Page 104 - Nutrition Counseling and Education Skills: A Guide for Professionals
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The counselor develops a relationship with the client.
CASE ANALYSIS 2
What SOC is Mr. Howard in?
Maintenance
In stage 5, Maintenance, a person consolidates and integrates new health behaviors into his or her lifestyle
made over several months. With time, new behaviors need to become automatic. The client has to maintain
the new, healthier habits and work to prevent relapse.3,7 Maintaining weight loss, for example, takes
continuing effort. For some people, this stage continues for months, years, or a lifetime, or until the behavior
becomes a pattern and is incorporated into one’s lifestyle.3 The counselor may ask: “How do you handle small
lapses?” Additional information on counseling about lapses and relapse is found in Chapter 8.
Termination
The ultimate goal is the Termination stage, in which changes have been maintained for years. The termination
of a behavioral problem occurs if the client reacts automatically, is no longer tempted by the former behavior,
and is no longer lapsing or relapsing. Some people never reach this stage, but periodically struggle with the
health problem. In situations like weight control, a lifetime of maintenance may be the realistic goal.4
Recycling
Most people do not maintain changes in behaviors successfully on the first attempt. How long do your New
Year’s Eve resolutions last, for example? Prochaska proposed that most people proceed through the stages in a
spiral, rather than a linear fashion.3 Because lapses and relapse are common problems, recycling to an earlier
stage, such as from action back to preparation or from preparation back to contemplation, may be expected
several times as people struggle to modify or cease behaviors.3
People may avoid high-fat and fried foods, for example, and then start eating them again. Moving back and
forth through the stages represents a learning process for the client. Lapse and relapse and the negative
emotional reactions (guilt, shame, failure) that may result are discussed along with the skills to recover in
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