Note form Nicolas: On the current California State Risk Assessment form, the back is used only for instructions on how to fill out the front. In order to have the form match the counseling style of the clinic, I created a back of the form which I xerox onto the back of the State risk asessment form. It provides a check-list of topics to cover for both pre and post test, a space to write down the clients chief concern, and what risk reduction plans were discussed, so that the results counselor has a good sense of what still needs to be covered. There is also a check list of local referals. The most helpful feature of the new back of the form that we use is that counselors can take a few moments to write down what they did. This has a cathartic effect, allowing the counselor to get a clean slate before counseling the next client. This kind of charting is not a substitute for the post-shift debriefing sessions, but it certainly helps counselors debrief before moving on. To see the form
A counselor is describing how she use the back of the form and offers some suggestions.
C: I use the back of the sheet a lot because I feel the next counselor who comes behind me and gives them their results needs to have the whole picture. And so, when I give results I look at the back of the sheet and if nothing's written there I'm almost a little bit lost and I almost feel like, I look at their sheet and I say ok, uh, they've had some STDs, I wonder if they were told by about STDs or, uhm, you know, they're sleeping with sixteen people, you know, it doesn't give me a feel for what they've gone through, so I go through like a little mini thing, uhm, you know depending upon when their last unprotective sex was cause on the back of mines I'll know that they had unprotective sex, something here to close the window, window open or whatever so I say, I have to ask you some questions, well are you here to close your window, if they look at me like they don't know, I explain what the close of a window is, uhm, I see you had an STD, was it explained to you about what happens with STDs in relation to HIV, they tell me no, you know, then I give them a little spiel about [that
N: Right
C: Uhm, not to redo the whole session but I think if there's nothing on the back, you know, you sort of, you're sort of at a loss and then I always ask them do they have any questions for results when I'm doing a pretest, I tell them jump in any time they have any questions, no question is stupid, no question I probably never heard, uhm, feel free to tell me every anything or that they want to tell me, it's confidential don't think I'm going to get embarassed by it or or turn up my nose or anything like that, that's not the kind, that's not what we're here for. We're here to, you know look at what they've been doing, assess the risk, answer some of their questions, put some of their fears to rest if we can and then I start.
N: Anything on the back that should be changed?
C: Uhm, you know I had thought about that because uhm, I thought there should just be a section for just thoughts,(.) you know because sometimes they're talking to you and you're writing things down that I think is important that the counselor knows, the next counselor, the result counselor or whoever's reviewing these knows but it doesn't actually fit into a concern that we're having or it doesn't even fit into a plan.
N: So maybe just leave a blank?
C: Just a section for thoughts. You know.
N: So just take out the concerns and the plan or do you want that?
C: No, I think that should be in and then a thought section because uhm sometimes what we've discussed is not a concern uhm it's not a concern of mine, it's not a concern to them but it's something that needed to be discussed, uhm, so I'll note it and I can see if I've got somebody who'se buying onto it, so I'll put into the plan sections like the condoms from the rectum to the vagina. And I'll also put you know, discuss condoms, condom use, when to use, but see there's no place for me really to put that so I've been putting that under Plan, but that should be under discussion or under my thoughts because I actually did it. I mean it may have started like I may put in the concern, client never used condom before, client hates to use condoms, but the time he ends my session I try to get him to buy onto something, and I get them to agree to something.
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