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1. Behavior Change
Communication for Health
Interpersonal Communication
Counseling

2. Advantages and disadvantages of
interpersonal communication channels
Advantages
Reach people face to face
Allows for immediate audience feedback
Very useful in influencing a group; messages may be
tailored fit to the group
Ideal for sharing knowledge and skills, problem-solving,
reaching agreements and planning actions.
Delivers message in non-threatening way; cultural
acceptable.
Disadvantages
May reach a relatively smaller number of people, may be
costly
Communication effectiveness may be influenced by the skill
of the facilitator and the organizer or information officer

3. Some forms of interpersonal media
Forms
Demonstrations
Advantages
Disadvantages
Suggestions
Shows in practical way how to
do things. Makes abilities of
the worker evident, thus
promoting community trust.
Allows for brad participation
through technique of “learn by
doing”.
Requires careful preparation.
May be misleading since
situation in real life is generally
different. External factors may
affect results. In poor
communities, it is difficult to
obtain resources for
demonstration.
Have audience participate in
demonstration. Establish
situation as close as possible
to real life. Test
demonstration, anticipating
possible snags. Combine with
discussion and written
materials.

4. Forms
Home visits
Advantages
Establishes good relationships
between families and staff.
Useful in providing timely
relevant information to family.
Lend themselves to keeping a
record of what has been
learned.
Disadvantages
Very time-consuming.
Tendency to visit only most
accessible homes. Requires
careful programming, in order
to select appropriate time
which does not interfere with
work or other family activities.
Suggestions
Keep record of visits and
accomplishments. Leave
pamphlet or other instructional
materials for family. Visit those
most in need.

5. Forms
Story telling
Advantages
Disadvantages
Suggestions
Abundant availability in some
communities. Culturally
relevant and acceptable.
Stimulates participation,
generates and maintain
interest. Problems, outmoded
customs, etc… of a community
may be indicated in a
simulated fashion without
offending anyone.
Only useful where there is
tradition of story telling and
listening. Audience may feel
offended by childlike treatment.
Message may be lost in plot.
Difficult to find pleasant
narrator. If interrupted to
provide clarification, train of
thought may be lost.
Collect stories about and with
community. Use local
narrators whenever possible.
Illustrate story with audio visual
aids. Combine with group
discussion. Use stories which
are short, with simple plots and
few characters.

6. In the area of health, interpersonal
communication takes place:

using various methods and approaches

at several different levels of interaction

within a variety of environmental or social
contexts.

7. Levels of interpersonal interaction and approaches in
health
Levels of Interaction
1. Client-provider Interaction
 To enable clients to make free and informed choice
among health options
 To promote the safe, effective and correct use of
contraceptive methods or new health behavior
Approaches
G
A
T
H
E
R
Counseling
Provider Perspective
Greet
Establish rapport
Ask
Gather information
Tell
Provide information
Help
Facilitate decision
Explain
Demonstrate and practice
Reinforce
Revisits for use and return
satisfaction

8. Levels of interpersonal interaction and approaches in
health
Levels of
Interaction
1.client-provider
interaction
Approaches
V
A
L
U
E
S
H
A
R
E
Counseling
Client Perspective
Value your needs
Ask provider to clarify
Lead the conversation
Understand the benefits for you and your family
Establish an action plan and encourage others
Interaction
Share conversation
Heighten client participation
Agree on mutual goals
Respect each other
Equal input

9. Levels of interpersonal interaction and approaches in
health
Levels of
Interaction
2. Husband-wife
(Spousal communication)
Approaches
Counseling
Interpersonal Communication
Persuade
Negotiate
Seek agreement and/or approval
Share decision making
Participate and learn together
Appreciate each other
Discuss together

10. Levels of interpersonal interaction and approaches in
health
Levels of
Interaction
3. Couples and Family
Approaches
Counseling
Interpersonal Communication
(small group)
Persuade
Negotiate
Seek agreement and/or approval
Share decision making
Participate and learn together
Appreciate each other
Discuss together
Educate other family members

11. Levels of interpersonal interaction and approaches in
health
Levels of
Interaction
4. Peer groups and social
networks
Approaches
Counseling
Group communication
Advocacy
Community mobilization
Organizational mobilization
 peer pressure
 social support
 strengthen in numbers
 credibility
 high priority
 establish new norm

12. Environment and social context
A supportive environment and social context is
essential for promoting effective interpersonal
communication.
Program managers and decision-makers need to
enhance effective IPC by introducing and
improving the following:

13. Clinic and Community
 Budget: adequate staff, sufficient training, materials for
client and providers.
 Environment: clinic hours, client flow, reception, space
arrangements, waiting areas, counseling areas, group
meeting areas, examination areas.
 Staff: job description, specific procedures,
communication among staff, monitoring counseling,
performance, recognition of good performance.

14. Mass Media
 Role modeling: modeling how to talk to spouse,
good questions to ask the service provider, establish
the social norms.
 Reinforce/Support: reminders in mass media to see
service provider, testimonials to discuss new health
behaviors with spouse and family, call to action to join
a community mobilization effort.

15. Policy
 Budget Support: mandates to provide financial support
for IPC/C
 Systems support: monitoring and supervising systems,
reward systems, specific procedures
 Staff support: mandate enough managers and
personnel to support effective IPC/C.

16. Five General Principles of Motivational
Counseling
Motivational counseling focuses on five general
principles to identify the stage of change the
client is in and to assist with change.

Express empathy
Develop discrepancy
Avoid argumentation
Roll with resistance

Support self-efficacy




17. Express empathy
When a client presents a potential problem with following a treatment
regimen, the service provider should start by soliciting information
like:





What concerns does the patient have?
What barriers does he/she see?
What will be the hardest thing(s) about this change?
Does the patient have anyone at home to assist with the change?
What does the patient understand about his/her condition and its
treatment?

18. Develop discrepancy

Client are ambivalent or unsure about change. Therefore,
it is the job of the service provider to move the client in
the direction of the desired behavior.


Persuasive strategies do not work when the client is in the precontemplation or contemplation stage.
The useful strategy is to develop discrepancies between a
client's present behavior and the behaviors desired.

People are much more highly motivated to change when
discrepancies exist between current behavior and desired
personal goals.

19. Avoid argumentation


During motivational counseling, the health service
provider increases the client’s awareness of problems and
the need to do something about them.
However, the provider must be careful not to argue with
the client.

Arguing tends to increase resistance rather than increasing
motivation to change

20. Roll with resistance

When dealing with patients who do not want to change,
are overwhelmed, or won't take their illnesses seriously,
there is a tendency for the health service provider to
become frustrated or angry.

But the health service provider should avoid trying to persuade
patients even more that they have a problem. Do not force the
issue.

21. Support self-efficacy
Clients have to believe that they have the knowledge and
skills or abilities to carry out the needed health behavior
change. The health service provider can do this by:
1.
2.
3.
4.
5.
providing and clarifying information;
offering realistic hope and expressing confidence in the patient's
ability to succeed
noticing successful attempts at adherence, even if they are shortlived;
praising ideas that the patient comes up with to solve problems; and
continuing to emphasize and support the responsibilities that both
the patient and provider have in improving treatment adherence and
treatment outcomes.

22. Express empathy
When a client presents a potential problem with following a treatment
regimen, the service provider should start by soliciting information
like:





What concerns does the patient have?
What barriers does he/she see?
What will be the hardest thing(s) about this change?
Does the patient have anyone at home to assist with the change?
What does the patient understand about his/her condition and its
treatment?

23. See File: RH BCC WHCF
Example