Collaborative Care Between Nutritionists & Therapists

Learn how collaborative care can be beneficial for patients. Find out how nutritionists and therapists can work together.

Multidisciplinary care brings many benefits to both wellness clients and healthcare providers. Cross-sharing information like client progress, challenges, and goals across providers ensures that the client is receiving the most comprehensive care. We cannot underestimate the value of treating the “whole patient,” as clients continue to seek out, and expect, personalized care.

As a nutrition professional, working with your client’s therapist is often one of the most critical professional collaborations. Clients tend to work tangentially with their therapist, meeting frequently, to discuss and resolve they underlying psychological factors serving as barriers to their health, including their nutritional intake.

Some issues that therapists can with clients on, that may directly impact nutritional intake:

  • Anxiety
  • Depression
  • Eating disorders
  • Trauma and PTSD
  • Poor self esteem
  • Obsessive compulsive disorders
  • Substance abuse
  • Abuse
  • Grief

Learning how to professionally collaborate with your nutrition client’s therapist can facilitate the best, most comprehensive care for your client. You can help your mutual client to work towards the same health goals, by addressing both sides of the issue: the emotional/psychological component and the behaviors surrounding food. Collaboration also gives you the advantage of knowing when a client is falling off from care, for either provider, as it’s often common for clients to step back from care when they feel like they are struggling. Encouraging (or requiring) a client to continue to work in a team approach to care can drive the success of your mutual client.

Here are 5 tips for collaborating with your client’s therapist as a nutrition professional:

1. During your intake process, assess mental health issues and therapy details

Often times, when clients are asked about their healthcare providers, they will only think to mention doctors or medical specialists. They may not immediately make the connection between their psychological issues and their current nutritional challenges. Taking an active approach to asking details about your client’s mental health, current therapist, and past therapy work is critical to your nutritional assessment. Many nutrition providers add this field directly within their intake paperwork and assessment, asking questions such as:

Do you have any past mental health issues or concerns?

Are you currently working with a therapist?

If yes, how often do you meet with your therapist?

What date did you begin your therapy counseling sessions?

Please provide your therapist contact information?

Please sign below if you give me consent to connect with your therapist regarding your nutritional care.

If your client indicates that they have mental health issues/concerns and they are not receiving therapy, then it is within your scope to recommend they seek mental health care. For some of the above-mentioned mental health issues, like an eating disorder, you may want to require that a client have a therapist and/or psychiatrist on their care team.

This could vary depending on the severity of the condition, and what your client is seeking nutritional counseling for. For example, if you work with anorexic clients and your client is underweight or stepping down from a higher level of care, you may want to establish upfront that your client has a medical provider and therapist on their care team. This will ensure that your client is medically stable to continue working with you, and that they are receiving the essential mental health counseling to work on their eating disorder. Collaborative care in this case is a critical requirement, and will greatly benefit your client.

For other mental health issues, such as anxiety or depression, you may uncover over time that these issues are negatively impacting your client’s nutritional progress. In this case, and after creating a rapport with your client, you can recommend that they seek counseling. Outline the benefits of working congruently with a therapist to reach the goals. For nutrition professionals, it’s important to understand a professional scope of practice — and refer clients to therapists (or other healthcare providers) as needed. When approached the right way, clients can understand the value of collaborative care, and will appreciate any therapist referrals that you provide them.

2. Obtain a signed Consent Form from your nutrition client

To protect your nutrition practice from liability, you must obtain a signed Consent Form before disclosing any information to your client’s therapist. Your wellness client must give you their consent to speak to any member of their care team. If your client’s therapist has received a consent form, but you have not, do not jump the gun and begin sharing client information. Politely let the therapist know that you have yet to obtain a consent form, but will be in touch as soon as you receive one

Download sample practice forms below, including a template for a client consent form. Tailor your form for your practice, and be sure to have your business attorney review any client paperwork.

3. Ensure your client has also filled out a Consent Form with their therapist

In most cases, your client will let you know that they have filled out a consent form for your their therapist as well — but just as a best practice, you can always confirm. Some nutrition professionals choose to ask the therapist for a copy of their signed Consent Form, to keep on record. Put the practices in place that will best fit your business, and your client-base.

4. Communicate relevant information for therapists in your updates  

When sharing progress updates with your client’s therapist, you’ll both want to take a moment to share what is new with your client’s progress with their nutritional counseling and identify where you can connect to reinforce approaches to care. Make the most of your time with your therapist by sharing information they will ideally want to know. If you’re unsure if this information is relevant, you can always ask. For example, “I have a history of our mutual client’s weights, would this be helpful for you to know?”

Here are some other types of information you may want to share with your client’s therapist:

New wellness goals you’ve set with your client

Nutritional plan details

  • Daily caloric intake
  • Weight goals and timelines
  • Number of meals/snacks per day
  • Food excluded/eliminated from your client’s diet
  • Foods you’re reintroducing to your client’s diet

Challenges your client has been experiencing

  • Inability to accomplish goals and suspected/identified reasons
  • Events or situations that were triggering to your client (ie. a relative making a comment about their weight)
  • Weight fluctuations (ie. a drop-off in weight due to recent restrictive eating behavior)

Any mental health issue or concern that your client has reported during their nutrition counseling session and/or how this has impacted their food intake

  • Anxiety towards trying a new food
  • Emotional feelings driving food intake
  • Episodes of binge-eating, purging, laxative abuse or restricting
  • Dangerous situations your client reported: self-harm, suicidal ideation, substance abuse, suffered abuse (note, report these immediately)

Ideas on how your therapist can reinforce the nutritional goals or approaches you’re taking with your client or any behavioral strategies you’d like to propose

  • Coping mechanisms surrounding meal times
  • Triggering situations that your client needs strategies on managing
  • Stress-reduction techniques
  • Addressing over-exercising or other compensatory mechanisms
  • Improving motivation and finding confidence to achieve x nutritional goal

Ask how you can support your therapist, and help drive their objectives.

  • If client has been inconsistent with attending therapy sessions, you can reinforce with your client that it is a part of their treatment plan to attend with x frequency

Relevant anthropometrics

  • Height, weight, BMI.
  • You may find that some therapists also weigh their clients, especially if they work in an eating disorder recovery program. It could even be a requirement that their staff weighing clients and even informing them of their weight. If you prefer to take a blind-weight approach, or non-weight centric approach to care then it is important to discuss this with the therapist. You may be able to come to an agreement, one that benefits your client’s care.

5. Only use HIPAA compliant methods of communicating with your client’s therapist.

Protecting your client’s private health information (PHI) is always a priority. Failing to do so can put your business at risk. When communicating with a therapist, or any healthcare provider, choose platforms or tools that are HIPAA-compliant. Regular email, google docs and skype are not considered HIPAA-compliant platforms — whereas there are other more secure mail and telehealth platform. Speaking with a healthcare provider on the phone is secure, however make sure that the location you are in is private.

You may also want to adopt the practice of only utilizing your client’s initials in communication when possible. For example, when leaving a voicemail for your client’s therapist, you can state “I’m calling on behalf of our mutual client EB, when you have a moment you can reach me at…”

Looking for a secure EHR and telehealth platform to run your wellness business? Healthie is a HIPAA-compliant practice management platform designed for nutrition and wellness professionals. With secure messaging, charting, document storage, video chat, and E-Fax capabilities, Healthie has all the tools you need to run your business and collaborate with other wellness professionals.

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