We’ve all been there.
You open your client’s email only to read a long list of new symptoms and challenges since implementing your recommendations…
You pick up the phone to a panicky voice outlining all the ways she’s feeling worse, not better…
Your heart skips a beat when you read the urgent text asking “is this normal?” as he outlines what’s not working…
We’ve all been there. That sinking pit in your stomach when you realize something’s not working, something went sideways, maybe things even got a lot worse. And, at first glance, it’s because they did something you suggested they do. Ugh.
If you’ve been practicing for any length of time, you know of what I speak. It’s the risk we take when we set out to help people with their health – especially those who are really sick and struggling. Of course, as practitioners, we do absolutely everything within our power to reduce the risk of this happening, but it’s part of the job. Sometimes things get worse before they get better. Sometimes clients have healing reactions. Sometimes they don’t tolerate an ingredient in a supplement.
If you’ve ever experienced this, first let me say: it’s okay. You’re not alone. You’re not a failure. It’s part of our learning process. And: it’s what you do in these types of challenging moments that defines you as a practitioner.
Here are eight strategies to consider when things go sideways:
Take a few big breaths and remember why you do this work. Anchoring yourself back to your original “why” and standing firmly in the change you’re here to make will help remind you of your core intentions. Write it down. You can then use these intentions to guide your further actions.
Step back and look at the big picture for this client. One of the most common mistakes we make is precisely what isn’t going to help: diving into the weeds and troubleshooting micro details of your protocol. When you can’t see the forest for the trees, you can’t effectively troubleshoot what’s going on. A problem can’t be solved when you’re too far down the rabbit hole. Perspective is everything. I find taking a walk and getting some distance on the problem is very helpful in these moments. We often see things more clearly from our peripheral vision than when staring straight at it, so give yourself the space to do this.
Ask lots of questions. You need to understand the timeline and the circumstances of their symptoms. What changed? Have your client talk you through the timeline and give you a play by play of what they did before, during, and after things went sideways. In addition to asking about the pieces you specifically recommended, also ask about other things going on in their life. Just a couple of weeks ago a client of mine, we’ll call her Zoe, wrote me in a panic because her skin was breaking out badly after we made an adjustment to her protocol. Of course, my knee jerk reaction was to roll back the protocol changes, but after asking a few more questions, I learned she’d attended a social gathering where she’d indulged in gluten, sugar, alcohol, and several other foods we’d been specifically avoiding on her protocol. And these are all foods that cause skin flares for her. Thank goodness I asked! It wasn’t the new supplement that was causing the issue at all.
Course correct as necessary. Depending on what you uncover when you dig into the context in step 3 above, change course. There is no shame in adjusting as you go – in fact, that kind of flexibility is essential as a practitioner. This might mean stopping a supplement protocol for a few days to see if symptoms resolve, and then layering them back in one at a time to determine if it’s an adverse reaction to an ingredient in one of the products or their system is simply in overwhelm. This might mean making some dietary changes and restrategizing your recommendations. Or it might mean better supporting elimination pathways, making sure all exit doors are open – that all waste and pathogens have an easy exit route out of the body (oftentimes, healing reactions simply mean you’re going too quickly or elimination pathways aren’t working properly).
Make sure you’re using the right tools. Of course, ideally, you’ll avoid getting into this situation in the first place and minimize the possibility of things going sideways. Working with the right tools is an essential way to prevent this from happening. One of the reasons we are so passionate about using objective lab data is that when you have that data alongside the client’s symptom presentation and health history, your protocols are far more targeted and accurate, which means the likelihood of adverse reactions is greatly reduced because your protocols are better informed.
Get help! If you’re feeling stumped, reach out to a colleague or mentor you trust and ask for help. Our alumni frequently use our private practitioner Facebook group where they can ask for help and ideas from a group of seasoned practitioners using the same tools and framework. That kind of support is invaluable. You can also seek advice and support from a more experienced practitioner in a mentoring capacity. The key is that you don’t have to do it alone: reach out to your tribe for help.
Own your part. When you’re talking to the client and helping them troubleshoot through the challenge, if there’s a piece of this that is your responsibility (and almost always there is), then make sure you own that aspect gracefully. They will appreciate your honesty and professionalism and you will feel better about yourself for taking responsibility for your role.
Debrief and learn from the experience. Challenges like this are the best learning experiences you’ll have, so make sure you don’t skip this step! Take a moment when you’re on the other side to unpack and understand what happened. What did you learn? What could you have done differently? Is there a new process or a new system you will apply with future clients as a result of this experience?
How do you support yourself and your client when things go sideways? Next time you find yourself in this situation, use these strategies to help guide you through the challenge and allow it to be a moment that defines you as the one who was professional, thoughtful, and responsive.
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FAQ
These frequently asked questions expand on the key clinical reasoning and practitioner decision-making concepts discussed in this article.
What should a practitioner do first when a client feels worse after starting a protocol?
The first step is to pause, stay calm, and evaluate the situation before making immediate changes. Reconnecting with your purpose and approaching the case objectively helps prevent reactive decision-making. A thoughtful assessment creates the best foundation for determining what happened.
Does a client feeling worse always mean the protocol is wrong?
No. A worsening of symptoms does not automatically mean the protocol is inappropriate. The article explains that healing reactions, ingredient intolerance, or unrelated lifestyle factors may all contribute, making careful assessment essential before changing course.
Why is it important to look at the whole clinical picture before troubleshooting?
Looking at the big picture helps identify the true cause of a client’s symptoms rather than focusing too narrowly on individual protocol details. Stepping back allows practitioners to recognize broader patterns and avoid missing important contextual factors.
How can building a symptom timeline improve clinical troubleshooting?
A detailed symptom timeline helps identify what changed before symptoms developed. Walking through events before, during, and after symptom onset can reveal contributing factors that may not initially seem related to the protocol.
Useful questions include:
- What changed recently?
- When did symptoms begin?
- What occurred before symptoms appeared?
- Were there any dietary, lifestyle, or environmental changes?
What questions should practitioners ask when symptoms suddenly worsen?
Practitioners should explore both protocol-related and non-protocol-related factors. The article emphasizes asking about supplements, diet, lifestyle, and recent events to understand the full clinical context before drawing conclusions.
Can lifestyle factors be mistaken for reactions to a protocol?
Yes. Symptoms may be caused by factors outside the protocol rather than by supplements or recommendations themselves. As illustrated in the article, dietary choices such as consuming foods known to trigger symptoms may explain a flare more accurately than recent protocol changes.
How should a practitioner adjust a protocol when something goes sideways?
Protocol changes should be guided by the information uncovered during assessment. Depending on the situation, this may involve temporarily stopping supplements, reintroducing them individually, modifying dietary recommendations, or slowing the pace of the protocol.
What is the role of elimination pathways when clients experience healing reactions?
The article suggests that inadequate elimination pathways may contribute to healing reactions. Supporting normal elimination and ensuring appropriate waste removal may help when clients appear to be progressing too quickly through a protocol.
How can objective lab data reduce the risk of adverse reactions?
Objective lab data helps practitioners create more targeted recommendations. When combined with symptoms and health history, laboratory findings can improve protocol precision and reduce the likelihood of unintended reactions.
When should a practitioner seek help from a mentor or colleague?
Practitioners should seek support whenever they feel uncertain or unable to confidently resolve a challenging case. Consulting experienced colleagues or mentors provides additional clinical perspective and helps improve decision-making.
Why is taking responsibility important when managing challenging client cases?
Taking responsibility demonstrates professionalism and builds client trust. The article encourages practitioners to honestly acknowledge any role they may have played while continuing to guide the client toward an appropriate solution.
How can difficult client cases improve clinical practice?
Challenging cases create valuable learning opportunities. Debriefing after the situation is resolved allows practitioners to identify lessons learned, refine clinical processes, and strengthen future decision-making.
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ABOUT THE AUTHOR
Margaret Floyd Barry, FNTP MRHP is owner and Executive Director of the Institute of Restorative Health. She’s a functional nutritionist, author, speaker, educator, and real food advocate. Through years of experience working with the most complex client cases, including reversing her own autoimmune condition, Margaret uses a powerful system for restoring health by addressing the root cause of illness.
Today, Margaret teaches fellow practitioners the same proven system she uses to get her clients life-changing results through the Institute of Restorative Health – a two-year comprehensive functional nutrition certification program for qualified health professionals. Margaret also runs Restorative Corporate Wellness, a team of Restorative Health Practitioners facilitating health transformations with corporate clients. She is the author of Eat Naked and its follow-up cookbook The Naked Foods Cookbook. She’s also the host of the Clinician’s Corner podcast, where she interviews some of the world’s top experts in the fields of functional health and nutrition.
