O.A.R.S for Outpatient

Using O.A.R.S. to steer counseling sessions can help move patients forward, motivating them to make positive changes.

O= Open Ended Questions

A= Affirmations

R= Reflective Listening

S= Summarizing

I had the exciting opportunity to use O.A.R.S. with real patients in the outpatient setting of my clinical rotation. Motivational interviewing techniques such as O.A.R.S. use a client based approach. Just like oars help a rower steer a boat, O.A.R.S. help the dietitian direct the counseling session, while the patient chooses the destination (the goal, such as weight-loss, healthy eating habits, etc.). There might be a few barriers in the water, but the dietitian guides the patient around them to successfully reach the desired destination.

Here is how O.A.R.S. can help you guide your clients to their destinations:

Open Ended Questions- these are what help you gather information from clients to get a better idea of why they came to see you. You can find out tons of information about their past experiences, feelings, thoughts, and beliefs by letting them explain their story. You want to ask questions that go beyond  a simple “yes” or “no” response so they provide you with details. Try asking them “how did you do this” or “what made you do that,” rather than “did you do this?” Remember that you hold the “oars” and your questions are what guide the session.

Affirmations- these are small statements or actions that acknowledge your clients’ efforts in achieving their goals. This is important in improving clients’ self efficacy, which is their beliefs of their own ability to succeed in tasks. The more positive they feel, the more motivated they will be to reach their goal. Some examples of affirmations are eye contact, relaxed facial expressions, and feedback, such as “It is great that you want to find a way to accomplish this.”

Reflective listening- this is when you listen to what clients have to say and reflect on what is pertinent to the counseling session. For example, if he or she wants to lose weight, but explains eating a dozen cookies everyday and then stepping on a scale after eating them, you might want to respond with “So you’re feeling a bit guilty every time you eat too many sweets.” They might agree or disagree with your interpretation, but this shows the client that you are trying to understand their situation.

Summarizing- this is when you summarize your clients’ thoughts in order to keep the session organized and lead to transitions or closures. It might start with something like “Earlier you explained wanting to make your diet healthier... maybe now we can think of some goals to help you accomplish that.” Summarizing information can also help clients decide when to schedule follow-up appointments

O.A.R.S tremendously helped structure my counseling sessions. By following the steps of O.A.R.S, I helped patients become more aware of their barriers and create achievable goals. Some of the patients' goals involved weight-loss, weight-gain, and overall healthy eating habits. I had a great learning experience and am excited to do more nutrition counseling in the future-- I’ll remember to bring my oars!

Practicing on my fellow intern/roomie, Alyssa!