Counselling as a distinct professional discipline is a relatively recent development in Pacific societies.

The exact number of qualified counsellors across the region is unknown, but each year more people from Pacific countries are graduating from the counselling programmes of various academic institutions in regional and neighbouring countries.

Yet counselling is often clouded in mystery. “It’s common for people to ask counsellors—are you reading my mind right now?” says Alistair Mac Donald, Counselling Development Officer at the Secretariat of the Pacific Community (SPC).

“This question is not limited to the Pacific, and probably highlights more serious and widespread misunderstanding about what counselling is, when or where it happens and who does it.”

“People have a good idea of what to expect when they visit a doctor or nurse, but their expectations of counselling are most likely going to be very different depending on their occupational, educational or cultural background.”

 Counselling is not new to the region and probably takes place in some form or another in all Pacific societies. Commonly, churches have provided a form of pastoral counselling, as do many village elders and chiefs.

However, there are likely to be fundamental differences in the counselling provided by ministers or traditional networks and that available from the growing number of often ‘not-for-profit’ professional counselling services.

But they complement each other and offer communities a choice. Professional counsellors are highly trained in well-recognised skills and techniques and use these along with the provision of information to guide clients to finding their own solution to a problem or issue.

“Bad counselling is no less dangerous than bad medicine. Therefore, it’s essential that counsellors are regularly and frequently supervised and challenged on their practice,” says MacDonald.

Pacific people are increasingly seeking out counselling for varied reasons including grief, sexual health, depression, suicidal thoughts, anger management, or sudden traumatic events such as rape.

Alistair MacDonald works in SPC’s HIV and STI Section specifically to support the development of counselling services focused on issues related to HIV and other STIs (sexually transmitted infections).

“Knowing your HIV status can save lives—yours, your partner’s and that of your family. So when someone is considering taking a significant and positive step, such as finding out their HIV status, they should receive counseling and it’s crucial they know what to expect.”

Studies show that the usefulness of counselling relies significantly on the skill of the person providing the service. Clients must feel able to trust the counsellor and to speak honestly without fear of judgment.

“People want to know that the information they provide and their test result will be preciously guarded by the service they seek the test from—that it’s a confidential service.”

It is equally important that the person is sensitively provided with good information and is given enough time and support to consider how the results of an HIV test might impact on their life. They can then make an informed decision about getting tested.

 “There are plenty of good reasons to have an HIV test, but in small communities people worry about someone finding out that they simply had the test—never mind others finding out the result. Or someone might be concerned that the person who did the testing and counselling—the doctor, nurse or counsellor—will tell the community about it,” says MacDonald.

Much of this fear and concern is related to historical taboos, and stigma and discrimination related to sex, sexuality and HIV. But gradual and important improvements in the quality of training in HIV and STI counselling skills for health professionals, and the application of minimum standards for agencies providing such services, are positive steps.

“All good businesses have quality controls and seek to continuously improve. HIV counselling services have to do the same if they want people to come to them. 

“Ongoing training and setting quality benchmarks are good for everyone—the agency develops a good reputation, staff morale improves, and most importantly, the person at the sharp end gets a better service.”

Recent assessments in seven Pacific countries showed that there are many good HIV test counselling services in the region. “It is clear that many of the services assessed are genuinely focused on doing things as professionally as possible, and improving what they do.”

SPC’s is assisting regional country partners to improve the quality of their counselling skills training programmes and practice.

MacDonald believes that marketing initiatives designed to promote the benefits of counselling to Pacific societies are also important.

“It’s not just about advertising where such services exist. It is also about helping people understand what these services provide and how counselling can help—then people are more likely to want to use the services and benefit from them,” he says.