15.Coaching Behavior Change.pdf

Health Coaching • Helping patients gain the knowledge, skills, tools and confidence to become active participants in their care so that they can reach their self-identified health goals Resistance to Change • Stems from fear, often leads to defensive behavior • Reflect or reframe resistance • Whe...

Health Coaching • Helping patients gain the knowledge, skills, tools and confidence to become active participants in their care so that they can reach their self-identified health goals Resistance to Change • Stems from fear, often leads to defensive behavior • Reflect or reframe resistance • When encountering resistance--shift approach • Highlight and acknowledge pros and cons of change Signs of Resistance • Arguing • hostility • Interrupting • Ignoring • Changing the subject • Providing no response • Denying • Disagreeing • Blaming • Unwilling to change How to ‘sell’ behavior change to each stage of ‘readiness’ • Motivational interviewing • Clinical empathy Motivational Interviewing Principles Strategies • Roll with Resistance • Express Empathy • Avoid Argumentation • Develop discrepancy • Support self-efficacy • Ask open-ended questions • Affirmation • Reflective listening • Summarize Clinical Empathy • The ability to understand the patient’s situation, perspective, and feelings and to communicate that understanding to the patient • Promotes diagnostic accuracy, therapeutic adherence, and patient satisfaction while also being time-efficient Clinical Empathy • Clinician ‘enters into’ the perspective and experience of the other person with verbal and nonverbal cues • Emotional focus- “walk a mile in their shoes” • Action component- checking back with patient Effectively Expressing Empathy • Active Listening (nonverbal; minimal expression) • “Uh-huh” • Framing • “Sounds like what you’re telling me is….” • Reflecting Content • “If I have this clear, you felt one way earlier, and those feeling have changed since... ” • “So you mentioned your inability to fall asleep and stay asleep... ” • Identifying the Emotion • “I have a sense you feel strongly about this, can you tell me more about these feelings?” • “ I‘m getting the impression that this makes you rather upset... ” • Requesting/Accepting Correction • “Did I miss anything? Is there anything more I should know?” The 5A’s Behavior Change Model Barriers of implementing 5A’s