Page 131 - Nutrition Counseling and Education Skills: A Guide for Professionals

changes and see both the pros and the cons, the counselor’s goal is to have the client make several arguments
or reasons for change while the counselor avoids the “Righting Reflex.” This is an urge to correct the client’s
ambivalence and set him or her on the correct course, such as recommending exercise to help lose weight. It is
the client who should find the reason and make the arguments for change. This is especially important with
clients ambivalent about change.

The counselor asks open-ended questions in determining the issues.
Source: Centers for Disease Control and Prevention.

Periodic summaries move the interview along. The professional may summarize the client’s statements
about the problem, the client’s ambivalence, self-motivational statements made by the client, “change talk,”
and an overall assessment of the situation.7 Draw together the client’s reasons for change. This helps clients
make up their minds. It reinforces what they may already know to be true, but may be avoiding. Reflection is
especially important after answers to open-ended questions, after self-motivational statements, and after
“change talk.”

CASE ANALYSIS 6

How would you respond to Robin’s “change talk?”

The DARN acronym may be used to generate client statements about change. Change talk may be
recognized by statements of Desires, Abilities, Reasons, Needs (DARN), taking steps, or commitment to
change. Clients who state reasons, desires, or needs for change may exhibit greater intentions and
commitments for change although the strength of commitment may vary. The basis for wanting to change
may be a health or personal goal.7 The counselor gathers the examples of change talk and can summarize and
reflect them back to the client. The summary should be phrased as a present change in a behavior and not
what the person plans to do at a future time.6

“I need to get more exercise” is not a commitment to change or the same as saying “I’m going to walk 3
days every week,” which is a commitment and action step.7 A client may acknowledge that change is
important, but lack confidence. “I would like to exercise, but never was good at it.” One may ask how

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