The Role of Negotiation in Counseling: Borrowing from TIPS (Trials of Improved Practices)

CORE Spring Meeting May 2014Janine Schooley, MPH

TIPS A participatory, asset-

based approach Based on concept of “test

marketting” Negotiation and

experimentation leading to practical, feasible recommendations for behavior change

Motivators and barriers are key to those recommendations working

Program participants try out a new practice during a trial period to assess its feasibility within the culture/situation

Has been used in many countries, primarily for improving feeding of young children

Both research and implementation

TIPS indicate both what behaviors should be included and not included in the program and how best to promote them

Certain behaviors that are impossible to predict precisely (such as childbirth) or which take a long time (child immunization series) are a challenge to test with TIPS

TIPS is:

Formative research Empowering to the

client/patient Can provide field workers

with much needed practice in counseling and negotiation skills

Really 2 kinds of TIPS: negotiation TIPS and learning TIPS

TIPS leads to a better understanding of:

Current practices -- Helpful? Harmful? Don’t know? Among what group?

Problem (s) Beliefs, practices, and influences

– Potential motivators– Constraints

Recommendations This then becomes the foundation

of counseling guidelines,

behavior change strategies, etc.

TIPS helps us pinpoint and articulate:

Behaviors that are both feasible and efficacious

Behaviors that the project should NOT promote

Motivations and barriers Level of change expected Level of health and nutrition

impact expected

TIPS Steps:Field Work over 2-3 visits

(assessment, interviews, observation)

Negotiation (feedback, solutions, suggestions, discussion, agreement, evaluation)

Analysis (quantitative, qualitative, influencers, barriers, what was easy/hard, how did they overcome barriers, perceived benefits, intentions to continue? Etc.)

Negotiation Process Introduce problem Recommendations by

the mother Recommendations by

the field staff Motivators and

encouragement Mother’s response and

compromise Mother will try… Result? Reasons? Will continue practice? If not, why not?

So, what can we learn from TIPSand how can we apply that learning more broadly?