It’s one thing to tell a client what to do it’s another thing altogether whether they choose to do it or not. The quality of your client relationships can be gauged on whether your client feels comfortable enough to disagree with you.
The relationship that most people have had with their health professionals will mean they are comfortable to be told what to do; it is what they are used to in this setting and it is also the easiest option.
As Dietitian’s we don’t have the luxury of being able to simply prescribe a medicine to get the cure. When we give advice we are asking our clients to change some of the things they really love (food and eating) and do some other things they really hate! (exercise) When we prescribe a diet we provide the easy way out. Following someone else’s plan means you don’t have to think, you also don’t need to look at yourself or your role in your current situation, there is very little responsibility for the client and therefore lower risk- this will mean a satisfied client but not necessarily a healthier one.
If your client feels comfortable enough to disagree with you, you can say you have a good rapport and the potential to assist them to change to some healthier behaviours.
While studying motivation Interviewing I came across a wonderful statement that I still find challenging.
If you tell your client what to do you are denying them the opportunity to develop self-efficacy.
Self-efficacy is one of the essential qualities needed before anyone will attempt to make a change. If they don’t believe they can do it, they are unlikely to even try as no one likes to set themselves up knowingly for failure.
Past performance is a strong predictor of future behaviour – thank you Dr Phil! Past failure is most certainly what our clients will be relying on to predict their success at the next diet- particularly those with a very long diet history and who have struggled with weight all their lives. How many times have you heard from a client that they were first put on a diet by their parent under the age of 12 and have had people commenting on their weight ever since?
Working with your client and allowing them to tell their story and feel comfortable enough with you to discuss their plans and disagree with your proposed solutions is a key to creating some shift or motivation toward change.
Some useful questions to ask your clients:
•Why do you want to lose weight?
•What have you done well in the past?
•What is something you are proud of?
•What do you feel is your biggest problem area?
Each one of these questions leads to other discussions and can be incredibly useful to finding what motivates your client, what are their barriers to change, what are the unhelpful thoughts they have around their own ability to change.
If you think that asking your clients more about themselves will be time consuming and you will not have enough time for the other things you need to achieve, I would encourage you to think about how much change you are inspiring in your clients currently. Taking the time to get to know what makes your client tick is the best thing you can do to help them implement a healthy lifestyle in the long term.
Lisa Renn is an Accredited Practising dietitian and behaviour change expert whose passion is helping her clients create healthy habits in the long term. Lisa has begun training health professionals to implement simple techniques to equip clinicians to inspire their clients to change unhealthy behaviours, get motivated and experience success in their weight loss and health goals. Lisa is the author of “Body Warfare- The Secret to Permanent Weight Loss” (Brolga publishing 2011)which is a “how-to” book assisting people to create long term change and outlines a number of activities that are used in her health professional training program. www.bodywarfare.com.au