Counseling may take place at the bedside of a patient, in a clinic, or in the home. Regardless of the setting it is essential that privacy be maintained, that interruptions be avoided, and that there be no distracting noise. A patient is more likely to be attentive some time following a meal than he would be when he is hungry or when he has just finished his meal.
Effective counseling takes time. An initial session during which the diet history is obtained requires one-half to one hour. Later sessions might require as little as 15 minutes. For patients in the hospital it is often advantageous to break up the initial counseling into several shorter sessions. In this way the patient is more alert, and also has opportunity to think about the content between sessions and to raise questions.
Dietary counseling requires constant interaction between patient and counselor. It is not a one-sided lecture by the counselor telling the patient what to do.
The dietary counselor must be able to interpret the principles of dietary change into practical terms that the patient can understand. She believes that the individual can change his dietary habits, but also realizes that change is likely to occur gradually. She understands the patient’s needs and values. She is able to communicate at the level of the person being counseled. She respects the individual’s dignity and maintains confidentiality.
The patient is an active participant in the counseling process. He provides the information pertaining to his diet history and food intake; listens to the counselor’s evaluation of his food patterns and the reasons why changes are recommended; sets his own goals for what he can realistically accomplish; studies the materials that he is given; and makes notations of questions he needs to ask.