CLT Nutrition Counseling & Meal Planning 3 — Questions and Answers
Question 1: Which counseling model is most aligned with helping a LEAP client navigate resistance to dietary change?
- Cognitive behavioral therapy (CBT) for eating disorders
- Motivational interviewing (MI) (Correct answer)
- Psychoanalytic free association
- Acceptance and commitment therapy (ACT) for chronic pain only
Correct answer: Motivational interviewing (MI)
Motivational interviewing helps resolve ambivalence and builds intrinsic motivation for adherence to restrictive dietary protocols like LEAP.
Question 2: A client states, 'I know I should follow the meal plan, but eating out with friends is really hard.' A CLT using motivational interviewing would BEST respond with:
- 'You must strictly avoid eating out during Phase 1.'
- 'Tell me more about what makes eating out challenging for you.' (Correct answer)
- 'Most clients find it easy once they memorize the food list.'
- 'Skip Phase 1 if social eating is a priority.'
Correct answer: 'Tell me more about what makes eating out challenging for you.'
Reflective listening and open questions explore the client's barriers, a core MI technique that builds rapport and supports behavior change.
Question 3: When a CLT sets SMART goals with a client for meal planning, what does the 'T' in SMART stand for?
- Therapeutic
- Time-bound (Correct answer)
- Tested
- Transformative
Correct answer: Time-bound
Time-bound goals include a specific deadline, making them more actionable and measurable for the client.
Question 4: A client with IBS on a LEAP plan reports that her husband cooks all meals and is skeptical of the protocol. The CLT's BEST strategy is to:
- Advise the client to cook her own meals separately
- Invite the husband to a counseling session to explain the evidence base and practical meal strategies (Correct answer)
- Switch to a less restrictive plan to reduce household conflict
- Recommend only restaurant meals to avoid home friction
Correct answer: Invite the husband to a counseling session to explain the evidence base and practical meal strategies
Engaging key household members improves the social support environment, which is a critical determinant of dietary adherence.
Question 5: Which stage of the Transtheoretical Model (Stages of Change) describes a client who says, 'I've been meal prepping my LEAP foods every Sunday for three months'?
- Contemplation
- Preparation
- Action
- Maintenance (Correct answer)
Correct answer: Maintenance
Maintenance is characterized by sustained behavior change beyond six months; three months of consistent behavior places the client in the Action stage, but consistent practice beyond six months would indicate Maintenance.
Question 6: Which assessment tool is most useful for a CLT to identify a client's readiness to adopt a therapeutic elimination diet?
- 24-hour dietary recall
- Readiness ruler or confidence/importance scaling from MI (Correct answer)
- Food frequency questionnaire
- Resting metabolic rate measurement
Correct answer: Readiness ruler or confidence/importance scaling from MI
Readiness rulers from motivational interviewing quickly quantify both importance and confidence, guiding how much counseling support the client needs before beginning the protocol.
Question 7: A client in Phase 1 of LEAP reports feeling isolated because she cannot share meals with coworkers. The CLT should FIRST:
- Advance her to Phase 2 early to allow more food choices
- Validate her feelings and brainstorm compliant portable meal options she can bring to shared settings (Correct answer)
- Recommend she eat before or after coworkers to avoid social pressure
- Refer her to a psychologist immediately
Correct answer: Validate her feelings and brainstorm compliant portable meal options she can bring to shared settings
Validating emotions and problem-solving together demonstrates empathy and builds practical strategies that support adherence without bypassing the protocol.
CLT Nutrition Counseling & Meal Planning 3
Which counseling model is most aligned with helping a LEAP client navigate resistance to dietary change?