Resource for Trainers

Training materials

These materials are designed to be used in conjunction with the book and are intended to encourage and consolidate learning. Trainers will also find the Video and Case Studies useful material to include in a training programme.

Activities for students to do on their own

1 First impressions (Chapter 5)

Take time to look at a portrait of someone unknown to you (e.g. in a gallery or magazine). Note your impression, paying attention to their facial expression, posture, dress, culture and other characteristics described in Chapter 5. Describe what you see, the assumptions you make about them and their life as a result of your observations, and your thoughts about them as a person (e.g. your prejudices, your attraction to them or your dislike of them). (If two people have looked at the same portrait, it is useful for them to share their descriptions and observe the differences and similarities).

2 Analysis of a conversation (Part 2)

Take the opportunity to eavesdrop on a conversation between two people (e.g. when travelling on public transport or sitting at a table in a café). Note who talks and who listens. Does one dominate, or do they exchange roles frequently? How loudly or quietly are they speaking? What do their tone of voice and other non-verbal communication signify to you? What cultural aspects do you assume from the language they use? How does the listener demonstrate that they are listening? What types of response are given (e.g. low-, medium- or high-risk)? If one interrupts the other, how does this affect their conversation? What communication skills are being demonstrated (e.g. questioning, paraphrasing)? Do you think the speaker feels heard and understood? What do you understand about the nature of their relationship?

Activities for students to do in groups

3 Putting skills into practice: further considerations (Part 3)

Working in small groups, choose a chapter from Part 3 to study over an agreed length of time. A nominated person then reports to the whole group in turn, outlining the main points that the dietitian needs to take into account when working in the different situations described in the book, including the following:

• • the concerns of the patient;
• • the possible difficulties for the dietitian and any support needed;
• • the communication skills to be used;
• • any issues to do with boundaries such as time, confidentiality and referral for further support;
• • the group’s experience of working together.

This activity will require time both to prepare and to present to the group. Time also needs to be allowed for groups to discuss what they have learned.

4 Statements for reflection and discussion

The following statements are based on topics raised in each part of the book and are designed to encourage different points of view and to consolidate learning.

Judgement needs to be exercised about the topic and the size of the group: some students may participate more fully in small groups of two or three; others may be comfortable in larger groups.

Part 1: Using a counselling approach in patient-centred practice

• • Counselling skills are only needed by dietitians working in health promotion, and not by those working with patients who need specific therapeutic diets.
• • Patients want to be instructed about what they can and cannot eat, and dietitians are the experts.
• • Using counselling skills takes too much time, because the more the dietitian listens, the more the patient will talk.
• • When patients are not motivated to keep to a diet, there is not much a dietitian can do.
• • The dietitian needs to control the interview, otherwise not all the information will be conveyed.
• • If a patient becomes emotional, they should be referred to a counsellor.

Part 2: The skills

• • Attending is a way of demonstrating acceptance, but what if I don’t agree with someone or I dislike them? How can I then accept them?
• • Reflective responding seems to be a key skill. What is so special about it?
• • The best way to confront a patient is to tell them the truth.
• • People often say they are just being assertive when in fact they are being aggressive.
• • Criticising someone can motivate them to try harder; praising someone allows them to stop trying to do better.
• • Most patients are very nice. As a dietitian, I’m unlikely to have to confront an aggressive patient.

Part 3: Putting skills into practice: further considerations

• • What might be your concerns when working with more than one person in the room?
• • How would you apply your counselling skills if a patient were to begin to tell you that a recent family bereavement has meant they have not been paying attention to what they have been eating for some time?
• • What might be your concerns if your patient was a child who came with a grandparent?
• • What support might you need to give patients who are bereaved?
• • What are some important points to consider when seeing a patient from a different cultural background?
• • How might you use your counselling skills to help a patient who unexpectedly told you about their bizarre eating behaviour?

Part 4: Areas for personal and professional development

• • How would you recognise when a patient or a colleague was feeling particularly stressed? How might they express their thoughts and feelings, and how might they behave?
• • What is the connection between feeling stressed and being able to use a counselling approach?
• • What is the connection between self-awareness and counselling skills?
• • How would you explain to someone else the connections between assertive communication and counselling skills?
• • How does self-esteem link in with stress, self-awareness and assertiveness skills?
• • What changes (if any) are you planning to make in your dietetic practice (or your personal life) that would ensure your greater safety and well-being?
• • How can reflecting on practice and writing about this be supportive and result in personal development?