Strategies for Motivating Patients: A Practical Guide for Dietitians

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Motivating patients to make meaningful nutrition changes is one of dietitians’ biggest challenges. Whether working with clients in an outpatient setting, residents in a long-term care facility, or patients in a hospital, you’ve likely encountered resistance, ambivalence, or frustration when discussing dietary changes.

The reality is that even the best advice can fail if a patient isn’t motivated to act on it.

That’s why understanding the psychology behind motivation and how to tailor your counseling approach is essential.

This article will explore evidence-based strategies to help patients build internal motivation, overcome barriers, and take ownership of their nutrition goals. Whether you have the luxury of ongoing sessions or only a brief interaction with a patient, these techniques can help you make the most of your time and increase the likelihood of lasting behavior change.

Foundations of Motivation in Nutrition Counseling

Motivation is complex and deeply personal. It fluctuates based on life circumstances, health status, past experiences, and an individual’s sense of autonomy and competence. As dietitians, understanding what drives behavior—and what hinders change—is essential for guiding patients toward sustainable nutrition choices.

Understanding Motivation

Motivation exists on a spectrum, ranging from external pressure to deeply internalized values. Recognizing where a patient falls on this spectrum can help tailor counseling approaches for better engagement.

• External Motivation – Driven by outside forces, such as medical recommendations, family pressure, or incentives (e.g., weight loss challenges). This type of motivation requires a reward and is often unsustainable without deeper personal meaning.
• Introjected Motivation – Based on internalized pressures, such as guilt, self-esteem, ego, or self-imposed expectations. Patients may follow a nutrition plan to “be good” but struggle with consistency due to feelings of shame or obligation.
• Identified Motivation – The patient acknowledges the value of a behavior and sees its relevance to their personal goals, making them more likely to adhere to changes.
• Intrinsic Motivation – The most sustainable form of motivation, where behavior is driven by personal satisfaction, enjoyment, or a sense of purpose. Patients who find joy in cooking new meals or feel empowered by making health-conscious choices are more likely to maintain lasting change.

Goals empowered by identified and intrinsic motivation are considered self-concordant. This type of goal and motivation are associated with higher level of positive mood and satisfaction with life.

Motivation is fluid, not static. A patient may start with external motivation (e.g., following a diet plan because their doctor told them to) but, with the right support, shift toward identified or intrinsic motivation over time.)

Theories of Motivation

Understanding the psychology behind motivation can help dietitians facilitate meaningful change. While numerous theories attempt to explain what drives human behavior, they generally fall into two broad categories:

1. Process Theories – These focus on how motivation develops, including reinforcement mechanisms and the impact of needs, rewards, and consequences.
2. Cognitive Theories – These emphasize why people are motivated, examining personal beliefs, goals, and self-perception in shaping behavior.

Several established theories offer insight into how motivation functions in nutrition counseling:

• Maslow’s Hierarchy of Needs – People are motivated to fulfill basic physiological needs (e.g., food, safety) before pursuing higher-level goals like self-improvement. This is further expanded on by Alderfer’s ERG theory, which states that when basic needs are met, the higher needs become more important.
• Expectancy Theory – Individuals weigh the expected outcome of a behavior against the effort required. If they believe success is achievable and worthwhile, they’re more likely to take action.
• Operant Conditioning – Behaviors reinforced by positive outcomes (e.g., feeling more energetic after eating well) are more likely to be repeated, while those associated with negative consequences (e.g., guilt after overeating) may be avoided or compulsively repeated.
• Goal Setting Theory – This integrated theory sees goals as the key determinant of behavior. This is the theory behind the SMART goals we all learned about in school

Dietitians can apply these theories in practice by reinforcing positive behaviors, setting realistic expectations, and helping clients identify meaningful personal rewards for behavior change.

Key Psychological Frameworks for Nutrition Counseling

Several psychological frameworks provide practical strategies for understanding and fostering motivation in nutrition counseling:

1. Self-Determination Theory (SDT)
   SDT posits that motivation is strongest when three fundamental psychological needs are met:
   • Autonomy – The sense of control over one’s decisions. Patients are more likely to engage in behavior change when they feel they have choices rather than being told what to do.Competence – Confidence in the ability to succeed. Small, achievable goals help patients build self-efficacy and momentum.Relatedness – Feeling connected and supported. Patients are more likely to maintain behavior changes when they feel understood and valued.
   → Application for Dietitians: Instead of prescribing rigid meal plans, dietitians should collaborate with patients to create personalized, flexible strategies that align with their lifestyle and values. Encouraging self-efficacy through small wins and offering social support can enhance motivation.
2. Transtheoretical Model (TTM) of Behavior Change
   TTM outlines the stages people go through when adopting new behaviors:
   • Precontemplation – The individual is not considering change and may be resistant to discussing it. This is the client that sees you because their doctor told them too, or their wife scheduled the appointment.Contemplation – Awareness of the need for change emerges, but ambivalence remains.Preparation – The patient begins planning small steps toward change.Action – Active effort is made to modify behavior.Maintenance – The new behavior becomes a consistent part of life.
   → Application for Dietitians: A patient in the precontemplation stage will not respond well to a strict meal plan but may benefit from open-ended questions to explore their beliefs. Someone in the preparation stage might be ready for meal-planning strategies or grocery store tips. Identifying where a patient is in this process allows dietitians to tailor interventions appropriately.
3. Motivational Interviewing (MI)
   MI is an evidence-based counseling technique that helps patients resolve ambivalence and strengthen their motivation for change. It is guided by four core principles:
   • Partnership – Working alongside the patient rather than directing them.Acceptance – Respecting the patient’s autonomy and choices.Compassion – Prioritizing the patient’s well-being and goals.Evocation – Drawing out the patient’s own motivations rather than imposing external ones.
   → Application for Dietitians: MI techniques include active listening, asking open-ended questions, and reflecting on patient responses to enhance self-awareness. Instead of saying, “You need to eat more fiber,” a dietitian might ask, “What are some changes you feel ready to make to improve digestion?” This approach helps patients feel empowered rather than pressured.

Putting It All Together

By integrating motivation theories and psychological frameworks, dietitians can move beyond simply providing nutrition information and instead become facilitators of meaningful behavior change.

Whether using SDT to foster autonomy, TTM to assess readiness for change, or MI to guide conversations, a strong understanding of motivation enhances the effectiveness of nutrition counseling and increases the likelihood of long-term success.

Identifying and Addressing Barriers

Even when patients express a desire to improve their nutrition, various obstacles can hinder motivation and progress. As dietitians, recognizing and addressing these barriers with empathy and collaboration is crucial for helping patients develop sustainable habits.

Common Barriers to Motivation in Nutrition Counseling

Understanding the most frequent challenges patients face allows for more effective, personalized strategies:

• Time Constraints – Busy schedules, work demands, and family responsibilities often make meal planning and cooking difficult. Patients may struggle to prioritize nutrition amidst competing obligations.
• Financial Limitations – The perception that healthy eating is expensive can discourage patients, especially those with tight budgets. Access to fresh food may also be limited in some communities.
• Cultural Food Preferences – Standard nutrition recommendations don’t always align with a patient’s cultural traditions or personal food preferences. If dietary changes feel restrictive or disconnected from their identity, motivation can wane. Additionally, some cultures don’t emphasize nutritional interventions for health concerns.
• Emotional and Mental Health Challenges – Anxiety, depression, and stress can impact eating behaviors, leading to avoidance of meal preparation, reliance on ultra-processed foods, or emotional eating patterns.
• Conflicting Priorities or Health Misinformation – Patients often receive conflicting nutrition advice from social media, friends, or other healthcare providers, making it difficult to determine which recommendations to trust.
• Personal Beliefs and Values – Ethical concerns (e.g., vegetarianism), religious dietary laws, or deeply held beliefs about food and body image can shape eating behaviors and openness to change.
• Lack of Buy-In – Patients who feel forced into dietary changes (e.g., due to a doctor’s orders or family pressure) may resist recommendations. Without a personal reason to change, motivation remains low.
• Past Experiences with Healthcare – Negative interactions with healthcare providers—such as feeling judged about weight, dismissed about symptoms, or pressured into unrealistic dietary changes—can create resistance to nutrition counseling.

Rather than assuming a lack of motivation, dietitians should approach these barriers with curiosity, helping patients identify obstacles and find realistic solutions that fit their unique circumstances.

Collaborative Problem-Solving

Addressing barriers requires a patient-centered approach that fosters trust and self-efficacy. Instead of prescribing solutions, dietitians can guide patients in uncovering their own strategies through open-ended questioning and collaborative goal-setting.

• Using Open-Ended Questions to Explore Barriers
  Encouraging patients to articulate their challenges helps them feel heard and empowered. Examples include:
  • “What makes it difficult for you to meal plan during the week?”
  • “Can you tell me more about your past experiences with dietary changes?”
  • “What concerns do you have about adjusting your eating habits?”
• Encouraging Patients to Propose Solutions
  Patients are more likely to follow through with changes they identify themselves. Instead of offering a generic solution, dietitians can guide patients toward realistic options:
  • Instead of “You need to cook more meals at home,” try “What are some simple changes to your usual meals that fit your goals and your schedule?”
  • Instead of “You should try a Mediterranean diet,” ask “What are some traditional foods you enjoy that align with heart-healthy eating?”

By shifting the conversation from rigid recommendations to collaborative problem-solving, dietitians help patients feel in control of their choices, increasing both motivation and adherence.

Leveraging Patient Strengths and Values

A strengths-based approach, rooted in positive psychology, focuses on what patients are already doing well. This mindset shift from “fixing” deficits to amplifying existing strengths can have a profound impact on motivation, fostering a sense of self-efficacy and optimism about future changes.

Strengths-Based Approach

Identifying What Patients Are Already Doing Well
Even if a patient feels overwhelmed or discouraged, it’s important to recognize their small victories. These could include eating vegetables with dinner, making an effort to cook at home, or choosing healthier snacks. Acknowledging these behaviors helps patients see that they already possess the ability to make positive changes.

• Example: “You’ve been consistently bringing a healthy lunch to work, which is fantastic! That shows you’re already taking steps to prioritize your health.”
• Why it works: Positive reinforcement boosts motivation by reinforcing the patient’s sense of capability and encouraging them to continue building on these habits.

Using Past Successes to Build Confidence
Reflecting on past successes—whether small or significant—can help patients reconnect with the confidence they’ve previously demonstrated in making changes. This is especially helpful for individuals who have tried and failed in the past, as it helps break the cycle of discouragement and sets a positive tone for future attempts.

• Example: “You mentioned that last year you made the decision to cut back on soda and felt better because of it. What helped you make that change, and how can we apply that same approach to your current goals?”
• Why it works: By identifying past strategies that were successful, dietitians can help patients build a sense of ownership and confidence in their ability to repeat similar successes.

Connecting to Values

Motivation is strongest when patients understand the “why” behind their behavior change. When a patient’s nutrition goals align with their personal values, it becomes easier for them to stay committed, even during challenging times.

Helping Patients Identify the “Why” Behind Behavior Change
A key part of motivational interviewing and strengths-based counseling is helping patients connect their behavior change goals to something deeply meaningful. The clearer the “why,” the more likely patients will maintain their commitment to change.

• Example: “What is most important to you about improving your diet? Is it to feel more energized for your kids, manage your health better, or set an example for others in your family?”
• Why it works: When patients can articulate a personal reason for change, it taps into their intrinsic motivation, making it more likely they’ll follow through.

Aligning Recommendations with Personal Goals
By aligning nutrition recommendations with a patient’s overarching life goals (such as family health, environmental sustainability, or long-term wellness), dietitians can make changes feel more meaningful and achievable. For instance, a patient who values sustainability might be more motivated by plant-based eating if it’s framed as both a health and environmental benefit.

• Example: “Since you’ve expressed concern about your family’s health, how do you feel about integrating more whole grains and vegetables into your meals? It could be a great way to improve both your health and your family’s wellbeing.”
• Why it works: Aligning dietary changes with the patient’s core values not only increases motivation but also enhances adherence, as patients are more likely to stick to goals that resonate with their personal identity and aspirations.

Strategies to Increase Patient Engagement

Sustained motivation in nutrition counseling often hinges on patient engagement. When patients feel actively involved in the process, they are more likely to take ownership of their health goals and follow through with changes. Dietitians can enhance engagement by tailoring strategies to each patient’s unique needs, strengths, and preferences.

Personalized Goal-Setting

Setting clear, realistic goals helps patients build confidence and momentum. Without structure, behavior change can feel overwhelming or directionless, but with the right approach, patients can make meaningful progress.

• Using SMART Goals
  SMART goals—Specific, Measurable, Achievable, Relevant, and Time-bound—help patients move from vague aspirations (e.g., “I want to eat healthier”) to actionable plans (e.g., “I will add a serving of vegetables to my lunch three times a week for the next month”).
  • Why it works: SMART goals provide clarity, accountability, and a sense of accomplishment as patients achieve small milestones.
• Breaking Large Goals into Smaller, Actionable Steps
  Complex or long-term goals can be intimidating, so it’s essential to break them into manageable steps.
  • Example: Instead of, “I want to manage my diabetes and come off my medications,” start with “I want to add 5 minutes of movement for every hour sitting at my desk and eat 1 serving of vegetables per day.”
  • Why it works: Small, achievable changes build momentum, making larger goals feel less daunting and more attainable over time.
• Positive Goals Work Better
  Encourage clients to add to their diet, rather than subtract.
  • Example: Instead of advising a patient to “cut out ultra-processed foods,” start with “Have a serving of fruit with some protein for a snack twice a week.”
  • Why it works: No one likes to be told no. This is not a toddler thing, it’s a person thing. Avoiding restriction while adding food that helps them reach their goals encourages a positive association with their goals, making them more sustainable.

Utilizing Motivational Interviewing Techniques

Motivational interviewing (MI) is a patient-centered approach that fosters engagement by reinforcing autonomy and self-efficacy.

• Affirmations and Summarizations to Reinforce Motivation
  Affirming a patient’s strengths and progress—no matter how small—can boost confidence and motivation. Summarizing key points from a session also helps patients feel heard and ensures they leave with a clear understanding of their next steps.
  • Example: “You’ve already started incorporating more home-cooked meals, which is a great step toward your goal. Let’s build on that momentum.”
  • Why it works: Positive reinforcement helps patients focus on what’s working rather than what’s missing.
• Encouraging Change Talk
  Change talk refers to the patient verbalizing their own reasons for making a change, which increases their likelihood of following through. Dietitians can elicit change talk by asking open-ended questions that prompt patients to express their motivations.
  • Example: Instead of saying, “You should eat less added sugar,” ask, “How would cutting back on sugar fit into your overall health goals?”
  • Why it works: When patients articulate their own reasons for change, they are more intrinsically motivated to act.

Visual Tools and Resources

For many patients, engagement improves when they have concrete tools to track progress and reinforce learning.

• Food Diaries, Meal-Planning Templates, and Progress Trackers
  Visual tools help patients stay organized and reflect on patterns in their eating habits.
  • Example: A simple meal-planning template can make home cooking feel more manageable and reduce decision fatigue.
  • Why it works: Writing things down increases accountability and helps patients identify opportunities for improvement.
  • Drawbacks: It’s hard to stay consistent, and easy to become obsessive. Food diaries should be a 3-4 days only, and be combined with mindful reflections.
• Apps and Digital Tools for Engagement
  Mobile apps can provide real-time feedback, reminders, and interactive features that make nutrition changes more engaging.
  • Example: Apps for tracking hydration, mindful eating, or meal prep can offer structured support between sessions.
  • Why it works: Digital tools offer accessibility and convenience, helping patients stay engaged even outside of appointments.

I have 2 favorites:

Wise Mind Nutrition‘s food log that is based on images and food groups, rather than nutrition and calorie tracking.

Practice Better: I use Practice Better as my EMR in my private pracice, and it has a food journal that covers a multitude of nutrients that you can set individual goals for and hide from the client if it is agreed upon. In addition to food, PB asks about hunger before and fullness after and you can track mood, exercise, bowel movements, hydration, sleep, and more, if needed.

Note: the link above is an affiliate link. I may earn a commission if you subscribe, at no cost to you.

Handling Resistance or Low Motivation

Resistance is a natural part of the behavior change process, not a sign of failure. Rather than viewing resistance as non-compliance (ugh), dietitians can reframe it as an opportunity to explore a patient’s underlying concerns, values, and readiness for change.

Reframing Resistance

Resistance often signals that a patient feels uncertain, overwhelmed, or disconnected from the proposed changes. Instead of pushing back against resistance, dietitians can use it as a starting point for deeper conversation.

• Example: If a patient says, “I just don’t have time for meal prep,” instead of countering with reasons why they should, acknowledge their concern and explore what’s realistic.
• Why it works: Meeting patients where they are fosters trust and keeps the conversation open rather than adversarial.

Practical Strategies for Managing Resistance

Using a patient-centered approach can help navigate resistance and build motivation over time.

• Rolling with Resistance Using Motivational Interviewing (MI) Techniques
  Rather than confronting resistance directly, MI encourages dietitians to work with it through reflective listening, affirmations, and open-ended questions.
  • Example: Instead of “You need to eat more vegetables,” try “What’s been your experience with adding vegetables to your meals?”
  • Why it works: This approach lowers defensiveness and encourages patients to explore solutions on their own terms.
• Reassessing Readiness and Adjusting the Approach
  Not every patient is ready for major changes. Actually, I’d argue most new clients aren’t. Identifying where they fall in the Transtheoretical Model (e.g., precontemplation, contemplation) helps dietitians tailor their approach.
  • Example: If a patient isn’t ready to change their diet, shifting the conversation to exploring their health values may be a better starting point.
  • Why it works: Aligning recommendations with readiness prevents frustration and improves long-term engagement.
• Exploring Ambivalence with Pros/Cons Exercises
  When patients feel stuck between wanting to change and fearing change, a structured pros and cons discussion can help clarify their motivations.
  • Example: “Let’s look at the pros and cons of drinking more water. What benefits do you see? What challenges might come up?”
  • Why it works: Seeing their own reasons laid out can help patients resolve internal conflicts and make more confident decisions.

By reframing resistance as part of the process and adapting strategies to the patient’s current mindset, dietitians can keep the conversation productive and build motivation at a pace that feels manageable for the individual.

Case Studies and Examples

Theory and strategy come to life through real-world application. The following case studies illustrate how different motivational approaches play out in practice, providing insights into how dietitians can adapt their counseling techniques based on patient needs.

Case 1: The Resistant Patient in Precontemplation

At my first RD job in a cardiologist’s office, I met a patient who came in “because the doctor told him to.” He made it clear from the start that he had no interest in changing his eating habits. He wasn’t just in the precontemplation stage—he was firmly opposed to making any changes.

Rather than pushing dietary recommendations, I took the opportunity to simply have a conversation. We talked about his daily routine, his favorite foods, and his general thoughts on health. There was no scheduled follow-up, but before he left, I made sure he knew that if he ever did decide he wanted support, I’d be there to help.

Key Takeaways:

• Motivational Interviewing in Action: Instead of pushing against resistance, I leaned into the MI principles of autonomy and acceptance.
• Planting the Seed: Change wasn’t on his radar that day, but the door remained open if and when he was ready.

Case 2: The Highly Motivated Patient Facing New Barriers

I worked with a patient who was the picture of motivation—she crushed every goal she set and even took on challenges she hadn’t initially planned for. Her progress was impressive, and she had a strong sense of ownership over her health. I’ve spoken about her before on this site.

Her biggest improvement was her reduction in frequency and severity of her depressive episodes.

Then she started a doctorate program. Suddenly, time management, stress, and sugar cravings, all well-managed before, became overwhelming. She felt like she was failing.

Rather than viewing this as a setback, we reframed it as an adjustment period. We identified what she was still doing well—maintaining physical activity, staying mindful about her eating, and still wanting to prioritize her health. From there, we restructured her goals to fit her new schedule, ensuring they were realistic given her current capacity.

A few months in, she pursued an ADHD diagnosis and started Adderall, which required us to adjust again. We discussed how the medication might affect appetite and energy levels and set expectations that allowed for flexibility until she graduated.

Key Takeaways:

• Behavior Change is a Nonlinear Process: Progress isn’t always about moving forward—it’s about adapting to life’s changes.
• Leveraging Strengths: By focusing on what she was still doing well, we kept her engaged rather than discouraged.
• Adjusting for External Factors: Medication, stress, and major life changes all impact nutrition habits, and counseling must evolve alongside them.

Case 3: The Culturally Diverse Patients and One-Size-Fits-All Advice

About a year into my private practice, I had a month where I noticed a pattern in client calls—several patients had been given the same dietary advice from their PCP: “Stop eating tortillas.” All different doctors even.

For these patients, tortillas weren’t just a food choice; they were a staple of their cultural diet. The recommendation to eliminate them felt dismissive and impractical, leading to frustration and disengagement.

Rather than focusing on elimination, I worked with each patient to explore balanced ways to incorporate tortillas into their meals. We discussed portion sizes, fiber-rich variations (like whole grain or homemade options), and how to pair them with proteins and vegetables for a more filling meal.

• Key Takeaways:
  • Cultural Competency Matters: Generic, restrictive advice often fails because it doesn’t account for personal or cultural significance.
  • Sustainability Over Restriction: Instead of taking away foods people love, dietitians can help patients find ways to enjoy them in a balanced way.

Connecting the Cases to Theoretical Frameworks

Each of these cases illustrates different motivational concepts:

• Self-Determination Theory: In Case 1, autonomy was key—pushing change on an unwilling patient would have been counterproductive.
• Transtheoretical Model: Case 2 highlighted the importance of reassessing readiness and adjusting strategies based on life circumstances.
• Motivational Interviewing: Case 3 reinforced the power of collaboration, allowing patients to be active participants in their own dietary changes.

By understanding where patients are in their journey, dietitians can tailor their approach to support lasting, meaningful change.

Long-Term Motivation: Sustainability in Counseling

Behavior change isn’t just about getting patients to make initial improvements—it’s about sustaining those changes over time. Dietitians play a crucial role in helping patients build the skills, confidence, and autonomy necessary to maintain their progress long after counseling ends.

Fostering Autonomy: Handing Over the Reins

Motivation is strongest when it comes from within. As dietitians, our role isn’t to dictate but to guide patients toward taking ownership of their health.

• Shifting Responsibility Gradually: Early on, clients may rely heavily on structured guidance. Over time, the goal is to reduce that dependence, helping them feel confident in making nutrition decisions on their own.
• Encouraging Critical Thinking: Instead of providing direct answers, asking patients reflective questions (“What do you think would work best for you?”) helps them develop problem-solving skills and truly internalize the concepts and goals you’re working on.
• Normalizing Setbacks: Sustainability means navigating challenges without feeling like they’ve failed. Reframing setbacks as learning opportunities reinforces resilience.

Empowering Patients with Knowledge

Education is one of the most powerful tools for long-term motivation. When patients understand why they’re making certain choices—not just what to do—they’re more likely to stick with them.

• Translating Science into Actionable Steps: Avoiding information overload and breaking down concepts into relevant, real-life applications. I use my intake paperwork to gauge a new client’s nutrition and health literacy before I see them.
• Building Self-Efficacy: Highlighting small wins and reinforcing patients’ ability to make informed decisions independently.
• Providing Reliable Resources: Directing patients to evidence-based materials, apps, and tools so they can continue learning beyond their sessions.

Follow-Up Strategies: Keeping Patients Engaged

Accountability and reflection help patients stay connected to their goals.

• Regular Check-Ins: Whether through follow-up sessions, emails, or patient portals, periodic touchpoints reinforce commitment and allow for course corrections.
• Encouraging Self-Monitoring: Tools like food diaries, habit trackers, or journaling promote awareness and help patients recognize patterns.
• Reflection Over Perfection: Asking patients to reflect on what’s working and what’s challenging fosters an adaptive mindset.

Long-term motivation isn’t about rigid adherence to a plan—it’s about equipping patients with the confidence, skills, and mindset to navigate their own health journey sustainably.

Motivation in Short-Term Interactions

Not all nutrition counseling happens in a setting where long-term relationships can develop. In acute care or brief encounters, the goal isn’t sweeping behavior change—it’s planting a seed. With limited time and a patient population often overwhelmed by immediate health concerns, dietitians must focus on high-impact, concise, and practical guidance.

Understanding the Limitations

• Time constraints and environment: Hospital stays, clinic visits, and inpatient consultations often don’t allow for in-depth counseling.
• Shift in focus: Instead of long-term behavior change, the priority is to provide patients with foundational knowledge and small, manageable steps they can act on.

Key Strategies for Single or Brief Encounters

1. Prioritize and Tailor the Message

• Identify one or two key takeaways that align with the patient’s immediate health needs.
• Use clear, concise language to explain the why behind the recommendation—patients are more likely to engage if they understand the impact.

2. Use Teach-Back Techniques

• Ensure understanding by having the patient explain the recommendation in their own words.
• If they struggle, reframe the message with simpler language or relevant examples.

3. Highlight Small, Actionable Steps

• Avoid overwhelming the patient—suggest one realistic, first step they can take immediately.
• Frame the recommendation around what’s possible rather than what’s ideal.

4. Focus on Empowerment

• Reinforce the patient’s ability to make positive choices, despite challenges.
• Use affirmations to boost self-efficacy:
  • “You’ve already taken a big step by coming here today.”
  • “Managing your nutrition doesn’t have to be perfect—small changes add up.”

Tools and Resources to Maximize Impact

• Provide simple written materials or quick-reference guides for post-discharge review.
• Suggest user-friendly apps or websites for continued learning.
• Connect patients with outpatient dietitians or community resources for follow-up care.

Examples of Effective Communication in Acute Care

Case 1: A patient with uncontrolled diabetes admitted for hyperglycemia

• Focus on stabilizing blood sugar with one or two dietary adjustments, such as spacing out carbohydrate intake or trying whole-grains.
• Use a teach-back approach to confirm understanding (e.g., “Can you tell me what you’ll do differently at breakfast tomorrow?”).

Case 2: A cardiac patient needing rapid dietary changes post-MI

• Emphasize heart-protective choices within their existing diet rather than an overhaul.
• Provide a simple swap (e.g., replacing fried foods with grilled options) and encourage small, sustainable changes.

Case 3: A malnourished patient in need of immediate nutrition repletion

• Address short-term needs first (e.g., calorie-dense, protein-rich foods) while considering long-term strategies for sustaining nutrition post-discharge.
• Offer accessible, culturally appropriate options to support recovery.

Emphasis on Collaboration

• Work with nurses, case managers, and social workers to reinforce key nutrition messages.
• Engage family members or caregivers to support (not enforce) dietary changes after discharge.

Short-term encounters may not lead to immediate transformation, but they lay the groundwork for future progress. By keeping messages targeted, practical, and empowering, dietitians can make the most of even the briefest interactions.

Conclusion

We cannot give patients motivation—it must come from within. However, we can play a key role in helping people discover their own reasons for change, build confidence in their abilities, and develop realistic, sustainable nutrition habits.

By incorporating strategies like motivational interviewing, personalized goal-setting, and strengths-based counseling, we can move beyond simply providing information and instead become true facilitators of change.

For dietitians who work in settings with ongoing patient relationships, motivation is a process that unfolds over time. But even in brief encounters, like in acute care, small shifts in communication can make a big difference.

A well-placed question, a moment of empowerment, or a simple, actionable step can set the stage for lasting change beyond the hospital room or clinic visit.

No matter your practice setting, the key is to meet patients where they are and support them in a way that fosters autonomy, confidence, and long-term success. Want to explore these strategies further? Check out the recommended resources below to strengthen your skills in motivational counseling.

For further reading and learning, check out my resource library at the top!