192–194
righting reflex and, 21–22
cravings and, 207–211
time restrictions and, 172–174
food variety and, 203–207
Compassion. See also Spirit of motivational
weight-neutral counseling and, 245
interviewing (MI)
Diet–binge cycle, 17, 18 f
example of, 37, 38 f
Diets. See also Weight management
overview, 26 f, 34–35
alternatives to, 17–20, 18 f
reflection and, 133
as a coping tool, 6
talkative clients and, 173–174
cravings and, 207–211
weight-neutral counseling and, 249 f
desire for a “quick fix” and, 16–20, 18 f
Compassion fatigue, 35
misinformation and unhealthy beliefs and,
Complex reflections. See also Reflections
184–185
mindful eating and, 210
overview, 232–233
motivation for physical activity and,
weight-neutral counseling and, 5, 240–243
218
Digging deep questions, 97–99. See also
overview, 123–124, 129 f, 130, 133
Open-ended questions
weight-neutral counseling and, 241, 248
Disarming questions, 103. See also Open-
Compulsive eating, 208–209
ended questions; Questions
Concern, offering, 78–79
Discord, 148–149, 149–160, 150 f, 157 f
Confidence levels, 86–88, 237. See also
Disordered eating, 232–233, 251–255, 254 f
Overconfidence
Double-sided reflections, 126–127, 129 f,
Contemplation stage of change, 10, 12–13.
131, 163. See also Reflections
See also Stages of change
Continuing the paragraph reflections. See
e
also Reflections
Eating disorders. See Disordered eating
misinformation and unhealthy beliefs and,
Eating for well-being, 234 f, 244–248, 246 f
184
Educating patients. See Information exchange
overview, 125–126, 129 f, 131, 132, 133
Elicit–provide–elicit (E-P-E) model. See also
weight-neutral counseling and, 238
Information exchange
Control, 22, 24
addressing barriers to physical activity,
Controlled motivation, 212–213, 220–222,
229
222 f. See also Motivation
expanding food variety and, 204
Core beliefs, 183–187. See also Unhealthy
information overload trap and, 157–159
beliefs
misinformation and unhealthy beliefs and,
Counseling, 251–255, 254 f. See also Fitness
177–183, 181 f, 183 f, 186–187
counseling; Nutrition counseling
motivation for physical activity and, 219,
Cravings, 207–211
221
Crying, 71
overview, 75–77, 75 f
272 Index
Elicit–provide–elicit (E-P-E) model
misinformation and unhealthy beliefs and,
( continued)
183–187
time restrictions and, 163–164
reflection and, 120–121
weight-neutral counseling and, 239,
summaries and, 136
241–243, 247
Fitness counseling
Emotional response, 71
addressing barriers to physical activity,
Empathy
223, 225–231, 225 f
compared to compassion, 34
motivation for physical activity, 212–222,
example of, 37, 38 f
215 f, 217 f, 222 f
overview, 22–24, 26 f, 30–32
overview, 4, 212
reflection and, 120, 121, 126–128, 130
referrals to other professionals and,
weight-neutral counseling and, 238,
251–255, 254 f
249 f
resources, 257–258
Empowerment, 33–34, 110
self-efficacy and, 222–223, 224 f
Encouragement, 34, 156, 157 f
weight-neutral counseling and, 5–6
Ending a session, 140
FOCUS acronym, 167–168
Engaging the client
Focus on a topic
open-ended questions and, 97
overview, 4, 41–48, 43 f, 47 f, 52–54, 53 f
overview, 4, 41–49, 43 f, 47 f
refocusing, 56–57
reengaging, 51–52
shortening the MI process and, 165,
shortening the MI process and, 165, 166,
166–167, 168, 169 f
169 f
time restrictions and, 164, 173
Enjoyment, 226–227
Food
Evaluation, 4, 46–47, 47 f
addressing the need for dietary changes,
Evocation. See also Spirit of motivational
192–194
interviewing (MI)
as a coping tool, 6
change talk and, 65–68
cravings and, 207–211
example of, 37, 38 f
expanding variety in, 203–207
expanding food variety and, 205
meal planning and preparation, 194–203,
meal planning and preparation, 197–198
199 f–200 f, 201 f
misinformation and unhealthy beliefs and,
Food and Feelings Journal, 80, 81 f–82 f
184
Forward-moving reflection, 130–133. See
motivation for physical activity and, 218
also Reflections
overview, 4, 26 f, 35–37, 41–48, 43 f, 47 f,
Fruits. See Dietary change; Food
58
Future-oriented questions, 102. See also
shortening the MI process and, 165, 167,
Open-ended questions
169 f
time restrictions and, 164
g
weight-neutral counseling and, 247,
Giving advice. See Advice giving
249 f
Giving information. See Information
Exercise. See Fitness counseling; Physical
exchange
activity
Goals
Exercise as a punishment trap, 227, 230–231
addressing barriers to physical activity,
Exercise Feelings Journal, 214, 215 f, 216,
227
217 f
goal setting, 79–86, 81 f–82 f
Expectations, 16–20, 18 f, 24
listening for ambivalence and, 15
Experiments, 84–86, 211
open-ended questions and, 101
Expert trap, 27–28, 29 f–30 f, 153–155
shortening the MI process and, 170
Explore–offer–explore (E-O-E) model. See
Guidance role of practitioner, 20–24, 27–28,
Elicit–provide–elicit (E-P-E) model
29 f–30 f, 56, 176
External motivation and rewards, 220–222,
Guilt trap, 227, 230
222 f
h
F
Habituation, 207–209. See also Cravings
Facial expression, 31–32, 48, 136
Happiness, 34–35
False-hope syndrome, 16–17
Health at Every Size (HAES) approach,
Feelings
234–249, 234 f, 246 f, 249 f. See also
engaging the client and, 49
Weight-neutral counseling
evocation and, 35–37
Health conditions, 227
Index 273
> Health enhancement, 234 f, 239–243
Listening, 15, 33–34, 50–51, 51 f. See also
Hypothetical questions, 99, 211. See also
Reflective listening
Open-ended questions
“Looking back” questions, 102–103. See also
I
Open-ended questions
“Looking forward” questions, 102. See also
“If any” questions, 99. See also Open-ended
Open-ended questions
questions
Imperatives, 27–28, 32–33, 78
M
Information exchange. See also Elicit–
Maintenance stage of change, 11. See also
provide–elicit (E-P-E) model;
Stages of change
Misinformation
Meal preparation and planning, 194–203,
expanding food variety and, 205, 206
199 f–200 f, 201 f
expert trap and, 155
Mental health professionals, 252–255, 254 f
information overload trap and, 157–159
Metaphor reflections, 124, 129 f, 132
meal planning and preparation, 196–198
Microskills of MI, 5, 91. See also
mindful eating and, 210
Affirmations; Communication
misinformation and unhealthy beliefs and,
techniques; Open-ended questions;
177–183, 181 f, 183 f
Reflections; Summaries
motivation for physical activity and, 219,
Mindful eating, 209–211, 244–245
221
Misconceptions, 30
overview, 73–79, 75 f
Misinformation. See also Information
referrals to other professionals and, 254 f
exchange; Unhealthy beliefs
shortening the MI process and, 168, 169,
elicit–provide–elicit (E-P-E) model and,
170
177–183, 181 f, 183 f
temporary changes as an experiment and,
exploring, 183–187
85
overview, 175–176
time restrictions and, 163
righting reflex and, 177–178
weight-neutral counseling and, 239, 242,
Mixed messages, 61–63
247
Mobilizing change talk, 59–61, 59 f, 60 f. See
Information overload trap, 157–159
also Change talk
Interest, 95, 137
Monitoring, 4, 46–47, 47 f
Internal misinformation, 183–184. See also
Motivation, 18–20, 212–222, 215 f, 217 f,
Misinformation
222 f
Interrupting clients, 173–174
Motivational interviewing (MI) in general,
Intervention, 4, 46–47, 47 f
2–6, 256–257
Introductions, 48
Motivational interviewing (MI) processes.
J
See also Engaging the client; Evocation;
“Jumping the gun,” 71–72
Focus on a topic; Planning process of
Jump-to-planning trap, 159
making change; Spirit of motivational
interviewing (MI)
k
overview, 4, 41–48, 43 f, 47 f
Kindness, 173–174
resources, 256–257
l
shortening the MI process and, 165–172,
169 f
Language choice, 180–182, 181 f
Leading questions, 94–95. See also Questions
n
Life-enhancing movements, 234 f, 248–249
Narrowing the focus, 168, 171. See also
Lifestyle changes. See also Change
Focus on a topic
challenges with, 9–10
Needs for change. See also Change
cravings and, 207–211
change talk and, 59–61, 59 f, 60 f
dietary changes and, 192–194
meal planning and preparation, 196
food variety and, 203–207
weight-neutral counseling and, 238, 247
meal planning and preparation, 194–203,
Neural plasticity, 12–13
199 f–200 f, 201 f
Non-diet approach. See also Weight-neutral
motivation for physical activity and,
counseling
212–222, 215 f, 217 f, 222 f
eating for well-being and, 244–248, 246 f
physical activity and, 225–231, 225 f
Health at Every Size (HAES) approach
weight-neutral counseling and, 233–235,
and, 234–249
234 f, 235 f
overview, 5–6
274 Index
Non-diet approach ( continued)
P
physical activity and, 248–249
Partnership. See also Spirit of motivational
weight-neutral counseling and, 239,
interviewing (MI)
240–243
collaboration, 96, 148
Nonverbal communication, 48, 61–63, 136,
example of, 37, 38 f
147–149. See also Body language
overview, 26 f, 27–28, 29 f–30 f
Nutrition Care Process (NCP), 4, 96
weight-neutral counseling and, 249 f
Nutrition counseling. See also Weight-neutral
Past-oriented questions, 102–103, 214. See
counseling
also Open-ended questions
cravings and, 207–211
Permission, asking. See Asking permission
dietary changes, 192–194
Persistence, 111
food variety and, 203–207
Physical activity. See also Fitness counseling
meal planning and preparation, 194–203,
barriers to, 223, 225–231, 225 f
199 f–200 f, 201 f
motivation for, 212–222, 215 f, 217 f,
overview, 4, 191
222 f
referrals to other professionals and,
self-efficacy and, 222–223, 224 f
251–255, 254 f
weight-neutral counseling and, 248–
resources, 257
249
weight-neutral counseling and, 5–6
Picky eating, 203–207
o
Planning meals. See Meal preparation and
OARS acronym, 91, 140–144. See also
planning
Affirmations; Open-ended questions;
Planning process of making change. See
Reflections; Summaries
also Motivational interviewing (MI)
Open-ended questions.
processes
See also
Communication techniques; Questions
client-centered goal setting, 79–86,
addressing barriers to physical activity,
81 f–82 f
223, 225, 226, 228–229, 230
information exchange, 73–79, 75 f
jump-to-planning trap and, 159
affirmations and, 112, 114, 118
overview, 4, 41–48, 43
compared to closed-ended questions, 92,
f, 47 f, 73
preparing for, 68–72
93 f
shortening the MI process and, 165,
cravings and, 208–209
167–168, 169 f
engaging the client and, 49
Positive reinforcement, 113
evocation and, 58, 65, 66–67, 68
Praise, 112–113. See also Cheerleading trap
examples of, 140–144
Preappointment questionnaire, 96–97
expanding food variety and, 205, 206–207
Precontemplation stage of change, 10. See
forming, 92–93, 93 f, 94 f
also Stages of change
&n
bsp; meal planning and preparation, 195–197,
Preparation stage of change, 11, 12–13,
202–203
68–72. See also Stages of change
mindful eating and, 209–211
Preparatory change talk, 59–61, 59 f, 60 f. See
minimizing sustain talk and discord and,
also Change talk
153
Preparing meals. See Meal preparation and
misinformation and unhealthy beliefs and,
planning
184–186
Presence, 51 f
motivation for physical activity and, 214,
Probing questions, 203, 229, 237
216, 218–219
offering concern and, 78–79
Q
overusing, 95–97
Querying extremes, 103. See also Open-
overview, 5, 91
ended questions
readiness for change and, 70
Question–answer trap, 149–153
summaries and, 134
Questions, 42, 91. See also Close-ended
temporary changes as an experiment and,
questions; Open-ended questions;
86
Scaling questions
time restrictions and, 164
Quick fixes, 16–20, 18 f
types of, 97–107, 105 f
weight-neutral counseling and, 236–237,
r
238, 239, 241, 247–248
Rapport, 97, 134, 147–149, 160
Overconfidence, 71–72. See also Confidence
Readiness for change, 68–70, 71–72,
levels
161–162, 164
Index 275
Reasons to change. See also Change
Refocusing, 56–57, 173. See also Focus on
change talk and, 59–61, 59 f, 60 f
a topic
open-ended questions and, 101–102
Reframing reflections, 109, 124–125, 129 f.
time restrictions and, 164
See also Reflections
weight-neutral counseling and, 247
Resistance to change, 147–149
Recipes, 199 f–200 f, 201
Resources, 256–259
Reengaging, 51–52. See also Engaging the
Respect, 22, 33–34, 95
client
Respectful care, 234 f, 243–244
Referrals to other professionals, 237,
Righting reflex, 21–22, 177–178
251–255, 254 f
Reflections. See also Communication
s
techniques; Reflective listening
Scaling questions. See also Open-ended
addressing barriers to physical activity,
questions
226, 228–229
addressing barriers to physical activity,
affirmations and, 109, 111, 114, 118
229
assessment and, 69, 97
assessing readiness for change and, 68–70
benefits of, 120–121
GAB acronym and, 87–88
change talk and, 65–68
meal planning and preparation, 198,
cheerleading trap and, 156
201
cravings and, 208–209
overview, 103–104
examples of, 140–144
shortening the MI process and, 167, 170
Motivational Interviewing in Nutrition and Fitness Page 37
