John Maher

There is limited theory or knowledge regarding dietitians’ nutrition philosophies and how these philosophies are generated and incorpo- rated into their professional practices. For the purposes of this research project a conceptual framework explains and defines ‘philosophies’ as three different types of knowledge; episteme, techne and phronesis. This study aimed to develop an explanatory theory of how dietitians source, utilise and integrate nutrition and practice philosophies in their private practice. Grounded Theory methodology was used to inform the sampling strategy, data collection and analytical processes. Data were collected via in-depth, semi-structured inter- views, with ten private practicing dietitians in Australia. Analysis of transcripts occurred concurrently with data collection and informed further sampling. Data analysis was initially inductive; coding concepts, categories, properties and dimensions which were then grouped into central categories or themes. This study highlighted that private practice offers a unique context in which dietitians deal with complex issues as both therapists and business owners. The results how that dietitians form collaborative relationships with their clients to nurture change over time. They use intrinsic and intertwined forms of episteme, techne and phronesis which allows them to respond both practically and sensitively to their clients and their needs. Learning and integrating these forms of knowledge are situated in and enriched by their own practice experience. Dietitians’ philosophies of practice and nutrition adapt through experience, feedback and reflection and become embedded over time. Dietitians in private practice strive to continuously learn, improve and adapt their business and nutrition practice philosophies to better serve their client base

There is limited theory or knowledge regarding dietitians’ practice philosophies and how these philosophies are generated and incorporated into their professional practices. For the purposes of this study, a conceptual framework will explain and define the ‘philosophies’ as three different types of knowledge; episteme, techne, and phronesis. This study aimed to develop an explanatory theory of how dietitians in private practice source, utilise, and integrate practice philosophies. A grounded theory qualitative methodology was used to inform the sampling strategy, data collection, and analytical processes. Semi-structured interviews with dietitians in private practice were undertaken and data were collected and analysed concurrently. The results show that dietitians form collaborative relationships with their clients, in order to nurture change over time. They use intrinsic and intertwined forms of episteme, techne, and phronesis, which allow them to respond both practically and sensitively to their clients’ needs. The learning and integration of these forms of knowledge are situated in their own practice experience. Dietitians adapt through experience, feedback, and reflection. This study highlights that private practice offers a unique context in which dietitians deal with complex issues, by utilising and adapting their philosophies.

“Insofar as ethics occurs in the context of human relationships, our ability to discern right from wrong and good from bad depends to a significant extent on how open we allow ourselves to be to others. By sharing and comparing stories we learn to better appreciate where our lives and experiences intersect with the lives and experiences of others. Ethics takes place at this intersection. In a very real and important sense, the ethical landscape of each clinical encounter is subtly negotiated through shared understanding. Through sharing we cultivate empathy, and from empathy we internalize the motivation to behave toward others as we ought. Empathy is the impetus to respect, and respect is the core of ethics. Narrative is the mechanism that brings it all together.”.

These short cases are intended to stimulate thought or perhaps serve as a useful tool in a classroom or discussion group setting. The cases have been modified to protect confidentiality but do represent real life elements and situations that have been encountered by ACT team staff. Many or most case situations presented may be familiar to ACT Team staff members. Will all ACT team members view each of these as ethical problems? Were others aware that all of these things happen within the clinical milieu of assertive community treatment?