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All the requirement, details and rubric will be included in the instruction file. please read it carefully. this assignment requires using the ADIME format and PES statements. Also the final report for the scenario requirement will included in the instruction file as well.

NUTR 3407: Introduction to Client Care
Fall 2020
Faculty: Dr. Phillip Joy
⽂本1, 2020
Mock Counselling Assignment: Due Date: Dec
Purpose of Assignment
The aim of this assignment is:
To gain experience conducting a client interview and nutrition assessment using knowledge
and skills acquired in NUTR 3407.
To reflect on and give feedback about the process of conducting a client interview and
nutritional assessment.
To gain experience documenting a client interview/nutrition assessment using the ADIME
format and practice using Standardized Nutrition Language through use of PES statements.
Formatting Requirements:
APA referencing style
Size 12 font, Times New Roman, Double-spaced
Cover page – including names, student ID numbers, date and course name
1. You will be assigned a partner with whom you conduct a client interview and nutrition
assessment. Each client interview should take approx. 60 minutes. Each team will do the
activity twice, with team members playing the client in one scenario and the counsellor in the
other scenario.
Note: Although the activity is done in pairs, each student must submit an individual
2. If you do not feel comfortable playing the role of client with your own experiences, you can
role-play if needed.
3. While one partner is assuming the role of the clinician they must complete and submit the
Client Assessment Forms (Appendix 1). The other partner being interviewed is
responsible for completing and submitting the Calgary-Cambridge Guide (Appendix 2)
which evaluates the communication that was directed by the ‘clinician’. Each student needs
to submit both Appendix 1 and 2 to the faculty member for evaluation.
Nutrition Assessment Assignment Check List
1. See textbook and lecture notes (Chapters 3, 4, 5) for further explanation of interviews
phases, theories, and steps.
2. Preparation:
o Review the following procedures and guidelines
§ Figure 4.2 (in text – page 76): The motivational nutrition counselling
algorithm to be familiar with all phases of the interview.
§ Exhibit 14.1 (found in Appendix 1 of assignment documents): Protocol for
obtaining consent in preparation for session 1
3. Give copies of Forms 5.1 (Client Assessment Questionnaire) and 5.2 (Food record-decide if
you would like the client to complete 1-7 days and give appropriate # of sheets) and 8.2
(Physical Activity Log) to your client at least 1 week before the nutrition assessment.
4. Bring the following forms:
• 5.1, 5.2, and 8.2 (in case the client forgets to bring it with them)
• 5.3 24-hour recall, usual diet
• 5.4 Food frequency questionnaire
• 5.6 Client’s concerns and strengths
• 14.2 Nutrition counselling agreement (2 copies)
• Calgary-Cambridge Observation Guide
Other Things to Think About thee Interview
• Bring Appendix B (BMI chart)
• Bring a calculator
• Minimize distractions
• Bring visuals to estimate portion size
• Anything else you think will help you during your session
Steps in the Interview Process
Involving Phase:
• Greeting
• Thank client
• Set agenda
• Sign consent form (Exhibit 14.1). Provide your client with a copy and keep a copy for your
Transition to Exploration Phase:
• Transition Statement
Exploration-Education Phase:
• Ask your client to describe themselves (age, cultural groups, occupation, interests)
• Ask your client whether he/she has any nutritional concerns
• Review the completed Client Assessment Questionnaire
• Ask client about their experience completing the Client Assessment Questionnaire
• After reviewing the Client Assessment Questionnaire ask for clarification where
• Appropriate
• Review the provided Food Record(s)
• Ask client about their experience completing the Food Record(s)
• After reviewing the Food Record(s) ask for clarification where appropriate
Reviewed the Physical Activity Log
Ask client about their experience completing the Physical Activity Log
After reviewing the Physical Activity Log ask for clarification where appropriate
Thank client for completing the required forms and summarize
Complete the 24-hour recall and Usual Diet Form and/or Food Frequency
Assess your client’s readiness to change using 1 or more of the suggested techniques (see
pages 79-82) 1) Stages of change algorithm, 2) Readiness to change open ended questions, 3)
Readiness to change graphic, 4) Readiness to change scale question.
Summarize and provide feedback in a non-judgmental way
Resolving Phase:
• Determine level of readiness to change
Briefly practice using 1-2 strategies tailored to the level of readiness to change:
Level 1: Not motivated:
o Raise awareness of health problem and diet options
o Personalize benefits
o Explore importance of change and promote change talk
o Help identify importance and motivators
o Summarize
o If the opportunity arises offer advice
o Express Support
Level 2: Unsure, low confidence
o Raise awareness of health problem and diet options
o Explore confidence and promote change talk
o Elicit identification of barriers
o Explore ambivalence
o Pros and cons
o Imagine the future: “create a picture of the future”
o Explore past successes
o Summarize ambivalence
o Ask about next step….maybe a goal can be set?
Level 3: Motivated, confident and ready
o Praise positive behaviors. o Explore change options.
o Look to the past.
o Review options that have worked for others. o Client selects an appropriate goal.
o Develop action plan.
5. *** During your counselling session you can provide nutrition education and advice that is
general in nature. ‘Person specific’ nutrition education and guidance should not be offered at
this time in your training. You can further comment (hypothetically) on what advice could
be provided in your report ***
Closing Phase:
o Summarize and review
o Plan for next session (hypothetical)
Final report should include the following:
Section 1: Introduction: Name of person interviewed, location, time, and date of meeting. Describe
the person you have interviewed (age, cultural groups, gender, occupation). Remember that this
could be a role-played character.
Section 2: Reflection as the Counsellor: Reflect on your experience conducting each phase of the
nutrition assessment process. Concisely summarize what occurred during each phase between
yourself and your client and reflect on/discuss what was learned during each phase (Ex: What, if
anything, would you do differently in the future? What were some challenges you faced in your role
as counsellor? What went well? Etc.) and the specific questions noted below.
Include the following headings in your reflection:
• Preparation Reflection
• Opening/Involving Phase Reflection
• Exploration-education Phase Reflection
• Resolving Phase Reflection
• Closing Phase Reflection
Section 3: Chart Note: Document your client interview/nutrition assessment using the A.D.I.M.E
format and include a PES statement.
Section 4: Reflection as the Client: Reflect on your experience as the client. How did the counsellor
make you feel? Did the encourage communication or create communication roadblocks? How?
Discuss how being a client may help you be a more effective counsellor.
Section 5: Conclusion: Provide a brief summary to the assignment.
Section 6: Appendix – In your appendix section include/attach the following completed forms:
5.1 Client assessment questionnaire
5.2 Food record
5.3 24-hour recall, usual diet *
5.4 Food frequency questionnaire *
5.6 Clients concerns and strengths
8.2 Physical activity log
14.2 Nutrition counselling agreement
Calgary-Cambridge Guide: completed by you (as experienced while in the client role)
on the performance of your partner (in the counsellor role). Provide as much detail
as you can.
Rubric – Worth 35% of final mark.
Introduction (3 points)
The introduction identifies the topic
and indicates the purpose of the
research paper. The introduction
provides the reader with sufficient
background information on the
topic and presents clearly how the
information is connected to the
thesis statement.
The conclusion captures the focus
of the assignment and summarizes
the writer’s main points. The
conclusion provides a
recommendation and includes an
ending comment that inspires the
reader to continue thinking about
your topic.
(Sections 1, 5).
Reflection (20 points)
Summary of phases and reflections.
Demonstrates strong evidence of
critical thinking in applying,
analyzing, evaluating key
knowledge of each phase of the
interview and key course concepts
and theories from readings, lectures,
media, discussions activities, and/or
assignments. Provides examples
that illustrate this knowledge.
Conveys strong reflections on own
work with a personal critique of
their abilities as a counsellor/client.
(Sections 2,4).
Documentation of Client Interview/Nutrition Assessment (10 points)
Documentation is completed,
including ADIME formatted chart
note in correct format, include PES
statement in correct format (Section
3,6). Neat and organized, easy to
Professionalism, Organization, Spelling, Punctuation, Grammar (2 points):
Well written and clearly organized
using standard English,
characterized by elements of a
strong writing style and basically
free from grammar, punctuation,
usage, and spelling errors.
Calgary-Cambridge Observation Guide – Communication Process
Observer/Client: ____________________
Counsellor: ________________________
Comment if the counsellor included each of the learning sections in their interview. Reflect and critique
their use integration of each point in the interview.
Establishing initial rapport:
1. Greets patient and obtains patient’s
2. Introduces self, role and nature of
interview; obtains consent if necessary
3. Demonstrates respect and interest,
attends to patient’s physical comfort
Identifying the reason(s) for the consultation:
4. Identifies the client’s problems or the
issues that the client wishes to address
with appropriate opening question (e.g.
“What would you like to discuss today?”)
5. Listens attentively to the patient’s
opening statement, without interrupting
or directing patient’s response
6. Confirms list and screens for further
7. Negotiates agenda taking both client’s
and counsellor’s needs into account
Exploration of client’s issues/problems:
8. Encourages client to tell the story of the
issue/problem (e.g. when it first started
to present, in own words)
9. Uses open ended and closed questioning
technique, appropriately moving from
open to closed
10. Listens attentively, allowing client to
complete statement without interruption
and leaving space for client to think
before answering or go on after pausing
11. Facilitates client’s responses verbally and
non-verbally (e.g. use of encouragement,
silence, repetition, paraphrasing,
12. Picks up verbal and on-verbal cues (body
language, speech, facial expression,
13. Clarifies client’s statements that are
unclear or need clarification
14. Periodically summarizes to verify own
understanding of what the client has
said; invites client to correct
interpretation or provide further
15. Uses concise, easily understood
questions and comments, avoids or
adequately explains jargon
16. Establishes dates and sequence of
Additional skills for understanding the client’s
17. Actively determines and appropriately
explores: Patient’s ideas, concerns,
18. Encourages patient to express feelings
Making organization overt
19. Summarizes at the end of a specific line
of inquiry to confirm understanding
before moving on to next section
20. Progresses from one section to another
using transitional statements; including
rationale for next section
Attending to flow
21. Structures interview in logical sequence
22. Attends to timing and keeping interview
on task
Using appropriate non-verbal behavior
23. Demonstrates appropriate non-verbal
behavior (eye contact, facial expression,
posture, position, vocal cues i.e. rate,
volume, tone)
24. If reads, writes notes or uses computer,
does in a manner that does not interfere
with dialogue or rapport
25. Demonstrates appropriate confidence
Developing rapport
26. Accepts legitimacy of client’s views and
feelings; is not judgmental
27. Uses empathy to communicate
understanding and appreciation of the
client’s feelings or predicament; overtly
acknowledges client’s views and feelings
28. Provides support: expresses concern,
understanding, willingness to help;
acknowledges coping efforts and
appropriate self-care; offers partnership
29. Deals sensitively with
embarrassing/disturbing topics
Involving the client:
30. Shares thinking with client to encourage
client’s involvement (e.g. “What I’m
thinking now is…”)
31. Explains rationale for questions or parts
of examination (e.g. anthropometric
measurements etc.)
32. During physical exam, explains process,
asks permission
Providing the correct amount and type of
33. Chunks and checks: gives information in
manageable chunks, checks for
understanding, uses client’s response as
a guide to how to proceed
34. Assesses client’s starting point: asks for
client’s prior knowledge early on when
giving information, discovers extent of
patient’s wish for information
35. Asks patients what other information
would be helpful
36. Gives explanation at appropriate times:
avoids giving advice, information or
reassurance prematurely
Aiding accurate recall and understanding:
37. Organizes explanation: divides into
discrete sections, develops a logical
38. Uses explicit categorization or
signposting (e.g. “There are three
important things I would like to discuss.
1st…”, “Now shall we move on to…”)
39. Uses repetition and summarizing to
reinforce information
40. Uses concise, easily understood
language, avoids or explains jargon
41. Uses visual methods of conveying
information (e.g. diagrams, food models,
written information and instructions)
42. Checks client’s understanding of
information given/plans made/goals set
(e.g. ask client to re-state in own words;
clarifies as necessary)
Achieving a shared understanding: incorporating
the patient’s perspective:
43. Relates explanations to client’s illness
framework: to previously elicited ideas,
concerns and expectations
44. Provides opportunities and encourages
client to contribute: to ask questions,
seek clarification or express doubts;
responds appropriately
45. Picks up verbal and non-verbal cues e.g.
client’s need to contribute information or
ask questions, information overload,
46. Elicits client’s beliefs, reactions and
feelings e.g. information given, terms
used; acknowledges and addresses
where necessary
Planning: shared decision making and goal
47. Shares own thinking as appropriate:
ideas, thought processes, dilemmas
48. Involves client by making suggestions
rather than directives
49. Encourages client to contribute their
thoughts: ideas, suggestions and
50. Negotiates a mutually acceptable plan
51. Offers choices: encourages client to
make choices and decisions to the level
that they wish
52. Checks with client if accepts plans, if
concerns have been addressed
Forward planning:
53. Contracts with client re: next steps for
client and counsellor
54. Safety nets, explaining possible
unexpected outcomes, what to do if plan
is not working, when and how to seek
Ensuring appropriate points of closure:
55. Summarizes session briefly and clarifies
care plan
56. Final check that client agrees and is
comfortable with plan and asks if any
corrections, questions or other items to
Negotiating mutual plan of action:
57. Discusses options
58. Provides information/resources
59. Obtains client’s view of need for action,
perceived benefits, barriers, motivation
60. Accepts client’s views, advocates
alternative viewpoint as necessary
61. Elicits client’s reactions and concerns
about plans and treatment including
62. Takes client’s lifestyle, beliefs, cultural
background and abilities into
63. Encourages client to be involved in
implementing plans, to take
responsibility and be self-reliant
64. Asks about client support systems,
discusses other support available
Adapted from: Calgary-Cambridge Observation Guide
Kurtz SM, Silverman JD, Draper J (1998) Teaching and Learning Communication Skills in Medicine. Radcliffe Medical
Press (Oxford)
Silverman JD, Kurtz, SM, Draper J (1998) Skills for Communicating with Patients. Radcliffe Medical Press (Oxford)

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