Developing appropriate illustrations
Counseling for behavior change
Improving health provider skill
reminder materials




Counseling cards


Counseling cards usually have pictures on the front to facilitate discussion and often have text on the reverse side. The text includes questions for the counselor to ask, along with suggestions on how to negotiate small improvements in practices based on current practices and what the client or the family or community is willing to try. The cards have a logical organization to facilitate discussions about information that is relevant to them based on their current situation. They do not literally have to be "cards," although large, plasticized cards are a common format, bound on top or on the side as a flipchart or separate pieces.

Manoff Group counseling cards are distinctive in several important ways. Counseling card sets often include separate "assessment" cards, which help identify current practices and "counseling" or "negotiation" cards, which assist a discussion with the person, family or community about agreeing to try one or two recommended practices.

Where appropriate, (child health for example) cards are color-coded by the age or developmental stage of the child or by other important factors such as current illness and growth pattern. This ensures that the counselor gives relevant information and negotiates recommendations that will have maximum impact. In other words, communication is tailored to specific needs.

The cards and the process go beyond giving ideal "messages," to promoting those recommendations that will make a difference based on epidemiological data and what has been identified by people as feasible. The cards help the counselor to negotiate practices that are specific to each individual person, family or institutions. Over time, the counselor can motivate gradual improvements in practices to eventually reach or at least approach ideal practices.

The Manoff Group has learned that building the capacity of counselors—whether health professionals or community volunteers—is not merely a matter of a one-time training. Effective counseling requires that counselors respect their clients and are committed to problem-solving, Achieving this requires practice and supportive supervision (including modeling of good counseling) over time. The effort is significant, but the payoff in beneficial changes in behavior is clearly worth the effort.