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!