Webinar—Change Talk: Using a Patient’s Own Words to Support Behavior Change
Written by: Amanda Proscia, Registered Dietitian Nutritionist
In order for an individual to positively alter their lifestyle, it is vital that they increase their commitment to change. As Registered Dietitians (RDs), we must encourage positive behavior change among our clients in order for them to transform their unhealthy lifestyle habits. Unfortunately, difficult challenges may arise when patients express resistance to change or demonstrate non-compliance. Molly Kellogg, RD, LCSW aims to teach RDs how to overcome those challenges by discussing motivational interviewing (MI) techniques in her webinar, “Change Talk: Using a Patient’s Own Words to Support Behavior Change.” Motivational interviewing is defined as “a collaborative, goal-oriented method of communication with particular attention to the language of change. It is designed to strengthen an individual’s motivation for a movement toward a specific goal by eliciting and exploring the person’s own arguments for change.” Counselors and their clients must work together to foster constructive lifestyle changes through positive reinforcement, listening skills, and the “MI spirit.”
The spirit of MI consists of collaboration, evocation, autonomy, and compassion. Both
the RD and the client must listen to each other. Commitment to change is enhanced when clients think of their own plans; however, an RD can still offer advice. By asking open ended questions, it helps to elicit responses from clients. It is important for the RD to understand that the patient will ultimately do what he or she deems fit for their lifestyle. The ability to express empathy for ones struggles is also another key component that will help decrease client hostility. RDs have the abilities to impact a clients’ resistance, it just takes a little time and patience…on both ends.
Kellogg identifies seven different types of statements that helps RDs recognize “change
talk.” Each type of expression statement is categorized under words, which are as follows: desire, ability, reasons, need, commitment, activation, and talking steps. Examples of clients’ “change talk,” which may include, “I want to…,” “I could…,” “I would probably feel better if…,” “I have to…,” “I will…,” “I’m willing to…,” “I am now doing…,” respectfully. A critical role of the RD is to uncover the different forms of “change talk” that take place during counseling sessions. Sometimes a “change talk” phrase can be straightforward and other times it may be embedded in a statement.
Each counseling session is different therefore it is essential for the RD to determine how to tackle clients’ issues using a specific “language.” Responses to “change talk” are critical. Kellogg reminds us that the best ways to reply to clients’ “change talk” are to elaborate with open questions, affirm efforts and strengths, reflect “change talk,” and summarize all the “change talk” heard. It is important to reinforce, reiterate and reflect “change talk” to clients in order for behavior change and forward thinking to begin.
Reflections of a clients’ affirmation should be made a bit stronger in order to be effective. A positive affirmation in response to a clients “change talk” may go above and beyond what they stated in order for lifestyle adjustments to occur. Successful outcomes of motivational interviewing are reached when both the client and RD work together to facilitate change. Most of the time, neutral advice from the RD does not spark client resistance. Kellogg’s suggestions include: to elicit (what client already knows and wants to know), offer (information in a neutral manner), and elicit (client’s response to, interpretation of the information). Hopefully, with more neutral conversation, client resistance to change is decreased and commitment to change is increased.
The objective of using a patient’s own words to support behavior change is to enhance client adherence to the program, improve outcomes, and foster constructive lifestyle modifications. Motivational interviewing allows an RD to coach their client to help them reach their full potential. Patience, listening, understanding, communication, and guidance are all key ingredients that make up a successful counseling session. By incorporating both nutrition education and motivational interviewing into counseling sessions, clients are more likely to alter their lifestyles for the better.
About the Author
Lisa Samuels is a Long Island native who is currently a Dietetic Intern at LIU Post. She has a B.A. in Art History from Ithaca College, a B.S. in Nutrition from LIU Post & was also a practicing baker for two years. Lisa has finally found her calling. Combining her love for food, writing, and nutrition, she strives to bring you the latest news in the field.
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