Mentorship Model

Build a future worth protecting

Food and Nutrition

Week 1: Initial Assessment

Defining Objectives

What insights do we expect the client to attain? What actions will they take this week, both in and out of session?

  • Client will recognize the negative impact that his diet has in other areas, connecting the behavior (poor nutrition) to at least one tangible or emotional consequence (lack of energy, negative body image, health issues). Client will also explore the associated feelings surrounding his diet
  • Client will develop a deeper knowledge of what healthier food and nutritional choices look like and be able to draw a connection between making those choices and bringing about a desired goal or outcome.
  • Client may reflect on his relationship to food and his usual dietary choices. Client will begin to consider making a change based on his learning and increased self-awareness

Taking Action

What will you look for in this session? What actions will you take to facilitate the desired outcomes for the client?

  • Provider will assess the client’s motivation for moving through stages of change model. Provider will tailor psychoeducation to meet the client where they are at and set realistic expectations for progress.
  • Provider will use motivational interviewing skills like open ended questions, decisional balance and scaling questions to gauge client’s awareness of how his diet and nutrition may factor into the goal or desired outcome the client set out to achieve (ie: freedom from his parents, improved self image, more motivation/drive, feeling better about self)
  • Provider will offer psychoeducation around the benefits of healthy eating. Provider will help the client to identify one tangible, positive change that the client can implement to improve his diet
Questions to Consider Resistant Client Corner
  • What are some of the client’s ideas and beliefs about food?
  • How does the client’s family think about and experience food?
  • What kind of access does the client have to nutritious food during the week?
  • Does the client exhibit any rigid or disordered patterns in their diet?

Consider the client’s other interests and role models. For instance, an athlete might respond to insights into what a star player on their favorite pro team eats during the season to boost recovery.

Pro Tip: Everyone is motivated by something! If the client is resistant to making changes, help the client to draw explicit connections between their diet and their personal goals.

When to Check In

It is common for a client to be skeptical about the impact of nutrition and diet. Adolescent and young adult males are known for their ability to eat poorly without as many visible repercussions as the rest of the population. As a provider, your role is to explore the client’s underlying relationship with food to help him build lifelong healthy habits. If you encounter any of the following indicators, however, it’s time to consult with your supervisor:

  • Extremely fixed or rigid beliefs about what foods are “safe” or “good” to eat
  • Indicators of disordered eating habits such as calorie restriction, hiding food, purging, or regular binge eating

Week 2: Re-evaluating Choices

Defining Objectives

What changes can the client implement to continue improving his diet? What impact has a more intentional approach to eating had in his daily life?

  • Client will build on his efforts to understand how diet may be negatively impacting his life life by envisioning the positive benefits that lasting change could bring
  • Client will be able to talk more openly about his diet choices, noting any changes he made alongside any relevant changes in his mood, energy, focus, or performance
  • Client will express more openness towards the idea of putting in conscious effort to improve his diet and develop a healthier relationship with eating

Taking Action

How will you define progress for this client? What degree and pace of change is going to be realistic?
Provider will assess the client’s self-awareness and ability to follow through on commitments made in previous sessions.

  • Provider will modify or supplement psychoeducation based on the client’s actual progress.
  • Provider will use motivational interviewing skills like open ended questions, decisional balance, and scaling questions to gauge the client’s willingness to build on recent changes
  • Provider will celebrate last week’s behavioral change, encouraging continued change(s) or consistent adherence to previous change while tying it back to client’s motivation
Questions to Consider Resistant Client Corner
  • How successful was the client at implementing his goal over the past week?
  • What does the client’s description of his typical eating habits tell you about his ability and willingness to care for himself?
  • How might the client’s home life or personal circumstances be impacting his ability to improve his diet?
  • Does the client exhibit any rigid or disordered patterns in their diet?

Clients may respond with sarcasm or cynicism when confronted with a challenge to protect themselves. If the client states that he “doesn't care enough” or “just forgot” about his goal, dig deeper to understand what they did put effort into and why. Ask open ended questions that engage the client in a respectful dialogue, versus closed questions that end the conversation and can appear patronizing.

The client may also be covering up for embarrassment at their perceived lack of knowledge about or lack of access to a healthy diet. Emphasize that each client’s journey is their own and offer to support next week’s goal with a text reminder or scheduled check-in to promote accountability.

When to Check In

For younger clients who may not be fully in control of the foods they have access to, the food their family purchases will have a big impact on how that client eats. It may be worth consulting with your supervisor to schedule a family meeting if:

  • The client reports a lack of access to fruit, vegetables, and high-quality protein at home
  • The client reports going to bed hungry or not getting enough to eat
  • The client’s overly strict preferences are causing friction at home
  • The clients diet is contributing to clinically significant negative outcomes

Week 3: Establishing Consistency and Promoting Curiosity

Defining Objectives

How can the client move from short-term changes to long-term habits in his diet? How do we want the client to feel as he is walking out the door?

  • Client will talk about the challenges associated with previous efforts to make behavioral or lifestyle changes
  • Client will feel a sense of optimism and confidence in his ability to stick with a new habit. Client will feel heard and listened to as he collaborates with his provider around different behavior change approaches 
  • Client will walk away from session feeling like consistency is more important than breadth or quantity of changes made to diet and nutrition

Taking Action

What support systems will the client need to envision long-term change?

  • Provider will assess the client’s previous week’s behavior change and will encourage continued growth in those specific behaviors. Provider will celebrate small wins and offer encouragement that the client’s efforts will pay off
  • Provider will remain mindful of pacing and keep in mind that change is hard. Provider will support client by attending to ambivalence with motivational interviewing and validating the client’s struggles
  • Provider will intervene with methods that encourage client to remain consistent in his change(s) versus adding more
Questions to Consider Resistant Client Corner
  • How does the client think about his own efforts and ability to change?
  • Has the client done any research or experimentation with diet beyond what was discussed in session?
  • How does his progress align with your initial impressions?
  • How might the client’s presentation and demeanor be impacting people’s expectations and treatment of the client?

If a client is doubtful about his ability to stick with a goal, think about how you as a provider can support the work he has already done. For instance, if a client had success eating more fruits and vegetables, make a list of his favorites for the next grocery run or even go together to shop for the foods on his list.

Ensure that the client does not feel undue pressure to change all at once. Consider avenues for finding balance, such as a “cheat day” or celebratory lunch that allow the client to enjoy themselves while still making progress overall.

When to Check In

By this point, you should have some solid insights into the client’s ability to follow through on their goals as well as their self-concept and belief in their ability to change. Consider checking in with the client’s care team if:

  • If the client demonstrates variability in their ability to remain consistent 
  • If you feel like you are working harder than your client by this time on this domain, it’s worth bringing this up with your supervisor

Week 4: Lessons Learned

Defining Objectives

What will the client take away from this module? How will he apply what he has learned to his daily life once diet and nutrition are less of a focus in sessions?

  • Client will be able to make distinctions between past and present efforts to improve his diet, identifying key changes he has or will make in order to maintain his progress
  • Client will make firm commitments with himself and his provider using language like “I will…” and “I plan to…” around the concrete behavior changes the client will make moving forward. 
  • Client will be able to use his newfound knowledge to summarize in his own words the work he has done and the plan he has created

Taking Action

What steps will you take to prompt self-reflection and create a supportive environment for goal-setting

  • Provider will engage the client in reflective discussion around growth and changes, paying particular attention to connections between the client’s observations on his diet and the broader goal or motivation that the client has identified
  • Provider will elicit change talk and commitment from the client through MI, challenging the client to build future plans based on previous results
  • Provider will ask the client to summarize the interventions that have taken place, the challenges he has overcome, and the successes he has experienced in order to ensure comprehension
Questions to Consider Resistant Client Corner
  • How well has the client understood the work he has engaged in? Is the client internalizing lessons around diet and nutrition in a way that will allow him to apply those lessons on his own? How do I know he is or isn’t?
  • How will you and the client respond to a slip-up or regression in his diet? What factors in the client’s life are most likely to trigger a step back?

If the client is resistant to a verbal summary, consider alternatives like a written contract, journal entry, or video diary.

Invite clients to offer advice to their past selves or otherwise make the task their own.

When to Check In

As the module wraps up, the client should be exhibiting signs of comprehension and commitment towards improving their diet. Before moving on, you should have confidence that the client can retain at least some of the behavioral changes discussed on his own outside of session. In planning for the next stage of the client’s program, consider checking in with your supervisor if:

  • The client seems unable to identify the interventions you have discussed even after multiple meetings
  • The client has exhibited an overall lack of progress in this area or expresses a lack of commitment towards improving their diet