The four pillars
CTEVT PSC curriculumCTEVT PSC curriculum: on the official Psychosocial Counselor syllabus, can appear in the exam. Beyond curriculum: added for completeness, not examinable. A chip like 296.2x · F32 is the diagnosis code: the DSM-5's older ICD-9-CM number, then the ICD-10 "F-code" used in hospital records. Non-students can ignore all of these.
1 · The counselling setting. The room itself is an intervention: it says you are safe here.
- A peaceful, private, confidential room
- Comfortable seating at an angle, not across a desk
- Tissue, water, and a first-aid box
- Play and drawing materials for children
- A waiting space that protects privacy
- Barriers managed: noise, interruptions, smoke, alcohol
2 · Documentation. The individual file sits under a code number, never a name.
- Intake form
- Consent form (a Nepali template is in the CTEVT course pack)
- Session notes: presenting problem, interventions done, plan
- Assessment forms and checklists (Hopkins, PTSD)
- Case-update and progress reports
- Referral forms
- Supervision forms
- Client-satisfaction and termination forms
- The centre's register and daily record
Locked storage. Notes written the same day. Facts and observations, not judgments: write every note as if the client might one day read it, because they may.
3 · Supervision. Not inspection: protection, for the client and for you. Forms:
- Clinical supervision with a senior (case review, blind spots)
- Peer supervision (colleagues learning from each other)
- Your own supervision of CPSWs and trained teachers/health workers
- Bring your hardest case
- Bring your suicide-risk cases
- Bring the case you don't want to talk about: that one first
4 · Linkage, coordination, referral. Map your district before you need it. Know your contacts by name:
- Psychiatrist and hospital
- Senior counselor or psychologist
- Doctor
- Lawyer and human-rights organisations
- OCMC and safe houses
- VCT and drug counselors
- Physiotherapist
- Rehab centres and shelters
- Vocational training
- Schools and teachers
- Psychosocial-trained health post workers
- Child protection committees
- Clubs and mothers' groups
- Traditional healers: coordinate respectfully; they see your clients first
Referral is a skill: explain why, write the referral letter, take consent, give the client the information, follow up whether they arrived. Refer up always for:
- Psychosis
- High suicide risk
- Severe self-neglect
- Children in danger
- Anything beyond your training
Composite scenario. Priya, 24, first-episode psychosis, referred by a community health post. The health post worker noticed declining self-care and heard voices two weeks ago.
Reasoning: the referral is needed because psychosis is beyond the counselor's training scope and carries risk.
The referral letter reads: "Priya, 24, presents with two weeks of auditory hallucinations and declining self-care. Suspected first-episode psychosis. Urgent psychiatric assessment needed. Consent obtained from the client. Information given to the client about the referral."
Outcome: the psychiatrist confirmed the diagnosis and started antipsychotic medication; the counselor continued supportive sessions alongside the medical team.
Test yourself
Three friendly questions to settle what you just read. This is reassurance, not a test: a wrong answer is part of learning, and you can try again.
1) List the documents of an individual file from intake to termination, in order.
✔ Intake form · consent form · session notes · assessment forms and checklists · case-update and progress reports · referral forms · supervision forms · client-satisfaction and termination forms, plus the centre's register and daily record.
Not quite; have another look. The answer is in the documentation section above.
2) Draft a three-line referral letter for a client with first-episode psychosis.
✔ Refer up always for psychosis; the letter explains why, gives the client information, and takes consent before the transfer.
Not quite; have another look. The answer is in the referral section above.
3) Your me-map of the district: name one real contact for six of the referral channels above; the gaps you find are this week's homework.
✔ This is ongoing fieldwork: your six contacts change as you build the map, and the gaps are the week's real homework.
Not quite; have another look. The answer is in the linkage and referral section above.