Manual for Male Circumcision under Local Anaesthesia

Male circumcision under local anaesthesia Version 2.5C (Jan08)
Active listening
Active listening involves paying attention to what a client says and
does, in a way that shows respect, interest and empathy. Active
listening is more than just hearing what clients say. It is paying
attention to the content of the message, as well as the client’s feelings
and worries that show through his movements, tone of voice, facial
expressions, and posture.
Example:
The client looks very nervous and is biting his nails, but tells the
counsellor he is fine.
Counsellor: “Sometimes when we think we are relaxed, we can still
feel quite anxious inside. I see you are biting your nails. Perhaps
something is bothering you that you do not know how to express.
Do you have any idea what that might be?”
Open questioning
Open questions are questions that require more than a one-word
answer. They usually begin with words such as “how”, “what” or “why”.
Open questions encourage clients to express their feelings and share
information about their situation.
Examples:
“Why have you decided to come for male circumcision?”
“How do you think circumcision can reduce your risk of STI or HIV
infection?”
“What do you do that may make it possible for you to get infected
with an STI or HIV?”
“What are you currently doing to protect yourself against STIs and
HIV? How is this working?”
Probing
Probing is using questions to help clients express themselves more
clearly. Probing is necessary when the counsellor needs more
information about the client’s feelings or situation. Asking a probing
question is a good way to follow up on a question that has been
answered by “yes” or “no.”
Examples:
“Can you tell me more about that?”
“How do you feel about that?”
Educating and Counselling Clients and Obtaining Informed Consent Chapter 3-7
Male circumcision under local anaesthesia Version 2.5C (Jan08)
Focusing
Clients are often overwhelmed by emotional or personal problems
related to their particular sexual and reproductive health problems.
They may want to address all the issues at once. If clients start to talk
about problems or situations that will be discussed later in the session,
the counsellor may want to bring the topic of discussion back to the
current issue.
Example:
At the beginning of the first counselling session, the client begins
talking about the most recent situation when he may have been
exposed to HIV. He asks about where and how he can get
condoms.
The counsellor does not want to interrupt the flow of the
discussion, so says: “Using condoms is an excellent way to reduce
your risk of getting an STI or HIV infection. We can talk about that
in a few minutes. Right now, let’s continue talking about your HIV
situation.”
If the client wants to talk about other emotional or personal issues,
such as problems at home or a partner’s drug use problem, the
counsellor should help the client find appropriate support.
Affirming
Affirming is congratulating or complimenting clients on the positive
actions that they have taken. It is important to encourage success.
Complimenting clients helps them feel respected and valued and
encourages them to try to make other changes to reduce their risk of
HIV infection. It may also make them more willing to share information
about other actions they have taken.
Example:
Client: “I’ve recently started using condoms each time I have sex”.
Counsellor: “That’s a really positive step in protecting yourself
against HIV and sexually transmitted infections. Well done!”
Clarifying
Counsellors clarify in order to make sure that they understand a
client’s statements or questions. Clarifying also helps the client
understand his own situation or feelings better and identify uncertainty
or conflict between his thoughts and behaviour.
Example:
Client: “My partner gave me gonorrhoea. I’m afraid of getting HIV.
But I’m also afraid that, if I use condoms when I have sex with her,
she’ll think I am not faithful.”
Educating and Counselling Clients and Obtaining Informed Consent Chapter 3-8