WIC Step by Step

Step-by-Step: 
Client-Centered Skills for
WIC Counselors 

This program is designed to complement WIC staff training. The focus here is on the basic skills that are the foundation of quality nutrition counseling. It is recommended that you work these units slowly over a number of weeks. This allows you to practice one skill at a time. It can take a lot of practice to incorporate these skills so it’s a good idea to cycle back through the units again every six months or so.

The Group Discussion Points will give you ideas if you are working through these units as a group with fellow WIC counselors.

Introduction: 

Engaging the client  

  • Print notes pages
  • Listen to 13-minute podcast (or view this Video)
  • Read Tip #102, The Very Beginning

The Basics: OARS

Open-ended questioning

  • Print notes pages
  • Print, Open-Ended Questions to Further the Process of Change.
  • Listen to 8-minute podcast (or view this Video)
  • Read Tip #60, Open and closed questions
  • Read Tip #108, Forming Effective Open Questions
  • Optional Spanish version of Open-Ended Questions to Further the Process of Change

Affirming

Reflecting

Summarizing

Group Discussion Points:

  • What is it like to attend to the process instead of the content of the session?
  • What responses do you notice in the client when you use these skills?
  • Which of these four skills come naturally to you and which ones do you need to practice more?
  • More OARS Practice Ideas to use in a group

Resistance:

Behavior change and resistance to change

  • Print notes pages
  • Listen to 18-minute podcast (or view this Video)
  • Read Tip #9, Dealing with Resistance and
  • Read, Tip #103, Rolling with Resistance

Group Discussion Points:

  • What signs of resistance have you already noticed in clients?
  • Were you able to notice your own “righting reflex”?
  • As a group, bring up examples of resistance you have seen or heard and brainstorm what you could say.

Attending to the client:

What is important to the client?

Group Discussion Points:

  • Notice how difficult it is to keep your focus on the client’s perspective.
  • What surprises have you noticed about what the WIC parents believe? What some care about? What they already know? and what they want from you?
  • If you had a chance to reflect back to the client what was important to him/her, what effect did it have?

Working with a client’s confidence to make a change

  • Print notes pages
  • Listen to 11-minute podcast (or view this Video)
  • Read Tip #42, Boosting your client’s confidence

Group Discussion Points:

  • Share what happens when you ask the scaling question.
  • Brainstorm together more ways to guide the person to a SMARTer goal.

Listening for change talk

Group Discussion Points:

  • Listen to the sample monologue in the podcast together. Stop it after each example of change talk and brainstorm various responses.
  • Discuss the different patterns of change talk you notice from one client as compared to another.
  • More Change Talk Practice Ideas ideas to use in a group

When it’s time to provide advice:

Providing advice effectively

Discussion Points:

  • Discuss the different client responses you notice to imperative vs. neutral wording.
  • Brainstorm ways to word advice neutrally.
  • More Advice Practice Ideas to use in a group

Pulling it all together:

How this fits into a WIC contact

Discussion Points:

  • How do these MI skills fit into what you already do?
  • How do you see tweaking what you do now to be even more client-centered in your contacts?
  • How might you continue to practice these skills?
  • What supports you to practice and grow?
  • What are you going to do this week?

Optional Suggested Reading:

  • Rollnick, S., Miller, W.R., Butler, C.C., Motivational Interviewing in Health Care: Helping Patients Change Behavior. 2008
  • Clifford, D., Motivational Interviewing in Nutrition and Fitness. 2016
  • Kellogg, M., Counseling Tips for Nutrition Therapists: Practice Workbook series
  • Kellogg, M., Counseling Tips for Nutrition Therapists Archives
  • Kellogg, M., FREE Counseling Tips E-Newsletter