Josephine, a 20-year-old female salsa instructor, is seeking counseling for an eating disorder. She struggles with guilt over fried foods prepared by her Honduran and Guatemalan mother and compensates with excessive exercise or purging. Her recent labs and weight of 117 pounds at 5'2" concern her doctor. The counselor determines Josephine is in the contemplation stage of change based on her desire to change behaviors but ambivalence about changing family routines. Rapport would be built by active listening and validating her cultural background and struggles. Behavior change would be encouraged using motivational interviewing, cognitive restructuring, and psychoeducation on healthy exercise habits versus excessive or compensatory exercise.

1. Unit 6 Assignment
Unit outcomes addressed in this assignment:
1. Identify counseling skills needed for behavior change
2. Recognize behavioral, cognitive, and psychoeducational
treatment strategies
Course outcome assessed/addressed in this assignment:
NS420-1: Apply professional nutritional counseling skills to a
client session
Instructions
Imagine yourself in the role of a Nutrition Counselor and
Josephine in your client. Josephine
is a 20-year-old female who is present for an eating disorder not
otherwise specified. She
currently teaches salsa lessons at the community college and is
in her last semester of
college. She reports she is living at home and the food her mom
prepares is not the

2. healthiest because her mom is from Honduras and her father is
from Guatemala, so the
food is prepared differently. She indicates she has been thin all
her life, but she began
struggling with her weight as soon as she went through puberty.
Since she is a salsa
instructor, she has to remain fit. She reports she feels very
guilty if she has consumed fried
foods during the day, but since that is the way her mom
primarily cooks, she feels awful to
tell her mom to stop cooking that way. She reports if she does
consume too much fried
foods or junk food, she will run at least 2-3 miles that day or
else force herself to vomit, but
all the food does not come out. She reports sometimes if she has
a later class, she will not
eat dinner or only eat 1 meal per day. She has tried counting
calories, but then she gets so
mad at herself for having more than 1200 calories it causes her
to exercise more, which
then leads her to feeling exhausted. She indicates she is on no
medication, but does take a
multivitamin when she remembers. She indicates she has gone
from 110 pounds to 125

3. pounds over 5 years and wants to be back down to 110 or even
less. She also had gone to
the doctor and he was quite concerned with her lab values. She
has provided you a 24 hour
meal record:
Breakfast:
1-6” corn tortilla
½ cup fried beans cooked with peppers, onions and oil
½ cup rice
1 cup no sugar added orange juice
Lunch:
1 slice of whole wheat bread
2 slices turkey
1 small apple
Dinner:
2- 6” tortillas
Beef with onions, peppers cooked in oil
Tomato, onion, pepper salad (made with oil and lime juice)

4. 2 cups of rice
Height: 5’2” Weight: 117 pounds (based on your scale in the
office)
Labs:
Test Result Reference Units
Albumin (visceral protein stores) 3.3 g/dL 3.5-4.8 g/dL
Sodium 133 mEq/L 136-145 mEq/L
Potassium 3.8 mEq/L 3.5-5.2 mEq/L
Iron 0.4 mg/dL 0.6-1.1 mg/dL
Vitamin B12 185 pg/mL 200-835 pg/mL
Questions for Unit 6:
g to the Stages of Change Model, what stage of
change do you believe
Josephine is in? Explain how you determined that stage of
change? How does this
affect her readiness to learn?
client?

5. encourage behavior change
for the client
-behavioral therapy
techniques you would use with
this client.
is considered normal
exercising and
excessive exercising?
in length and include
at least two references.
conventions of Standard
American English (correct grammar, punctuation, etc.). Your
writing should be well
ordered, logical, and unified, as well as original and insightful.
Your work should
display superior content, organization, style, and mechanics. Be
sure to use APA in-
text citations and a reference page to attribute each source.

6. Please be sure to download the file “Writing Center Resources”
from Doc Sharing to assist
you with meeting APA expectations for written assignments.
Submitting Your Work
Put your responses in a Microsoft® Word® document. Save it in
a location and with the
proper naming convention: username-CourseName-section-Unit
1_Assignment.doc
(username is your Kaplan username, section is your course
section, 1 is your Unit number).
When you are ready to submit it, go to the Dropbox and
complete the steps below:
1. Click the link that says “Submit an Assignment.”
2. In the “Submit to Basket” menu, select Unit 1: Assignment.
3. In the “Comments” field, make sure to add at least the title of
your paper.
4. Click the “Add Attachments” button.
5. Follow the steps listed to attach your Word document.
To view your graded work, come back to the Dropbox or go to
the Gradebook after your
instructor has evaluated it. Make sure that you save a copy of
your submitted project.

7. Unit 6 Assignment Grading Rubric =130 points
Assignment Requirements Points
possible
Points
earned by
student
Discuss the stage of change and how this would affect
her readiness to learn.
0-26
Discuss how would you establish a rapport with the
client
0-26
Identify and discuss 3 counseling skills you would use
to encourage behavior change for the client
0-26
Identify and discuss 2 cognitive-behavioral therapy
techniques you would use with this client.

8. 0-26
Discuss how you would educate the client on what is
considered normal exercising and excessive exercising.
0-26
Total (Sum of all points)
Points deducted for spelling, grammar, and/or
APA errors.
Adjusted total points
Instructor Feedback: