Health Coaching (2) Flashcards
Within a health coaching relationship, what expectations are important to clarify with the patient?
Practicalities - timing and location of consultations
Confidentiality
Roles of the practitioner and patient
Boundaries of the work - limits on competence
Keeping a record - written report of what has been discussed to help keep track
How can you build rapport in face to face conversations?
Be present in the conversation
Actively listen
Use non-verbal communication - even when writing / making notes
How can you build rapport in remote conversations?
Spend time with introductions
Speak slower, clear language, more paused = increased clarity
Video calls = use non-verbal communication, keep background uncluttered, make sure you are clearly visible
Use tone and watch out for patient’s tone
What does the acronym OARS in motivational interviews stand for?
Open questions
Affirmations - positive statements / gestures made by practitioner that emphasised patient’s strengths and abilities
Reflective listening - pick up and reflect back the patient’s own words or behaviours
Summaries - summarise and clarify the conversation, slip in ‘change talk’ e.g. It sounds like you have started making positive changes…’
What are some ways to make questions effective?
Keep questions open and short
Avoid double, triple or quadruple questions?
Start with ‘what’ or ‘how’, rather than ‘why?’ (why = defensive)
Pause
What methods can we adopt when working towards setting and clarifying expectations with patients
• Practicalities
–>Agree practical details e.g. location + timing of consultations
• Approach to confidentiality
–> Discuss terms of confidentiality inc. that it may need to be broken in some circumstances
• Expectations of the roles of practitioner and patient
–> Be clear from the start to reduce misunderstanding later
• Boundaries of work
–> Includes limits of competence/who you may need to signpost the patient to
• Keeping a record
–> A written record for both you and the patient to help keep track
Rapport building techniques in practice
- Be fully present in the conversation
- active listening and Non verbal communication (eye contact/nodding/leaning forward)
- Non verbal cues
- Clear speech with pauses
- Emphasise non verbal communication and look at both camera and face for video consultations
- Remotely: more time on introductions, speak slower, non verbal communication, facial expressions, tone of voice, visual cues, whiteboard function, plain backgrounds, good Internet connection
What is OARS and how can we implement it
O – Open questions
• What are your thoughts on this?
• What do you want, ideally?
• What part of this do you have control over?
• How confident do you feel about this?
A – Affirmations
• What you described just nowwas very brave.
• I really appreciate that you have made the time to focus on this.
• The way you handled that situation really demonstrates your resourcefulness
R– Reflective Listening
• You used the word ‘busy’ a few times. Can you say more about that?
• I noticed you smiled when you said that.
S– Summaries
- correction from patient and shows listening
- summarise change talk
tips in constructing effective questions using a coaching framework
Tips
1) Keep questions open and short
• More likely to be impactful
2) Avoid double/triple/quadruple questions
• Confusing for the patient
3) Start questions with ‘what’ or ‘how’ rather than ‘why’
• ‘Why’ can cause a more defensive answer
4) Pause
• Gives patient space to think
Explain the benefit of ‘change talk’ rather than negative language used by the patient to maximise motivation to change
Change talk = positive language
• What is stopping you from achieving your ideal outcome?
• What needs to happen for this change to become possible?
• What part of this do you have control over?
• What would be different and better for you if you make this change?
• How will you know when you are ready to make the change?
• What is going right?
• Imagine you are your own best friend. What do you say to yourself about this issue?
How can we use Health coaching to help a patient to identify possible options, opportunities and resources available to help them achieve their goal, address what might get in the way and plan next steps for action
Useful solution-oriented questions questions to help the patient plan next steps include:
• What are your options?
• How will you decide which option(s) to follow?
• What are your next steps?
• What might get n the way of your plans?
• How could you adapt your plan if need be?
• What resources can you access to help you?
• Who can help support you in your plan of action?
• What would really make a difference to achieve success?
• When will you make a start?
• How will you review your progress?
non judgemental tone and body language
- signpost
- ask about barriers
How does non verbal communication play a role in building rapport
(smiling, nodding, eye contact)
- helps build a good rapport with the patient by giving them full attention, signalling this verbally through reflecting and summarising, through non-verbal communication, e.g. smiling, eye contact, nodding, leaning forward) and by holding an empathic, curious, non-judgemental mindset.
- When rapport is present, it often follows that there is alignment of body language and the tone of voice.
How does reflective listening play a role in building rapport
- reflect back the patient’s words
- a word the patient had themselves used.
- the ideal aims the patient is hoping to achieve.
- Reflecting back positive and hopeful language in this way can help increase motivation for change. MI practitioners call this language ‘change talk’.
- helps to increase rapport and when this is present, it often follows that there is alignment of body language and the tone of voice.
What is change talk in motivational interviewing
Reflecting back positive and hopeful language in this way can help increase motivation for change.
Why are open questions important in health coaching
Open questions help to explore a patient’s thoughts and feelings about their issue and to explore meaning, values and goals.
