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How counselors can encourage healthier living

Date: March 26, 2018

While counselors are most often concerned with the mental health of their clients, physical health cannot be forgotten. Indeed, mental and physical health are closely related. Depression can manifest in clients as joint pain, chronic pain, weight gain and gastrointestinal problems. The truth is that counselors don’t just treat their clients’ mental health issues, but are also involved in addressing their physical health.

However, there’s a fine line to walk when trying to help a client improve his or her physical health alongside their mental well-being. Counselors have to be careful not to overstep. While acceptable to brainstorm with a client on different ideas for healthy living, counselors must stay away from diagnosing medical conditions and focus on helping a client make healthy decisions in life.

When mental health counselors are asked by clients to promote better physical health, not just mental well-being, the situation calls for preparation. Not only can earning an online master’s degree help, so too can understanding the greater factors at play in health care. Here are some of the strategies counselors should address with clients interested in making lifestyle changes for the better.

Help clients address CVD

Cardiovascular disease (CVD) is the single greatest killer of American adults, both men and women, according to the U.S. Centers for Disease Control and Prevention. Around 610,000 people die a year from heart-related conditions. Considering the scale of CVD problems in the country, any help counselors can offer in helping clients’ reform unhealthy habits is needed.

Tackling the CVD issue takes a collective professional effort, and counselors have a large part to play. The U.S. Preventive Services Task Force (USPSTF) issued an evidence-based recommendation in July 2017 that physicians caring for adults at risk for CVD should consider referring patients to behavioral counselors. Those professionals can help clients adjust their diet and prioritize getting more regular activity throughout daily life.

“Existing evidence indicates a positive, but small, benefit of behavioral counseling for the prevention of CVD in [adults at low to moderate risk of CVD],” the final recommendation read. “Persons who are interested and ready to make behavioral changes may be most likely to benefit from behavioral counseling.”

The USPSTF research supported the idea that counselors can have a meaningful impact in assisting clients at CVD risk. In a 2014 review of data published in the Annals of Internal Medicine, USPSTF researchers found that after 12 to 24 months of intensive lifestyle counseling, selected persons displaying risk factors for CVD experienced reduced cholesterol levels, decreased blood pressure, lower relative risk of diabetes and better weight outcomes on average. In all, the USPSTF concluded behavioral counseling can have a modest positive effect in persons with CVD risk factors.

Some healthy living strategies to address with clients at risk of CVD:

  • Getting more exercise: The USPSTF said the majority of adults don’t get the recommended amount of exercise they need to ward off CVD risk factors: that is, either 30 minutes of moderate physical activity (walking) five days a week, or 20 minutes of vigorous physical exertion (running) three days a week. Often the greatest barrier to getting out and being active is motivation, something counselors can help with. To address this issue, counselors can work with clients to create a physical activity schedule that varies activities and can serve as a reminder to get out and exercise.
  • Eating better: Poor diet is among the most pronounced risks for cardiovascular disease, according to the CDC. And again, many of the same factors that prevent clients from getting regular exercise stop them from eating as well as they should. Ordering takeout is easy compared to shopping for ingredients and spending each night cooking dinner. Encouraging clients to pursue more healthy habits is crucial here, and motivation counts a lot. Help clients get some of the legwork out of the way by connecting them with free community-based resources for recipe and diet planning, as well as advocate organizations for healthier eating.

Guide clients on how to quit smoking

Another overarching risk factor for CVD and general health problems is smoking. Also associated with various cancers (for example, of the lung and the mouth) and other serious conditions, smoking is a major problem for many in the American population. According to the CDC, more than 16 million Americans live with a disease caused by smoking. Just as individuals with poor eating and exercise habits want to change, smokers also attempt to change their habits, but rarely with success. In a 2015 statement, the CDC said that about 7 in 10 current smokers wanted to quit, while more than half had made an attempt in the past year.

Quitting is often a matter of building the personal strength and courage to give up cigarettes or other tobacco products, or receiving outside positive reinforcement, like the kind found in counselor interventions.

Some of the strategies counselors can use to help motivate a client to quit smoking:

  • Framing the situation: Sometimes, the message can only get through to a client in terms they understand. For difficult situations, try framing the smoking problem in dollars. According to Cancer.org, the average U.S. price of a pack is $6.36, and a pack-a-day habit can amount to around $2,300 a year. What’s more, each pack costs $35 in health care costs to the average smoker, which is $12,600 in added medical bills a year if smoking one pack a day. Putting the dire situation in financial terms can sometimes make everything finally click for a client.
  • Motivational interviewing: This is tactic can help long-time smoking clients reconcile the pros and cons of the habit. Smokers often know very well that smoking is bad for them, but for different reasons find it difficult to quit. When approached from a lecturing or “Don’t you know that’s bad for you” perspective, smokers may retreat even further into their habit. In Motivational Interviewing, counselors help clients acknowledge the pros and cons of their habit, and then encourage “change talk,” or personally derived reasons for quitting. In many respects this is about building up a client’s confidence in his or her own abilities to take control of their lives and make a lasting, healthy change.
  • Drawing attention to habits: Smoking becomes so ingrained in people’s daily lives that they might not see the habit as an unhealthy aberration or something they need to change. Lighting up a cigarette when waiting for the bus, after a meal or at regular intervals at work is an action that is baked into a smoker’s every day, and something that counselors can help a client see in a truer light. Once smokers identify routines or triggers that enforce their smoking habit, they can take focused steps that help them quit.
  • Designing coping mechanisms: Still, quitting can be an intensely difficult process for any smoker. Cessation efforts are helped along, however, when smokers have suitable means of coping or otherwise distracting themselves from craving. Raising awareness of quitting products like nicotine gum or patches can help client find alternatives that support healthier lifestyles. Helping clients to think positive thoughts or repeat mantras when feeling an urge to smoke can go further.

Encourage clients to record healthy activity

Getting off the couch once to go for a run is a good first step, but making exercise a regular habit is much harder. Though counselors can provide enough motivation to spur a client to action, the client must take the next step to make that a normal part of his or her life. Mental health professionals can help clients make lasting changes by encouraging them to record their healthy habits, which acts as positive reinforcement to keep clients on a healthy pathway forward.

Some ideas to bring up with clients:

  • Exercise journals: Making a record of exercise helps clients visualize practical gains, as well as motivate them to continue being active.
  • Fitness wearables: Clients can use wearable fitness trackers and accompanying apps to visualize their health and take an active stake in making positive changes. It is important to note that clients must see their physician prior to counselors incorporating interventions that address diet or physical activity. Counselors are responsible to confirm that treatment plans that incorporate diet or physical activity are in compliance with physicians’ knowledge and support.

Get an online master’s degree from Bradley University

Counselors being asked, or expected, to step in and provide physician-like advice to clients, is a sign that modern counseling demands require professionals to get all the education they can to build a diverse skill set. When looking for a graduate degree to build on your learning, consider Bradley University’s online Master of Arts in Counseling program. Contact an admissions officer today to learn more.

Sources:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC486942/

https://www.cdc.gov/heartdisease/facts.htm

https://www.aafp.org/news/health-of-the-public/20170717uspstfcvdfinal.html

https://www.cancer.org/research/infographics-gallery/tobacco-related-healthcare-costs.html

http://www.apa.org/monitor/2008/11/smokers-quit.aspx

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