Page 122 - Nutrition Counseling and Education Skills: A Guide for Professionals

chapter, including nondirective and directive counseling, Motivational Interviewing, and the Health Belief
Model. Chapters 7, 8, and 9 expand the discussion of counseling to include other theories and models of
counseling for behavior change.

Nondirective Counseling

The nondirective approach to counseling is often called “client-centered,” “person-centered,” or “Rogerian
counseling” and is best represented by the writings of its originator, Carl Ransom Rogers. Rogers used the
term “nondirective” as the client directs the flow of conversation. The theory is one of the more detailed and
consistent.

A basic assumption in the Rogerian client-centered point of view is that people are rational and realistic.
Individuals possess an inherent tendency toward realizing their potential for growth and self-actualization, if
their needs for positive regard from others and for positive self-regard or self-esteem are satisfied.

One of the most important characteristics of the Rogerian theory is the therapeutic relationship between
the counselor and the client. The underlying assumption is that the client cannot be helped simply by listening
to the knowledge the counselor possesses or to the counselor’s explanation of the client’s behavior.3–5
Prescribing “cures” and corrective behaviors are seen as being of little lasting value. The relationship that is
most helpful to clients enables them to discover within themselves the capacity to use the relationship to
change and grow. One of the phrases that is used to describe Rogers’ therapy is supportive, not reconstructive.

Rogers’ approach suggests six conditions that are necessary in the relationship with the client.3–5

1. Relationship. The counselor and client have a relationship in which each makes a difference to the other. The counselor needs to be accepting
of and respect the clients as individuals as they are, with their good and bad points, their conflicts and inconsistencies without judgment or
disapproval. Only after clients are convinced that they are accepted with unconditional positive regard can they begin to trust the counselor.

2. Vulnerability. The client is vulnerable to anxiety in the relationship, but is motivated to continue the counseling relationship.
3. Genuineness. In the counseling relationship, the counselor is willing to express his or her own feelings. Exceptional counselors are

characterized by congruence or genuineness within the counseling relationship. They are honest, integrated, and consistent, with no
contradictions between what they are and what they say. These counselors are able to express outwardly to their clients what they are feeling
within themselves. Their verbal and nonverbal behaviors are consistent.
4. Unconditional positive regard. The counselor experiences unconditional positive regard for the client. The counselor cares about the client and
this is perceived by the client. The client’s positive self-regard is strengthened.
5. Accurate empathy. The counselor experiences the client’s world through empathy and communicates the understanding to the client. The
counselor must experience an accurate, empathic understanding of the client’s world as seen from the inside, sensing the client’s world as if it
were his or her own. This understanding enables clients to explore freely and deeply and develop a better comprehension of themselves. It is
of no value for the counselor to be accepting, genuine, and understanding if the client does not perceive or experience this. The acceptance,
genuineness, and understanding need to be communicated to the client verbally and nonverbally.
6. Perception of genuineness. The client perceives the acceptance and understanding of the counselor. The counselor must be seen as genuine for
the client to trust the empathy and caring of the counselor. This type of relationship can facilitate positive change.5

The process of change in client-centered therapy is conceptualized as a “combination of consciousness raising
and corrective emotional experiencing that occurs within the context of an affirming, and empathic
relationship.”5 The counselor listens actively and accurately reflects back the client’s thoughts and feelings.
This directs the client’s attention to become fully conscious of their experiences.

The counselor uses reflection of what the client says by the mirroring back to the client of what he or she is
saying to increase awareness. If the client says, for example, “my life is too busy to make food changes,” the
counselor reflects this back by saying, “So you have a lot of commitments right now.” This communicates that

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