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Imagine yourself in the role of a nutrition counselor, and Josephine is your client. Josephine is a 20-year-old female who presents with a purging disorder, an “Other Specified Feeding or Eating Disorder” (OSFED). She currently teaches salsa lessons at the community college and is in her last semester of college. She reports she is living at home, and the food her mother prepares is not the healthiest because her mom is from Honduras and her father is from Guatemala, so the food is prepared differently. She indicates she has been thin all her life, although she has struggled to maintain her weight since going through puberty, and since she is a salsa instructor, she has to remain fit. She reports that she feels very guilty if she consumes fried foods during the day, but that is the way her mom primarily cooks. She feels awful telling her mom to stop cooking that way. She reports that if she consumes too much fried food or junk food, she will run at least 2-3 miles or else force herself to vomit, but all the food does not come out. She reports sometimes if she has a later class, she will not eat dinner or only eat one meal per day. She has tried counting calories, but then she gets so mad at herself for consuming more than 1,200 calories that it causes her to exercise more, which then leads her to feeling exhausted. She indicates she is on no medication but does take a multivitamin when she remembers to. She indicates she has gone from 110 pounds to 125 pounds over five years and wants to be back down to 110 or even less. She also had gone to the doctor, and he was quite concerned with her lab values. She has provided you a 24-hour meal record:
One 6” corn tortilla
1/2 cup fried beans cooked with peppers, onions, and oil
1/2 cup rice
One cup no-sugar-added orange juice
One slice of whole-wheat bread
Two slices turkey
One small apple
Two 6” tortillas
Beef with onions and peppers cooked in oil
Tomato, onion, pepper salad (made with oil and lime juice)
Two cups of rice
Weight: 117 pounds (based on your scale in the office)
*See attached labs*
You are addressing a group of nutritional counseling interns in a training session. Josephine has given you written permission for this because as a student herself, she appreciates the value of education and training, as long as she can remain anonymous.
The students have completed the coursework for their degree in nutrition, so they have read about the Stages of Change model and about counseling and cognitive-behavioral techniques. They also are familiar with what constitutes normal versus excessive exercise.
Your goal is not to teach those concepts to them, but rather to help them understand how to apply them in a practical situation.
You will discuss the following concepts with them:
1. The stage of change this client is in, and how you determined that. (Include at least three supporting reasons for your conclusion.)
2. How her stage of change could affect her willingness to learn.
3. How you would establish rapport with her, and why you would do it in that way.
4. Three counseling skills that would be appropriate for this client, and why (include at least two reasons for choosing each skill).
5. Two cognitive-behavioral techniques that could help in her situation, and why you chose them.
6. How you would educate this client on normal versus excessive exercise.
Next you will demonstrate how you would use active listening with this client to help her get past her feeling of helplessness about how her mother cooks so she will be ready to brainstorm possible solutions to her dilemma with you.
This will be a PowerPoint presentation with a voice-over (Leave notes and I will conduct voice overs). When you create a PowerPoint slide, be sure to follow the 6X6 rule described in your textbook. (No more than six lines; no more than six words per line). Use a word or very short phrase for each point. You will explain and discuss in the voice-over (Leave notes and I will conduct voice overs).
You will use 12 slides, as follows: (Follow along on your template)
1. Title slide, with the title of your presentation and your name, course name, and section.
Introductory slide, where you give a brief overview of her case. 2. This must include only 4-6 features of her case. Do not describe them on the slide; use only a word or short phrase for each. You will discuss them in the voice-over (Leave notes and I will conduct voice overs).
3. Name the stage of change you believe Josephine is in, then bullet point at least three reasons you have categorized her in that way and discuss them in the voice-over (Leave notes and I will conduct voice overs).
4. Bullet point at least three ways you would establish rapport with her, and discuss them on the voice-over (Leave notes and I will conduct voice overs) as well as why you chose them for her.
5. Name a counseling skill, then bullet point at least two reasons you chose it, then discuss the reasons on the voice-over (Leave notes and I will conduct voice overs).
6. Name a second counseling skill and do the same.
7. Name a third counseling skill and do the same.
8. Name a cognitive-behavioral technique you would use for her, then bullet point (and discuss on the voice-over) at least two reasons it could help.
9. Name a second cognitive-behavioral technique and do the same.
10. Bullet point at least two concepts you would cover with Josephine to help her understand how normal exercise differs from excessive exercise, and explain how you might discuss them with her on the voice-over (Leave notes and I will conduct voice overs).
11. Active listening: This slide will be a demonstration to the interns of how three or four rounds of active listening might go with Josephine. You may play both Josephine and the counselor if you wish, or you may publish a friend or family member to play Josephine. Don’t forget to change Josephine’s name to protect her anonymity. And if you play both parts, be sure to identify who is speaking each time it changes. (Or you can have some fun and use a different voice for her.)
a. Create a scriipt to use, in which she starts out by saying, “I just don’t know what I can do. My mom is making me fat, and I have to eat what she cooks.”
b. Then write what you as the counselor would say to reflect her feeling back to her and show that you understand. (Please be sure you have read the section on active listening in the textbook.)
c. Follow that with what you imagine her response would be to what you said.
d. Respond back to her, once again using active listening.
e. Continue until she has resolved enough of her emotion to start brainstorming possible solutions with you.
TIP: Do not placate her or dismiss her emotion. Don’t offer any advice until she has resolved enough of her emotion to be ready to brainstorm with you.
References: Your textbook will be one, but you will also need to use at least one other. The textbook is entered in proper APA style for you already, but you will need to add page numbers. Your second reference will also need to be in APA style. APA style should be followed for all references and citations.