An introduction to Coaching for Health

1. An introduction to Coaching for Health 1

2. Effectiveness of Health Coaching • Smoking cessation (McAllister et al, 2004) • Obesity (Petersen et al, 2008) • Cardiovascular disease (Vale et al, 2003) • Physical & mental health (Butterworth et al, 2006) • Diabetes (Fera et al, 2008) • Medication adherence (Melko & Terry, 2010)

3. What is Coaching?

4. Definitions: Coaching is… “…unlocking a person’s potential to maximise their own performance; helping them to learn rather than teaching them” Timothy Gallwey “…building awareness, responsibility and self-belief” Sir John Whitmore 6

5. Definitions: Health Coaching “A behavioural intervention that facilitates participants in establishing and attaining health-promoting goals in order to change lifestyle-related behaviours, with the intent of reducing health risks, improving self-management of chronic conditions, and increasing health-related quality of life.” Van Ryn & Heaney (1997) 6

6. Shared Decision Making “A process in which clinicians and patients work together to clarify treatment, management or self-management support goals, sharing information about options and preferred outcomes with the aim of reaching mutual agreement on the best course of action”

7. Expertise Clinician’s Expertise Patient’s expertise Experience of illness Social circumstance Attitude to risk Values Preferences • Diagnosis • Disease aetiology • Prognosis • Treatment options • Outcome probabilities

8. Telling Instructing Giving advice Pull – Helping someone solve their own problems Offering guidance Directive Making suggestions Non-Directive Providing feedback Push – solving someone’s problems for them Paraphrasing / summarising Reflecting back Asking questions that raise awareness Listening to understand

9. t – G.R.O.W Myles Downey

10. Coaching Framework • (t – Topic) • G – Goal • R – Reality • O – Options • W – What next? G.R.O.W R.G.O.W T-GROW – Myles Downey

11. Telling Instructing Giving advice Pull – Helping someone solve their own problems Offering guidance Directive Making suggestions Non-Directive Providing feedback Push – solving someone’s problems for them Paraphrasing / summarising Reflecting back Asking questions that raise awareness Listening to understand

12. Directive Non-Directive

13. Directive v. Non-directive • Directive = “you should try this solution” • Non-Directive = “which solution would work best for you?” 61

14. Directive • When will you address the issue directly? • What could you do about it? • What do you think the best thing is to do? • Can you describe the situation? Non-Directive 62

15. Directive transformations Useful principles: • De-personalise – take the ‘subject’ out (or replace ‘you’ with ‘we’) • Start at the Non-Directive side of the spectrum • Provide your own options (Directive questioning) • To generate a Directive question, simply turn the statement directly into a question 66

16. Directive transformations • “Tell me what you did wrong.” • “I’m starting you on a new drug.” • “You need to have a healthier lifestyle.” • “You’re procrastinating, you should just get on and do it.”

17. Overview of Full Course 2. Skills 1. Mindset 3. Frameworks Arnstein’s Ladder Values & Beliefs Behaviour change Coaching Principles Listening Questioning Reflecting back Challenging t-GROW Transactional Analysis Resources – Barriers Motivation

18. Evaluation Findings • Over 400 participants have completed the 2 and 3 day trainings since 2011 • 98% would recommend the course to others, 95% have already done so and 78% have already shared the learning with colleagues • After three months, 53.3% of participants said they were using their skills "All or most of the time“, and 31.4% said they were using them "Some of the Time"

19. Thank you! nick.nielsen@osca.co dougjhing@gmail.com