Emotion-Based Counseling

What does this person need from me today?

Every person has needs. Nutrition educators are trained to focus on nutritional and health needs. These needs can be determined by assessments and questions. Logical discussions of how to meet these needs often follow. Sound familiar?

But every person has deeply personal emotional needs that are far more powerful than their knowledge needs. Emotions drive behaviors, making them far more important than facts and logic in the behavior change process.

Emotion-based counseling represents a shift from focusing on knowledge needs to recognizing and attending to emotional needs. We can’t ignore emotions and be successful behavior change agents. WIC is in the behavior change business. Helping people fulfill their emotional needs will help WIC be more successful.

Is it possible to fulfill emotional needs in a WIC clinic?

Yes, it is possible to fulfill emotional needs in a WIC clinic. All people want to feel good about themselves. Emotion-based counseling is the process of using underlying emotional motivators to drive behavior change. People feel good about themselves when they feel more powerful, intelligent, capable, successful and secure.

Traditionally, WIC educators have provided functional reasons for changing behaviors. Here are examples of functional benefits of taking health-related actions:

• When your child is active, she will have less chance of being overweight.
• When your child is breastfed, he will have fewer ear infections.
• When your child drinks from the cup rather than the bottle, she will have less chance of developing baby-bottle tooth decay.

It is the emotional benefits, however, that are likely to drive behavior change. Here are examples of emotional benefits of taking the same health-related actions:

• I am an intelligent, caring parent who protects my child's future when I choose to be active with her daily.
• I am a powerful influence in my baby’s life when I choose to breastfeed. I am giving him a gift that only I can give. I receive a special bond that will never be duplicated. My gift is mine alone, one that only I can give, and the results of that gift can last my child a lifetime.
• I am a mother who takes charge and feels in control of my child’s future when I offer her milk from a cup rather than the bottle. This may seem like a small thing, but I am protecting her innocent smile. When I see her smiling kindergarten picture, I will know that I did what was right.

Feelings are more important than facts

Emotions drive behaviors — but facts and information are still an important part of the behavior change process. In emotion-based counseling, feelings hook people first and logic and factual information follow close behind. Once people are motivated to change, they need simple, practical information to act on. Both emotions and knowledge work together for change, but emotions come first.

The Touching Hearts, Touching Minds (THTM) emotion-based messages follow this simple formula: touch hearts first, and then minds. Images and engaging words hook parents on the front and lead them to read the facts and information on the back.

Open. Dig. Connect. Act.

Emotion-based counseling is invigorating and exciting, not complicated or difficult. These four easy steps will lead you to a more effective way of helping WIC families.

Open: Emotion-based counseling starts with provocative questions, activities or stories that lead to emotion-based conversations, not to an immediate transfer of knowledge. The goal of this "open" step is to allow parents to:

• Feel comfortable sharing emotions and feelings
• Begin to think about a particular topic in an emotional way
• Know that WIC conversations target the authentic core person rather than remain at a superficial level
• Feel that there is a real heart and soul that drives WIC services

Dig: Parents are hooked on the "open" questions and likely curious about what will happen next. During the "dig" step, the WIC counselor uses questions to gain more insight into a parent’s true feelings around a certain issue. As they enter into a comfortable climate for sharing, parents will be able to:

• Feel safe being open, real, candid, honest and genuine
• Recognize that they are not being judged
• Go a little deeper because of the non-threatening climate
• Understand that the intent of the session is to solve real problems, not just transfer knowledge
• Believe that their conversation will help them achieve their desire to be a better parent

Connect: During the "connect" step, parents connect the conversation topic with their values, attitudes, beliefs and feelings. It is these core values that drive behaviors. During the "connect" step, parents reflect on their personal needs and wants and connect them to the health-related behaviors being suggested. In this "connect" phase, parents will be able to:

• Connect deeply held feelings with specific behaviors
• Feel that the desired behaviors are important for them to do because they will make them feel better about themselves as people and parents
• Experience authentic conversations with people who share similar successes, challenges and experiences

Act: Great intentions need landing gear as well as wings. Well-intended thoughts and desires are cemented into action during this step. In this "act" phase, parents will be able to:

• Identify specific action steps they can take to help them be the parent they want to be
• Believe that they can make a difference in their families’ lives by taking action

What is an emotion-based counseling session like?

Emotion-based counseling resembles an authentic conversation between old friends. Both parent and educator are comfortable being open and honest. They don’t dance around on superficial topics or ask direct, closed questions. Instead, the conversation gets to the heart of what concerns parents.

Both educator and parent are comfortable and relaxed and appear to be enjoying each other’s company. Their informal, interactive conversation is peppered with laughter and smiles. They have a conversational tone and share sustained, meaningful eye contact that makes both feel like they really care and are listening. The educator opts for self-disclosure when appropriate, giving a greater sense of trust in the relationship.

A training video was developed for emotion-based facilitated group discussion. While this video obviously focuses on groups, it provides a glimpse of how emotion-based counseling looks and feels. This website has a link to the video under the "Implementation Tools" heading.

There are no defined rules for emotion-based educators but here are some actions that successful ones do often:

• Warmly welcome children of all ages, always saying something positive and affirming to them.
• Use language that shows they are not talking down to the participant, yet simple enough to appeal to WIC families.
• Relate to the feelings and challenges of parents.
• Renew each parent’s sense of hope, allowing them to leave the WIC clinic inspired to change and with a clear path to success.
• Remind parents that they are powerful and that each small action they take can make a difference in their child’s life.
• Affirm parents and make them feel successful, makes them feel like they are great moms.
• Share personal challenges briefly, yet honestly, when appropriate.

People are feeling machines that think, not thinking machines that feel.

So what does this mean for WIC educators?

• Targeting powerful emotional "pulse points" may make WIC more successful at changing behaviors. Pulse points are those key emotional motivators that drive people’s thoughts and actions.
• Changing others may require us to change ourselves first. We need to think of ourselves as behavior change agents who are comfortable talking about emotion rather than merely as information providers.

Commonly asked questions

Is there evidence that emotion-based approaches are effective in changing behaviors?

Advertising and marketing experts have known for years that emotion-based approaches are very powerful and effective at changing buying behaviors. Although no formal behavior change studies using emotion-based techniques have been conducted with WIC participants to date, research suggests that these same approaches will work in changing nutrition and physical activity behaviors.

Is WIC really the best place to talk about emotions? Sessions are already too long and talking about emotions will only lead to emotional outbursts we are not prepared to handle.

Emotion-based counseling highlights the emotional benefits of acting on health-related behaviors. That is very different than just talking about emotions. Parents will likely welcome behavior suggestions that lead them to feel more positive about themselves as parents and people.

Can we use the THTM emotion-based materials without doing emotion-based counseling?

THTM emotion-based materials can be used with any counseling style. However, using them with emotion-based counseling will allow the parent to perceive your approach as harmonious with their needs and interests, and will likely lead to greater behavior change.

I am concerned that the THTM emotion-based materials and approaches are manipulative. Shouldn't the WIC Program take the "high road" and just present facts?

WIC is in the behavior change business. Research suggests that emotions drive behaviors. Logic and facts alone are weaker forms of persuasion than emotions combined with logic. Choosing to highlight the emotion-based benefits of taking health-related actions is an effective behavior change approach, not a form of manipulation.

I didn’t go to school for 6 years to listen to a participant talk about her feelings or emotions. I prefer to give her the information I know she needs.

Our role and responsibility is to change behavior. Because emotions, not facts and information alone, drive behaviors, we need to first talk about and use emotions as a behavior change tool. We can then use our nutrition knowledge to support parents in turning those motivations into specific actions.

How is emotion-based group discussion different than traditional facilitated group discussions?

Emotion-based group discussion is like traditional facilitated group discussion in that both involve interacting with a group of WIC families. Facilitated group discussions focus on logic-based information without highlighting the emotion-based benefits to taking action. In emotion-based group discussion, the facilitator uses provocative questions, stories and activities that lead to acknowledging and discussing feelings rather than focusing on facts alone.

The goal of emotion-based group discussion is to show parents that they can feel good about themselves—more intelligent, important, secure, successful—when they act in ways that promote the health of their family. In this group environment, parents learn from other parents’ challenges and successes—an interaction that focus group findings have shown to be extremely valuable and influential in making decisions about nutrition and parenting.