Poor Tom Got it WRONG! BRAND NEW Training Announcement. Learn about GOOD open questions stems
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Issue 22 October 2015

Welcome to Issue 22


What a fabulous day of training Pavestones experienced in Orange NSW this month with such an enthusiastic and insightful group of APDs. We enjoyed experimenting with all sorts of new skills and some familiar friends in the new 1 day Pavestone Workshop: 'Counselling Skills for Behaviour Change An Introduction'. Plenty of laughs and brave debriefs greased the wheels of a powerful day. I am very grateful to Rosie Baccarini for organising the training for 20 or her colleagues and for going the extra mile to make me feel so very welcome. Thanks Rosie!

Are you a regional APD? Do you work in a team that would be interested in a fun day of skills practice? Why not consider Practice Pavestones for an in-service at your area health or hospital department in 2016? Check out the details in the Classified boxes at the end of the newsletter. Get in touch! I'd love to hear from you.


Give-Aways and CPD Quiz next Issue!

Can you believe this will be our last issue with new editorial for 2015! Where has the year gone? The final issue for 2015 will be a combined Nov/Dec issue with a new CPD Quiz for the year's newsletter content just in time for APD renewals for 2016. Don't miss it for a fabulous promotional give away for Quiz customers.

In This Issue

In Issue 21 last month, we opened up an exploration on the topic of questions and invited some consideration of using open questions that promote exploration for the benefit of our client's insight and autonomy in the change process. For quick revision or if you missed it take a look here. In this issue I am going to briefly present a couple of word stems that can help shift our questions from closed, data-heavy blockers to open, exploration inviters
As always if you are short on time scroll down to the
Purple Pavestone Box at the end..........happy reading!


 Practice Pavestones Presents:


'Skills and Wisdom for Working with Appetite'


One Day Workshop
Facilitated by: Sue Zbornik APD
Author of 'Find Your Happetite'

February 5th 2016 Crows Nest Sydney .

Sue Zbornik is an Accredited Practicing Dietitian with a Master’s Degree in Educational Counselling from the University of Wisconsin.  For more than 20 years Sue has specialised in helping clients to manage the symptoms of their eating problems and to trust their bodies – and appetites – again. Ms Zbornik works in private practice in Bondi Junction, NSW and is the author of Find Your Happetite a book providing practical tools to help clients reconnect with their natural appetite.
Practice Pavestones is proud and excited to present this wonderful  learning opportunity with Sue Zbornik. Brave and creative thinkers like Sue do not come along very often. For all you need to know about the workshop - who should come, what you'll learn, costs and closing dates please click on the 'Learn More' button below


Have you attended a Pavestone event in the past?
Alumni can access Early Bird rate until final regos close!


Nov/Dec Issue of  Pavestones

will be giving away 5 copies of

'Find Your Happetite' 


2015 CPD Quiz customers. 


Why? Why? Why? Delilah!

How to Start a Helpful Open Question

Nothing I say today will teach me anything.
If I am going to learn I must do it by listening

Larry King

The ability to ask the right question is more
than half the battle to finding the answer

Thomas J Watson

I have no special talents I am only passionately curious
Albert Einstein

First of all, so sorry for getting 'that' song in your head! Poor Tom, such agony. For those of you who don't know Delilah and Tom's tale of woe, you're going know exactly what I'm talking about with this month's soundtrack.

As mentioned in the wrap up of last issue, this editorial will be exploring in more detail the formulation of open questions and we'll get some practice in converting closed to open questions using handy word stems. 

'Word Stems' for Open Questions

Typical choices for getting your questions off to an open start include:
  • What
  • Why
  • How
  • Where
  • When
  • Which
This is in contrast to these typical closed question openers:
  • 'Do you......'
  • 'Did you.....'
  • 'Can you....'
In the list of 'Word Stems' above, the blue, bold, heavy-hitters are handily represented in this graphic:

You'll notice in this graphic that the 'WHY' is represented as a red hot button. Most of us know we need to take care when pressing a red hot button! Starting off a question with 'WHY' needs to be done very carefully. I'll say a little more before we close.

Let's Play with some Examples

Here is a sample of four questions we experimented with converting from closed to open formats at the recent one day training in Orange NSW.

As you read through, you may like to get a sense of how the open conversion invites much more exploration and gets the client thinking. Getting our clients thinking is what we want when aiming to enhance their sense of autonomy in the change process.

You may like to imagine some the the possible answers to these questions both open and closed. Perhaps think about how responses to the open questions may naturally include some 'change talk'. Change talk is when the client verbalises their own change idea or own reason for change. It's juicy good work when that starts to happen.

(if the table doesn't display correctly you may need to view on your desktop)

Closed Question

Did you make the changes we discussed last session?

Open Conversion

What did you notice about your eating after the changes we discussed last session?
Can you eat more vegetables?
How could you add some vegies to your diet?
Did you lose weight when you exercised in the past?
What impact did exercise have on your health and well-being last time?
Do you drink on the weekend? 
How much do you drink on the weekend?
What are your drinking patterns like on the weekend?
You'll notice I did a tricky thing with the last example. I included a 'How' question as an example of a closed question. This is to demonstrate there are no guarantees with the open question word stems. A 'How' or 'What' question may still invite a closed, one word, data-style answer. Consider the response to: "What brand of milk do you drink?'. So the invitation is to practise and listen to ourselves.

Closed questions aren't entirely a no-no of course. Sometimes we have to collect some quick data. In these explorations you are invited to become aware of how often you use closed questions and where it would be appropriate to start substituting for an open one. The benefits are powerful. 

Why, Why, Why..... is 'Why' a bit Dodgy?

Remember the red hot button above?

'Why' questions can go so straight to the point they can feel a bit intrusive.

'Why' questions aren't impossible to use well,  in fact responses to them can be epiphanous! we just need to be very careful with tone and soften down a bit. Where possible when you are just starting out (and even when well practised) try to substitute 'What' and 'How' for a 'Why'.

Consider the difference between:

Why did you think skipping carbs would be helpful this week?
What got you thinking skipping carbs would be helpful for you this week?

You may sense the call to 'justify yourself' that can subtly lurk in the 'Why' question. Good open questions contain and require an implicit safety to be able to invite exploration. That's where 'Why' can get a bit dodgy.
Like 'shootin' fish in a barrel' as they say for this issue. Most of you will be very familiar with the Tom Jones 60's anthem 'Delilah'. For a serious laugh you must watch the clip. The dancing in the audience ....there are no words to describe it! Click on the very young Tom below. Enjoy!


'Why? Why? Why? Delilah'

Issue 22 Pavestone
Open Question Word Stems


Nutrition is a science. Eating is a Behaviour. 
Behaviour change is difficult.

Active Listening is a fundamental skill, core to the process of understanding our client's experience, inviting their trust and building the helping alliance

Active listening is as much about how we respond to our clients' communications as it is about how we attend to our clients' communications.

The questions we ask our clients can open up opportunities to actively listen or close them down.

A closed question is typically a question which can be answered by a specific short answer, single word or a 'Yes' or a No'.

An open question is harder to answer and invites the client to think in order to respond. An open question is explorative and invites the client's expertise not the practitioner's.
Open question word stems include 'What', 'How', 'Why', 'When'  and 'Where' . The safest and most effective to start with are 'How' and 'What'

Caution needs to be exercised with the use of 'Why' as this can be experienced as intrusive and impact on our client engagement.

Suggestions for Reflection

Listen out at work or brainstorm with your colleagues, all of the closed questions you can think of or hear yourself say. Write them in your reflective practice journal

Use the word stems to practise translating your closed question samples into open questions. Try to develop a couple of open samples for each closed question you think of.
I'd love to hear your thoughts, curiosities, insights. Please email me to let me know.

Enjoy experimenting!
Keep reflecting!

Tara MacGregor

Counselling Skills Training for Health Care Agencies and Hospital Departments

PLAN NOW for 2016

Practice Pavestones has recently delivered a new one day training program specifically written for Hospital and Health Agency in-services. Titled: 'Counselling Skills for Behaviour Change: An Introduction' the training received some fabulous feedback:

'Thanks again for such a fantastic training day last week. Implementing counselling skills has been the hot topic around the office all week, and I have received lots of positive feedback on the day. We found it both rewarding and challenging (in a good way), and already we can identify so many patients who would benefit from our new skill kit. Hopefully we can have you back in the Central West sometime soon! R.B APD

The information flyer for this training is currently being published and will be available next issue. If you are interested in organising training for your department next year please email Tara Here as the schedule is being planned now.

Food-Eating-Body-Mind-Workshops for Dietitians

Melbourne - Nov 26 & 27 2015

Day 1 (Nov 26th) - Boosting Body Image
Day 2 (Nov 27th) - Dietetic interventions with over-eating & binge eating presentations
More information: HERE

Great PD just around the corner - don't miss out!

Dietitians Retreat, Byron Bay

March 12-16, 2016

"Bringing Neuroscience & Mindfulness into Food, Eating & the body"

This is the 2nd Byron Bay Dietitians Retreat, with last years sold out in 3 days! Please join us for an unforgettable 5 days of learning, networking, yoga-ing and relaxing in a stunning location.

More information: 

Supervision and Mentoring
A Great Way to Affirm Your Skills

To learn more about Supervision and Mentoring have a look at Tara's Supervision page HERE 

Have you ever worked with people with weight concern?  

Fiona Willer, APD, is undertaking research as part of her PhD into the factors which influence the weight control beliefs of dietitians.  This research has the potential to benefit the profession of dietetics by providing insight into the factors which influence dietetic practice and thus also potentially benefit dietetic patients/clients by broadening the choice of treatment available for weight concern. 

There are minimal risks associated with your participation in this project. These include possible discomfort if you have a history of disordered eating. 

If you would like to participate in this study, please follow this link to the study site.

You will be provided with further information to ensure that your decision and consent to participate is fully informed. Thank you!


Looking for Past Issues of Practice Pavestones?

It's so easy to access past issues now through Tara's blog on the new website. Click here and do let Tara know if you have troubles finding what you are looking for

This Month's Good Read

Judith Matz, LCSW is a Clinical Social Worker, author of Amanda’s Big Dream and co-author of The Diet Survivor’s Handbook (2006) and Beyond a Shadow of a Diet (2nd edition, 2014), has published this article on 'the body is not an apology' website:

9 Common Mistakes Parents Make About Their Kid’s Weight

Highly recommended. Great reference section at the end

Beyond a Shadow of a Diet is an excellent practitioner resource; one of my personal favourites

Affirm Your Knowledge!
Online CPD Quiz for Editions 1-11

You can turn your dedicated reading of Practice Pavestones into assessed CPD hours with on-line convenience using the 2014 Quiz.

You can access the quiz Here for a fee of $9.95

The CPD Quiz features 11 multiple choice questions with multiple correct answers based on the content of editions 1-11. Points are awarded for each correct answer. You can print your results for your records with all marked questions recorded. Price includes multiple attempts of the quiz if you wish to learn as you repeat. You can also break during testing if needed and access your incomplete quiz on-line at a later date.

If you would like to access issues 1-11 for revision the best way to do this is via Edition 12 which has a synopsis of each issue and a link for handy access to the complete editorial for each issue. It's available Here

Tara MacGregor PACFA Reg. 21520

 BSc MSc H.Nut & Diet. G.Dip Couns

Tara MacGregor is a dual qualified Accredited Practising Dietitian and Counsellor & Psychotherapist in private practice. Graduating from Sydney University in 1991 she has worked in a broad spectrum of clinical areas in public and private hospitals until specialising in disordered eating in 2004. Tara works exclusively in the non-diet paradigm and is a committed teacher and promoter of the Health At Every Size (R) philosophy. Tara is a PACFA Accredited Supervisor, Member of the Motivational Interviewing Network of Trainers (MINT) and author of The Essential Counselling Skills for Dietitians Workshop. Tara provides skills training and mentoring in the form of clinical supervision for Health Professionals and enjoys tremendously the exciting opportunities, insights and growth this offers both herself and supervisees. 

Make an enquiry about supervision and mentoring with Tara.

Suite 3, 780a Pacific Highway Gordon NSW 2072
M 0459 991 788
Copyright © 2015 Tara MacGregor, All rights reserved.

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