Question 1

A client is aware that a dietary behavior problem exists but is not sure whether to do something about it. What stage of change is this client in?&#10;A) Precontemplation&#10;B) Contemplation&#10;C) Preparation&#10;D) Relapse

Accepted Answer

During contemplation, the client goes back and forth in considering the advantages and disadvantages of making a behavior change. In precontemplation, the client is not even aware that a problem may exist. During preparation, the client needs help in finding an acceptable change strategy to address the problem. In relapse, the client needs help to restart doing the actions that she had previously been doing to bring about the behavior change.

Question 2

Traditional nutritional counseling focuses on change matched to&#10;A) action and relapse.&#10;B) empathy.&#10;C) precontemplation and preparation.&#10;D) action and maintenance.

Accepted Answer

Change matched to action and maintenance is the focus of traditional nutrition counseling. However, many people with a dietary behavioral problem are in a preaction stage and therefore not ready for change. This may be one of the reasons that traditional nutrition counseling has not always demonstrated long-term success.

Question 3

Educating and counseling with cultural competency should acknowledge surface and deep structure. Surface structure includes things like&#10;A) the client's appearance.&#10;B) language and foods.&#10;C) social beliefs.&#10;D) health diagnoses.

Accepted Answer

Surface structure includes such things as food and language. Deep structure includes psychologic and social beliefs and the context of the intervention.

Question 4

When counseling a client who speaks a different language, the most effective way to communicate is to&#10;A) use a family member or close friend who speaks the language and can translate.&#10;B) use a visual aid that has been developed using international symbols.&#10;C) find a counselor who speaks the same language and can do the counseling.&#10;D) use a certified translator.

Accepted Answer

Unofficial translators are not usually a good choice because of the lack of understanding of nutrition and health. Using professional translators is also not without limitations but is the best option.

Question 5

Which technique is NOT useful in working with clients during a not-ready-to-change counseling session?&#10;A) Asking open-ended questions&#10;B) Affirming&#10;C) Agreeing with a twist&#10;D) Summarizing

Accepted Answer

When dealing with clients during the precontemplation stage, the goal is to facilitate their ability to consider change. For this to occur, strong communication skills are necessary. These include asking open-ended questions, listening reflectively, providing affirmation, and summarizing the client's statements. Agreeing with a twist is a means of dealing with resistant behavior by agreeing with the client and then redirecting the focus of the conversation.

Question 6

Which of the following techniques is appropriate for use with a patient ready to change behavior?&#10;A) Elicit self-motivational statements.&#10;B) Negotiate change.&#10;C) Establish an action plan.&#10;D) Develop discrepancy.

Accepted Answer

During the ready-to-change session, the goal should be to work with the patient to set goals for change that include a plan of action. Eliciting self-motivational statements is used for the patient in the precontemplation stage to help create awareness of an existing problem in the patient. Negotiation for change occurs in the unsure-about-change session. Developing discrepancy is an activity used by the counselor throughout the counseling process that helps the patient identify the benefits and disadvantages of the behavior change.

Question 7

What counseling activity is based on the idea that thoughts and beliefs that affect behavior can be changed to promote behavior change?&#10;A) Cognitive behavioral therapy&#10;B) Transtheoretical model&#10;C) Reflective listening&#10;D) Shifting focus

Accepted Answer

Cognitive behavioral therapy focuses on changing maladaptive thoughts and beliefs through cognitive restructuring. This technique is particularly effective in working with patients with body image issues. The transtheoretical model is not a counseling activity itself but rather a model for setting up counseling related to the stage a person is in regarding a needed behavioral change. Reflective listening is a technique used with patients who are not ready for change and involves the counselor communicating understanding of the patient's feelings through a statement. Shifting focus is a means used for dealing with patient resistance that involves the counselor changing the focus of a patient from a perceived barrier to change to one more appropriate.

Question 8

The most important thing to establish in the first counseling session is&#10;A) the counseling relationship.&#10;B) likes and dislikes in the counseling environment.&#10;C) fees for service.&#10;D) reimbursement potential by insurance providers.

Accepted Answer

The counseling relationship needs to be developed during the first counseling session. The environment and the way the counselor communicates, both physically and verbally, can help establish rapport and trust on the part of the client. Without this, the client may not feel the necessity to continue with counseling.

Question 9

One of the five tenets of cultural competency is&#10;A) you must know a culture's communication style to be an effective counselor.&#10;B) cultural competency eliminates racism.&#10;C) culture is defined as race, religion, and ethnicity.&#10;D) culture is mutable and multiple.

Accepted Answer

Knowing about a culture does not eliminate racism, and part of cultural competency is to avoid any stereotyping, including how a specific culture wants to communicate. Culture is mutable and multiple, and any understanding of particular cultural context is always incompletely true, always partial, and always somewhat out of date.

Question 10

Resistance to change can be overcome by all the following techniques EXCEPT&#10;A) affirming.&#10;B) double-sided reflection.&#10;C) agreeing with a twist.&#10;D) reflecting.

Accepted Answer

Techniques used for addressing resistance to change include reflecting, double-sided reflection, shifting focus, agreeing with a twist, emphasizing personal choice, and reframing. Affirming is a technique used when counseling clients not ready to change. Affirmation involves acknowledgment that the counselor understands what the client is doing or thinking is normal.

Question 11

During which type of counseling session is one of the goals to identify barriers to change?&#10;A) Not-ready-to-change session&#10;B) Unsure-about-change session&#10;C) Ready-to-change session&#10;D) First counseling session

Accepted Answer

The answer of During which type of counseling session is...

Question 12

Which of the following is NOT an activity that facilitates behavior change?&#10;A) Self-efficacy&#10;B) Empathy&#10;C) Reframing&#10;D) Discrepancy

Accepted Answer

The answer of Which of the following is NOT an...

Question 13

Assessment of a patient's stage of change should be completed&#10;A) when the patient is referred for counseling.&#10;B) at the beginning of the first counseling session.&#10;C) by the end of the first counseling session.&#10;D) before the second counseling session.

Accepted Answer

The answer of Assessment of a patient's stage of change...

Question 14

Which stage of change is characterized by the patient's feelings of ambivalence?&#10;A) Precontemplation&#10;B) Contemplation&#10;C) Preparation&#10;D) Maintenance

Accepted Answer

The answer of Which stage of change is characterized by...

Question 15

When a counselor elicits self-motivational statements, this includes all of the following EXCEPT&#10;A) optimism.&#10;B) problem recognition.&#10;C) reframing.&#10;D) intention to change.

Accepted Answer

The answer of When a counselor elicits self-motivational statements, this...

Question 16

If a counseling session ends with the client not ready to change, which of the following should the counselor do?&#10;A) Establish goals for the client.&#10;B) Arrange for follow-up contact.&#10;C) Persuade the client to perform some change.&#10;D) Express disappointment with the client.

Accepted Answer

The answer of If a counseling session ends with the...

Question 17

Which tool can be used to assess a client's readiness to change?&#10;A) An adherence ruler&#10;B) A food diary&#10;C) A weight scale&#10;D) Food models

Accepted Answer

The answer of Which tool can be used to assess...

Question 18

What does double-sided reflection involve doing?&#10;A) Monitoring a counseling session from behind a two-way mirror&#10;B) Using the client's previously expressed ideas to show a discrepancy&#10;C) Asking questions multiple times&#10;D) Reframing

Accepted Answer

The answer of What does double-sided reflection involve doing?&#10;A) Monitoring...

Question 19

Which of the following is NOT a stage of change?&#10;A) Precontemplation&#10;B) Motivation&#10;C) Relapse&#10;D) Action

Accepted Answer

The answer of Which of the following is NOT a...

Question 20

Which of the following is a client's belief in his ability to carry out change?&#10;A) Self-efficacy&#10;B) Self-management&#10;C) Self-monitoring&#10;D) Self-reflection

Accepted Answer

The answer of Which of the following is a client's...

Deck 14: Education and Counseling: Behavioral Change