Basic Counselling Skills: Facilitator Manual
Basic Counselling Skills: Facilitator Manual
Basic Counselling Skills: Facilitator Manual
Module 2
Facilitator Manual
LifeLine/ChildLine Namibia
FHI 360 is a nonprofit human development organization dedicated to improving lives in lasting ways by
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© 2006 LifeLine/ChildLine, Namibia. All rights reserved.
This manual may be freely reviewed and quoted provided the source is
acknowledged. This book may not be sold or used in conjunction with
commercial purposes.
Facilitators who use this manual must be trained in both facilitation and
advanced counselling skills.
In 1988, I started working as a young community liaison officer for a Namibian non-
profit organisation. This experience opened my eyes to the tremendous gaps
between the values, norms and cultural influences of the country’s different ethnic
and racial groups and between those living in urban and rural settings. These
differences in experience and perspective added to the tension amongst people,
leading to a lack of trust and an inability to work together.
Amanda W. Krüger
NATIONAL DIRECTOR
LifeLine/ChildLine Namibia
director@lifeline.org.na
Over the last eight months I have lived, breathed and dreamt about community counselling,
training and curricula. Developing the Community Counselling Training Toolkit has been an
incredible experience for me. It enabled me to share my passion and concern to provide
psychosocial support and counselling to meet the needs of so many around the world,
particularly those affected by and infected with HIV. For me, it has been an honour to live
and work in Namibia and to share in the lives of so many who are tirelessly working to fight
HIV and its effects.
As is true with all curricula development, the entire team creates the finished product. The
team I have worked with at Family Health International (FHI) and LifeLine/ChildLine has been
especially generous, delightful and supportive.
Let me start by thanking the training team at LifeLine/ChildLine. The training team includes
staff trainers Nortin, Frieda, Maggy, Angela and Cornelia, and volunteer trainers Dube,
Christine, Hilarie, Emmy, Emelle and Jonas who have been absolutely fabulous to work with.
When I rushed to complete drafts of Facilitator Manuals just days before a training workshop,
the trainers never lost patience, even though it meant they had limited time to prepare for
their sessions. Their enthusiasm and willingness to try new material has never ceased to
amaze me. They have welcomed new ideas and significant changes to both the training
materials and the methodology. The encouragement and feedback I have received from the
trainers has been invaluable! You have been a delightful group of people to work with on this
project.
I would also like to thank Amanda Kruger, Hafeni Katamba and Simon Kakuva at
LifeLine/ChildLine for recognising the need to make substantial changes in the Community
Counsellor Training Toolkit and for their support throughout the process of curricula
development, encompassing piloting and testing new material as well as training trainers in
process facilitation.
None of this would have been possible without the incredible support from the entire staff at
Family Heath International/Namibia. You are all a truly talented, dedicated and fun group of
people. I would specifically like to thank Rose de Buysscher for making this whole project
possible, not only through the allocation of funds, but also for her support in turning what
began as a “harmonisation” into a more extensive project involving significant changes to
existing curricula and the design and development of new material. The technical
contributions and support for person-centred counselling offered by Dr. Fred van der Veen
enabled me to challenge some of the rigid tenets of HIV counselling, and encourage
counsellors to focus on their client’s emotional needs rather than adhering to fixed protocols.
Finally, I would like to express my deepest gratitude to Patsy Church for her inspiration and
generosity in providing so many resources, for engaging in so many stimulating
conversations, for being a cheerleader at times, and for always believing that these materials
could make a difference. Patsy tirelessly read through drafts and offered valuable feedback
and encouragement. Patsy has not only become a role model, she has become a dear friend.
My hope is that, with this Training Toolkit, community counsellors in Namibia will be better
equipped to support their clients emotionally, offering them hope as they wrestle with so
many difficult issues such as stigma, loss, coping with their HIV status, death and treatment,
as well as financial and emotional uncertainty.
After counselling and the role of the counsellor have been clarified, the focus
is on introducing basic counselling skills. These are the building blocks to be
honed throughout the Community Counsellor Training Toolkit. Each skill is
presented through a brief explanation with examples, followed by practical
activities designed to enable participants to understand the concepts and
practise these new skills. The basic counselling skills covered in this module
are listed below.
Empathy*
Listening Skills*
Reflecting Skills:
Reflecting Feelings*
Restating/Reframing
Affirmation*
Summarising*
Probing/Action Skills:
Asking Questions (Clarifying)*
Interpretation or Making Statements
Confrontation or Challenging
Information Sharing and Education
Problem Solving/Problem Management
* These are the essential counselling skills. For slower groups, especially
groups who have trouble with language, only focus on these skills.
Some of these skills may be intuitive for participants, but many of them take a
great deal of practice to master. It is not enough for participants simply to
have the skills explained to them; counsellor trainees must practise and
practise these skills to be able to use them effectively in counselling. It is due
to this fact that the focus during Basic Counselling Skills should be on role
plays, stressing quality role plays to develop these fundamental skills.
After all the basic counselling skills have been introduced and practised, there
are a couple of important sessions: Ethics in Counselling and Understanding
Behaviour Change. An ethical approach to counselling is critical for providing
quality counselling to clients. Understanding Behaviour Change sets the
stage for the different kinds of HIV counselling that will be addressed in future
modules. Most counselling, especially HIV counselling, involves some kind of
decision-making and behaviour change. Therefore, participants must
understand how they have changed their own behaviour prior to exploring this
process with clients.
The last section of Basic Counselling Skills addresses some specific issues in
counselling. These counselling topics include: substance abuse, domestic
violence, crisis counselling, suicide prevention and child abuse. The focus of
these sessions is on content and information about these specific counselling
topics rather than on developing the skills for working with clients who are
struggling with these issues. As a result of this focus on content, there are few
role plays and opportunities to practise counselling skills. There is a great
deal of information included in the participant manual which participants can
use as a reference since the time spent on these topics during training is not
sufficient to understand and master the skills required to address these issues
in counselling.
Finally, the concepts of stress and caring for oneself, both as an individual
and a counsellor, are introduced at the end of this module. This is also an
essential skill for counselling, even though it is practised outside of the
counselling session. Future modules will pick up this theme and explore it
further in the context of counselling.
Time Management: As with most of the modules in this Toolkit, unless your
group learns quickly, there is too much material in the Basic Counselling
Skills Module to cover in a week-long workshop. Focus on the core
counselling skills, as these are the skills that all counsellors will use in every
counselling setting. You may skip some of the counselling topic sessions
such as Substance Abuse, Domestic Violence and Child Abuse. These
topics can be covered in later weeks of training such as HIV Counselling and
Testing, Adherence Counselling or Counselling and PMTCT.
Objectives:
1. Open the second training module.
2. Check-in.
3. Review assignments from Personal Growth.
Session Overview
Check-In: 15
Weather Report minutes
Review Assignment from 15
Personal Growth minutes
Introduction to Basic 15 Flipchart paper
Counselling Skills Module minutes Markers
Activity 1
Time: 15 minutes
Note to Facilitator: It is best to start the workshop with an engaging activity. Since
participants already know each other from Personal Growth, you could do a short
“Ice Breaker” activity such as the one described below. Refer to the Facilitator’s
Guide, “Introductions: The First Session of a Workshop” for additional ideas for
opening activities.
Have You Ever: (a variation of the signature game and all my neighbours)
Have the group form a circle. Then ask a question starting with “Have you
ever…” Anyone who has done that thing should go to the middle of the circle.
Ask one of the people in the centre to ask the next question. Some “have you
ever…” questions are listed below:
• Have you ever climbed to the highest point in your country of birth?
• Have you ever ridden a horse?
Activity 2
Time: 15 minutes
• We are going to report on the weather this morning. You have all seen
the weather report on television. The weather reporter talks about the
weather using terms like sunny, hot, dry, humid, possible
thunderstorms, chance of rain, highs and lows, pressure systems, etc.
• Each of you is going to give your weather report. You can include the
weather for the week that you were in your communities or you could
give the forecast for this week of training.
• Have fun with this activity. Participants may exaggerate their role as
the weather reporter.
Activity 3
Time: 15 minutes
We are going to talk about your assignments from Personal Growth. Remind
me of your assignments. Let the participants respond. The basic
assignments are listed below. The full assignment is included at the end of
this session.
• Write in your journal every day.
• Write about why you want to be a counsellor, what you are looking
forward to and what your fears are.
Processing Questions:
Note to Facilitator: You can collect the journals at the beginning of the week.
However, I would suggest that you do so at the end of the week so that
participants can continue to journal throughout the week. Encouraging them to
journal is just one technique for developing self-reflection and evaluation skills. It
also can be a way to reduce stress.
Time: 15 minutes
Note to Facilitator: In this section, you should cover the following topics:
Outline of the course. Highlight the following:
o First, we will define counselling.
o Then we will focus on developing basic counselling skills. The skills
fall in five categories: empathy, listening skills, reflecting skills,
probing/action skills and problem-solving techniques.
o Since we are developing skills, we will focus on practising these new
skills through role plays. We will be doing many role plays this week.
o At the end of the week we will look at some specific topics in
counselling.
Review the group rules. Be sure you bring the rules pictures/flipchart that the
group created during Personal Growth.
Cover any housekeeping issues.
You may also address any expectations that participants have for the course.
Note: Make sure that you prepare your introduction with notes so that it is short
and to the point. It does not need to be long, but you will need to cover the main
points.
Write your responses in a journal. We will be asking you about each activity
when you return for Basic Counselling. Make a note in your journal for each
one; write about what it was like to do the exercise.
3. Enjoy Life’s Little Joys: Pay close attention to the small and
momentary (short) pleasures, like the crunch of an apple when you bite
into it, the warmth of sunlight on your back, or the cool crisp air on a
winter night. Take “mental photographs” on these moments so that
you can remember them in less happy times. You can write about
4. Thank a Mentor: Is there someone who has been there for you at a
turning point in your life, such as a difficult time in your life or when you
had to make an important decision? It could be a family member, an
old friend, a teacher or principal who believed in you, etc. Do not wait
to express your thanks in detail, and if possible, speak to them directly.
If you cannot speak to them directly, write them a letter of thanks. Write
in your journal what it was like to thank them.
Another part of your homework is to write in your journal every day. You can
write about any of the topics we have discussed during this week of Personal
Growth.
• If there were any questions or journal suggestions that you have not
written about, this is a good opportunity to write about them. Take
another look at the journal topics and questions at the beginning of the
Personal Growth Manual.
Objectives:
1. Define counselling as a process and relationship.
2. Identify characteristics of a counsellor.
3. Discuss key qualities and unique characteristics of the counselling
relationship.
Session Overview
Activity 1
Introduction
Time: 10 minutes
This section of your training will focus on basic counselling skills. All of you
are here to be trained as counsellors, but we have yet to define what exactly
counselling is. Each of you has an idea of what you think counselling is, and I
would like for us to spend some time talking about this.
Note to Facilitator:
Brainstorm a list of what counselling is.
It might be helpful to have someone act as a scribe. This person should write
all responses on flipchart paper.
When the list is exhausted, highlight that counselling is many things, but
above all counselling is a relationship. Point out that the relationship is the
foundation for counselling.
Activity 2
Time: 35 minutes
Activity 3
Time: 15 minutes
• Explore options and help the client make his/her own choices and
decisions.
Activity 4
Time: 30 minutes
• One person in each pair, please put on the blindfold. Make sure you
cannot see anything.
• Now, I would like for the “seeing” partner to guide the blindfolded
person around the room.
Processing Questions:
Once the counselling relationship has been established and trust has begun
to be developed, the counsellor and client can work together towards:
What is counselling?
(for reference)
• Counsellors are people who help others express, understand and accept
their own feelings.
• People solve their own problems. Counselling gives no advice, only helps
people to be able to face their problems, examine their options,
understand their feelings and choose alternatives that seem best to them.
Objectives:
1. Define interpersonal communication.
2. Distinguish between verbal and non-verbal communication.
3. Understand that communication includes much more than the
message or what is said.
4. Experience different types of non-verbal communication.
5. Identify barriers to good communication.
Session Overview
Activity 1
Introduction
Note to Facilitator: If
Time: 10 minutes your participants have
more formal education
One thing that we mentioned as a central part of and are comfortable
relationship building is communication, also called communicating in
interpersonal communication. In this session, we English, you can move
are going to focus on interpersonal quickly through this
session. You may
communication. We will begin by trying to define
skip activities such as
interpersonal communication. the Telephone Game
and the Birthday
How would you define interpersonal Order.
communication? Brainstorm a list: interpersonal
communication involves a lot of things. Highlight the following:
• Person-to-person communication – it goes two ways. It is a dialogue.
• Involves the sharing of information, thoughts and feelings.
• Both verbal and non-verbal.
Community Counsellor Training Toolkit Page 18
Basic Counselling Skills: Facilitator Manual May 2006
Draw the diagram below on the white board or flipchart.
send interpret
interpret respond
• What is said and what is heard, or received, are two different things.
Activity 2
Telephone Game
Time: 10 minutes
• Divide participants into groups of 8 to 10 participants. All participants
should stand in a circle. If your group is not more than 18-20 people,
you can do this in one large group.
• Instruct one person to come up with a very short story (no more than 3
sentences) and whisper it to the person to his/her right.
Note to Facilitator: Below are some sentences you could use for this game. You
can simplify them for the group if needed. Only use one sentence.
1. My mother went to Pick-n-Pay last Saturday morning. She bought a five
kilo bag of maize meal and two loaves of white bread.
2. Last Sunday when my sister went to church she wore a pink, flowered
dress and sandals.
3. Next weekend I am going to Windhoek to visit my brother and his family.
My cousin is getting married.
4. Every weekend I wash my clothes, do my shopping, clean my house and
visit my mother’s house.
• The message goes around the circle to the last person. The last
person then says what he/she heard out loud to the whole group.
Processing Questions:
Key Point: What is said and what is heard are often different. In order to make
sure that you are heard and understood, it is often important to check the client’s
understanding by asking them what he/she understood. It is also important to
make sure you regularly check your understanding of what the client has said to
you.
Activity 3
Time: 10 minutes
Activity 4
Time: 10 minutes
• Verbal communication
• Non-verbal communication
Activity 5
Time: 40 minutes
• Stand up and form two straight lines facing each other, about 1 meter
apart.
• Line A participants: tell the person facing you in line B what you did last
weekend for 1 minute.
• Both of you take one small step backward so that you are about 2
meters apart.
• Line B participants: tell the person opposite you what you did last
weekend for 1 minute.
• Both of you take one large step forward so that you are right in front of
each other.
• Line A participants: tell line B what you notice about what they are
wearing, again for 1 minute.
• Take a step back.
• Pair up with the person you were facing in the line and sit down next to
each other.
• Now one person should remain seated and the other stand up. The
person standing should talk for one minute about the last exercise.
Processing Questions:
• In pairs, set up your chairs so that you are facing each other. Begin a
conversation about what you enjoy doing in your free time.
• One person should turn away and not make eye contact.
• Switch roles.
Processing Questions:
Exercise 4: Touch
• Talk about your trip to the training centre for this course.
• After two minutes, share with each other how comfortable you were
holding hands.
Conclusion:
• It is equally important to be aware that the clients we care for also have
individual comfort levels.
You may give an example from your culture to get the discussion started. For
instance, it is acceptable for women to touch one another on the arm, but it
would not be culturally appropriate for people of the opposite gender.
(This should be no more than a 5-10 minute discussion. The purpose is to get
participants to think about these issues and realise that there are no hard and
fast rules.)
Time: 15 minutes
We have been talking about communication. Now we are going to talk about
“noise” in communication. What do you think “noise” would mean when
talking about communication? Let participants give their ideas.
• Language barriers
• Lack of communication skills, i.e. poor verbal and non-verbal
communication
• Distance
• Environment, i.e. interruptions
• Interpretation of message
• Attitude or values
• Cultural differences
• Gender
• Emotional issues
• Religious beliefs
Objectives:
1. Describe person-centred counselling and its basic theoretical
assumptions.
2. Explain these assumptions as they apply to the counselling setting.
3. Discuss how this approach may be different from pre-conceived ideas
of counselling.
Time: 45 minutes
Session Overview
Activity 1
Introduction
Time: 30 minutes
• The central part of Carl Rogers’ theory is that the client, or the
person, knows best.
• The client is essentially the expert on his or her life, and what he/she
is thinking and feeling, etc.
• This style of counselling has also been called “non-directive”
counselling, to emphasise that the counsellor’s role is to enable the
You can also list external resources such as relationships, community, family,
job, etc.
Based on Carl Roger’s theory, there are some basic assumptions to this
counselling approach we will be teaching you.
• People are responsible for and capable of making their own decisions.
Refer to Decision Making: Locus of Control Session from Personal
Growth.
Additional Explanation: There are things that people cannot change in their
environment. For instance, they may not be able to change their living situation.
However, they often do have more options or choices than they may perceive. In
a difficult living situation, for instance, they may be able to rearrange the rooms,
suggest a cleaning schedule, or change an attitude. People often feel trapped
when in fact they have more options than they realise.
Additional Explanation: Understanding that people are simply trying to meet their
needs can sometimes help in treating them with compassion. People do things
for a reason and sometimes looking past the behaviour in order to understand the
purpose can be helpful.
• People are capable of changing; they can learn new behaviours and
unlearn existing behaviours.
Additional Explanation: While old habits are hard to break, people are
capable of change. So much depends on one’s self-motivation and
willingness to change.
• People feel trusted and respected when you have enough confidence
in them to offer honest and constructive feedback and allow them to
make their own choices and direct their own growth.
Time: 15 minutes
• The focus is the relationship between the counsellor and the client and
the process of change.
• The counsellor is not the expert to provide all of the answers and
solutions.
• The client is the expert, and the relationship with the counsellor allows
the person to trust him/herself through trusting the counsellor.
• Is this what you thought counselling was when you first applied to become
a community counsellor? How is it different?
Let participants discuss this. Most likely this is quite different from most
people’s understanding of what counsellors do. This discussion should help
participants understand the significance of this approach to counselling.
• In some ways this approach is very difficult, because it runs counter to our
society that thrives on efficiency, quick answers and the role of the expert.
Because of this social influence, the counsellor may feel pressure from the
client to act in the role of the expert and to try and “fix” things. The
counsellor should stick to the process and the experience of the client.
Objectives:
1. Identify and discuss the four phases of a counselling session.
2. Apply this counselling process model to role play scenarios.
Time: 50 minutes
Session Overview
Activity 1
Introduction
Time: 10 minutes
Activity 2
Presentation/Discussion
Time: 40 minutes
There are five main stages or phases in the process of a counselling session:
1. Trust Building
4. Resolution (Decision-Making)
5. Termination
• Notice that in the counselling model, it lies at the centre of the diagram
and underlies each stage of the counselling process. Remember that
counselling is a relationship; building trust is part of developing a
relationship. Building trust continues throughout the counselling
relationship for as many sessions as a counsellor and client work
together.
• Physical Environment:
• This is the first thing you do to build trust. You are setting the
framework for the counselling relationship.
• If your client seems uncomfortable, you can always start with easier
questions to put the client at ease. These questions should be
common knowledge questions or questions you would ask someone
when you first meet them. Think about things that would fall into the
“Free Self” window of Johari’s Window. Some examples of these
questions:
o Can you tell me a little bit about your family?
o Where are you from?
o How long have you lived in ______?
• Some clients are so ready for counselling that they almost instantly
trust the counsellor and very quickly develop a high level of self-
disclosure, but for others this will be a slower process.
• Notice that in the counselling model, “Exploration” is the longest (or the
largest based on the model) stage or phase of the counselling session.
This is where you will spend most of your time.
• Use empathic listening and reflecting skills during the beginning of the
exploration phase.
• After the client has “vented” (expressed their thoughts and feelings),
you can start to help him/her focus by defining the problem. In order to
do this, you will use more probing or action skills. You will start to ask
more questions and maybe make some interpreting statements.
• Make sure that when you define the problem you give it clarity, both in
terms of the situation as well as the thoughts and feelings associated
with the issue.
• The counsellor may use some confrontation towards the end of the
“Exploration” phase if the trusting relationship has been established.
4. Resolution (Decision-Making)
• Towards the end of the counselling session, you move into the
resolution phase.
• The client might not be ready to make a decision by the end of the
counselling session. If that is the case, let the client leave with the
resolution to make a decision before he/she returns. Do not force the
client to make a decision prior to the end of the session.
Note (Model of Counselling Session): the arrows back and forth on the sides
between Exploration and Resolution mean that it does not always move smoothly
from exploration to resolution.
Sometimes a client will be ready to resolve only a small portion of the
problem and then they will jump back to exploration of the broader issue.
If the client is hesitant or resistant to come to a resolution about the
problem, it could mean that there are other issues involved that he/she has
not talked about. In this case, jump back to the exploration phase. Explore
the thoughts and feelings around the problem at length.
Especially for beginning counsellors, there is a tendency to race through
these phases because of our anxiety about helping the client. Slow down,
take deep breaths and allow full exploration of the problem before trying to
work with the client to resolve it.
Remember that it may come as a huge relief to the client to just talk openly
about his/her problems. Often clients feel as though they have no one to
talk to, so just being able to talk freely is healing in and of itself.
• Summarise what was discussed during the session; include the focus
and any decisions or plans that were made.
• Reiterate the focus. This is important in order to make sure the client
stays focussed on what he/she has control over and lets go of what
he/she cannot change.
• Highlight any referrals that were provided to the client.
• Discuss any future counselling sessions and make necessary
appointments.
• Gives the counsellor some tools, or a map, for guiding the client
through a problem.
EXPLORATION
Understanding the Problem
RESOLUTION
Decision-Making
TERMINATION
Ending the Session
Objectives:
1. Identify the importance of role plays and how they will be used in this
course.
2. Discuss guidelines for giving feedback.
Time: 40 minutes
Session Overview
Activity 1
Introduction
Time: 5 minutes
Before we talk about basic counselling skills and how to conduct counselling
sessions, there are a few ground rules about how we are going to go about
learning how to be a counsellor.
• Over the rest of your training we will be reviewing and practising the
basic counselling skills that you will learn this week.
Time: 35 minutes
Can anyone tell me what a role play is? Let participants come up with their
understanding of role play. Below are key points to highlight:
• In order to make the role plays most effective, it is best if you bring real
life examples. For example, as the client you could present a problem
that has been resolved. If it is a real scenario, then you can identify
the feelings and issues around the problem.
• Do not try to pretend to be someone you are not in the role play. For
instance, do not act out the role of 12-year-old boy, or a 75-year-old
widowed woman.
• Usually we will do our role plays either in the larger group or in small
groups of three. One person will be the counsellor, one the client and
one person will have the job of observing and then giving feedback.
Sometimes these role plays will be done in small groups, and sometimes they
will be done in front of the class. For many of you, the idea of doing a role
play may be scary and intimidating. Do not worry: we will be easing into role
plays and giving you a chance to become more comfortable with them.
Since most of the role plays that we will be doing in this training will involve
three people, we should talk about the duties or roles of each of the
participants in our role plays.
Note to Facilitator: This can be a discussion since the participants should be able
to generate their own ideas about what each of these roles entail. Let them
come up with their ideas. This is part of empowering them as future counsellors.
Remember, as a facilitator you are modelling many of the counselling
characteristics we have discussed. Key points are highlighted here.
• This means that the client in a role play should use a real-life
example. This can be a minor problem that may have already been
resolved.
• You can also role play a problem which you have observed
troubling someone else or with which you are familiar.
• If you present a problem that you are not familiar with, it will be
much harder for the counsellor to practise his/her skills.
• During the role play, the observer should not say anything.
• After the role play is over, he/she will provide feedback to the
counsellor.
Again, let the participants come up with their ideas. Some key points are
below:
• These skills take practise. The feedback helps us see what we did
well and what we need to improve.
Always give feedback soon after the role play. It can be helpful to think of
giving feedback like a sandwich. The bread on the top and bottom of the
sandwich represents positive feedback and the filling is the constructive
criticism or areas for improvement.
Constructive
Suggestions for
Improvement: be
very specific
Positive Comment
on overall
performance
Before providing feedback, ask the counsellor and the client how the role play
was for them. Always let the counsellor evaluate his/her own performance
I praise loudly
I blame softly
Catherine the Great
Objectives:
1. Define empathy.
2. Distinguish between empathy and sympathy.
Time: 30 minutes
Session Overview
Activity 1
Time: 30 minutes
• Have any of you ever heard the word empathy? What does this word
mean to you?
What is empathy?
Let the participants come up with their definitions. Below are some to add if
the participants do not mention them. You may need to explain some of these
definitions. It may be helpful to put these definitions on a flipchart or refer to
the Participant Manual.
Short Activity: Everyone please take off your shoes. Your neighbour should now put
on your shoes. Stand up and walk around a little bit. Give them a minute to do this.
Processing Questions:
What is it like to wear someone else’s shoes? Does it feel the same as your
shoes? Do your toes fall at the same place? Is it comfortable? The point
you are trying to communicate is that each person’s shoes are unique to
them, just like each person’s perspective and experience are unique to
them.
Do you like wearing someone else’s shoes? Some will be very resistant to
wearing other’s shoes, while others may not mind it. This can be used to
illustrate how different people feel coming to counselling. Use this to
illustrate that some may be very uncomfortable in counselling; this exercise
might give us empathy for what it is like for them.
1. Open-mindedness: you must set aside for the moment your own
beliefs, values and attitudes in order to consider those of the other
person.
Often we hear the words sympathy and empathy together. What is the
difference between sympathy and empathy?
Objectives:
1. Define listening as an active skill.
2. Define empathetic listening and identify its components.
3. Develop an understanding of empathetic listening, which is essential
for counselling.
4. Practise active listening skills through role plays.
Session Overview
Activity 1
Pair Activity
Time: 20 minutes
Most of you know that listening is one of the most important aspects of
communication and essential in counselling. But before we define listening
and talk about listening any further, I would like us to do a short exercise.
1. Instructions: I would like each of you to pair up with the person sitting next
to you. I would like one of you to talk and the other to not listen. Did you get
that? One person should talk and the other person does not listen.
Processing Questions:
What was that like for the talkers? What was your response to not
being listened to?
What was it like for the non-listeners? How did you not listen?
Processing Questions:
What was that like for the talkers? Did you feel heard and
understood?
What was that like for the listeners? Is it hard to keep your
mouth closed and not talk?
3. Instructions: We have one more activity in your pairs. I would like one
person to talk and the other person should listen. This time the listener can
also speak.
Processing Questions:
Key points:
• Listening is active.
• There is more to listening then simply not talking, or lending your ears
to somebody.
There is none so blind as
• There are verbal and non-verbal those who will not listen.
components to listening. You can listen William Slater
without saying anything.
• Listening involves more than just one sense. It is not just hearing with
your ears, but also involves observing with your eyes and saying things
at times. It can include touch as well.
Presentation/Discussion
Time: 30 minutes
• Participating in the world of the other person and being a part of what
that person is experiencing.
• Not just hearing words but listening to how the words are being said,
what tone of voice is being used, what words are being used to
describe the experience, what body language the person is displaying,
what facial expressions show, what gestures indicate, the flow of
words and the hesitations.
Empathetic listening is not: (NOTE: Skip this section if you are working with a
group is slower in grasping the concepts.)
• Defensive: interpreting what is being said into either what you want to
hear or what you think you are hearing.
• Too anxious to make sure that the client know that they empathise with
him/her that the person becomes sympathetic and takes sides.
Have you ever had an experience when you talked with someone about a
problem? It could have been a friend or family member who simply listened to
you. They did not give you a solution or tell you what to do; they simply
listened while you talked about your thoughts and feelings. Afterwards you
felt better, just because you talked about it and felt heard. Often just the
experience of talking while another person listens can be healing.
Time: 20 minutes
Key Point: Role plays are not a test. They are tools that we use to practise
specific skills. It does not matter if you make mistakes; that is how you learn!
• We have been talking about active listening and what it is. Now we will
practise what we have been discussing. Remember that active
listening takes into account the non-verbal communication that we
talked about several sessions ago. So, do not forget to communicate
your active listening skills verbally and non-verbally through body
language.
• I would ask for you to divide into groups of three. One person will be
the client, one the counsellor and the third person will observe. The
client will present a problem of some kind. You can discuss any
personal issue if you feel comfortable with that, or you can present a
hypothetical problem. It would be helpful if you used a real-life
example. It can be a recent problem or something that has already
been resolved.
• The counsellor will practise active listening. Try to keep from asking
any questions. You are practising active listening. The observer will
quietly listen to the counsellor/client interaction, noting what the
counsellor did that characterised active listening.
• After five minutes, stop the role play. Ask the observer to check with
the client and counsellor on how the experience was for them, and
then give feedback to the counsellor. They should mention at least two
things that the counsellor did well that characterised active listening.
• Allow 2-3 minutes for the feedback and then rotate roles. Again, stop
the role play after 5 minutes and have the observer give feedback to
the counsellor. Switch roles and repeat the process. Everyone should
have the opportunity to function in each role.
Note to Facilitator: It is absolutely essential that you move around the room as
participants are doing their role plays and giving feedback. This allows you to
see if they are practising the new skills. If there is more than one facilitator in the
room, all facilitators should be roaming around the room listening to the role
plays.
How did it feel in the different roles? Which were the most
challenging/easiest?
Did active listening come easily? Is it natural for you or does it take
a lot of work?
When you were the counsellor, how did you communicate to the
client that you were listening? Make sure you get specific answers
i.e. not just body language (it is too general), but she nodded, she
leaned forward when I talked, his facial expression was warm and
inviting, etc.
When you played the role of the client, did you feel heard? Did you
feel like the counsellor understood your experience? What made
you feel heard?
What was it like to be the observer and give feedback?
What about receiving feedback? What was it like to receive
feedback from your colleagues?
Activity 4
Time: 20 minutes
What hinders active or empathetic listening? Let participants brainstorm a
list, and make sure the following are included:
Also, refer to the Communication Session in Personal Growth, particularly to
the section on noise in communication.
• What is happening in your own life: this may change your perspective
about what your client is going
through. Note to Facilitator: You can
point out that many of the
• Your own emotions or emotional same things that hinder
empathy also hinder active
things happening in your life.
listening.
• Preparing response: if you are preparing what you will say, you cannot
be listening to the client.
Creative Listeners: (Optional) Skip this section if your group learns more
slowly.
• Are willing to hear all you want to say, even the dull or confused ideas
and feelings.
*This is a skill that requires training, discipline and practise. It does not come
naturally.
Throughout your training, we will be coming back to listening skills so that you
can develop and practise your ability to being a creative and active listener.
**We will be practising the skill of active listening throughout the entire
training, so you will have the opportunity to really build your active listening
skills. This is one of the most important things for successful counselling.
Objectives:
1. Define reflecting skills.
2. Understand the purpose and general guidelines for reflecting skills in
counselling.
3. Develop and expand feeling word vocabulary in local languages.
4. Practise reflecting feelings.
Session Overview
Activity 1
Presentation/Reflecting Skills
Time: 20 minutes
What do you think reflecting skills are? Think about the word reflect: what
does it mean to you?
• Bring out the mirror to talk about what a reflection is. A reflection just
shows what is there; it does not make a judgement about it, it does not
add to the image, it does not say you cannot do that or you should not
have said that, etc.
Why are reflecting skills important? What do you think the purpose is of
reflecting back to the client?
Let the participants list their reasons; ask someone to record them on a
flipchart for you.
We are going to highlight four different reflecting skills. These are skills that
can be used at any stage of the counselling session, but are especially
important for trust building and exploration.
1. Reflecting feelings*
2. Restating/Reframing
3. Affirmation*
4. Summarising*
Note to Facilitator: The key reflecting skills are reflecting feelings, affirmation and
summarising. If your group is struggling with language or the content of the course,
please spend more time on those skills so that participants can master them through
practise, rather than rushing through all of the skills in this session. Skip
restating/reframing skills if participants are having a difficult time understanding the
concepts and mastering the skills.
Example:
Client: “I’m the only one working in my family. My mother, my sister and
her two children stay with me and my three kids. My sister just came a
month ago and she can’t find any work. I can’t afford the school fees for
my own children so I don’t know what to do about schooling for my sister’s
kids.”
Activity 2
Time: 40 minutes
MAD
• See if you can come up with at least five different words under each
category. Put the words on a line like we just did, based on the
intensity of the feeling.
• Give each group flipchart paper and markers to draw their continuums.
Give the group about 20 minutes to do this exercise.
• You do not need to do much processing after the activity; just ask
some of the questions below. Make sure that you post the feeling
continuums in different languages on the wall.
Processing Questions:
Key Point: I would encourage you to continue to work with feelings in your
local languages. Talk to your friends and families and develop your own
feeling words lists. It is also helpful to put them on a continuum, or scale,
just like we have done. Your reflecting feelings skills are dependent on
your feeling word vocabulary.
Activity 3
Exercise
Time: 20 minutes
• We will take turns reading each of these examples. After it has been
read, we will first identify the feelings. What might the client be
feeling? Make sure people identify a number of different feelings.
Remember we usually do not feel just one feeling at a time.
• After the feelings have been named, we will then give some responses
a counsellor might say to reflect the client’s feelings. Make sure to
Note to Facilitator: When talking through each of these examples you can point
out the following:
Notice that none of the clients are actually stating their feelings.
There are many different feelings that could be correct for each example.
Point out how a client could be feeling different things simply with a different
tone of voice or their non-verbal communication.
Focus on the client and the client’s feelings, NOT the situation or the person
they are talking about.
Introduce ways of reflecting feelings i.e. “It sounds like…,” “You seem…,”
“Maybe you’re…,” “It seems like…”
Comment on tone of voice and body language when reflecting feelings.
3. “Things have been difficult with my husband for a while. He works far
away in Walvis Bay and is only home a few times a year. When he
comes home we argue. Sometimes I wish that he just would not come
home.”
4. “For years and years I worried about my son. Now he finished grade
12 and just found a job last week.”
6. “I have been going through a difficult divorce this year. It has been
unfair and especially hard for my kids.”
7. “Since I came in for my HIV test last week I have not been able to
sleep waiting for my test results.”
Activity 4
Time: 40 minutes
We are going to do an activity called a Relay Role Play. Does anyone know
what a relay is?
• We will start with one volunteer counsellor, who will begin the
counselling session practising reflecting feelings. You can just stay in
your seat and counsel the client from there. That way you should not
feel too much on the spot.
• When that counsellor gets stuck, he/she can ask for another volunteer
counsellor. The new counsellor will then pick up where the previous
counsellor left off.
• We will continue this for a few minutes so that several counsellors can
have a chance to practise.
Processing Questions:
What was that like for those of you who were counsellors? What
was challenging/easy?
How do the rest of you think the counsellors did? Can you give
them some feedback?
Objectives:
1. Define restating/rephrasing, affirmation and summarising skills.
2. Practise all reflecting skills through role plays.
Session Overview
Note to Facilitator: The key reflecting skills are reflecting feelings, affirmation and
summarising. So, if your group is struggling with language or the content of the
course, please spend more time on those skills so that participants can master
them through practise rather than to rush through all of the skills in this session.
Presentation/Discussion
Time: 10 minutes
Example:
Client: “I’m so angry with my husband. I just want to kill him; he makes
me so mad.”
Counsellor: “It sounds like your irritation and frustration with your husband
has increased and is reaching a climax.”
How is this skill different from reflecting feelings? How is it the same? Ask
this question to verify participants’ understanding of the material.
Exercise
Time: 30 minutes
• Keep in mind that you are reflecting both feelings and content (what
the client is saying).
1. “I started seeing this guy. We have spent quite a bit of time together
and I really like him. We have been really careful and had protected
sex. It has been about two months and now my boyfriend does not
want to use a condom. He says that if I trust him I should not ask him
to use a condom. I am so confused. I do not know what to do.”
2. [crying] “Last night my husband came home really late. He was drunk
again. We started arguing, but it is no use. I am so angry at him. He
will never change.”
3. “My mother is getting sick. She is alone in the village up north and
only has one of my brother’s children staying with her. But, I am not
sure that the boy is really taking good care of her. I am so worried
because they are far from the hospital and he will not know what to do
if she gets sicker.”
4. “Lately my last-born girl has been teased a lot at school. They call her
names and say that she is ugly. Last night she was crying again. I get
so angry at those cruel kids and want so badly to protect her.”
5. “My wife passed away a few weeks ago. She was sick for some time
but she refused to be taken to the hospital. I am scared that she might
have had AIDS but I do not know.”
7. “My best friend just got tested and found out she is HIV positive. I
know that there is a lot that can be done for treatment now, but I still
feel so sad and hopeless.”
8. “I am so tired all the time. There never seems to be enough time in the
day to do everything. I finish work and have to do the shopping, then
go home and care for the kids and make supper. I am so
overwhelmed and feel like everyone depends on me.”
Activity 3
Presentation
Time: 10 minutes
Affirmation: acknowledges the client; affirms or encourages them in the
choices they have made. Affirmation can be for choices, knowledge or
behaviour.
• This skill is very similar to how a teacher affirms or verbally rewards a
learner, or how a parent might encourage a child by saying “well done”
or “you have done a good job” or “you have done your best.”
• This may begin with the counsellor affirming the client for his/her
choice to come for counselling.
• But, unlike the affirmation of a teacher to a learner, the key skill of
affirmation in counselling is encouraging the client to affirm him/herself;
this is something the client can do for him/herself, rather than to
depend on the counsellor for it. For instance, instead of saying, “I am
so proud of you for coming back to get your test results,” the counsellor
should say, “You should be very proud of yourself for …returning for
your results” or “…for making the choice to use a condom this
weekend.”
• Affirmation is an important skill for empowering clients; by affirming
them, we are encouraging clients in the healthy decisions and
behaviours they have chosen and thereby empowering them to
continue making similar choices.
Time: 10 minutes
• The next activity we are going to do in pairs. Please pair up with the
person sitting next to you.
• Each of you should think of an affirmation you can give to your partner.
This can be something you have noticed that your partner does well, or
a positive characteristic that they possess such as good leadership,
patience or peacefulness, etc.
• Then I want you each of you to share your affirmation with your
partner. Remember to pay attention to your body language, your tone
of voice and your facial expression.
Processing Questions:
Activity 5
Presentation
Time: 10 minutes
Example:
Counsellor [at the end of the counselling session]: “Today you have been
talking a lot about the overwhelming amount of responsibility you feel for
all the family members staying with you. We have looked at ways for you
to let go of things that you have no control over and to look at choices for
responding and behaving where you didn’t see yourself as having a
Activity 6
Time: 40 minutes
We are going to do another relay role play, but this time we are going to use
all of the reflecting skills.
• [Name of facilitator] is the client – you may want to set up the scenario.
Note to Facilitator:
• Who wants to start as the counsellor? Pass Please refer to the
the ball to that person. previous section on
reflecting feelings and
• Remember that you are not allowed to ask follow the same
questions! We are practising listening and instructions on this
reflecting skills. relay role play.
• Continue on with the role play, stopping when the counsellor gets stuck
and passing the ball to the next volunteer. In order to practise
summarising skills, each new counsellor can summarise as a way to
begin his/her section of the relay role play.
Activity 7
Time: 40 minutes
• Divide into groups of three. We will be doing role plays and I am going
to ask each of you to play a different role. The three roles are client,
counsellor and observer. We have talked some about these roles, but
let me remind you again of how this role play will work.
• The counsellor should practise these four skills that we have been
talking about. You are only using reflecting and listening skills.
Remember, this means that you cannot ask questions.
• Each role play will be for 5 minutes. I will keep track of the time and
tell you when to stop the role play. When the role play is stopped,
check with the client and the counsellor before the observer gives the
counsellor feedback for a few minutes. Remember to use the
feedback skills that we have talked about.
• We will do this three times so that each person will have the
opportunity to play each role.
• Have the role plays begin and circulate to see how the groups are
doing. Did the participants grasp and understand these skills? Is role
playing hard for them? What needs to be focussed on?
Large Group Processing: ask about the participants’ experiences in each role.
As participants bring up difficulties or challenges, and model empathy and
acceptance. No experience is wrong; some might find it easy, while others
may find it intimidating and very difficult.
Objectives:
1. Define probing and action skills.
2. Understand the purpose and general guidelines for probing and action
skills in counselling.
3. Identify, understand and practise two probing and action skills: asking
questions and interpretation.
Session Overview
Warm-up Activity
Time: 10 minutes
1. Divide into small groups. The size or number of groups does not
matter, as long as the groups are not too big. Ideally, groups should
have 4-10 members.
2. Tell the group that you are going to call out a feeling word. In their
groups, they need to write down as many synonyms to that feeling
word as possible. This would roughly follow the feeling word lists
provided to participants.
3. The group with the most feeling words wins. You may want to offer
some candies, stickers or a pen as a prize.
4. Time permitting, you can play it a couple times with different words.
Note to Facilitator: There are many adaptations you can make to this activity.
You can have participants list as many words on their own as possible. You can
even have them write a list of words in their local languages. Use it as a quick
warm-up, but do not spend a lot of time on it.
Activity 2
Presentation/Discussion
Time: 20 minutes
• Ways or skills for exploring the client’s thoughts, feelings, actions and
behaviours.
• These skills are a little more invasive and directive than listening or
reflecting skills.
*Note to Facilitator: If you have a group that is less educated and is struggling
either with language or with these concepts, you can focus on Clarifying or Asking
Questions. The other skills are less important for basic counselling skills and can
be skipped if need be. It is better to spend your time focussing on fewer skills so
that participants can master them than to give participants too much confusing
information and not have time to practise the skills.
Pair Activity
Time: 10 minutes
• I want each of you to pair up with the person sitting next to you. I want
one of you to only ask closed questions. Remember, these are
questions that you can answer with one word. So, one person will ask
closed questions and the other person will answer.
• You have two minutes. Stop them after two minutes and ask pairs to
switch roles. Again, stop the pairs after two minutes.
Processing Questions:
Activity 4
Presentation/Discussion
Time: 5 minutes
• Now that we have discussed closed questions, can anyone tell me what
open questions are? Let participants respond.
Pair Activity
Time: 10 minutes
• We are going to go back to our pairs again. This time, I want you to
ask only open questions. The partner should take his/her time in
answering the question. Build your next open question on what your
partner just said.
Processing Questions:
Activity 6
Written Exercise
Time: 20 minutes
Presentation/Discussion
Time: 15 minutes
Examples:
o Can you tell me more about what that was like for you?
o How have you been doing since you started caring for your
mother?
o What happened after your husband came home drunk?
Examples:
o How did you react to your test result?
o Who have you disclosed your HIV status to?
o When were you first tested?
Examples:
o If you were to disclose your status to your boyfriend, how do you
think he would react?
o If your boyfriend found out from your best friend that you were
pregnant, what do you think would happen?
o If you asked your brother to help with the cooking, what do you
think his response would be?
Examples:
o What is the worst thing that could happen?
o If we could only deal with one thing today, what would be most
important to you?
Tips for asking questions:
• Ask questions directly and clearly.
• Ask questions concisely; be specific and brief. Do not ask long, drawn out
questions.
• Share your purpose for asking the question.
• Ask questions gently, even tentatively at times.
• Either/or questions because they can be leading. The client will want
to answer them with what they think you want to hear. For example:
“In the future, would you stay at the bar late on the weekends or would
you stay home?”
• Multiple questions: if you ask more than one question at a time, it can
be confusing. It can also make the client feel interrogated. Ask only
one question at a time. Let the client answer that question before
asking another one.
Exercise
Time: 40 minutes
• Refer participants to their manuals for the scenarios below. These are
the same scenarios for practising restating/rephrasing.
• We are going to break into small groups of 3-4 people. In your groups
you will come up with at least one question for each of these
scenarios. If you can, try and come up with two or more questions for
each scenario. Remember that you want to ask open questions.
• Give the groups some time to come up with their questions. Then bring
the large group back together and go over each scenario and the
potential questions.
Note to Facilitator: There are many adaptations you can do with this exercise:
Assign it as homework; ask that participants think of at least two questions for
each scenario.
Ask groups to each prepare one role play scenario, modelling how to ask
their questions.
Assign two or three scenarios to each group in order to move through the
exercise more quickly.
Suggested questions:
o What are some of the things that keep going around in your
mind?
o How do you feel about what he said; that if you trust him,
you should not have to use a condom?
2. [crying] “Last night my husband came home really late. He was drunk
again. We started arguing, but it is no use. I am so angry at him. He
will never change.”
3. “My mother is getting sick. She is alone in the village up north and
only has one of my brother’s children staying with her. But, I am not
sure that the boy is really taking good care of her. I am so worried
because they are far from the hospital and he will not know what to do
if she gets sicker.”
Suggested questions:
o Can you tell me about what makes you question whether this
boy is taking good care of your mother?
o What has happened in the past that makes you wonder if
your mother is being well taken care of?
4. “Lately my last born girl has been teased a lot at school. They call her
names and say that she is ugly. Last night she was crying again. I get
so angry at those cruel kids and want so badly to protect her.”
Suggested questions:
o Can you tell me more about what feelings this stirs up in
you?
o Try and describe the feelings that come up when you see
your child crying like this.
o Were you ever treated in a similar way by kids at your
school?
5. “My wife passed away a few weeks ago. She was sick for some time
but she refused to be taken to the hospital. I am scared that she might
have had AIDS but I do not know.”
Suggested questions:
o Can you tell me some more about your suspicions?
o Will you describe more of your fears about the possibility of
your wife having had AIDS?
6. “Both my good friend and I were looking for work. We talked to the
same company. Yesterday I was told that I got the job. I feel so guilty.
Why did they want me instead of my friend? How am I going to tell
Simon?”
Suggested questions:
o Please explain the history of your friendship with Simon.
o Can you describe your fears and concerns in more detail?
Community Counsellor Training Toolkit Page 79
Basic Counselling Skills: Facilitator Manual May 2006
7. “My best friend just got tested and found out she is HIV-positive. I
know that there is a lot that can be done for treatment now but I still
feel so sad and hopeless.”
Suggested questions:
o Can you tell me more about the hopelessness?
o What impact does her positive status have on you?
8. “I am so tired all the time. There never seems to be enough time in the
day to do everything. I finish work and have to do the shopping, then
go home and care for the kids and make supper. I am so
overwhelmed and feel like everyone depends on me.”
Suggested questions:
o It sounds like you are carrying the weight of the entire family.
How did you end up with all the responsibility?
o When do you take care of yourself?
Activity 9
Presentation/Discussion
Time: 10 minutes
Interpretation or Making Statements: this skill involves making a statement
about the counsellor’s understanding of what the patient is communicating.
Example:
Client: “I am so overwhelmed with trying to make enough money to
support my family, keeping the kids in school, cooking food and cleaning
the house. There is just so much to do
and not enough time.” Note to Facilitator: Using lots of
examples will help participants
Counsellor: “Maybe it feels like you are understand. Participants also
can generate their own relevant
the pillar of strength holding your family
examples.
together.”
Example:
Client: “I seem to be continually tired. I do not ever seem to have any
energy. When I get home from work my wife starts nagging me and the
kids are all over the place. All I feel like doing is climbing into bed and
sleeping.”
Activity 10
Time: 45 minutes
This role play will be conducted just like the role plays done in the previous
sessions, using Reflecting Skills.
• Divide the group into triads (groups of 3). Each member of the group
will have a turn being each of the three roles: counsellor, client and
observer.
• In this role play, I want you to remember your reflecting skills, since
these should come before and after any probing or action skills you
use. Observers, please pay special attention to the questions the
counsellors ask. You may even want to write them down so that you
can address them in your feedback.
• Once again, the role plays will be for 5 minutes and I will stop you and
tell you when it is time for the observers to provide feedback.
Note to Facilitator: You may substitute a relay role play or even have two
facilitators demonstrate the skills as client and counsellor. The important thing to
remember is that when participants are practising their skills in triads, you must
circulate among them to make sure they are applying the skills correctly.
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2. [crying] “Last night my husband came home really late. He was drunk
again. We started arguing, but it is no use. I am so angry at him. He
will never change.”
3. “My mother is getting sick. She is alone in the village up north and
only has one of my brother’s children staying with her. But, I am not
sure that the boy is really taking good care of her. I am so worried
because they are far from the hospital and he will not know what to do
if she gets sicker.”
4. “Lately my last born girl has been teased a lot at school. They call her
names and say that she is ugly. Last night she was crying again. I get
so angry at those cruel kids and want so badly to protect her.”
5. “My wife passed away a few weeks ago. She was sick for some time
but she refused to be taken to the hospital. I am scared that she might
have had AIDS but I do not know.”
6. “Both my good friend and I were looking for work. We talked to the
same company. Yesterday I was told that I got the job. I feel so guilty:
why did they want me instead of my friend? How am I going to tell
Simon?”
7. “My best friend just got tested and found out she is HIV-positive. I
know that there is a lot that can be done for treatment now but I still
feel so sad and hopeless.”
8. “I am so tired all the time. There never seems to be enough time in the
day to do everything. I finish work and have to do the shopping, then
go home and care for the kids and make supper. I am so
overwhelmed and feel like everyone depends on me.”
Objectives:
1. Define probing and action skills.
2. Understand the purpose and general guidelines for probing and action
skills in counselling.
3. Identify, understand and practise two probing and action skills:
confrontation/challenging and information sharing/education.
Session Overview
Activity 1
Presentation/Discussion
Time: 20 minutes
Purpose of confrontation:
What might you confront in counselling? Let participants offer their ideas.
What to confront:
• Unrealistic expectations
Example: “We have talked a couple of times about how your
husband has been drinking heavily for years. After the last
binge you are now telling me that he has promised that he will
stop drinking now. What makes you believe him this time?”
Time: 40 minutes
• I will give you 25 minutes in your groups. When we come to the larger
group again, I will ask your group to role play the client and counsellor
for these scenarios.
1. “I have just been through a very painful and difficult divorce” [said with
a smile].
Suggested confrontation:
o You are talking about such a difficult thing yet you are
smiling. I am wondering what your smile is hiding.
2. “She kept my secrets last time. But, I do not know if she can be
trusted now.”
Suggested confrontation:
o You say that she kept your secrets last time but yet you
doubt her trustworthiness. I am wondering what the
doubting is about.
o I am confused as to why you would doubt her
trustworthiness since she proved to be trustworthy last time.
Presentation/Discussion
Time: 10 minutes
Activity 4
Time: 50 minutes
Note to Facilitator: You do not need to stop and provide feedback after every
counsellor. At times, it is best to keep up the momentum of the counselling
session and provide feedback later.
Note to Facilitator:
You can set up chairs in the front of the room so that it seems more like a
counselling session.
This works best when you have two facilitators. One can play the role of the
client and the other can facilitate the relay role play process.
Do not allow a poor counsellor to continue in the role play too long. Balance
the need for everyone to have practise and the importance of having quality
counselling skills demonstrated.
You can also have a facilitator demonstrate as one of the “relay counsellors.”
This is helpful when you want to move the counselling session along or if you
want the participants to see a good example of counselling skills.
Each new counsellor can start by summarising what has been discussed by
the previous counsellor/s. This will give participants the opportunity to practise
their summarising skills.
Processing Questions:
It seems to work best to have only the counsellors evaluate themselves and then
to have the facilitator provide feedback. Be sure to sandwich the feedback and be
very specific.
Involve the participants by getting their suggestions for how a question could
have been phrased better or how to create a more supportive atmosphere.
Objectives:
1. Explore problem-solving techniques.
2. Identify and experientially understand three ways to address problems
in counselling.
Session Overview
Activity 1
Introduction
Time: 5 minutes
I want you to think back and reflect on how you We cannot solve our
have solved various problems in your life. What problems with the same
techniques have you used to solve your problems or level of thinking that
to make decisions? created them.
Albert Einstein
Let participants have a discussion about this. Keep
the discussion specific; do not let the participants be too general. We want to
know the specific tools they have used. It might be helpful to give their
techniques names and list them on the flipchart paper. Refer to the
“Decision-Making: Circles of Influence & Concern” session from Personal
Growth.
Presentation
Time: 10 minutes
Note to Facilitator: There are numerous ways to manage problems. Below we are
just focussing on three examples. Depending on the skill level of the group, you
may incorporate some problem-solving techniques that participants have used
themselves. Encourage them to be creative with problem management.
Alternatives/Options
• Many clients’ problems stem from their beliefs that they have no
options. They feel stuck in a certain situation. Often clients have
options or alternatives that they have not considered. These
options can include a potential action, a new perspective or even
an alternate attitude.
• Counsellors can ask the simple question, “Have you thought of any
options open to you?”
Brainstorming Activity
Time: 25 minutes
We are going to do a brainstorming activity. Please take out a sheet of clean
paper or open to a clean page in your notebook.
• In the very middle of the page I want you to draw a circle. Inside
the circle, I want you to write the following problem: “How can I
disclose my positive HIV status to my family and friends?”
• From your problem in the centre you should now draw lines out
from the centre circle to other circles. In each of those circles, write
an option or alternative. Think of as many possibilities as you can.
Give participants 5 to 10 minutes to do this.
• Now from those option circles, draw other lines representing
potential outcomes to that alternative. Again, come up with as
many outcomes as possible. Give participants another 5 to 10
minutes.
• Now pass your paper to the person to your right. See if you can
come up with any more options and potential outcomes that your
neighbour has not identified. Give participants a few more minutes.
Observe them to see how many are adding new options.
• Now pass the paper in front of you to the person to your right.
Again, see if you can think of any new options that your colleagues
have not written down. Again, observe participants to see if they
are writing.
• When you are all finished, please pass the paper back to the
person who started it (pass it twice to the left). Everyone should
have their original paper in front of them.
Processing Questions:
What was it like to do this exercise? Key point: It is important to
Did your neighbours come up with new use the help and support of
ideas to add? Are you surprised? others. We can come up
Why did we do this? Why did we pass with better options and
our papers to our neighbours? ideas when we include
How could you use this activity in a others in our thinking.
counselling session? Let participants
come up with ideas. There is no right answer.
In what kinds of situations could this activity be helpful?
Presentation
Time: 5 minutes
Balancing Out Sheet
• This can help the client gain clarity, objectivity and perspective
about his/her problem.
Activity 5
Advantages/Disadvantages Activity
Time: 20 minutes
I want you to think of a recent decision you made or a decision that you will
need to make in the near future. On the top of your paper you should write
the decision (not the problem).
• In the first column you will write all the advantages, and in the second
column you will write all the disadvantages of that decision. You can
include advantages and disadvantages to yourself, your family, your
friends, etc. List as many as you can think of in each column.
• Once you are finished you can rank your list. Each item listed should
receive a number; include items listed as both advantages and
disadvantages. The most important item should be a number “1.” This
can help you consider the weight of each of the advantages and
disadvantages.
• You can also divide each of the lists into categories such as “for
myself,” “for my family,” and “for my friend,” in order to help you sort
out the outcome of the decision for different people in your life.
Key Point: The counsellor is not responsible for solving the problem, just helping
the client approach it and explore options. The decision-making is the client’s
responsibility, NOT the counsellors’.
Activity 6
Presentation
Time: 10 minutes
Creative Bridging of Realities
• Then the gap between reality and preferred reality can be explored.
• The counsellor can help the client think of steps that need to be
taken in order to reach a goal.
Example:
Goal/Dream: To get a job as a nurse.
Currently: Unemployed and living off your husband’s job at the local Pick-n-
Pay.
2. Explore what the profession is like and what the possible options are.
Ask as many people as you can, and include doctors and enrolled
nurses in your interviews.
3. Contact UNAM and other nursing training programs to find out what
requirements are for entrance as well as school fees.
6. Explore ways to pay for training, i.e. enrolled nurse training programs
or potential resources, loans, etc.
Activity 7
Time: 45 minutes
Hand out paper to each person and distribute markers, coloured pencils and
crayons amongst the participants. You can also simply have participants use
their Participant Manual for this activity.
• I would like each of you to think of one goal or dream that you have for
your life. It can be anything, for example, to get a specific job, to have
a family, to study, or to buy a home, etc. The goal can be anything, but
it should be something that is not easy to achieve.
• On the right side of the paper, draw your dream or your goal.
• When you have done this, draw a bridge or stepping stones from
where you are now to where you want to be. Each of these steps
should be something you need to do to reach your goal. Think about
• Each step that you need to take should be clearly labelled. Think
about what you need to do to prepare, then how to implement your
plan.
When most participants have finished their bridge, ask a few of them if they
are willing to share with the rest of the group. Make sure the participants
have specific steps they need to take in order to reach their goal. If not, have
the group help them through this process.
Processing Questions:
Potential Decision:______________________________________________
I.e. Disclose my positive HIV status to my mother
Once your advantages and disadvantages are listed, you can rank them in
terms of importance.
You can also divide them into categories, i.e. for myself, for my family, etc.
Objectives:
1. Appreciate the importance of empathy and the barriers to it.
2. Identify barriers to empathy in local communities.
3. Develop strategies to overcome barriers to empathy as community
counsellors.
Session Overview
Activity 1
Time: 30 minutes
Hand out pieces of paper to each participant. These can be small pieces of
paper.
• I would like each of you to think of one fear you have about being a
counsellor. It can be anything related to becoming a counsellor. Some
of you might be afraid of what you will say or have fears about not
really being able to help someone. Others of you might be afraid of
working with a suicidal client. There are many different things you
might be afraid of.
• On the small piece of paper that I gave you, please write one fear you
have about counselling. Be specific as you can in writing your fear
down.
• When you are finished writing your fear down, please fold your paper
and drop it into this hat. The facilitator should also write a fear down
and put it into the hat. When you have collected everyone’s fears in the
hat, continue.
• We are going to take turns around the circle reading the fears to the
group and then explaining how that person feels. Describe at least
one feeling you think the person who wrote that fear might feel and
describe the situation. Pass around the hat and let each person take a
fear. This will give them the opportunity to read it and think about
some feelings before it is their turn.
• I will begin. Read the fear and then briefly describe how you might
feel. Continue around the circle until everyone has read their fears.
Note to Facilitator: When facilitating this activity, model how to reflect feelings.
Make sure that each fear is validated and treated with respect. Participants should
not laugh at other’s fears and the feelings associated with them.
Processing Questions:
What was it like to read the fear of another person and then try to
imagine what he/she might be feeling?
Was it hard to imagine what that person might feel? Did anything
help you imagine what he/she might be feeling?
Did any of you have trouble imagining how someone could have
the fear that you read?
Did the person who read your fear describe it accurately?
Why do you think we did this activity? Refer back to the definition
of empathy.
Activity 2
Discussion
Time: 20 minutes
Foster a discussion about what hinders empathy. Some barriers are listed
here; facilitate a discussion with the large group about how these would
hinder the development of empathy. Refer to Personal Growth and relate
what was explored about attitudes, values and labels to the development of
empathy.
Activity 3
Time: 40 minutes
• Divide the participants into small group of 5 – 7 people. Discuss the
following questions:
o What are the barriers to empathy in your communities?
o How can you, as community counsellors, overcome those
barriers to empathy?
• Provide groups with flipchart paper and markers. Give the groups 10 –
15 minutes, depending on how well the discussions are going.
Circulate among the groups to help facilitate discussion.
• Bring groups back together and discuss the barriers to empathy and
strategies for overcoming them in order to develop empathy.
Session Overview
Activity 1
Introduction/Discussion
Time: 15 minutes
What are ethics? Let participants respond. Possible responses include the
following:
• Standards
• Responsibility
• Moral rules or principles for a particular profession
Do you think there should be any limits on who a counsellor can counsel?
For instance, is it ethical to counsellor your sister or your good friend? If
not, why not? Let participants discuss this briefly before continuing on. It
will allow them to think about these issues before presenting the material
below.
• Defines who the counsellor should counsel (who you should see in
counselling).
• Counselling is a relationship that is unequal in power. The counsellor
is in a position of power over the client.
Time: 45 minutes
Case Scenarios:
1. A married woman comes in for voluntary counselling and testing and is
found to be HIV-positive. She refuses to disclose her status to her
husband.
2. At the beginning of a counselling session, you (the counsellor) realise that
this client is your mother’s sister’s husband.
• 3. When you go to introduce yourself to your new client, he is your former
boyfriend from two years earlier.
4. Your sister has started dating a man that she is madly in love with. When
you meet her new boyfriend, you realise that you counselled him 6 months
ago. He came in for VCT and tested positive.
• In your groups, please discuss the case and address the following
items:
o Identify the ethical issue.
o Outline at least two different plans of action or approaches to
the situation. If you have time, you can outline more than two
different approaches.
o Make a recommendation for what your group thinks is the best
plan of action.
• When the small group discussions are finished, have each of the
groups present their case and their findings. After each presentation
have a short discussion with the large group about the ethical issues.
Note to Facilitator:
There will most likely be differences of opinion about the best plan of action
in each of these scenarios.
Make sure to discuss the ramifications, outcomes or results of those actions
for the client, for the counsellor and within the community.
You are modelling for the participants how to brainstorm and come up with
possible outcomes to different actions. This is a problem management
technique for a counsellor.
2.3 Notification
Note to Facilitator: This insert of the MoHSS Confidentiality Policy has been
included for clarification. In the discussions, participants may bring up the issue
that a counsellor should break confidentiality to notify a client’s partner of his/her
HIV-positive status. Note that in this passage it is only medical practitioners who
are entitled (but NOT OBLIGED) to disclose a patient’s HIV status. Community
counsellors are NOT medical practitioners, so this does not apply to them.
Objectives:
1. Reflect on personal experiences of behaviour change.
2. Learn the five-step process of behaviour change.
3. Understand the relationship between behaviour change and
counselling.
Session Overview
Activity 1
Pair Activity
Time: 40 minutes
I would like each of you to think of a time in your life when you changed your
behaviour. It could be when you changed a habit like smoking, drinking,
eating or exercise habits. It could be a change in religious practice or even a
change in routine or schedule.
• We are going to break into pairs. You may find a partner who speaks
your local language; you do not need to do this activity in English.
• Each of you is going to take turns interviewing the other. You will have
10 minutes each. Ask the questions listed on the flipchart. NOTE: you
will need to explain the questions to the group. Give an example when
explaining the questions, i.e. stopping smoking, losing weight, etc.
Processing Questions:
Key Points:
• During counselling, clients will often go through a process of behaviour change.
We need to understand what that process is like. This helps us develop empathy.
• Especially when talking about HIV in counselling, we will be working with clients
about changing their behaviour, i.e. practising safer sex, adhering to treatment,
healthy living, etc.
Activity 2
Presentation/Discussion
Time: 40 minutes
Key Point: Behaviour change is rarely a simple, single event. Usually a person
moves from being uninterested to considering a change to deciding and preparing to
make a change. Behaviour change happens gradually over time; it is a process.
*Note: these stages do not happen in a linear pattern. A person usually slips
backwards and goes between the stages like a spiral.
Why is understanding the stages of change important for you as counsellors? Let participants come up with their own reasons.
Possible responses:
• Many of the topics of counselling are about behaviour change.
• Communicating a realistic view of the work involved in behaviour change can prepare clients for the work and commitment
required to make changes.
• To help clients gain an awareness of themselves in order to sustain the behaviour change.
• To distinguish between relapse and a setback. Setbacks are normal and part of changing behaviour.
• To understand that changing any behaviour is a process. It does not happen overnight, and as counsellors we must be
patient with our clients as they are attempting to change their behaviours.
NOTE: There will be more sessions and discussion on behaviour change related to HIV and counselling in future modules. See the
HIV Counselling and Testing Module.
Objectives:
1. Define substance abuse.
2. Identify characteristics and causes for substance abuse.
3. Review model for substance abuse counselling.
4. Practise techniques for counselling people who abuse alcohol.
Session Overview
Activity 1
Time: 30 minutes
Substance abuse: repeated substance use that leads to one or more of the
following situations:
• The person wants the substance all the time, or finds it impossible to
stop once they start. For instance, they may say that they will just
have one drink, but they continue to drink until they are drunk, and
cannot stop at one drink.
• The person spends lots of time getting, using or recovering from the
substance.
SUBSTANCE ABUSE
Before we move into talking about counselling and substance abuse, I would
like for each of you to spend a few minutes thinking about how alcohol and
substance abuse have affected your life.
Processing Questions:
Note to Facilitator: Since alcohol use and abuse is a significant social problem in Namibia, it is
crucial that participants examine their own responses to alcohol and substance abuse. Their
experiences, attitudes and feelings will affect their counselling. Participants can do this
privately just by thinking about it.
Or, if time permits, you could have participants discuss this in small groups or even as a large
group. Participants could also write about it in a journal. This could be done as a homework
assignment.
Activity 2
Presentation
Time: 30 minutes
1. Counsellor’s Attitude
• Very important, as the client will have encountered negativity from
others, i.e. family and friends.
• Focus on building the relationship and then deal with the substance
abuse.
• Work on the basis that the client has inner resources, strength and
motivation for change.
• The counsellor should tell the client that he/she has the right and
ability to decide what to do with his/her own life and to make
informed choices.
• Build up the client rather than tear him/her down. Empower the
client to make a change.
4. Goal Setting
• The first goal setting will simply involve establishing a good
relationship and agreeing to counselling.
• This could also include an agreement that the client will not be
counselled if he/she is intoxicated or under the influence of the
substance.
6. Identify Triggers
• Identify with the client what the things are that make him/her want
to drink. For instance, is it a fight with his/her partner, Friday
afternoon at the end of the month, or is it hanging out with his/her
friends?
• Make sure that the client identifies people who will truly be
supportive; sometimes they may have to change their behaviour as
well. For instance, it may be difficult to attend a braai with beer, so
friends and family may have to abstain themselves for a period of
time in order to support the recovering alcoholic.
Time: 45 minutes
Use the relay role play technique to conduct a role play with an alcoholic. It is
best if a facilitator plays the role of the client in order to have the most
productive role play example. The key is to let participants practise the
counselling model for substance abuse.
Again, if possible, it is best if there are two facilitators for this type of role play.
One can facilitate the relay role play process and the other can stay in the
role of the client.
Processing Questions:
What was that like for those of you who played the role of the
counsellor?
What was the same or different from our other role plays?
Did you find anything particularly difficult?
2
Assessment
10 3
Accept the Motivate
Client the Client
9
Get Support 4
from Family Goal Setting
& Friends 1
Counsellor’s
Attitude:
Empathy and
Respect
8
Improve 5
Nutrition & Affirm the
Physical Client
Activity
7
Develop 6
Harm Identify
Reduction Triggers
Strategies
There are 12 Steps that substance abusers focus on during their recovery.
These twelve steps are listed below:
1. Honesty: We admit we are powerless over alcohol and that our lives
have become unmanageable.
2. Faith: We have come to believe that a Power greater than ourselves
can restore us to sanity.
3. Surrender: We have made a decision to turn our will and our lives over
to the care of God, as we understand Him.
4. Soul Searching: We make a searching and fearless moral inventory of
ourselves. We examine ourselves, our lives and our choices.
5. Integrity: We admit to God, to ourselves and to another human being
the exact nature of our wrongs.
6. Acceptance: We are entirely ready to accept that we have character
defects and have God remove all these defects of character.
7. Humility: We humbly ask Him to remove our shortcomings. It is not
something we can do ourselves.
8. Willingness: We make a list of all persons we have harmed, and are
willing to make amends to them all.
9. Forgiveness: We make direct amends to such people wherever
possible, except when to do so would injure them or others.
10. Maintenance: We continue to take personal inventory and when we
were wrong promptly admit it.
11. Making Contact: We seek, through prayer and meditation, to improve
our conscious contact with God, as we understand Him, praying only
for knowledge of His will for us and the power to carry that out.
12. Service: Having had a spiritual awakening as the result of these steps,
we try to carry this message to other alcoholics and to practise these
principles in all our affairs.
Objectives:
1. Define domestic violence.
2. Identify difficulties in helping those who are in abusive relationships.
3. Explain unique interventions for domestic violence in counselling.
Session Overview
Activity 1
Introduction/Discussion
Time: 20 minutes
What does domestic violence mean? Let participants brainstorm about what
domestic violence is.
Activity 2
Video
Time: 45 minutes
Before starting the video, write the following questions on a flipchart. These
are questions for participants to think about during the video.
Activity 3
Time: 20 minutes
After the video, either divide participants into small groups to discuss the
questions above, or facilitate a group discussion. Below are some possible
responses for questions 1 & 2.
1. Forms of abuse:
• Physical abuse
• Emotional abuse – verbal put-downs
• Not wanting her to work
• Expecting her to be at his beck and call
• Distrust when she is with friends
• Stopping her from contacting friends and family or speaking to
others
2. Difficulties in helping someone who is a victim of domestic violence:
• Secrecy: Secrecy is a key characteristic of domestic violence.
There is so much hiding and lies to cover up what is happening.
Sometimes the secrecy is because of shame about what is
happening, sometimes it can be because of denial, sometimes
• Gender issues
Activity 4
Presentation/Discussion
Time: 35 minutes
Cyclical Pattern of Domestic Violence
Domestic violence has a typical pattern that is cyclical; it follows a pattern that
goes around in a circle. This pattern makes it very difficult to intervene.
Abusive Incident:
Emotional or
Physical
Normalcy
Abuser’s Guilt
Stable Period
Abuser begs for
(no violence)
forgiveness
Reconciliation/Making Up
(gifts, flowers, special dates)
• After an abusive incident, the abuser usually feels very guilty and will
beg the victim for forgiveness.
Abuse Checklist
If you or your client is unsure about whether he/she is experiencing abuse,
use the following checklist.
If a partner uses one or more of the following to control their partner, the
person is experiencing domestic abuse:
Pushing, hitting, slapping, choking, kicking or biting
Threatening you, your children, other family members or pets
Using or threatening to use a weapon against you
Keeping or taking your paycheck
Putting you down or making you feel bad
Forcing you to have sex or do sexual acts you do not want or like
Keeping you from seeing family and friends or from going to work
In order to work with domestic violence in counselling, you will need to use all
the skills that you have learnt so far, but you can also offer some concrete
suggestions to your client:
• When you are in danger, call the police if you are confident that the
police in your community are reliable.
• Tell your friends, family and neighbours. Choose to tell people who
can support you to get help and take care of yourself.
• Find a safe place. This can be with a friend, neighbour or family
member.
• Tell friends and neighbours to call the police if they hear angry and
violent noises.
• Identify the safest places in your home where there are exits and no
weapons.
• Consider putting together a bag of things you may need if you leave in
a hurry.
If your client is considering leaving the abuser, he/she should think about the
following:
Objectives:
1. Define crisis and trauma; identify differences.
2. Define post-traumatic stress disorder (PTSD); identify symptoms.
3. List aims and techniques of crisis counselling and trauma debriefing.
Session Overview
Activity 1
Presentation/Discussion
Time: 20 minutes
1. A woman is held up at knife point while intruders search her home for
things they wish to take. They threaten her, attempt to suffocate her
and finally rape her.
2. A father is fired from his job for stealing. The family has no other
income.
3. A man witnesses a very bad car accident. People are killed, there is
lots of blood and one body is missing a leg. For half an hour, he is the
only person there and he is helpless. He uses his t-shirt and other
items of clothing to stop bleeding, but it is no use. Four people die and
he feels he should have been able to save them.
When discussing examples, make sure to identify what factors make the
example a crisis or a traumatic event.
Activity 2
Presentation/Discussion
Time: 40 minutes
Key Point: After traumatic events or in times of crisis, rely on your “humanness:”
sitting quietly together, sharing a cup of tea, or holding a hand can be very
supportive. Rely on empathetic body language simply to be with someone. Do
not feel like you have to talk.
Step 1: Establish if the event could be considered TRAUMA. Has the person
experienced it as life-threatening?
Step 2: Allow the person to talk about the event in detail if he/she wishes to
do so. Encourage the client to tell the story of what happened. Listen to
facts, feelings and thoughts.
Community Counsellor Training Toolkit Page 130
Basic Counselling Skills: Facilitator Manual May 2006
Step 3: Normalise their reaction to the event. Normalise the feelings and
reactions such as numbness, avoidance, increased arousal, inability to sleep,
etc.
Step 4: Reinforce coping strategies. Explore any feelings of guilt and/or self-
blame, as well as any fantasies of retribution (getting even). Encourage
problem solving and coping.
Step 5: Help the person make a plan for his/her own safety if necessary.
Refer if you are concerned about him/her at this point. Successful trauma
debriefing should be done within 24 – 72 hours after the event. This is one
intervention that can be helpful in preventing Post-Traumatic Stress Disorder
(PTSD).
If you think your client is likely to experience a normal recovery and does not
need a referral, suggest the following activities.
• Design a routine for yourself and structure your time so that you have
times of rest and activity.
• Eat nutritious food regularly. Even if you are not hungry, eat small,
healthy meals.
• See if you can return to your normal schedule as soon as you feel
ready.
• Allow yourself to feel down every now and then; you are not crazy and
your reactions are normal. You do not have to fight the disturbing
thoughts, and they are likely to get a bit better if you allow yourself to
live with them.
• Try to be active in designing your immediate life, but try not to make
any major life decisions for a while.
It is useful to enlist the help of the client’s family members in the process of
helping someone to put their life back together again.
Note: children who have experienced a traumatic event may show extreme
emotional distress or experience physical pain.
Referrals:
• LifeLine/ChildLine has a team of specially trained trauma counsellors.
Telephone 061-226889
Recovery
Counselling 6 – 8 weeks
Traumatic Or
Trauma Debriefing
after the
Event
24 – 72 hours traumatic
after event event
PTSD?
Referral
Objectives:
1. Explore taboos and personal experiences with suicide.
2. Identify risk factors for suicide.
3. Explain counselling assessment and intervention approaches to
suicide.
Session Overview
Activity 1
Introduction/Discussion
Time: 15 minutes
I am going to ask some questions that I want you to think about. You do not
have to answer the questions out loud, but you may share your thoughts if
you wish.
• Has anyone ever talked to you about suicide? If so, what was that
experience like for you? What did you do?
• Has anyone close to you committed suicide? If so, what were the
circumstances around the suicide?
Key points:
• Have you ever wanted to end your life?
• Suicide is a taboo topic in
Did you ever share those feelings with many cultures.
someone else? • There is a stigma
associated with suicide.
Ideally you will have a group that is willing to • Suicide, suicide attempts
share some of their experiences. However, and suicidal thoughts are
since these are sensitive topics, do not push usually surrounded by
people to share. If the group is not forthcoming secrecy.
you can possibly share some of your
experiences and facilitate a discussion highlighting the key points.
Presentation/Discussion
Time: 45 minutes
Model for Suicide Prevention in Counselling
Stage 1: Connect
1. Explore “clues.”
• People who are considering suicide usually display “clues” that they
are in pain or wanting their lives to end.
• People who think about suicide are usually ambivalent: part of them
wants to live and part of them wants the pain to end.
• Always take suicidal comments very seriously. Do not assume that
someone is talking about suicide to get attention; this can be a
disastrous error.
Risk Factors or Warning Signs (“Clues”) for Suicide
Start by making this a discussion if possible. Have the participants brainstorm
a list of risk factors. If they have had any experiences with suicide, they
should be able to come up with some warning signs. Again, you as the
facilitator are empowering them as counsellors by building on the knowledge
and experiences that they already have. Also, refer to the Suicidal Checklist
(page 140).
Note: a suicidal person may not display all these characteristics, but the list
can offer some guidelines of what to look for.
• Talking about suicide will NOT give someone the idea to do it.
• Listen empathetically.
• Let the client talk and express emotions. Practise active listening
and reflecting skills.
• Listen to reasons for dying, which may include events, the meaning
of events and the person’s reactions to those events. For instance,
a university student may have failed an important exam. To
him/her, this might mean that he/she is a failure and will never
succeed in life. The student’s reaction might then be to kill
him/herself since life is meaningless without success.
• Listen to reasons for living, which may include both internal and
external things. Internally, they might be feelings, hopes, beliefs,
values, attitudes or skills. Externally, they might include resource or
support people, hobbies, family, friends, etc.
• When? “Have you thought about when you would do it?” or “Do you
have a plan for when you will kill yourself?” It is important to know if
the plan is for tonight, or next week, or after the holidays, etc.
After you have explored the client’s feelings and reviewed their risks, if the
client has a plan, you should develop and contract a safety plan. The
safety plan should include the following:
• Support People: Involve friends and family of the client. Have the
client identify several people who he/she can disclose his/her
feelings to. You can actually call one or two of those people during
the session if the client agrees.
• Remove the Means: If the client’s plan involves the use of a gun,
call the police to remove the gun from the house. If the plan
involves taking pills, remove extra medication from the house. You
can involve friends and family in this process.
• Plan to Not be Alone: Develop a plan so the client will not be alone
if the person is acutely (actively, i.e. has a plan, method and
means) suicidal. Involve a support person or people to stay with
the client or have the client make arrangements to stay with family
or friends.
• NOTE: Develop your own contract. Do NOT photocopy and use the
example contract included in this manual.
6. Follow up on commitments.
• Did the client uphold the safety plan contract? Talk about how
he/she did that, what worked and what did not work, what he/she
needs for the future, etc.
• At this stage you can also talk about triggers. Are there behaviours,
situations or events that increase the intensity of the suicidal
thoughts and feelings? For instance, are suicidal thoughts worse
when the client is alone, or when he/she is drinking, etc.
Time: 45 minutes
Use the relay role play technique to conduct a role play with a suicidal client.
It is best if a facilitator plays the role of the client in order to have the most
productive role play example. The key is to let participants practise the
counselling model for suicide prevention.
Again, if possible, it is best if there are two facilitators for this type of role play.
One can facilitate the relay role play process and the other can stay in the
role of the client.
Processing Questions:
What was this like for you who played the role of the counsellor?
Was it difficult to ask some of these direct questions?
What was the same or different from our other role plays?
Did you find anything particularly difficult?
CURRENT FACTORS:
¾ Current Suicide Plan
How? How Prepared? How soon? YES √
¾ Pain
Do you have pain that sometimes feels unbearable? YES √
¾ Resources
Do you feel you have few, if any, resources? YES √
BACKGROUND FACTORS
¾ Prior Suicidal Behaviour
Have you ever attempted suicide before? YES √
¾ Mental Health
Are you receiving or have you received mental health care? YES √
I will not take any action until after I have spoken with ______________________.
Support Person or Counsellor
________________________ _____________________
Client’s Signature Date
_____________________________ _____________________
Counsellor’s Signature Date
*The time frame of the contract should be no more than a week, but shorter, even
overnight, if the client is acutely suicidal.
C L I E N T
Client feels:
Meet client’s needs ¾ Accepted
for: ¾ Respected
Perspective
Care
C O U
Community Counsellor Training Toolkit N S E PageL143 L O R
Basic Counselling Skills: Facilitator Manual May 2006
SESSION 21: CHILD ABUSE
Objectives:
1. Define child abuse.
2. Identify signs of emotional abuse in children.
3. Review counselling steps for responding to child abuse.
Time: 45 minutes
Session Overview
Activity 1
Discussion/Presentation
Time: 45 minutes
What is child abuse? Brainstorm a list with participants. The list should
include the following:
• Physical abuse (non-accidental injury)
• Sexual abuse
• Emotional abuse
• Neglect
• Bullying
• Ritualistic abuse
A child may not want to tell you about the abuse because he/she:
It can be helpful to have a child draw pictures to help explain what happened.
Some of the things you might say when counselling a child who has been
abused:
• “I believe you.”
• “Thank you for telling me that this has happened to you. I am going to
try and help you.”
• “I am sorry that this has happened to you.”
• “It is not your fault.”
• “What this person did is very wrong.”
• Encourage the child to talk it out.
• Answer the child’s questions honestly.
• Explain what will happen next.
• It is a time to act; do not simply reflect the child’s feelings, but also do
not try to take the matter into your own hands.
• A social worker will follow up the case and arrange for the child to have
a medical examination.
• Children are not a verbal as adults, so you may need to use other ways
to find out what happened.
Talking too much and not giving the child time to express him/herself.
Being critical, judgemental or argumentative.
Laughing at or humiliating the child (mocking the child).
Being aggressive or bullying.
Showing signs of being upset.
Trying to get too much information on first contact or when child is ill.
Assuming caregiver who brought the child is the best contact for the
child.
Not paying attention to non-verbal communication.
Being uncomfortable or embarrassed when a child is upset.
Not respecting the child’s beliefs, ways of life, or concerns.
Not creating a situation of trust.
Constantly trying to reassure the child despite their legitimate fear, or
the counsellor’s inability to protect the child.
Disclosing HIV status to caregiver and child at the same time.
Objectives:
1. Practise basic counselling skills.
2. Experience being videotaped.
3. Reflect on and evaluate own counselling skills.
4. Receive feedback on counselling skills from facilitator and others.
Session Overview
Notes to Facilitator:
It is best if you can introduce this session before
lunch on Thursday. This may also be done earlier in
the week, i.e. Wednesday afternoon to give
participants more time to practise.
Allow people to form their triads and determine who
is going to be taped first, second, and third.
You may want to draw triad names out of a hat or
draw straws to decide who is taped first unless you
have some eager volunteers.
Groups who are taped first can start practising their
role plays over lunch.
In order to complete all of the taped role plays, you
will need to make sure to monitor the time carefully.
Introduction
Time: 10 minutes
Before lunch on Thursday, or earlier.
• Seeing yourself on video allows you to have a better idea of how you
are perceived.
• Allows you to observe your own counselling and identify what you did
well and what you need to improve.
• Builds self-confidence.
• You are going to be divided into groups of three (triads), just like we
have done in previous role plays. One person will be the counsellor,
one the client and one the observer. You will all have a chance to play
each role.
• Each of you will conduct a counselling role play as the counsellor for no
more than 10 minutes. This role play will be videotaped.
• We will spend the entire afternoon taping these role plays. When you
are not being taped, you can spend time in your groups practising your
counselling skills.
• Remember that the counselling role plays are best when as a client
you use a real life example as your presenting problem.
• Tomorrow morning, we will view the taped role plays in three groups
and then provide feedback to the counsellor in each role play.
Time: 3 hours
Afternoon on Thursday
Note to Facilitator:
If you have additional cameras or a smaller training group, you may adjust
the length for each of the role plays and manage the time differently.
Record in a different room from where the participants are practising their
role plays.
**Make sure that you record the role plays on three different video tapes so
that they can be viewed in three different groups the following morning.
• After a triad completes their taped role plays, each of the counsellors
should fill out a self-evaluation form evaluating their performance as a
counsellor in the role play. You will review this self-evaluation again
after the group views your taped role play tomorrow morning.
After each triad has completed their recording, remind participants to fill in
their self-evaluation forms.
Activity 3
Small Groups
Time: 40 minutes
• Once groups have finished recording their role plays, each participant
should fill out the “Self-Assessment and Improvement Worksheet,”
evaluating their own counselling skills.
• In the same role play small groups, they should meet and discuss their
“Self-Assessment and Improvement Worksheet.”
• Individuals should not only share their self-evaluation, but they should
also comment on each other’s strengths and areas for improvement,
including how to use those strengths and improve the weaknesses.
• Ideally a facilitator will be able to meet with the small group as they are
sharing and giving feedback to each other in order to make sure that
the feedback is useful.
Activity 4
Small Groups
Time: 2 hours
Friday morning
Note to Facilitator: In order to conduct the video viewing and feedback in three
groups you will need three facilitators. If you have more facilitators and more
televisions and VCRs you can even do this in smaller groups in order to take
less time.
• We are going to view each role play. After the role play the video will
be stopped.
• The counsellor from that role play will evaluate his/her performance.
Activity 5
Time: 30 minutes
Bring the large group together and reflect on the videotaping experience.
Processing Questions:
Strengths:
My strengths as a counsellor; the basic counselling skills I am good at:
Example: I am good at establishing the relationship and making the client feel
comfortable in counselling.
Objectives:
1. Define stress.
2. Identify personal responses to stress.
3. Explain how counselling and stress can be related.
Session Overview
Activity 1
Time: 20 minutes
What is stress? Can anyone give me a definition of stress?
Use overheads of the Stress Model to illustrate this definition.
• Stress exists when the demands of our lives are greater than our inner
resources to deal with them.
• Our perceived demands are not only external demands (demands from
others, i.e. paying school fees for our children), but also internal
demands (expectations we have for ourselves, i.e. “I must always be
Key Point: Stress exists when our perceived (internal and external)
demands exceed our perceived (internal and external) coping ability.
Is stress always a bad thing? Can it ever be good or helpful? Let participants
respond.
Activity 2
Written Exercise
Time: 10 minutes
Before we continue, I want each of you to think about and write down three
internal demands that you place on yourself. These would be things that
make you feel guilty if you do not manage to do or accomplish them. Write
these internal demands as follows:
You can refer participants to the Participant Manual or write what is below on
flipchart paper.
I should always…
1. __________________________________.
2. __________________________________.
3. __________________________________.
These internal demands you are writing down are just for yourself. You will
not be asked to share them. They are for you to be able to identify ways you
increase your own stress levels through your internal demands.
Written Exercise
Time: 20 minutes
How do we respond to stress? What are positive and negative ways we
respond to stress? Let participants respond.
Possible responses:
• Spiritually: pray more, seek out support from church friends or pastor
Draw the outline of a body. Then shade in where your body signals its own
particular reaction to stress, or distress. Refer to the Participant Manual.
Now add other ways that you react to distress; you can draw or write them in.
Processing Questions:
Time: 20 minutes
For the rest of this session we will be talking about the specific stress of
counselling, how to care for yourself as a counsellor, and why that care is so
important. We can begin by discussing what you think are the biggest
problems or stresses that counsellors face.
Time: 30 minutes
• Give the groups 15 minutes or so to come up with their self care ideas.
• In order to share the small group ideas with the larger group, I am
going to ask each group to share one of their self care ideas. When
you share it, one group member should bring it up to the front and stick
it onto this flipchart. We will take turns so all the groups can participate
and share their ideas.
DEMANDS RESOURCES
RESOURCES
DEMANDS
RESOURCES
DEMANDS
Write down three internal demands that you place on yourself. These would
be things that make you feel guilty if you do not manage to do or accomplish
them.
I should always…
1. __________________________________.
2. __________________________________.
3. __________________________________.
These internal demands you are writing down are just for yourself. You will
not be asked to share them. They are for you to be able to identify ways you
increase your own stress levels through your internal demands.
Draw the outline of a body. Then shade in where your body signals its own
particular reaction to stress or distress.
Now add other ways that you react to distress; you can draw or write them in.
Objectives:
1. Explain what referrals are.
2. Understand the importance of referring, and when and how to refer.
3. Give referral resources development assignment.
Time: 30 minutes
Session Overview
Activity 1
Discussion
Time: 30 minutes
What are referrals and why are they important? Generate a discussion on
this.
• Referral: sending a client to another agency or organisation for help or
information.
• A referral can only be made after assessing the client’s needs. You
must know more about a client and what he/she wants in order to make
a good referral.
• Always counsel and work with a client; never blindly refer, even if
requested.
• You can also refer clients to address one aspect of their problems and
continue with counselling. For instance, you could refer them to get
social grants and continue to work with them for adherence
counselling.
• Visit agencies and meet people working at places you may refer to so
that you can better understand what services they provide.
Suggested questions:
• Please tell me about your agency and its history in Namibia/this
community.
• What kind of services do you provide?
• What populations do you work with? Who do you help?
• What kinds of help do you provide?
• Are there any criteria that a client must meet in order to receive your
services?
• Do you have a process for referrals?
• Is there a waiting list?
• What is the best way to contact your agency? Who is the contact
person?
Make sure the participants understand this assignment and have the
opportunity to ask questions. You may also want to provide 3-5 copies of the
referral form for each participant.
Note to Facilitator: It is best to give this assignment before you facilitate the
VCT module. With some groups, you may facilitate General HIV prior to VCT,
in which case you could give this optional assignment at the end of General
HIV.
Evaluation
Out of 10
Introduction/Greeting (Establish the Relationship)
INTRO
proximity
Verbal: tone of voice, volume
Affirmation
Restating/Reframing
Interpreting/Making Statements
Confrontation/Challenging
TERMIN R E S O L U T I O N
Trust Building
1. Show interest in what the other person is saying. This can be done
through body language such as eye contact, nodding and responding
appropriately.
1. Ask if he or she would like to talk about the problem. A person may not
be ready to talk about a situation because they are too emotional. Be
respectful of the client’s feelings and wishes.
4. Ask how he/she feels about the situation. Do not assume that you
know how a person feels. Ask the client to clarify or to encourage
him/her to talk about the feelings.
8. Respect the right of the other person to express different values and
preferences from you. Try to keep your values and preferences to
yourself. It is not necessary to share them with the client. However, if
they express dislike of the picture on your wall, that is OK.
Resolution: Decision-Making
1. Counsel rather than advise. You can present information so that the
person has more data and can then make his/her own decision. Be
careful not to tell the client how to behave or what decision to make.
2. When you provide information, make sure that you are providing
accurate information. Do not just provide opinions, but give clients
facts and let them make their own decisions.
3. Encourage client’s to use “I” or “me” messages. Steer the client away
from blaming others for his/her behaviour and take ownership for
his/her thoughts, feelings and behaviours. For example, instead of
saying, “Your radio is so loud and annoying,” say “I am having trouble
concentration with your radio on so loud.”
5. Avoid criticising.
Client: “My boyfriend just found out he is HIV-positive. But things are going
on as usual. I feel pretty good about it.”
Wrong: “How can you feel good about it? You must change your
behaviour so that you don’t get infected!”
Correct: “I am not sure I understand. Can you tell me more about
what you are thinking and feeling?”
7. Avoid threats.
Client: “I had unprotected sex again this last week.”
8. Avoid burdening others with your own difficulties. Do not bring up your
problems and concerns with a client.
Client: “I do not have enough money to pay the rent next month.”
Wrong: “I hear you. I don’t have enough to pay for electricity. I don’t
know what I’m going to do.”
Correct: “Sounds like you have some real financial concerns. Let’s
talk more about that.”
10. Avoid political or religious discussions: avoid sharing your personal beliefs
or values. If the client wants to talk about his/her beliefs, you can listen
and reflect, but do not insert your values.
Client: “The church I attend says it is wrong to have sex before marriage.
What do you think?”
Wrong: “The church is absolutely right. That is why AIDS has spread
so rapidly.”
Correct: “Tell me more about what you think and feel about it.”
12. Avoid ridiculing: this does not show acceptance and understanding.
Client: “I have only had sex with my husband so I will not get AIDS.”
Wrong: “That is such a naïve way to think. Are you stupid?”
Correct: “It sounds like you are a very trusting person.”
13. Avoid belittling. Remember that you are to encourage and empower the
client, not embarrass or belittle them.
Client: “I stayed out really late last night at the bar and was too tired to get
up this morning and go to work.”
Wrong: “You are behaving like a teenager or a child. It is time you
grew up and behaved like an adult.”
Correct: “What are the results of the decision you made last night to
stay out so late?”
Community Counsellor Training Toolkit Page 168
Basic Counselling Skills: Facilitator Manual May 2006
14. Avoid blaming another person. Encourage the client to take responsibility
for his/her own behaviours.
Client: “It is my husband’s fault. He makes me so mad and then I do
things I regret.”
Wrong: “If your husband had not made you mad, you would not have
behaved irresponsibly.”
Correct: “What are you in control of? What are other possible reactions
to your husband?”
19. Avoid probing of difficult or emotional material when the client resists.
Client: “I just do not want to talk about my mother right now!”
Wrong: “You must do so if you want to see some positive changes.”
Correct: “It is hard for you to talk about her.”
Day 1
Time Session Facilitator
08:00 -10:30 Introduction to Basic Counselling Skills/Review
Assignment
Counselling Introduction
Day 2
Time Session Facilitator
08:00 -10:30 Check-In/Recap
Listening Skills
Day 4
Time Session Facilitator
8:00 -10:30 Check-In/Recap
Ethics in Counselling
Understanding Behaviour Change
10:30 -11:00 Tea Break
11:00-13:00 Counselling in Crisis Situations
Crisis Counselling: Suicide Prevention
13:00-14:00 Lunch
14:00-15:30 Video Taping Role Plays
15:30 -15:45 Tea Break
15:45-17:00 Self-Assessment and Improvement Worksheet
(during videotaping)
Day 5
Time Session Facilitator
8:00 -10:30 Check-In/Recap
Small Group Video Viewing and Feedback
VERY
PLEASE RATE THE QUALITY OF THE FOLLOWING… POOR FAIR GOOD EXCELLENT
GOOD
2. Think about what you already knew and what you learned during this training
about Basic Counselling. Then evaluate your knowledge in each of the following
topic areas related to Basic Counselling Skills Before and After this training.
1 2 3 4 5 Empathy 1 2 3 4 5
1 2 3 4 5 Listening Skills 1 2 3 4 5
1 2 3 4 5 Reflecting Skills 1 2 3 4 5
1 2 3 4 5 Probing/Action Skills 1 2 3 4 5
Ministry of Health & Child Welfare Zimbabwe, Integrated Counselling for HIV
and AIDS Prevention and Care, Primary Care Counsellor Training. Zimbabwe.