Page 169 - Nutrition Counseling and Education Skills: A Guide for Professionals

8C H A P T E R

Counseling for Cognitive Change

Objectives

• Explain how cognitions affect people’s behaviors.
• Discuss the types of cognitive distortions and the effects they have on people’s behaviors.
• Explain the three phases of cognitive restructuring.
• Discuss self-efficacy’s role in the initiation and maintenance of health behavior changes and in a

person’s choice of activities.
• List the advantages and disadvantages of the four sources of efficacy information.
• Explain the use and advantages of self-monitoring of cognitions.
• Explain high-risk situations and the cognitive–behavioral model of the relapse process.
• List determinants and predictors of lapse and relapse and how to assess them.
• Identify treatment strategies to prevent lapses and relapse.

CASE CHALLENGE 1

Carol Jones is a 50-year-old woman recently diagnosed with type 2 diabetes mellitus. Her
maternal grandmother had diabetes. Mrs. Jones was an overweight child and is now an overweight adult at
5’4” and 180 lb. She is married and works part-time at a retail clothing store in a local mall.

Dr. Smith referred her for counseling to lose weight. Joan Stivers, the nutritionist, notes in her
assessment that Mrs. Jones seems to have a problem with low self-image and negative cognitions and that
her overweight is related to cognitive distortions. As a result, the current priority is cognitive restructuring.

169