As new versions of the form are introduced, the sheer amount of data we must collect has grown each time. This severely limits the counselor's ability to control the purpose of the session as anything other than data collection. Putting the form aside and using a conversational style to discuss the client's experiences with testing and safer sex can help focus the session on the issues important for that client, rather than following a bureaucratic, form centered format. We take the risk assessment form pretty much for granted as something which largely structures the session. For this counselor who has been working since 1986, years before any forms were used, the form is seen as an impediment to his more conversational style. In the extract below, the counselor describes how he has gotten used to incorporating the form into the session almost as an afterthought. This is one way that counselors can structure the session with out letting the form take over.
N: Uhm, so when you started having to use a form, for your counseling, how did you adjust to that? Or have you?
C: I have adjusted, sort of, uhm, and the way that I adjusted was to just pretend like it didn't exist and to have whatever kind of session we were gonna have and then at the end, you know, the State is using us as data collectors and I could do this really quickly with you but do you know that you're welcome to decline any or all of these questions, that's completely within your power. Just like that, so then it's like OK go ahead, and then just zooom, maybe something comes out of that, maybe some laughter, there's one question about how many sex partners you've had and it's parenthetically 0 to 999 in the last year, and I say that because you know, I think it's funny and it gives people the freedom to state some pretty large numbers if that's the truth, so, uhm, and, I think that the way that I ask the stuff, I don't think it's real intrusive, you know mostly, some people use it, really use it as a way of getting into stuff, I don't, I prefer doing that conversationally and often what comes up is don't you hate forms and isn't it horrible how this sort of describes your experiences really without describing your experience at all, or it could look on the form like you're an incredibly high risk person but on the back, I might say has unprotected sex with primary partner, has safer sex outside the relationship, you know whatever, so anyway, it's not a big part of what I do and I just try to minimize the effects of it and give the client complete power of rejection, ask the questions really routinely, like I'm not gonna react to any of this, and it's true occasionally something will come up that hadn't come up before or will be clarified by the form
N: Have you noticed other ways that the counselors use the form?
C: Some counselors just to go right to the form. And I sort of have a problem with that and if I were a client, that would feel too abrupt to me, but I think some counselors, I know that one counselor who I think is a great counselor, he frames it right when the person comes in, you know there's a few questions I need to ask you before you get your blood drawn, which is interesting because people are often confused like what are we, and what are we doing, they think that we're gonna draw their blood, so, I appreciate that he provides just a single sentence little frame that orients the client but it is form bound and I think he, expands from the form, it's not like he just fills out the form and the session's over, but that's how he starts and I think people who are less experienced or not as comfortable, just like
N: There's no trust established before they start.
C: Right.
N: Doing this bureaucratic thing.
C: Right. Or like they're not sure of or comfortable with their own interpersonal skills so they use the form to organize it. On a rare instance I'll do that when it's not happening, there's, we're missing, where the client's just really cut off, really doesn't want to be there, but even then I would probably say first, do you hate this? Do you just hate this whole process?
N: So you use phrases like that to cut the tension.
C: Let them vent, acknowledge that this, how shitty that they even have to do this. You know, whatever it is, and uhm, it always seems like if you give the client total freedom, no you don't have to fill that out. I mean, one man I saw out in the waiting room where we have them fill out one little column of the demo form themselves, he wanted to use a pen rather than a pencil, and it's like sure you know, here, let me find you a pen, and then he was, I could tell he was uncomfortable and I said do you, you don't have to do that if you're hating this, we can just go on in to the counseling room and you don't have to fill that out, and then when it got to the form, you know I offered him to decline and he did, and then eventually after I had taken away every single thing that he supposedly had to do, then at the end of the session he said, we can fill out the form now. And I would be that way too you know if somebody gave me total freedom then I wouldn't feel backed into a corner.
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