COUNSELING SKILLS PRACTICE CHECKLIST

PARTICIPANT_________________________ COURSE/DATE _____________________

Instruction: Check the appropriate column for each of the tasks. Choose any mother you know
maybe at home, a friend or a workmate etc. and interview them. Make an interpretation about the
information you gather through your counselling.
Key: 2= Yes 1= Yes, but needs improvement 2 1 0 N/A
0= No
NA= Not applicable
Interpersonal Communication
1. Maintains eye contact with the client.
2. Uses simple language that the client understands
3. Uses appropriate tone of voice.
4. Exhibits positive non-verbal communication
5. Uses the cue card effectively.
6. Asks open-ended, closed, and probing questions effectively.
7. Listens attentively to client’s response and concerns.
COUNSELING PROCESS
1. Greets client and introduces herself.
2. Offers the client a seat
3. Asks reason for client’s visit.
4. Respects clients right by:
– Ensuring confidentiality
– Providing privacy
5. Invites client to speak freely.
New Clients
6. Uses the FP Form 1 to obtain relevant information.
7. Assesses the client’s reproductive needs (short-term, long-term,
permanent)
8. Asks client if s/he has a method in mind and what s/he knows about
the method.
9. Assesses what the client knows about FP methods.
10. Asks if client has previously used an FP method and reasons for
discontinuing.
11. If postpartum, assesses the client’s willingness to breastfeed.
12. Assesses reproductive health needs of clients
• Risk for STIs
• Gender-based violence (VAW)
13. Checks what possible methods client can use by using the WHO
Medical Eligibility Criteria (i.e., wheel or summary table).
14. Corrects rumors and misconceptions.
15. Tells the client about available methods based on her/his
knowledge and reproductive needs.
• Mode of action
• Advantages and disadvantages
• STI and HIV prevention
• Possible side effects
16. Allows the client to choose a method among those previously
presented to him/her.
17. Determines suitability of the chosen method using the method
specific MEC checklist.
18. Helps the client make a decision by asking her how s/he will cope
with potential side effects of the chosen method.
19. Correctly explains to the client how to use the chosen method.
20. Offers condoms to clients with risk for STIs for dual protection
and/or back-up.
21. Correctly explains the warning signs and what s/he should do if any
of these occurs.
22. Checks at appropriate times if client has understood the information
or instructions given.
23. Asks the client to repeat all instructions in his/her own words.
24. Tells the client when to return for routine follow-up, if needed.
25. Refers the client for methods or services not offered at counselor’s
site.