Tips for Emotion-Based Nutrition Counseling

Tips on setting a comfortable climate for sharing

Tip: Engage people before launching into counseling. Think of people not as participants, clients or message targets but people who, like you, want to be the best they can be.

Engagement begins when the person first arrives at the clinic. A warm welcome sets the stage for successful counseling. Greet children and chat as you would to a good friend as you walk to the counseling location. If waiting for other people, ask meaningful questions that show you have a sincere interest in their children and them. Provide a calm, fun, peaceful oasis in their busy lives and they will look forward to seeing you again.

How do you know when groups are engaged? Parents are reluctant to leave. They may share phone numbers for later contact. They may sincerely thank you when they leave. And you will have the warm feeling that results when good friends get together and have a good conversation.

Tip: When you’re meeting with parents, keep in mind what you’re really trying to achieve in your time together:

• Make them feel comfortable and connected
• Let them know they can trust you with their feelings by respecting and honoring them as individuals
• Make your time together feel natural and reassuring, not forced and artificial
• Connect desired behaviors with the feeling that doing them makes them feel good
• Discuss practical steps to achieving success

Tip: Add a dash of unpredictability and anticipation to the WIC routine. Stimulation, novelty and diversion are important ways to capture attention. Here are unexpected ways to add fun to group counseling sessions:

• Tape a world map on the wall and ask people to put a pin in the map on the city/town where they were born or grew up.
• Dress in a costume. Educators dressed as fairy godmothers, princesses or pumpkins grab attention from parents and children.
• If you know the participants, share something you appreciate about each of them.
• Play the hokey pokey. Invite children and parents to join you as they arrive.
• Do a pop-up survey to encourage group connections. Ask a question and have people stand up if they answer yes. Sample questions:
  • Who just moved here from out of state?
  • Who likes chocolate?
  • Who wonders what it is like to have a toilet trained child?
  • Who would like a good night sleep?
  • Who has more than one child in diapers?

Tip: People find positive energy appealing. Comfortable, soothing, light, fun, fresh, upbeat, active, vibrant and invigorated are words associated with positive energy. (Positive energy doesn’t mean high energy, which could be difficult to sustain all day.) Boring, dull, bland, uninspired, routine and annoying messages are associated with low energy people and groups.

Why is your energy important? When people see you energized by topics, they think, “This must be important because that person seems so excited about it.” Interestingly, facilitators with low energy are often perceived as having low self-confidence.

How can you get the energy balance right? Focus only on the people you are with and give it your all. Block out the office, schedules, and co-workers. Be fully present for your families.

Tip: People may forget exactly what you say but they will never forget how you make them feel. Think about how you want parents to feel before each session and keep your focus on feelings throughout.

• Do you want them to feel successful? Tell them what they are doing that makes them a successful parent.
• Do you want them to feel confident? Let them know you believe they will be able to accomplish whatever they set out to do.
• Do you want them to feel intelligent? Talk to them in a way that lets them know you respect their abilities.

Tip: The more people speak during group meetings, the more ownership they have over the outcomes. The introduction can help ensure everyone says something. Use these questions to get everyone to share during the first minutes of the group:

• What’s one precious thing your child did this week that you hope you will never forget?
• What surprised you most about being a parent?
• What delighted you most about the first weeks of your child’s life?
• What’s one dream you have for your child?
• What’s one thing your parents did for you that you hope to do for your child?

Tip: Involve children in the group, when possible. If there is a lull in the conversation or if people aren’t talking, ask children what they think about the topic or for advice on how to take action. Parents may be surprised and delighted with the fun and practical wisdom shared by children.

Tips: Start group sessions on time. It is important to respect the time and efforts of those who arrived on time. But it’s likely that one or more participants will arrive late to group sessions. Smile warmly as they arrive, greet them with a friendly voice and give them a ten-second update on the group discussion. Then move on with the conversation, encouraging the participation of late arrivals with eye contact and a smile.

Tips on getting people to talk in groups or individual sessions

Tip: Silence is golden, especially when it comes to emotion-based conversations. It takes time for parents to hear and process questions and comments that touch their hearts. Sit back, relax and wait for gems to fall from their mouth rather than rushing to their rescue by providing more probes or prompts.

Tip: Want parents to share more ideas and solutions? Ask “What else?” rather than “Anything else?”

Tip: The group leader is in control of the group, but she is the least important person in the room. Share personal experiences, challenges and successes sparingly while keeping the focus on group members. This does not mean hiding behind walls but rather keeping the spotlight on others.

Tip: Conversation lagging? It is time to energize the group. Try these techniques:

• Use questions to encourage discussion. Example: “Why do you disagree? What would make you agree?”
• Summarize group decisions and ask them to evaluate ideas, identifying those that might work best for them.
• List pros and cons of actions, always highlighting emotion-based benefits as well as logic based ones.
• Using a flip chart, ask parents to identify actions that fit in these categories: “Good” or “Change”. List first all the great things they are doing well and then what things they would like to change. Probe, encouraging successful parents to share successes and tips with those considering changes.
• Disruptive baby? Ask a group member to lead the conversation while you take a fussy baby from a parent. Remain in the room and pay attention and be surprised to see how the group responds to the challenge.

Tips on encouraging emotion-based sharing

Tip: There are many ways of asking questions.

• “What do you know...” questions encourage parents to give the logical, “textbook” responses.
• “What have you heard...” questions allow parents to share answers, even if they don’t know if they are accurate. It also allows you, the educator, a “safe” way to correct responses that aren’t accurate. A simple response that allows the parent to save face is “Thanks for sharing that. It’s a common misconception that is often shared in the press. I wouldn’t want anyone leaving today thinking that was true. I really appreciate your sharing.”
• “How do you feel about....” questions encourage emotion-based responses.

Tip: Acknowledge and name feelings to generate deeper discussions. Examples:

• “Some people may be skeptical that serving vegetables make a difference. How do you feel about that?”
• “Frustration may be one of the feelings parents feel when people talk about getting children to be more active. Is anyone feeling frustrated by having one more thing to add to their already busy life? What might make adding daily walks with your child worthy of being part of your daily routine?”
• “Sometimes I feel overwhelmed by my desire to be perfect and give my child healthy foods at every meal, especially when I fall short so often. Anyone else feel this way? What might make this desire less overwhelming?”
• “Does anyone feel eating as a family is impossible or impractical? What might change your opinion?”

To generate feeling statements from the group, say: “I’m not trying to talk you into anything. I am just trying to understand how you feel.”

Tip: Focus on the emotion-based reasons WHY parents should take action before discussing HOW TO do so. Why is this effective? Until people know the emotion-based benefits—personal value—of taking action, they don’t care about how to do it. Moving too quickly to HOW TO information assumes that parents understand how the action will enrich or bring joy to their life. Focus on the emotion-based benefits of taking action first, not the logical ones.

Tip: Some nutrition educators purposely build walls to prevent becoming too emotional about the people they serve. They prefer to view people from a distance, sidestepping real issues, and avoiding authentic conversations that may be upsetting, yet more effective in changing behaviors. Emotions may not easily fit with traditional nutrition training, but they do drive behavior change. Challenging traditional mind sets may be the first step in becoming an emotion-based counselor.

Tip: Be a “vibe” watcher.

• If someone is yawning, dozing or fidgeting, smile and say, “It looks like it has been a long day. What could we talk about that would make your time here today valuable?”
• If someone looks upset, ask: “My goal today is for everyone to leave with a tip or an idea to make your job as a parent easier? What could we talk about today that would help you?”
• If people are having side conversations or interpreting, ask: “Each of you is a great source of wisdom and I want to hear from each of you. Would you please talk one at a time so we don’t miss any of your valuable thoughts?”

Tip: Expect emotion-based counseling groups to be interactive and fun. But there may be times when some people don’t participate or act as expected. Here’s how to handle those situations:

• Expert participants: “Experts” may have great knowledge and experience—or just want the group members to think they do. In addition to establishing themselves as experts, they often seek control of the discussion. Once you notice this behavior, acknowledge their expertise but encourage others to share as well. Example: “Karen, it sounds like you know a lot about this. Now let’s hear what others feel about it. Who else would like to share?”
• Dominators: Some people just like to talk. You’ll notice this as they enter the room as they can often be spotted making small talk with everyone. If possible, ask the dominator to sit next to you. This allows you to use body language to subtly let them know when to be quiet. Slowly turn your back toward them when asking a question, making eye contact with others in the room. Kindly ask questions like: “Does anyone think differently than Julie?” “Thank you, Julie. Are there others who wish to add to Julie’s comments?” “That’s one point of view. Who would like to share a different point of view?”
• Ramblers: Some people never get to the point, if they have a point. They often want to talk on every topic, providing endless stories and examples that may not even relate. The best thing is to discontinue eye contact after about a minute and jump in and interrupt with a new question when they pause or take a breath.
• Quiet and shy: These people may have great ideas to share, but they don’t open up. Even if they speak, their voice may be soft and difficult to hear. Use eye contact to encourage their participation. Look directly at them after asking a question, pause and smile slightly, as if expecting them to respond. If they don’t respond, move your eyes elsewhere so they don’t feel uncomfortable. You can also direct questions to them in a soft way. Examples: “Jan, I would be very interested in hearing what you feel about this.” “Jan, I don’t want to miss what you have to say. Would you like to add anything?”

Tip: Here’s a quick checklist for you to consider at the end of emotion-based sessions:

• Did I help parents feel good about themselves?
• Did I suggest emotion-based benefits along with logic-based benefits?
• Did participants openly and willingly share their ideas and concerns?
• Did parents leave feeling successful?
• Did participants seem happy to be part of the group?

If the answers aren’t what you want, make a plan to improve next time.

Tip: Don’t expect emotion-based counseling to follow a cookie-cutter format. Trust participants to take the group where it wants to be. Relax, enjoying the unique twists and turns that come when groups are fully engaged in discussing and changing their lives. Don’t watch the clock. Expect group members to care about you and your feelings too, showing respect and support as you guide the group.

Tip: The goal of emotion-based counseling is to connect actions with emotions, values and beliefs. When people share their inner-most feelings, it is possible that words, experience and memories may cause them to become upset or unleash tears. Offer a tissue and a pat on the back while thanking the mother for sharing her honest feelings. Continue the discussion on a lighter note and before leaving reconnect with the mother to be sure she is emotionally okay.

Tips on encouraging behavior change

Tip: Suggestions on how to change behaviors can come across as critical or judgmental. Give at least three compliments on what the parents are already doing “right” before discussing ways to change.

Tip: Be likeable. People don’t act on advice from people they don’t like. That means that being likeable is essential to your job.

Deciding to be likeable is the first step to being likeable. Here’s a list of characteristics that make you more likeable:

• Acknowledge and compliment parents on their children
• Let people know you like and enjoy them
• Be enthusiastic, always allowing your joy for living to be visible
• Listen fully, without interpreting, rather than waiting for someone to finish so you can talk
• Show a genuine interest in participants and their lives
• Take time to build relationships rather than being task-oriented
• Accept each person with unconditional, positive regard
• Smile
• Like yourself—it’s contagious

Tip: People are more likely to take action when the decision is theirs and when they come up with action steps and timelines. It may be easier for you to offer suggestions and ideas, but it is more important that they do it themselves.

Tip: The biggest challenge to transition from traditional methods of nutrition education is to overcome the tendency to tell people what to do and how to do it. Unfortunately, the more you direct and suggest, the less people listen and act. Instead, listen to what is important to them—emotional benefits—and frame suggestions as a way to reach those needs. Your job is to make them curious about what could be, and then step back and watch them astonish themselves with what they do. Their resulting pride will inspire them to keep changing.

Tips on encouraging participants to share practical advice with others in groups

Tip: Approach parent conversations with the belief that the person you are talking to has the answers to her challenges. This belief will likely change your listening-talking balances with you doing most of the listening and the parents doing most of the talking. Actually listen to what they are saying; don’t just wait for them to finish so you can speak.

Tip: Some parents may share tips or information that is not accurate and may even cause harm. Facilitators need to correct potentially harmful advice while protecting the parent’s self-esteem. In addition, they need to preserve a comfortable climate for future sharing. They can do this by thanking the participant for sharing this information, noting that it is a common myth and one that can cause harm. After correcting the misinformation, thank them again for helping others hear about the myth so that no one acts on this.

Tips on how to be a good group facilitator

Tip: There’s a lot more to being a great parent than just choosing health-promoting behaviors and those topics are likely to come up during group discussions. If they can be resolved or discussed quickly, continue the discussion and gradually redirect it to WIC topics. Use these comments when the subject wanders too much:

• “Hang on to that thought and let’s discuss it after the session.”
• “Let’s put that topic into the “to be discussed” bin.
• “Fascinating topic but time is limited today. Let’s save that topic for a later time.”

Tip: It is important to provide closure to the group time. Don’t let it fizzle to a meaningless ending. Close the meeting with the same care used to start it. The goal is to reinforce the sense of community created. Here are simple ways:

• End the meeting with each person sharing their feelings about the topics and decisions they made.
• Say goodbye and connect with each person by shaking hands or touching them lightly on the back.
• Thank them individually as they leave for their great comments, practical tips and/or powerful insights.
• Ask them if it is OK to share their tips with other parents..
• Tell them you look forward to celebrating their successes next time and next time, follow up on this.

Tip: A group facilitator is not there to display her expertise. If a parent asks you a question, rephrase it for the group to respond. Example: “You asked about ways to get children to eat vegetables. What’s worked with your children? What suggestions do you have for Rachel?” The facilitator should respond directly to a question only when she is sure that the group members have exhausted their own knowledge and experiences.

Tip: Reframe the conversation if people argue or become confrontational. Sometimes people who can’t agree about details can agree on a concept or goal. For example: people don’t agree on when to first offer cereal to babies. Redirect the conversation to the larger goal—protecting precious babies as they develop—and try again to identify ways of doing this.

Tip: Have a plan for your sessions, but be ready to throw it out. A good plan provides the “safety net” needed when trying new approaches, but great groups often happen “in the moment.” Be tuned in at all times to what is happening and be able to “fly by the seat of your pants” as the group works to meet their objectives.

Tip: Children, motherhood, eating, feeding—what topics are more emotional? Conversations about these topics are personally important and deeply meaningful. As you exchange words about the most private and meaningful parts of life—being a great parent—consider these ethical considerations:

• Protect the mother’s heart. Inspire them to feel successful so they want to continue to the best they can be. Participants should leave in better emotional condition than when they came.
• Protect the mother’s confidence. What happens in the counseling session stays in the counseling session.
• Protect the mother’s trust. People are vulnerable. They are seeking clues as to who they can trust with the important issues of their lives. Your actions reveal your heart. Let mothers know that you know they want to be the best they can be and that they care greatly about their children.

Tip: When conversations get off track or are rambling, gather attention and focus with this statement: “Let me tell you what I am hearing; tell me if you agree.”

Tip: Don’t be afraid to ask the group for help. If you’re stuck, ask the group to suggest a new topic. If the conversation is meandering, ask them to summarize the discussion so far. If there is conflict, ask them to restate key points for each perspective. If only a few people are participating, ask non-participants to suggest topics they are interested in discussing.

Tip: Occasionally, a participant may be hostile, angry, confrontational, demanding or combative. They may demand immediate correction of a problem or refuse to participate in the group. The best way to deal with a hostile person is to dig deep within yourself and feel empathy for this person. Proceed with kindness, softly, slowly and respectfully talking with them. Don’t force them to participate. Say something supportive like: “Seems like this has been a frustrating day. I will do my best to make it better.”

Tip: Be yourself. No need to be an entertainer or stand-up comedian. But you must convey that you understand their emotional needs as well as their physical ones. That skill comes from being an authentic person who recognizes that all humans experience successes and challenges. You can feel empathy even if your challenges are not exactly the same as those your participants experience.

Tip: Some groups are physically charged, filled with dynamic and lively people who love connecting and exchanging. But some groups lack energy. Here are ways to increase liveliness in low energy groups.

• Change energy physically by asking parents to get up and take different seats.
• Role play for greater engagement. “Let’s do a little fun role playing. Imagine you are your best friend. What’s your best friend’s name? OK—If you were talking to Jen, what would you say to her about eating while pregnant? (Or getting your child to eat vegetables?) And what would she say?”
• Recognize and understand: “What’s going on here today? Seems like everyone is quiet.”
• Ask for help: “I really want to make this time together valuable for you. What could we do to make it the highlight of your day?”
• Have a creative, participatory activity in your “back pocket” to get a quiet group talking.

Tip: Tell stories. People are wired for stories. They create mental images visuals that help them remember and recall stories later. Best of all, stories impact their emotions and cause them to reflect more frequently on what they have heard.