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For Nutrition Professionals
supervision | training | home study | coaching
Nutrition
Program Directors and Professors
Internship
Directors and Preceptors
WIC Trainers
These resources help
you teach counseling skills to future nutrition
Professionals...
Newsletter
Archives
February
2, 2010
In this
issue:
Inspiration
from the field:
Melanie Brede, MS, RD, CSSD, is a preceptor who works at
the University of Virginia’s Student Health Center.
She has this strategy for interns who want to practice
counseling with patients in an outpatient setting when
their skill level is not yet adequate. First, she
assigns Counseling Tips to the interns to read. Then
they observe one of her sessions and use the Counseling Session
Feedback Form to pick out the skills they see
demonstrated. If Melanie is seeing a client who would
feel uncomfortable with an intern in the room, she
lets the interns use the Feedback Form with a previously
recorded session.
Interns get frustrated when we don’t let them counsel real clients. When they do work with clients, they understandably focus on the content of what they need to cover because this is fairly new to them. Their process tends to get off track, and we cringe. This interim step of focused observation gives them experience with attending to the process when it’s easy to get distracted by the content. It may be useful to set up the observation session by promising to discuss the nutrition issues afterward, but emphasizing that you want them to focus this time on tallying open and closed questions or by noticing the client’s “change talk.”
You could choose the Tips or you could let the interns choose a few (thereby demonstrating choice). You and the interns could design the observation exercise based on the Tips chosen. For example, an intern may be fascinated with self-disclosure and what to do when clients ask personal questions. You would assign Tips #1, Self -Disclosure, and #18, How to Handle Personal Questions. Then during the session, the intern can be assigned to jot down any self-disclosure on your part and/or note times she would have been tempted to add something about herself if she were the counselor. Afterward, discuss the pros and cons of each example of disclosure.
Share your
strategies! Got something that is working well? Send
me an e-mail.
In a coming issue, I’d love to see:
• Ideas on coordination to further learning of
counseling skills. Do you have experience coordinating
between a DPD program and a DI program in the same
institution? What ways have you found within a DI
program to coordinate efforts from one placement to
another?
• Formats or checklists that you use to show students
how a session can smoothly incorporate both
client-centered counseling and the Nutrition Care
Process. I’ve been sent one and would love to share
several.
• Methods for feedback to students/interns on their
counseling process. Anyone using the standardized
patient process described in these articles?
o Henry, B.W, Duellman, M.C, Smith, T.J. Nutrition-based
standardized patient sessions increased counseling
awareness and confidence among dietetic interns. Top
Clin Nutr. 2009;24:25-34.
o Henry, B.W, Smith, T.J. Evaluation of the FOCUS
(Feedback on Counseling Using Simulation) instrument for
assessment of client-centered nutrition counseling
behaviors. J Nutr Educ Behav. 2020; 42:57-62.
Q:
I have your Toolbox of materials and am teaching
counseling skills to undergraduates for the first time.
Can you direct me to basic exercises for first-time mock
counseling?
A: I
would start with the Mirroring Exercise since the
process of reflecting is so critical to all counseling.
Some students are natural mirrors, and reflecting will
come easily since they already do it in their social
conversations. For them, you are highlighting a natural
process they can employ strategically with clients.
Other students do not yet mirror out loud in their
social interactions, and the skill will be difficult and
take practice. All students will benefit from your
suggestion to practice it with friends and bring their
experiences to the next class.
The Unpacking Exercise gives students a chance to practice focusing on what is important to the client without the distraction of nutrition content. I have often seen even experienced nutrition counselors get off track quickly when instructed to unpack what is important to their mock client when the topic is nutrition or health. Instructing the “client” to talk about something that matters to him (unrelated to health or food) makes it more likely that the counselor will not get off track and give advice too soon. The counselor can focus on exploring the topic in detail, practicing open-ended questions and reflecting.
The Elicit/Provide/Elicit Exercise works well, too. Students may be excited about providing nutrition advice. Introducing this process for embedding the advice in a client-centered frame early in their training will serve them well later.
Free
Webinar:
Looking
for content on eating disorders for your students
or interns?
Here is a
link to a 75-minute
webinar you are free to share. It was recorded in
January, 2010 for the ARAMARK Dietetic Internship
Program. I serve as a volunteer for A
Chance to Heal, an advocacy and education non-profit
in Philadelphia and conduct several lectures per year
for future health professionals to ensure they will
respond appropriately when they encounter an eating
disorder. I share this to further this mission.
Resources
from others:
Run into articles, textbooks, videos, websites or other
resources that help you do a better job? Let me know and
I’ll post them here.
Here’s one of my favorite articles: Miller, W.M, Rose,
G.S, Toward a theory of motivational interviewing.
American Psychologist. 2009; 64:6, 527-537.
It reviews the latest research on the effectiveness of
Motivational Interviewing. I particularly appreciate
that it includes research on training for MI. It’s
probably most appropriate for graduate courses, though
I’d love to hear feedback from others who have
assigned it.
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