FP Counseling, Handout #8
Roleplays Optional Practice
Role Play Scenario 1 — Adolescent client is interested in and eligible for COCs
COCs Scenario —Client Information Sheet
COCs Scenario 1—Observer Information Sheet
Client Description
You are a 17-year-old female who has been counseled about the
benefits of using family planning by a nurse at the antenatal clinic.
You were pregnant but miscarried six days ago. You read the
pamphlet on family planning method options given to you by the
provider at the clinic and have made a decision about which method
you believe best suits your needs.
Make note of whether the provider performs these case-specific tasks:

Asks about the client’s reproductive health goals, fertility
intentions, life plans

Ensures that client understood the contraceptive options in the
pamphlet, including emergency contraception

After client reveals COCs as her method of choice, confirms
eligibility using the checklist

Provides COCs, instructions on correct use, including what to do
if pills are missed, and information about resupply

Encourages her to be tested for STIs

Explains the benefit of using condoms for protection from STIs
and suggests she bring her boyfriend to the clinic for couples
counseling to support consistent condom use

Discusses benefits of healthy timing and spacing of pregnancies,
noting it is best to wait until at least age 18 and at least six
months after miscarriage before trying to become pregnant
Offer this information only when the CHW asks relevant questions:

You have had a steady boyfriend for about six months.

Your boyfriend was taking antibiotics recently after he went to
see a doctor at the STI clinic.

You do not use condoms.

You feel healthy and have no health problems.

You would like to have a child someday, but your boyfriend says
he is not ready so you have chosen to use COCs as you believe
that COCs would best suit your needs.
Training Resource Package for Family Planning
1
FP Counseling, Handout #8
Role Play Scenario 2 —Client is interested in and eligible for female condoms (can be adapted for male condoms)
Condoms Scenario—Client Information Sheet
Condoms Scenario 1—Observer Information Sheet
Client Description
You are a 17-year-old female who has been referred for
contraception from an HIV care and treatment provider. You
were pregnant but miscarried two months ago. You read the
pamphlet on family planning method options given to you by the
provider and have made a decision about which method you
believe best suits your needs.
Make note of whether the provider performs these case-specific
tasks:

Assesses the client’s reproductive health goals, fertility
intentions, life plans

Ensures that the client understood the contraceptive options
in the pamphlet, including emergency contraception

After client reveals female condoms as her method of
choice, reviews the benefits of dual protection

Provides female condoms and instructions on correct use and
resupply

Helps client explore approaches for negotiating condom use;
asks client if she would like to role-play the conversation;
does role play if client wishes

Suggests bringing partner to the clinic for couples
counseling
Offer this information only when the provider asks relevant
questions:

You have had a steady boyfriend for about six months.

You are both HIV-positive.

Your boyfriend was taking antibiotics recently after he went
to see a doctor at the STI clinic.

You want to use female condoms because they would give
you some control and you can delay pregnancy for now.

You are not sure how you want to discuss this with your
partner. When asked where, when and how, you choose the
bench in front of your house, after Friday night dinner;
suggesting to your partner that you want to avoid reinfecting
each other.

You feel healthy and your menses returned to a regular
pattern after miscarriage.

You might consider another method in addition to female
condoms.
Training Resource Package for Family Planning
2
FP Counseling, Handout #8
Role Play Scenario 3—Client is interested in and eligible for male condoms
Condoms Scenario 4—Client Information Sheet
Condoms Scenario 4—Observer Information Sheet
Client Description
You are a 41-year-old man. You have two teenage daughters with
your wife and a two-year-old son by your current girlfriend, who
was using oral contraceptive pills, but forgot to take them for
several days and became pregnant. Your wife now has an IUD.
You are interested in using condoms with your girlfriend until she
decides on a reliable contraceptive method that suits her better.
Make note of whether the provider performs these case-specific
tasks:

Assesses the client’s reproductive health goals, fertility
intentions, life plans

After client reveals male condoms as his method of choice,
discusses effectiveness, prevention of pregnancy and
protection from STIs and HIV

Provides condoms, gives instructions on correct use,
practices to avoid, and where to go for resupply

Asks client to demonstrate correct use

Offers suggestions for making condom use more enjoyable

Suggests he refer his girlfriend to you or to another provider
for FP counseling

Discusses benefits of testing for STIs/HIV; suggests testing
for himself and his partners at the local health center
Offer this information only when the provider asks relevant
questions:
 You have no serious health problems.
 You have had experience with condoms on occasion, but felt
that they dulled your sensitivity and reduced pleasure.
 You are not interested in a vasectomy at this time.

You have not been tested for STIs or HIV and you do not
know if your partners have been tested.
Training Resource Package for Family Planning
3
FP Counseling, Handout #8
Role Play Scenario 4—Negotiating condom use (may be adapted for female condoms)
Condoms Scenario —Client Information Sheet
Condoms Scenario 6—Observer Information Sheet
Client Description
You are an 18-year-old single woman and have come to the clinic
for your first general check up. You have recently begun dating
someone who you like very much. You know he has had other
girlfriends. You don’t want to become pregnant or get an STI so
you want to talk about using condoms.
Make note of whether the provider performs these case-specific
tasks:

Assesses the client’s reproductive health goals, fertility
intentions, life plans

After client reveals male condoms as her method of choice,
discusses prevention of pregnancy and protection from STIs
and HIV

Suggests testing for STIs and HIV for herself and her
boyfriend

Reviews benefits of dual method use to ensure pregnancy
prevention in case her boyfriend will not use condoms
consistently or client does not have condoms handy

Provides condoms and instructions on correct use and
resupply

Suggests client seek emergency contraception in case
condom is not used or is used incorrectly

Helps client make a plan for discussing condoms with
boyfriend and asks client if she would like to role play the
conversation; does a role-play practice with client if she
wishes
Offer this information only when the CHW asks relevant
questions:

You have no serious health problems.

Two days ago you and your new boyfriend had sex for the
first time since you started dating. It was spontaneous and
you did not use a condom or any other FP method.

Your period started five days ago; and they are usually very
short, but do not come on a regular schedule.

You have not been tested for STIs or HIV, and you do not
know if your partner has been tested.

You are very worried about getting HIV.

You have had one previous boyfriend who you dated a year
ago. He used condoms, but not every time.

You do not feel comfortable discussing condoms with your
new boyfriend.

You want children in the future, but not for at least two or
three years.
Training Resource Package for Family Planning
4
FP Counseling, Handout #8
Role Play Scenario 5—Client without children is interested in but is not eligible for implants
Implants Scenario —Client Information Sheet
Implants Scenario 2—Observer Information Sheet
Client Description
You are a 28-year-old married woman with a busy professional career.
You do not want to have children. You have been married and
monogamous for over eight years. You have recently seen a
promotion for progestin-only implants and have come to the family
planning site to learn more about them.
Make note of whether the provider addresses these case-specific issues:
• Assesses the client’s reproductive health goals, fertility
intentions, and life plans
• Ensures that the client understands the possible side effects of
implants, especially the likelihood of irregular bleeding (which is
very different from the regular bleeding pattern of COCs)
• Describes implant insertion and follow-up procedures
• Determines the client’s medical eligibility using the implants
screening checklist
• Explains that the client is not eligible at this time due to
unexplained bleeding and must be evaluated to determine the
cause before implants are initiated
• Offers couples counseling to address the husband’s concern
about infertility and to correct misunderstandings about implants
Offer this information only when the provider asks relevant questions:
• You are interested in implants, but your husband is concerned that
they will make you infertile.
• You are currently using COCs but are tired of the daily pill-taking
routine.
• You do not want to have children, but your husband has recently
said that he might want children some day.
• You have recently had unexplained bleeding after intercourse.
• You feel healthy and have no other health problems.
• Your last period started four days ago.
• You smoke cigarettes, about 10 to 15 per day.
Methods for which the client is eligible:*

COCs

Male or female condoms
* After the cause of the unexplained bleeding is determined, the client
may be eligible for implants, DMPA, NET-EN, or an IUD.
Training Resource Package for Family Planning
5
FP Counseling, Handout #8
Role Play Scenario 6—Young client is interested in and eligible for DMPA/NET-EN
Injectables Scenario —Client Information Sheet
Injectables Scenario 1—Observer Information Sheet
Client Description
You are a 17-year-old female. A friend at school told you that
the injection was now being offered at the local health center
and was available to adolescents. You go to the health center
where the receptionist gives you a pamphlet on family
planning method options offered by the center. After reading
it, you make a decision about which method you believe best
suits your needs, and now you want to talk with a provider
about starting the method.
Make note of whether the provider performs these case-specific
tasks:

Asks about the client’s reproductive health goals, fertility
intentions, and life plans

Checks that the client understands the contraceptive options
described in the pamphlet given to her at the clinic, and that she
has made an informed choice to use DMPA or NET-EN

Screens the client for eligibility for DMPA or NET-EN using the
checklist

Makes sure the client understands and is willing to tolerate
potential side effects caused by use of progestin-only injectables

Asks the client which injection site she would prefer; provides
injection, and reminds her not to massage the injection site

Explains the reinjection schedule for DMPA or NET-EN and
makes an appointment for the next injection

Explains that she might have acquired an STI and recommends
STI screening/testing; if client is interested, provides screening
or referral as appropriate

Recommends she bring her boyfriend in for couples counseling

Explains the benefits of using condoms and encourages condom
use in addition to DMPA/NET-EN for protection against STIs

Provides condoms if the client is interested

Encourages the client to return if she has questions, any
problems, or concerns about side effects
Methods for which the client is eligible:

Progestin-only injectables
Male or female condoms

Implants

COCs

Fertility awareness methods
Offer this information only when the provider asks relevant
questions:

You have had a steady boyfriend for about six months.

Your boyfriend was taking antibiotics recently after he
went to see a doctor at the STI clinic.

You do not use condoms.

You have regular periods, and your last one started 10
days ago.

Your boyfriend was away on business for two weeks, but
he is coming back tomorrow.

You feel healthy and have no known health problems.

You would like to have a child someday, but your
boyfriend says he is not ready so you have chosen to use
DMPA/NET-EN as you believe that an injectable would
best suit your needs.
Training Resource Package for Family Planning
6
FP Counseling, Handout #8
Role Play Scenario 7—New client is interested in and eligible for DMPA/NET-EN
Injectables Scenario —Client Information Sheet
Injectables Scenario 2—Observer Information Sheet
Client Description
You are a 23-year-old woman with two children who wants to
prevent another pregnancy. You heard from the midwife that you
can prevent pregnancy by breastfeeding, but would prefer a more
reliable option. You have come to the clinician to talk with him
(or her) about starting DMPA and/or NET-EN.
Make note of whether the provider performs these casespecific tasks:

Asks about the client’s reproductive health goals, fertility
intentions and life plans

Reinforces the importance of breastfeeding for a healthy
baby

After client makes an informed choice to use DMPA/NETEN, counsels her about benefits and side effects

Assesses client for eligibility (she is healthy and protected
from pregnancy by LAM)

Asks the client which injection site she would prefer;
provides injection, and reminds her not to massage the
injection site

Explains the reinjection schedule for DMPA or NET-EN and
makes an appointment for the next injection

Encourages the client to return if she has questions, any
problems, or concerns about side effects
Offer this information only when the provider asks relevant
questions:

You gave birth six weeks ago.

You are currently fully breastfeeding your baby and your
menses have not yet returned.

You will soon return to work and will have to be away from
home; when that happens, your mother-in-law will give the
baby pumped breast milk or formula.

You used DMPA to space your previous pregnancies and
would like to use it again.

You feel healthy and have no known health problems.

You would like to have another child someday.
Training Resource Package for Family Planning
Methods for which the client is eligible:

Injectables

IUD

Implants

Male or female condoms
7
FP Counseling, Handout #8
Role Play Scenario 8—New client is interested in but not immediately eligible for DMPA/NET-EN
Injectables Scenario —Client Information Sheet
Injectables Scenario 3—Observer Information Sheet
Client Description
You are a 28-year-old woman with three children. You and your
husband consider your family complete and you do not want any
more children, but you do not want to have your tubes tied. You
have been using condoms; you would like to use a more effective
contraceptive method. You have come to the provider today to talk
with him/her about starting another method—possibly the
injection.
Make note of whether the provider performs these casespecific tasks:

Asks about the client’s reproductive health goals, fertility
intentions and life plans

Reinforces client’s decision to use a more effective method
of contraception

Counsels her about other contraceptive methods that are
available (including long-term methods), to ensure that she
has made an informed decision about which method suits
her best

After client reveals injectables as her method of choice,
assesses eligibility using the checklist

Determines that client is not eligible to receive the injection
immediately because she has unexplained vaginal bleeding,
which requires evaluation prior to initiation of injectables

Evaluates the cause of the bleeding or refers for evaluation
as appropriate

Encourages her to continue using condoms until evaluation
is completed and injectables can be provided
Offer this information only when the provider asks relevant
questions:

You have been using condoms consistently and correctly.

After the provider counsels you about available contraceptive
options, you decide that you want to initiate injectables.

You feel healthy, but for the past two months you have
noticed some irregular light bleeding/spotting, which is
unusual for you. You meant to see a doctor sooner, but did not
get around to it.

You have no other health problems.
Methods for which the client is eligible:

COCs

Male and female condoms
Training Resource Package for Family Planning
8
FP Counseling, Handout #8
Role Play Scenario 9―New adolescent client who recently miscarried is interested in and eligible for DMPA
DMPA Scenario —Client Information Sheet
DMPA Scenario 1—Observer Information Sheet
Client Description
You are a 17-year-old adolescent female who found out from a friend
at school that her mother now provides contraceptive methods for
women in the community, including adolescents. You read the
pamphlet on family planning method options given to you by the
provider at the clinic and have made a decision about which method
you believe best suits your needs. You visit your school friend at her
house in hopes of talking with her mother about contraception.
Make note of whether the provider addresses these case-specific issues:

Asks about the client’s reproductive health goals, fertility
intentions, and life plans

Ensures the client understands how pregnancy occurs and the
menstrual cycle

Checks that the client understands the contraceptive options in
the pamphlet given to her at the clinic

Determines the client’s medical eligibility using the checklist

Counsels about side effects―especially bleeding changes
common among DMPA users

Gives the DMPA injection and reminds the client not to massage
the injection site

Records the date for the client’s next injection on the client’s
reminder card and the client tracking form

Explains the benefits of using condoms and encourages their use
to prevent STIs and unintended pregnancy

Provides condoms if the client is interested

If client is interested, refers to clinic for couple counseling and
possible STI testing

Encourages the client to return if she has questions or to go to the
clinic if she experiences any problems or has concerns about side
effects
Offer this information only when the provider asks relevant questions:

You have had a steady boyfriend for about six months.

You were pregnant but miscarried one week ago.

Your boyfriend was taking antibiotics recently after he went to
see a doctor at the STI clinic.

You do not use condoms.

You feel healthy and have no other health problems.

You would like to have a child someday, but your boyfriend says
he is not ready, so you have chosen to use DMPA because you
believe that DMPA would best suit your needs.
Training Resource Package for Family Planning
9
FP Counseling, Handout #8
Role Play Scenario 10―New client is interested in but not eligible for DMPA
DMPA Scenario —Client Information Sheet
DMPA Scenario 2—Observer Information Sheet
Client Description
You are a 23-year-old woman with two children who wants to prevent
another pregnancy. You heard from the midwife who delivered your
baby that it is now possible to receive injections from Community
Health Workers (CHW) rather than going to the clinic. You used
DMPA to space your previous pregnancies and would like to use it
again. You have come to the CHW to talk with her about starting
DMPA.
Make note of whether the provider addresses these case-specific issues:

Asks about the client’s reproductive health goals, fertility
intentions, and life plans

Reinforces the importance of breastfeeding for a healthy baby

Uses the checklist and determines that the client is not eligible to
initiate DMPA until her baby is six weeks old

Explains why she is currently not eligible to start injectables

Tells the client to come back in two weeks

Offers condoms in case the client stops fully breastfeeding before
she can return for an injection
Offer this information only when the provider asks relevant questions:

You gave birth one month ago.

You are currently fully breastfeeding your baby.

You will soon return to work and will have to be away from
home; when that happens, your mother-in-law will give the baby
pumped breast milk or formula.

You used DMPA to space your previous pregnancies and would
like to use it again.

You feel healthy and have no known health problems.

You would like to have another child someday.
Training Resource Package for Family Planning
10
FP Counseling, Handout #8
Role Play Scenario 11―New client with two children is interested in but not eligible for DMPA and may require referral
DMPA Scenario —Client Information Sheet
DMPA Scenario 4—Observer Information Sheet
Client Description
You are a 30-year-old woman with two children. You and your
husband have not decided whether to have more children but have
decided that you do not want any for at least three years. You have
come to the CHW to talk with him about starting a method. One of
your close friends has been using DMPA and seems to like it.
Make note of whether the provider addresses these case-specific issues:

Asks about the client’s reproductive health goals, fertility
intentions, and life plans

Reinforces her decision to start another method so that she and
her husband can decide when and whether they have more
children

Counsels her about available contraceptive methods (short- and
long-term), to ensure that she has made an informed decision
about which method suits her best

After client reveals DMPA as her method of choice, assesses
eligibility using the checklist and determines that the client is not
eligible to initiate DMPA because in her situation she will
answer no to all pregnancy questions on the eligibility checklist

Gives (or completes a referral for) emergency contraception

Tells her to wait until her next period so that you can be sure she
is not pregnant (if period is late, refers for pregnancy test)

Encourages her to use condoms in the meantime, and provides
condoms as needed
Offer this information only when the provider asks relevant questions:

After the CHW counsels you about DMPA and reviews the other
available contraceptive options, you decide to try DMPA.

You have been using LAM (fully breastfeeding) since the baby
was born about six months ago.

You started having your period again 10 days ago, so you want
to start another method as soon as possible.

You and your husband have been having unprotected sex
(including since your period ended two days ago).
Training Resource Package for Family Planning
11
FP Counseling, Handout #8
Role Play Scenario 12―New client with four children is interested in and eligible for DMPA reinjection
DMPA Scenario —Client Information Sheet
DMPA Scenario 5—Observer Information Sheet
Client Description
You are a 35-year-old woman with four children. You and your
husband have decided that you do not want any more children. You
have been going to the clinic for DMPA injections but were excited
to learn that starting today, September 28, you can now get DMPA
injections from a CHW in your local community. You have come to
the CHW to talk with her about getting a reinjection.
Make note of whether the provider addresses these case-specific issues:

Asks about any changes to the client’s reproductive health goals,
fertility intentions, and life plans

Reinforces her decision to seek a reinjection from a CHW

Follows the steps in the job aid to decide whether the client is
eligible for reinjection

Determines that the client is eligible for reinjection (she is within
the reinjection window and has no new health problems)

Reassures the client that amenorrhea is normal for women who
use DMPA for a longer period of time

Gives the DMPA injection and reminds the client not to massage
the injection site

Records the date for the client’s next injection, December 28, on
the client’s reminder card and on the client tracking form

Encourages the client to return if she has questions or to go to the
clinic if she experiences any problems
Offer this information only when the provider asks relevant questions:

You have been using DMPA since weaning your fourth child
about 18 months ago.

You had your last injection on July 7.

Your client card says that you are due for reinjection on Oct 6
(because your reinjection date is close, you decided to ask the
CHW whether it would be possible for her to provide a
reinjection).

You have had no new health problems.

Your monthly bleeding, which had become light and spotty prior
to the last injection, has now stopped completely.
Training Resource Package for Family Planning
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