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NBHWC questions and answers with verified content
Preparing for a coaching session (3) 1. Prepare 2. Get Present 3. Get curious Qualities of an authentic + nurturing coaching relationship 1. Co-... [Show More] constructed 2. Encouraging, compassionate, caring 3. Authentic inquiry + reflections How to develop an authentic + nurturing coaching relationship 1. Communicating genuine confidence in client's success 2. Keeping the focus on what the client wants (vs. what they do not want--approach motivation vs avoidance motivation) 3. Listening for the client's needs 4. Telling the truth, using courage + kindness 5. listening to your intuition unconditional positive regard being completely accepting towards another person, without reservations -Carl Rogers (meeting them where they are) Coaching program guidelines Phase 1: Prospect stage (welcome, intro coaching, payment + fees) Phase 2: Program Startup (COACHING AGREEMENT, expectations, prepare, explore assessments, 3 mo goals, vision, action plan) Phase 3: Ongoing coaching program Phase 4: Coaching Program Close (explore reasons why, reflect + encourage, express gratitude) Establishing trust + rapport Requires: holding unconditional positive regard, showing empathy, being a humble role model, slowing down, under-promise + over-deliver, allow client to find answers, maintain confidentiality, be authentic Flow of Initial Coaching Session 1. Welcome and thank you. 2. Thank client for completing assessment. 3. Introduce yourself. 4. Review Session Agenda and get agreement 5. Explain coaching 6. Talk through confidentiality 7. Record keeping 8. Establish Coaching Contract The Coach Model is to.... Inspire and Advocate Design Thinking Coach honors the principles of design that rely on: empathy, optimism, Collaboration, Experimentalism Time Management in the 1st coaching session 1/3 of the foundation session should be devoted to addressing each of the topics *order can be adapted to your preference* Wheel of life the intent is to gain awareness and to eventually move into the direction of a more balanced wheel instead of a jagged one Awareness Coaching (TMSA) Thanks Motivation Successes + Strength Assessment Wellness Vision Beginning of the coaching process; what they want it to look like (Write it, visualize it, or speak it) *complete in the present tense using I AM statements* Identifying the Gap Decisional Balance! Where are they vs where do they want to be. What are the costs of changing + what are the benefits of changing Time Management of a 30 min session Session Opening - 7% (2 minutes) Weekly Goal Review - 20% (6 minutes) 3 Month Goal Review - 7% (2 minutes) Generative Moment - 40% (12 minutes) Goal Setting - 20% (6 minutes) Session Close - 6% (2 minutes) Mindful Listening Noted as the most important of all coaching skills Weekly Goal Review -Start with the positive! -Address challenges and stay away from judgement -Be the Ally not the Adversary1 -Identify strengths! -Affirm, affirm, affirm -Identify their % of success --Work with clients to set goals at least 60% of the time. If goal achievement is consistently less than 60%, the goal may be too ambitious. If goal achievement is consistently greater than 80%, the goal may not be sufficiently ambitious.1 3 Month Goal Review -Monthly -Validate the relevance and make sure the weekly goals are in line with the larger vision of where they are going. -What was the best learning/growth experience? -What is the level of commitment? -AFFIRM the clients strengths, abilities or growth. Generative Moment -Moments when clients are aroused along the path of change and growth. -These moments revel underlying needs and can be recognized by the "strength of their emotional charge".1 -These moments are often described as an "intuitive dance". -Ask permission to explore! -Uncover the heart of the matter -Brainstorm Options -Motivational Interviewing (MI) to work with any ambivalence The goal of MI is to..... encourage change talk + discourage any resistance talk -the more clients make the case for change, the more likely they are to make the change (opposite is true if coach makes case for change) 4 Principles of MI 1. Express empathy 2. Develop discrepancy 3. Roll with resistance 4. Support self-efficacy Session Close -Show Appreciation of the session and the work of the client -Reflect what has been learned -End on the positive note!! -Invite feedback from the client on the session -Show appreciation to the client for the work involved in the session -Schedule next session Chronic disease conditions that last longer than 1 year and require ongoing medical attn Systolic BP (the first number) - indicates how much pressure is exerted by blood against vessel walls when the heart beats. Diastolic bp (the second number) - indicates how much pressure by blood is exerted against vessel walls while the heart is resting between beats. type 2 diabetes involves a problem w/insulin receptors Metabolic Syndrome (def) the name for a group of risk factors that raise your risk for heart disease and other health problems, such as diabetes and stroke. You must have at least three metabolic risk factors to be diagnosed Metabolic Syndrome (Risk Factors) 1. Abdominal Obesity 2. Hypertension 3. Hyperglycemia 4. Hyperlipidemia 5. Decreased HDL cholesterol 4 Main Types of Arthritis (inflammation+swelling of joints) 1. Osteoarthritis (OA) 2. Rheumatoid Arthritis (RA) 3. Gout 4. Childhood Arthritis Elicit-Provide-Elicit an approach that allows the coach to share info or recommendations when specifically given permission to while keeping the convo/relationship client driven 4 A's of Absolution (when discord occurs) 1. Admit It 2. Apologize 3. Ask Forgiveness 4. Amend Your Ways cognitive reappraisal Stepping back and becoming an observer to a stressful situation. We separate the event and our interpretations of the event. Naming the threat can calm the amygdala and enables more constructive activity in the problem-solving part of the brain. Non violent communication (NVC) Observe, Feel, Need, Express/Request VS Evaluations,Thoughts,Strategies,Demands (what we end up with w/o NVC) Formula for Self-Compassion 1-Extend mindful acceptance of negative emotions, NAMING! 2-Heartfelt connection to others who share similar negative emotions. Human experience. 3-Self-kindness, perhaps crossing one's hands over the heart area for a moment. Emotional Intelligence (EQ) The ability to recognize our own feelings and process them in a positive way as well as discern the feelings of others and show empathy for them. 1-Identify/Name Feelings 2-Take responsibility for how you feel 3-Express and process emotions appropriately Listening with HEART meaning Healing: what are you hoping for? Energy: what are your feelings about moving forward w/this challenge? Awareness: what do you understand about the challenges you are facing? Resiliency: what has worked well for you in other times of challenge? Transformation: in facing challenges, what brings you experiences of joy? Metaphors are used in coaching to -Metaphors as a form of imagery. Paint the picture. Connect the dots. -Gaining a new perspective: seeing yourself or your situation in a new light. Right-time to use close-ended questions Used to focus + redirect Use sparingly End topic or session Ask further questions Specific, brief responses, reply yes/no/I don't know "Were you able to stick to your schedule?" "Did you?" How to interrupt/redirect -Focus -Structure -Specific direction -Resistance -Discord / Ambivalence Interrupt - Pause - Redirect Bottom-Lining -Helps person get to the heart of the matter (client avoiding difficult convo) -Helps coach not talk too much -Less words -Essence of message again, focusing and refocusing Scaling questions Used to: -Define goal -Intention to change -Highlight progress -Ongoing feedback -Importance, readiness, confidence Collecting summary (def) 2-3 items are shared by the client, coach gathers information together, coach presents it back to user; keep conversation moving forward; recall a series of interrelated items as they accumulate Linking Summary coach contrasts ideas heard in present moment with objective data &/or information that has been shared previously Transitional Summary wrap up a session or topic by highlighting what was important in the conversation; choose or change direction of conversation; used as a prelude to an open-ended question that guides in a new direction Health Assessment (def) is taking into consideration the various aspects of the client's personal health information and evaluating: -Where they are -What they want to achieve -Along with any medical barriers This includes but is not limited to : Heart Disease Weight loss/BMI Diabetes Prevention Stress management/Sleep Physical strength/injuries/pain levels or limitations 3 Key points to a Health Assessment 1. Observation 2. Gather Info and Take Notes 3. Provide Guidance & Resources It is NOT diagnosing but provides guidance and resources to promote independence + self-sufficiency Examples of Health Assessments 6 Dimensions of Wellness Mindful Attention Awareness Wheel of Life Five Facet Mindfulness Scale Value in Action Quickie Well-Being Assessment Myers Briggs Type Indicator Decisional Balance Positivity Rational Transtheoretical Model of Change Self-Compassion Scale Exploring Assessment Results 1. Read with an Open Mind 2. Seek Out Success 3. Notice Client's Arousal 4. Consider Stages of Change 5. Identify Readiness 6. Question Gaps 7. Reframe Failures 8. Note Concerns Resources for Medical Clearance or Exercise participation American College of Sports Medicine ACSM's Guidelines for Testing and Prescription Resources for Nutrition Academy of Nutrition and Diabetes CDC Nutritionfacts.org Main objective (responsibility) as a health coach Assists the client in finding and utilizing health and wellness resources, as well as accurately evaluating and integrating multiple sources of health information. These sources may include health care provider input, health & wellness assessments (including self-assessments -"wheel of life, Positive psychology," - health risk assessments, basic biometrics, and appropriate referrals." ideal reflection to question ratio 2:1 Simple reflections Want to mirror because you don't want to work harder than the client, so this can be helpful when the client is being short with you Amplified Reflection A technique that exaggerates what a client has said with the hope that the client will present the other side of ambivalence Maximize or minimize what they are saying to create disagreement to roll in the direction of change talk --Not meant to start a fight but to stir the pot a bit Ex. "I hate eating vegetables so I can't eat healthy" "I'm hearing you say that eating healthy is impossible (accentuate) because you don't like vegetables" Need to be VERY careful w/tone Double sided reflection Reflections that capture both sides of a dilemma that is fostering ambivalence Use prior readiness statements when met with resistance to gain perspective and make different decisions as to if/how they want to move forward OARS Open ended questions Affirmations Reflection Summary Health, Wellness, + Life Visions are (5): 1. Grounded (building on current success) 2. Bold (stretching the status quo) 3. Desired (what people truly want) 4. Palpable (as if they were already true) 5. Participatory (involving many stakeholders) Vision determines the goal Behavioral goals should always tie back to the vision; the vision activates intrinsic motivation. "How is this goal connected to your vision?" Goal Attributes (4) -Directed Attention -Mobilized Effort -Persistence -Strategy Goal Moderators -Commitment -Feedback -Task Complexity -Situational Constraints -Framing Outcome goals (overview) What the client desires The desired results Lead to behavior change when supported by a plan Behavior Goals (overview) How the client will fulfill their desires Stretches client Identifies specific actions Supports self-efficacy Creates evidence-based data precontemplation-->contemplation most difficult transition Patient Activation (def) Activation is the term used by health insurers to refer to individual's ability and willingness to manage their health and health care. Patient activation is based on (3): 1. Skill in managing health 2. Knowledge in managing conditions 3. Confidence in collaborating w/providers to maintain function and access of the health care system Patient Activation Measure (PAM) -Was developed by Judith H. Hibbard and colleagues at the University of Oregon -Measures how engaged a patient is in managing their health -PAM is comprised of 13 questions that measure competency along a continuum of 4 levels. How to reframe a. Get down to the truth, what is the core negative belief? b. Define it! c. Question it, find truths or untruths Reframe Fear based motivation Deficiency based (internal--shows up in "shoulds" + external--norms and beliefs) Threat based: illness, known + unknown threats Development Based Motivation Personal Growth (fulfillment of needs), self-actualization (internal + external), love-based Non-Negotiable Law I am complete but not finished "Satisfied Needs, be they physical, psychological, or spiritual, do not motivate. Only unsatisfied hungers move people. This is one of the most powerful understandings we can have of ourselves and of others" Controlled vs autonomous motivation controlled: external, compliance, defiance (someone making you/telling you) autonomous: volition, choice, interest Social Cognitive Theory (SCT) Resource for understanding self-efficacy A dynamic and reciprocal interaction: Personal - Individual beliefs and feelings Environmental - role models or support networks Behavioral - Experiences and accomplishments Wheel of Life Determines the level of satisfaction in 8 areas Helps connect values to decisions Life Purpose, mission or vision statements Fear & Dissonance Our Role Self-Determination Theory The "End Game" of Coaching -the client has reached their highest level of motivation, engagement, performance, persistence, and creativity -3 primary psychological needs to achieve this are autonomy, competence, and relatedness Motivational Interviewing (def) A person-centered counseling style for addressing the common problem of ambivalence about change. 4 Processes of MI 1. Engaging 2. Focusing 3. Evoking 4. Planning Engaging (within MI) -rolling w/resistance, open-ended qs, appreciative inquiry -Coach argues against ambivalence (bad) vs counterbalancing ambivalence with appreciative awareness of reasons for not changing Focusing (within MI) -decisional balance -reflections! (simple, double-sided, amplified, shift-focused reflection) Evoking (within MI) -generating a connection to the client's autonomous motivations and drives -finding meaning, dive deeper into motivation Planning (within MI) designing action plans that support the building of self efficacy the primary resource for understanding self-efficacy Social Cognitive Theory Evoking change talk--DARN CAT Preparatory Change Talk: Desire Ability Reason Need Implementing Change Talk: Commitment: I will make changes Activation: I am ready, willing, prepared Taking Steps: I am taking specific steps to change The Connection Scale Self Nature and environment Family Relationships Spirituality Career Social Liberation -The process by which changes in society increase the options and opportunities for individuals to live healthier and happier lives -Assisting clients to empower themselves to navigate through barriers -Be cautious not become an advocate or problem solve Coaching self-regulation Diligently planning, preparing and executing behavioral experiments, unpacking learning followed by making adjustments (how, what, when) to continue practicing new behaviors Growth Mindset Our intelligence is malleable. Someone with a fixed mindset believes their intelligence and abilities are set and cannot change. Someone with a growth mindset believes growth and change is possible. Building Growth Mindset -the power of "yet" -build awareness of words + thoughts -risk taking -provide constructive feedback (vs praise) focusing on effort/learning Decisional Balance A tool for exploring the pros and cons of change, used when exploring discrepancies and ambivalence; Helps clients to think through whether they are ready, willing, and able to make a change; Helps a client appreciate the source of their autonomous motivation Active experimentation and self-discovery the process by which a coach guides a client through the means of developing greater self-awareness and insight, encouraging the development of a growth mindset and the client's willingness to explore ambivalence/change. [Show Less]
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NBHWC 4 — Ethics/Legal, questions and answers with verified content
Definition of Self-Care Taking care of oneself on all levels; a way of living that incorporates behaviors that enable one to maintain personal health and ... [Show More] balance, replenish energy and motivation, and grow as a person. Definition of Burnout The extinction of motivation or incentive, especially where one's devotion to a cause or relationship fails to produce the desired results. Two core characteristics of an effective coaching environment 1. Safe enough (doesn't always mean comfortable!) for clients to take the risks they need to take 2. Courageous place where clients are able to approach their lives and the choices they make with motivation, curiosity, and creativity. Two qualities for a safe and courageous coaching environment - Confidentiality: promotes disclosure - Trust: believing, and believing in the client + confidentiality Explain accountability A simple accounting for promises of action and the insight of learning. No judging or requiring proof. Respecting client vision and action plans but also willing to be honest and direct for their sake. When using the expert hat (4 things) 1. Check that the info you have is truly relevant to client and client's situation — what will be gained from sharing it? 2. Be CLEAR that you are not wearing the coach's hat, but rather of someone who has some expertise in a given area 3. Make sure the client wants the information and ask permission 4. Be clear that you are offering this without attachment, that you don't assume you have the right answer, and there are no strings attached. What to be clear about - Coaching definition - Coaching design - Distinctions between coaching and consulting, mentoring, etc. - Role of the coach - Boundaries of coaching (esp. regarding advice-giving ... won't do w/o the professional qualification i.e. medical, legal, financial) Describe consulting - Paid to understand the problem and present workable solutions. Describe mentoring - Provides wisdom and guidance based on own experience. - May include advising, counseling, and coaching. Describe training - Programs set out by trainer or instructor - Assumes a structured learning path that coincided with an established curriculum Describe health education - Work to encourage healthy lifestyles and wellness through educating individuals about behaviors that promote healthy living and prevent diseases and other health problems - Attempt to prevent illness by informing and education Describe therapy - Deals with pain, dysfunction, and conflict within an individual or in relationships - Focus on difficulties arising from the past that hamper an individuals emotional functioning in the present, improving overall psychological functioning, and dealing with try present in more emotionally healthy ways How does coaching differ from therapy? - Supports personal and professional growth based on self-initiated change in pursuit of actionable outcomes. - Future-focused Primary focus on actionable strategies for achieving specific goals - Emphasizes action, accountability, and follow-through Client experiences that may indicate a need to refer out to another professional - Decline in ability to experience pleasure and/or increase in sadness, hopelessness, helplessness - Intrusive thoughts or unable to concentrate/focus - Unable to get sleep, or awakens during night and unable to get back to sleep, or sleeps excessively - Change in appetite, whether increase or decrease - Guilt because others have suffered or died - Despair or hopelessness - Hyper alert or excessively tired - Increased irritability or outbursts of anger - Impulsive, risk-taking - Thoughts of death and/or suicide When in the coach role, avoid these 7 things - Advise - Educate - Console - Reassure - Explain - Correct - Solve problems Three coaching skills associated with self-management 1. Recovery 2. Asking Permission 3. Bottom-Lining Explain "Recovery." The ability to notice the disruption or disconnection and reconnect. Notice it. Name it. Reconnect. Explain "Asking Permission." Allows clients to take responsibility for managing the relationship and their work. Honors client's power in the relationship and demonstrates that the coach knows the limits of their own power in the relationship i.e. "May we work with this issue? — "Can I tell you what I see?" — "Would you like some feedback on that?" Explain "Bottom-Lining." The skill of getting to the point and asking the client to get to the point, too. It's helpful to cover this skill in early work with clients so they are not caught off guard when you use it. Coach talk should be bottom-lined in nature ... clients do the talking. What do negative emotions and sensations usually mean? That some of our needs aren't getting met. What is body intelligence? The awareness, knowledge of, and engagement in health habits that generate physical energy and thriving. Definition of empathy The respectful understanding of another's personal experience, including their feelings, needs, and desires. Four qualities of being empathic - Curious without being demanding - Interested without being intrusive - Compassionate without being condescending - Persistent without being impatient Describe "Being Skills." Skills coaches use to build growth-promoting relationships and also to represent a coach's way of being when at his or her most authentic; often a calm, confident energy radiated toward clients. Includes qualities such as mindfulness, empathy, warmth, affirmation, calm, zest, playfulness, courage and authenticity. Definition of "mindfulness." A nonjudgmental awareness of what is happening in the present moment. Two main components of mindfulness - Self-regulation in order to pay attention in the moment - A posture of curiosity, openness, and acceptance. Ethics Definitions: Health and Wellness Coaches partner with clients seeking changes that are (5): 1. Self-directed 2. Lasting 3. Aligned with their values 4. Promote Health and Wellness 5. Enhance Well-Being Ethics Definitions: Health and Wellness coaches do the following (4) ... 1. Display unconditional positive regard 2. Display a belief in clients' capacity for change 3. Honor that each client is an expert on their own life 4. Ensures that all interactions are respectful and non-judgmental Ethics Definitions: Main component of a Professional Coaching Relationship ... An agreement (including contracts) that defines the rights, roles and responsibilities of each party (including sponsor if any). Ethics Definitions: List Coaching Roles (6) ... 1. Client 2. Sponsor 3. Student 4. Faculty 5. Mentor 6. Conflict of Interest Ethics Definitions: Client - Client: person being coached (also coachee, patient, or member) Ethics Definitions: Sponsor - Sponsor: the entity (including representatives) paying for and/or arranging coaching services to be provided. Ethics Definitions: Student - Student: Someone enrolled in a coach training program or working with an approved faculty member or coach mentor in order to learn the coaching process or to develop and enhance their coaching skills Ethics Definitions: Faculty - Faculty: An individual who provides a primary instruction/training to students enrolled in an approved coach training program. Ethics Definitions: Mentor - Mentor: An individual who conducts coaching skills performance audits and provides feedback to coaching students/coaches for the purpose of developing and enhancing health and wellness coaching skills. Ethics Definitions: Conflict of Interest - Conflict of Interest: A situation in which a coach has a private or personal interest sufficient to appear to influence the objective of their professional role or responsibility as a coach, faculty, or mentor. NBHWC Standard of Ethical Conduct: Conduct myself in accordance with... - NBHWC Code of Ethics in all coaching interactions NBHWC Standard of Ethical Conduct: Commit to take appropriate action to ... - Address any ethics violation or possible breach as soon as I become aware of such a situation, whether it involves me or others. NBHWC Standard of Ethical Conduct: Communicate and create awareness ... - In others, who might need to be informed of the responsibilities established by this Code. NBHWC Standard of Ethical Conduct: Refrain from ... - Discrimination in all occupational activities ... and consistently demonstrate dignity and respect in all professional relationships NBHWC Standard of Ethical Conduct: Make verbal and written statements that are ... - True and accurate about what I offer as a health and wellness coach, the coaching profession, and the NBHWC. NBHWC Standard of Ethical Conduct: Accurately identify ... - My coaching qualification, expertise, experience, training, certifications and NBHWC credentials. NBHWC Standard of Ethical Conduct: Recognize and honor ... - The efforts and contributions of others and only claim ownership of my own material. NBHWC Standard of Ethical Conduct: Strive at all times to recognize ... - Any personal issues that may impair, conflict with or interfere with my coaching performance or my professional coaching relationships. - I will promptly seek the relevant professional assistance and determine the action to be taken, including whether it is appropriate to suspend or terminate my coaching relationship(s) whenever the facts and circumstances necessitate. NBHWC Standard of Ethical Conduct: Recognize that the Code of This applies to ... - My relationship with coaching clients, students, mentees, sponsors, and other coaches. NBHWC Standard of Ethical Conduct: Conduct and report research with ... - Competence, honesty, and within recognized scientific standards and applicable subject guidelines NBHWC Standard of Ethical Conduct: Research I participate in will include... - Informed consent - Approval of all regulatory bodies - Complies with the applicable laws and regulations of the jurisdictions involved. NBHWC Standard of Ethical Conduct: Regarding the handling of records ... - Maintain, store and dispose of any records, including electronic files and communications created during my coaching engagements in a manner that promotes confidentiality, security and privacy, and complies with any applicable laws, regulations and agreements. NBHWC Standard of Ethical Conduct: Regarding use of NBHWC credentialed coach contact information ... - Will use such contact information only in the manner and to the extent authorized by the NBHWC. NBHWC Conflicts of Interest: Seek to be conscious of ... - Any conflict or potential conflict of interest, - openly disclose any such conflict to all stakeholders involved, - and offer to remove myself when a conflict arises. NBHWC Conflicts of Interest: Clarify ... - Clarify roles for health and wellness coaches, - Set boundaries and review with sponsors and stakeholders conflicts of interest that may emerge between coaching and other role functions. NBHWC Conflicts of Interest: Disclose ... - All anticipated compensation from third parties that I may receive for referrals of clients of pay to receive clients. - Compensation from the sale of products or non-coaching services before coaching begins NBHWC Conflicts of Interest: Regarding quality and quantity of coaching services - Must not be dependent in any way upon the purchase of any additional products or services by the client. NBHWC Conflicts of Interest: Regardless of FORM of compensation ... - Honor an equitable coach/client relationship NBHWC Professional Conduct: Ethically speak what I know to be true ... - To clients, prospective clients or sponsors about the potential value of the coaching process or of me as a coach. NBHWC Professional Conduct: Make clear ... - What activities fall within the Scope of Practice as well as outcomes that can be reasonably expected. NBHWC Professional Conduct: Adhere to ... - All ethical standards of practice for their respective health care licenses and credentials NBHWC Professional Conduct: Carefully explain and strive to ensure that ... - Prior to or at the initial meeting, my coaching client and sponsor(s) understand the nature of health and wellness coaching, the nature and limits of confidentiality, financial arrangements, and any other terms of the coaching agreement. NBHWC Professional Conduct: Regarding the coaching agreement - Have a clear coaching service agreement with my clients and sponsors before beginning the coaching relationship and honor this agreement - Agreement shall include the roles, responsibilities and rights of all parties involved. NBHWC Professional Conduct: Hold responsibility for - Being aware of and setting clear, appropriate and culturally sensitive boundaries that govern interactions, physical or otherwise, I may have with my clients or sponsor(s). NBHWC Professional Conduct: Avoid ... - Any sexual or romantic relationship with current clients, sponsor(s), students, mentee or supervises. - Be alert to the possibility of any potential sexual intimacy among the parties including my support staff and/or assistants and will take the appropriate action to address the issue of cancel the engagement in order to provide a safe environment overall. NBHWC Professional Conduct: Respect the client's right ... - To terminate the coaching relationship at any point doing the process, subject to the provisions of the agreement. - Remain alert to indications that there is a shift in the value received from the coaching relationship. NBHWC Professional Conduct: Strive to protect ... - Health, safety and welfare of the client. - Encourage the client or sponsor to make a change if I believe they would be better served by another coach or by another resource - Support my client seeking the services of other professionals when deemed necessary or appropriate NBHWC Confidentiality/Privacy: Maintain strictest levels ... - Of confidentiality with all client and sponsor information unless release is required by law NBHWC Confidentiality/Privacy: Have a clear agreement ... - About how coaching information will be exchanged among coach, client and sponsor, including mobile health/electronic health data collected by the client. NBHWC Confidentiality/Privacy: Conditions in which confidentiality may not be maintained... - Have a clear agreement about conditions under which confidentiality may not be maintained - i.e. illegal activity, pursuant to valid court order or subpoena, imminent or likely rest of danger to self or others - Make sure all agree in writing to that limit of confidentiality - Where I believe the above is applicable, I may need to inform appropriate authorities NBHWC Confidentiality/Privacy: Require all those who work with me ... - To adhere to these Confidentiality and Privacy Standards. NBHWC Continuing Development: I commit to ... - The need for continued and ongoing development of my professional skills. NBHWC Pledge of Ethics: - As a Health and Wellness coach, I acknowledge and agree to honor my ethical and legal obligations to my coaching clients and sponsors, colleagues, and to the public at large. I pledge to comply with the NBHWC Code of Ethics and to practice these standards with those whom I coach, teach, mentor or supervise. NBHWC Scope of Practice: HWC's work with ... - Individuals and groups in a client-centered process to facilitate and empower the client to develop and achieve self-determined goals related to health and wellness. NBHWC Scope of Practice: Coaches support clients in ... - Mobilizing internal strengths and external resources - Developing self management strategies for making sustainable, healthy lifestyle, behavior changes. NBHWC Scope of Practice: HWC's do not ... - Diagnose conditions - Prescribe treatments - Provide psychological therapeutic interventions NBHWC Scope of Practice: May provide expert guidance when: - In areas in which they hold active, nationally recognized credentials, and may offer resources from nationally recognized authorities such as those referenced by NBHWC NBHWC Scope of Practice: Manner of supporting clients ... - As partners and facilitators, HWC's support their clients in achieving health goals and behavioral change based on their clients' own goals and consistent with treatment plans as prescribed by individual clients' professional health care providers. NBHWC Scope of Practice: Coaches assist clients to... - Use their insight, - personal strengths and resources, - goal setting, - action steps and - accountability toward healthy lifestyle change. Two basic legal competencies required - Maintain security and privacy of client records - Awareness of relevant federal and state regulations that affect health coaching [Show Less]
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NBHWC Practice Questions with verified answers, latest updated
A 40-year-old man speaks with the coach on the phone as part of a lifestyle management program to decrease his stress. During today's session, the client s... [Show More] ets a goal of practicing relaxation exercises that consist of deep breathing, light stretching, and visualization for at least 15 minutes daily. Based on his goal, the coach asks the client to rate his confidence. A 10-point scale is used, in which 0 is "not confident" and 10 is "extremely confident." The client says "6." Which of the following is the most appropriate response from the coach? A. "Are you sure you can achieve that goal?" B. "What are you going to do to increase your confidence from a 6 to a 10?" C. "How come you rated yourself a 6 and not an 8?" D. "Why did you rate your confidence a 6 and not a 4?" Answer: D Focus: Scaling ruler. They are testing your knowledge of using one, and how to evoke change talk. Distractor: Age, gender, details on relaxation exercises. NOTE: It is important to practice the style of test questions and how they are created. What are the true questions and what is extra information not critical to the answer. You want to focus on specifics of the question and not extra information that is irrelevant. In preparing to set up your business you must mandatorily have key information in your coaching agreement. Which of the following is mandatory to include? A. Area of Specialty B. Training programs you completed C. Guarantee of client outcomes D. Client testimonials with approved consent E. Client and coach responsibilities Answer: E Focus: Coaching Agreement Key Word: Mandatory Distractor: A & B: A coaching agreement may include the coach's areas of specialty or training programs they completed, but these are not required. Distractor: C: A coaching agreement would not include guarantee of client outcomes. A 55-year-old man comes to the coach's office for his 18th weekly session. He has improved his sleep hygiene and stated he has decreased his level of daily stress. He now wants to lose weight. A part of their session conversation is below: Client: I have struggled with being overweight since childhood and have suffered verbal judgment from peers. Coach: That must be very upsetting and disheartening. What skill is the coach most likely demonstrating? A. Pausing B. Bottom-lining C. Patience D. Summarizing E. Empathizing Answer: E Type of question: Case Study Question. Focus: Coaching Skill Distractors: Pausing, summarizing are distractors and not the skill being demonstrated. Distractor: Patience "could" be an answer. Distractor: Age, gender and session # are not relevant to the specific question. NOTE: Many questions will be related to client sharing and Coach response, as a large percentage of the test is on the coaching process, as stated on NBHWC.org exam prep. A 60-year-old woman meets with her male coach at the clinic for her first session. The client says, "My provider sent me for health coaching for my diabetes because my blood sugar level is up, but I really believe everything is okay. I do not have any diabetes in my family and I feel awesome!" This client is in which stage of change? A. Maintenance B. Denial C. Preparation D. Action E. Precontemplation Answer: E Focus: Testing you on stages of change. Focus: Key is focusing on what the client said. Distractor: Gender and age were not relevant. Session number did not influence answer. A client comes in for his 10th weekly session and he just had his 50th birthday. His goal is to do exercise for 20 minutes 4 times a week. His wife keeps reminding him to get up off the couch and exercise and it annoys the client. What could the coach answer to reframe the client's perception of his wife?" A. "Your wife sounds as if she is a record player that goes round and round." B. "You wife seems to truly care about your well-being and health. C. "You don't like being annoyed by your wife?" D. "Your plan was to get 80 minutes of exercise in each week." E. "Do you still want to stay with this goal?" Answer: B Focus: What is client's perception and how can that be reframed? The answer will apply to reframing. Distractor: D (nothing to do with reframing) Distractor: A & C (reflections). A 60-year-old man speaks with the coach on the phone for his 5th session. The client has a goal to improve his overall health; he is not satisfied with how his clothes fit due to gaining weight and he is tired and lacks daily motivation. He lost his job five years ago due to the company closing and had to take early retirement. He does not know how to spend his time and does not have any energy to do things. When he was thinking about his past job, he knew he was good at organizing materials, tracking assignments, networking and creative marketing for sales. What is the next best approach to guide the client to move forward? A. Tell client to start participating in activities that he can be around more people and discuss his desire to work again. B. Suggest the client to track times of the day he is tired and when he has energy and see if his food intake is related to fatigue. C. Explore the client's past success in his job and strengths to see how they could relate to his goal. D. Ask the client to journal out his thoughts and feeling about his forced retirement. Answer: C Focus here is: Skill Recognition by coach to highlight strengths. Distractor: A, B & C are all coach led and prescribed. A coach would not do this. Your client came to her session and was confused about information from her Physician. She has just found out she has diabetes and the doctor wants to monitor her A1c. She has no idea what that is and has found herself more anxious at times during the day. She wants to know what A1c means. What is the most appropriate response? A. Tell your client it is not a priority and provide with her deep breathing exercises that she can do to help her remain calm throughout the day. B. It is your average blood sugar level over time. C. It is your average hemoglobin level at the time you get up in the morning. D. It is your average cholesterol level after you eat. Answer: B Type of question: Definition Focus: What is the key question, client wants to know what her A1c is. Distractor: Client is confused and anxious. A Coach is certified to sell nutritional supplements through a well-known company and has disclosed this on the initial session. He fails to share that he is part owner of the company. During the client's 3rd session, she states that her fatigue is increasing and she is not sure what to do. The coach elicits from her that she has tried reducing coffee and getting more sleep. The coach then provides her with a brochure of the supplements that he sells and recommends the top three for reducing fatigue. He then asks her which one she would like to purchase? In accordance with the NBHWC code of ethics, what ethical principle is being violated? A. Consent to purchase B. Scope of Practice C. Confidentiality D. Conflict of Interest E. Licensure Answer: D. Focus: What is the question? It is about the code of ethics. Focus: What is being violated. Distractor: Certified to sell nutritional supplements and disclosure of this. Distractor: Eliciting information, providing her with recommendations and giving her a choice A client stated that his nurse measured his height and weight to determine his level of body fat during his standard physical. He has a history of diabetes in his family and heart disease. They are setting him up for a 6-week wellness plan and want to have accurate information. What screening metric takes into account measurements of height and weight? A. Diabetic screening metric B. Cardiovascular rhythm metric C. Body Mass Index D. Body Circumference Measurement E. Skinfold Measurement Answer: C Type of question: Definition Focus: Screening metric for Body Mass Index Distractor: Diabetic and cardiovascular history. A 42-year-old man who is recently divorced and has never exercised wants to increase his energy. He sets a goal to start exercising next week on Monday, Wednesday, and Friday after work at 4:30 for 3 months to improve his overall vitality. What is missing from this SMART goal? A. It is not specific. B. It is not realistic, as he has not been exercising at all. C. There is no way to measure it. D. It doesn't have a time frame. Answer: A Focus: SMART goal, all the components: Specific, Measurable, Action oriented, Realistic, Time based. Distractor: Case history and that he never has exercised influencing realistic view. NOTE: It is not specific, as it does not identify the type of exercise he will do or for how long he will exercise. [Show Less]
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NBHWC Section 1: Coaching Structure, 100% correct | A+ content
Four phases of a coaching program Prospect Start-up Ongoing sessions Program close/wrap up Coach preparation prior to the session reviews... [Show More] materials eliminates distractions takes time to become mindful and present Competencies associated with session preparation Coach is calm, present, and emotionally available Review available client materials Logistics (meeting location, conference call arrangements, etc.) The coach's aims for the initial session, or intake session describe the coaching process review information and assessments provided by the client determine if the client is an appropriate candidate for coaching Roles and expectations of coaching the coach will not diagnose or prescribe, nor give unsolicited advice the client will self-determine his/her vision, goals, and action steps; and the client will be actively engaged in trying new behaviors as planned with the coach Coaching principles: coach I will help my client identify and fully engage his or her strengths on the path to a better future I will ask provocative questions and encourage my client to arrive at his or her own answers whenever possible and co-create answers otherwise I will encourage realistic expectations and goals I will be direct and firm with constructive reflections when needed I will support my client in brainstorming creative possibilities for moving forward and navigating roadblocks When appropriate, with permission, and within my scope of practice, I will offer advice, instruction, and resources for improving health, well-being, and performance I will be punctual and responsive I will recognize early whether the chemistry with a client is good or not optimal. If not optimal, I will refer to another coach I will acknowledge when my client has an issue that is outside of my scope of knowledge and skill and recommend other resources I will send a summary of each coaching session, including vision and plan for client editing (or ask the client to do so) Coaching principles: client I want to improve my level of health, well-being, or performance in life or work I am ready to take responsibility to make and sustain changes in at least one area. I am ready to invest at least three months to make improvements I will be open and honest and I share personal information that is relevant to my health, well-being, and performance I am ready to become more self-aware I am curious and open to suggestions and trying new things I understand that setbacks are normal on the path of change and necessary in order to establish new mindsets and behaviors I will be punctual and responsive Four phases in protocol for designing the coaching relationship Set expectations Prepare for the start-up session Session opening Explore well-being assessment Designing the coaching relationship: Set Expectations What is coaching and what is not coaching? Introduces coach's biography Confidentiality and record keeping Discuss coaching agreement principles Clarify expectations regarding logistics (payments, scheduling, rescheduling, and length of sessions) Share assessment for client to complete Designing the coaching relationship: Prepare for Start-up Session Review the well-being assessment: seek out success, notice aliveness, consider stages of readiness, question gaps, and note concerns Practice mindfulness Remember the key coaching skills: mindful listening, open inquiry, perceptive reflection Formulate curious, strengths-based inquiries Designing the coaching relationship: Session Opening Welcome and thank you Thank client for completing assessments Review the agenda: confirm client's expectations and agenda, review an assessment, gather additional information, create vision, design goals Designing the coaching relationship: Explore Well-being Assessment Ask client what questions they have after completing the assessment Ask client what insights they might have had after completing the assessment Gather missing information and clarify the coach's questions Discuss client's medical history and need for physician release, if applicable At their best, health, wellness, and life visions have these qualities Grounded (building on current successes) Bold (stretching the status quo) Desired (what people truly want) Palpable ( as if they were already true) Participatory (involving many stakeholders) Coaching agreement confirms logistics and responsibilities can include: roles logistics fees scheduling inclusion of others if appropriate confidentiality Coaching competencies Calm, present, and emotionally available Show empathy Establish rapport Ensure client's agenda, needs, interests and preferences drive the coaching Invite client to select focus of session Explore the client's vision of optimal health and well-being Establish long-term goal(s) to be enacted by 3-6 months or by end of coaching agreement) Establish or refine client's short-term SMART goals or action steps for what will be accomplished between sessions Actively Listen Ask Open‐ended Questions Help client explore and articulate values, sense of meaning and purpose Explore broader perspectives and inspire interest in new possibilities Share information Discuss and honor client's preferences for self-monitoring Facilitate process of self‐ discovery, learning and insight Prompt for, and amplify positive resources (including past successes, qualities, strengths, and skills) Recommended % of time spent within each section of a 30-minute coaching session Session opening 7% (2-3 mins) Weekly goal review 20% (5-7 mins) Three-month goal review (monthly) 7% (2-3 mins) Generative moment 40% (10-12 mins) Goal setting 20% (5-7 mins) Session close 6% (2-3 mins) Steps in session opening Ask how the client is "in this moment" Use reflection to understand the client's state Ask the client to share the best thing that happened from the previous week(s) Reflect something positive about the client Ask the client to select the first weekly goal to be discussed These are explored in initial stages of coaching values vision purpose priorities # of behavioral goals client might work on between sessions 2-5 Appreciative Inquiry (AI) an approach for motivating change and enhancing well-being that focuses on exploring and amplifying the best in a person or situation It's most effective to begin with this type of question when reviewing goals a positive, "best experience" question ask about what went well and the lessons learned Examples of inquiries for the review process What was the best experience with your goals in the past week? What percentage of achievement did you reach for this goal? What contributed to this level of success? What kept it from being lower? Higher? What did you learn from this experience? Reasons to refer a client to a mental health provider 1. exhibiting a decline in ability to experience pleasure or increase in sadness 2. intrusive thoughts or unable to concentrate/focus 3. unable to sleep or sleeps excessively 4. change in appetite 5. guilt over someone's death 6. feelings of despair or hopelessness 7. hyper-alert or excessively tired 8. increased irritability or anger 9. impulsive/risk-taking behavior 10. thoughts of death or suicide Role of consultant diagnose problems and prescribe and/or implement solutions Role of mentor provides wisdom and guidance based on experience Role of trainer facilitates learning based on prescribed curriculum Role of health educators teach about lifestyle behaviors that promote healthy living and prevent disease Role of personal trainers Guide and direct behavior based on knowledge. Focus is on identifying individual's opportunity for development based on strengths and capabilities. Role of therapy healing pain, dysfunction, and conflict within an individual or relationships Therapy vs. coaching therapy deals with healing pain, dysfunction, and conflict coaching supports growth based on self-initiated change in pursuit of specific outcomes Coaches may only provide advice in these areas where one has nationally recognized credentials Coaches must inform clients of these scope of credentials and expertise These take precedent in matters of professional conduct existing professional, licensure, or certification affiliations Certified coaches may only provide these legally permissible services within the scope of practive of their respective certification Certified coaches must be truthful about these qualifications and limitations of expertise they can only provide services consistent with their competencies Confidentiality the act of holding information in confidence, not to be released to unauthorized individuals HIPAA (Health Insurance Portability and Accountability Act) requires individuals, organizations, and agencies that meet the definition of a covered entity to comply with the law's requirements to protect the privacy and security of health information and must respect certain rights Authenticity "Share what is there", because honest communication leads to learning and growth Mindfulness nonjudgmental awareness of of what's happening in the moment including: thoughts, feelings, physical sensations, and the environment Mindfulness questions (examples) Where am I? What is my body position? What is going on around me? Am I really hungry? What does the food look, smell, feel, and taste like? What am I thinking about? What am I feeling?/ What do I really want to eat? How can I enhance my experience of eating? Steps to activate mindfulness before coaching take three deep breaths close eyes for five seconds become aware of your breathing say to self: - I am grateful for this opportunity to connect and make a difference - I have an opportunity to make a pivotal contribution - I am open and curious about what will unfold Three Core Coaching Skills Mindful listening Open-ended inquiry Perceptive reflections Mindful listening giving careful and thoughtful attention and responses to the messages we receive Cognitive listening listening to the facts Affective listening listening to the feelings and the needs behind the facts Tips for mindful listening Do not think about what you'll say next until client is done speaking Pause after your client has spoken Weave the client's last words into the next step Weave the client's story into later steps Listen for emotions as wells as facts Do not interrupt (except for when your client wanders off track) Mirror what the client has said to confirm understanding Open-ended inquiry Questions that elicit long, narrative answers. Some examples include: What is the best experience you have had with your desired future behavior? What concerns do you have about your current behavior? What values do you seek to live by in your life? Design thinking strategies Empathy Optimism Collaboration Experimentalism Clients base their trust of the coach on these principles benevolence honesty openness reliability competence commitment to maintaining confidentiality Benefits of wellness assessment Trust and rapport Honoring personal preferences The written word Developing discrepancy Wellness assessments provide valuable information about these topics Current state: physical health, lifestyle habits, strengths, life satisfaction, and readiness to make changes A better understanding of client's life context (illness vs. fitness) Awareness of situations such as major loss or recent diagnosis Early indication of the client's strengths and healthy habits as well as health risks and areas of challenge Identification of red flags related to physical health or mental health issues Six Dimensions of Wellness physical emotional intellectual interpersonal spiritual environmental Wheel of Life (co-active coaching) Healthy finances Healthy environment Healthy self-care Healthy relationships Healthy thoughts Healthy time Wellcoaches well-being assessment Energy Life satisfaction Mental and emotional fitness Weight management Physical activity/exercise Nutrition Health Wellbeing assessment can provide information about (uncovering motivation) Priorities Confidence Readiness for change Steps to explore assessment results Read with an open mind Seek out success Notice the client's arousal Consider the stages of change Question gaps Note concerns Ways to establish trust and rapport Hold clients in positive regard Express empathy Slow down Listen with full attention Allow clients to formulate and find own answers Honestly share observations Under-promise and over-deliver Be humble in sharing information and advice Honor confidentiality Experiment/Goal Review Explore full experience with weekly goal, starting with the positive Uses reflections to show listening and understanding of the goal experience Expands inquiry about the client's best experience with his or her weekly goal Responds to client challenges with judgment free reflections and inquiries Asks what the client learned form their experience Affirms the clients strengths, choices and/or situation Inquires about the client's percentage of success Three-month goal review Validates the relevance of the client's vision and connection to the three-month goals Asks about the client's best learning or growth experience with their three-month goals Affirms the client's strengths, abilities, or growth Generative moment Collaborates with client to identify topic (emotional energy) Asks to explore now Encourages client to explore what they really want Explores strengths and values to leverage Explores the environments the client can leverage Explores the decisional balance and develops discrepancy when the clients demonstrates ambivalence Engages client in brainstorming Expresses confidence in clients ability to move forward Goal setting asks the client to choose a goal that is important and that they are ready to pursue explores the support, structure, or environments needed to ensure success and handle challenges assists the client to refine goal to be a SMART behavioral goal uses confidence ruler to improve the client's confidence in reaching that goal asks client to restate goals affirms clients ability to achieve their goals Situation: client is overzealous and unrealistice Approach: monitor goals and help keep them realistic Situation: clients slow to become motivated, no noticeable progress Approach: address readiness for change through AI or MI Situation: client becoming bored Approach: add variety to generative moment discussions, offer new assessment, explore other domains for change Situation: clients not making change process a priority (excuses, missed appts, etc) Approach: share observations, express empathy, inquire what would make a priority Situation: client realizes coach is not a magician, this will take work Approach: normalize their experience, emphasize smaller steps Situation: clients are not attempting behaviors they set as SMART goals Approach: look for what is working and set new goals to get a fresh start, probe deeply for motivators Situation: client is not at 50% of 3-month goal at week 6 Approach: re-assess 3-month goals , revisit vision to reignite its power Situation: client gets discouraged by not seeing results Approach: focus on what is working and on client's strengths, spend extra time on areas which have not been met, create a plan for improvement Phase 4: Coaching Program Close explore reasons for client choosing to stop coaching, ask to complete a brief survey harvest and celebrate their learning, explore what they may want to consider next encourage them to keep making progress and to let you knowhow they are doing ask if you may check in from time to time express your gratitude for the privilege to work with them Phase 1: Prospect phase email personal welcome and introduction discuss what coaching is and is not introduce coach's biography discuss program protocol, fees, and payment terms Phase 2: Program start-up Set expectations Prepare for session Session opening Explore assessment Design a vision Design 3-month goals Design action plan Session close Phase 3: Ongoing coaching program prepare for session session opening actions/experimental goal review 3-month goal check-in generative moment goal setting session close Protocol for designing a wellness vision Value What's working now Strengths Thrive Important Motivation Visualize Past successes Strengths to realize vision Major challenges hurting confidence Strategies Recap Commit Open-ended inquiry (Motivational Interviewing) these allow clients to take an active role in the coaching session as they explore both positive and negative impacts of their behaviors Perceptive reflections (Motivational interviewing) these function like mirrors, enabling clients to see themselves in new ways and improve both motivation and capacity for change Ideal ratio of reflections to questions (Motivational interviewing) 2:1 Rolling with Resistance (Motivational Interviewing) clients don't resist change, they resist being changed these can increase resistance: moralistic judgments diagnostic labels enemy images guilt trips making demands denying choice or responsibility rewards and punishments making comparisons Engaging (Motivational Interviewing) create a calm, safe, judgment free relational space in which people feel secure in honestly sharing their thoughts, feelings, needs, and desires without fear of judgment, ridicule or pressure Focusing (Motivational Interviewing) enable a focused exploration of the discrepancies between a client's stated values and goals and their current behaviors [Show Less]
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NBHWC Section 3: Biometrics questions and answers, 100% correct
Blood pressure Diastolic/Systolic Normal: <120 and <80 Elevated: 120-120 and <80 HBP Stage 1: 130-139 or 80-89 HBP Stage 2: >140 or >90 HBP Stage 3: ... [Show More] >180 or >120 Diabetes Normal / Pre / Diabetes A1C % < 5.7 / 5.7-6.4 / >6.5 Fasting Blood Sugar mg/dl <99 / 100-125 / >126 Glucose Tolerance mg/dl <140 / 140-199 / >200 Random Blood Sugar mg/dl na / na / 200 BMI less than 18.5 underweight 18.5 to 24.9 normal or Healthy Weight 25.0 to 29.9 overweight 30.0 or higher obese Obesity Classes (BMI) Class 1: 30-34.9 Class 2: 35-39.9 Class 3: >40 Waist Circumference (WC) (higher risk for developing obesity-related conditions) men >40" women >35" Waist-to-hip ratio (higher risk of heart attack/stroke) men >.95 Women >.85 Desired cholesterol levels LDL <100 mg/dl HDL > 60 mg/dl Triglycerides <150 mg/dl Total 200 mg/dl Optimal ratio TOTAL /HDL = 3.5 Risk factors for metabolic syndrome (you must have at least three of five) Large waistline (m>40, w>35) High triglycerides (>150) *or on meds Low HDL (m<40, w<50) *or on meds High blood pressure (>130/>85) *or on meds High fasting blood sugar (>100) *or on meds Sleep recommendations Age 18-60: 7+ hours Age 61-64: 7-9 hours Age 65+: 7-8 hours Short sleeper is <6 hours Alcohol use Binge drinking Men: 5+ in 2-3 hours Women: 4+ in 2-3 hours Excessive Men: 15+ per week Women: 8+ per week Exercise guidelines at least 150-300 minutes/week moderate-intensity or, 75-150 minutes/week vigorous-intensity aerobic physical activity or, an equivalent combination of moderate- and vigorous-intensity aerobic activity. Preferably, aerobic activity should be spread throughout the week Adults should also do muscle-strengthening activities of moderate or greater intensity and that involve all major muscle groups on 2 or more days a week [Show Less]
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NBHWC Section 2 — Coaching Process, questions and answers with complete top solutions
2.1. Client-centered relationship Client-centered relationship Competencies (6) 1. Client's agenda, needs, interests, and preferences (vs. coach's) drive... [Show More] s the coaching relationship 2. Share coach's personal information/experience only when appropriate 3. Share information or recommendations only when specifically asked or given permission to do so or as otherwise required within scope of practice 4. Observe, name, and refer to client's beliefs and values 5. Convey the belief that client is resourceful, expert in own experience 6. Adjust approach according to client's health literacy Four cornerstones of coaching (Arloski) 1. Clients are naturally creative, resourceful and whole 2. Coaching dares the client's whole life 3. The agenda comes from the client 4. The relationship is a designed alliance Two unique aspects of coaching - Coaching is a designed relationship - Coaching language is permeated with permission Coaching conversations focus on - Goals - Unutilized potential - Solving problems (but not just that) - Developing skills - Finding intrinsic motivation Bark's 4 phases of coaching 1. Setting the Foundation 2. Co-Creating the Relationship 3. Communicating Effectively 4. Facilitating Learning and Results Bark's Grid for Exploring the Unknown 1. What the clients knows but the coach doesn't know 2. What neither the coach nor the client knows 3. What the coach knows and what the client knows 4. What the coach knows but the client doesn't know Humanistic approach assumptions of the client - Unique and whole - Intelligent and a problem-solver - Capable of focus, follow-through, and accomplishment - An adult and personally accountable - Imaginative and creative - Acting from their own sense of order and organizing principles - Willing to be a learner - Clear - Resilient - Competent in the work - Able to provide for themselves - Strong, talented, brave - Able to act from their own inner compass and unique vision, dream, or goal Mid-session tasks and competencies (Jordan) - Reinforce self-accountability - Reflect needs and interests of client - Evoke agenda, goals, objectives from within the client - Ask open-ended, powerful questions - Identify key resources and support circles - Analyze readiness for change - Listen for re-cycling along Transtheoretical Model - Apply Adult Learning Theory when appropriate - Facilitate cognitive change Key words for the coach approach - Accept - Ask - Guide - Help - Uncover - Support - Address - Assist - Encourage - Harness - Reframe - Enable - Inspire Coaching DONT'S Don't: - Assume clients already know the answers - Make decision and judgment call quickly - Think about what to say next - Generate even the tiniest bit of quiet resistance - Rush clients through their "muck" - Be on "automatic pilot" More of what is NOT a coach approach: 1. Ordering, directing, or commanding 2. Warning, cautioning, or threatening 3. Giving advice, making suggestions, or providing solutions 4. Persuading with logic, arguing, or lecturing 5. Telling people what they should do; moralizing 6. Disagreeing, judging, criticizing, or blaming 7. Agreeing, approving, or praising 8. Shaming, ridiculing, or labeling 9. Interpreting or analyzing 10. Reassuring, sympathizing, or consoling 11. Questioning or probing 12. Withdrawing, distracting, humoring, or changing the subject Highlights of the coach approach 1. Clients are working at least as hard as you are 2. Clients are talking more than you 3. Clients first try to find answers for themselves 4. Ask permission before giving expert advice 5. Brainstorm with client to inspire creative thinking 6. Speak less, and speak simply — one question at a time 7. Prioritize the coach approach over the expert approach 8. Balance questions with reflections (avoid interrogation) 9. Use silence to elicit deeper thinking 10. Help clients define a path for gaining new knowledge or skills 11. "Less is more" is a good rule of thumb What within the client is fundamental to successful coaching? VALUES Describe affirmation - Conveys acceptance and appreciation - Has to do with combining mindfulness and empathy 2.2. Trust & rapport — Trust and rapport competencies (4) 1. Demonstrate benevolence, honesty, sincerity, and authenticity 2. Convey unconditional positive regard 3. Follow through on commitments made to the client 4. Openly name and address discord/conflict between coach & client as it occurs and resolve in a timely manner Trust & rapport overview - Coach create a positive and stable environments - Offers acceptance and support - Allows for honesty and vulnerability - Demonstrates confidence in client's ability to learn, grow and change - Attends to clients emotions, words and behaviors - Can address conflict and discomfort with acknowledgment and curious interest How to build trust (Arloski) - Authenticity - Integrity - Professionalism - Competence - Compassion - Consistent and reliable - Listening Building rapport (Jordan) - Relaxed ease - Humor (respectful) - Mirroring techniques (NLP) i.e. matching posture, speaking style, energy - Eye contact - Listening intently, not interrupting - Presence, attention, support, empathy Building trust (Co-active coaching) - Confidentiality - Results - Punctual, reliable - Believing in clients Building trust & rapport (Coaching Psych Manual) - Hold unconditional positive regard - Show empathy - Be a humble role model - Slow down - Under-promise and over-deliver - Client's find the answers as far as is possible - Confidentiality is crucial - Be authentic - Solicit input and suggestions 2.3. Active listening and presence — Active listening and presence competencies (6) 1. Be attentive and mindful 2. Be open-minded 3. Be curious without assumptions 4. Pace communication to fit client's needs 5. Listen for what is not being said 6. Nonverbal communication - Use silence appropriately - Attend to and address nonverbal communication Active listening and presence overview - Attune to nonverbal cues (expression, tone, emotions, energy - Notice relevant behaviors (or lack of) - Mindful awareness + curiosity and non-judgment about what is happening with client - As well as what is happening with themselves - Never assume you know what client needs (if so, self-management required) - Active listening and holding space - Allow clients time to reflect, process, identify what emerges Active listening skills (Arloski) - Paraphrase & Restatement - Reflection of Feeling - Use of Silence - Relying on Intuition - Request for Clarification - Acknowledgment - Summarization Describe Paraphrasing / Restatement - Stating back the essence of what was said - Allows them to feel heard, understood - To realize what they said - To clarify their true meaning - Evidence of listening - Restatement = verbatim in tone of "checking it out" Describe Reflection of Feeling - Meaning behind the words - Feelings rather than content - NOT same as interpretation - Estimation of what feeling you're observing - Empathy - "You seem" / "What I hear is" / "It sounds like" Describe Use of Silence - Waiting before responding ... allowing room for more - Allow for client-centeredness - Allows for deepening - Esp. after client makes a powerful statement - Allows client to follow own thought process Describe Relying on Intuition - Sharing a gut feeling as a form of reflection - Offer tentatively and sparingly Describe Requesting Clarification - Asking for elaboration on anything you're unsure/unclear about - Allow client to deepen exploration - Reassures client that you want to understand them completely - Avoids assumptions Describe Acknowledging - Sharing the value of who the client is - The validity of their experience - What they did Describe Summarizing - Review in a concise way what's been expressed and experienced in coaching so far - At the end of every coaching session - Periodically throughout session as well - Helps clients tay focused on task - Helps to clarify what was covered and agreed upon Elements of Powerful Questions - Open the individual up to possibilities - Not presume an answer - Promote deep thinking - Be in positive terms - Be delivered in an appropriate tone of voice 5 things to listen for - Focus: is the destination clear or fuzzy? - Mindset/Attitude: What is the current emotional position? - Skills and Capacities: What resources can the client draw from? Where are the gaps? How to fill them? - Habits, Practices, Patterns: What's automatic? Refrain from labeling good or bad. - Attending to Client's Energy: Are they excited about a goal? What drains their energy? Tools to develop presence and strengths - NonViolent Communication - Emotional Intelligence - Appreciative Inquiry - Gratitude - Mindfulness meditation - Creativity - Affirmations - Playfulness and laughter Levels of Listening (Co-Active Coaching) - Level 1: what does this mean to ME? - Level 2: awareness totally on clients. Empathy, clarification, collaboration - Level 3: Global listening, all the senses, expanded awareness, intuition. What to do if triggered during a session? - Notice the feelings - Set them aside and stay focused on client - Examine feelings later Mindful listening bullet points - Don't think about what you'll say next until client finished talking. - Pause after client has spoken - Weave client's last words into the next step - Weave client's story into later steps - Listen for emotions as well as facts - Do not interrupt (unless needed to get back on track) - Mirror to confirm understanding Four qualities of empathy - Curious without being demanding - Interested without being intrusive - Compassionate without being condescending - Persistent without being impatient 24 character strengths 1. Creativity 2. Curiosity 3. Open-mindedness 4. Love of learning 5. Perspective 6. Bravery 7. Persistance 8. Integrity 9. Vitality 10. Love 11. Kindess 12. Social intelligence 13. Citizenship 14. Fairness 15. Leadership 16. Forgiveness and mercy 17. Humility/modesty 18. Prudence 19. Self-regulation 20. Appreciation of beauty and excellent 21. Gratitude 22. Hope 23. Humor 24. Spirituality Coaching Relationship Skills 1. Perceptive Reflections 2. Positive Reframing 3. Silence 4. Humor and Playfulness 5. Championing 2.4. Client emotions and energy — Client emotions and energy competencies (5) 1. Attend to the client's state of being (mood/affect/presence) 2. Acknowledge client's emotions 3. Ask client to describe emotions when appropriate 4. Show empathy (resonance with) 5. Foster self-compassion Client emotions and energy overview - Emotions can generate insight - Emotions can impact the brain's capacity for learning and change - Coach calls attention to positive shifts in energy or emotion that may support behavior change - Coach encourages client to foster self-compassion and acceptance of emotions - Emotions allow a more honest appraisal of one's behaviors - Emotions allow for better self-care - Harsh self-criticism leads to avoidance and undermines insight Questions for Sense of Purpose and Meaning - What brings you great joy? - When do you feel most alive and vital? - What makes getting out of bed in the morning worth it? - Who do you admire? What is that person's life purpose? - How would getting more connected to your sense of purpose change your life? When and how to use compassion? - When client wants to cultivate love for self and others - Ask client what helps them feel more love and opens their heart - Offer the practice of loving kindness meditation Tips for handling negative emotions - Radiate warmth, patience, and empathy - Model or elicit self-compassion - Mindful acceptance of negative emotions - Heartfelt connection to others who share similar negative emotions - Crossing hands over heart - Help make reappraisal a conscious, ongoing process - Distinguish between events and interpretations - Aim for positive to negative ratio of 3:1 - Support clients to learn from behavioral experiments to substitute curiosity for negative self-talk Define self-esteem - The belief that one has value and worth as a person; healthy self-respect - Drives us to set a high bar for our achievements and measure how well we are performing - Can lead to self-criticism if not careful Benefits of self-esteem - Resilience - Initiative - Leadership - Relationship to feelings of happiness Pitfalls of self-esteem - Narcissism/Aggression - Increased social comparison - Inflated view of how others perceive you - More critical of others - Risky health behaviors How to ensure a healthy self-esteem - Keep it grounded in self-kindness. Three elements of self-compassion - Self-kindness - Common humanity - Mindfulness Key aspects of self-compassion - Willingness to be vulnerable and truly seen - Uncover and have compassion for shame - Recognize impact of environment - Open to experiencing full range of human emotions and honoring them - Self-compassion leads to self-determination Key aspects of empathy - Respectful and appreciative understanding - Involves both emotional and cognitive awareness - NOT pushing too hard - NOT sympathy (identifying with someone's experience; interferes with listening) - NOT pity (grieving someone's experience; undermines self-esteem; implies fateful resignation) Expressing empathy with NVC - Make observations, not evaluations - Express feelings, not thoughts - Identify needs, not strategies - Make requests, not demands NVC Communication Model 1. Observe (When I see/hear/notice; objective descriptions) 2. Feel (I feel ...) 3. Need (Because I need; universal requirements) 4. Express/Request (I appreciate/Would you be willing to...?; Connection action) 2.5 Reflections — Reflections competencies (4) 1. Simple content reflections, paraphrasing 2. Double-sided & other types of reflections as indicated in Motivational Interviewing (e.g., amplified, feeling & meaning reflections) 3. Summaries 4. Recall previous information and experiences of client Reflections Overview - Convey active listening - Give client opportunity to witness own words, perspectives and beliefs - Engage client and inspire learning - Use double-sided reflections to raise awareness around discrepancies in words, emotions or behavior - Use amplified/exaggerated reflections to elicit a reconsideration of aspects of resistance 2.6. Expand the conversation — Expand the conversation competencies (7) 1. Open-ended questions 2. Evocative (powerful) questions 3. Use of metaphors based on client language and interests 4. Brainstorm 5. Connect the focus to multiple dimensions of client's life 6. Explore broader perspectives and inspire interest in new possibilities 7. Incorporate coach's intuition Expand the conversation overview - Help client expand possibilities by asking curious questions that evoke deeper thinking and self-reflection - Use open-ended questions ("what" or "how") to encourage exploration and highlight strengths, values, and opportunities for learning - Help expand client perspective and explore interconnections in client's life Key to Exploration with Questions - Pose questions for your clients to ask themselves. - Let go of playing detective Bark's Tools for Expanding the Conversation - Scaling (even for what is a 10? Then where are you now?) - Walking the Talk - Intuition - Silence - Magic Wand Powerful questions have these effects ... - Meet people where they are but stretch them - Reveal hidden assumptions that act as barriers - Have tremendous energy, allowing people to find meaning and relevance - Create possibility-oriented responses and further conversations - Shift the conversation away from a problem to a possibility-focus - Generate curiosity in the listener - Stimulate reflection and refuel purpose and meaning - Are thought-provoking - Invite creativity - Focus attention and inquiry - Stay with you, linger - Evoke more questions Other powerful questions tips ... - Stay on track — ask questions relevant to the client's agenda, values and growth, not your own - Redirect the client if they are getting off track by reminding them of the agreement to keep them on track - Start with wheel assessment and look at discrepancies - Use possibility thinking — what could be possible? - Avoid "why" questions. Instead use "how, when, what else? - Most helpful questions are for clients, not you - Leave your client with an inquiry - Evoke, don't direct Mid-session tasks and competencies Pt. 1 (Jordan) - Reinforce self-accountability - Reflect needs and interests of clients - Evoke agenda, goals, objectives from within client - Ask open-ended, powerful questions - Identify key resources and support circles - Analyze readiness for change - Listen for re-cycling along Transtheoretical Model - Apply Adult Learning Theory when appropriate - Facilitate cognitive change Mid-session tasks and competencies Pt. 2 (Jordan) - Apply imagery interventions - Reflect client motivation - Celebrate wins; affirm and acknowledge - Demonstrate MI skills (invite "change talk," explore ambivalence, assess impact of next steps, use scaling techniques) - Demonstrate ability to pick up nonverbal body cues - Demonstrate ability to evoke and elicit versus guiding/directing - Keep records; monitor progress Mid-session tasks and competencies Pt. 3 (Jordan) - Summarize growth and change - Support Client self-efficacy - Support client with time management skills - Help a client understand benefits of building self-esteem - Show appreciation and voice confidence - Serve as a resource for access to useful CAM therapies - Serve as a resource with basic knowledge of chronic conditions Aspects of powerful questions (Co-Active Coaching) - Invite introspection - Present additional solutions - Lead to greater creativity and insight - Invite clients to look inside or into the future - Expansive and open up further vistas - Tend to stop people in their tracks - Are best followed by silence from the coach - Simple and direct Example of simple powerful questions - What does what you want look (or feel) like? - What's next? - What about that is important to you? - What else? - What did you learn? - What will you do and when will you do it? - Who do you need to be? Define brainstorming in coaching - A creative collaboration between client and coach with the sole purpose of generating ideas, possibilities, and options. - Clients will pick the option with the most appeal Ground rules for brainstorming - There are no bad ideas - Don't worry about practicality at this point - Coaches should not be attached to their own good ideas - Coaches should not use brainstorming as a camouflage for pitching their own solutions. Five steps to moving from stuck to possibility (Co-Active Coaching) 1. Perspective: identify and expand current perspectives 2. Choice 3. Co-Acive Strategy 4. Commitment 5. Action Tools for expanding perspective - Have a clear subject to explore - Imagine a subject or object from "all sides" - Use intuition to listen below the surface - Maintain curiosity Ways to express an intuitive sense - I have a sense ... - May I tell you about a gut feeling I have? - I have a hunch that ... - Can I check something out with you? - I wonder if ... - See how this first for you. - My intuition tell me ... DARN acronym in Motivational Interviewing - Desire - "What do you want, like, wish, hope, etc.?" - Ability - "What is possible? What can or could you do? What are you able to do? - Reasons - "What reasons would you have for making this change? What would the benefits be?" - Need - "How important is this change?" "How much do you need to do it?" (DARN elicits change talk) Ways to present open-ended inquiry - Take time to evoke and listen - Evoke storytelling - Invite clients to elaborate and tease out nuance, meanings, treasure - Display curiosity - Listen to what's being said and not being said - Elicit what's on the client's mind, not the coach's mind Examples of open-ended questions - 1, 3, 5 year question (I.e. around wellness) - Top 3 values or goals - What part of your life is most important to you? - What would you like less/more of? - What excites you? - Best case and worst case scenarios - What will it take for you to make changes? - What are some new possibilities you haven't considered before? - What is holding you back or standing in your way? And how is it holding you back? - What are you afraid of? - What is at risk for you? - What is happening when you feel ____? What to do when a client avoids or fails to respond to a question, or if you think they aren't being totally authentic? - Drop it and come back another time. - Accept the client's decision about what to share and what to keep private. Again ... top expand the conversation skills - Mindful listening - Evocative inquiry - Perceptive reflections - Honoring silence - Open-ended inquiry - Creative brainstorming - Facilitating generative moments - Explore decisional balance and develop discrepancy 2.7. Focus and refocus the conversation — Focus and refocus the conversation competencies (5) 1. Closed-ended questions 2. Interrupt and re-direct 3. Bottom-lining 4. Scaling questions (using a scale of 0-10) 5. Ask the client to summarize the topic Focus and refocus the conversation overview - Balance coaching between exploratory thinking and action-oriented focus - After exploration, narrow conversation toward decision, goal-setting, and commitment to support action Closed-ended questions (when to use) - Ask during check-ins - Ask to confirm commitment - Can be used powerfully if it creates reflection, i.e. "It's time to stop analyzing and act, isn't it?" - Efficient way to gather specific information Bottom-lining - The skill of getting to the point - "Intruding" helps get to the heart of the matter, accelerates getting to the core - Takes high awareness to know the right time - Prepare clients for this during beginning of coaching relationship - Think of it as intruding on story that gets in the way, not on them - Okay to be clear that it's what you're doing Scaling questions (0-10) General - Can elicit change talk - Only as good as the quality of rapport between you and the client - Using the wellness wheel to scale different aspects of life - Help gauge where a client is and where they want to go - Can imagine and actual scale if they want - Imagine what a 10 would be like and work up or down the scale to get there and to identify the details - Also help identify readiness for change Types of Post-Scaling Questions - Straight question: Why a 5? - Backward question: Why a 5 and not a 2? - Forward question: What would need to be different to move you fro ma 5 to a 7? - (No name) — What would have to happen in your life to go from a 5 to a 7? Other terms for scaling questions - "rulers" for readiness, importance, confidence, commitment, motivation - i.e. Willingness ruler, Confidence ruler, Readiness ruler Ask client to summarize the topic - Allows for their own reflections - Creates a clear topic to scale MI acronym RULE - Resist the righting reflex / pulling for resolution - Understand the client's motivations - Listen with empathy - Empower the client MI acronym WAIT - Why - Am - I - Talking? 2.8. Assist client to evaluate and integrate health information — Assist client to evaluate and integrate health information overview - One objective is for client to be well-informed of health and well-being status - First identify what the client understands - Assist client in finding and using resources - Assist client to accurately evaluated and integrate multiple sources - i.e. health care provider input, assessments (existing and self-assessment), health risk assessment, basic biometrics, appropriate referrals Integrative Health & Wellness Assessment (IHWA) Wheel Topics 1. Life Balance & Satisfaction 2. Relationships 3. Spiritual 4. Mental 5. Emotional 6. Physical 7. Environmental 8. Health responsibility Integrative Health & Wellness Assessment (IHWA) Guidelines - Open session - Invite client to choose topic - Allow client to determine direction of conversation - Hear client's story - IHWA statements (on 8 topics) - Listen for "should" and "could" - Explore stages of change - Help client find strong motivators - Close session 2.9. Goals and implementing action — Goals and implementing action competencies (10) 1. Transtheoretical Model (stages of change) - Recognize by what client says - Know which techniques to apply in what stage 2. Specific, measurable, achievable/attainable, realistic/relevant, timely (SMART) goals 3. Patient activation and engagement models 4. Facilitate visualizing to elicit intrinsic motivation and goal direction 5. Commitment to action 6. Encourage behavioral stretches but also set a comfortable pace of learning and implementation of client's goal 7. Anticipate, plan for, and help client navigate challenges 8. Behavior tracking 9. Develop and manage accountability plan 10. Behavioral goals (also known as process goals or learning goals) vs. outcome goals - Recognize different types of goals (i.e. behavioral vs. outcome goals - Behavioral, AKA process or learning goals, may be more effective Goals and implementing action overview - Support client to choose goals and action steps carefully - Small, gradual successes predict long-term engagement - Recognize readiness to change - Support client in designing appropriate action steps toward self-determined goals - Track progress over time - Allow client's to learn to track their own behavior, problem solve, and observe impact of actions - Do not focus on outcome when reviewing progress, but rather emphasize client's effort and what was learned in both successes and setbacks What are the 6 stages of change? - Precontemplation - Contemplation - Preparation - Action - Maintenance - Termination Stages of Change statements 1. Precontemplation: "I won't," "I can't." 2. Contemplation: "I may" 3. Preparation: "I will" 4. Action: "I am" 5. Maintenance: "I still am" Describe Precontemplation and how to work with it - No intention of changing - Deny having problem - In coaching because other people tell them - Demoralized Change by - Consciousness raising - Social liberation - Helping relationships Describe Contemplation and how to work with it - Acknowledging problem and beginning to think about - Struggle to understand problem and potential solutions - Not quite ready to change - May spend a while in this stage Change by - Consciousness raising - Emotional arousal - Self re-evaluation - Helping relationships Describe Preparation and how to work with it - Planning to take action in next month - Making final adjustments - May not have resolved ambivalence Change by - Developing a firm and detailed action plan - Self re-evaluation - Commitment - Helping relationships Describe Action and how to work with it - Overtly modify behaviors and surroundings - Modifying behavior is most visible, but also changing level of awareness, emotions, thinking, etc. Change by - Reward - Countering - Environmental control - Helping relationships Describe Maintenance and how to work with it - Consolidate gains made and prevent lapses and relapses - Can last from 6 months to lifetime Change by - Commitment - Countering - Environmental control - Helping relationships Arloski - Pre-contemplation - No thought of changing now or later - Use formal or informal assessments to build awareness Arloski - Contemplation - Considering but can be ambivalent - Use introspection, what the payoff is, bring in rational mind and emotions into play - Can get stuck weighing pros and cons, so look at how behavior working for them and not - Internal and external exploration Arloski - Preparation - Getting read to change - Gathering information about topics and resources - Removing temptations - Planning how action will be taken - Arranging support and understanding - Arrange substitutes for a missed habit or activity with care - Difficult to move from contemplation to preparation, often - Preparatory steps are the new action - Agreements can be built into coaching method and accountability set up to be in client's realm Arloski - Action - Stage most of us picture, actual practice of the new way of being - Make sure action feels entirely congruent with who client it and how ready they are - Coaching accountability methods ensure greater follow-through - When follow-through fails, explore motivation Arloski - Maintenance - Maintaining an action that's been taken - Remember it's a spiral model, up and down - Recognize lapse and take immediate action to curb self-criticism and save the effort - High accountability support - When spirals back, help re-set goals based on new stage - Support self-monitoring or self-tracking - Help avoid self-deception - *Recycling is often done on way to true maintenance and termination Arloski - Termination - Behavior has become a regular part of person's life - Engage in behavior without much thought - Sometimes total termination may not occur, but rather a lifetime of careful maintenance - Confidence peaks after a year, but temptation to lapse continues for 2-3 years - Help person know when they've achieved their goal - Help client make distinctions between on-going maintenance and termination - Help client focus on other behaviors or what they want to work on next - Help clients work towards independence and self-sufficiency, and termination of coaching How to Coach using Readiness for Change 1. Help client recognize stage they're in for specific behaviors 2. Coach for completion of the client's current stage 3. Coach the client toward the next step in the spiral model of change [Show Less]
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NBHWC Section 4.3 - HIPAA & Ethics questions and answers with verified content
What are the key elements of the HIPAA Privacy Rule? Who is covered What information is protected How protected health information can be used and discl... [Show More] osed. Who is Covered by the HIPAA Privacy Rule? Health plans - Individual and group plans that provide or pay the cost of medical care are covered entities. Health care providers - Every health care provider, regardless of size, who electronically transmits health information in connection with certain transactions, is a covered entity. Business Associates - a person or organization, other than a member of a covered entity's workforce, that performs certain functions or activities on behalf of, or provides certain services to, a covered entity that involves the use or disclosure of individually identifiable health information. Health care clearinghouses - entities that process nonstandard information they receive from another entity into a standard (i.e., standard format or data content), or vice versa. What Information is Protected by the HIPAA Privacy Rule? "individually identifiable health information" held or transmitted by a covered entity or its business associate, in any form or media, whether electronic, paper or oral; Includes demographic data, that relates to: - the individual's past, present or future physical or mental health or condition, - the provision of health care to the individual - the past, present, or future payment for the provision of health care to the individual, Are there restrictions on de-identified health information? No When can a covered entity use or disclose protected health information? (1) as the Privacy Rule permits or requires. (2) as the individual who is the subject of the information (or the individual's personal representative) authorizes in writing. What is meant by "minimum necessary" use and disclosure in relation to the HIPAA Privacy Rule? A covered entity must make reasonable efforts to use, disclose, and request only the minimum amount of protected health information needed to accomplish the intended purpose of the use, disclosure, or request. What are the twelve Public Interest and Benefit Activities of The Privacy Rule that permit use and disclosure of protected health information, without an individual's authorization or permission? - Required by Law. - Public Health Activities - Victims of Abuse, Neglect or Domestic Violence - Health Oversight Activities - Judicial and Administrative Proceedings - Law Enforcement Purposes - Decedents - Cadaveric Organ, Eye, or Tissue Donation - Research - Serious Threat to Health or Safety - Essential Government Functions - Workers' Compensation Under the HIPAA Privacy Rule, a covered entity must share their privacy policy with all patients. When is it required that they share this privacy policy? Not later than the first service encounter When Requested by a patient Electronically on their website How often must a covered entity share their Privacy Policy with it's patients? At least every three years to notify them that it is available upon request How long must a covered entity retain any records or documentation related to personal health information for a patient? Until six years after the later of the date of their creation or last effective date What are the key elements of the HIPAA Security Rule? who is covered what information is protected what safeguards must be in place to ensure appropriate protection of electronic protected health information. Who is Covered by the HIPAA Security Rule? Health plans - Individual and group plans that provide or pay the cost of medical care are covered entities. Health care providers - Every health care provider, regardless of size, who electronically transmits health information in connection with certain transactions, is a covered entity. Business Associates - a person or organization, other than a member of a covered entity's workforce, that performs certain functions or activities on behalf of, or provides certain services to, a covered entity that involves the use or disclosure of individually identifiable health information. Health care clearinghouses - entities that process nonstandard information they receive from another entity into a standard (i.e., standard format or data content), or vice versa. What Information is Protected by the HIPAA Security Rule? Individually identifiable health information, called protected health information (PHI), as explained in the Privacy Rule, specifically the subset of information covered by the Privacy Rule, which is all individually identifiable health information a covered entity creates, receives, maintains or transmits in electronic form (ePHI). The HIPAA Security Rule requires covered entities to maintain reasonable and appropriate administrative, technical, and physical safeguards for protecting e-PHI. Specifically, covered entities must follow what four steps? 1. Ensure the confidentiality, integrity, and availability of all e-PHI they create, receive, maintain or transmit 2. Identify and protect against reasonably anticipated threats to the security or integrity of the information 3. Protect against reasonably anticipated, impermissible uses or disclosures 4. Ensure compliance by their workforce. What Physical Safeguards must a covered entity utilize? Facility Access and Control - limit physical access to its facilities while ensuring that authorized access is allowed Workstation and Device Security - implement policies and procedures to specify proper use of and access to workstations and electronic media What Technical Safeguards must a covered entity utilize? - Access Control - technical policies and procedures that allow only authorized persons to access electronically protected health information (e-PHI). - Audit Controls - hardware, software, and/or procedural mechanisms to record and examine access and other activity in information systems that contain or use e-PHI. - Integrity Controls - policies and procedures to ensure that e-PHI is not improperly altered or destroyed. - Transmission Security - technical security measures that guard against unauthorized access to e-PHI that is being transmitted over an electronic network. What are the names of the five sections of The NBHWC Standards of Ethical Conduct? Section 1: Professional Conduct at Large Section 2: Conflicts of Interest Section 3: Professional Conduct with Clients Section 4: Confidentiality/Privacy Section 5: Continuing Development What is the The NBHWC Pledge of Ethics? As a Health and Wellness coach, I acknowledge and agree to honor my ethical and legal obligations to my coaching clients and sponsors, colleagues, and to the public at large. I pledge to comply with the NBHWC Code of Ethics and to practice these standards with those whom I coach, teach, mentor or supervise. [Show Less]
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NBHWC Exam Prep (from slack channel) questions and answers ,latest updated
A 48 year-old, female client is on her fifth coaching session and has made some progress toward her goal to eat a serving of fruit and a serving of vegetab... [Show More] les every day at work for lunch. She indicated that she does struggle the most whenever her co-workers go out to lunch because she either has to decline or when she goes with them she ends up not meeting her goal for that day. During the coaching session, a coach would most likely focus on: A. Building the client's willpower B. Listing the reasons why the client should not eat out C. Exploring the benefits of eating alone D. Exploring what the client feels is most important in this situation D. Exploring what the client feels is most important in this situation When coaches ask about the pros and cons of making a change and the pros and cons of not making a change they are engaging in what coaching activity? A. Growth mindset B. Active listening C. Empathy D. Decisional Balance D. Decisional Balance A client is on their 5th session and has set the goal to get better sleep in general most days of the week. Client: I slept horrible all week. Coach: Tell me about it.Client: I am very stressed at work and anyone with my stress wouldn't sleep well. Coach: Stress is the primary reason you didn't sleep well this week. Client: Yep. And anyone else that had the week I had would have done the same things. Coach: There was one behavior you zeroed in on last week which was no social media before bed to help with that too. How did that go? Client: There is no way I had any other choice. When work is this stressful using social media at night helps relax me. Discord may appear during a coaching session. Which of the following best categorizes the type of discord the client may be exhibiting? A. Defending B. Interrupting C. Disengagement D. Questioning A. Defending Your client is going to be assessed for obesity at his next visit. The ______ measurement is best for assessing visceral fat. A. Abdominal skinfold B. BMI C. Waist circumference D. Hip circumference C. Waist circumference A 38-year-old woman comes to her fifth session. She is working with her coach to reduce the overall stress in her life. The coach and client get into a lengthy exploration of how the client starts her day. During this conversation the coach becomes aware that she is thinking about what to say next while the client is talking. The coach makes a quick note to practice more _____________? A. Sympathy B. Open-ended questions C. Amplified reflections D. Mindful listening E. Empathy D. Mindful listening A client has requested that what she is about to talk to you about not be put in her record, your electronic coaching notes, or even written down. Which response is most appropriate? A. "Your confidentiality is important to me and I will not put anything in your record, in my electronic notes, or write anything down." B. "I am required by HIPAA to keep a record of everything." C. "I am happy to honor your confidentiality but if it is anything do with a health-endangering behavior or something illegal for example I will not be able to keep that private." D. "Everything you say to me is 100% confidential." C. "I am happy to honor your confidentiality but if it is anything do with a health-endangering behavior or something illegal for example I will not be able to keep that private." A 42-year old man comes to his coach for their 3rd session. The man decided to try coaching to get some help with trying to quit smoking cigarettes. Client: Whenever I try to quit I get really hard to live with. I'm not very nice. Coach: You really get irritable when you're withdrawing from nicotine. Client: Yeah. I know there's that gum that can ease ya down but I am thinking just doing to cold turkey and get it all over with. Coach: That's what fits you best. How could you do that? Client: I definitely need a plan for those early days. I think I'd need to be away form people for a couple of weeks in the wilderness (laughs). Coach: So you don't irritate other people.Client: For my protections actually. I still want to be married and have friends when this is all over. Coach: So overall you are not sure about getting through the really rough withdrawal part, you are worried that quitting cold turkey could affect relationships in your life, and what you will do during the early days of quitting. The last statement by the coach is an example of what coaching skill? A. Appreciative inquiry B. Summary reflection C. Affirmations D. Increasing self-efficacy B. Summary reflection A coach noticed an advertisement in her local paper for another NBC-HWC certified health coach's services. The advertisement indicates that if people buy a 60-day supply of supplements the coach will give them 3 free coaching sessions. In addition, the advertisement indicates most people lose 30 pounds in 60 days. Which of the following is the reason why this advertisement violates NBC-HWC Code of Ethics? A. Coaching sessions are contingent upon purchase of supplements B. It's impossible to lose 30 pounds in 60 days C. The coach placed an advertisement in a paper D. None of the above A. Coaching sessions are contingent upon purchase of supplements A 29-year-old man comes to his 4th coaching session ready to discuss the progress he has made on getting more sleep overall in the past two weeks. The following conversation ensues: Client: I knocked my first goal out of the park. Coach: What does that feel like; knocking a goal out of the park? Client: It feels incredible! I got 8 hours of sleep each day last week. I slept 4 hours each night and the. Was able to sneak in several power naps throughout the day and since they were power naps they added up to an additional 4 hours. Coach: Do you mean you took several naps the next day after sleep 4 hours the night before and those naps totaled an additional 4 hours. Client: Yep! I took a 1.5 hour nap at 10am and then a quick 30 minute power nap at 2pm which counts for double the time since it was a power nap and then another nap at 5pm for about 1.5 hours. Coach: You can't do that. We know from sleep science researchers that it is best if the 8 hours of sleep is continuous for the most part. You need to try to sleep 8 hours in a row. Client: Oh. So it doesn't even count then. Shoot, I totally thought I made my goal. What aspect of the conversation above would NOT be considered the coach approach? A. Asking what meeting the goal felt like B. Not asking permission before giving advice C. Talking 3 times as much as the client D. Asking clarifying questions B. Not asking permission before giving advice Which of the following is NOT a CDC recommendation for proper sleep hygiene? A. Be consistent. Go to bed at the same time each night and get up at the same time each morning, including on the weekends B. Make sure your bedroom is quiet, dark, relaxing, and at a comfortable temperature C. Remove electronic devices, such as TVs, computers, and smart phones, from the bedroom D. Avoid eating or drinking anything before bedtime E. Get some exercise. Being physically active during the day can help you fall asleep more easily at night. D. Avoid eating or drinking anything before bedtime A coach has his NBC-HWC and a degree in psychology. His client describes an ankle injury he recently got running. He says that his ankle is bruised and he can't really run on it anymore and it hurts to even walk, especially down some stairs. Which of the following should the coach recommend next? A. Recommend the client see a medical provider to get it checked out B. Recommend the client use an ACE bandage to help keep it stable C. Recommend the client just walk for the next few days until it feels better and lay off of the running D. Recommend the client rest, ice, compress with a bandage, and elevate his leg for the next week and then try to run again and see how it goes. A. Recommend the client see a medical provider to get it checked out A 45-year-old woman comes to the coach's office for her eighth session. She began coaching after relocating for her job to work on a "fresh start." In her early sessions, the client was positive and made significant progress. After the client was laid off from her job, the coach has noticed that her mood has shifted from upbeat and optimistic to sad an unhappy. Today, her posture is visibly slumped, and her appearance is disheveled. The coach reflects these observations, and the client responds, "Life is too hard right now, and I do not see it getting better." Which of the following is the most appropriate next step by the coach? A. Advise the client that her situation is outside of the coach's scope of practice and offer to connect her with a mental health professional B. Encourage the client to explore her network and to reach out to her support system C. Redirect the conversation to a positive topic and persuade the client to focus on future opportunities D. Reflect on the client's past successes and explore her personal strengths A. Advise the client that her situation is outside of the coach's scope of practice and offer to connect her with a mental health professional A 28-year-old woman speaks with the coach on the phone for her third session. The client has a goal to improve her health and appearance; she is not satisfied with her appearance due to weight gain. She went through a difficult divorce five years ago which has left her feeling resentful and cautious about relationships. She also "generally feels run down" because of work. Prior to this session she took a strength assessment. Her top five strengths were fairness, creativity, integrity, humility, and prudence. Her five lowest categories were perseverance, zest, bravery, capacity to love and gratitude. Which of the following is the most appropriate approach for this client? A. Encourage the client to engage in more social interactions B. Encourage the client to use a gratitude journal C. Establish a schedule to set aside regular time for deep breathing exercises D. Explore the client's strengths to find creative ways to meet her goals E. Suggest the client work on improving one of her lowest categories D. Explore the client's strengths to find creative ways to meet her goals A 54-year-old man is on his ninth coaching session and has been working with a coach to manage his overall stress. He has made steady progress each week incorporating several stress management techniques such as deep breathing, keeping a consistent morning schedule, and doing more enjoyable things on the weekend such as reading. During his ninth session, he indicates he is having trouble concentrating and doesn't feel like eating much. When you ask how his reading on the weekends is going to help manage his stress he indicates that reading is not that fun for him anymore. Which of the following is the appropriate next step for the coach? A. Help the client explore other options for incorporating enjoyable things on the weekend. B. Refer the client to a mental health professional C. Explore reasons why he may be having trouble concentrating D. Re-frame the situation and note all the amazing progress he has made. E. Affirm the client's strengths B. Refer the client to a mental health professional A 35-year-old woman is on her fourth coaching session and has been working with a coach to manage her arthritis. She frequently gets flare-ups that set her back for up to a week. Coach: How is your arthritis impacting you today? Client: I have good days and bad days and today is a bad day. Coach: What does a bad day look like? Client: I had a flare up but I was able to repeat what I did last week and do some gently yoga and I felt much better. I know if I did more yoga I would probably feel better most days. The client's response to the coach's question about what does a bad day look like is an example of what? A. Change Talk B. Sustain Talk C. Decisional Balance D. Empathy ... A 32-year-old woman comes to the coach's office for her third session. The client is eager to start losing weight and decreasing her stress level related to her new job, and she wants the coach to provide immediate guidance on how she can accomplish these goals. During the session, the coach gives the client an exercise to help her distinguish between which of her goals are important and which of her goals are urgent. Which of the following best describes the purpose of this exercise? A. Clarify the next steps the client is willing to take to achieve her goals B. Define the client's long-term goals that will lead to her desired outcomes C. Explore the client's willingness to commit to changes in her lifestyle D. Identify the assumptions that the client has about healthy lifestyle change E. Increase the client's confidence in reaching her goals B. Define the client's long-term goals that will lead to her desired outcomes A 28-year-old female client is on her fourth coaching session. She has been struggling with stress as she does not get along with her current roommate. Client: I just don't know whether to move out or not. Coach: You should do whatever you think is best. Which of the 12 Thomas Gordon's Roadblocks to Communication did the coach demonstrate? A. Warning B. Shaming C. Telling people what to do D. Interpreting C. Telling people what to do If a health coach owns their own business and contracts with a third party to host their clients health information on their server, the coach must ensure that: A. A signed contract is in place B. The third party abides by HIPAA Security rules C. The third party abides by HIPAA Privacy rules D. All of the above D. All of the above In health and wellness coaching, coaches often use motivational rulers to gage where their clients are at. It is recommended that if a client answers that their motivation is a 6, on a scale of 1-10 the next question should explore why their answer was not a 5. This is recommended since the clients answer is most likely to evoke what? A. Empathy B. Sustain Talk C. Resistance D. Change Talk D. Change Talk A client came to her first session, from their providers office, with a list of their biometrics. Blood pressure: 118/72mmHgLDL: 175 mg/dl Waist-to-hip ratio: 0.95Physical activity: yoga, 60-minutes 3x per week and running, 30-minutes 5x per weekA1C: 5.0% Which of the following is most concerning as it increases her risk for a heart attack? A. Blood pressure B. Cholesterol C. Waist-to-hip ratio D. Physical activity level E. A1C ... [Show Less]
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NBHWC Practice Test Questions with complete top solutions
Practice Question #219: A 39-year old man comes to his coach for their 4th session. The man is working on reducing the amount of sugar that he eats. Cl... [Show More] ient: I get so irritable when I don't have sugar. Coach: Giving up sugar is causing some unpleasant side effects. Client: Yeah, I knew it wasn't going to be a walk in the park and prepared myself for that by letting my family know my plan and trying to take it nice and slow so I don't cause them to move out. Coach: Your skill in really thinking this all through and thinking about how this change will affect your family exemplifies you're commitment. The last statement by the coach is an example of what coaching skill? A: Amplified reflection B. Righting Reflex C. Affirmation D. Open-ended questioning C Practice Question #221: About half way through your coaching agreement with a client, the coach notices that the client is arriving to the coaching calls late and has missed a couple of sessions without notifying you in advance. Which of the following approaches would be BEST to pursue with your client?: a. Explore what's working, revisit client's strengths, and create a plan for improvement b. Explore why coaching isn't working and get feedback on what specific things they don't like c. Share your observations, express empathy, and inquire as to what could make their vision and goals more of a priority d. Confront client, assess readiness for change, and discuss whether coaching is appropriate at this time C Practice Question #223: A client comes to their 5th coaching session and has made progress in improving their sleep but is having trouble with their goal of increasing their physical activity. Client: "I really want to feel better...but it's just too hard. I've got two jobs and I take care of my parents too." Which of the following coach responses is NOT a response that would increase change talk? a. "What makes the protocol feel hard and impossible?" b. "What changes have you made in your life that felt frustrating and impossible and yet you achieved them?" c. "Let's pretend that making this change is possible and that it's not hard. What might work?" d. "What small step might be possible and not feel as hard?" A Practice Question #224: Which of the following is recommended by MyPlate as part of a healthy diet: A. Total carbohydrate consumption should be less than 20g per day B. Total fat consumption should be less than 20% of daily caloric intake C. Eat a vegetarian diet 80% of the time D. Limiting trans and saturated fats D Practice Question #226: An 18-year old woman comes to her fifth coaching session to discuss her continued efforts to lose weight and get healthy. After the session, the coach receives an email from the woman's parents indicating they are paying for the sessions and would like to discuss their daughter's progress so far. What is the best response from the coach? A. I would be happy to set up some time. Please email me back potential times that will work for you. Also, your daughter must be present at this meeting. B. I am not able to discuss anything about my coaching services or any clients without prior written consent from the client. C. I will ask your daughter to give me permission and get back to you. D. I would be happy to set up some time what works for you? B Practice Question #225: A 42-year old man comes to his 5th coaching session eagerly working toward his goal of improving his relationship with his boss. Client: I tried to reason with her three times this week but my boss just didn't get it. She doesn't live in a world with reason and logic. She twice called me out in front of the group and on Friday told me I needed to step up my game AFTER I reached a major sales goal. Coach: A lot happened this week that seems frustrating. What is one thing that happened during the week between you and your boss that was an improvement from last month? The coach is demonstrating the use of what coaching technique? A. Empathy B. Amplified Reflection C. Use of Positive Psychology D. Righting Reflex C Practice Question #222: A 55-year old woman comes to her first coaching session having completed several wellness assessments. The coach asked the client to work on these assessments at the end of their first session for what purpose? A. An assessments help the client see what parts of the wellness wheel she needs to focus on improving B. Assessments help the coach figure out where to begin with this client C.Assessments are a tool coaches use with all clients as part of their scope of practice D. Assessments help the client reflect on her life and discover aspects of her wellbeing E. The coach can refer to these assessments later in their relationship to help move the client forward with her goals D Practice Question #220: Please LIKE the answer when posted to ensure more people see it. At the beginning of each coaching session, before contacting the client, a coach rings a small bell three times. This is an example of an activity to improve what coaching technique? a. Mindfulness b. Perceptive Reflections c. Appreciate Inquiries d. Affirmations A Practice Question #218: What is the main purpose of familiarizing yourself with your client's health risk assessment? A. To offer education and insight into their current health status B. To provide empathy, trust and greater understanding of their present life C. To assist in making goals around any biometric numbers that may need work D. To offer immediate referrals for any high risk behaviors B Practice Question #217: A 32-year old woman comes to her third coaching session to co to use to work on her eating habits. Specifically, the client is concerned about her sugar intake. Client: I plan to quit sugar. I am going to give it up completely for the next 6 months. Coach: Have you thought about taking a more gradual approach. What if you just decreased your sugar intake by a little bit each week? The coach is demonstrating what? A. Empathy B. Appreciative Inquiry C. Simple Reflection D. Righting Reflex D Practice Question #216: In the NBHWC Code of Ethics, there is mention of the "importance of recognizing and honoring the efforts and contribution of others and only claiming ownership of your own material." This component falls under which section of the code of ethics? A. Professional Conduct at Large B. Conflicts of Interest C. Professional Conduct with Clients D. Confidentiality A Practice Question #215: A client came to her first session, from their providers office, with a list of their biometrics. Blood pressure: 118/72mmHg LDL: 175 mg/dl Waist-to-hip ratio: 0.95 Physical activity: yoga, 60-minutes 3x per week and running, 30-minutes 5x per week A1C: 5.0% Which of the following is most concerning as it increases her risk for a heart attack? A. Blood pressure B. Cholesterol C. Waist-to-hip ratio D. Physical activity level E. A1C B Practice Question #214: Which open-ended question would be best if your client is in the stage of contemplation? A. What would have to happen that would signal you that it's time to start thinking about changing? B. What would be some pros and cons of making a change right now? C. What has worked for you in the past? D. Why make this change? B Practice Question #213: A 28-year-old female client is on her fourth coaching session. She has been struggling with stress as she does not get along with her current roommate. Client: I just don't know whether to move out or not. Coach: You should do whatever you think is best. Which of the 12 Thomas Gordon's Roadblocks to Communication did the coach demonstrate? A. Warning B. Shaming C. Telling people what to do D. Interpreting C Practice Question #212: A 35-year-old woman is on her fourth coaching session and has been working with a coach to manage her arthritis. She frequently gets flare-ups that set her back for up to a week. Coach: How is your arthritis impacting you today? Client: I have good days and bad days and today is a bad day. Coach: What does a bad day look like? Client: I had a flare up but I was able to repeat what I did last week and do some gently yoga and I felt much better. I know if I did more yoga I would probably feel better most days. The client's response to the coach's question about what does a bad day look like is an example of what? A. Change Talk B. Sustain Talk C. Decisional Balance D. Empathy A Practice Question #211: A 54-year-old man is on his ninth coaching session and has been working with a coach to manage his overall stress. He has made steady progress each week incorporating several stress management techniques such as deep breathing, keeping a consistent morning schedule, and doing more enjoyable things on the weekend such as reading. During his ninth session, he indicates he is having trouble concentrating and doesn't feel like eating much. When you ask how his reading on the weekends is going to help manage his stress he indicates that reading is not that fun for him anymore. Which of the following is the appropriate next step for the coach? a. Help the client explore other options for incorporating enjoyable things on the weekend. b. Refer the client to a mental health professional c. Explore reasons why he may be having trouble concentrating d. Reframe the situation and note all the amazing progress he has made. e. Affirm the client's strengths B Practice Question #210: Which of the following is NOT a CDC recommendation for proper sleep hygiene? A. Be consistent. Go to bed at the same time each night and get up at the same time each morning, including on the weekends B. Make sure your bedroom is quiet, dark, relaxing, and at a comfortable temperature C. Remove electronic devices, such as TVs, computers, and smart phones, from the bedroom D. Avoid eating or drinking anything before bedtime E. Get some exercise. Being physically active during the day can help you fall asleep more easily at night. D Practice Question #209: A 29-year-old man comes to his 4th coaching session ready to discuss the progress he has made on getting more sleep overall in the past two weeks. The following conversation ensues: Client: I knocked my first goal out of the park. Coach: What does that feel like; knocking a goal out of the park? Client: It feels incredible! I got 8 hours of sleep each day last week. I slept 4 hours each night and the. Was able to sneak in several power naps throughout the day and since they were power naps they added up to an additional 4 hours. Coach: Do you mean you took several naps the next day after sleep 4 hours the night before and those naps totaled an additional 4 hours. Client: Yep! I took a 1.5 hour nap at 10am and then a quick 30 minute power nap at 2pm which counts for double the time since it was a power nap and then another nap at 5pm for about 1.5 hours. Coach: You can't do that. We know from sleep science researchers that it is best if the 8 hours of sleep is continuous for the most part. You need to try to sleep 8 hours in a row. Client: Oh. So it doesn't even count then. Shoot, I totally thought I made my goal. What aspect of the conversation above would NOT be considered the coach approach? A. Asking what meeting the goal felt like B. Not asking permission before giving advice C. Talking 3 times as much as the client D. Asking clarifying questions B Practice Question #208: A coach noticed an advertisement in her local paper for another NBC-HWC certified health coach's services. The advertisement indicates that if people buy a 60-day supply of supplements the coach will give them 3 free coaching sessions. In addition, the advertisement indicates most people lose 30 pounds in 60 days. Which of the following is the reason why this advertisement violates NBC-HWC Code of Ethics? A. Coaching sessions are contingent upon purchase of supplements B. It's impossible to lose 30 pounds in 60 days C. The coach placed an advertisement in a paper D. None of the above A Practice Question #207: A 42-year old man comes to his coach for their 3rd session. The man decided to try coaching to get some help with trying to quit smoking cigarettes. Client: Whenever I try to quit I get really hard to live with. I'm not very nice. Coach: You really get irritable when you're withdrawing from nicotine. Client: Yeah. I know there's that gum that can ease ya down but I am thinking just doing to cold turkey and get it all over with. Coach: That's what fits you best. How could you do that? Client: I definitely need a plan for those early days. I think I'd need to be away form people for a couple of weeks in the wilderness (laughs).Coach: So you don't irritate other people. Client: For my protections actually. I still want to be married and have friends when this is all over. Coach: So overall you are not sure about getting through the really rough withdrawal part, you are worried that quitting cold turkey could affect relationships in your life, and what you will do during the early days of quitting. The last statement by the coach is an example of what coaching skill? A. Appreciative inquiry B. Summary reflection C. Affirmations D. Increasing self-efficacy B Practice Question #206: A 38-year-old woman comes to her fifth session. She is working with her coach to reduce the overall stress in her life. The coach and client get into a lengthy exploration of how the client starts her day. During this conversation the coach becomes aware that she is thinking about what to say next while the client is talking. The coach makes a quick note to practice more _____________? A. Sympathy B. Open-ended questions C. Amplified reflections D. Mindful listening E. Empathy D Practice Question #205: A client is on their 5th session and has set the goal to get better sleep in general most days of the week. Client: I slept horrible all week. Coach: Tell me about it. Client: I am very stressed at work and anyone with my stress wouldn't sleep well. Coach: Stress is the primary reason you didn't sleep well this week. Client: Yep. And anyone else that had the week I had would have done the same things. Coach: There was one behavior you zeroed in on last week which was no social media before bed to help with that too. How did that go? Client: There is no way I had any other choice. When work is this stressful using social media at night helps relax me. Discord may appear during a coaching session. Which of the following best categorizes the type of discord the client may be exhibiting? A. Defending B. Interrupting C. Disengagement D. Questioning A Practice Question #204: Your client is going to be assessed for obesity at his next visit. The ______ measurement is best for assessing visceral fat. A. Abdominal skinfold B. BMI C. Waist circumference D. Hip circumference C Practice Question #203: A client comes to you as part of their company's insurance benefit program. They receive a reduction on their premium if they attend five coaching sessions. The client was referred to the program because their health risk assessment indicated they are a current cigarette smoker. Your client is very clear they have no interest in quitting at this time. Which open-ended question would be best given the clients lack of interest in quitting? A. Tell me about the last time you tried to quit and what didn't work for you? B. What would be some positive aspects of changing right now? C. What does your life look like as a non-smoker? D. What are some positive aspects of not changing right now? E. What would have to happen that would signal you that it's time to start thinking about changing? E Practice Question #202: A coach owns her own business and specializes in coaching around diet, energy levels, and weight loss. She is promoting gut biome supplements that will help her clients lose 20 pounds in four weeks if they take the supplement daily. The coach is most likely violating which of the following guidelines: A. NBC-HWC Code of Ethics B. HIPAA Laws C. USDA Nutritional Guidelines D. Confidentiality/Privacy A Practice Question #201: A client is a 40 year-old Latino man who has a BMI of 24. He has a sister recovering from cancer and was diagnosed was recently diagnosed with anxiety. Which of the is considered a risk factor for your client for type 2 diabetes? A. Age B. BMI C. Ethnicity D. Sister with cancer C Practice Question #200: Jamal is a wellness coach and also sells supplemental shakes to his coaching clients in which he makes a commission. At what point in the coaching relationship must Jamal disclose this information to his client per the NBC-HWC ethical guidelines? A. At some point during the coaching relationship. B. Before the sale is made to the client. C. At minimum, after the sale to the client. D. Before any coaching begins. D Practice Question #199: Coaches are often encouraged to make observations not evaluations. For example, "you drank 1 glass of water each day last week" is an observation vs. the evaluation of "you failed at meeting your goal of drinking 3 glasses of water a day". This tenet of observation vs. evaluation is an example of: A. Non-violent Communication B. Sympathy C. Stages of Change D. Self Determination Theory A Practice Question #198: A client is in their third session and is indicating some ambivalence about making a change to eat healthier. Coach: Would you be open to exploring all sides of this? Client: You bet. Coach: Let's talk through the pros and cons of changing and the pros and cons of staying the same. Where would you like to start? Client: Let's start with the pros and cons of trying to eat healthier. The skill the coach is demonstrating is: A. Enhancing self-efficacy B. Double-sided reflections C. Appreciative inquiry D. Exploring decisional balance D Practice Question #197: Client: All food is bad depending on what you read. First coffee is good then it's bad for you. Everything gives you cancer. It is all so crazy. Coach: Sifting through all the information is confusing and it's hard to know what is true. Where seems reasonable to focus first? Client: I want to get my head around how much fat to eat. How much should I eat in a day? Coach: Woukd it be ok if I shared some specifics? Client: Sure Coach: Fats are an important part of a healthy diet. There are different types of fats and some are better than others. It is better to eat more unsaturated fat vs. saturated fat. Does that make sense? What else can I tell you about it? Which of the following motivational interviewing technique is the coach demonstrating? A. Developing Discrepancy B. Elicit-Provide-Elicit C. Increasing Change Talk D. Rolling with Resistance B Practice Question #196: Which of the following best explains nonmaleficence as it relates to ethics in coaching? A. Respect for human freedom and dignity B. Pros must outweigh the cons C. Do no harm D. Fairness C Practice Question #195: In session #2, the coach and the client decide to explore the client's vision of his/her optimal health. Coach: Have you ever thought about what your future might look like? Client: No not really. Coach: What is your understanding about creating a vision? Client: It's like setting some goals for the future. Coach: It's kinda like that but more just creating a picture in your head of what something may look like that you want to create for yourself. Do you want to create a vision for your future health? Client: That sounds good. Coach: I would like you to close your eyes and sit quietly for a minute. After a minute, I am going to guide you through an activity where we look toward the future and try to visualize what that looks like. Client: So I keep my eyes closed the whole time? Coach: Yep. I just want you to try to see in your mind what the future might look like. Client: O.K. Coach: Are you ready and comfortable? Client: Yes. Which part of the above conversation exemplifies the coach approach of honoring the client's autonomy. (Muth, 76) A. Exploring creating a vision during the second session B. Asking permission to do the visualization activity C. Asking open-ended questions D. Guiding the visualization activity. B Practice Question #194: A client has just completed their well-being assessment prior to their first coaching session. The client's biometric information included the following: Male Age: 45 Nurse Blood Pressure: 110/70 mmHG Total Cholesterol: 185 ml/dL BMI: 24 Fruits/Vegetables: 9 servings per day Physical activity: Runs 2x week for 30 minutes Which of the following would be the most concerning to the coach in the context of recommended health guidelines? A. Blood pressure B. Total cholesterol C. Fruits/Vegetable intake D. Physical activity level D Practice Question #193: A client meets with her coach for their 15th session. Over the course of the past year, the client has met and even surpassed many of her goals. Her most recent goal is to wake up early twice per week to have the time to prepare a healthy breakfast. Client: I have tried every tip I can think of. I've stated to go to bed earlier, I have all the ingredients I needed purchased ahead of time, I asked my partner to get the kids in the morning so I can have to time to cook breakfast and none of it has worked. I hit snooze each time for the past 4 weeks and didn't once wake up early. I am not making any progress at all and I've met every other goal. Seriously, how lazy can I get? Coach: You set a goal and have tried many strategies to set yourself up for success and are feeling defeated because you did not meet the goal one time. Which coaching skill is the coach demonstrating? A. Empathy B. Amplified Reflection C. Evoking change D. Summary reflection D Practice Question #192: A 40 year old man comes to the coach's office for his 11th session to help him reach his goal of getting more and higher quality sleep. He set a goal each week to focus on decreasing his screen time at night. Client: I reached my goal this week and reduced my screen time by 50%. Coach: You worked really hard and succeeded at reaching your goal. What coaching skill is the coach demonstrating? A. Open-ended questioning B. Affirmations C. Empathy D. Strengths-based coaching B [Show Less]
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