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					M’Call Toon

October 4, 2010: Critical Evaluation

Client Session:

       As a client I have type 2 diabetes, and my blood glucose is generally over 200mg/dl. My

BMI is 30 and I experience hypoglycemia several times a week and cope with it by drinking a

coke to bring my blood glucose back up. I eat 3 meals a day and 2 snacks in between and I do

not pay attention to the amount of food I intake. I try to stay away from high sugar foods and

focus on fruits and vegetables but my main issue is that I get no regular exercise. During my first

session of Nutritional Counseling with Mr. Mike Gilmer I was able to evaluate his skills in active

listening, paraphrasing, reflecting, and many more skills in communicating and my reflections on

how well he did is provided below.

       As the nutrition counseling session began Mike provided excellent skills in active

listening and active feedback. His nonverbal communication made him seem relaxed and

somewhat easy to talk to. Our body position was separated by two desks but it was still within

the appropriate consultation distance of three feet. He often expressed his feelings of my diet and

choices of food and physical activity through his facial expressions and gestures. It seemed as

though he was very interested in my situation but he was mainly focused on implementing

change in my life. Some other strengths that Mike had as a counselor was he helped me pull

information of what I like to do and have done in the past to get physical activity into my life.

Mike was able to notice my true feelings and thoughts about my previous life before I had to

worry about my diet and he was able to use that information to help me integrate a plan for

improvement to exercise more frequently. Mike also helped me address and identify the stage of

change that I was willing to make by asking me open ended questions. He was able to ask me an
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appropriate amount of factual questions while also forcing me to pinpoint the underlying issue

that I was trying to avoid. After he summarized and paraphrased what I had actually said, it was

then that I realized I needed to make a change in my life to improve my health status and lead to

a lower BMI and more steady blood glucose not only for myself but also for my children’s sake.

His “why” questions are when I realized that because of my healthy eating but a low physical

activity level, I may be causing my children to have similar issues when they get older. As a

woman I believe this to be a weak spot for a parent and he hit that weak spot, forcing me to do

what I needed to do to change. Some of Mike’s weaknesses as a counselor included adjusting to

his client. I was very grateful of Mike’s questions however his encouragers were somewhat

lacking. During our consultation I was very interested and wanted to know how to do better, but

as a woman, it is often hard and very discouraging to work so hard to lose a few pounds then

gain it back after one meal. I believe if Mike could have had a few more heart- felt encouraging

words, I may have responded even better.

       Overall Mike did an incredible job on counseling me to help me find a way to address my

health concerns and put a plan into action. The effectiveness of the counseling session was very

beneficial. I left the consultation with an idea of what to do to get on track of a healthy lifestyle

and by doing it in a way that is pleasurable and personable to me. I was only able to do this

because Mike asked questions related to how things made me feel verses simple yes and no

questions that lead to factual answers. Mike’s strengths allowed me to connect feelings and turn

them into meanings. Some recommendations I would have for Mike would include continuing

helping the client find the underlying issues and areas of concern to help the client pinpoint what

they can do in a fun way and not just as a requirement of “doctor’s orders” to better their overall
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health. Mike helped me to understand that sometimes the client is ready to take into action, and

sometimes they are not. I would also advise Mike to give more positive feedback and

encouraging words, especially to individuals who may seem that they have been fighting their

weight and continue to be worn down as success turns to failure and gaining back more pounds.

As a client, I noticed and appreciated that my counselor helped me pull information and tackle

my issues of planning designated times for activity while also providing ideas of increasing my

physical activity by discovering underlying issues and meanings through active listening and


Counselor Session:

       As the counselor my client had a very poor overall healthy lifestyle. His cholesterol was

very high, he was obese, had a sedentary job and lifestyle due to a back injury, and was

constantly snacking on unhealthy no nutrient snacks throughout his day. His priority for the

session was to develop better eating habits. He knew that he needed to e at healthy and that

consisted of a better intake of fruits and vegetables however it was very inconvenient to his

schedule. He had previously made attempts to better his overall health status and had success

through the “Atkins Diet” however he noticed after time the weight began to creep back on him.

My client believed the impact of his lifestyle had changed and he discussed with me that he

wanted to get back where he was in his overall health status, however, he is limited on time and

cannot exercise due to his back injury.

       To have true success with my client I believe that a successful change in his routine

would not be established with only one visit. He was having a difficult time decided exactly what
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he could do to make a change in his daily lifestyle to better his health status. As a counselor I felt

I excelled in the basics of nonverbal communication through active listening. I maintained eye

contact and constant involvement with the conversation by responding back to my client's

questions and statements. I was also available and concerned for the well-being of my client and

that was obvious by my facial expressions of concern and my warmth in my tone through

discussion. If I, as a counselor, could help him with specific meals and scheduled p lanning I

believe it would help him become more successful though a relationship and trust was still

needed between the client and myself. I was able to read into and paraphrase his underlying

issues of his lack of healthy eating; I believe that through small changes he would be successful

in dropping his weight. My client often has struggled with sticking to a plan due to lack of

convenience and during the reflection of what he was saying to me, he realized this.

       During our consultation there was a continuous flow of conversation and though his

feedback was slightly negative in ways of improvement conversation was key in his visit. The

communication was very fluent between myself and the client and I think this helped build a

relationship and trust. I believe my strengths as a counselor consisted of discussion content with

my client. I felt I was doing a good job at communicating with door opening encouraging words

to the client. Rather than just saying "you can do it" I gave true confidence to the client by saying

"tell me of ways you have succeeded." Open ended question were also asked in order to allow

my client to express and show his true feelings. I felt I had some success in getting to the bottom

of his problems but after many more consultations and the strengthening of the client-counselor

relationship, I feel like his response would be much more active. I had a difficult time with my

client because he was very depressed about his situation and stated more than once that he knew
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he needed to change his diet but he did not have the time to do so. Coming back with

encouraging and helpful words were difficult when he would provide me with these close-ended

answers. I also struggled with summarizing. It was hard for me to remember and cover ever issue

we had discussed during our consultation without reading my notes I had taking and maintaining

eye contact, which I believe helps the patient to feel more secure and less like a judgmental

interview. My weaknesses also consisted of pulling out the information and ideas he had as an

individual to better himself. In the allotted time we had, we were not able to cover all aspects of

the discussion I felt we needed. But after more consultations I feel as though my client would be

more ready to open up and participate more in active communication.


       Overall I felt this exercise was very useful. It was a learning process for me as a client

and a counselor. I do not have issues with conversing with others, however during this exercise I

was able to understand exactly how to continue active listening and respond back with the client

is unwilling and struggling to change. My partner was great in showing me ways to better

communicate and get on the same level with the client. As a counselor it was difficult to work

with a patient who believed they did not have the time to change, but after realizing sometimes

time is all that can help, it was rewarding to think of the ways I can help others just from what I

have been learning the past four years.
   M’Call Toon

Nutrition Counseling


  October 4, 2010

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