Excerpted from Counseling Tips for Nutrition Therapists: Practice Workbook, Volume 3
by Molly Kellogg,RD, LCSW, Kg Press, 2014
This month, I am spotlighting my colleague and friend, Molly Kellogg, who has written a wide variety of practice tips for nutrition professionals.
We humans come in wondrous variety, and we approach the world with an infinite range of cognitive styles. These styles are usually enduring and mostly unconscious. They affect the client’s view of the world, self and others, and they significantly influence the client’s process of change. Working with a person’s style rather than trying to change it will increase your success rate. This means understanding who the person is and how her brain works. With some clients, it will involve setting aside your favorite ways of working.
You can pick up a client’s approach quickly through careful listening to language. Subtle matching of your language to the client’s will build rapport and allow the client to hear you better. When you get used to observing and matching language, you can go to the next step and look for the deeper worldviews.
If you are puzzled and wonder what style or styles fit a client, ask questions. For example, “I just used the word ‘ experiment.’ Is that OK or do you prefer I use another word in talking about these ideas you are going to try out?” Or “I wonder what approaches to making changes in your life have worked for you in the past. For example, what motivated you to quit smoking all those years ago, and how did you do it?” The answers may seem odd to you. See if you can roll with the client’s style even if it is very different from yours. Acknowledge the style out loud! Put into words the differences between you and the client. For example, “Boy, I keep going back to all these details about the biochemistry of diabetes and losing you, don’t I? I’m sorry I’m slow catching on to your style. You tend to look at these changes in terms of how they will affect your family. Please remind me when I get off track again.” Some clients fit your style naturally. They seem easy to work with and you likely enjoy them. For example, you may approach problems with a scientific mind-set and love to research topics on the web. You will likely work smoothly with other such “scientists,” directing them to resources to aid their natural process.
The challenge is working with a client who is very different from you. Consider stretching yourself to fit more and more styles. The easiest way to do this is to employ the client’s own language. When you hear the client use key words that you understand but never happen to use, try using them with this client. With a client I find challenging, I write down her key words and worldview in the chart to remind myself of her style before the next visit. Expecting a client to change a whole outlook on life is unrealistic. You are not trained to do this, and do not have an implicit contract to do this work with your client. It is more realistic to be as flexible as you can, adapting your style to work within the client’s approach to life. You are asking your client to make dramatic changes to lose weight or get blood sugar under control. When you allow the client to use her accustomed style and skills to accomplish these goals, progress is more likely. A caution: Sometimes by going along with a client’s style, you collude with the very thing that is holding the client back. You may need to go along with and even Molly Kellogg, RD, LCSW support a client’s current process while holding the truth that this style is not normal or healthy. You may decide to offer to work on changing it when the client is ready. For example, some clients with anorexia have a rigid, ritualistic approach to life. Indeed, this is a significant contributor to their illness. It may be necessary in the first stages of recovery to use the client’s style, dysfunctional as it may appear to be. Designing a rigid food plan may save this client from dangerous weight loss and hospitalization. Someday, she may be ready to take the small steps toward a more normal process of feeding herself. This treatment process involves a delicate balancing act. Discuss it with the client’s therapist to ensure you are on the same page about treatment goals.
Molly Kellogg, RD, LCSW, is the author of the Counseling Tips for Nutrition Therapists: Practice Workbook series and a member of the Motivational Interviewing Network of Trainers. She trains health professionals around the country in her “Counseling Intensive” workshops. Subscribe to her free Tips newsletter at www.mollykellogg.com,
