My RD Journey

From Undergrad -> Internship -> RD -> Private Practice!


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5 Tips for Running a Nutrition Support Group

Have you ever sat through a meeting, group discussion, or any class for that matter and thought, “I really wish ___ would stop talking and give someone else a chance?” This is one of the exact situations you want to avoid in leading group discussions within a support group (or class).

After running multiple weight management support groups and nutrition classes, I found the most effective sessions were those that had a designated topic and were gently guided. Below are 5 of the key tips that will help you run an effective support group style class!

1 – Come Prepared
Having a topic for your group discussion is absolutely key! This gives the class direction and focus. I would also suggest creating an outline with estimated time frames and talking points. I also had “extra” notes on my outline in case the class was smaller and/or a bit more quiet. Think also about 1 relevant topic handout you could provide and a recipe or two.

2 – Set Ground Rules
In the beginning of the first couple of classes, I laid out the ground rules for all of the participants. I made it a point to say that everyone is in a different place in their health journey and to be respectful of others’ viewpoints and struggles. You would be surprised how many times I had to remind adults of this. I also outlined the flow of the class (see below), noted the time constraint, and asked all phones to be put on silent or turned off.  

3 – Be Aware of Group Dynamics
During the first class or two, you will start to see different personalities emerge. I usually had a small group of participants who were the most engaged (i.e. always giving feedback/input), a handful of really chatty ones (who I often needed to cut off), a few silent listeners (some of which preferred to ask questions after the session finished), and maybe one (if any) aggressive or very negative participant. While you don’t want to put anyone in a “box” necessarily, being aware of the dynamic will help you facilitate more effective discussions and know when you might need to intervene. There are a ton of resources online that can help you in managing certain group dynamics if you feel stuck.

4 – Take Charge of the Discussion
After leading quite a few group classes, I began to realize that the most positive feedback I received was in regards to how I kept “in control.” Taking control of the class means allowing meaningful discussion, yet redirecting when needed. This also means (politely) cutting someone off who is chatting too much. This also means spinning negative comments into positive and actionable ones. If you feel like the class got a bit off track, don’t be afraid to redirect the discussion. Often I would say things like, “Suzie, you make a great point about exercise being a struggle. I will make note of your comments so we can focus on them when we get to that topic.” Avoid getting too far off track during every session since many of your participants could be really looking forward to the topic originally planned and may feel upset that it didn’t receive adequate time/attention.

5 – Create Actionable Goals
At the end of every group session, I would take about 5 minutes to have all participants write down an action goal for the week. I would give everyone the opportunity to share their goals and provide encouragement and support for others. I felt like this tied the discussion topic together and gave participants something positive to work towards (other than just weight).

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Sample Class Flow (1-hour)
I have run 45 and 60-minute support groups before. I always did the weigh-ins prior to the class (optional) and avoided talking about weight during the class discussion in an effort to keep things positive for all.
-Optional weigh-ins prior to class
-Introduction to myself (2 min)
-Ground rules/reminders (3 min)
-Discussion of last week’s topic/goals – what worked, what didn’t, questions (10 min)
-Topic introduction from Dietitian – why this topic is important, what I want to discuss (2 min)
-Main topic – Dietitian has talking points, ask class about struggles (8 min)
-Class input on topic – strategies that worked well for them (10 min)
-Additional questions/Dietitian recap (5 min)
-Goal setting + sharing (10 min)

Sample Support Group Topic Ideas
Be specific when choosing a support group topic. I tried to avoid broad topics (like weight-loss) and instead focus on particular habits or health attributes.
-Healthy snacks – components, samples
-Reading labels – what to look for, samples
-Eating on-the-go – can be broken into eating-on-the run and eating out
-Mindful eating – what is it and how to incorporate
-Tips for incorporating more fruits/veggies
-Incorporating exercise into a busy schedule
-What is meal balance – i.e. what should be on your plate
-Strategies for eating well: on vacation, over the holidays, at BBQs, etc

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My First (Horrible) Experience with a CPE Seminar

As part of keeping your Dietitian title/license, you need to complete continuing education credits (75 over 5 years). It’s pretty standard for many other medical/health professionals as well (Pharmacists, RNs, OTs, PTs, etc). I have been leaning towards a mix of webinars, self-study courses, and lectures to gain credits. It works the best for me with having 2 jobs and an overall busy schedule.

Recently, I went to a seminar called, “Food Addiction, Obesity, and Diabetes,” provided by INR. I was super excited! It was going to cover overeating, binge eating disorders, managing food addiction, managing Diabetes, sleep, stress, and so much more. It would also be my first seminar and it was $81 for 6 credits, which isn’t too bad at all! Anyways, I made the 45 minute drive and attended with another Dietitian friend of mine. Let me just say, thank goodness for the free coffee and company or I would not have made it through the lecture. What a disappointment!

First of all, the lecturer (we will call her Dr. X) started late. Big pet peeve of mine! So, Dr. X does the introductions and starts off with the food addiction. She used a ton of medical terminology and definitely seemed liked she was very knowledgable. May I just say that “seemed” is the key word here. We get into food addiction, all very interesting; however, we are not following along in the 41 page (front and back) booklet I have, which apparently was due to someone different writing the slides. Anyways, Dr. X quotes a ton of research articles, which is great, except it takes an extra couple minutes for her to locate each one. This might sound great to you because she is using evidenced based research; however, for each claim she had 1 article and only read a few lines in the summary (not mentioning those involved in the study and other information you would want to know). Still not a big deal until we get to the first break and we are already very behind, aka we were supposed to had moved on to obesity and were still on the first section of the first topic!

As we get back from the first break, me with more coffee, I start to notice that when anyone asks a question, she gives a politician answer. By that I mean, she does not actually answer the question. Dr. X gave this round about answer quoting another 1-2 studies (spending the time to again find them) and leaving many people frustrated. We again continue to trudge along and make it to the lunch break. At this point, I notice that we are still not through part 1 (supposed to be on part 2 of 4) and that we spent so much time on the super science part (aka names of specific hormones and transporters) that I didn’t feel like I learned anything useful/practical yet.

So, my RD friend and I head to the in-hotel dining area, where lunch is not provided (my mistake for thinking my $81 also extended to lunch). Here we have another depressing scene: $7.95 for cold salad bar and soup or $12-something for the hot bar. Now, I am starving and want to check out the menu for the hot bar. We have vegetables (nothing fancy), bratwurst and cabbage (oh yum), chicken schnitzel, and potatoes with bacon. Glad I looked because chicken schnitzel means breaded chicken patties that you would expect to find in a school lunch program.  I went with the soup and salad bar, which actually had a lot of options, and a lovely dessert of fresh fruit and a cookie (very good). It seems lunch was looking like the highlight; however, I go in open-minded to our second half of the day.

In talking about diets, Dr. X mentions the diet fads; one of which is the Paleo diet. Her take on this is that we shouldn’t tell people to cut out food groups because it does not work long-term. I generally don’t tell people to start cutting things out in counseling either. Dr. X goes on to say that Paleo dieters cut out grains/carbohydrates, using those terms interchangeably. I have a few issues with this. One of which is that not all carbohydrates are grains (aka fruits). Also, many Paleo diet followers (many RDs I follow online) are more-so cutting back on the breads and pastas and aiming for majority of carbohydrates from fruits and veggies. Nothing wrong with that!

Right after saying not to cut foods out, Dr. X answers a question regarding red meat. Here Dr. X states to not eat the red meat because of it having saturated fat. My issue is meat quality. Grass-fed beef is way better than conventional fed meat (fed grains).  To quote Mayo Clinic: Grass-fed beef has,” less total fat, more heart healthy omega-3 fatty acids, more conjugated linoleic acid (thought to reduce heart disease and cancer risks), and more antioxidant vitamins, such as vitamin E.”

My last remaining hope died with Dr. X’s statement towards Diabetic meal plans. She quotes this (apparently from the American Diabetes Association) in terms of macronutrient distribution, “50-60% carbohydrates, 30% protein, and 10% fat.” What?! The AMDR for fat is 20-35% so 10% is way too low. What Dr. X might have meant to say was the American Diabetes Association recommends less than 10% from saturated fats. What frustrated me the most is that people in the lecture were taking notes and writing down things she said. This misinformation turns into what health professionals are then spreading!

Quick note: I am 6 cups of coffee in for the day (one of the best parts of the lecture was the unlimited coffee). We are getting to the last hour of the seminar and we have 3 parts still to go over! Dr. X decides it is a good idea to have no more questions from the group and to blow through about 25 pages (front and back) of information in an hour. Well, that didn’t turn out well. The seminar contained a lot of good information; however, I have to read through and learn it on my own. Part of attending a seminar is so you don’t have to spend extra time teaching yourself!

Besides my unlimited coffee for the day, one other benefit was that they had discounted self-study courses. I was able to buy 2 at $10 each (3 credits each) and one at $25 (5 credits). Great deals on interesting CPEs that I can use. Just as a disclaimer, I spoke to another Dietitian who attended the same seminar in another location and she had a much better experience than I did. I apparently just got the bad apple of the lecturers. Looks like I will be sticking to my self-study courses and webinars from now on 🙂

To end on a positive note, I went to my Dietitian meeting today and got a King Trumpet mushroom!

 

My Top Webinars/Self-Study Courses
http://www.todaysdietitian.com
http://www.dietitiancentral.com/ceu/continuing_ed.cfm
http://www.pbhfoundation.org
http://www.nutrition411.com