Details

Counselling Skills for Dietitians

3. Aufl.

von: Judy Gable, Tamara Herrmann
52,99 €
Verlag:	Wiley-Blackwell
Format:	EPUB
Veröffentl.:	22.12.2015
ISBN/EAN:	9781118943786
Sprache:	englisch
Anzahl Seiten:	288

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Titelbeschreibung

The third edition Counselling Skills for Dieticians has been fully revised and updated to reflect the recent developments, research and interests in the field. It explores the skills required for dietetic counselling, and includes frequent examples of dialogue from patient consultations, as well as exercises and activities so that the reader can undergo experiential learning relevant to their practice. <ul> <li>Includes examples from daily practice to illustrate the difficulties encountered by dietitians and demonstrate the application of counselling skills</li> <li>Clearly explains theoretical models of accepted counselling practice underpinning the skills described</li> <li>Has been updated to include additional information on topics such as assertiveness skills and eating distress</li> <li>Addresses practical and psychological issues faced by dietitians and patients</li> <li>Includes the latest research evidence for counselling skills in dietetic practice</li> <li>Draws upon research evidence, theory and experience from the fields of psychotherapy and counselling</li> <li>Now provides access to a range of supportive online material including videos of consultations, case studies and resources for trainers</li> </ul>

Inhaltsverzeichnis

Foreword xiv About the authors xvi Preface to the third edition xvii Acknowledgements xx Introduction xxi About the companion website xxv Part 1: Using a counselling approach in patient‐centred practice 1 1 The dietitian 3 The role of the dietitian 3 Using a prescriptive approach 4 Control, compliance and responsibility 5 Changing approaches to providing health care 5 Developing a patient‐centred approach 7 Introducing counselling skills 8 Developing a counselling approach 10 Portrait of a dietitian using a counselling approach 10 Qualities for a dietitian to develop 11 Providing care 12 Personal and professional development 12 Self‐awareness 13 Frame of reference 13 Self‐worth 13 Reflective practice 14 Benefits of reflective practice 14 Use of the word ‘reflection’ 15 Different approaches to counselling and psychotherapy 15 Psychoanalytic approach 15 Behavioural and cognitive approaches 16 Humanistic approach 16 Transactional Analysis 17 Systemic therapy 17 Neuro‐linguistic programming 17 Mindfulness 18 Overview of the evidence concerning the use of communication skills in dietetic practice 18 References 19 2 The patient 22 Using a patient‐centred approach 22 The concerns of the patient 23 The feelings of the patient 24 The expectations of the patient 25 The nature of change 26 Change has a ripple effect 26 Change occurs in a number of ways 26 People react and adapt to change in various ways 27 Change is paradoxical, in that we both want it and do not want it 27 Change can have implications of which we are not aware 27 Reactions to change 27 Shock 28 Release of emotion 28 Talking about it 28 Ambivalence 29 Bargaining 29 Doubt about being able to cope 29 Blame 30 Distancing 30 Adapting to change 30 Patient satisfaction 31 References 32 3 The relationship between dietitian and patient 33 Circumstances surrounding the dietitian’s relationship with the patient 33 Core conditions for a helping relationship 34 Empathy 34 Acceptance 37 Genuineness 39 Issues arising between patient and dietitian: power, dependency, transference and counter‐transference 40 Power 40 Dependency 41 Transference and counter‐transference 41 The working alliance 42 A therapeutic bond 42 Goals 43 Tasks 43 Further points to consider 44 References 44 4 Aspects of the helping process 45 The dietitian’s concerns 46 Keeping boundaries: how the dietitian can manage time, confidentiality and referral 46 Establishing a time boundary 47 Maintaining confidentiality 47 Recognising professional and personal limitations: when, how and where to make a referral 50 Recognising the different developmental stages of the helping process 51 Stage 1: Listening to the patient’s story 51 Stage 2: Clarifying what the patient wants 52 Stage 3: Planning ways to achieve goals 54 Looking at the psychological process of change 55 Putting it into practice 55 Coping with ambivalence 57 Incorporating systemic awareness 58 Examples of questions to ask about diet and the home situation 59 How to end 59 Support for the dietitian 61 References 61 5 Conducting a structured interview 62 A framework for the interview 62 Beginnings 63 The interview setting 63 Preparing to provide a helping relationship 64 Opening the interview 65 Forming first impressions 65 Making introductions 68 Finding a starting point 68 Middles 69 Setting the agenda 69 Assessing motivation 71 Making a contract 72 Taking a diet history 73 Giving dietary advice 75 Monitoring the relationship 79 Endings 81 Acknowledging the ending 81 Summarising what has taken place 81 What next? 82 Saying goodbye 82 After the interview 83 References 84 Part 2: The skills 85 6 Active listening 87 The process of listening 87 Attending: a way of demonstrating acceptance 88 Attending is giving someone our attention as fully as we can 88 A listener who conveys acceptance is someone who is safe to talk to 89 Barriers to attending 90 Eye contact 90 Environment 90 Events and emotions 90 Echoes within 91 Attending to non‐verbal communication 91 Voice 91 Eye contact 92 Facial expression 92 Appearance 93 Posture 93 Gesture 93 Discrepancies and incongruities 93 Developing powers of observation 94 Distinguishing between observation and interpretation 94 Managing silences 95 Mirroring 96 Touching 97 References 98 7 Ways of responding 99 The effects of responding 99 Types of response 100 Low‐risk responses 101 Moderate‐risk responses 101 High‐risk responses 101 Very high‐risk responses 103 Self‐disclosure 103 The purpose behind a response 104 The power of language 105 Use of ‘we’, ‘you’ and ‘I’ 105 Language of success or failure 106 Language of doubt 106 Language of negativity 106 Reflective responding 107 The technique of reflecting 108 The skill of reflecting 109 Focusing on feelings 111 Mirroring language 112 When to use reflective responding 113 When reflective responding is not helpful 113 References 114 8 Making helpful interventions 115 Moving towards a helping conversation 115 Helpful interventions 116 Examining attitudes 117 Providing the core conditions when making a helpful intervention 118 Timing and level of intervention 119 Ways to intervene 121 Asking questions 121 Open questions 122 Closed questions 123 Highlighting paradoxes, discrepancies and inconsistencies 123 Confronting absolutes 123 Choosing a focus 124 Addressing sensitive issues 125 When the dietitian does not believe the patient 125 Helping someone towards clearer thinking using CBT 126 Recognising thoughts and distinguishing them from feelings 126 ‘What’s going through your mind when you think that?’ 126 References 130 9 Conveying a clear message: assertiveness in action 131 Counselling skills and assertiveness 131 What is assertive communication? 132 Developing assertiveness 132 Self‐awareness and assertiveness 132 Self‐esteem and assertiveness 133 Communicating feelings 133 Aggression 133 Passivity 134 Manipulation 134 Advantages and disadvantages of assertiveness 134 Advantages 134 Disadvantages 135 Delivering a clear message 135 Preparation and reflection 135 Rehearsal 135 Delivery 135 Examples of assertiveness skills in practice 136 With a patient 136 With a GP practice manager 137 Confronting difficult situations 138 Confrontation from a colleague 139 Confrontation from a patient 139 Confronting a patient 140 Confronting a colleague 141 Handling criticism and praise 142 Criticism 142 Praise 144 Support with handling criticism and praise 145 Dealing with aggressive behaviour 145 Assessing risks 146 Taking care of yourself 146 Defusing the situation 147 Be A DEFUSER 147 Coping with the after‐effects 148 An ABC for conveying a clear message 148 References 150 Part 3: Putting skills into practice: further considerations 151 10 Working with more than one person 153 When others are in the room 153 Reasons for others to be present 153 Context of the interview 154 Risks and benefits of involving another person 154 Issues to consider when others are present 155 Dynamics between those present 155 Agendas of those present 156 Relationships between those present 156 Language and culture of those present 157 Maintaining equity and creating structure and boundaries 158 Maintaining equity 158 Creating structure and boundaries 159 Family meetings 159 Example 160 Who is responsible for finding a solution? 161 Who is leading the consultation? 161 Group work 162 Group size 162 Group demographics 162 Group dynamics 162 Group process 163 Using counselling skills with a group 164 References 165 11 Coping with loss and bereavement 166 How loss concerns dietitians 166 The need to grieve 168 Our reactions to grief 168 The process of grieving 168 How the dietitian can help 169 Loss of weight: a loss or a gain? 171 Loss of self‐esteem 171 Loss of health: living under threat of death 172 Loss of appetite 173 Support for the patient and the dietitian 174 References 175 12 Developing cultural awareness 176 What is culture? 176 Cultural changes within dietetics and the NHS 177 Move away from tradition and hierarchy 177 Prevention of disease and the rise of nutrition 178 Growth of the profession and an increase in diversity 178 Introducing a patient‐centred approach 179 Evidence‐based practice and CPD 179 Stress from change and limited resources 180 Developing cultural awareness 180 Prejudice and its development 181 Attitudes and expectations 182 Effect of prejudice on the helping relationship 182 Towards more effective communication 183 Example 183 Making introductions and establishing credentials 183 Language 184 Boundaries and goal setting 185 Social rituals and customs 186 Making effective use of an interpreter 186 Who is the interpreter? 186 Preparing for the interview 187 Working with an asylum seeker 188 Coping with difficulties 188 Ways of building bridges 188 References 189 13 Working with parents and children 190 Challenges for the dietitian 190 The needs of the child 191 Meeting the family 192 Background 192 Interview 192 Reflections 193 Considerations 193 Making a plan 194 Next meeting 194 Summary of how Sue worked with Peter 195 When a child withdraws 195 Guidelines for handling this situation 196 The angry child 196 Guidelines for handling this situation 196 The well‐behaved child 197 Guidelines for handling this situation 197 Overprotective parents 197 Guidelines for handling this situation 198 Aggressive parents 198 Guidelines for handling this situation 198 The absent parent 198 Guidelines for handling this situation 199 The dying child 199 Guidelines for handling this situation 199 Reference 200 14 Working with difficulties in physical and mental health 201 Minority needs as part of society 201 Effect on patient and dietitian 202 The patient 202 The dietitian 203 Resources for the dietitian to develop 203 Internal resources 203 External resources 204 Physical difficulties 204 Hearing 205 Sight 205 Speech 206 Mobility and movement 207 Appearance 207 Invisible disabilities 208 Mental health 208 Recognising anxiety and depression 208 How the dietitian can help 209 Helping those with eating distress: disordered eating and eating disorders 211 Hearing suicidal thoughts: how can I bear it? 217 Maintaining confidentiality when making a referral 218 References 219 Part 4: Areas for personal and professional development 221 15 Developing self‐awareness 223 Why self‐awareness is important 223 Ways to develop self‐awareness 224 Time for ourselves 224 Becoming more mindful 224 Self‐esteem 225 Ways to build self‐esteem 226 Acknowledgement 226 Tips for building self‐esteem 227 Coping with stress 227 Ways to unwind 229 Keeping a reflective diary 231 References 231 16 Giving and receiving support 233 When support is needed 233 Knowing your limits 234 Supporting yourself 235 Reflecting on practice 235 Creating a dialogue 235 Building a support network 236 Asking for support 237 Tips for asking for support 237 Giving support 238 Tips for giving support 239 Giving constructive support 239 Support from training, assessment and monitoring 240 Training in communication skills 241 Training in counselling skills 242 Supportive peer discussion 243 Making arrangements 243 Managing the session 243 Supervision 244 Personal counselling 244 What does counselling involve? 245 Who seeks counselling? 246 References 247 Index 248

Autorenportrait

Judy Gable worked as a dietitian for many years, specialising in paediatrics in the 1970s and diabetes research in the 1980s. In the early 1990s she established the course in communication skills for dietetic students at King’s College and during the next ten years also facilitated introductory courses in counselling skills and assertiveness for dietitians. She continued to work as a counsellor in primary care until 2010. Tamara Herrmann has worked for many years as a GP/Community dietitian and during this time developed her interest in obesity, eating disorders and communication skills. Tamara now works in private practice as a registered dietitian and registered psychotherapist.

Back cover copy

“Counselling Skills for Dietitians should be studied by student dietitians and registered dietitians alike and has a well-deserved place in all departments of nutrition and dietetics and university libraries. It will also be of great value to registered nutritionists and other clinicians and researchers involved in nutrition counselling” From the foreword by Kevin Whelan, Professor of Dietetics, King's College London. Dietitians need to use advanced communication skills as well as technical expertise in order to assess clients′ needs, identify their problems and help them to manage their diet and lifestyle. This book is designed to help dietitians to develop the approach and communication skills most effective in helping others. In view of the ever increasing emphasis on lifestyle change and preventive measures in health care, it is intended that Counselling Skills for Dietitians will also benefit a wider range of health professionals. The third edition of this thought-provoking and useful text has been fully revised and updated to reflect the recent developments, research and interests in the field. It explores the skills required for dietetic counselling, and includes frequent examples of dialogue from patient consultations, as well as exercises and activities so that the reader can undergo experiential learning relevant to their practice. Counselling Skills for Dietitians, third edition: <ul> <li>Includes examples from daily practice to illustrate the difficulties encountered by dietitians and demonstrate the application of counselling skills;</li> <li>Clearly explains theoretical models of accepted counselling practice underpinning the skills described;</li> <li>Has been updated to include additional information on ways to address issues of concern when working with more than one person at a time and topics such as assertiveness skills and eating distress;</li> <li>Makes reference to evidence based practice and cultural changes;</li> <li>Addresses practical and psychological issues faced by dietitians and patients</li> <li>Now provides access to a range of supportive online material including videos of consultations, case studies and resources for trainers</li> </ul>