Summary: The Transtheoretical Model
20 year-old female, comes into the office today for a nutritional assessment and counseling session. My client, Josephine currently weighs 117, at a height of 5’2”. Josephine has concerns and complains of eating disorder. No meds taken-only multi-vitamin. Client currently lives with both parents who are from Central America. Mother, is from Honduras and Josephine’s father is from Guatemala. In addition, she stays active by passionately teaching, salsa lessons to the general public. For the most part, Josephine clarifies that she has been thin most of her life, but since puberty it has been hard to maintain her weight. Diet consists of ethnic fried foods and junk food. Josephine, states that she finds herself running 2-3 miles
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a day, in addition; forcing herself to vomit at times and limiting herself to one meal per day while counting calories of 1200 a day as well.
While practicing this unhealthy lifestyle, Josephine complains of feeling exhausted and noticing her weight fluctuating between 110-125 in the last five years. As Josephine’s nutritional counselor, I believe the stage of change Josephine is struggling with currently is maintenance & relapse. For instance, “in this stage, people have sustained their behavior change for a while (defined as more than 6 months) and intend to maintain the behavior change going forward. People in this stage work to prevent relapse to earlier stages”(The Transtheoretical Model (Stages of Change)). “The Transtheoretical Model (also called the Stages of Change Model), developed by Prochaska and DiClemente in the late 1970s, evolved through studies examining the experiences of smokers who quit on their own with those requiring further treatment to understand why some people were capable of quitting on their own. It was determined that people quit smoking if they were ready to do so. Thus, the Transtheoretical Model (TTM) focuses on the decision-making of the individual and is a model of intentional change. The TTM operates on the assumption that people do not change behaviors quickly and decisively. Rather, change in behavior, especially habitual behavior, occurs continuously through a …show more content…
cyclical process. The TTM is not a theory but a model; different behavioral theories and constructs can be applied to various stages of the model where they may be most effective” (The Transtheoretical Model (Stages of Change). Josephine’s, readiness to learn and implement a healthier way of living, is unfortunately influenced by her surroundings, culturally, socially and emotionally. Furthermore, I have attached a sample of Josephine’s daily intake, and lab values below to better understand overall nutritional health.
Breakfast:
1-6” corn tortilla
½ cup fried beans cooked with peppers, onions and oil
½ cup rice
1 cup no sugar added orange juice
Lunch:
1 slice of whole wheat bread
2 slices turkey
1 small apple
Dinner:
2- 6” tortillas
Beef with onions, peppers cooked in oil
Tomato, onion, pepper salad (made with oil and lime juice)
2 cups of rice
Height: 5’2” Weight: 117 pounds (based on your scale in the office)
Labs: Test Result Reference Units
Albumin (visceral protein stores) 3.3 g/dL 3.5-4.8 g/dL
Sodium 133 mEq/L 136-145 mEq/L
Potassium 3.8 mEq/L 3.5-5.2 mEq/L
Iron 0.4 mg/dL 0.6-1.1 mg/dL
Vitamin B12 185 pg/mL 200-835
pg/mL
Clearly, Josephine’s diet intake reveals unhealthy choices of foods and her lab values report state that her albumin, sodium, iron and vitamin b12 are lower than the norm; versus her potassium levels are a bit elevated. As her nutritional counselor, my approach to Josephine would be by displaying genuine, humble, trusting, and eager to assist her in whatever way she feels is comfortable and yet healthy to her needs. Communication, I believe is key to building a great rapport with a client like Josephine. Sharing common grounds of interests and setting goals to move forward to making better decisions is important. I believe, three counseling skills to encourage a change in Josephine’s behavior would be to evaluate, educate, create and implement both short and long terms nutritionally and physically towards living a healthier lifestyle, in spite of her living conditions. I believe, focusing on priceless goals of feeling and having a better image of oneself by working towards making small changes in food choices and engaging in exercising at least three day a week will be achievable and overall allow Josephine to feel the change in her past habits a behaviors. These changes, I believe will encourage Josephine to have better self-image and have a sense of self-awareness of her choice in life.
References:
King, K., & Klawitter, B. (2007). Nutrition therapy: advanced counseling skills (Third ed.). Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins
(n.d.). Retrieved October 31, 2017, from http://sphweb.bumc.bu.edu/otlt/MPH-Modules/SB/BehavioralChangeTheories/BehavioralChangeTheories6.html
a day, in addition; forcing herself to vomit at times and limiting herself to one meal per day while counting calories of 1200 a day as well.
While practicing this unhealthy lifestyle, Josephine complains of feeling exhausted and noticing her weight fluctuating between 110-125 in the last five years. As Josephine’s nutritional counselor, I believe the stage of change Josephine is struggling with currently is maintenance & relapse. For instance, “in this stage, people have sustained their behavior change for a while (defined as more than 6 months) and intend to maintain the behavior change going forward. People in this stage work to prevent relapse to earlier stages”(The Transtheoretical Model (Stages of Change)). “The Transtheoretical Model (also called the Stages of Change Model), developed by Prochaska and DiClemente in the late 1970s, evolved through studies examining the experiences of smokers who quit on their own with those requiring further treatment to understand why some people were capable of quitting on their own. It was determined that people quit smoking if they were ready to do so. Thus, the Transtheoretical Model (TTM) focuses on the decision-making of the individual and is a model of intentional change. The TTM operates on the assumption that people do not change behaviors quickly and decisively. Rather, change in behavior, especially habitual behavior, occurs continuously through a …show more content…
cyclical process. The TTM is not a theory but a model; different behavioral theories and constructs can be applied to various stages of the model where they may be most effective” (The Transtheoretical Model (Stages of Change). Josephine’s, readiness to learn and implement a healthier way of living, is unfortunately influenced by her surroundings, culturally, socially and emotionally. Furthermore, I have attached a sample of Josephine’s daily intake, and lab values below to better understand overall nutritional health.
Breakfast:
1-6” corn tortilla
½ cup fried beans cooked with peppers, onions and oil
½ cup rice
1 cup no sugar added orange juice
Lunch:
1 slice of whole wheat bread
2 slices turkey
1 small apple
Dinner:
2- 6” tortillas
Beef with onions, peppers cooked in oil
Tomato, onion, pepper salad (made with oil and lime juice)
2 cups of rice
Height: 5’2” Weight: 117 pounds (based on your scale in the office)
Labs: Test Result Reference Units
Albumin (visceral protein stores) 3.3 g/dL 3.5-4.8 g/dL
Sodium 133 mEq/L 136-145 mEq/L
Potassium 3.8 mEq/L 3.5-5.2 mEq/L
Iron 0.4 mg/dL 0.6-1.1 mg/dL
Vitamin B12 185 pg/mL 200-835
pg/mL
Clearly, Josephine’s diet intake reveals unhealthy choices of foods and her lab values report state that her albumin, sodium, iron and vitamin b12 are lower than the norm; versus her potassium levels are a bit elevated. As her nutritional counselor, my approach to Josephine would be by displaying genuine, humble, trusting, and eager to assist her in whatever way she feels is comfortable and yet healthy to her needs. Communication, I believe is key to building a great rapport with a client like Josephine. Sharing common grounds of interests and setting goals to move forward to making better decisions is important. I believe, three counseling skills to encourage a change in Josephine’s behavior would be to evaluate, educate, create and implement both short and long terms nutritionally and physically towards living a healthier lifestyle, in spite of her living conditions. I believe, focusing on priceless goals of feeling and having a better image of oneself by working towards making small changes in food choices and engaging in exercising at least three day a week will be achievable and overall allow Josephine to feel the change in her past habits a behaviors. These changes, I believe will encourage Josephine to have better self-image and have a sense of self-awareness of her choice in life.
References:
King, K., & Klawitter, B. (2007). Nutrition therapy: advanced counseling skills (Third ed.). Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins
(n.d.). Retrieved October 31, 2017, from http://sphweb.bumc.bu.edu/otlt/MPH-Modules/SB/BehavioralChangeTheories/BehavioralChangeTheories6.html