Page 157 - Nutrition Counseling and Education Skills: A Guide for Professionals

covered with Hollandaise sauce. If the client is told that asparagus can be grilled for a delicious flavor, he or
she may be open-minded enough to try it again and perhaps develop a taste for this low-fat vegetable.
Changes in eating patterns that are pleasurable are self-reinforcing. If new patterns are a chore and are
disliked, they will fail to provide self-reinforcement.

The counselor can work with the client to establish reinforcers. Asking “What do you like to do with your
leisure time?” may identify activity reinforcers. Reinforcers may be walking; attending movies, plays, or
sporting events; taking a bath; gardening; knitting; playing cards; or reading. Social reinforcers may be found
by asking “Whom do you like to be with?” Reinforcers may include visiting or calling family or friends. Other
questions are “What do you find enjoyable?” and “What do you like to buy when you have extra money?”
other than unhealthy foods, of course.4 Box 7-2 summarizes the identification of reinforcers.

1. Make a list of leisure-time activities and hobbies that you enjoy.
2. Make a list of people you like to be with.
3. Make a list of things you would like to purchase with small amounts of extra money.
4. What do you find relaxing?
5. What do you do for fun?
6. What are your favorite possessions?

Box 7-2 ■ Identifying Reinforcers

A very important point here is to recognize that the counselor is also part of the reinforcement. Rather than
focusing on failures, the counselor should emphasize what the person has done right with verbal reward and
praise. Remind clients to reward themselves cognitively by telling themselves they are making progress and
have done something right. For the obese, the ability to fit into smaller-sized clothes hanging in the closet and
the weight loss itself are reinforcing. New reinforcers need to be established and introduced for weight
maintenance, such as engaging in enjoyable activities, joining a gym for physical activity, engaging in social
events not centered on eating, or walking laps around shopping malls. The reinforcement provided by
significant others and self-monitoring are discussed later in this chapter.

SELF-ASSESSMENT 3

1. What rewards do you get from eating?
2. What rewards do you think others receive from eating?
3. Identify one or two reinforcers that may help you change an eating behavior.

After one or two eating changes or goals are identified, a schedule of reinforcement needs to be discussed
and established. The schedule specifies which behaviors, if any, will be reinforced and how frequently
reinforcement will be provided. Continual reinforcement is the simplest method, but this may lose its
effectiveness if the reinforcer is used excessively. An alternative is intermittent reinforcement, such as
reinforcement three times a day or once a day. Eventually, the time may be lengthened between
reinforcements. The schedule should be appropriate to the behavior one is trying to strengthen, convenient for

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