Problem Solving Approach
FNU 425-FAR FALL 1435-1436
5/ 5/ 1436
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outline
Problem Solving Approach in Nutrition counseling
Why use PSA in Nutrition counseling
Model Assumptions
PSA steps and criteria
SMART goals
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Problem solving approach
1.
Build foundation
2.
Define problem multidimensionally
3.
Select alternative solutions
4.
Plan for change
5.
Reach commitment
6.
Evaluate progress
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Why use problem solving in nutrition counseling
To help Clients:
Increase awareness to solutions for the problem
Consciouslyand intentionallychoose to control behavior
Reacha higher level of nutritional decision making
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Model Assumptions
a. Each individual is unique
b. Client and counselor are consistently changing
c. Counselor uses best knowledge but not responsible for client
d. Counselor aware of abilities and deficits
e. Client safety come before need fulfillment of counselor
f. There are always alternatives, few times problems insolvable
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Model Assumptions – cont’d
g. Client is the best expertof his or her problems
h. Counselor should be flexible repertoire of activity from directive to non directive
i. Should not expect success in every situation
j. Many alternatives exist in conceptualizing the problem – no one best strategy or approach
k. Effective counseling done withthe client not to/for the client
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Bases for Assumptions
1.
Focus on client goals
2.
Focus on client lifestyles
3.
Focus on client ability to make decisions for themselves
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1-Build a foundation–steps &
criteria
1. Introduction
2. Small talk to establish rapport
3. State purpose of visit
4. Address client appropriately
5. Determine readiness to change
6. Obtain accurate dietary data
7. Obtain complete information- use motivational interviewing techniques
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2- Define problem-
multidimensionally Four dimensions
A. The Client dimension
Attitude and beliefs
Culture
Feelings
Nutritional needs
B. The psychological dimension (emotions)
Empathy needed
C. The psychosocial dimension (environment)
D. The Counselor dimension
Setting shortand longterm goals
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Define problem-criteria &
steps
1. Allow client to use own words to state problem (use mirroring)
2. Elicit real issue from client (use motivational interviewing)
3. Allow client to express feeling along with facts
4. Counselor offer his/her own idea of the problem
5. Allow client to decide short and long term goals
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3- Select alternative solutions
Allow client to set own alternative
Helping client “unpack”
Counselor offers tentative suggestions
If client is not very responsive
Brainstorming atmosphere
Freedom to make any suggestion come to mind
No obligation for commitment at this stage
Fine tune alternatives
When thinking about implementation
Client owns alternatives
May only be realized later in change planning or commitment
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4 - Plan for Change
Client chooses one or two alternatives from brainstormed list
Appropriate to set goals
Counselor affirms client’s ability to change
Encouragement and motivation
Include coping mechanism
Help with details about handling a difficult situation
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Contract (signed agreement )
Determine willingness of client to execute contract
Client to complete own contract
State short term and long term goals (SMART)
Specific steps should be stated
Workable
Feasible
Identify obstacles
Obtain feedback from client about satisfaction with contract
Ask for feeling toward contract
Client summarize contract verbally
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SMART Goals
Specific
Measurable
Achievable
Relevant
Time bound
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Sample Goals
“I will eat fruit instead of baked desserts starting tomorrow”
“I will eat at least two fruits (apple, mango, banana, watermelon, orange, peach) every
day during next two weeks until my next visit”
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6-Evaluate Progress
Session evaluation
Signals ending session
Summarize session
Overall evaluation
Not done every session
Point out measurable overall changes
Point out improvement in quality of life
Bringing about closure
Done at end of counseling relationship
Point out client’s achievements
Share positive feeling about client and relationship
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