/Topic 3 Full source-text version: all educational wording from the extracted learning source is retained; only presenter/tutor metadata and web-layout noise are removed, while formatting is improved for readability. PST 06102 : Counselling and Guidance Session 3: General Types of Counselling 1 Learning tasks At the end of this session, students are expected to be able to : Explain individual counseling Explain group counseling Explain couple counseling 2 Activity: Buzzing What is individual counseling? 3 Individual counselling It is a one-to-one helping relationship in which the counsellor helps the client to accept, own, solve or cope with the problem. Features of individual counselling includes client comes on his/her own or he/she is referred from another counsellor/source . 4 Individual counselling Client coming for counselling may be an adult, youth or child who is: Able to talk rationally Mentally distraught – unable to think/talk rationally With varied life experience 5 Duration of individual counselling It may involve one or more than one sessions. The setting can be a counselling centre , VCT centre /hospital. The nature and duration of individual counselling cannot be determined until the nature of the problem is clarified. In most cases the initial session begins in a similar way of staying with a client for 45 minutes to 60 minutes per session. Counselling relationship may be terminated when a counsellor and client reach to a successful conclusion of the counselling relationship or client referral is made. 6 Group Counseling It is a one-to-group helping relationship in which the counsellor works with the group in seeking a solution to their common problem. Example: new candidates of ARV therapy Group Counselling is designed to help clients in a group to achieve increased mutuality, integration, and acceptance of reality, socialization, realistic goals, adaptability and responsibility for self esteem. The general aim is to help members appraise themselves so that they may gain understanding, and broad perceptive of themselves in relation to others. 7 Features of Group Counseling A group of clients must have the following features; Clients in the group must have a common problem. There must be dynamic integration among members. Members must be reasonably mature and mentally sound to be able to talk about and tackle their common problem. Members must have capacity for self-direction. Members should be as compatible as possible 8 Couple Counselling Couple refers to two people, usually of opposite sex, who may be: Married Cohabiting (not married but a man and woman are staying together) Friends Couple counselling occurs when two individuals who have had or who intend to have sexual relations wish to discuss issues concerning HIV together and look for ways to cope with the situation. 9 Couple Counselling Usually two people come in for couple counseling if: They intend to get married One or both member/s is/are sick They intend to have children They are having conflicts in the home around being honest about sexual practices and safer sex The couple has a sick child; or the child dies of AIDS or any other diseases They have been referred to the clinic by a doctor 10 Key points Individual counseling is a one-to-one helping relationship in which the counsellor helps the client to accept, own, solve or cope with the problem Features of individual counselling includes client comes on his/her own or he/she is referred from another counsellor/source. Group Counselling is designed to help clients in a group to achieve increased mutuality, integration, and acceptance of reality, socialization, realistic goals, adaptability and responsibility for self. 11 Review questions What are the features of group counselling? What is couple counselling? 12 References MoHSW (2005) National guidelines for the clinical management of HIV and AIDS , Dar es Salaam . Hubley , J. (1993). Communicating Health. An action and guide to health and health Promotion. 1st Edition. British Angotti N, et al. (2009) Increasing the acceptability of HIV counseling and testing with three C’s: convenience, confidentiality and credibility. Thailand MM, Ostermann J, Crump JA, (2010). Characteristics of HIV voluntary counseling and testing clients before and during care and treatment scale-up .Moshi, Tanzania. Jones A. J (1951), Principles of Guidance and Pupil Personal work . New York. McGraw Hill 13 ← Previous TopicNext Topic →View all Counselling and Guidance topicsOpen Complete Full Notes PDF / OFFLINE NOTES Unataka kutumiwa notes hizi kupitia WhatsApp?Kwa notes zilizopangiliwa vizuri kwa kusoma offline au PDF, bonyeza kitufe hapa chini. Ujumbe wenye Level, Semester, Module na Topic utaandaliwa moja kwa moja.TUMIWA NOTES WHATSAPP WhatsApp: 255620339260

NTA Level 6 • Semester 1 • PST06102 Principles of Counselling and Guidance Counselling and Guidance • Source Session/Topic 2 Full source-text version: all educational wording from the extracted learning source is retained; only presenter/tutor metadata and web-layout noise are removed, while formatting is improved for readability. PST 06102 : Counselling and Guidance Session 2: Principles of Counselling and Guidance 1 Learning tasks At the end of this session, students are expected to be able to : • Define principles of counseling and guidance • Explain principles of quality counseling • Identify principles of quality guidance • Explain the differences between guidance and counseling 2 Definition of Principles of counselling and guidance Principles are fundamental norms, rules, or values that represent what is desirable and positive for a person, group, organization, or community, which help in determining the rightfulness or wrongfulness of its actions. Principles are more basic than policy and objectives, and are meant to govern both. 3 Activity: Buzzing What are the principles of Quality Counselling 4 The principles of quality counseling The following are the principles of quality counseling Establish and maintain rapport with the client Assess the client's needs and personalize discussions accordingly Work with the client interactively to establish a plan Provide information that can be understood and retained by the client Confirm client understanding 5 a. Establish and maintain rapport with the client This is vital to the encounter and achieving positive outcomes, it can begin by creating a welcoming environment and should continue through every stage of the client encounter, including follow-up. Counseling models that emphasized the quality of the interaction between client and provider have been associated with increased rational use of medicines, increased use of more effective methods, increased use of repeat or follow-up services, increased knowledge, and enhanced psychosocial determinants of medicines 6 b. Assess the client's needs and personalize discussions accordingly Each visit should be tailored to the client's individual circumstances and needs, standardized questions and assessment tools can help providers determine what services are most appropriate for a given visit Assess the client's needs and personalize discussions accordingly to his or her problem, for example if it is problem of poor adherence to prescribed medicines, outcomes of counseling can increase poor adherence or eliminate poor adherence. 7 c. Work with the client interactively to establish a plan Working with a client interactively to establish a plan, including a plan for follow-up, is important. Establishing a plan should include setting goals, discussing possible difficulties with achieving goals, and developing action plans to deal with potential difficulties. Use of computerized decision aids before the appointment can facilitate this process by interactive framework for clients to analyze their available options systematically 8 d . Provide information that can be understood and retained by the client Clients need information that is medically accurate, balanced, and nonjudgmental to make informed decisions and follow through on developed plans. When speaking with clients or providing educational materials through any medium e.g., written, audio/visual, or computer/web-based, the provider must present information in a manner that can be readily understood and retained by the client. 9 e. Confirm client understanding It is important to ensure that clients have processed the information provided and discussed. One technique for confirming understanding is to have the client restate the most important messages in her or his own words. This teach-back method can increase the likelihood of the client and provider reaching a shared understanding, and has improved compliance with treatment plans and health outcomes Using the teach-back method early in the decision-making process will help ensure that a client has the opportunity to understand her or his options and is making informed choices. 10 Principles of Quality Guidance The following are the principles of quality guidance Take time to solve problems and make decisions. Let the counselee develop his own insights. Guidance is a lifelong process. Guidance service should be extended to all, not simply to the maladjusted. Guidance workers should rigorously observe a code of ethics . 11 Guidance places emphasis on the dignity, worth and individuality of the clients as a means of promoting the democratic way of life. Guidance is concerned with the choices and decisions to be made by the client. Guidance is primarily concerned with prevention rather than cure. Guidance is a continuous process throughout the treatment process. 12 Difference Between Guidance and Counseling Guidance process aims at making clients be aware of the rightness or wrongness of their choices and decision , on which their future depends. It is a service that assists clients in selecting the most appropriate treatment for them, to discover and develop their psychological abilities and ambitions. Guidance results in self-development and helps a person to plan his present and future wisely Counseling is not just giving advice or making a judgment, but also helping the client to see clearly the root of problems and identify the potential solutions to the issues. The counselor also changes the viewpoint of the client, to help him take the right decision or choose a course of action. It will also help the client to remain intuitive and positive in the future 13 Similarities of Guidance and Counseling Both are helping services Both aim at solving problems Both are principled activities 14 Key Points Principles are fundamental norms, rules, or values that represent what is desirable and positive for a person, group, organization, or community, and help in determining the rightfulness or wrongfulness of its actions . Principles are more basic than policy and objectives, and are meant to govern both. 15 Review questions What are the differences between counseling and guidance? What are the Principles of Quality Guidance ? 16 References Beardsley, R. S., Johnson, C. A., & Wise, G. (1977). Privacy as a Factor in Patient Counseling. Journal of the American Pharmaceutical Association (1961), 17 (6), 366-368. doi:10.1016/s0003-0465(16)34218-5. Bernstein L, Bernstein RS. Interviewing: ( 2000) A Guide for Health Professionals. N ew York: Appleton-Century-Crofts, Agrawal, R (2006) Educational, Vocational Guidance and

NTA Level 6 • Semester 1 • PST06102 Introduction to Counselling and Guidance Counselling and Guidance • Source Session/Topic 1 Full source-text version: all educational wording from the extracted learning source is retained; only presenter/tutor metadata and web-layout noise are removed, while formatting is improved for readability. COUNSELLING AND GUIDANCE SKILLS Introduction to Counselling and Guidance Complete learning session 1 / 20 Counselling and Guidance Skills Learning outcomes • Define Introduction to Counselling and Guidance. • Explain its main principles and classifications. • Apply the concept safely in pharmaceutical practice. • Recognise common errors and appropriate corrective action. 2 / 20 Counselling and Guidance Skills Why this topic matters • Counselling is a purposeful helping relationship that supports informed choices. • Confidentiality, respect and non-judgment build trust. • Correct understanding supports safe, effective and accountable practice. 3 / 20 Counselling and Guidance Skills Core definition • Introduction to Counselling and Guidance is studied as a structured concept within Counselling and Guidance Skills. • Counselling is a purposeful helping relationship that supports informed choices. • Use precise terms before attempting application or calculation. 4 / 20 Counselling and Guidance Skills Foundational principles • Confidentiality, respect and non-judgment build trust. • Active listening uses attention, reflection, clarification and summarising. • Each principle should be linked to a practical decision. 5 / 20 Counselling and Guidance Skills Key components • Counselling is a purposeful helping relationship that supports informed choices. • Active listening uses attention, reflection, clarification and summarising. • Open questions encourage clients to explore concerns and options. 6 / 20 Counselling and Guidance Skills Classification and organisation • Group the subject by function, structure, source, risk or stage as appropriate. • Use one classification system consistently. • State the feature that separates one category from another. 7 / 20 Counselling and Guidance Skills How the process works • Confidentiality, respect and non-judgment build trust. • Active listening uses attention, reflection, clarification and summarising. • Follow the sequence from input or cause to outcome. 8 / 20 Counselling and Guidance Skills Professional terminology • Distinguish related terms that are often confused. • Use names, units and abbreviations consistently. • Define technical words before using them in explanations. 9 / 20 Counselling and Guidance Skills Practical application • Open questions encourage clients to explore concerns and options. • Prepare the required materials, information or records before starting. • Complete each step in order and document important observations. 10 / 20 Counselling and Guidance Skills Quality requirements • Referral is necessary when needs exceed the counsellor’s competence. • Check identity, accuracy, completeness and fitness for purpose. • Record deviations and take corrective action promptly. 11 / 20 Counselling and Guidance Skills Safety and risk control • Identify hazards before beginning the task. • Use appropriate protective, ethical and legal safeguards. • Stop and refer when the situation exceeds competence or available resources. 12 / 20 Counselling and Guidance Skills Common errors • Using an incorrect definition, unit, category or sequence. • Skipping verification, documentation or a final reasonableness check. • Applying a general rule without considering the patient, material or research context. 13 / 20 Counselling and Guidance Skills Preventing avoidable mistakes • Use a written procedure or checklist. • Independently verify high-risk calculations and decisions. • Communicate unclear or abnormal findings before proceeding. 14 / 20 Counselling and Guidance Skills Worked application • Start with a clearly stated problem related to Introduction to Counselling and Guidance. • Select the correct principle from the earlier slides. • Show the decision or calculation step by step. • Confirm that the final answer is reasonable and professionally usable. 15 / 20 Counselling and Guidance Skills Practice scenario • A routine situation requires the learner to apply Introduction to Counselling and Guidance. • Identify the information that must be collected first. • Explain the safest action and the record that should be completed. 16 / 20 Counselling and Guidance Skills Decision points • What finding confirms that the chosen approach is suitable? • What warning sign requires correction, referral or further investigation? • What evidence must be documented to support the decision? 17 / 20 Counselling and Guidance Skills Connection to patient care • Accurate practice reduces preventable harm. • Clear communication helps patients and colleagues use information correctly. • Monitoring outcomes shows whether the intended benefit was achieved. 18 / 20 Counselling and Guidance Skills Session summary • Counselling is a purposeful helping relationship that supports informed choices. • Confidentiality, respect and non-judgment build trust. • Active listening uses attention, reflection, clarification and summarising. • Open questions encourage clients to explore concerns and options. • Referral is necessary when needs exceed the counsellor’s competence. 19 / 20 Counselling and Guidance Skills Self-check questions • Define Introduction to Counselling and Guidance in your own words. • List three important principles or components. • Describe one practical application and one common error. • Explain one quality or safety control. 20 / 20 Next Topic →View all Counselling and Guidance topicsOpen Complete Full Notes PDF / OFFLINE NOTES Unataka kutumiwa notes hizi kupitia WhatsApp?Kwa notes zilizopangiliwa vizuri kwa kusoma offline au PDF, bonyeza kitufe hapa chini. Ujumbe wenye Level, Semester, Module na Topic utaandaliwa moja kwa moja.TUMIWA NOTES WHATSAPP WhatsApp: 255620339260