Q. For what kind of client is CRCS intended?
A. CRCS is designed to provide intensive, client-centered risk reduction counseling to persons for whom risk reduction is difficult to achieve or maintain but who also are willing to work on these issues. These clients may not benefit from less intensive risk reduction interventions until after psychosocial needs (e.g., mental health, substance abuse, or housing) that interfere with risk reduction are addressed.

Q. How soon should we begin risk reduction counseling with CRCS clients?
A. You should begin risk reduction counseling as soon as possible with CRCS clients. First, during screening and enrollment, clients should learn that the primarily purpose of CRCS is risk reduction. Some agencies even begin risk reduction discussions during initial outreach to potential clients. During the initial assessment conversations, it is necessary to discuss risk reduction desires, goals, and needs. Focused risk reduction counseling depends on a good assessment of risk and risk-related issues with each client. After assessment activities, formal risk reduction begins. But it is important to remember that every interaction with a client is a chance to provide risk reduction messages and support.

Q. What do we have to report about CRCS in PEMS?
A. The sample data collection forms do include some PEMS items, as indicated on each form by R or *; however, note that PEMS reporting requirements are currently (05/2006) being reviewed. Please address specific questions about PEMS, including questions about up-to-date reporting requirements, to CDCPEMS.gov or to your Project Officer.

Q. Can CRCS risk reduction sessions be conducted in a group context?
A. CRCS is by definition a client-centered intervention. This means that a counselor’s work with a client to determine primary risk issues and challenges and determine best approaches to meeting those challenges is done at the individual level. However, your client and counselor may also determine that specific group activities, such as group-based behavioral interventions or support groups, could be a useful component of the client’s intervention plan.

Q. We have CRCS staff who work on CRCS as part of their work load, but do other tasks to fill their work load. For agencies such as ours with few resources and a lot to do, is this a good approach to CRCS?
A. CRCS counselors need to be available to meet the prevention needs of their clients. Prevention for CRCS clients tends to be intensive and complex. We have found that counselors have lots of difficulty maintaining an on-going and consistent relationship with their clients if they are also working with other interventions or program activities at the same time. Unless the CRCS workload is exceptionally small (fewer than 10 clients) or the other activities can fit well into the CRCS flow of activities (e.g., counselors are also responsible for providing HIV testing to their enrolled CRCS clients), we recommend that CRCS counselors be full time.