Does the Transformation of Dietitians from Counseling to Therapy Also Apply to the Physical and Therapeutic Environment? A Case Study of Israeli Practice

Research output: Contribution to journalArticlepeer-review


Background: Lifestyle change can be influenced through effective interaction between care receiver and care provider. The physical environment where the interaction occurs can affect the dynamics of long-term therapeutic treatment. There have been no studies on the perception of the physical environment in nutritional treatment. Objective: Our aim was to ascertain the impact of the physical environment on the dynamics and communication between dietitian and patient based on perceptions of dietitians. Design: We conducted qualitative constructivist phenomenological research. Participants: In-depth interviews (n=10) and eight focus groups (n=62) were held with dietitians who offer treatment in a physical environment designed according to the medical model and/or in a physical dynamic environmental design according to the dynamic model. Results: Most dietitians in Israel treat their patients in a physical environment arranged according to the medical model. The participants reported that the physical environment affects the interaction. However, the idea of transforming the physical environment according to the dynamic model raised reservations. Barriers include upsetting therapeutic boundaries, challenging professional authority, and lack of therapeutic tools suitable for the change. Conclusions: Changes in the spatial design in which the therapeutic interaction occurs might support the dietitians' transformation from counseling into therapy. The barriers toward such change suggest that professional training is needed to enable dietitians to overcome them. We recommend conducting further research to evaluate the current physical environment, as well as raising dietitians’ awareness and training them to work in the new environment, reflecting a counseling/therapeutic mindset. These changes should be followed by additional research among practitioners to report on their effects.

Original languageEnglish
Pages (from-to)1047-1056
Number of pages10
JournalJournal of the Academy of Nutrition and Dietetics
Issue number6
StatePublished - Jun 2018

Bibliographical note

Publisher Copyright:
© 2018 Academy of Nutrition and Dietetics


  • Medical and dynamic models
  • Physical environment
  • Profession of dietitians
  • Spatial design
  • Therapeutic interaction

ASJC Scopus subject areas

  • Food Science
  • Nutrition and Dietetics


Dive into the research topics of 'Does the Transformation of Dietitians from Counseling to Therapy Also Apply to the Physical and Therapeutic Environment? A Case Study of Israeli Practice'. Together they form a unique fingerprint.

Cite this