Page 161 - Nutrition Counseling and Education Skills: A Guide for Professionals

blood pressure are other self-monitoring techniques. In a systematic review of the literature on self-
monitoring for weight loss, Burke and colleagues 17 determined that an association between self-monitoring
and weight loss was consistently reported despite weaknesses in study design. Self-monitoring may be
conducted by traditional paper and pencil diaries or more advanced use of technology such as a digital recorder
or online tools.

Time Food/Amount/ Room/ Others How You Felt Activities at the
Prep Method Place Present Before Eating Same Time

Example: Watching television

9:30 PM 8 cookies, 10 oz Family Husband Bored, tired
milk room

Table 7-1 ■ Self-Monitoring Food Record

Self-Management

In most behavior modification programs for weight control, the client and counselor are together only for a
brief duration at specified intervals. Consequently, the counselor cannot be continually in control of
dispensing rewards and punishments or withholding them for appropriate and inappropriate behavior, which
is the basis of behavior modification. Therefore, self-regulation or self-management techniques are taught to
clients so that they can regulate and control their own behavior. In this way, progress may be achieved in the
interval between meetings of the client and counselor.

Research has shown the importance of developing behavioral self-management techniques. Skinner18
explained that self-management or “self-control” occurs when the individual manipulates the variables on
which the behavior rests. Self-management programs have been designed to help persons become aware of
and modify antecedents of eating and to self-administer rewarding consequences for eating differently. As
self-management programs have evolved, more emphasis has been placed on cognitive change. People have
been helped to modify thoughts and beliefs that interfered with adherence to specific dietary regimens and to
make use of self-reinforcing thoughts when appropriate behaviors occur. Becoming aware of one’s inner state
can assist in achieving the desired self-management. For example, referring to a diet has connotations of an
ephemeral event, whereas adapting a lifestyle change leads to a more permanent behavior modification.

CASE ANALYSIS 5

What self-management and/or self-monitoring techniques might be successful for Martha?

Social Support

Clients’ social environments consist of people they are in contact with daily. It is important to include the
person’s family and significant others when planning lifestyle and dietary changes. The nutrition professional
should include family members in counseling for change whenever possible, since the changes in food plans at

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