Identifying Problems/Barriers to Change
Before any change can happen it is essential to first identify the actual problem or the reasons why certain behaviours are occurring. Using this technique, the dietitian explores, or prompts the client to explore, factors that might be influencing the behaviour. This analysis will help generating/selecting the best strategy for behaviour change.
A client’s conversation with a dietitian about his/her diet and lifestyle can be an invitation to share concerns and anxieties. It may even be the first time he/she has ever reflected and really thought about the nature of the problem. Oftentimes, the issue lies deeper and is related to family, work, or an underlying illness. Client-centred, non-judgemental listening and asking questions that will help guide a client through an honest exploration of the problem/s are crucial for understanding exactly what is happening and administering the right treatment.
A 24-hour diet recall or asking the client what they typically eat and do during the day gives a sense of their patterns and routines, and ultimately help to identify some of the problems and barriers to change.
See how the dietitian identifies that Alice’s perceived lack of time is a barrier to prepare healthy, home-cooked meals for her family, by asking Alice what her son typically eats during the day.
The dietitian enquires about the goals set during the last consultation and identifies that Queenie is not well aware of the risks and the importance of change, which is a barrier for Queenie to actually make these changes.
See how the dietitian prompts Brian to think about the reasons why he has lost weight recently. She identifies that some of the dietary changes that Brian made lately, although they were motivated by him wanting to be healthier, are not so healthy for him after all.