Female Genital Mutilation - World Health Organization

66
FEMALE GENITAL MUTILATION
STUDENT MANUAL
Preparation for counselling
session
● Find a suitable setting – this should be a room
where you will not be disturbed by other people,
which can be locked if necessary, and where
privacy and confidentiality can be assured.
● Prepare the place – there should be comfortable
seating.
● Confirm the appointment with your client, and
make sure that you both have allowed adequate
time for the discussion.
The counselling session
● Welcome the client (and her partner/husband if
appropriate) and invite her to sit down.
● Greet her and introduce yourself in the culturally
appropriate manner.
● Ask client her name and ask if you can help her
with anything.
● Let the client talk and encourage her by nodding or
saying “ah” from time to time.
● Give client information about the services available
in your clinic or ward or centre and the staff who
will care for her.
● Let client explain her concerns; be patient as she may
find it hard to express her experiences and feelings.
● Listen carefully and observe non-verbal cues (e.g.
body language; tone of voice) to enhance your
understanding of the client’s situation.
● Paraphrase the client’s information from time to
time to check that you have heard her correctly and
avoid misunderstanding.
● Show concern throughout the session by being
attentive and making eye contact from time to time.
● Empathize with client when she is describing a
disturbing experience, which may make her weep.
● Explain to client how you can help
● If the purpose of counselling is to raise with the
client the need for opening up her infibulated
vulva after type III FGM, give her detailed
information about the procedure, and advise her
that her genitalia will be changed by the operation.
Give her information about her after care (see
information on opening up type III FGM).
● If counselling is for psychosocial or sexual problems,
ask questions as appropriate to draw out as much
information from the client as possible about her
problems. Advise her that there are various ways of
conducting sexual relationships; teach her appropriate
techniques by which both she and her partner may
be aroused. If she expresses a wish for her partner to
be involved in the discussion, draw him into the
counselling session also. It is known that FGM does
not necessarily lead to inability of a woman to
achieve orgasm or enjoy sex. Therefore sexual
problems may be due to fear of pain, rather than to
any physical malfunction. However, if sexual
intercourse is not possible as a result of infibulation
or extensive scarring the issue of opening up the tight
introitus should be addressed during counselling.
● Assist the client, and her partner where
appropriate, to make an informed decision on the
steps to be taken to solve the problem.
● Assist them to act on their decision by giving
advice on how to proceed.
● Give client an appointment for another counselling
or follow-up session to prepare for the next step.
● If the problem persists refer to a specialist.
Please note:
A client’s problem may not be resolved
in a single counselling session. Several
sessions may be required for her to
resolve a relationship problem and reach
optimal psychological well-being. You
should be prepared to spend as much
time as is necessary for this process.