Client-Centered Counseling Utilizing a Harm Reduction Approach for Populations Resistant to Behavior Change. J Brookman. Health Initiatives for Youth, San Francisco, CA.

Issue: Many clients seeking HIV related services are resistant to changing high risk behaviors despite having sufficient knowledge about the behaviors' consequences.

Project: A client-centered model can help human service providers to work more effectively with clients resistant to behavior change. In this model, counseling interactions are tailored to assess the client's needs, including behavioral risks and contextual issues (social, psychological and economic factors, etc.). Use of a harm reduction approach (gradual minimization of risk behavior over time) as the basis for interventions encourages the client and counselor to work together to select specific behavior changes which realistically reflect the clients' circumstances and willingness to change.

Results: Counselors who are adequately trained and supported to use a client-centered counseling model are more skilled and prepared to assess the contextual issues related to increased risk of HIV, constructively confront resistance to behavior change, and help clients design alternatives to high risk behaviors.

Lessons Learned: Behavior change can occur when the skilled provider and the client work together to design a realistic behavior change plan that is implemented over time.

Contact: Jackie Brookman, P.O. Box 3164 Moss Beach, CA 94038 USA. Telephone: 415.728.2734, Fax: 415.728.2734.

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