Training lay counsellors to provide psychosocial support to ART users: successes and failures.

This study reports on a pilot project to train eight patient advocates (PAs) who provided psychosocial support to users of antiretroviral therapy (ART) in basic counselling skills. PAs received 18 hours of training over the course of 3 months. A cadre of raters evaluated the PAs after the training using the Counsellor Rating Form and a Counsellor Evaluation Form. Counsellor activities that were rated as approaching acceptability were: reflection of content, encouraging, summarising, gathering data, exploring alternatives, giving directives and terminating the session. Counselling activities rated as requiring further training were reflection of feeling, interpretation, exploring logical consequences, confrontation, identifying positive assets and challenging. These results are discussed in the context of creating and sustaining a health-enabling community for ART users.