Page 159 - Nutrition Counseling and Education Skills: A Guide for Professionals

times.
Goal setting and problem solving in a supportive environment are key factors of behavior modification.15

Goals must be set realistically yet high enough to provide significant change. The role of the counselor is to
help the client develop his own integrated plan geared toward defined and measurable goals. The nutrition
counselor serves as a guide or facilitator of change rather than a director or controller of change by suggesting
behavioral techniques appropriate to the situation. The counselor should assist the client in assessing the
triggers to eating problems and should suggest possible goals, strategies, and techniques to deal with them.5

Ultimately, the client must determine which suggestions seem manageable at that time and must be willing
to implement them. It is also a good idea to ask the client to give an example of the specific behavior change
rather than the concept by stating, for example, “The next time I am out of milk I will buy low-fat milk
instead of whole milk.” This is a concrete action plan compared with merely stating “I’ll try to follow a low-fat
diet.”

Since clients are not routinely in daily contact with the counselor, they must be ready to assume personal
responsibility for sound dietary changes and eventually become independent. They must learn to analyze and
solve their own eating behavior problems. Have the client start with small, easy changes, which are most likely
to be successful, and progress incrementally to more difficult ones in later sessions.

To be self-reinforcing, the eating changes should be pleasurable ones. If clients enjoy potato chips, ice
cream, pizza, and beer, they have to find substitutes they enjoy, such as baked chips, fresh grapes, unbuttered
popcorn, and calorie-free beverages or light beer. It may be sufficient to start by reducing the quantity of
favorite foods consumed. However, some people may elect to avoid a food item entirely to reduce the
temptation of having more. Needless to say, strategies must be highly individualized, and what is appropriate
for one client may be inappropriate for another.

Nutrition counselors have the opportunity to share the experiences of others. By having counseled patients
and clients on various issues and using customized approaches, counselors learn to assist patients at every point
of change. The process of counseling can be compared with making bread. Every baker knows that particular
ingredients, kneading, and rising time are essential to making a loaf of bread, but he or she also introduces
artistic expression and ingredient variation to make a unique loaf of bread that meets the distinct tastes of
loyal customers. When preparing a new recipe, it is often helpful to see pictures of the finished product;
however, the baker or chef must sometimes adjust the recipe for cooking at different altitudes or with varying
ingredients. Similarly as counselors, we need to be cognizant of the right things to convey at the right time
and be able to customize along the way.

159