COUNSELORS SELF ASSESSMENT

TOOL To work on… (goal for building skills)

Notes for na, desire to do more or less of
SPECIFIC SKILLS something or no change if looking good

IIncrease, NC No change, D Decrease

With Permission (ADP)
Advise (AD)
Without Permission (ADW)

Appreciation, expressed confidence,

Affirm (AF) reinforcement for spec beh/thought

Confront (CO) Challenge ideas, confrontation

Praise, punishment, disapproval, moralizing

Contingencies (CT)
Emphasize Control (EC)
Evocation (EV)
in response to client discourse
Emphasis on client personal control,
choice, and responsibility.
Question, reflection or strategy to foster
alternative viewpoints/change talk

Verbiage that supports exploration or

Facilitate (FA) unfolding issue more

Filler (FI) Chit chat/report building

Counselor focus/reflection on change talk

(FC)
Follow Change Talk (FC)
Missed opportunities to explore change talk
(MO)

General information (GI)

Giving Information (GI)
Question (QU)
Protocol (intervention) specific information
(PI)
Closed Question (QUC)
Open Question (QUO)

With Permission (RCP)

Raise Concern (RC)
Without Permission (RCW)

Focus/refocusing conversation intentionally

(RDI)
Redirection (RD)
Changed topic unintentionally or producing
missed opportunity (RDU)

Simple (RES)
Reflect (RE)
Complex (REC)

Providing alternative explanations/view

Reframe (RF) points

Advocating for prevention/health rather than

Righting (RT) joining in ambivalence (RT)

Roll with Resistance Joining client in reflecting on/feeling

negatively about pro-health/pro-self-care
(RR) options
Silence (SI) Strategic use of silence (vs filling silence or
unintentional interruption of it)

Support (SU) General support for efforts

Other:

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 GLOBAL RATINGS
Low High
Acceptance
1 2 3 4 5 6 7
Empathy/Understanding
1 2 3 4 5 6 7
Spirit
1 2 3 4 5 6 7

FIDELITY
iNSC-SEXUAL HEALTH Notes
1. Introduction and Rapport-building.

2. Review

3. Explore
(How did you frame this? Words used? Ideas for next time?)
a. Facilitators
(Wording for this? Non-judgmental? Assist in pushing for
deeper understanding?)
c. Challenges
(Wording for this? Non-judgmental? Assist in pushing for
deeper understanding?)
4. Tailor
(What insights/observations did you use? What did you under-
use?)
5. Needs
(What does client need to try/continue with sexual health
protection? How did you inquire about this? How was client
engaged in generating this? Needs identified for
maintenance?)
6. Strategies
(How might client address/continue to address
needs/wants/desires for sexual health? How was client
engaged in this? What questions did you ask or not ask?)
7. Agree/Goal setting
(Which strategy will client try? How did you work with client to
get this? Collaborative decision making?)
TRANSITION FOR ON PREP CLIENTS
(How to you switch gears? Smooth?)
iNSC-PREP ADHERENCE
3. Explore
(How did you frame this? Words used? Ideas for next time?)
a. Facilitators
(Wording for this? Non-judgmental? Assist in pushing for
deeper understanding?)
c. Challenges
(Wording for this? Non-judgmental? Assist in pushing for
deeper understanding?)
4. Tailor
(What insights/observations did you use? What did you under-
use?)

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5. Needs
(What does client need to try/continue with sexual health
protection through PrEP? How did you inquire about this?
How was client engaged in generating this? Needs identified
for maintenance?)
6. Strategies
(How was client engaged in this? What questions did you ask
or not ask? How collaborative was this?)
7. Agree/Goal setting
(Which strategy will client try? How did you work with client to
get this? Collaborative decision making?)
CLOSE. Thank Participant and summarize main insights and
goals for next contact/next visit

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SKILLS DICTIONARY

Basic definition

SPECIFIC SKILLS

With Permission (ADP)

Asking before providing
Advise (AD) advice/recommendation
Giving advice unsolicited or without
Without Permission (ADW) permission (note: may be appropriate
depending on context)
Reinforcing client comments/reflections on
Appreciation, expressed confidence,
Affirm (AF) reinforcement for spec beh/thought positive things/insights (note: does not include
general praise or positive comments)
Expressing opposing ideas or overt debating
Confront (CO) Challenge ideas, confrontation with client (note: may be appropriate
depending on context)
Use of praise, disappointment or concern to
motivate adoption of change resulting in direct
Praise, punishment, disapproval, moralizing
Contingencies (CT) in response to client discourse or implied contingencies for client to “earn”
counselor respect or positive regard. (note:
typically inappropriate in most situations)
Reflections or comments that reinforce or
Emphasis on client personal control,
Emphasize Control (EC) choice, and responsibility. introduce client choice and power in discourse
or in general
Introducing or steering conversation towards
alternatives or inconsistencies in views or
Question, reflection or strategy to foster
Evocation (EV) alternative viewpoints/change talk behaviors (note: distinct from confrontation by
counselor’s use of reflection and questions
that target change talk)
Questions, reflections and non-verbals that
Verbiage that supports exploration or
Facilitate (FA) unfolding issue more move client towards continued or deeper
exploration of an issue
Generic conversation- often promoting a
Filler (FI) Chit chat/report building sense of history between client and counselor
or commonality or courtesy
Counselor notes and explores client verbiage
Counselor focus/reflection on change talk
that reflects desire, ability, reasons for
change, need for change, commitment
Follow Change Talk (FC) towards change, action or taking steps
Client expressed desire, ability, reasons,
Missed opportunities to explore change talk need, commitment, action or taking steps and
counselor does not reflect or explore
General information (GI) Provision of general information
Giving Information (GI) Information about sexual risk, risk
Protocol (intervention) specific information
(PI) management, adherence, or PrEP (or other
material related to protocol/study)
Closed Question (QUC)
Questions with answers that resemble
response options or yes/no
Question (QU) Questions that cannot be answered with a
Open Question (QUO) simple option or reply- choices for response
not provided or implied
Asking to share a concern, worry or fear
Raise Concern (RC) With Permission (RCP) typically in relation to what the client just
shared

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 Stating a concern, worry or fear about
Without Permission (RCW)
something the client shared without
asking/permission (note: may be appropriate
depending on context)
Changing topics or shifting conversation to
Focus/refocusing conversation intentionally different content intentionally (eg., to close a
(RDI) topic, refocus an unproductive discussion, or
manage conversation length)
Redirection (RD)
Topic shifts or changes introduced that were
Changed topic unintentionally or producing not intentional-questions that redirect
missed opportunity (RDU) conversation from one area to a different one
for unclear reasons
Reflecting back client statements or
experiences in a way that maintains client’s
Simple (RES)
content or level of insight (echo, repeat,
Reflect (RE) rephrase, reword)
Statements that paraphrase to emphasize
Complex (REC) connections, new insights or offer potential for
deeper understanding/meaning or feeling
Offering an alternative and typically more
Providing alternative explanations/view
Reframe (RF) points functional or empowering way of looking at
something the client has shared
Statements or questions that emphasize what
Advocating for prevention/health rather than
Righting (RT) joining in ambivalence (RT) the client should think or do that are pro-
health or pro-self-care.
Statements, questions, reflections that join
Joining client in reflecting on/feeling client’s negative feelings/thoughts about
Roll with resistance (RR) negatively about pro-health/pro-self-care adopting/maintaining a health behavior-
options specific avoidance of touting the “should do”
point of view
Allowing for silence in an appropriate manner-
Strategic use of silence (vs filling silence or
Silence (SI) unintentional interruption of it) productive silences- and using silence to learn
about client

GLOBAL RATINGS
Basic Definition
Counselor demonstrates openness to client and
Acceptance discourse- willing to discuss difficulties without judging
or correcting them.
Counselor demonstrated ability to “sit with” difficult
Empathy/Understanding content, positions client experiences within the context
of his/her life and genuinely engages with client.
Overall presence of counselor promotes a supportive
environment. Counselor appears engages in
Spirit conversation and mixes his or her own expressions and
affect to create a positive productive working alliance
with client.

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