A successful nutrition counseling session flows naturally through stages. In motivational interviewing, these are called the four processes. They are somewhat linear. A skillful counselor will circle back and move forward as needed. This deliberate shifting from one process…

  Reflections are the most effective of all the strategies in conversations about change. Here, we explore how to make reflections more powerful by making them more complex. What does this do?

At a recent training, I was asked for examples of characteristics to affirm. The trainee was having trouble noticing strengths in her clients and wanted some ideas to get her started. I’ve included a list below.

  I am often asked, “What should I do when a client sets a goal and I know it’s unrealistic?” The client is the only one who knows for sure whether it’s realistic. Your experience with other clients may tell…

  If you have been a nutrition counselor for a while, this situation will be familiar to you. The client has an insight or comes up with an idea about how to handle something that is obvious or old hat…

  How often have you heard, “He’s a control freak” or “I don’t have a choice”? These are common statements that show how important control and choice are in our lives. We humans do like control. When we have a…

One of the core Motivational Interviewing values is supporting the client’s autonomy. In addition, our job is to direct the session toward changes that will serve the client’s best interest. How do we find the ideal balance between accurately following…

It’s not easy for most of us to sit with silence. Like “dead air” on the radio, it just doesn’t seem right. It may seem as if nothing is happening and time is wasted. When someone is considering or planning…

  In a recent email, a dietitian asked me what to do when a return client says he is doing everything he is supposed to do and yet a careful assessment shows he is hardly following any of the recommendations.…

I am often asked about interrupting clients, whether to do it and how. This is a complex issue that does not lend itself to easy answers. Personal style (yours and the client’s,) cultural differences, the setting, and even your mood…