In my field of work, I do nutrition counseling with a lot of people (about 10 per week on top of my other duties). More and more, I notice people have this skewed idea of what counseling is like. Some examples: “So, you’ll tell me what to eat right?” or “You make diet plans, right?’ or when non-clients state, “Your job must be so easy” or when co-workers say “Don’t people know this stuff already?” The truth is, I won’t tell you what to eat (exactly), I don’t typically make a “diet plan,” my job isn’t always the easiest, and people certainly do not know this stuff (to put it simply).
So, if nutrition counseling isn’t any of those things, then what is it? Counseling is not only an assessment of the person’s diet and health history, but also their emotions towards food. Counseling is establishing a rapport with the client so they will trust your suggestions. Counseling is working with clients to figure out how they can be motivated to make changes (and see them through). Counseling is not only being the credible knowledge source, but translating that knowledge into practical strategies that will work for various clients. Counseling is….. well you get the idea 🙂
Besides being all of those things I mentioned, doing one-on-one nutrition counseling can be a little intimidating when you first start out (whether it is inpatient or outpatient). When I first started doing outpatient counseling, I would stumble over what I was explaining. I was nervous about clients asking crazy questions and me not knowing the answer. I brought every handout I owned JUST in case. I was constantly saying to myself, “I wish I had said this instead of _____.” I had a lot of bumps in my early stages of counseling; however, I began to find my own rhythm (trust me, you will too!) and things ran much more smoothly. It seemed like the information just came out so easily when I needed it to! Just a side note here, if you ever do any courses or credits for counseling, it seems like so much to learn (being empathetic, saying key words, phrasing properly, etc); however, once you get practice, these strategies become so natural!
One of my greatest pieces of advice is that it is perfectly okay to say, “I don’t know much about the research for ______, but I can find out and get back to you.” People look to you for credible information and yes they can Google it themselves, but lets face it, they don’t/probably won’t. Plus, most of the people I see in counseling say they get overwhelmed and just don’t know where to look. Again, where the Dietitian comes in 🙂 Just an example, I had a client come to me looking for the Vitamin K content of edamame. This person had to watch their intake because of the medication they were on. I certainly do not know how many micrograms of Vitamin K are in edamame (41mcg for frown unprepared in case you were dying to know). So, I said to this client that I wasn’t sure off the top of my head, but I could get back to them about it. They were very happy with that and came back later for a print-out. Again, MOST people just want the information handed to them and know that you are the credible source to give it. Just a side note, the USDA has an awesome database for this!
Another thing I learned in nutrition counseling is that you can PLAN for what you want to cover; HOWEVER, always be prepared for a curve ball. Like a client who brings you a list of 15 supplements they are taking or a client who doesn’t have time for snacks because they exercise for 2 hours between meals (aka 10000 crunches, push-ups, etc) or a client who has an underlying pre-occupation with food or a client who said they would be bringing their family and that meant 6 other people. And if you are wondering, these people exist because I have counseled them! Don’t let situations like these rattle you! Go with the flow and just make do with what you have. Again, situations like these will get way easier with more practice.
The way I handled the first person in counseling consisted of me mostly asking about the supplements and the reasons for use. I didn’t tell the client to stop taking them, we just discussed ways of spacing them out or how combining a few into one pill would be better. You are not going to change people’s mind by telling them they should or should not do something. It is best to give them all the information and allow them to have tools to make a more science-based decision. With the second client, we talked about bulking up the meals for more calories instead of having snacks. The third client, started off talking about sports nutrition and turned into obsession over calories. This client was a lot more rational than the typical eating disorder patient; however, they did have a history. That being said, I didn’t refer out since the client was focused on being healthy and eating enough for both exercise and the potential carrying of a baby. The last client(s) was a bit chaotic, since I have a small counseling space; however, it worked well to have most of the family sit while I stood in front of the “U-shaped circle” to talk about nutrition.
With all that being said, hopefully you have a better idea of what nutrition counseling is like as a client or Dietitian. Feel free to leave a comment or send a message of your experience with nutrition counseling 🙂