Nikki Finkenthal

KNH 403
Professor Schmidt
Observation of Nutrition Counseling Session
1. The counseling session I observed was with Kate Ferro, RD at The Hull Institute
in Beachwood, Ohio on November 21st and the session was from 1:30PM- 2:30.

2. The physical setting took place in one of the counseling session rooms at The Hull
Institute. The room was somewhat bland with white walls, a desk and multiple
chairs to serve the number of clients attending the session. On the walls there
were motivational posters with quotes and sayings and as well as informational
posters about nutrition and eating disorders.

4. Client description
a) The client I observed was a 20 year old white female
b) There was a helping relationship established because this client is struggling
with an eating disorder and is getting the counseling sessions to help her treat
her disorder. The counselor encouraged her progress every step of the way and
gave her a lot of positive feedback and affirmation when discussing her
progress and treatment.
c) The client is currently struggling with an eating disorder and is a returning
client who was cured briefly and a few years later she relapsed and is now
back getting counseling sessions and help.
d) Yes, there were various occurrences with collaboration between the counselor
and client to establish dietary objectives. While this is a client who struggles
with not wanting to eat, the focus of this session was a lot more on the
connection between mental feelings in relation to her eating habits. The
counselor and client talked about foods she enjoys and should incorporate in
her diet. They also talked about having someone monitor her eating as well as
herself with food journals in order to ensure that someone is present to make
sure is eating and not throwing away food when someone leaves the room,
because that was a past struggle they faced.
f) The only teaching/ visual aid that was used during the session was a planned
out calendar that had significant dates, events and counseling sessions in order
for the client to be successful.
g) There was evidence of tailoring dietary objectives in order to meet the clients
lifestyle issues. The client is currently enrolled in college away from home
and her parents and counselors want her to come home for a semester or
longer in order to make sure she is eating and completes the dietary objectives
and counseling needs in order to help subside her eating disorder. Away from
home no one can watch her lifestyle issues and keep track of her eating, but
when she is living at home she has more access to counseling and her parents
can observe her dietary habits and lifestyle.
h) The client has a high educational level understanding and needs. This client
has already attended many eating disorder sessions so she is aware of the
 information and techniques, but due to her relapse she needs a better
understanding and more strict plan and assistance.
i) Currently this client seems to be in the denial phase and is struggling to
achieve self-efficacy. Due to the fact that she is in these sessions because of a
relapse her self-efficacy is low in regards to her dietary objectives.
j) The clients major barriers to meeting the dietary objectives is the fact that she
has no desire to eat and thinks that she has her problem under control and that
her relapse was just a one time thing
k) This client is currently in the precontemplation phase of change because she is
in denial of her problem and wont accept the help because she has already
been at this point in her life before. While I think she knows she is in need of
assistance, she is very stubborn and unwilling to work with the counselor.
l) There was no known evidence of social support to meet the dietary objectives.
If the client does return home from college and gets the help she needs from
her parents and counselors than her social support will increase in order to
meet her dietary objectives.

5. Client centered counseling- the counselor has respect and unconditional positive
regard for the client dealing with her struggle of having an eating disorder.
Currently the client hasnt discovered the capacity to use relationships in order to
change and grow

Cognitive Behavioral Therapy- with this session there was talk about how
behavior is learned and how altering the environment the client is currently in by
being away at school can influence her behavior development

Solution-focused therapy- this technique was not used during this session because
it concentrates on things that have worked in the past and this client is a relapse
client whos previous experiences have not worked for her

Motivational Interviewing- this technique was used frequently throughout the

counseling session because the counselor and client discussed perceptions and
discrepancies in her behavior versus the values and goals. The counselor was also
listening with empathy and trying to empower the client to accept the help she
needs

6. Overall I thought this counseling session went really well considering the
circumstances. The counselor was very patient, empathetic, supportive and
understanding with a client who is struggling with a relapse and doesnt want the
needed education, support and change. This counseling session really opened my
eyes to how much a struggle certain sessions can be depending on the issue the
client is dealing with.