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The Art of Counseling Step 1: Assess - Blog Image

The Art of Counseling Step 1: Assess

BY: Andrea Nakayama

DATE: 2018-05-29

Have you ever noticed that as soon as the cat is out of the bag that you know a little something about health, nutrition, and how to help people feel better, that people start coming out of the woodwork, asking you how to fix this or remedy that?

Or perhaps you’re keen on building your business, so you mention that you work in the field of diet and lifestyle counseling, only to get barraged by questions from people hoping you might have that elusive quick-fix they’ve been searching for.

People approach you—on the soccer field, at birthday parties, even in the produce section of the grocery store…“My daughter tested negative for candida, but we can’t seem to remedy her itchy butt. Do you think this oil of oregano will help?”

You want to help.

That’s why you got into this field in the first place—you have a strong desire to help people feel better.

But the moment you give a dinner party (or grocery store aisle) consultation, I’m afraid you’re no longer practicing Functionally.

The Answer on how to Practice Functional Nutrition Effectively

To practice Functionally, you need to look at the whole person. Not just all of their symptoms (ie. that itchy butt), but their entire life.

To give a Functional recommendation, you need to know their current circumstances, their genetic predispositions, their everyday routines and habits, and even what I call their Inspiring Factor—the deep—down sometimes-embarrassing thing that really inspires them to make the lifestyle choices that it’ll take to finally feel better.

What is an example of an Inspiring Factor?

For the girl whose mother asked about oregano oil, her Inspiring Factor might be to avoid sneaking away from her middle school friends and gymnastic practice to scratch her butt every 15 minutes, or the distressing appearance of scratched red skin on her bottom that’s visible in the girls’ changing room. Or it may be that it’s getting increasingly difficult to sit on the hard chairs at school.

There’s an art to practicing Functionally, and it begins with learning more about your client than you can possibly glean from a 5 minute conversation while you both stare at the ingredients of an over-the-counter supplement in the health food store or a plateful of food balanced on your lap at a potluck.

Step 1: The ‘A’ in the Art of Nutrition Counseling

The first step to practicing Functionally is to assess.

You cannot give sound recommendations if you do not know who it is that you’re advising and what they’ve been through to date.

What Makes a Good Nutrition Assessment?

A good assessment makes use of a comprehensive Intake Form, the Functional Nutrition Timeline, and the Functional Nutrition Matrix. It also takes time, patience, and curiosity to understand the complexities of the unique person seeking your help and their individualized case.

Only after you properly assess can you move on to Step 2—the ‘R’ in the Art of Counseling—recommend. And even that’s done with a watchful eye!

I’ll speak about the ‘R’ and the ‘T’ in the Art of Counseling in separate posts, (can you guess what the ‘T’ stands for?), but before I do, let me be clear that to assess is different than to diagnose. And this is great news, because whether or not it’s in your scope of practice to diagnose, you can assess!

Why is a Functional Assessment Essential?

A Functional assessment is missing from most health and medical practices. It’s even missing from most Functional Medicine practices, creating a GAP in Functional Medicine that is in need of practitioners like you.

Functional assessments provide the chance to slow things down and ask WHY instead of just focusing on WHAT and HOW.

And it’s the WHY that enables us to find and address the root causes of our client’s symptoms. That’s what it means to practice Functionally. And like its name suggests, it’s a method that functions well if you follow the steps, but more importantly, helps your client’s body to function as it physiologically should! This is where she finally starts to feel better.

Avoid Fragmented Nutrition and Wellness Diagnoses

When we jump the gun and provide nutrition consults at the dinner party over the wild salmon and kale salad, we’re as stuck in what I call the X for Y Paradigm—continually attempting to squelch one symptom with one remedy—as the systems and paradigms we know don’t typically work. We can put our hands on our hips and claim that what we do with diet and lifestyle modification is important and maybe even “better” than the standard of care, but it’s an approach that falls prey to the same problems as antibiotics given prior to determining the bacteria that needs to be targeted by that intervention if a proper assessment is not employed.

The good news is that practicing Functionally really can get at those roots, helping even those who’ve been everywhere and tried everything to finally feel better. This is why embracing Step 1 (the assessment) is so key. It sets you apart.

Remember, no matter how badly someone wants an answer, you’re not serving anyone by skipping steps.

Next time you’re approached as the expert that you are, show your integrity and expertise by saying something like this:

“Ooooh, I’m sorry to hear your daughter is experiencing that. There are a number of factors that can lead to the itching she’s experiencing. If it persists, feel free to reach out and I can explain how I work to understand the whole history of a case, along with the presenting symptoms, to more effectively find a sustainable resolution.”

Give it a try and please do let me know how it works for you!

Learn More about the 3 Steps to Practicing Functionally by Continuing to Part 2: Recommend

The 3 Steps to the ART of Practicing Functionally:

A.R.T. | Functional Nutrition Lab

The 3 Steps to the ART of Practicing Functionally:
Step 1: Assess
Step 2: Recommend
Step 3: Track

Related Blogs

The Art of Counseling Step 2: Recommend
The Art of Counseling Step 3: Track
Ditch the X for Y Paradigm
What’s Functional and What’s Not, Part 1

Andrea Nakayama

By: Andrea Nakayama, FxNA Founder & Functional Medicine Nutritionist

Functional Nutrition Alliance provides the comprehensive online Functional Nutrition training in the Science & Art of the Functional Nutrition practice. Learn to address the roots of your clients’ suffering with client education, diet & lifestyle modifications.


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