Preparing for a coaching session (3)
1. Prepare
2. Get Present
3. Get curious
Qualities of an authentic + nurturing coaching relationship
1.
... [Show More] Co-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]