1. Module 4: Options Counseling

2. Melanie Zurek Sept 2010 www.provideaccess.org Module 4: Objectives In Module 4, our objectives are to train frontline providers to effectively: Understand basic pregnancy options counseling techniques, including validating, seeking understanding, reframing, and referring Review the options for patients/clients with an unintended pregnancy

3. Melanie Zurek Sept 2010 www.provideaccess.org Module 4 Our Goals as Providers To create a space where the patient or client feels it is safe to ask questions, it is critical to listen without an agenda. To be a person whom the patient or client trusts, you must be known as someone who will give them accurate information. To establish an environment free of stigma around pregnancy decisions, you should use unbiased language.

4. Melanie Zurek Sept 2010 www.provideaccess.org Options Counseling Framework  Validate  Seek Understanding  Reframe  Refer This is not problem solving The client has the answers and you are there to help her see her own strengths and abilities This is not problem solving The client has the answers and you are there to help her see her own strengths and abilities Module 4

5. Melanie Zurek Sept 2010 www.provideaccess.org Module 4 Validate “That makes sense.” “I see what you are saying.” “Lots of people feel that way.” “I hear you.”

6. Melanie Zurek Sept 2010 www.provideaccess.org Module 4 Seek Understanding “Tell me more about that.” “What makes you think that?” “How does that work for you?” “Help me understand that.” “Are you saying... ?” “It sounds like you mean... is that right?”

7. Melanie Zurek Sept 2010 www.provideaccess.org Module 4 Reframe “Yes, that is hard, and you have some real strengths, some things in your favor, some assets you’re not thinking about.” “I know it feels hopeless, but I’m wondering if you’re missing part of the picture. It seems like...” “It seems like you’re being really hard on yourself, what would you say to a friend in this situation?” “This is a tough situation, but it sounds like you’re trying to make the best decision for your whole family.” “It seems to me you like you’re being selfish, but I see it differently.” “It sounds like you’ve been through a lot. It must have taken a lot of strength and courage to get to this point.”

8. Melanie Zurek Sept 2010 www.provideaccess.org Module 4 Reframe “I know you want to help me, but you should know that I’ve been one big screw-up my whole life.” Sample response: “It sounds as though you have struggled in the past. But you are here now and I’m observing you to be both thoughtful and ready to the take the steps that you need to take.”

9. Melanie Zurek Sept 2010 www.provideaccess.org Module 4 Reframe “I don’t think I can handle this. I’m just going to pretend like I never found out that I’m pregnant.” Sample response: “Listening to you, it seems as if you are feeling pretty overwhelmed. But I see you as facing this situation with courage. For example, you came in for a pregnancy test.”

10. Melanie Zurek Sept 2010 www.provideaccess.org Module 4 Reframe “I have friends who did all the same stuff I did, and they didn’t get pregnant. It’s not fair that this happened to me.” Sample response: “Tell me if I’m wrong, but I sense that you’re feeling angry and asking, ‘Why me?’ While you can learn from the past, let’s focus now on taking good care of yourself in this situation.”

11. Melanie Zurek Sept 2010 www.provideaccess.org Module 4 Reframe “I feel like I can’t think straight. I have no idea what I’m going to do and I don’t know how I’m going to decide.” Sample response: “I hear you saying that you are struggling to process this information. It’s okay to feel overwhelmed. I can offer some tools to help you think this over and am confident you are able to figure out the best path for you.”

12. Melanie Zurek Sept 2010 ACT Be prepared to help the client/patient to ACT A A – Adoption C C – Continuing Pregnancy to Parent T T – Terminate www.provideaccess.org Module 4

13. Melanie Zurek Sept 2010 A.C.T. Help her to A.C.T. www.provideaccess.org Module 4

14. Melanie Zurek Sept 2010 A.C.T. Help her to A.C.T. www.provideaccess.org Module 4

15. Melanie Zurek Sept 2010 A.C.T. Help her to A.C.T. www.provideaccess.org Module 4

16. S UPPORTIVE T HOROUGH A CTIVE R EFERRAL-QUALITY Be a STAR........... www.provideaccess.org Module 4: The STAR Model for Effective Referrals

17. S UPPORTIVE “I know my role in the face of my client’s/patient’s need.” “Supporting my client’s decision is the best way I can do my job in helping her.” T HOROUGH A CTIVE R EFERRAL-QUALITY........... Be a STAR www.provideaccess.org Module 4: The STAR Model for Effective Referrals

18. S UPPORTIVE “I know my role in the face of my client’s/patient’s need.” “Supporting my client’s decision is the best way I can do my job in helping her.” T HOROUGH “I have the correct information about the service she needs.” “I am knowledgeable about the care she is seeking.” A CTIVE R EFERRAL-QUALITY........... Be a STAR www.provideaccess.org Module 4: The STAR Model for Effective Referrals

19. S UPPORTIVE “I know my role in the face of my client’s/patient’s need.” “Supporting my client’s decision is the best way I can do my job in helping her.” T HOROUGH “I have the correct information about the service she needs.” “I am knowledgeable about the care she is seeking.” A CTIVE “I actively help my client/patient locate and schedule the care she needs.” “I actively assess her needs for, and help connect her to, supportive services such as childcare or transportation—to help her to utilize the referral she is seeking.” R EFERRAL-QUALITY........... Be a STAR www.provideaccess.org Module 4: The STAR Model for Effective Referrals

20. S UPPORTIVE “I know my role in the face of my client’s/patient’s need.” “Supporting my client’s decision is the best way I can do my job helping her.” T HOROUGH “I have the correct information about the service she needs.” “I am knowledgeable about the care she is seeking.” A CTIVE “I actively help my client/patient locate and schedule the care she needs.” “I actively assess her needs for, and help connect her to, supportive services such as childcare or transportation—to help her to utilize the referral she is seeking.” R EFERRAL-QUALITY “I follow up, asking about her experience accessing this provider and if there is anything else she needs.” “I use her experience to better help the next client or patient seeking a referral.”........... Be a STAR www.provideaccess.org Module 4: The STAR Model for Effective Referrals

21. S UPPORTIVE T HOROUGH A CTIVE R EFERRAL-QUALITY Be a STAR www.provideaccess.org Module 4: The STAR Model for Effective Referrals