PocketGuide: Counseling

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PocketGuide for Family Planning Service Providers

Counseling

Introduction | Counseling Process | Who Should Provide Counseling? | Family Planning Information

Counseling is a vital part of family planning. It helps clients:

arrive at an informed choice of reproductive options,
select a contraceptive method with which they are satisfied, and
use the chosen method safely and effectively.

Good counseling focuses on the individual client's needs and situation. Good counselors are willing to listen and respond to the client's questions and concerns.

Keys to good counseling

A good counselor:

Understands and respects the client's rights
Earns the client's trust
Understands the benefits and limitations of all contraceptive methods
Understands the cultural and emotional factors that affect a woman's (or a couple's) decision to use a particular contraceptive method
Encourages the client to ask questions
Uses a nonjudgmental approach which shows the client respect and kindness
Presents information in an unbiased, client-sensitive manner
Actively listens to the client's concerns
Understands the effect of nonverbal communication
Recognizes when s/he cannot sufficiently help a client and refers the client to someone who can

To be effective, counseling must be based on the establishment of trust and respect between the client and counselor. In serving clients, it is important to remember that they have:

the right to decide whether or not to practice family planning,
the freedom to choose which method to use,
the right to privacy and confidentiality, and
the right to refuse any type of examination.

Also, while many contraceptive methods are highly effective, method failure can occur. In the case of method failure, the client should be counseled, informed about the available options and referred for appropriate services.

Counseling Process

In discussing contraceptive options with clients, service providers should briefly review all available methods, even if a client knows which method s/he wants. Service providers should be aware of a number of factors about each client that may be important, depending on the method in question. These are:

reproductive goals of the woman or couple (spacing or timing births);
personal factors including the time, travel costs, pain or discomfort likely to be experienced;
accessibility and availability of other products that are necessary to use the method; and
the need for protection against STDs (e.g., HBV, HIV/AIDS).

Counseling can be divided into three phases (see Figure 1. Steps in Counseling):

initial counseling at reception (all methods are described and the client is helped to choose the method most appropriate for her/him);
method-specific counseling prior to and immediately following service provision (the client is given instructions on how to use the method and common side effects are discussed); and
followup counseling (during the return visit, use of the method, satisfaction and any problems that may have occurred are discussed).

The provision of counseling, however, should be part of every interaction with the client.

Who Should Provide Counseling?

Information and counseling commonly will come from more than one source. Therefore, all staff should be knowledgeable about all available contraceptive methods.

Family Planning Information

Table 1. Method Characteristics and Figure 2. Mechanisms of Action and Figure 3. Range of Theoretical and Typical Use Pregnancy Rates per 100 Women During First Year of Use provide information that will help staff and clinicians in educating and counseling clients about all contraceptive methods.

Note: While all methods of contraception can be started anytime you can be reasonably sure the client is not pregnant (see Client Assessment chapter), the recommended time to start each method is provided in Table 1. Method Characteristics.

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