Topic 4 A Health Behavior Change and Counselling Session Step-by-Step
What is actually counselling?
There is a big difference between a professional counsellor and a person who uses counselling skills. A professional counsellor is a highly trained and well-qualified health professional who is able to use a different range of counselling approaches.
Hence, counselling is:
- The process that occurs when an individual and a counsellor sed aside time in order to explore difficulties which may include the stressful or emotional feelings of the individual.
- The act of helping the individual to see things more clearly, possibly from a different point of view. This can enable the individual to focus on feelings, experiences or behavior with a goal to facilitating positive change.
- A relationship of trust. Confidentiality is paramount to successful counselling.
This Photo by Unknown Author is licensed under CC BY-NC
Counselling is NOT . . .
- giving advice;
- judgemental;
- attempting to sort out the problems of the individual;
- expecting or encouraging an individual to behave in a way in which the counsellor may have behaved when confronted with a similar problem in their life;
- getting emotionally involved with the individual;
- looking at individuals’ problems from health professional’s perspective based on health professional’s value system.
What a health behavior change and counselling session needs?
The intervention related to nutrition issues needs to follow a specific structure with the aim to:
- exchange information,
- reduce resistance,
- enhance self-efficacy
The following figure summarizes the specific stages of a health behavior change session.
Click on the boxes below to learn more
At this stage a “warm” atmosphere is created between the individual and the health professional. The general purpose of the counselling session is defined and agreement is sought on the framework of cooperation. To establish a heathy relationship with the individual, the establishment of three conditions is needed:
- Empathy: Health professional senses accurately the feelings and the personal meanings that the individual is experiencing and communicates this acceptant understanding to the individual.
- Genuineness: This refers to the health professional’s stage of mind. It means that health professional can respond to the individual as a human being and not in terms of therapist. Hence, the health professional has to be congruent, spontaneous, non-defensive, consistent and comfortable.
- Unconditional caring: This indicates to the acceptance of the individual. To achieve this health professional may use non-verbal behavioral techniques such as smile, tone of voice, facial expression etc.
This stage includes beyond the general physical, dietary and lifestyle assessment of the individual, the assessment of individual’s knowledge on nutrition- and weight-related issues as well as previous relevant experiences.
- Communication tools: open ended questions, reflections
SMART goals are:
- Specific: Well-defined, clear, and unambiguous
- Measurable: With specific criteria that measure your progress toward the accomplishment of the goal
- Achievable: Attainable and not impossible to achieve
- Realistic: Within reach, realistic, and relevant to your life purpose
- Timely: With a clearly defined timeline, including a starting date and a target date. The purpose is to create urgency.





The health professional can monitor the individual either in the form of assessment sessions or in the form of supportive sessions. Supportive sessions can be done on a monthly basis or less frequently, over time, so that the individual is gradually “cut off” by the health professional when the main part of the intervention is completed.
