Coach prep for session- overview (prior to session prep)
review materials, eliminate distractions, be mindful calm, and present.
Initial Intake
... [Show More] coaching session
Describe
Review
Determine
Clarify
Allow
Confirm
1.) Describe coaching process,
2.) Review info & assessments provided,
3.) Determine if coaching is appropriate.
4.) Clarify roles & expectations;
5.) Allow client to self determine their vision, goals, and action steps; & actively engages in new behaviors.
6.) Confirm logistics and responsibilities in written agreement.
session opening
ask how the client is, use reflections. Ask positive inquiry about previous week, reflect something positive, ask client to select goal to review
Early coaching session (1 or 2) competencies (5 total)
Assess
Identify
Explore/Clarify
Establish/Refine
Support
1.) Assess current & optimal state of health & well being,
2.) Identify gaps between current & optimal states.
3.) Explore/Clarify priority areas of focus, and learning preferences and accountability
4.) Establish/refine client's specific short term and long-term goals
5.) Support the client in achieving goals, action steps, back up plans
Routine Ongoing Sessions- overview (5 total)
Ask about the:
Refer to shifts in the
Support the client in:
Reflect the client's:
Closing:
1.) client's current state (e.g., energy, mood);
2.) client's state, facilitate review of previous action steps,
3.) defining new action steps,
4.) understanding, perspectives, and learning.
5.) Closing: the client articulates new personal discoveries.
Routine Ongoing Sessions general order:
client self assesses state
goal review
topic of importance
short term smart goals
new action steps
take-aways
appreciating client's work
feedback on coaching
Goal Review
explore full experience, starting with positive
use reflections, expands inquiry about best experience, respond to challenges with reflections/inquiries, affirms client strengths, inquire about percentage of success
FINAL SESSION:
Invite the client to reflect on
Assist in developing a:
:progress made, challenges experienced, lessons learned, and growth attained
:sustainable pathway forward and/or maintenance/relapse prevention plan including available support and resources
Client is the expert in:
The coach provides:
:navigating his/her own life, based upon personal preferences and past experiences.
:the structure of the session and serves as a facilitative partner.
The coach's primary role does NOT include:
a content expert or educator who diagnoses, advises, or instructs the client on what to do.
Client's:
Share personal info/experience/recommendations only when:
Observe, name, and refer to client's:
Convey the belief that client is:
Adjust approach according to:
Client's agenda, needs, interests, and preferences drive the relationship.
appropriate or when specifically asked/given permission to do so
:beliefs and values.
:resourceful, expert in own experience.
:client's health literacy
Demonstrate:
Convey:
Follow Through on:
Openly name and address:
:benevolence, honesty, sincerity, and authenticity
:unconditional positive regard
:commitments
:discord/conflict as it occurs and resolve in a timely manner
The coach establishes a:
positive and safe environment where the client feels accepted and supported, which helps the client clarify values/access motivation.
The coach's confidence in the client's ability to______, ________, &________
supports the client's_________.
learn, grow, and change / self-efficacy.
The coach builds trust by attending to the client's
emotions as well as words and behaviors; i.e., when the coach senses conflict, discomfort or confusion, the coach acknowledges what is happening with curious interest.
The coach facilitates behavior change by empowering the client to:
self-discover values, resources, and strategies that are individualized and meaningful.
Generative moment
identify topic, ask permission to explore, client describes what they want, explore strengths, environments to move forward, including pros/cons, develop discrepancy, brainstorming, express confidence in client's ability to move forward
Active listening & Presence
Be:
Pace communication to:
Listen for:
Attend to and address:
Use silence:
1.) attentive and mindful, open-minded, be curious
2.)fit client's needs,
3.)what is not being said,
4.) nonverbal communication,
5.) appropriately.
In addition to listening to verbal information shared by the client, the coach is attuned to nonverbal cues which are:
The coach also notices:
expression, tone, emotions, and energy.
relevant behaviors (or lack thereof).
The coach uses ____ ______ to notice with _____ and _______what is happening with the client and with themselves during coaching.
mindful awareness/curiosity and non-judgment
goal setting
ask client to choose a goal, explores support needed to ensure success, refine goal to be SMART, use confidence ruler, client restates goal, affirm client's ability to achieve goals
Active listening involves using _________ appropriately to _____ ___ _____ and allowing clients time to _____, _______, and _______what emerges.
silence/ "hold the space" / reflect, process, and identify
Emotions can generate:
insight and impact the brain's capacity for learning and change.
The coach calls attention to
positive shifts in the client's energy or emotion that may support healthy behavior change.
The coach encourages the client to foster:
and harsh self criticism tends to lead to:
self-compassion and acceptance of emotions, since these qualities allow a more honest appraisal of one's behaviors and better self-care./
avoidance and undermines insight.
session close
appreciates client's work, reflects what client learned, asks for feedback on coaching, schedules next session
Attend to the client's:
Acknowledge client's:
Ask client to describe:
Show:
Foster:
1.) state of being (mood/affect/presence)
2.) emotions
3.) emotions when appropriate
4.) empathy (resonance with)
5.) self-compassion
Types of Reflections
Simple, Double-sided, amplified, feeling, and meaning
Reflections convey _______ ____________ and give clients the powerful ___________ to __________ the sound of their own words, perspectives, and beliefs.
active listening/ opportunity/ witness
Nonjudgmental reflections ________ the client and inspire___________.
Engage/ learning
When the coach notices a discrepancy in the client's words, emotions, or behavior, a _______ __________ reflection
a double sided/may raise the client's awareness of the discrepancy.
When the coach uses an _____________ reflection, the client may reconsider aspects of ___________________ when they hear the ______________ reflection.
amplified/ resistance/exaggerated
The coach helps the client expand possibilities by asking
curious questions that evoke deeper thinking and self-reflection.
Open ended questions (starting with what/how) encourage:
The coach helps expand the client's:
1.) exploration and highlight strengths, values, and opportunities for learning.
2.) perspective and explores interconnections in the client's life.
Expanding the conversation competencies (6 total)
1.) Open-ended & powerful questions
2.) Metaphors- based on client
3.) Brainstorming
4.) Connect the focus to multiple dimensions of client's life
5.)Explore broader perspectives & inspire interest in new possibilities,
6.) Incorporate coach's intuition
The coach facilitates a conversation that balances
a client's exploratory thinking with action oriented focus.
These techniques help narrow the conversation toward decisions, goal-setting, and commitment- all which support action. (5 total)
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
Part 1. An objective of coaching is for the client to be well-informed of the status of his/her health and well-being. This process begins with:
identifying what the client understands.
Part 2
The coach then assists the client in _____and ______health and wellness resources, as well as accurately ______ and ______ multiple sources of health information.
Finding/utilizing, evaluating/integrating .
Part 3
These health info sources may include: (5 total).
1.) health care provider input
2.) health & wellness assessments
3.) health risk assessments
4.) basic bio-metrics
5.) appropriate referrals.
The coach supports the client in choosing goals and action steps carefully, since ______ and ________ successes predict long-term _________.
small/ gradual/engagement.
The coach _________the client's ________and asks ________-__________questions to enhance the client's _______-_________ and foster new ________________.
reflects/views/open-ended/
self-awareness/ perspectives.
Positive reframing is:
Positive conversations are:
:looking at things in an alternative, more positive way—to shift perspectives
:are more likely to inspire motivation and forward progress.
Reframe competencies: (3 total)
1.) Address self-defeating perceptions
2.) Explore patterns related to client behaviors and decision tendencies (e.g., triggers, thoughts, emotions, physical sensations, and environment)
3.) Awareness of self-talk and adjustment as appropriate
patterns related to client behaviors and decision tendencies:
triggers, thoughts, emotions, physical sensations, and environment
The knowledge and experience of the client—vs __________, are:
the raw materials for coaching conversations that facilitate lasting change.
Elicit the client's perspectives including:
reasons for change, solutions, ideas, experiments, desires, reactions, desired outcomes, rewards/incentives
Help client explore and articulate:
values, sense of meaning, and purpose
Discuss and honor client's preferences for:
self-monitoring, accountability, mode of connecting (email, text, phone call)
Self-determination theory posits several universal needs for psychological health and well-being:
autonomy, competence, and connection (relatedness)
The coach helps the client develop self-efficacy, which is:
the client's belief in his/her ability to initiate change and achieve goals.
The coaching process cultivates self-efficacy as the client:
better understands his/her needs,
gains self-awareness & insight that supports behavior change, learns from setbacks, develops new resources, and finds new ways to navigate his/her environment.
coaching program close
explore reasons for stopping, get feedback via a survey, celebrate learning, explore what they'd like to do next, encourage progress and/or check ins, express gratitude
the coach helps the client to build a support system, which is:
relationships, tools, resources, environments that enable ongoing success after the coaching program ends and developing supportive relationships
Decisional balance helps the client
evaluate pros and cons of changing or not changing a behavior
a growth mindset is the belief that:
the client's abilities can be improved continuously through experimentation and persistent efforts.
The coach helps the client develop positive psychological resources by
cultivating meaning, reflecting positive emotions, applying strengths, and affirming self-worth and efforts.
Positive psychology has demonstrated the value of positive resources in improving:
creativity, open-mindedness, strategic thinking, resilience, connection, and health.
By definition, health and wellness coaches are not: and do not:
content experts in health or disease/ diagnose or prescribe, unless a coach has credentials in another profession that allow expert advice to be given.
The coach should be able to identify
risk factors for chronic disease, commonly used biometric measures, and current lifestyle recommendations for optimizing health.
Wellness, as a concept, includes all aspects of:
and it involves:
1.) physical, psychological, spiritual and social well-being; it is multi-dimensional and holistic. 2.) a self-directed and evolving process to achieve full potential.
Blood pressure is
the pressure of blood pushing against the walls of your arteries. Arteries carry blood from your heart to other parts of your body.
Systolic blood pressure (first #)
measures the pressure in your arteries when your heart beats.
The second number, called diastolic blood pressure,
measures the pressure in your arteries when your heart rests between beats.
A normal blood pressure level is
less than 120/80 mmHg.1
High blood pressure is called:
and it increases risk for:
hypertension
heart disease, heart attack, and stroke, kidney disease and TIA
Stage 1 hypertension range is (prehypertension)
130-139/or 80-89
Stage 2 Hypertension range is:
greater than or equal to 140/90
High blood pressure
has no warning signs or symptoms, and many people do not know they have it. Measuring your blood pressure is the only way to know whether you have high blood pressure.
High blood pressure can damage the following organs:
heart, brain, kidneys, and eyes.
High blood pressure can damage your arteries by
hardening them, decreasing blood flow, and making your heart work harder
A heart attack happens when the blood supply to your heart is:
blocked and heart muscle begins to die without enough oxygen. The longer the blood flow is blocked, the greater the damage to the heart.
Heart failure is a condition that means your heart:
can't pump enough blood and oxygen to your other organs.
High blood pressure can also causes strokes, which happen when
arteries that supply blood and oxygen to the brain burst or are blocked. Brain cells die during a stroke because they do not get enough oxygen.
Stroke can cause serious disabilities in _____, _____, and other basic ________. And a stroke can also _____you.
speech, movement,activities/ kill
Having high blood pressure, especially in midlife, is linked to
having poorer cognitive function and dementia later in life.
Adults with diabetes, high blood pressure, or both have a higher risk of
developing chronic kidney disease than those without these conditions.
High blood pressure is called the "silent killer" because
it usually has no warning signs or symptoms, and many people do not know they have it.
Prevent or manage hypertension (high blood pressure)
at least 150 minutes of physical activity each week
Not smoking, Eating a healthy diet, limit salt/alcohol
healthy weight, manage/lower stress
Because your blood pressure tends to rise as you get older,
your risk for high blood pressure increases with age. About 9 out of 10 Americans will develop it sometime during their lifetime.
Black people and high blood pressure
increased likelihood compared to other groups of people and happens earlier in life.
Women are _______as likely as men to develop high blood pressure at some point during their lives.
equally
If you have diabetes, your body either:
doesn't make enough insulin or can't use it well, which leads to too much blood sugar in your bloodstream.
Over time, too much blood sugar in your bloodstream can cause serious health problems such as:
heart disease, vision loss, and kidney disease.
There are three main types of diabetes:
type 1, type 2, and gestational diabetes
Type 1 diabetes:
autoimmune reaction- body doesn't make insulin.
5-10% of people have type 1
symptoms develop quickly
diagnosed in children, teens, young adults
take insulin every day
no way to prevent this type of diabetes
Type 2 diabetes
Body doesn't use insulin well.
90-95% of people with diabetes have type 2.
slowly develops, usually adults
no symptoms, get blood sugar tested
can be prevented/delayed with losing weight, eating healthy food, and being active.
Gestational diabetes
develops in pregnant women
your baby could be at higher risk for health problems. Gestational diabetes goes away after your baby is born but increases your risk for type 2 diabetes later in life. Your baby is more likely to have obesity as a child or teen, and more likely to develop type 2 diabetes later in life too.
Pre-diabetes
88 million adults—more than 1 in 3—have pre-diabetes. more than 84% of them don't know they have it. blood sugar levels are higher than normal and it raises your risk for type 2 diabetes, heart disease, and stroke.
Type 1 diabetes risk factors
Family history: direct relations with Type 1
Age: any age, but more likely as a child, teen.
whites are more likely to develop type 1 diabetes than African Americans and Hispanic/Latino Americans.
Type 2 diabetes and pre-diabetic risk factors
prediabetic, Are overweight,
Are 45 years or older
family history,
physically active less than 3 times a week
gestational diabetes,
or given birth to a baby above 9 lbs.
Are POC
Gestational diabetes risk factors
has had it before
Birth to baby 9 lbs +, overweight
25+ years of age
family history of type 2 diabetes
Have polycystic ovary syndrome (PCOS)
POC
Diabetes symptoms
Urinate frequently, Are very thirsty
Lose weight without trying, very hungry
blurry vision, feel very tired, numb or tingling hands or feet, very dry skin, sores that heal slowly
more infections than usual
Type 1 diabetes symptoms
nausea, vomiting, or stomach pains.
develop in just a few weeks or months/ severe
usually a child, teen, or young adult but can happen at any age.
symptoms of gestational diabetes
usually shows up in the middle of the pregnancy and typically doesn't have any symptoms.
should be tested between 24 and 28 weeks
preventing type 2 diabetes
losing 5-7% of your body weight.
getting 150 minutes a week of physical activity
A1c Test
measures average blood sugar level over the past 2- 3 months.
normal: below 5.7%
pre-diabetes: 5.7- 6.4%
diabetes:6.5% or above
Fasting blood sugar test
overnight fast
normal: below 99 mg/dL
prediabetes: 100 to 125 diabetes: 126 mg/dL or more
oral glucose tolerance test measures your blood sugar:
before and after you drink a glucose liquid
after fasting overnight After ingesting the liquid, it's checked 1, 2, and 3 hours afterwards
oral glucose tolerance (OGTT) ranges:
At 2 hours, a blood sugar level of
normal: 140 mg/dL or less
pre-diabetes: 140 to 199
diabetes: 200 + mg/dL
random blood sugar test
Random, no fast.
diabetes: 200 mg/dL or higher
glucose screening test
drink a liquid that contains glucose, test one hour later:
normal: 140 mg/dL or less. higher than 140 mg/dL, requires a glucose tolerance test
People who are overweight or obese are more likely to have
diabetes, heart disease, stroke, and some types of cancer, and depression
Obesity is a complex health issue resulting from a combination of causes and individual factors such as behavior and genetics. Factors include
physical activity and inactivity, dietary patterns, meds, food and physical activity environment, education and skills, and food marketing and promotion.
Physical activity guidelines for Americans recommends adults do at least
150 minutes of moderate intensity activity or 75 minutes of vigorous intensity activity, or a combination of both, along with 2 days of strength training per week.
Some illnesses/drugs lead to weight gain/obesity. These include
Cushing's disease, and polycystic ovary syndrome. Drugs such as steroids and some antidepressants may also cause weight gain.
People who have obesity are at increased risk for many serious diseases and health conditions, including
All-causes of death, hypertension, dyslipidemia
Type 2 diabetes, CAD
Stroke, gallbladder disease
OA, sleep apnea, breathing issues
Many types of cancers , Low quality of life
Mental illness,
Body pain and difficulty with physical functioning
Body Mass Index (BMI) and waist circumference are:
screening tools to estimate weight status in relation to potential disease risk.
To calculate BMI:
a person's weight in kilograms divided by the square of height in meters. kg/m(squared)
If your BMI is less than 18.5, it
is within the underweight range.
If your BMI is 18.5 to 24.9
it is within the normal or Healthy Weight range.
If your BMI is 25.0 to 29.9
it is within the overweight range.
If your BMI is 30.0 or higher
it is within the obese range.
BMI can be used as a screening tool but is not diagnostic of
the body fatness or health of an individual.
Excessive abdominal fat may be serious because it places you at greater risk for developing
obesity-related conditions like: Type 2 Diabetes, high blood pressure, and CAD
Your waistline/circumference may be telling you that you have a higher risk of developing obesity-related conditions if you are:
male and more than 40 in.
A non-pregnant woman, more than 35 in.
Excess body fat is associated with high levels/low levels of:
It also impairs the body's responsiveness to:
(high) LDL ("bad") cholesterol and triglycerides / (low) HDL ("good") cholesterol. insulin, raising blood sugar and insulin levels.
ways of evaluating obesity include:
BMI, waist to hip ration, waist circumference
Flaws of BMI
it may inaccurately reflect body fat in adults who have lost substantial amounts of muscle mass. It reflects total body fat without regard to how the fat is distributed.
abdominal fat comes in two different forms:
subcutaneous: fatty tissue just beneath the skin.
visceral: Fat inside the abdomen around organs
lipotoxicity
visceral fat cells release their free fatty acids directly into the portal circulation, which affects the liver and surrounding organs, leading to organ dysfunction
Abdominal obesity, using waist to hip ratio.
With abdomen relaxed, measure waist at the navel. Next, measure hips at their widest point. divide your waist size by your hip size: Waist (in inches) / Hips (in inches) = ratio
if a waist to hip ratio rises above: (men & women) the chance of suffering a heart attack or stroke increases.
man's ratio above 0.95; for women above 0.85.
Men and waist circumference risk
Men risk:
low 37 in.
mod: 37.1-39.9,
high 40 and above
Women and waist circumference risk
Women risk:
low 31.5 ,
mod: 31.6-34.9 ,
high 35 and above
BMI will give you, while your waist measurement will give you:
BMI the best estimate of your total body fatness,
best estimate of your visceral fat and risk of obesity-related disease.
Angina is and is the:
chest pain and discomfort, most common symptom of CAD.
symptoms of a heart attack(myocardial infarction)
1. Chest pain,
2. light headed/nausea, tired
3. Pain or discomfort in the jaw, neck or back
4. Pain or discomfort in the arms or shoulder
5. Shortness of breath
Risks for CAD (Coronary Artery Disease)
Overweight, physical inactivity, unhealthy eating, and smoking tobacco, family history of heart disease, especially a family history of having heart disease below 50 years of age
CAD is diagnosed using the following tests
Electrocardiogram(ECG, EKG) Echocardiogram, exercise stress test, chest x-ray,cardiac catheterization, coronary angiogram, Coronary artery calcium scan
CG or EKG (electrocardiogram):
Measures the electrical activity, rate, and regularity of your heartbeat.
Echocardiogram
Uses ultrasound to create a picture of the heart.
Exercise stress test
Measures your heart rate while you walk on a treadmill. This helps to determine how well your heart is working when it has to pump more blood.
Cardiac catheterization
Checks the inside of arteries for blockage by inserting a thin, flexible tube through an artery in the groin, arm, or neck to reach the heart. measures blood pressure and the strength of blood flow, and blood samples are collected and/or dye is injected into the coronary arteries.
Coronary angiogram
Monitors blockage and flow of blood through the coronary arteries. Uses X-rays to detect dye injected via cardiac catheterization.
Coronary artery calcium scan
A computed tomography (CT) scan that looks in the coronary arteries for calcium buildup and plaque.
Cardiac rehab includes:
Physical activity
Education about healthy living, healthy eating, taking meds as prescribed, support with quitting smoking
Counseling to relieve stress and improve mental health
What health conditions increase the risk of heart disease?
hypertension, hyperlipidemia, diabetes, obesity
LDL (low-density lipoprotein) cholesterol is considered to be:
"bad" cholesterol because it can cause plaque buildup in your arteries,
HDL (high-density lipoprotein) cholesterol is considered to be
"good" cholesterol because higher levels provide some protection against heart disease.
What behaviors increase the risk of heart disease?
Eating a diet high in saturated fats, trans fat, and cholesterol, inactivity, smoking, drinking
About ______of all Americans have at least ____of 3 key risk factors for heart disease: high blood pressure, high cholesterol, and smoking.1
47% , 1
Although your brain makes up only____% of your body weight, it uses ______% of the oxygen you breathe.
2, 20
An ischemic stroke occurs when
blood clots or other particles block the blood vessels to the brain. Fatty deposits called plaque can also cause blockages by building up in the blood vessels. most common type of stroke
A hemorrhagic stroke occurs when
a blood vessel bursts in the brain. Blood builds up and damages surrounding brain tissue.
signs and symptoms of stroke (5)
Sudden:
numbness/weakness in face, arm, or leg, especially on one side of the body
confusion, trouble speaking, difficulty understanding speech
trouble seeing in one or both eyes
trouble walking, dizziness, loss of balance, or lack of coordination,
severe headache with no known cause
Acting F.A.S.T. Is Key for Stroke and stands for:
F—Face: Ask the person to smile. Does one side of the face droop?
A—Arms: Ask the person to raise both arms. Does one arm drift downward?
S—Speech: Ask the person to repeat a simple phrase. Is the speech slurred or strange?
T—Time: If you see any of these signs, call 9-1-1 right away.
If stroke symptoms go away after less than 5 min
then it is probably a transient ischemic attack (TIA). or mini stroke,
Generally there are three treatment stages for stroke:
prevention, therapy immediately after the stroke, and post-stroke rehabilitation.
The most common treatment for stroke is:
Medication or drug therapy: anti-thrombotics and thrombolytics [Show Less]