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Chapter 6


am the right person to talk with about this?” To the con- trary, when a patient tells you his or her private thoughts, this is an indication that you have done a fine job building rapport and nonjudgmental trust.7


However, it is not within


the scope of your practice to respond with advice on per- sonal issues such as relationships, past trauma or abuse, or other personal topics. In these situations, the appropriate reply is “That would be a great topic to discuss with your counselor.” In some cases, a patient may not be in contact with a


counselor when he or she begins working with you. Many patients will seek the services of an RDN thinking that their issues have their root in nutrition, not realizing there is more to the picture. You may be the very first person in whom a patient has confided his or her struggles. In these cases, you are offering a gift to your patients in the form of a sensitive and caring referral to the appropriate psycho- therapist or other mental health professional. A simple way to phrase this recommendation is, “I can see that this is an important area for you to discuss, but I’m not the best person to advise you on this issue. I would like to add a counselor to our team.” Chapter 7 contains more informa- tion about referring a patient to additional types of care.


Keeping the Focus on Nutrition


If you develop a good working relationship with an individ- ual, you may find that conversations flow toward and then away from nutrition-related topics. It is essential to find the right balance between nutrition counseling and chit- chat, but it takes time. Remember for most eating disorder patients, you are one of only a few people who have access to very personal details, so when coming in from the out- side world, your patients may need time to transition from small talk to serious business. If small talk or “How was your week?” responses start to take up too much of your


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