Why is good rapport essential? Once its initially established, is it established once and for all?
•Good rapport is essential for
1.an honest
... [Show More] discussion
2.constructive understanding of clients' behavior
3.Creating openness to change/stage of change
4.Creating trust
5.Thorough exploration
When trust and rapport are absent, so is a growth-fostering environment.
Trust and rapport are not earned once and for all .They can be earned, or lost, during every moment of every coaching conversation.
What should a coach consider when establishing rapport with a client?
Coach:
•Coaching continuity •the number of coaching clients/sessions a coach has per day •personal distractions and stressors
- can create difficulty remaining mindful if not managed well •Personal self-care
- does the coach need coaching?
What thing should be communicated to a client when establishing rapport and trust?
Coaching Policies:
-Informed consent
-Confidentiality
-Referrals- how and when
•Definition of coaching: Clearly explain what it is . . .
•Growth-promoting relationship, building a new mindset, empowering change . . . and what it's NOT •Coach telling the client what to do and how to do it
What are the steps to establishing rapport?
Step 1: in all sessions: Get yourself into the right mindset
(Vision, listen, Tell the truth, Trust your intuition)
Step 2:Greeting
Step 3: Introduce yourself
Step 4: Find out your client's initial perspective on coaching
Step 5: Define coaching and coaching process
Step 6:Explain your objectives for the first coaching session
Why is the first coaching session the longest?
Typically the longest session due to content:
Establishing rapport
Review of Policies and Procedures
Discussion of assessments
Exploration of motivation, resources and wellness vision for the future
Setting of long-term wellness goals
Why do coaches ask the client for feedback at the end of every session?
Feedback: important both for your own learning and for your client's growth
Why do coaches explore the highlights of the past week at the beginning of a weekly follow-up session?
1.enhance rapport and client motivation
2.Provide accountability
3.Make any necessary adjustments to the wellness plan or wellness goals
4.Address any challenges that may arise along the way
When reviewing each weekly goal with a client, what do coaches discuss first?
-Discuss successes FItRST, then address challenges
**Keeps up the positivity level and the ability to engage in generative dialogue that is more productive
Why do coaches conduct a monthly review of client's 3 month goals?
Review 3-month goals at least monthly in order for the weekly goals to stay connected to the client's larger vision and purpose.
(This is motivating and empowering to connect the dots between success with smaller, incremental steps and larger life goals.)
What are the 5 steps through which a generative dialogue evolves?
1. Identify and clarify the issue/topic they are motivated to discuss
.
2.Uncover the heart of the matter-what is really going on here
3. Brainstorm options for
-overcoming challenges
-Adjusting goals
-Exploring/re-exploring importance
4. Design 3-month goal:
-New 3-month goal
-New/adjusted weekly goal
-New/adjusted solution to a challenge
Why do we encourage clients to create a wellness vision?
A wellness vision, is the foundation for change. It answers the question, "Who do I want to be?"
With the assistance of a coach, the client creates a clear picture of their best self and everything that contributes to making that picture real and alive.
The best wellness visions:
support and promote core values
are based on strengths and resources, NOT on deficits or, what they DON'T want
are written in action words, as if the client sees it happening in their future
are written in the client's voice
What elements make the best wellness vision?
importance is based on connecting the vision to their core values.
1. core values
2. strengths and resources
3. importance = Motivation
4. Confidence=Self-efficacy
What is the relationship between confidence and importance, or motivation to change?
How to each impact the other?
Importance=Motivation
Confidence=
Self-efficacy
--->Without self-efficacy, even the strongest motivation may go to sleep
---Confidence drives change
--->But, without a connection to the deeper meaning and value of change, exploring and even enhancing self-efficacy may not be as meaningful or effective.
---> The bottom line: explore and monitor levels of both starting with motivation
What is the definition of motivation?
The reason(s) a person will or will not engage in a particular behavior.
"You are motivated to do exactly what you're doing" Tonemah
---> For this reason, its imperative to explore why the vision has meaning and value since it does not necessarily reflect current behavior
What are core values? Upon what are they based?
Core Values
Those elements in a client's life that define them and make life worth living:
1.self-worth
2.competence
3.autonomy
4.relatedness
5.Spirituality
Questions related to Core Values:
1.Who am I?
2.What do I treasure most in life?
3.What do I believe in?
4.Why does change matter a lot to me, right now?
What is intrinsic motivation? Be able to recognize examples of this type of motivation.
Intrinsic Motivation:
Motivation that is based on internal core values such as autonomy, competence and self-worth that is internally driven.
----> Intrinsic motivation is associated with a strong sense of self-efficacy.
Intrinsic motivation last much longer and take longer to identify to connect deeply
What is introjected regulation? Upon which type of motivation is it based?Is it effective at strengthening commitment to change?
Introjected regulation:
--a form of intrinsic motivation driven by self-imposed expectations.
--Can be a challenge rather than an asset if self-efficacy is low and/or autonomy has been suppressed
---Reflected in negative self-talk and unrealistic expectations
What is integrated regulation? Upon which type of motivation is it based?(Intrinsic) Is it effective at strengthening commitment to change?(Yes)
Integrated regulation:
intrinsic motivation based on the value of the outcome, regardless of enjoyment or interest:
the behavior is performed for the sake of the outcome
What is extrinsic motivation? Be able to recognize an example this type of motivation.
Driven by external core values such as one's need for relatedness, adaptation to environmental factors and external rewards.
Extrinsic motivators are based on:
--external regulation (example: someone telling you what to do)
----Results in a low or short-term investment in change
----external rewards (example: fitting into that wedding dress; pleasing a spouse)
----Don't supply sustainable, long-term motivation
Positive aspect of Extrinsic Motivators:
---they are more quickly and easily identified than intrinsic motivators
What are the tips for success when exploring motivation? Why base motivation on these tips? Is fear an effective motivator? Why or Why not?
Help your clients identify motivators that:
Reflect core values in the behavior or outcome
Reflect positivity
Are intrinsic and outcome-oriented whenever possible.
These type of motivators are usually the most powerful and more easily maintained over the long haul.
Leverage extrinsic factors until intrinsic ones can be enhanced or identified
Motivation should NEVER be a reflection of fears or cons about not changing.
What is self-efficacy? What are the tips for success when exploring self-efficacy?
: confidence that one can engage in the goal behavior(s) or achieve the desired outcome(s) in the face of changing, challenging or tempting situations
When creating a wellness vision, coaches assist a client in exploring confidence in their ability to engage strengths and sustain motivators throughout the change process
They may not be ready to tackle the entire vision so exploring confidence will help them identify those facets they are most able to achieve in the present
What is the relationship between confidence and self-worth?
Low self-worth can underlie a low confidence level:
Often has a psychosocial origin outside the scope of coaching
Success with small changes can not only enhance confidence, it can have a positive impact on self-worth
Introjected Regulation can impede this effect.
Example: successes being perceived as insignificant or insufficient
why set a SMART goals?
A SMART goal is one that the client is fully in charge of achieving and success is accountable to their efforts:
Assists clients in being specific about the steps and actions they are committing to.
Turn chaos into clarity
Helps clients to focus and mobilize their motivation around realistic and meaningful steps and actions
What exactly does the acronym SMART stand for?
Specific
Measurable
Action-based
Realistic
Time-line
Be able to tell the difference between a vague 3-month or weekly goal from a specific 3-month or weekly goal and be able to rewrite each to be specific if asked?
Vague - I will be exercising more.
Specific- I will be walking at a moderate pace at the gym five days per week for 30 minutes.
Vague - I will be eating less fast food.
Specific- I will only be eating fast food lunch meals 2 times per week.
Vague - I will be eating more healthy
Specific- I will be eating 2 servings of vegetables for lunch and 1 serving of vegetables for dinner every day.
Why do coaches encourage clients to set measurable goals? Should weekly goals be action-oriented or outcome-oriented? Why or why not? Can 3-month goals be based on outcome? If so, what must weekly goals include?
Measurement of goal achievement is central their success.
Action based or Behavioral 3-month goals are easily measurable b/c:Weekly goals are smaller actions or behaviors directly related to the 3-month goal, making goal achievement easily quantified weekly:
3-month Goal: I will be walking at a moderate pace at the gym five days per week for 30 minutes.
Weekly Goal: "I will walk at a moderate pace at the gym on Monday and Wednesday next week for 30 minutes."
Percent success = 50%
Reason = "I only walked on Monday and not Wednesday."
3 month goals are outcome-oriented, how your client measures progress will depend upon their weekly goals being focused on behaviors that can result in the desired outcome.
Common outcome oriented 3 month goals:
(-Health risk reduction-cholesterol levels, blood pressure, blood sugar)
-Weight reduction
-Increased Fitness level-Peak VO2Max, 1Rep max, range of motion)
Why is it important to set realistic goals?
Realistic goals can increase confidence
Realistic goals are achievable but challenging so clients feel a sense of accomplishment when they are met
increases self-efficacy > increased motivation
Unrealistic goals can decrease confidence
If they are too challenging, based on too many behavior changes at once or faulty perceptions of success, goal attainment may not be possible
If they are too easy, or based on behavior(s) that are already easily being performed with consistency, then there is no sense of accomplishment
Goals should reflect the balance between challenging your clients to do more than they think they can do, while not discouraging them by reaching for goals that are too ambitious
Why do coaches use a 3-month timeline when coaching clients?
A three-month timeframe is short enough to provide a sense of urgency about achieving weekly goals, but long-term enough to allow time for internalization of change
--Research shows it takes a minimum of 21 days to retain new habits
Why do coaches continually assess confidence throughout the SMART goals process?
Scale confidence often:
a client's confidence levels are dynamic and specific to each goal
Explore scale deeply and the subsequent responses:
So why are you at a 6 on your confidence to walk after dinner and not, say, an 8?
What is the purpose of identifying social support? Who would make an appropriate social support? Be able to recognize examples
Social support is an intervention component geared towards:
Directly supporting specific behavior changes.
Creating an environment that is helpful to individuals in making behavior change
Developing skills to build support.
Social support can be provided by professionals (e.g., trained coaches), peers, friends, or family members.
Peers can be strangers, or existing members of the same social network.
Although one review of the evidence across multiple health behaviors and health outcomes could not determine any difference in effectiveness per source, it has been concluded that social support is more effective when the giver and receiver have similar characteristics, both generally as well as specific to the targeted health issue.
What are the keys to reducing challenges?
1. Set SMART goals
------>if goals are SMART, then challenges should be minimal and perceived as surmountable.
2. Connect the client's vision, motivators, desired outcomes, and goals to the process of addressing challenges:
Personal strengths
so challenges seem more surmountable
Importance/values
So the drive to overcome challenges is enhanced
exposes ambivalence and confidence issues that may impede success
Why should you scale confidence after each goal is defined?
exploring why confidence is not higher should illuminate challenges to goal attainment
Even if they don't reveal challenges in your scale exploration, or score their confidence at a 10, you should still ask them to creatively explore any challenges they can think of that may impede success
Even the best intentions, and the SMARTest goals, can be sidelined by unaddressed challenges
Which coaching skills and techniques are useful when exploring challenges and solutions in a positive way?
You can use all your coaching skills and tools to explore challenges and their solutions in a positive way
OARS, especially perceptive reflections
Decisional Balance
Deep Scaling
Perceptive reflections
Brainstorming
A Typical day. . .
Cognitive-Behavioral Therapy Techniques
Stimulus control
cognitive rehearsal
What is brainstorming? How does the process of brainstorming work? What are the benefits of brainstorming to clients?
the rapid generation of ideas and possibilities that will help a client reach their vision
Brainstorming is an essential coaching skill and a fundamental part of generative moments in coaching
Although brainstorming can be used at any point during coaching sessions, it is particularly important when identifying solutions to challenges and supportive relationships.
enables clients to:
develop creativity in their approach to change
design the most successful plan for change.
see challenges they may face as having multiple possible solutions
↑ Self-efficacy
Reinforces rapport because coaches and clients co-generate a wide variety of possible ideas for consideration.
What is considered good practice when brainstorming?
Important for identifying solutions to challenges and supportive relationships
What are the benefits of using the typical day coaching tool?
Take me through a typical day. . ."
Benefits of using a typical day tool
Provides a wealth of information about the client's world
Can be used at any point in a coaching session but works well in the challenge discussion
Facilitates exploration of both challenges and solutions in a naturally flowing way
Can illuminate faulty perceptions about challenges
Leads well into the brainstorming process
What are the "don'ts" when using the "typical day" coaching tool
Avoid imposing any interpretations, ideas or analytical questions on the story until the client has fully expressed themselves
fire a series of investigative questions at a person
Interrupt a client during their recall to pursue a "problem" in more detail
If the exposed issue truly seems problematic, make a note of it and find a more appropriate time to discuss it
force the acquisition of "thorough" details about their typical day
There may be aspects of their day they do not want to discuss. Find a balance between a thorough picture and an intrusive interrogation
How do you know you've got it right when using the typical day coaching tool?
You are doing very little talking
The client seems engaged in their story
You are learning lots of interesting information, both verbal and non-verbal, about the client, their situation, their perceptions, etc
Cognitive rehearsal
Cognitive rehearsal
rehearse one's thoughts and behaviors prior to experiencing the potentially difficult situation, and to be armed with healthy adaptive responses
Example in dietary behavior change:
imagine the original situation that is causing temptation
eating at the buffet in the cafeteria with all those unhealthy, tasty options
describe thoughts and feelings that accompany the adaptive situation and make positive self-statements about it
"I will feel good mentally and physically when I choose the fruit salad rather than the chocolate cake for dessert."
Then immediately follow the positive self statement with a positive adaptive behavior
"I see myself choose the fruit salad from the buffet."
Finally, individuals are encouraged to reward themselves for doing well in a difficult situation, with either positive statements or material rewards, or both.
"I am so proud of myself for making this change a reality and I had more energy for the rest of the work day!"
Stimulus Control
Identifying stimuli that may encourage lapses and replace with cues to engage in goal behaviors.
limit exposure to high-risk situations
increase exposure to healthy alternatives
Example:
to inhibit unhealthy behavior:
limit the times and places where you eat meals
placing unhealthy snacks out of sight or eliminating them altogether
to promote healthy behavior:
place workout clothing and shoes in front of bedroom door
Put the exercise bike in front of the television
Why should you asses and reassess confidence?
Levels of confidence will vary throughout the process of identifying solutions to their challenges.
Helping a client to stay aware of their confidence levels will assist them in identifying the most effective solutions to challenges
Deep scaling
Affirm situations where self-efficacy is high
Explore situations where self-efficacy is low, looking for opportunities to increase it
What are tips for success when assisting clients to resolve challenges to change?
Clients are enthusiastically engaging their resources and supportive relationships
They either have or are willingly seeking out knowledge they need to enhance success
Their confidence/readiness levels are relatively high (scale = 8-10)
They can consciously connect their goals and solutions to challenges to the importance/values of changing
They have realistic expectations about outcomes
They creatively and dynamically embrace the process of finding solutions
What should coaches do to successfully coach a client in the action stage?
Help action stage clients make a stronger connection between their new behaviors and their strengths and values
Which process of change are effective when working with clients in the action stage?(Be able to recognize an example of the use of this process of change)
Process of Change--Self-liberation: the belief that one can change and the commitment and recommitment to act on this belief
---Leveraging Self-liberation
Help a client bridge their actions and successes to their commitment to sustained change
What should coaches do to successfully coach a client in the maintenance stage?
Challenge maintenance stage clients to keep growing and aspiring to new levels of wellness
How should coaches help clients in the action and maintenance stages view a lapse? What is the benefit of a lapse?How should a coach address a lapse?
---Lapses are Normal and expected part of the process of change
(there are no failures)
----Assist clients in viewing lapses as opportunities to refine their plan
How should a coach help clients in the action and maintenance stages define new strategies to prevent relapses? Which processes of change are effective in preventing relapse when working with clients in the maintenance stage?
Be able to recognize examples
Use
---Brainstorming
---Cognitive rehearsal
Process of change:
-Helping Relationships=Supportive Relationships
-Process that come from CBT:
-Counterconditioning
-Contingency Management
What are benefits of using contingency management to overcome a lapse?
Focusing the client on the relationship between a behavior (Positive or negative) and its consequences (Positive or negative)
What are some other tools for addressing a lapses?
Revisit your client's 3-month goals and their wellness vision to insure relevance
Use perceptive reflections to illuminate AHA moments
If the lapse is even your fault, take responsibility
-remind client of prior progress using past efforts for future success tool
-establish and re-establish supportive relationships
What is Resistance?
Verbal exchanges and/or behaviors that indicate a client is ambivalent or conflicted about changing.
What causes resistance?
Causes of ambivalence:-anxiety/fear/apprehension about change, inner conflict,low-self-worth/self-efficacy
Resistance can arise when:-The client brings it into the coaching sessionReadiness, confidence levels and/or motivation to change are either low or drop-The coach elicits conflictDid not or incorrectly assessed client's readiness, motivation, confidence, etc.The coach labels the client based on exchange of information or past experiencesThe coach steps on a client's autonomy and suggests ideas without permission or makes choices for the client-A combination of the above
What are the behavioral signs of resistance?
-Negative talk
-Distracted, or not engaged during session
-Conflict with coach
-Deflecting responsibility
Which (MI) motivational interviewing skills are designed tp help clients create a safe space for clients to explore ambivalence?
Express empathy-develop discrepancy-Come along side the client
-Roll with resistance-support self-efficacy
If implemented correctly, MI can be useful to help a client understand and dislodge their "stuckness" and move forward.
What are the benefits of resistance?
When a coach effectively engages their doing and being skills, especially perceptive reflections, some resistance can actually provide the kind of energy in a coaching session that generates: -Relational flow-"Aha" moments-deeper rapport-a spark that moves a client to the next stage of changeA coach should practice respectful, productive and playful exploration of resistance-Helps a client see resistance realistically and without judgement-Fosters the confidence to reach for new possibilities.
What are the types of resistance can be caused by the coach? How can coaches avoid these traps?
The Expert Trap
The Premature Focus Trap
The Labeling Trap
What are the types of resistance can be caused by the client?
-The Question/Answer Trap (This is an avoidance trap characterized by the client steering the coaching process into a pattern of question/ answer... This is a problem bc is that it tends to promote passivity allowing the client to avoid deeper levels of exploration.
Avoiding (Client) Question/Answer Trap
Rather than engaging the futile exchange, encourage client to voice their reasons for change, with just a little questioning and guidance
"Why do you want to eat more healthy?"
"now lets talk about what changes you want to make to your diet"
(Client) The Blaming Trap
-When a client attempts to blame other or give excuses for their challenges
-How a coach reflects this to the client can result in even greater resistance
Avoiding the (Client) Blaming Trap
-Communicate in a respectful manner that blame is irrelevant
-Establish a "no-fault" policy with your clients:
Client: "My husband is the reason i eat ice cream every night!"
Coach: "Rather than looking at the problem, lets look at what YOU can do and what you can control so you can stay on track with the eating goals you really want"
The (CLIENT) Confrontation Trap
The coach and client engage in an argumentative confrontation in which the client counters each argument for change with an argument for not changing. If this argument escalates or continues for too long, it can cause irreparable damage to the trust and rapport between a coach and a client Confrontation may be the result of a client perceiving a threat to their autonomy: -Can trigger an unconscious need to defend their position, regardless of its validity.
Avoiding the CLIENT Confrontation Trap
-Roll with Resistance: this is the first and most important step in avoiding this trap.
"Its equivalent in dance is paying attention to keeping yourself and your partner from stepping on each other's toes"
Paradoxical element brings client back to balanced or opposite perspective.
Come alongside the client
Shifting Focus
Develop Discrepancy: Allowing client to move forward
USE perceptive reflections to develop discrepancy
-gently plants the seeds of thoughtfulness and, possibly, change
Addressing the CLIENT Confrontation Trap
1. Amplified Reflection
---the coach amplifies or exaggerates what the client said in a way that allows the client to see their statement more clearly and either agree or disagree with what was said
2. Double-sided Reflection
---with a double-sided reflection, the counselor reflects both the current, resistant statement, and a previous, contradictory statement that the client has made. This allows the client to see their resistance or misperception more clearly and address the discrepancy.
What steps does Wellcoaches suggest you take if you suspect your client is self-sabotaging
1. Level with the client about your perception that the client is self-sabotaging with a non-judgmental question, such as " I get the feeling you might be sabotaging yourself by...Do you think this might be true?"
2. Get the client to acknowledge the self-sabotage
"I think we've hit a wall here"
3. If the client is still in denial say "There may be things going on here that are hurting your motivation for which I'm not qualified to help you" Recommend Therapists concurrently
5. Clients who refuse to get outside help and aren't jolted into participating more fully in their coaching program after hearing your concerns may not be at the right stage for a coaching program
What are the benefits of joining a professional organization?
-Provides professional support
-Referrals through certified professional database
-Job search engines
-Provides continuing education opportunities
(Helps keep your certification active and your knowledge up to date)
-Provides professional resources
(Client hand outs, assessment tools, professional coaching articles, liability insurance, web support
-Makes you more attractive to employers
What are the reasons for becoming certified?
-Makes you more attractive to employers
-Insures to employers that you have the minimal core competencies necessary to function in the capacity of a coach or to utilize coaching skills in your prospective position.
Insures consistency with a specific paradigm of health coaching
Shows your ability to commit to a task and follow through with that commitment
Shows your knowledge of and commitment to the recognized credentials of your chosen career discipline
Allows you to meet employment qualifications
What are the reasons for becoming a nationally board certified health and wellness coach?
With an explosion of health and wellness coaching programs, it is difficult to determine the expertise and quality of coaches. Without agreed upon standards for the training and practice of health and wellness coaches, the public and healthcare professionals are confused about what to expect from coaches and how they complement other professions. National standards and board certification: Are based on extensive research. practicing health and wellness coaches gathered for three days to identify core competencies that are vital to effective coaching. a rigorous Job Task Analysis (JTA) was conducted to identify the tasks, skills and knowledge necessary to be mastered by a competent coach These tasks, skills and knowledge points were then validated through a survey completed by more than 1,000 practicing health and wellness coaches. in 2016, facilitated by the National Board of Medical Examiners, a comprehensive examination blueprint was developed which expanded upon the JTA.is accelerating the professionalization of health and wellness coaching, and enabling the growth of an evidence base. has identified reputable coach training and education programs to prepare for the board certification. allows proficient coaches to stand apart from coaches who have not received adequate coach training or assessment of their coaching skills and knowledge.
What should you consider when choosing
With whom is the certifying body accredited or partnered?
(ICF?IAC? a recognized health organizations(NCHEC, ACSM, NCCA)
-Do they serve the profession as well as themselves?
-Are the faculty reputable, accomplished member of the profession?
-Does the organization support their certified coaches with career resources
What is the group coaching?
The application of coaching principles applied to a group of participants working towards a common purpose.
What is the role of the coach in group coaching? What is NOT considered group coaching?
The coaches role in group coaching:
-Facilitate discussion and group support
-Guide group dynamics
-Wear their coach hat at all times
What group coaching is NOT:
-Individual coaching with more than 1 person
-Health behavior education
-group therapy
What are the benefits of group coaching to the coach?
*Cost-effective
*Smaller time commitment overall
*Can be as effective as individual coaching
* Amplifies and strengthens coaching skills
In a clinical setting:
Coaches can offer content education and skill-building during group sessions
-Potential to have a positive impact on numerous patients simultaneously using fewer staff members
The use of peer facilitators can further enhance the reach of the program
What are the benefits of group coaching to the client?
To the client:
-More affordable
-Increases access and potential population impact
-Provides the opportunity for shared ideas and learnings
-Creates a sense of community
-provides the opportunity
What are the challenges associated with group coaching?
Maintaining consistency of groups with a fixed program start/end dateLimits availabilityIf you don't have consistent attendance of at least 4 group members, then the benefits are alteredAbsences can dilute the benefits of a unifying relationship and exposure to realistic role modelsOpen groups with no set program start/end date increase availability and consistency, but:Newcomers may not feel "welcome" Requires a skilled coach to facilitate the ongoing change in group dynamicsGroup dynamics can shift over time, making cohesion difficult
What are the logistics of a group coaching session?
Have the group set guidelines at the first meeting and share them with new members who join laterBuilds group cohesion and buy-in to the guidelines and the group itselfThe coach is responsible for enforcing the group's guidelines whenever necessaryCoaches can conduct an initial individual coaching session/screening with each prospective group member before the first group meeting to insure that the group dynamic is best for themThose that are intimidated to share in a group, or those that may be more likely to monopolize the group, can be referred to an individual program
Important group guidelines to observe:
No judgements!
No advice giving
-use deep listening
Focus on participant
Each group member is an expert of their own lives
No hogging "air space"
Observe confidentiality
When are the group coaching sessions most effective?
...
What are the elements of a typical group coaching session?
... [Show Less]