Specialised counsellors needed for effective counselling

Untrained counsellors in HIV health centres could harm rather than help the voluntary counselling and testing (VCT) process, delegates attending a Kenya Association of Professional Counsellors (KAPC) conference in the capital, Nairobi, heard this week.

"There is a need to distinguish counselling staff from medical staff in order to ensure the clients are dealing with people qualified to handle the situation," said Cecelia Rachier, executive director of the KAPC.

Although Kenya has several stand-alone VCT sites, many clients still visited health centres, where they were counselled and tested by medical personnel.

"Untrained counsellors would destroy the clients more than build them, as they are not skilled to address issues," Carol Ngare, VCT manager of Kenya's National AIDS and Sexually Transmitted Infections Control Programme (NASCOP), told IRIN PlusNews.

Dr Ernest Nyamato, deputy director of service delivery at Liverpool VCT, Care and treatment, a non-governmental organisation affiliated to the UK-based Liverpool School of Tropical Medicine, said misdiagnosis and failure to handle clients' reactions to their results were among the dangers of having counsellors not specifically trained in VCT.

"If you haven't been taught how to read the test, you may easily register false negative or false positive results," he told IRIN/PlusNews. "There is also the danger of causing emotional damage to a client."

Nyamato said Liverpool had trained 70 percent of the lay VCT counsellors in Kenya. Apart from teaching prospective counsellors about the science and social aspects of HIV, they engaged in role-plays where several likely VCT scenarios were presented to trainees. 

KAPC's Rachier noted that there was also a need for VCT centres to strengthen the follow-up component of their work. "There is a lot of emphasis on prevention and treatment, but care of patients extends well beyond just drugs," she said.

KAPC is encouraging the government to extend counselling to marginalised vulnerable populations, such as men who have sex with men, abused children, orphans, the disabled and sex workers.

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