Nutrition Counseling: How to Help

Written by Cassie Vanderwall, MS RD LDN CPT
How do we, as registered dietitians, inspire and support nutrition behavior change and truly help individuals?

Nutritional counseling is “a supportive process to set priorities, establish goals and create individualized action plans that acknowledge and foster responsibility for self-care” (Curry, 1998). This process may include assisting the client in recognizing their nutrition-related priorities, establishing patient-stated goals and creating individualized actions plans.

Strong evidence supports the combination of behavioral theory and cognitive behavior theory in modifying dietary patterns, weight and health risk factors.This evidence is strongest when applied in intermediate (6-12 months) and long-term (12 month+) durations. Both behavioral and cognitive behavioral theories function under the assumption that all behaviors are learned and influenced by an individual’s internal and external environments. The internal environment may be their physical and mental well-being; where as their external environment may be stress, relationships and availability of unhealthful foods at home. (Spahn, et al, 2010) There are many theories that can help assist a registered dietitian practicing nutritional counseling, including the transtheoretical model (Prochaska, 1994) and several strategies, such as motivational interviewing.

Knowledge of these theories and strategies is important, but even more so is the recognition of our role as helper. The following are five reminders to help promote behavior change and not hurt. A helper:

  • Focuses on the positive, not the negative,
  • Encourages hope, not fear,
  • Respects the potential in the person and the situation,
  • Attempts to understand the prospective of the individual, and
  • Releases a client to pursue their choice, rather than “our” choice.

Often times, when we as nutritional counselors seek dominance rather than encouragement, exhaustion results. It is best to use our energy on raising awareness of the benefits of the proposed change rather than the negative consequences, or the “right” way to pursue health and creating an environment that promotes change. It is also crucial to care for ourselves, in order to maintain these skills, abilities in focus so, we can truly help others. What are you going to do to care for yourself today?



Curry KR, Jaffe A. Nutrition counseling and communication skills. Philadelphia, PA: WB Saunders Co; 1998.

Spahn JM, Keim KS, et al. State of the evidence regarding behavior change theories and strategies in nutrition counseling to facilitate health and food behavior change. JADA, 2010;110(6):879.

Prochaska JO, Norcross JC, DiClemente V. Changing for good: A revolutionary six-stage program for overcoming bad habits and moving your life positively forward. New York, NY: Avon Books Inc; 1994.

“Helping.” #5003-6. Families Anonymous, Inc. Rev. 9/96  © Copyright 1996

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Stephanie Hofhenke

Stephanie Hofhenke

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