Value Value Enhanced Enhanced Nutrition Nutrition Assessment Assessment (VENA)(VENA)Counseling Counseling Sessions: Sessions:

Providing Client-Centered Nutrition Services

This module, Value Enhanced Nutrition Assessment Counseling Sessions, is part of the WIC SPIRIT Readiness training series.

The series is designed to be an overview of major changes in the Arkansas WIC Program and to prepare WIC staff for further training in regards to SPIRIT, the new Management Information System.

The series includes VENA, the Value Enhanced Nutrition Assessment initiative; the WIC food packages; and nutrition risk factors.

VENA Counseling Sessions Objectives

By the end of this module the

learner will be able to:

1. State the guiding principles of VENA.

2. List the seven elements of a VENA counseling session.

ObjectivesObjectives (continued) (continued)

3. Describe activities that are involved in each element of a VENA counseling session.

4. Demonstrate application of the elements of a VENA

counseling session.

Guiding Principles of VENAGuiding Principles of VENA

1. VENA is a joint exploration of health goals by WIC staff and client.

2. VENA allows the WIC family to express their concerns.

Guiding Principles of VENAGuiding Principles of VENA

3. VENA supports and promotes a personalized care plan.

4. VENA provides a positive approach based on desired health outcomes.

Elements of a VENA Elements of a VENA Counseling Session:Counseling Session:• Welcome and introduction

• Establish rapport with client

• Gather and assess information

• Identify and explore client’s needs & concerns

Elements of a VENA Elements of a VENA Counseling Session: Counseling Session: (continued)(continued)

• Provide information

• Discuss and set behavior change goal(s)

• Close session

Welcome Welcome and Introduction IntroductionGreet the client

-Smile-Greet client by name-Introduce yourself & your role-Explain purpose of visit-Acknowledge wait time if appropriate-State the (approximate) appointment length-Ask a general open-ended question(s)

-Examples: “How’s your pregnancy going?” What questions or concerns do you have today?

Establish RapportEstablish RapportEnsure privacy

-Keep voice low-Close door-Move to private location

Demonstrate caring-Be patient-Use nonjudgmental language-Display respect & understanding for other

cultures-Offer help-Show concern for the client’s feelings

Establish Rapport (continued)

Promote positive communication-Handle distractions politely-Use appropriate non-verbal communication

-Examples: spatial proximity; body posture

-Use body language that encourages client to talk-Examples: nodding ; pleasant facial expressions

Establish Rapport (continued)

Promote positive communication (continued)

-Maintain eye contact-Focus on the client when using translators-Use active listening skills

-Examples:(demonstrates support/indicates sympathy): “I see”, “uh, huh”, “sure”, “tell me more”, “I understand”

Gather and Assess Information

Seek relevant information without dwelling on irrelevant issues (using VENA questions in SPIRIT)-Review client’s past history-Collect missing information

Gather and Assess Gather and Assess InformationInformation

Use probing questions to clarify response-Ask for clarification: In what

ways? How much? When?-Ask for a specific example-Ask : What else?

Gather and Assess Information

Share findings with client in a nonjudgmental manner

Extend gratitude for honesty and willingness to answer questions

Identify and Explore Client’s Identify and Explore Client’s Needs/ConcernsNeeds/Concerns

Involve client in determining the main health concern

Use open-ended questions to explore client’s

-current concerns-current questions-current knowledge-stages of change

Use active listening skills

Identify and Explore Client’s Needs/Concerns

Help client to explore feelings and attitudes about main health concern

Validate client concerns-Example: “I appreciate your willingness

to talk about this difficult issue.

Identify and Explore Client’s Identify and Explore Client’s Needs/ConcernsNeeds/Concerns

Identify and acknowledge client’s positive behaviors (strengths)

Maintain focus on desired health outcome

Assess client’s readiness to change

Provide InformationProvide Information

Ask permission

Limit number of nutrition messages given during one session-Tailor nutrition message-Keep message simple and concise

Provide Information

Speak directly to client in friendly manner

Speak according to client’s education, culture, interest, language, learning ability and stage of change

Provide Information

Provide nonjudgmental responses

Cover topic’s main points

Use visual aids that fit client’s education, culture and interest

Provide Information

Correct misinformation gracefully

Assess client’s understanding of nutrition message

Encourage questions

Discuss and Set Behavior Change Goals

Summarize the conversation

Ask client what issue he/she is willing to work on

Discuss and Set Behavior Discuss and Set Behavior Change GoalsChange GoalsAssist client in setting goal(s) that is

specific and realistic for family lifestyle

-Remember: client is the best judge of what will work

Document goal(s) in SPIRIT with client’s stage of change. Click here to access the Change Process module to refresh your knowledge and skills.Important Note: To return to the PowerPoint module, click on the back arrow at the upper left hand side of the screen.

Close Session

Close on a positive note

Summarize what was discussed

Restate goal(s) and check for understanding-Review any agreements, plans, referrals

Close Session

Offer client chance to ask any final questions

Express appreciation for client’s time

Exhibit enthusiasm for follow-up.

Throughout the Session

EEncouragementncouragement-Identify and praise the client on his/her personal strengths-Provide a positive outlook and encouragement

CollaborationCollaboration-View client as the expert on his or her problems

Throughout the Session

Critical ThinkingCritical Thinking-Use your professional judgment-Use relevant information

Active ListeningActive Listening-Validate-Allow for silence-Don’t interrupt

View video “Making a Difference with Nutrition Education” found in your Local Health Unit

Click here to access and print the Video Outline. Important Note: To return to the PowerPoint module, click on the back arrow at the upper left hand side of the screen.

Use the Video Outline document to follow along while viewing the video.

Making a Difference WithNutrition Education Video Summary

Setting the Stage - Client must be relaxed enough to

hear what you are saying, think about it, and be able to respond.

Listening - It’s important to really listen to people.

Making a Difference WithNutrition EducationVideo Summary Address Nutrition Concerns - People are much more interested in

nutrition if it relates directly to them or their family.

Using Pamphlets - Information alone is dull,

boring, and lifeless. Help the client use the information in a personal way.

Making a Difference WithMaking a Difference WithNutrition EducationNutrition EducationVideo SummaryVideo Summary Setting Nutrition Goals - Setting goals helps people think

through what they can do at home.

Follow Up at the Next Appointment - Follow up gives us the chance to reinforce what we talked about but also lets the client know we are

interested in them and what they have been doing.

VENA Counseling Sessions Recap

The VENA Counseling session should include the following:

1.Welcome and introduction2.Establish rapport with client3.Gather and assess information4.Identify and explore client’s needs and

concerns5.Provide information6.Discuss and set behavior change goal(s)7.Close session

VENA Counseling Sessions

WIC works because WIC helps people make the important connection between health and nutrition. Our VENA counseling session is a way we can make this connection.

Through our counseling sessions, we have the chance to help people learn what good nutrition really is and how to fit good nutrition into their everyday life.

VENA Counseling Sessions Thank you for your efforts to improve

your education and counseling skills!

You deserve to feel good about your efforts at the end of every clinic day. You deserve to know you’ve made a real contribution – because you have!

Your efforts continue to make the Arkansas WIC Program one of the most successful public health programs ever!