You're reading another installment of Practice, Liberated, my bimonthly(ish) email where I share actionable tools, tips, insights, and strategies for growing a thriving, values-aligned private practice.

Hi Reader,

Someone posted a question in a dietitian Facebook group recently, and I thought I'd share a version of it here as I bet a lot of dietitians can recognize themselves in this (I know I can!):

This is so common, as most of us received a lot of training on how to educate but not much support in how to structure sessions to best support behavior change.

I too went from a clinical inpatient job to my own private practice, and oh boy, when I think back to those first clients I worked with...eeek yikes! Little baby dietitian counselor Alissa...I have lots of compassion for her (lol and for her clients!).

In acute care, and many other areas of nutrition, your job is to gather data fast, assess, and intervene (umm ADIME anyone?). You're trained to extract information and generate a plan.

That skill set doesn't disappear in private practice, but the container it lives in has to change completely.

Private practice (and outpatient nutrition in general) isn't about fixing everything in session one (or two, or three). It's about building a relationship, ensuring your client leaves session feeling heard, supported, hopeful about the process, and clear about what comes next.

Here's the part that trips a lot of dietitians up: structure doesn't mean a fixed lesson plan for each session.

Follow-up sessions work best when they're responsive to what your client is bringing that day, while also being held within a larger clinical arc. Your job is to do both at once: follow what's present for your client in the moment, while keeping the bigger picture in view.

If a client comes in wanting to talk about a rough weekend around food, that's the session. Don't override it with what you had planned (which is exactly why I don't recommend planning session content ahead of time). You never know what they're going to bring in.

At the same time, you're tracking patterns over time in a way your client often can't see for themselves. Part of your role is gently naming those patterns when the moment is right. The balance to hold: responsive enough that clients feel met, structured enough that they feel held.

So session "structure" isn't a script; it's things like:

• A repeatable shape to how sessions open and close, so clients know the rhythm, even when the content shifts.
• A general session "arc": check-in on last session's focus/goals/action items → new topic/education (maybe) → collaborative goal-setting → recap of what they're taking away.
• A way of tracking themes and progress across sessions, so you can name patterns clients can't see themselves

No matter what, your follow-up session "structure" should be a loose framework, not a rigid sequence.

As always, follow your client’s energy and get curious. My favorite question in a follow-up visit: “Can you tell me more?”

How do you structure your follow-up visits?? I'd love to hear! Send any thoughts, comments or questions my way :)

Warmly,

Alissa

P.S. If you're feeling like this dietitian — knowledgeable, but structure-less — that's exactly what the Client Retention Toolkit is built for: it includes my follow-up session template (structure AND a guide) and a session-by-session roadmap, along with a bunch of other rentention and relationship tools to use in your client sessions.

Alissa Rumsey, MS, RD, CDN, CSCS

CEO & Founder, The Liberated Clinician Business Training

Empower Your Practice: www.theliberatedclinician.com​