Is 1:1 Counseling Actually The Problem?
===
[00:00:00] One concern I hear from dietitians all the time is, "I love counseling, but I don't know if I can do it forever." Or maybe you're not even sure you love counseling, but you know for sure that it's not something that you want to do for the rest of your career as a dietitian.
A lot of dietitians and a lot of our clients have experienced back-to-back sessions, overwhelming documentation and prep work for one-on-ones, and even shortened appointments. There can be unpredictable days, insurance issues if you take insurance, and that kind of mental fatigue can make you wonder, "Can I really keep doing this?"
So naturally, the one-on-one starts to feel like the problem, but I think that the conclusion might have come a bit too quickly if you're blaming the actual counseling. Sometimes the counseling, it is part of the problem. But [00:01:00] before you decide that you need to get out of one-on-one entirely, I do think it's worth asking a better question.
Ask yourself what part of one-on-one actually feels unsustainable, because the answer might be very different from what you expect. Now, one-on-one gets blamed all the time.
And you might finish a day exhausted, and it makes sense because the obvious thing in your schedule could be the one-on-one clients, right? The sessions. Maybe you saw five clients or patients and maybe you did talk all day, and maybe you had a particularly complex session as we all do.
It's just a numbers game. After every few clients, there might be a complex situation. It could take a lot out of you, so you think, "I can't keep seeing this many people." And sometimes that's true. Maybe your caseload, it could be too high. But the kind of counseling you're doing, it also could be emotionally draining depending on who your population is.
And maybe you genuinely want [00:02:00] a different business model, like you just wanna do groups, brand deals, et cetera. But sometimes the sessions, they're only a fraction of what's making your day feel heavy. That's why I do an ideal day exercise with my clients and my students to help them understand what else is going on outside of these one-on-one sessions.
I want you to do something. I want you to imagine two dieticians who both see five clients a day. Now, one dietician is gonna finish the final session, complete a short note. She's gonna check a few follow-ups, and then close the laptop. Now, the other dietician's got five sessions, and he still has ninety minutes of documentation, client messages, rescheduling, insurance problems, unanswered emails, and follow-ups that he has to remember to send.
So these are the same number of clients, but they're completely different work days. And that's why I wouldn't automatically assume that one-on-one counseling itself is the problem. Now, I have felt [00:03:00] this too. So I've had seasons where I thought the answer was that I needed to get away from one-on-one. So I've been there.
But when I looked more closely and really analyzed my time, I realized that I actually really enjoy client work. It's one of my favorite things to do. What I hated was everything surrounding it So clinical work, consulting, teaching, speaking, cash pay work. The I love all of those things, but when you look at what is involved in accomplishing those things, the day can feel fragmented.
Maybe you don't have a lot of margin in your day if there's too many moving pieces. So you might be struggling with, sales or marketing or admin, or there might be too much complexity. Maybe you're not using AI charting, and it's just taking too long for you to standardize your notes. Maybe you're not confident yet in your niche, and you have to look up a lot of information.
And so if you're using a lot of your energy just to manage the work around your work, that's when the client [00:04:00] sessions can feel heavy. So I really encourage you to step back and take a broader look at your workday and your personal energy management. And that distinction matters a lot. So for me, the problem wasn't simply I don't wanna see one-on-ones or I wanna see, less.
The problem was larger than that. It was like, I don't really like how my work is structured overall. I think I need to configure something in my overall workflow. I need to adjust something in my day. And those are two very different problems, so I encourage you to think about your day and ask yourself the same question because if you solve the wrong problem, you can make a huge business change and still end up exhausted.
What actually makes one-on-one feel heavy is not what you think. A lot of the exhaustion can come from everything surrounding the session, not just the session itself. Also, there's how you manage the session, and that's a whole different podcast episode that I've done So maybe [00:05:00] every appointment can feel completely different, and you're constantly deciding what to do next, floundering.
Maybe you're even reinventing your recommendations every time instead of using frameworks that you may already know work, and maybe your follow-ups have no consistent structure. Maybe you're carrying a mental list of things that you need to remember for every client. You might not even be realizing this, and maybe documentation takes almost as long as the session, and maybe clients message you whenever they want, and you feel like you're always partially at work, even when your business hours are, air quote, "done for the day."
Maybe insurance and scheduling are creating more stress than the actual counseling, or maybe it's the sales piece. But those aren't the same problem, right? And they don't all have the same solution because structure is gonna change the experience. Structure makes a huge difference.
So when I say structure, I don't mean making every client session identical. I mean reducing unnecessary [00:06:00] decision-making, and that might look like having a consistent way that you do follow-ups and initial sessions or a consistent way that you run a group session. That means a repeatable way that you review progress, even a repeatable way of how you start and end your day.
A framework for identifying the biggest priority for that season can be really helpful, and a few educational frameworks that you repeat instead of recreating your teaching every single time can also help. So if you can condense your method and framework into half a sheet of paper, you're in a good position And then a repeatable way that you close the session and define next steps.
For example, I've talked about this on the podcast, I always end a session booking another session. I don't force somebody, but I say, "Based on what we talked about today, we should meet in X amount of weeks, this time and date works. Can I put you down for the schedule?" So I don't leave a session without booking another one, assuming that this person is a fit.
And so I want to ask you to reflect on what are ways that you close a session. Because if you don't [00:07:00] know and it's not standardized and you don't have a simple decision tree for knowing how to end the session, depending on the situation, that's where you want to start with. A documentation process also needs to be in place that does not require you to rebuild the note from scratch every single appointment.
So you should be following similar structure every time, and it should feel, repeatable, maybe even a little boring. And of course, counseling still needs to be individualized, but you're not reinventing your entire process start to finish every time someone gets on your calendar. And that's the huge difference.
that's why I teach repeatable session frameworks inside the Dietitian Boss membership and with my clients. And the goal is not to script you, it's to reduce the amount of unnecessary mental effort that you're using, so you can spend more of your energy on the parts that require your clinical judgment, because that's really where your energy should flow, the clinical judgment and even the rapport building with your clients and patients or speaking to large groups So I just wanna reiterate that busy and [00:08:00] burnout are not the same thing.
I think it's important to separate being busy from being burned out. You can have a full schedule and still feel good about your work, and you can also have a relatively small caseload and still feel completely overwhelmed. And I've experienced that myself. There have been weeks where my number of client sessions wasn't that high, but it's just, things felt heavy because of all the surrounding issues, especially when I moved and I had claim routing issues, breakdowns with insurance, and credentialing, and addresses on file.
A lot more heavy admin I didn't expect that delayed payments, resubmissions that came back denied again, s- scheduling conflicts, just loads of administrative work that felt like it had no ending. And if you can relate, I just wanna ask yourself, is that the issue or is it really the one-on-one sessions?
'Cause it's so easy to blame those one-on-one sessions. And that's different from being burnt out by counseling itself, right? Because the workload does matter, and emotional demands [00:09:00] absolutely matter, and your boundaries matter, your personal life matters, your start and end day of the work matters, and the types of clients that you see and are aligned with your skill set absolutely matters.
And structure arguably matters the most. So there's usually not, one single cause, and that's why I caution you about making huge business decisions based only on a feeling of, "I'm tired of one-on-one." I encourage you to get a little more specific first. Ask yourself a better question. So instead of saying, "How do I escape one on one?"
Ask yourself, "What specifically feels unsustainable about the way I'm doing one-on-one right now?" Is it the number of sessions, the type of clients, maybe the documentation? Maybe it's a specific insurance with a, they have a low payout, or it's client communication outside of sessions, or it's the lack of structure inside of your appointments.
Or is it that you genuinely do not enjoy counseling anymore? 'Cause that could be it. I just want you to ask yourself that question after you ask yourself the other questions, because the [00:10:00] answers to these questions I'm posing on this podcast episode, they lead to very different solutions. And if you do hate counseling, building better templates won't fix it.
But if you still love the actual client work and just hate everything surrounding it, you might not need to abandon ship. You might just need to edit your process a bit and just redesign how you deliver, which is just part of being a business owner. So your action step is for the next five workdays, I want you to pay attention to what actually drains you.
At the end of each day, I want you to write down one thing that felt the heaviest, and don't write one-on-one. I want you to get specific. So what was the number of clients, and what was the type of clientele? And was it the documentation, or was it that particular insurance payer if you take insurance?
Maybe it was something sales related if you take cash pay. Was it the messaging, the constant communication between sessions, or some decision fatigue about what to do with those late cancellations that happened back to back? Maybe it was a lack of structure in your process. Or was it something that [00:11:00] happened outside of work that just made your day feel heavier in general?
At the end of the week, I want you to look for patterns, because one-on-one is exhausting is a very broad diagnosis, and a broad diagnosis usually leads to broad solutions. Therefore, the more specific you can get about what's actually creating the problem, the easier it becomes to make the right change. So you may decide that you really do want fewer one-on-one clients, and you may decide that you want a completely different model.
But you may also realize that you still enjoy counseling. You just don't enjoy the way that your practice is currently structured. And if that pattern that you notice needs better systems, clearer session structure, or a more sustainable way to run your practice and make decisions, that's exactly what I help dietitians do inside of my membership, Dietitian Boss Library, and with my private coaching.
So you can learn more about those options at dietitianboss.com. Thank you for listening, and I'll see you next week
