Why Your First Session Feels Chaotic — And How to Fix It
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[00:00:00] I remember one of my first in-person sessions when I was just starting out as a dietitian. The client shared everything and I just kept gathering information instead of leading, but we ended the session with not quite a clear plan, and she did not rebook on the spot to see me again.
And I hear the same thing from dietitians all the time. That quiet, uncomfortable moment after a session where you think, did I even help that person? Now, if that's familiar, I want you to know that it's not a confidence problem at all. It's not even a knowledge problem. You know a lot. It's a structural problem, and today I'm gonna show you how to fix it and how I fixed it over the years.
So you might be wondering, like why do your first sessions feel chaotic or why do sessions feel chaotic in general? If you haven't really thought about it, it's because you're trying to do everything at once. Most of us are trying to solve a [00:01:00] lot of problems at the same time, so you're probably trying to get a full history.
Food journal review, education may be more than needed. Goal setting, motivation, action steps, smart goals, documentation. So it's not that you're doing it wrong, you're doing too much. A lot of my philosophy is finding ways to do less. So if you've ever felt like you're juggling 12 balls at once, that's probably because that is what's happening during a session, especially your first initial sessions.
The second reason why this session might feel chaotic is because there's not a predictable flow. that's actually been one of the hardest for me to really tighten up, is getting that flow structured and having us both be on the same page, me and the client. So if you're winging it, or if your client is emotionally unloading, those are hard for me.
in my practice, I've found that 40 minute sessions are the sweet spot. And I've done YouTube videos about that and talked about why 40 minutes [00:02:00] works because it's structured enough to create clarity, but it's also contained enough to prevent spiraling.
The third reason your sessions might feel chaotic is because the client unintentionally takes the lead. So they jump from hormones to stress, to sleep, to cravings, to weight. And you follow the thread because you wanna help them and you're a good person and you care about your patient and your client.
but the session can lose direction and create more chaos, and that's where motivational interviewing can feel confusing because. Motivational interviewing isn't not about letting the session drift, it's about guiding the session with intention. So it's just gonna take some practice and some reflection.
The fourth reason that your sessions feel chaotic is because the close can become a little rushed, so you run out of time because your client went on some tangents or they were emotionally unloading, and then rebooking feels awkward because you didn't quite make a full circle moment, right? Your structure got lost, and then the clients like unsure what to do [00:03:00] because the time wasn't structured in a way that gave them the benefit they need to leave feeling good,
That's super common. And so the fix is a four-part session spine I like to call it. And it's the structure that I've improved and worked on over time that's helped me, get your first sessions to feel calm and clear and in control. And when I say first sessions, initial sessions, your first time meeting a new client or a new patient, whether you're in clinical, private practice, or you work for a venture backed company ~like this is a client in front of you that you're helping.~
~So ~the first step of this spine, this, spine structure that I like to create and teach is opening expectations. And that takes a couple minutes. No more. Keep it quick. That's where you wanna have a warm welcome. Ask what name they like to go by. A quick human connection here. So that's also where you're setting the container of here's how today will go.
So for example, you might say, I find that when clients know what to expect, the entire session feels safer and more grounded. Here's how it works. First we're gonna A, then we're gonna B, then we're gonna C. How does that sound? And then you [00:04:00] move on. And so the second step, it's really important that you do that.
So the second step would be to clarify what the real problem is, and that might take five minutes, but ideally that's not gonna take the whole time. So the guiding question would be, what's the number one thing that you want help with today?
Yeah. And then you can follow up with that and say like, when does the thing they said feel the hardest? And what have you already tried? And so you're trying to get underneath the problem and really talk about what's going on with them. So some common like tension points here would be that they wanna cover everything, right?
That's what I find the most common. They start venting emotionally unloading, and they expect you to fix it all in one day, or they want a comprehensive 12 day meal plan on the first session. it can feel overwhelming because it's not always realistic, but at the same time, client doesn't really understand, what the expectations are.
so that's where you gotta come in and provide that structure in a gentle way that makes them happy. So a reminder here is that it's not your job to solve everything. Your job is to identify one [00:05:00] meaningful focus for today, and then keep the session structured to that focus. Now the third step of the spine would be one focus, one action.
I used to teach up to two actions. I've narrowed it down even more. Just one action. So that's where the real change happens. Like one needle moving behavior, right? One clear action step. And you wanna make it practical and repeatable, and you wanna resist over counseling or over coaching because you're trying to help them.
But you also wanna give the session some space to breathe. So for example, this week, let's stabilize breakfast or. Let's pick one lunch you can repeat, right? Consistency over perfection. So more information does not equal better care. Clarity does, right? Just like more information in your course doesn't necessarily equal a better course, but a more clear course does if you sell one, right?
If you're selling digital products, The fourth step would be. How do close with clarity and get them to rebook. That should be done on session, right? Because [00:06:00] you're looking for more retention. You want happy clients who are a good fit to continue with you, and you want them to wanna continue with you.
So the script you can use can be something along the lines of, today we focused on X, right? Whatever that might be. Next week we'll build on why. Whatever the next thing is, and it might be something that they've mentioned during the session that you didn't have time for,
Maybe they also mentioned something about snack ideas and you had to tell 'em, Hey, that's great. Let's save that for next session so that we can continue to focus on those lunch swaps for today. I am so glad that we have more to cover and that's where you can say, let's go ahead and schedule your next session, or when is a good time for, does this, same time work on X date, right?
Two weeks from today. And this matters because it feels supportive and it builds trust and it can prevent any momentum loss. And it also signals clinical leadership because you're taking initiative and telling them they'll come back on next day and that will help them. So optional layer here would be to reflect and use AI charting as a support ~system.~
~And ~I've talked about this on [00:07:00] YouTube videos as well. and this is where you can lightly evaluate your value without overwhelm. So one thing that's helped me stay structured with session structure over the years is reflection, and especially more recently with ai, is using AI as a thinking partner, right?
Like Heidi Health. And so after sessions, the HIPAA compliant AI charting tool, you could even use one that's integrated with practice better or simple practice. You can look at your transcript and just ask yourself when you're reviewing it did I stay focused?
Did I guide or did I drift? Did we land on one? Clear action. So looking over your transcript, you can see if the session was focused, you're actually looking at the documented transcript to see if you were focused and you really led them and guided them the way you intended.
And that'll help you improve from session to session. It's not about being perfect and beating ourselves up if we, drifted. It's about building awareness and strengthening our systems over time so we can be better clinicians and improve our retention rate and improve referrals and create [00:08:00] excellent customer care.
And that's exactly why you know this episode, it does include a worksheet to help you work through the structure on your own so you can reflect and notice patterns and tighten your flow. I wanna help you clarify the real problem, and that is what's the number one thing you want help with today?
That's what you wanna ask that person in session. Why does this feel the hardest? What have you tried, right? So you wanna make sure you're asking that common tension points is that they wanna cover everything. They start venting, they expect you to fix it. So again. It's not your job to solve everything you want.
One focus, one action. You wanna close with clarity and get them to rebook. And when you use the structure, sessions will feel calmer. You'll stop over explaining and over teaching. Clients can feel supported and you're gonna show up more confidently because you have a structure. And things like follow ups will feel natural, which will help retention improve, which can help you grow your business.
So the structure, it doesn't just make sessions smoother, it actually makes them more [00:09:00] humane and more effective. So if you want this broken down in a simple one page checklist, I do have a deeper dive and I provide feedback as well inside of my membership, including scripts, pacing common pitfalls. I give you scenarios quizzes and, certifications to help you improve.
Your skills so that you can grow your business. And that's inside of the dietitian Boss Library that you can find [email protected]. Some weekly episodes in the coming year will include supportive worksheets that you can get if you join the membership, and you can find a link in the show notes. So I want you to know that chaotic first sessions are not a signal that you're failing.
It's just a sign that you need structure. once you have. one session that runs a little smoother, and you've made one of these shifts that I've mentioned. Your confidence in your flow and your client experience all start to improve. So I look forward to hearing how today's conversation has really helped you make one change to feel more [00:10:00] confident when you have a new session on the books.
We'll see you next time.
