Page 160 - Nutrition Counseling and Education Skills: A Guide for Professionals

The mother influences the child’s cues for eating.
Source: Copyright Wolters Kluwer.

The counselor should discuss with the client the possibility of deviations from the planned behavior,
especially when under physical or emotional stress. Expecting immediate, total control over change is
unrealistic and may lead to diminished self-esteem in clients who have problems following diets, with eventual
abandonment of the dietary changes. Learning any new skill requires practice over a period of time.
Repetition of the same new behaviors gradually becomes reinforcing and habitual. Support and forgiveness
should be provided during any lapses.

Enthusiasm for change may be expected to drop rapidly after the initial period, especially if frustration and
disappointments arise. Weekly appointments, or alternative methods of communication phone or e-mail, with
the counselor may be needed and are desirable in the beginning, tapering to bimonthly and monthly.
However, preestablished rules and limits should be set forth in advance of embarking on alternative
communication.16

Self-Monitoring

Self-monitoring, or keeping records of eating behaviors to be controlled, was intended originally as a means of
supplying the counselor and client with data for analysis. Clients record what, where, when, and how much
they eat; the circumstances, for example, eating while watching television or while feeling bored; and the
persons present (Table 7-1). The exercise of keeping records has additional value of its own; it increases client
awareness and understanding of current eating behaviors and the influences on them and leads to such
realizations as “I’m eating too much during evening hours while I watch television.” Data provide a basis for
setting goals for change “I’ll eat a low-calorie snack instead.” and finding ways to reinforce new behaviors “I’ll
tell myself how well I’m doing.”

Keeping records serves as a measure of the person’s commitment to change. In addition, by having to write
down the foods and beverages consumed, the client may think twice about actually consuming an item rather
than eating it out of habit or while distracted. Patterns of weight change, physical exercise, blood sugar, and

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