Page 121 - Nutrition Counseling and Education Skills: A Guide for Professionals

Introduction

One of the key roles of nutrition and dietetics professionals is to promote the optimal health of the public.
The practitioner translates the science of nutrition into healthful foods and nutrient intake for individuals or
groups. To achieve appropriate food intake, often health behaviors and lifestyles must change.

Many factors influence the health behaviors we engage in, whether beneficial or harmful to our health, such
as failure to exercise or to eat healthfully. Some of these factors include socioeconomic status, environment,
culture, skills, attitudes, values, beliefs, and religion. Nutrition counseling focuses on helping clients
accomplish changes. Counseling also comes into play in the managerial aspects of dietetics in the form of staff
counseling for development or remediation.

In this chapter, counseling approaches, theories, and models are considered as approaches to implementing
a nutrition care plan and intervention. Strategies selected should be based on the best current knowledge and
evidence available. If the intervention, whether education or counseling, does not produce a change in
knowledge, skills, behavior, or health outcome, the continuation of the intervention will be questioned.

Using Theories and Models

Theory is a foundation of professional practice providing interrelated constructs, concepts, propositions, and
definitions with the purpose of understanding, explaining, and predicting relationships and health
behaviors.1,2 One selects the theory and intervention to use to achieve behavior change.

After identifying the person’s health issues and current behaviors, one’s professional experience is a guide in
implementing a theory-based intervention. Because no one theory is appropriate in every situation, it is not
unusual to combine constructs from different models and theories.1 If the theory or model helps explain a
behavior, it may suggest ways to design interventions that achieve behavior change and improve a person’s
health.

Nutrition counseling is a collaborative counselor–patient/client relationship to set priorities, establish goals,
and create individualized action plans that acknowledge and foster responsibility for self-care and self-
management. Nutrition counseling strategies are designed to achieve behavior change toward a particular
client goal.

Counseling assists people in learning about themselves and their environments. Counselors aid individuals
with the decision-making process, resolving interpersonal concerns, and helping them learn new skills and
ways of dealing with life situations. Counseling is a science as well as an art. The skills of the counselor allow
for customizing the counseling for the individual client.

This chapter views the counseling process as one that involves the development of a trusting, collaborative
relationship between counselor and client, includes the evaluation of client issues, and the use of various
techniques of problem solving. The approaches to counseling may be classified as nondirective or directive.
The nondirective or “client-centered” approach may be applied to the nutrition counseling of clients. It
includes active listening and helping the person determine how to proceed. Directive counseling is applied
more often to staff regarding job-related issues.

Counseling is an individualized process that involves suggesting constructive alternatives based on what is
important to and manageable for the client. Several theories, models, and approaches are described in this

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