Behaviour Change Communication and

Counselling: Skills of Care-Givers for

SAM Children

Anjali Singh
Associate professor
IIPH Delhi
17th Aug 2015
Scope of Presentation
 Communication
 Behaviour Change Communication
 BCC Model – Stages of behaviour change
 Counselling as a tool of behaviour change
 Interventions of BCC
Scope of Presentation
 Communication
 Behaviour Change Communication
 BCC Model – Stages of behaviour change
 Counselling as a tool of behaviour change
 Interventions of BCC
Communication

Encoding

Medium

Message
Decoding

Sender

Response
Receiver
4
1/5/2012
Singh A, IIPH-D
Communication
Scope of Presentation
 Communication
 Behaviour Change Communication
 BCC Model – Stages of behaviour change
 Counselling as a tool of behaviour change
 Interventions of BCC
Behaviour Change Communication

Behaviour Change Communication is a

process of using tailored messages
through an effective channel mix
addressing the target audience to
generate positive change in knowledge,
attitudes and practices.
BCC entails…
 Tailored messages
◦ Developing messages as per need of target
audience
 Channel of communication
◦ Selecting channel most suitable to target
audience
 KAP of audience
◦ Understanding the current KAP of target
audience
◦ Establishing goal for KAP of audience
Scope of Presentation
 Communication
 Behaviour Change Communication
 BCC Model – Stages of behaviour change
 Counselling as a tool of behaviour change
 Interventions of BCC
Pre-contemplation

 Audience is unaware of one’s (undesirable

or unhealthy) behaviour
 Denial of consequences of existing
behaviour
Contemplation

 Being aware of one’s undesirable

behaviour and its consequences
 Being aware of benefits of and barriers to
adopting new/ desirable behaviour
 Experiences inability to change
Preparation for action

 Person intends to change behaviour

 Plan of action to try new behaviour
developed
Action
 Person attempts to try the new behaviour
◦ Experience of trial of new behaviour is a
determinant for next stage of behaviour
change process
Maintenance

 Person adopts new behaviour

◦ Experience of trial of new behaviour plays an
important role
 Relapse can occur
◦ Relapse – an opportunity to determine factors
leading to relapse
Scope of Presentation
 Communication
 Behaviour Change Communication
 BCC Model – Stages of behaviour change
 Counselling as a tool of behaviour change
 Interventions of BCC
Role of Counselling
 It’s the key communication component in
influencing behavior change
 It provides options to clients
 It facilitates the decision making process
 It creates a forum for clarification of
issues
 It complements, reinforces and elaborates
messages presented from other sources
of information
Counselling skills
Rapport building
 A harmonious or sympathetic relationship
 Implies trust, mutual respect & best
interest
 Importance of rapport
◦ rapport building a critical step in effective
communication
◦ enables clients to express themselves
adequately
◦ With rapport establishment, clients are likely to
comply with advice
Listening skills
 Active listening:
◦ Know what you are listening for
◦ Listen to specific content (who, what, where,
when, why)
 Expressions of interest in the speaker
 Appropriate eye contact
 Keep non-judgemental attitude
 Resist distractions, thoughts, imaginations
etc
Observation skills
Areas of observation
 Physical: physical appearance, level of
energy
 Emotional: facial expression, eye
contact, body posture
 Interpersonal: How client relates to you
positively, negatively, neutrally
Counsellors need to develop keen
observation skills
Questioning skills
 Questioning skills are used to gather
information from client
 Questioning brings out specific information
 Increases counsellor’s awareness of
client’s feelings
 Types of questions
◦ Close ended
◦ Open ended
◦ Probing
◦ Leading
◦ Reality-based questions
Probing skills to gather information

 Asking open-ended questions

 Giving space and time to client for
making her/ him comfortable
 Non-verbal communication
◦ Eye contact
◦ Facial expressions
◦ Body posture
Paraphrasing
 Communication tool to ensure the
message is correctly understood
 Paraphrasing helps pick key points
mentioned by the client
 It helps bring back the attention of client
to key point of discussion when client
diverts too much
Reflecting and Summarising
 Reflection of feelings of client builds
stronger mutual relationship between
client & counsellor
 Summarising is useful to highlight key
points discussed in a counselling session
Essential points in Counselling
 Non – judgemental attitude of counsellor
 Respect
 Empathy
 Probing to collect information
 Listening attentively
 Observe non-verbal communication
Rights of a client in Counselling
 Information: To learn about benefits
and availability of different forms of
services and treatment
 Access: To obtain services regardless of
caste, class, sex or location
 Choice: To decide freely from the options
available
 Privacy: To have a private environment
during counseling or services
Rights of a client in Counselling
 Confidentiality: To be assured that
any personal information will remain
confidential
 Dignity: To be treated with courtesy,
consideration and attentiveness
 Comfort: To feel comfortable when
receiving services.
 Opinion: To express views on services
& treatment offered
Process of Counselling
Six Important Steps in Counseling: “GATHER”
1. GREET the clients (establishing rapport)
2. ASK clients (gathering information)
3. TELL (provide information)
4. HELP the client make informed decision
5. EXPLAIN to the client all the details
6. RETURN/REFER/REALITY CHECK (Return
visits or referrals should be planned where
necessary)
Types of Counselling
 Individual counselling
◦ Effective for clients to discuss private
behaviours or to discuss taboo issues
◦ Clients get full attention from the counsellors
 Group counselling
◦ Effective for sharing information with large
group in less time
◦ Certain issues need similar group to draw
sensitive information
Types of Counselling
 Telephonic counselling
◦ Generally used for
 follow-up of clients
 updating with new information
Scope of Presentation
 Communication
 Behaviour Change Communication
 BCC Model – Stages of behaviour change
 Counselling as a tool of behaviour change
 Interventions of BCC
Positive Deviant Approach
 Used for influencing social norms
 One or few community members adopting
healthy and desirable behaviours are
felicitated/ involved in the program
 Many community members, especially
fence-sitters are highly likely to be
influenced to adopt healthy and desirable
behaviours
Positive Deviant – Attributes and speed
of Adoption of Innovation

 Relative Advantage  Identified as

“advantageous”
 Compatibility  Created within cultural
context
 Complexity  Requires no special
resources
 Triability  Opportunity to practice

 Observability  Through personal

experience
Positive Deviant Approach
When to use PD Approach
 Problem requires behavioural or/and social
change (adaptive challenges versus technical
challenges)
 Compelling enough to require a new approach
 Presence of Positive Deviants (individuals/
groups exhibiting desired outcome)
 Leadership commitment to address issue : “PD
champions”
 Skilled facilitation
References
 Dutta-Bergman MJ. Theory and practice in health
communication campaigns: A critical interrogation. Journal
of Health Communication, 18, 103–122, 2005.
 Prochaska JO, DiClemente CC, Norcross JC. In search of
how people change. Applications to addictive behaviours.
The American Psychologist 1992 Sep;47(9):1102-14
 Jerry Sternin – Tufts University, Glasgow Centre for
Population Health, November 2006, Positive Deviance
Initiative
Thank You!