Question 3
How prepared do you think dietitians are for weight loss or obesity counseling? What aspects of didactic programs in dietetics(DPD programs) and dietetic internships are the most helpful in preparing us to be successful weight loss counselors, and what could be improved?
posted by Kalee @ 7:02 PM
34 comments
34 Comments:
I think dietitians are ready to offer advice to patients on how to lose weight but I am not sure how many dietitians have had practice with CBT and Behavioral Therapy to incorporate into a counseling session. DPD programs could be improved to include a nutrition counseling class if they don't already because it is a very useful class for helping clients to make changes. I think it is also important in DPD programs to also address the issue that many dietitians are faced with, the fact that many patients feel that we cannot relate to them because we are not obese, or have never experienced the discrimination that obese people deal with. Empathy is very crucial and it would be nice to learn appropriate techniques on how to include this.
A dietitian by definition has the factual knowledge of how our body utilizes the food we eat and therefore knows what needs to be done in order to reach and maintain a healthy weight. The hard part is finding ways to pass this information on to others, who may or may not want to hear what dietitians have to say. Counseling courses would be a useful tool in any DPD program and dietetic internships should provide interns with opportunities to observe counseling sessions and participate in such sessions when appropriate. The more exposure to counseling situations one has, the better they will become at knowing what works, and what is appropriate when counseling others on weight loss.
Most dietitians that have been working out in the field for many years have a much better handle on how to talk about weight loss and obesity. For a student to try this same task I feel personally I would have a very hard time with this. I now I am lacking the information at this point to be able to help a person with weight loss or obesity problems.
I have taken two counseling classes throughout college, one undergraduate and one graduate level and my opinion thus far is that I feel you can prepare yourself with knowledge but the real understanding comes from practice actually doing the counseling. Any classroom or academic setting does not compare to the actual experience you gain from “real world” counseling sessions. I believe this is why the Internship rotations are so important for the future dietitian because it is a chance to actually get involved with patients on a personal level. These rotations are probably the best preparation that one can get as far as being prepared, but I think years of experience are truly the most valuable insight for a dietitian to learn from. I have had many instructors use personal experiences when they were practicing in their field to try and give students insight and show how they too learned from mistakes and changed over time to be better at their job.
As a student still in training, I do feel I would have a lot of knowledge and advice to offer a patient, but wouldn’t feel 100% comfortable doing it at this point. I do expect that in my dietetic internship I will learn, grow, and build on that knowledge and comfort level with clients. I do think dietitians are prepared for weight loss counseling, but it takes time and experience to learn and develop the skills, as with any profession. I think the best preparation is getting out their in the real world and handling the situations thrown at you to the best of your ability and that through classes and internships you are as prepared as you’re going to be. I do think that possibly there should be counseling classes available, or maybe a different type of psychology class could also help, but without the hands on experience, the knowledge will do nothing.
Jessie Janik,
I like your idea of a class that covers counseling situations and hands on experience with weight loss programs. As students, we are receiving a lot of critical information and incorporating a class dealing with more situational experiences could only help us in the counseling aspect and learn how to adapt in certain situations! Then we could apply what we have learned in the classroom to situations we could see again in the future.
Speaking as an undergraduate student of a didactic program in dietetics, I feel we have encountered little in regards to counseling individuals on nutrition and health related issues. Now I am in the process of taking medical nutrition therapy and have yet to experience the rigors of an internship, so maybe after completing those programs, I will feel different in regards to dietetic student exposure to counseling situations. I think a whole class devoted to this portion of the field may be appropriate. Maybe, colleges and universities should have dietetic students declare an area of emphasis in the dietetics field. If that area of emphasis requires counseling have the student enroll in the counseling course. I know I am a good couple years (or more) away from becoming a licensed dietetic professional who can give counseling to individuals, but it is an area of concern for which I do not have a whole lot of confidence in myself. Maybe this is an area of the dietetics field that just comes with experience, but any aid or help with regards to coursework addressing counseling would be much embraced.
I think dietitians are somewhat prepared to counsel those individuals who are overweight or obese. I think the more experienced a dietitian is in counseling, obviously the more prepared they will be. Weight loss counseling is such a challenging aspect of dietetics because each client has a different situation. The challenge really is not the nutrition information it is discovering a method that the client will be most receptive to. I believe that the DPD programs and internships teach aspiring dietitians the knowledge they need to counsel, however, may not offer all the experiences they need to feel confident in counseling. I also feel that the cognitive approach is one that can be taught more in depth during the internship level. I think the psychological aspect of counseling poses the most challenging for dietitians and by incorporating techniques and cognitive approaches to behavior changes dietetics students will benefit. I also feel that to be a successful weight loss counsler, dietitic students should not only observe counseling sessions but practice sessions. This could be done through classroom scenarios, mock client interviews, etc. This way dietitians can know how to react in certain situations and how to deal with different types of clients.
Upon entering the ISU Master’s Degree-Dietetic Internship program, I had never taken a counseling class. I was fortunate enough to be a Dietetic Technician for a year and learned how to properly counsel clients. It helped me take the knowledge that I learned in the classroom and apply it to real clients. We learn so much factual information in class but rarely have to opportunity to apply it in undergraduate and even graduate school. Without my experience, I would not have been prepared to counsel effectively prior to my internship coursework. I believe that during my internship course work, I will learn to be a more effective counselor. Counseling clients each day will only make an RD more experienced and will help them improve with each client. Even though RD’s are very prepared for obesity and weight loss counseling after they complete their internship course work, the curriculum could include a few more mock sessions specifically dealing with nutritional counseling in undergraduate work.
I think that dietitians are very well-prepared in many areas for weight-loss counseling, while other more logistical areas could probably use some more attention. Factually, dietitians have all of the information they need. They can set up menus for weight loss, focus on calorie counting, and offer helpful concrete hints to clients about cutting calories and increasing activity. The area that I feel we could use some more training in is with the actual “counseling” skills. It is difficult to sit down and talk to people without having any actual training in those types of people-skills. I think myself and others would have benefited from a counseling class that was developed for medical professionals and explained how to talk to patients about difficult subjects concerning health. Weight loss and obesity are often very sensitive subjects that require some amounts of empathy and compassion; having a class that could’ve given us more experience with this type of thing would’ve been very valuable and very helpful for preparing us for weight-loss counseling.
I feel dietitians are very prepared for weight loss and obesity counseling. As an undergraduate student, I feel that I have acquired the knowledge to help give good advice to people on these particular topics, but I would not feel comfortable counseling and expressing the knowledge to a patient at this time. I think once I experience a more hands on situation and additional training such as an internship I will feel more confident and better prepared.
I think dietitians have the knowledge it takes to counsel one with a weight problem or obesity, however I believe not all dietitians are prepared to explain and clarify that information into something comprehensive for a patient uneducated in nutrition. Within didactic programs, I think metabolism and medical nutrition therapy courses are helpful in preparing students or interns to be successful weight loss counselors because these courses offer the biological and chemical information to students. Useful courses that may improve these programs are those that not only give important information, but also offer different strategies on how to teach a patient about obesity and ways to improve their health.
Annie,
I completely agree with your statement about "real world" counseling sessions. During our internship, we will actually be faced with a client and have to connect with them on a more personal level. This will allow us to practice using our factual nutrition information from class as well as our interpersonal counseling skills. I also agree that "practice makes perfect". The more experienced an RD is with counseling patients, the more effective they will be.
I think that RD’s are well prepared to deal with weight loss and obesity counseling in that they have the nutrition knowledge and science to help an individual who is ready, lose weight. When a client/patient is not ready to lose weight mentally or physically it makes our work a lot harder in that we are now dealing with issues beyond nutrition. Counseling classes and first hand experience of weight loss counseling are crucial when learning how to deal with this issue. I have participated in a weight loss management program, and I think that more experience like that would be beneficial. I have also taken regular counseling classes, but a counseling class specifically for dietetic students would be very nice!
Overall, dietitians are prepared to counsel for weight loss and obesity. It is just a matter of how much experience and education the dietitian has had in these areas. The dietitian might have to modify/adjust their counseling to accommodate the person’s goals. However, this will be done for any area a dietitian is not an ‘expert’ in. The requirements in order to become a dietitian do vary from university to university. At my undergrad, the counseling class was a great introduction to the aspects of counseling. We were able to counsel individual and group sessions. There should be more counseling classes offered that really focus and address different nutrition/medical situations that dietitians will encounter. Exposure and experience are the key ways to help dietitians be prepared to handle weight loss and obesity counseling sessions.
I think that overall we as dietetic majors get adequate information concerning weight loss and obesity. However when it comes to offering advice and counseling, I think more education and practice wouldn’t hurt. I personally learned a lot from my summer professional practice at Methodist Hospital in Peoria that I believed has helped me today. Also I hope to learn a lot by taking the course of Medical Nutrition Therapy this semester. I understand that a Professional Practice will also help in the hands on, clinical experience but as of right now I feel that a little more practice with counseling would be a good thing.
To be honest, I wish we were getting more invovled while we are in the program. I would much rather visit schools and hospitals and get hands on experience than sit and talk about what it will be like when we get there. I understand that going to visit places isn't easy for most, but I think it could be incorporated a little bit more. I think we are prepared depending on where we intern and how detailed our college program was. I am sure there are a lot of dietitians who come out of college and have no idea what a patient is asking them for or how to help someone. Most people want to be able to relate to the person who is helping them. We are not given lessons on how to get someone to trust us, just what to tell them when they ask for our help.
Jamie,
I agree with you about a dietitian needing to be fully aware of the client’s emotional and physical condition. I think that taking a few counseling courses would benefit us greatly. We can always use extra practice dealing with patients and all the incidents that may occur. It would be very beneficial for Dietitians to have extra teaching on how to deal with various clients and their conditions.
Dietitians seem to be adequately prepared for weight loss counseling because the DPD programs thoroughly educate students on obesity: the causes, the effects, and the solutions for such dietary counseling. Several aspects in the DPD programs are particularly helpful in preparation for weight loss counseling, such as various methods of dietary needs calculations, dietary recall methods, and menu planning/modifications. However, one of the most helpful aspects so far would be nutrition counseling (or counseling in general) techniques. A dietitian could be very knowledgeable in every technical aspect of dietetics, but the level of effectiveness will be extremely limited if proper listening and counseling skills are not developed. Although the counseling classes taken so far have provided me with a great deal of helpful information, I think this is a skill that can only be properly developed through real-life interactions (such as internships).
I think dietitians are well prepared for weight loss counseling. Everything from our basic 102 class through metabolism has talked about healthy eating. I have seen the values and percentages that we should consume for different foods in almost every nutrition class I have taken. The thing I am not ready for is the psychology part of it. I want to learn how to talk to patients and make them feel comfortable and to be able to trust me with the information that I provide to them. I think we should have a class that deals with the actual counseling part. It does not matter how much you know because presentation is everything. You can have all the education in the world, but if you can not present it in a way that makes people comfortable with you and with what you are telling them, they will not even listen. I am not in a dietetic internship yet, but I am sure that it helps with these communication skills.
I think it depends on the dietitians academic and work background to determine how well prepared they are for weight loss or obesity counseling. The more experience a person has in a field the more prepared they are. The DPD programs are very helpful in providing the educational background needed for weight loss or obesity counseling. It is the dietetic internships, however, that I feel you get the most knowledge from. It is in the internships that you get to deal with real life situations and hands on experience that can not be taught in a classroom. The way that the DPD program could be improved is by maybe having a course just on weight loss or obesity counseling and have the students volunteer at weight loss place maybe 2 or 3 times during the semester so they get first hand experience of what it is like to educate someone on weight loss. Another suggestion is that maybe in one of the classes in the DPD program a weight loss counselor could come and talk to the class. This way the students could learn from the counselor’s experiences.
I think it depends on the dietitian. I think all dietitians definitely have the knowledge to help people with weight loss and obesity counseling. I just do not think that everyone is cut out for doing individual weight loss counseling. Also, different dietitians focus on different areas such as, helping people in clinical settings, helping people with diseases, or working in the food service industry. I know that this is going to sound a little harsh, but I think some dietitians do not want to spend their whole careers telling overweight people to stop eating junk food. Those particular ones would probably not be prepared to do obesity counseling. Perhaps counseling training and certain psych. classes would be helpful. I think it is important for DPD student to get more real life experience. I think students (myself included) will not become comfortable counseling patients until they have more practice. I do not think I will feel fully prepared to start counseling patients when I graduate. It is something that you need to do multiple times in order so see what methods work for you and learn how to deal with different patients. Even just working at the Nutrition Mission, I found myself being very nervous working will some people. Of course, that was more of a shy thing. I feel as though I have the knowledge to help people but I need more work with my people skills.
I think that the DPD programs teach the methods of weight loss very well, however, I think that the programs should focus more on the counseling aspect, especially if CBT is becoming the therapy of choice. In my experience, I know I only took 2 psychology class and 1 counseling class (not taken during undergrad), and they were by no means tailored to the nutrition students...very broad in fact. So for the DPD programs to help dietitians it should be a requirement to include those classes specifically taught to help dietetic students because many times clients will have emotional ties to foods. Having counseling class will by no means prepare you for all the emotions that people have, but will better a dietitian to deal with the strong emotions and help break them down. As far as the internship goes, I believe that a combination of the clinical and community rotations will be best for helping students learn weight loss counseling. Clinical because this is were you will be doing the most calculations on body weight and calorie counting, and community because you are more one on one with the clients (at least based on my WIC visit my senior year of undergrad).
In the area of counseling clients/patients dietitians really have their work cut out for them. An undergraduate professor I had always used to say that "dietetics is an art form." I saw why he would refer to dietetics this way when I conducted my undergraduate professional practice requirement in a local hospital. A dietitian must be able to take scientific, factual information and apply it to each individual in a way that they can understand it and at the same time the dietitian needs to connect with that client/patient to inspire them to make a change. This comes with a great deal of experience dealing with people and probably can not be learned in any other manner. The one thing that I believe would be greatly beneficial is a class that provides young dietetic students fundamental ways they can talk with client/patients, but the class would need to stress that these tips are just that, tips, and will not work with every individual. Dietetic internship rotations will more than likely be were the majority of students will gain practical experience in this area, but the real knowledge will come through years of interactions with patients.
Nicholas Schwab,
I completely agree that a course intended for individuals going into the health field and that would help them gain counseling skills would be incredibly helpful. I also think that you bring up an interesting point about having dietitian students declare an emphasis. I’m not really sure if I agree or disagree. Declaring an emphasis would greatly restrict dietitians as to what sort of jobs they could pursue in their lifetimes. With the way that the system is set up currently, dietitians get a dab of training into every area of nutrition and then are able to get jobs in whichever area they are most interested. However, at the same time, declaring an emphasis would make us more of an expert in the area that we chose. I just think you brought up a very interesting point; it’s kind of interesting to think about how different our DPD programs would be if we were required to declare an area of interest.
Beverly Long,
I agree with you that an internship experience of learning and observing dietetic professionals in the field is probably the best means by which to attain these counseling skills. A workshop or two regarding counseling may in fact be a more appropriate option for dietetic students than an entire semester devoted to this specific aspect of our field. If the counseling skills needed in the dietetics field can be obtained without lengthy, expensive coursework then that is optimal, and undergraduate students can continue to devote most of their studies to the other wide-ranging aspects of the major.
Karin Orstrom,
I completely agree with you on the issue of dietitians having a hard time counseling patients with self-esteem/confidence issues. For the most part many dietitians do not have much experience in this area and have only taken a few psychology courses throughout their undergraduate/graduate experience. For this reason, dietitians may be lacking in the area of helping to sort out emotions and deal with psychological issues, but we must be able to identify that the patient has an issue and maybe refer that patient to another type of counselor. This will help the patient fully resolve the issue at hand, not just the physical symptom that has developed as a result of a some sort of emotional stress.
Undergraduate programs really prepare you to have an adequate knowledge base of nutrition to be able to educate a wide variety of people/disease states/weight issues, etc. It is through your internship program that you will actually apply what you have learned to real life settings. Even after years of practicing dietetics, you will find out that no client you counsel is ever the same. This makes it important to always be on-your-toes with nutrition information in order to tailor nutrition education/counseling sessions to each individual client. Experience and practice are two big aspects of nutrition counseling.
lynn2552,
I completely agree with you that counseling courses would be beneficial in the DPD program. Dietitians have the factual knowledge to help patients with weight loss, but finding ways to pass the information on to others will be difficult. I would definitely feel a lot more confident going into an internship having counseling experience.
Pam,
I agree that experience is the key to preparing a dietitian for counseling. I also agree at this point that I would not be able to help a person in counseling for weight loss. The courses we take I feel are lacking on the hands on experience that we would need to help counsel someone.
Katie Willet,
I completely agree with you about incorporating more learning experiences outside of the classroom. Although the dietetics courses I have taken are great preparation in terms of learning the basics and discussing future experiences post-graduation, true learning, for me, takes place in more hands-on or real-life situations. Although I did have a nutrition counseling course in my undergrad, it wasn't very helpful since it was more of reading about techniques, watching videos, and one or two mock counseling sessions with classmates (which weren't taken seriously since we didn't learn proper techniques) thus it was almost completely useless. Case studies do help in application of knowledge but I feel that settings outside of the classroom are where quality learning takes place.
Julie I agree that the way to approach counseling is through experience and practice. People can be unpredictable and each patient will have a different issue that has to be dealt with. We will be prepared for the patient but it will be our skills that will help us help the client. The mock sessions are important to understand the steps of counseling, become more familiar and comfortable with the entire process and ourselves.
Steph,
I completely agree with you that if a client is not ready for weight loss, it will make our job as RD's harder! Not only will the information we are teaching them go in one ear and out the other, but motivating them will probably be near impossible. Those clients who are referred to dietitians by a family physician most want to lose weight in order to obtain a healthy lifestyle...not just because their doctor told them so. I think a great motivator would be to have them try to follow a diet plan for a month...this way they might be motivated to lose weight if they see results in a month. Plus they will probably feeling healthier...keeping them motivated to be on a weight loss regimen.
This is a comment of several people’s postings. Many of you said similar things about feeling comfortable about our counseling skills. I do not think that our undergraduate education prepares us for counseling patients. Katie, I think your idea about visiting schools and hospitals and get hands on experience is very good. Look at education majors. They get an insane amount in school experience before they even have their student teaching. Granted they do a lot of observing at first, but I’d be fine with that to. I would love to observe dietitians or nutritionists and I think it would help prepares us.
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