The consultant-client relationship in nutrition counseling

A qualitative case study on client-centered nutrition counseling

Introduction

According to Rogers [1], the founder of scientific client-centered psychotherapy, and also according to the working group of Watzlawick [2], the consultant-client relationship is decisive in determining the course of counseling and its success. Rogers identified three basic therapeutic/counseling variables: unconditional positive regard, empathy and congruence. In numerous correlation studies, he was able to demonstrate that these basic variables are decisive in determining the course of therapy/counseling and its success [1]. Watzlawick, Beavin and Jackson, the founders of modern communication science, established the axiom: “The relationship comes before the content.” Therefore, the content that is communicated depends on the relationship [2].

In addition, some international studies have shown that a client-centered approach (the Rogers approach) to counseling in dietetic consultations is successful and should be taken into account [3–7 and others]. Levey and colleagues call for the importance of client-centered nutrition counseling and its implementation to be better communicated and more firmly integrated in nutrition consultant training and for evaluation instruments to be developed for continuous use in nutrition counseling [8]. For less health-literate clients in particular, nutrition is an intimate subject, and an understanding and respectful approach to the client is likely to be more successful than prescriptive health instructions [9–11].

This is why the relationship between consultant and client is at the center of the graphic model of the German Nutrition Care Process, with counseling methods and framework factors grouped around it [12].

Abstract

Study question: What influence does the consultant-client relationship have on the course and outcome of nutrition counseling from the subjective point of view of a nutrition consultant and from the perspective of the client?
Methodology: A case study based on qualitative, guideline-based interviews of a nutrition consultant and her client. The data were evaluated using the Mayring method of structuring content analysis.
Results: A good consultant-client relationship that conforms to the principles of client-centered therapy according to Rogers is the foundation on which the client builds the ability to find their own routes towards solving nutrition-related problems.

Keywords: nutrition counseling, consultant-client relationship, client-centered therapy, sense of coherence, obesity

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