Preparing to Meet Your Clients: Nutrition Education and Counseling

Preparing to Meet Your Clients Nutrition Education and Counseling Chapter 1  Nutrition education -"any combination of educational strategies, accompanied by Foundation environmental supports, designed to facilitate voluntary adoption...

Preparing to Meet Your Clients Nutrition Education and Counseling Chapter 1  Nutrition education -"any combination of educational strategies, accompanied by Foundation environmental supports, designed to facilitate voluntary adoption of food choices and other food- and nutrition-related behaviors conducive to of Nutrition health and well-being.” Nutrition counseling: a supportive process that uses a collaborative counselor–patient/client Counseling relationship to establish priorities, goals, and action plans related to food, nutrition, and physical activity. and The Haney and Leibsohn model - defines nutrition counseling as "an interaction in which the counselor focuses on client experience, client Education feeling, client thought, and client behavior with intentional responses to acknowledge, to explore, or to challenge (p. 5)."  Take a How do you decide what to eat? What is influencing your decision minute… to eat? Fundamentals of Food Behavior  Factors That Affect Food Choice Sensory Taste is one of the most important determinants of food appeal choice. Biological taste preferences evolve from childhood based on availability and societal norms. Taste preferences Factors and eating patterns can be modified by factors such as experiences, age, relocating to a new environment, or illnesses. Affecting Habit People who use cues such as time of day or habit as a trigger to eat are shown to be more likely to seek healthful food choices as compared with those who choose to eat “whatever is there” and stop eating because the food is gone. Nutrition counselors and educators can help clients Food Choice use preplanned cues to develop healthful habits. Health Health can be a driving force for food choice. Consumers concerns are more likely to respond to healthful food messages if the advice stresses the good taste of wholesome foods and convenient ways to include them in the diet. Health status (e.g., loss of teeth or digestive disorders) can also affect the amount of food consumed and food choice. Nutrition Those who have higher levels of knowledge are more likely knowledge to have better quality diets and to lose more weight in weight-loss programs.  Factors That Affect Food Choice (Cont’d) Convenience A culture of convenience increases the demand for easy-to- and time prepare meals, such as fast-food; takeout; value-added (precut, prewashed); and ready-made foods. These time-saving choices Factors are often more expensive and higher in calories, fat, and sodium than home-prepared food. Quick, easy-to-prepare, and healthful food options should be stressed. Affecting Culture Food is a key part of societal and cultural rituals influencing group identity. Ritual meals solidify group membership and reaffirm our relationships to others. Culture defines what foods are acceptable for consumption and influences food patterns (e.g., in the United States, snacking is common). Food Choice Religion Social Religion may advocate for food rituals or define food taboos (e.g., restrictions against pork for Muslims, beef for Hindus, and shellfish for Orthodox Jews). Food is often an integral part of social experiences. However, influences social eating frequently encourages increased consumption of less-nutritious foods and overconsumption. Media Media and advertising messages often encourage consumption influences of high-calorie foods that are nutritionally challenged. For example, commercials can influence the quantity and quality of food consumed.  FACTORS THAT AFFECT FOOD CHOICE (CONT’D) Physical Environments where people have access to a continuous environment supply of unhealthy food and large portion sizes (e.g., in the United States) increase opportunities for purchasing unhealthy food choices. Factors Economics Residence and socioeconomic status impact access to transportation, cooking facilities, refrigeration, grocery store options, and healthful food choices. Example: Low-income Affecting households purchase significantly fewer fruits and vegetables than high-income households and are more likely to purchase food from drug and convenience stores. Food Choice Availability Individuals exposed to increased numbers of food and variety encounters, larger portion sizes, and a variety of available choices tend to increase food intake. Variety of food intake is important in meeting nutritional needs, but when the assortment is excessive (e.g., food selections from a buffet), overconsumption is probable. Psychological Food behavior in response to stress varies among influences individuals. Some people increase consumption, whereas others feel too stressed to eat. Certain foods have been associated with depression and mood alteration. (Example: people with depression eat fewer antioxidants, fruits, and vegetables and consume more chocolate). Relationship Why is it important to have a good Building relationship with your client?  What characteristics would you like to see in a counselor? Characteristics of Effective Counselors Solid foundation of knowledge Self-aware Ethical integrity Have congruence Honest and genuine Communicate clearly Have a sense of gender and cultural awareness Have a sense of humor Flexible Optimistic and hopeful Respect, value, care about, and trust others Can accurately understand what people feel from their frame of reference (empathy) Understanding Yourself Why is it important to understand who you are? Take inventory of your personal characteristics and self-examine why you want to be a counselor. What happens if you’re like a dictator (you know what’s best sort of thing?) What happens if you tend to be a people pleaser? Understanding Yourself To become a culturally competent counselor, understand what constitutes your worldview (cultural outlook). Everyone belongs to several societal groups -- gender, age, sexual orientation, occupation Shape worldview Worldview Assumptions Supernatural Supernatural assumptions include beliefs regarding God, malevolent spirits, ancestors, fate, or Assumptions luck being the cause of illness. The concept of soul loss causing depression or listlessness is prevalent in many societies. In order to alleviate supernatural problems, societies have devised ceremonies or rituals. Individual and Not all societies make a clear distinction between human life and nature as in the United States. Nature Some societies believe that we are subjugated by nature and need to show respect for natural forces and attempt to live in harmony with nature. The dominant culture in the United States sees human beings as having higher value than nature with a need to exploit or protect it. Technology The citizens of the United States put great fate in technology and the scientific method. Diseases are viewed as correctable mechanistic errors that can be fixed by manipulation. Americans tend to think science can help humanity—a view not as highly held in Europe. Materialism Many people around the world believe that materialism dominates the worldview of Americans, that is, the need to acquire the latest and best possessions. This may have contributed to the popularity of “supersize food portions.” Functions of Cultural Values Provide a set of rules by which to govern lives. Serve as a basis for attitudes, beliefs, and behaviors. Guide actions and decisions. Give direction to lives and help solve common problems. Influence how to perceive and react to others. Help determine basic attitudes regarding personal, social, and philosophical issues. Reflect a person’s identity and provide a basis for self-evaluation. Understanding Yourself Be aware that certain beliefs, values, and cultural practices will have a strong impact on health- related attitudes and behavior. What are some examples? Understanding Yourself Cultural awareness can help prevent your personal biases, values, or problems from interfering with your ability to work with clients who are culturally different from you. Conscious and unconscious prejudices related to cultural issues could interfere with emotional objectivity in a counseling situation. Don’t allow your worldview interfere with the counseling process. WHY? Who are you? Take 5 minutes... Write down the following: 3-4 personal characteristics Briefly describe the culture in which you were raised. Note your upbringing and past experiences that may influence your attitudes. Implicit Bias Test Before Monday, take any of the implicit bias tests -- https://implicit.harvard.edu/implicit/takeatest.html Understanding Your Client What do we need to understand about our clients? Differences in Culture If your client is from a different culture than your own, learn about and explore that culture through means such as books, newspapers, and magazines workshops movies cultural encounters in markets, fairs, and restaurants Characteristics of a group are simply generalities. Avoid stereotypes or assumptions Understanding Your Client What are common reactions to receiving a terrible health diagnosis? The circumstances that bring clients to counseling can have a major impact on their readiness for nutrition counseling. Promoting self-sufficiency is often a stated goal of nutrition counseling. However, for some clients, that goal may need to be modified. For some clients, the act of seeking and receiving help can create feelings of vulnerability and incompetence. Relationship between Helper and Client Phases of the 1. Build the 2. Facilitate Helping relationship positive action Relationship Case Study Lilly – 42 yo. 3 children. 20 pounds overweight. Wants: increase energy level and endurance. Tires quickly. Joe – nutrition counselor Joe: Hello, Lilly. It's great you came a little early. Let's get you on the scale. OK, at 163 pounds, it looks to me as if you nee d to shed 20 pounds. You have a ways to go but worry not – we will get it off you. Everything will be fine. Lilly: I really... Joe: I am not kidding, Lilly -- don't worry. We will start slowly. What you want to do is get your BMI down, your muscle tissue up, a nd get rid of fat. If you follow me, I'll introduce you to everyone, sign up for an aerobics class, start you on a a routine. Lilly: Well, you see I only want... Joe: Hey Rick, this is Lilly. She's new. Rick: Welcome Lilly. Don't forget to take home some of our power bars -- they're great for beginners who may not know how to eat right. Joe: Yeah and be sure to bring a sports drink in with you. You will get mighty thirsty! No pain, no gain! What’s wrong with this scenario?  Relationship Building Building a Relationship with Your Client The scenario in Exercise 1.11 illustrates a common mistake helpers make—indicating that “everything will be fine.” Because it has no basis in reality, the comment belittles the client’s feelings. If the client actually feels reassured by the comment, the benefit is temporary because no solution to the problem has been sought. Patronizing a client is self-defeating. It indicates superiority and can automatically create negative feelings. Effective counselors provide reassurance through clarifying their roles in the counseling process, identifying possible solutions, and explaining the counseling program. Novice Counselor Issues Lack of confidence Lack of knowledge Assuming the role of either expert or empathizer