Page 118 - Nutrition Counseling and Education Skills: A Guide for Professionals

5C H A P T E R

Summary

All nutrition and dietetics professionals need to be knowledgeable about the theories, models, concepts,
processes, and techniques of counseling. A comprehensive approach to counseling that considers lifestyle,
environments, culture, and psychological and social factors is needed. The SOC construct from the TTM
identifies clients’ readiness and motivation to change health behaviors whereas the processes of change
identify a number of choices of interventions that are appropriate at the different SOC. Counselors assist
clients in formulating one or more realistic, behavioral goals for change as an incentive to measure
performance. The following chapters discuss other approaches to counseling.

Review and Discussion Questions

1. Explain the six steps in the SOC.
2. Compare the processes of change at the precontemplation stage with those at the action SOC.
3. Explain the decisional balance and how it may be used with clients.
4. Explain the steps in the process of goal setting.

Suggested Activities

1. During the next week, make arrangements to observe a nutritionist’s counseling session. Afterward, discuss the approaches and theories of
nutrition counseling.

2. Interview someone who would like to modify his or her food behaviors. Identify the person’s SOC. Determine which processes of change are
appropriate to the identified SOC, and implement them.

3. Form triads consisting of a counselor, counselee, and observer. Each person should take a turn in each of the roles for 7 minutes. The
counselee should play the role of a client with hypertension or obesity, and the counselor should use paraphrasing and empathizing along
with open and closed questions to determine the person’s SOC and facilitate disclosure and problem solving. After each round, the observer
should share reactions to the counselor’s approach and encourage feedback from the counselee to the counselor. From the counselee’s
perspective, what did the counselor do that helped their interaction; what did he or she do that hindered it?

4. In groups of two, take turns discussing a lifestyle problem and restating it as a goal for change.
A. Think of a lifestyle problem the counselee would like to change, such as eating too much; eating the wrong foods; needing to eat more
fruits and vegetables, more fiber, or less fat; exercising too little; needing to budget better; drinking too much; smoking too much; or the
like.
B. Help the person discuss the problem and the conditions and circumstances surrounding it. Then have the counselee restate the problem as
a positive goal for change, that is, “I will. . .”
C. Assess the importance of the goal on a scale of 1 to 10, with 10 representing the highest importance. Revise the goal if necessary.
D. Ask about and discuss the obstacles and barriers to accomplishing the goal, and try to have the person resolve these.
E. Have the person list the steps toward achieving the goal. What will the person do, and when will it be done?

5. Visit one or more web sites to determine what clients may find and how it may or may not help them change their food choices. Share your
results with the class.

6. In groups of two, discuss the following client statements to determine what SOC the person is in.
A. “I have made some changes in my food choices over the past 6 months.”
B. “I am intending to change the foods I eat in a few weeks.”
C. “I intend to make some changes in the next 6 months.”
D. “I don’t eat high-fat foods anymore.”
E. “Maybe I’ll make some changes.”
F. “I think my food choices are OK.”

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