2. Analyse the client’s needs, plan intervention actions in accordance with EBM principles.

2.1. Defining the goal of dietary intervention 

Although the topic of nutrition was long overlooked in the professional education of social workers, modern approaches to supporting people in difficult life situations show that nutrition plays a key role in mental health, social functioning, and the daily well-being of clients. Kayla Harter (2017) demonstrates that nutrition should be viewed as an integral part of the “person-in-environment” approach – a holistic perspective that considers the client within their biological, social, and emotional context. 

Harter’s research reveals that as many as 68.2% of social workers address nutrition in their practice, even though most of them (77%) have never attended any nutrition-related training, and 89% did not have such courses during their master’s studies in social work (Harter, 2017). 

This shows that the topic of nutrition is both important and necessary, and that social workers often act intuitively or rely on basic general medical knowledge. They do so because they recognise the link between food, mood, health, and the client’s day-to-day functioning. 

When working with individuals with mental illnesses, the topic of nutrition often comes up as a side issue – “someone eats too much,” “someone else hardly eats at all.” It’s easy to assume that a suggestion or a leaflet with information will suffice. However, if we truly want change to happen, we need a well-thought-out action plan – and its foundation is a clear goal. 

Setting an intervention goal is not just a formality – it’s a process that helps organise actions, define the direction of cooperation with the client, and strengthen their motivation. With a well-defined goal, the client can see the purpose of the change and feel that achieving it is possible – step by step. 

This is precisely why it’s worth using the SMART method – a tool that helps formulate goals in a way that is clear, realistic, and practical. 

When the social worker and the client formulate a goal using this model, it becomes easier not only to plan specific steps but also to assess progress and respond if something doesn’t go according to plan. 

To understand why the SMART method is so useful, it’s helpful to look at examples that do not follow this method: 

Research by Kayla Harter (2017) shows that as many as 68% of the social workers surveyed include nutrition in their conversations with clients – most often in a simple, everyday manner, adapted to the client’s situation and capabilities. They primarily talk about the basics of healthy eating. This is not about complex dietary knowledge, but about simple guidelines, such as: 

1. “Try to eat something warm once a day.” 

2. “It would be good to add vegetables to your lunch.” 

3. “Water instead of a sugary drink might help you feel better.” 

These are not theories – they are small changes that the client can understand, remember, and implement, even if they struggle with memory, motivation, or daily organisation. 

Another frequently raised topic is reducing “junk food” – sweets, crisps, fast food, and fizzy drinks. Social workers don’t issue ultimatums or pass judgement – instead, they ask questions like: 

1. “And what do you usually eat when you’re feeling sad?” 

2. “Some people feel more irritable after drinking a sugary drink – how is it for you?” 

These conversations connect emotions with eating, and their aim is not prohibition – but reflection, awareness, and small adjustments. 

An important and very practical topic is planning meals on a very limited budget. For this reason, many clients struggle with regular access to food, and even more so with cooking, planning shopping, or simply organising their day around meals. Here, a social worker can: 

1. help create a shopping list, 

2. point to a local food bank, 

3. plan a simple and affordable meal plan together. 

This is often a vital part of daily support – especially when working with people experiencing homelessness, living with disabilities, or facing mental health challenges. 

Some social workers also notice concerning eating behaviours that may indicate an eating disorder – for example, obsessively avoiding food, episodes of binge eating, or statements like: “I don’t eat because I don’t deserve to.” 

Although they do not make diagnoses, they respond with empathy and know when to refer the client to a specialist – a dietitian, therapist, or psychiatrist. Their role is to notice the first sign and help the client find appropriate support. 

As we can see, the nutrition-related topics addressed by social workers are not random – they stem from real needs, conversations, and observations. These topics are often a bridge to building a relationship, a first step toward change, and a way to show the client that someone sees their everyday struggles. 

It is important for the social worker to remember that their role in nutritional interventions has its limits. They can support the client in everyday actions such as: 

• encouraging small changes, 

• helping with shopping planning, 

• supporting the development of simple habits. 

However, in many cases, especially when: 

• there are signs of eating disorders (e.g. anorexia, bulimia), 

• the client has physical illnesses affecting diet (e.g. diabetes, malnutrition), 

• or the client refuses to eat and health risks arise – 
  collaboration with other specialists is essential, such as a clinical dietitian, doctor, or psychotherapist. 

The social worker should recognise when independent actions may not be enough and offer the client external professional support. 

Regardless of whether you are working on a small habit change or supporting a client with serious health issues, their well-being and safety must always come first. 
Setting realistic, jointly agreed goals not only enhances the effectiveness of the intervention but also builds trust and gives the client a sense of control – and that is a key element of any change, especially in the context of mental health. 

2.2 Assessment of the client’s needs and resources as the foundation of individualisation

What should a social worker assess? 

1. Client’s needs – which area truly requires support 
Needs assessment is not just about listing “problems to be solved,” but about understanding what is currently the most difficult for the client, what is holding them back, what causes them pain or distress. It’s the first step in building an individualised support plan. 

Typical areas to assess and practical guidance: 

Client’s resources – what can be built upon 

Resources are often the most underestimated part of an assessment. Yet they are precisely what enables the client to take action – despite illness, hardship, lack of money, or cognitive limitations. Identifying resources isn’t about finding the “ideal,” but about discovering even the smallest elements that can be strengthened. Resources don’t have to be large – just something to start with. 

Typical areas of resources and practical comments: 

2.2.2. Designing and implementing evidence-based interventions (EBP)

Which nutritional interventions have proven effectiveness? 

You’ll find detailed descriptions of the diets in Modules 3.2–3.4, but as a social worker, it’s helpful to be familiar with general approaches that are supported by research and can serve as a good foundation for discussion with the client. 

The most well-studied and recommended diets include: 

• Mediterranean diet: rich in vegetables, olive oil, fish, and whole grains. It supports mental health and may reduce the risk of depression. 
• MIND diet: a combination of the Mediterranean and DASH diets, focused on brain health. Recommended particularly in the context of cognitive decline. 
• Ketogenic diet: high in fat and low in carbohydrates; shows beneficial effects in some patients with neurological and psychiatric disorders, although its implementation requires specialist support. 

When does EBP in nutrition mean simple actions? 

Although Evidence-Based Practice (EBP) might sound like large clinical projects, in social work it often means small, specific actions that we know are effective – because research has confirmed their impact. 

Examples: 

• Instead of saying “eat healthily”, the worker helps the client introduce a specific habit: one vegetable with lunch every day for a week – because we know that increasing vegetable intake has a positive effect on mood. 

• A client drinks 3 litres of cola a day – the worker doesn’t forbid it but suggests: replace one glass with lemon water – because reducing sugar intake can lower irritability and improve sleep. 

And what if the client is making nutritional mistakes? 
Modules 3.3 and 3.4 describe the most common nutritional problems in people with mental health conditions – such as deficiencies in B vitamins, iron, or magnesium, as well as excess sugar, processed foods, and alcohol. 

The social worker should: 

• be aware of these risks, 

• recognise concerning patterns (e.g. binge eating, food avoidance, excessive use of energy drinks), 

• refer to a specialist if the problem goes beyond their scope of competence. 

The use of evidence-based interventions (EBP) in everyday social work practice doesn’t have to involve complicated actions or medical language. On the contrary – it’s about using current knowledge, the client’s needs, and real-life circumstances to plan small but meaningful steps that support mental health and improve day-to-day functioning. 

The case study below will allow you to follow the entire EBP intervention process: from identifying needs and resources, through selecting an appropriate course of action, to setting a goal and collaborating with other specialists. 

See how a client’s difficulties can be approached with empathy and knowledge, based on what actually works. 

Pay attention to the following steps: 

Case Study: Artur – How to apply EBP in social work practice  🧍‍♂️ Client Profile Name: Artur.  Age: 52 Health status: Diagnosed with depression, recently under psychiatric care; undergoing pharmacological treatment Life situation: Lives alone, unemployed, receives long-term benefit; struggles with daily structure and hygiene Lifestyle: Often doesn’t eat all day, then binges on sweets and bread in the evening; drinks 2–3 litres of sugary drinks per day Reported difficulty: “I have no energy, I can’t concentrate, I don’t feel like doing anything”  🎯 Step 1: Assess needs and resources Needs Resources Irregular and poor nutrition Can cook simple meals Low energy, depressed mood Has access to a kitchen and fridge Blood sugar spikes, irritability In contact with a social worker Social isolation Receives benefits and psychiatric care  🟢 Comment: Artur does not need a radical diet overhaul – he needs small, evidence-based steps tailored to his mental state and life circumstances.   📚 Step 2: Choose an Evidence-Based Nutritional Intervention  Based on the evidence discussed in Module 3 (3.2.1.1 and 3.4), and current knowledge on the impact of nutrition on mental health, the social worker decides to apply simplified elements of the Mediterranean diet and sugar reduction. 🔹 Instead of: “You need to switch to the Mediterranean diet”  🔸 Proposal: “Let’s try adding some vegetables to your lunch and replacing one sugary drink a day with water.”   🛠️ Step 3: Set a SMART Goal  Goal:  “For the next 7 days, Artur will drink one glass of water instead of a sugary drink each day and try to add one vegetable to his lunch.” SMART Criterion Assessment S – Specific Yes: one glass of water, one vegetable M – Measurable Yes: once daily, for 7 days A – Achievable Yes: client has access and does not feel pressured R – Relevant Yes: addresses health and mood-related issues T – Time-bound Yes: trial period of 7 days   🤝 Step 4: Support and Monitoring  The social worker: Helps the client write the goal on a note and stick it to the fridge At the next meeting, asks: “Were you able to make any changes? What was easiest, what was difficult?” Reinforces successes (even partial): “It’s great that you managed to eat carrots on two days – that’s already a step!” Suggests goal adjustments if needed – e.g. switching from raw to cooked vegetables if raw ones are harder to eat.   🧠 Step 5: Collaboration with Other Professionals  Since the client: Is on antidepressant medication Shows signs of binge eating and social withdrawal Has low motivation ➡️ The social worker contacts the psychiatrist and proposes a referral to a dietitian at the mental health centre (if available).   📌 Summary: What Did the Social Worker Do as Part of EBP?  ✅ Identified the need based on the client’s mental state and daily functioning  ✅ Applied elements of evidence-based interventions (Mediterranean diet, sugar reduction)  ✅ Set a realistic, measurable SMART goal  ✅ Provided support and monitoring  ✅ Involved relevant specialists – dietitian and psychiatrist.

Monitoring outcomes – what and when should be checked? 

Implementing an intervention is one thing – but its effectiveness can only be assessed if we know what to look for and how to check it. In social work, we don’t always have access to tests, medical records, or daily observations, so monitoring should be simple, specific, and usable in conversation with the client. 

What is worth checking? 

• Whether the client achieved the specific goal, e.g. “Did you add a vegetable to your lunch?”, “Did you drink fewer sugary drinks?” 

• How they felt physically and mentally – e.g. “Did you have more energy?”, “Did you feel less irritable?” 

• Whether anything made it difficult to follow the plan – e.g. lack of money, worsening depression symptoms, family conflict. 

How often should this be done? 

• For short-term interventions (1–2 weeks) – once a week or during each visit is sufficient. 

• In longer-term work – every 2–4 weeks, depending on how the case develops. 

• In longer-term work – every 2–4 weeks, depending on how the case develops. 
  
  

Remember: Even partial achievement of a goal is progress. It’s important to acknowledge and name it – this strengthens the client’s motivation and sense of agency. 

Mind your language! Instead of saying: “if you fail”, it’s better to say: 
“If things don’t go as planned – what can we do then to make sure something still works out?” 

2.2.3. Daily support for change – how to build client autonomy around food and health 

Building autonomy 

Changing eating habits in people with mental health disorders doesn’t start with a diet – it starts with micro-actions: drinking water, eating something warm, remembering to eat. That’s why in social work, it’s essential to focus on simple, achievable actions that the client can carry out in their daily life – even if their motivation, energy, or cognitive function is low. 

A social worker doesn’t need to be a nutrition expert – but they can be a catalyst for change, helping the client take that first step. Below are 5 practical steps with examples. 

✅ Tips for the social worker 

What to do	Example
Speak specifically, not vaguely	“What can you cook tomorrow?” instead of “Eat healthily”
Plan for the short term, but realistically	“Let’s plan tomorrow’s meals together”
Use local resources	Community fridge, soup kitchen, social services
Write plans down with the client	On paper, phone, or a note on the door
Set a backup plan	“What will you eat if you don’t feel like doing anything?”

Form: Weekly meal plan and budget 

🗓️ Complete this form together with the client. Indicate what and when they plan to eat and how much they expect to spend on each meal. 

Weekly menu 

Meal / Day	Mon	Tue	Wed	Thu	Fri	Sat	Sun
Breakfast
Lunch
Dinner

Food budget 

Product	Estimated price (PLN)	Comment (e.g. how long will it last for)

2.3.3. GROUP MEETINGS AS A MOTIVATIONAL TOOL 

2.3.3. PERSONAL HYGIENE AND DAYLI ORGANISATION AROUND MEALS

For many people with mental health disorders, basic daily activities – such as washing, getting dressed, preparing food, or eating regularly – can be a major challenge. Conditions like depression, schizophrenia, anxiety disorders, or psychotic episodes may lead to: 

• a disrupted daily structure (lack of routine, chaos).

• neglect of personal hygiene.

• forgetting to eat or bingeing at night.

• difficulty with planning and anticipating needs. 

As a social worker, you can play a key role in helping the client create a simple daily plan that: 

• includes meals.

• supports regularity and routines.

• restores a sense of control over everyday life. 

👥 Practice Example 

🧍 Agata (35 years old, depression, loneliness, low self-esteem) 

Situation: Sleeps until 12:00, does not wash, doesn’t eat until evening. Says she “has no strength” and “sees no point.” 

Actions taken by the social worker: 

• Started with a gentle question: “What time do you usually have coffee?” – response: “After 1 p.m., when I get up” 

• Together, they set the first daily ritual: coffee + yoghurt 

• Added a simple hygiene routine: “I’ll wash my hands and change my shirt” 

• After one week – they added another small step: dinner before her favourite TV show 

• The worker helped create a simple 3-step daily plan, which was hung on the fridge 

✅ Summary :

what to do to support the client :  

Goal	How to reach that?
Establish a daily rhythm	Ask what the client already does and build the plan around that
Support hygiene	Don’t impose – start with small actions (e.g. washing hands, changing clothes)
Link eating and hygiene	Eat after washing, brush teeth after meals
Create a simple plan	Use paper, phone, or visuals – with just 2–3 steps
Modify the plan together	Agree on changes collaboratively, adjust tasks to the client’s symptoms and mood

📊 Table for tracking daily rhythm and meals (1 Week) 

Recommendation: The client can complete this independently or with support from a social worker by marking basic activities and meals each day. 

Activity / Day	Mon	Tue	Wed	Thu	Fri	Sat	Sun
Got up before 10:00
Washed face/teeth
Ate breakfast
Ate lunch
Ate dinner
Had shower/bath or changed clothes
Went out or did an activity

✅ Legend : you can mark ✅ (done), ❌ (not done), or ➖ (not applicable). 

Bibliography

Prochaska, J. O., & DiClemente, C. C. (1984). The transtheoretical approach: Crossing traditional boundaries of therapy. Homewood, IL: Dow Jones-Irwin. Prochaska, J. O., DiClemente, C. C., & Norcross, J. C. (1992). In search of how people change: Applications to addictive behaviors. American Psychologist, 47(9), 1102–1114. https://doi.org/10.1037/0003-066X.47.9.1102 Harter, K. (2017). Nutrition and the person-in-environment perspective: Implications for social work (Master’s thesis, Grand Valley State University). ScholarWorks@GVSU