Emerging Technological Advances in Trauma-Informed Nutrition Counseling

Lisa Jones, MA, RDN, LDN, FAND; Julie Feldman, MPH, RDN

In this podcast, Lisa Jones, MA, RDN, LDN, FAND, interviews Julie Feldman, MPH, RDN, about how advances in technology are improving the accessibility and effectiveness of trauma-informed nutrition counseling and ethical considerations in leveraging technology for nutrition counseling for clients with a history of trauma. This is episode two of a four-part series on trauma-informed nutrition counseling. 

Additional Resources:

Adverse childhood experiences (ACEs). Centers for Disease Control and Prevention. June 29, 2023. Accessed March 22, 2024.

Listen to part one of this four-part series here

Listen to part three of this four-part series here



Hello and welcome to Nutrition411: The Podcast, a special podcast series led by registered dietitian and nutritionist, Lisa Jones. The views of the speakers are their own and do not reflect the views of their respective institutions or Consultant360.

Lisa Jones: Hello and welcome to Nutrition411: The Podcast where we communicate the information that you need to know now about the psychology and the strategies behind the practice of dietetics. Today's podcast is part of a series of short episodes featuring a Q&A with Julie Feldman. Julie Feldman is a registered dietitian nutritionist, nationally recognized nutrition expert, consultant, counselor, speaker, spokesperson, author, and owner and founder of Thrive Nutrition and Wellness, LLC, specializing in trauma-informed nutrition counseling for teens and adults. Julie is from West Bloomfield, Michigan.

Hi, Julie, and welcome.

Julie Feldman: Hi, Lisa. Thanks for having me.

LJ: In our most recent episode, we talked about uncovering the trends in dietetics. We had a great discussion about trauma-informed nutrition counseling. And I do want, if you have a moment, Julie, if you can sum up that conversation in one to two sentences. And I know there were so many great takeaways, but if you can just give our audience one or two from that episode, then we can have them go back and listen to it again.

JF: Sure. So, trauma-informed nutrition counseling, as I define it, incorporates the core principles of providing trauma-informed care in the nutrition setting. Those core principles are safety, choice, collaboration, trustworthiness, and empowerment. So, bringing these two fields together, I think moves us, as clinicians from just information giving to really collaborative work, helping clients to set goals and reach them in realistic ways based on their histories.

LJ: Well said. Alright, let's talk a little bit about emerging technological advances. So, how might advancements in technology, I know it's hard enough to keep up with the technology going on, so many advances, but how do the advancements in technology improve the accessibility and effectiveness of trauma-informed nutrition counseling?

JF: Great question.

And I don't know if we have any really solid data on this quite yet, because obviously all of the technology is emerging. And although trauma-informed counseling and the understanding of trauma, it's not brand new, I think it's still relatively new.

It’s definitely new in the nutrition conversation. Most of our research stems from studies done in the late 90s in the ACE study. If you haven't read or looked at the ACE study, which ACE stands for Adverse Childhood Experiences, that's also a really powerful place to do some reading around that. In terms of advancements in technology, I think just like advancements in technology in any aspect of our life, there are some really wonderful, amazing pieces of it and then there are downsides to it.

So, as we become more technologically advanced, perhaps we become less personal in our communication with each other.

I think in terms of access, the good news there is maybe I live in an area that doesn't have a lot of resources or there isn't someone who provides trauma-informed care in my area, but there is somebody who I'm able to see over telehealth that could be hundreds of miles away, depending on where you live, what your laws are, and so on in terms of providing telehealth in those areas. But I certainly think it opens up the opportunity to collaborate and work with more people because we're able to provide care in that way.

In terms of using AI to write patient education materials or to create presentations and stuff like that, I have not used AI to create a presentation. I do use it occasionally to create a couple of sentences on a topic. It can be really time-saving, but I think we just need to read it and reread it through a little bit of a lens of “Are there biases in this? How does this read?” We talk sometimes about health literacy and everything from what grade level the writing is to is it a person-first language. Even when going for a regular doctor appointment, I find sometimes the doctor is just like on their computer, they're just checking boxes, and everything is automated. And it can make an experience feel a lot less personal. I guess my hope is that we never lose that personal piece, because I think in order to create real change for clients, we have to be able to connect with them at that personal level.

LJ: Yes, I couldn't agree more with that.

I know what you're saying. You go to the doctor and the doctor's all on their computer and then they barely look at you. You could have gone in as somebody else, and they might not have noticed.

So, thank you for that. And then I'm also curious about the ethical considerations because I'm sure there are with technology, as we know, there are considerations that are kind of crossing that line, but specifically for nutrition counseling and particularly for clients with a history of trauma. Can you speak a little bit about that?

JF: Obviously, ethics are always important. I mean, I try to keep them at the forefront of every interaction and every conversation as it relates to technology. That's a really good question.

Anything from privacy? One thing that I do know and I guess something to be mindful of is when you are doing work over telehealth, just understanding where that person is meeting with you from. Are they in a safe place? Is it safe to talk about certain topics with other people around? Are they within earshot of potentially somebody in their house who will respond negatively to overhearing the conversation? So really ensuring that part, I think that is something definitely to pay attention to with telehealth and in terms of leveraging the technology.

I think it's just so new. I think it's really hard to say what are the downsides of this. I personally haven't really found any downside, but the way that I do my charting, I'm not checking boxes. I found that I just didn't like charting that way. But I've had years of experience doing it, so I kind of know what questions to ask.

If you're a new clinician, obviously having that flow and having questions in front of you can feel really helpful so that you're not missing things. But I do find, and I always say whenever I teach, if your client's talking about something, listen to them. Even if they're talking about their cat or their boss or their neighbor, the neighbor's boss's cat, like whatever it is, if the client's talking about it, there's some relevance of that topic to them in their lives. And the more you can make them feel safe, the better.

I also have really enjoyed, I switched to totally telehealth since COVID, but I actually think it's better because I'm able to see somebody in their surroundings. I work with a lot of teenagers. I'm able to see their bedrooms. I'm able to see somebody's space. I can tell if somebody has a room that they, look like they would feel comfortable in or live in a house that looks particularly disheveled, not that I would be judging in any way, but I think it's really interesting. And it can help sort of paint a picture where you understand the person better. Seeing somebody in their own surroundings. I know I'm sort of veering off the question a little bit, but I do think that that's perhaps one of the benefits of the advancements in technology.

I guess one thing to think about too is how people are receiving their nutrition information because of all of these advancements, there are all these apps, and there are all these quick little snippet-type things and if we assume that delivering these soundbites or having somebody interact with a digital interface where there's no personal connection is going to create the same outcome as really forming a trusting relationship with a clinician. I know that there is some data on that. I don't know the statistics exactly, but in my opinion, that just would not be the same. So, if we're talking about delivering nutrition information, particularly in a population of people who've experienced trauma in their lives, I would say while technology may be helpful in the initial connection, creating that really personal bond is where it's at.

LJ: Exactly, you can download an app, open it once, and then never use it again. The app's not giving you acknowledgment, and that's what you're giving to people. You're listening to them.

JF: They feel hurt. Not only is it not giving acknowledgment, but it's often re-traumatizing, really. It really is, because especially, let's say I'm using an app that tracks my intake, think about that.

And I've always struggled… let's say, to lose weight. And now literally all day, every day, I'm logging stuff in this app that's basically telling me that I'm bad or I'm not meeting my goals or so on and so forth.

So, it can be really, really traumatic to be interacting in that way where it's just black and white. It's just numbers.

LJ: Thank you for the good nuggets from this conversation and our talk all about technology.

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