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EFFECTIVE CONTRACEPTIVE COUNSELING ECC

ECC: The Purpose. To improve client contraceptive utilization

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EFFECTIVE CONTRACEPTIVE COUNSELING ECC

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    1. EFFECTIVE CONTRACEPTIVE COUNSELING (ECC) Applying the Science

    2. ECC: The Purpose To improve client contraceptive utilization & efficacy using a client-centered approach.

    3. The premise of the ECC model: Client centered interventions help clients increase BC efficacy and continuation which leads to… Fewer unintended pregnancies which leads to… Improved health of women, children & families and… A decrease in societal costs

    4. The Science – What interventions have been shown to improve client BC use? Client’s choice of contraceptive Several types to choose from are offered Client makes choice without coercion Adequate (not too much) information Help client weigh advantages, disadvantages Address potential side effects and how to cope

    5. The Science – What interventions have been shown to improve client BC use? Target couples: more effective than working only with woman or man Opportunity to discuss partner’s attitudes, beliefs Opportunity to discuss feelings about sex, sexual activity Follow up in the first three months – most likely time to quit method or make mistakes

    6. The Science – What types of interventions? Personalized, client-centered counseling

    7. The Science – Theory-Based Interventions Behavior change theory Motivational Interviewing

    8. The Science – Determinants of risk and contraceptive failure History or current sexual & physical abuse Substance use & abuse (including tobacco) Current living situation Gay/lesbian orientation (or questioning) Multiple sexual partners Ambivalence about becoming pregnant Feelings of hopelessness, depression Need for confidentiality

    9. Process characteristics of ECC Client-centered: Ask a series of open-ended questions Listen for client information, choices, needs and risk factors Provide client-focused information

    10. Process characteristics of ECC Uses Motivational Interviewing skills and techniques: OARS REDS

    12. Five ECC Components: Help client evaluate method choice. Assess & discuss personal issues. Discuss partner’s role. Discuss “back up” plan. Follow up & reinforce positive behaviors.

    13. Help client evaluate choice of method Focus on the client’s choice of method. Assess/clarify knowledge, misinformation & myths. Describe method benefits, including non-contraceptive benefits Address potential side effects and health risks. Provide culturally sensitive, clear, easy to understand printed materials.

    14. Assess & discuss personal issues Current exploitation or abuse (and history). Feelings about future, possibility of pregnancy. Current substance use & abuse. Current living situation. Feelings about her/his sexual activity. Client’s need for confidentiality.

    15. Discuss partner’s role Where possible, include partner in discussions Discuss partner’s (or partners’) attitudes, feelings about client’s contraceptive use. Reinforce male involvement in pregnancy prevention. Discuss partner’s role in supporting the use of an individual method, as appropriate.

    16. Discuss “back up” plan Address potential side effects and what client should do if has side effects or concerns. Discuss “back up” methods – e.g. condoms. Provide information about emergency contraception – or provide E.C. Rx Provide telephone numbers for client to call with questions and concerns.

    17. Follow up & reinforce positive behavior(s) Address questions and provide follow up appointment, as needed. Reinforce positive contraceptive and other self-protective behaviors. Follow up on any community referrals, as necessary.

    18. ECC Model Curriculum Combines experts’ wisdom and research Uses theory-based interventions (TTM & MI) Provides effective teaching models and activities using REDS and OARS.

    19. Motivational Interviewing: REDS R = Roll with resistance E = Express empathy D = Develop discrepancy S = Support self-efficacy

    20. Motivational Interviewing: OARS O = Open-ended questions A = Affirmations R = Reflective listening S = Summarizing

    21. ECC Model Curriculum Offers a flexible, client centered formula for counseling and education. Builds skills for helping clients be more successful with their chosen contraceptive method. Is modular and includes activities that will engage participants in active and interactive learning.

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