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close this bookEducation for Health (WHO, 1988, 274 p.)
close this folderChapter 4: Health education with individuals
View the document(introduction...)
View the documentThe purpose of counselling
View the documentRules for counselling
View the documentDifferent types of counselling
View the documentFacilitating decisions and follow-through
View the documentA sample counselling session
View the documentMore practice in counselling

Rules for counselling

The health worker in this example had obviously not learned the techniques of counselling, otherwise she would have followed the simple rules below.


Counsellors show concern and a caring attitude. They pay attention to building a good relationship from the beginning with the person they are trying to help. People are more likely to talk about their problems with someone they trust.

Identifying needs

Counsellors seek to understand a problem as the person with the problem sees it. People must identify their own problems.

Counsellors do not name the problems for them. The use of questions that lead to open comments will help here. A counsellor's task is to listen carefully.


Counsellors develop empathy (understanding and acceptance) for a person's feelings, not sympathy (sorrow or pity). A counsellor would never say 'You should not worry so much about that.' It is natural for people to have worries and fears about their problems. A good counsellor helps people to become aware of their feelings and to cope with them.


Counsellors never try to persuade people to accept their advice. If the advice turns out to be wrong, the person will be angry and no longer trust the counsellor. If the advice is right, the person may become dependent on the counsellor for solving all problems.

Counsellors help people to think about all the factors involved in their problems, and encourage people to choose the solutions that are best in their particular situation.


Counsellors will be told about many personal and possibly embarrassing problems. The information must be kept secret from all other people, even from the client's relatives. If a person you are counselling discovers that you have told other people about the counselling session, that person will no longer trust you and will avoid you. A client may even get into trouble because of what a counsellor has told others. Counsellors always respect the privacy of the people they are helping. They never reveal information without specific permission.

Information and resources

Although counsellors do not give advice, they should share information and ideas on resources which the client needs in order to make a sound decision. For example, many people do not realize the connection between their behavior and their health. Counsellors do not lecture, but should provide simple facts during discussion to help people have a clearer view of their problems.

All health or community workers can practice a counselling approach in their work. Parents and friends can be counsellors too. The important thing is that the nurse, teacher, father, or friend is willing to listen carefully and encourage the person to take as much responsibility as possible for solving his or her own problem.

Now that you have read about the rules for counselling, think again about the case of the mother with twins. How could the health worker have made a better beginning with this home visit? What comments and questions could have been used to find out more about the mother's problems? How could the other relatives in the house have been involved? Can you think of possible alternative solutions to the problem?