Ensuring that the decisions people make about their eating habits are sustainable and meaningful requires dietitians to enact communicative strategies that acknowledge and explore the complexity and diversity of people's experiences and life contexts. This study uncovered a deeper understanding of the complex and dynamic nature including diverse preferences, values and expectations regarding professional decision making of a group of early career dietitians and their patients. This deeper understanding exposes the key tensions in shaping a collaborative approach to decision making and identifies the core capabilities and required conditions for such an approach. Question and answer dialogues and coming to a shared understanding were emphasised in both the research methodology and in the resulting Interpretive Engagement Model for Collaborative Decision Making. This model will be a valuable resource for tertiary educators, early career practitioners and their mentors to provide a much needed collaborative decision making process for contemporary clinical dietetic practice.