Health Coaching Conversation

Question 1

What are the four main components for motivational interviewing?

Answer 1

Compassion
Acceptance
Partnership
Evocation

Question 2

What is compassion in regards to motivational interviewing?

Answer 2

The healthcare practitioner acts from a desire to support the patient’s wellbeing

Question 3

What is acceptance in regards to motivational interviewing?

Answer 3

The healthcare practitioner takes a respectful, non-judgemental approach, and values and affirms the patient’s autonomy and worth

Question 4

What is partnership in terms of motivational interviewing?

Answer 4

The healthcare practitioner works in partnership with the patient, recognising that the patient is resourceful and an expert in their own situation

Question 5

What is evocation in terms of motivational interviewing?

Answer 5

The healthcare practitioner helps a patient to identify their own perspectives and motivation for change.

Question 6

What types of questions can be asked in health coaching?

Answer 6

o What’s the issue?
o What do you want ideally around this issue?
o What part of this do you have control over?
o What are your options going forward?
o What is your next step?

Question 7

What are three coaching principles?

Answer 7

1) The patient’s assumed resourcefulness
2) A relationship based on mutual trust and respect
3) Coaching is about change

Question 8

In what two ways can health coaching help a patient?

Answer 8

1) Develop new perspectives about their health issue

2) Plan how to best achieve their health behaviour goals

Question 9

What is the practitioner’s role in health coaching?

Answer 9

Broadens from expert to enabler.
By recognising that the patient is resourceful, and an expert in their own life situation, the practitioner’s role broadens from expert to enabler, supporting the patient’s own thinking about the goals they want to set for themselves and how best to achieve these goals.

Question 10

What are the 5 expectations to consider in a healthcare setting?

Answer 10

A) Practicalities

2) Approach to confidentiality
3) Expectations of the roles of practitioner and patient
4) Boundaries of work
5) Keeping a record

Question 11

What are practicalities in terms of healthcare setting expectations?

Answer 11

It’s important to agree practical details about the location and timing of consultations

Question 12

What is the approach to confidentiality in terms of healthcare setting expectations?

Answer 12

Maintaining confidentiality is an important aspect of constructing trust in the relationship, and thus essential to discuss your approach to confidentiality from the outset - including discussing that confidentiality may need to be broken down in certain circumstances (risk of harm to patients)

Question 13

What are the expectations of the roles of practitioner and patient?

Answer 13

Being clear from the start about what to expect from the health coaching relationship can reduce misunderstanding later one.

Sometimes there might be an expectation on both sides that the practitioner is there to provide the answers for the patient and to fix their issue. Remember that in health coaching, the practitioner’s role shifts from expert to enabler, helping the patient to set their own health behaviour goals and identify their own solutions.

Question 14

What are the boundaries of work in a healthcare setting?

Answer 14

It is important to clarify the boundaries of work, including the limits of your competence, and who else you may need to signpost your patient to.

Question 15

What is the advantages of keeping a record in a healthcare setting?

Answer 15

It can be helpful to have a written record of what has been discussed and agreed for you. and the patient to refer to this when needed as you progress with the health coaching, to help you both keep track./

Question 16

What five elements help to construct rapport with a patient through an online consultation?

Answer 16

1) Spend more times on introductions and rapport-building.
2) Speak slower with clear language (more pauses between sentences)
3) Maximise capturing non-verbal communication by including your neck, upper body and arms (video calls)
4) The tone of your voice and patient’s voice become even more important to pay attention to when your conversation does not have nay visual cues.
5) Looking at the camera rather than at the patient’s face (build eye contact )

Question 17

What are the four main concepts when it comes to motivational interviewing skills?

Answer 17

1) Open questions
2) Affirmations
3) Reflective listening
4) Summaries

(OARS)

Question 18

What are open questions in motivational interviews?

Answer 18

Help to explore a patient’s thoughts and feelings about their issues and to explore meaning, values and goals.

Question 19

What are affirmations in motivational interviewing?

Answer 19

Positive statements or gestures made by healthcare practitioner that emphasise that the patient’s strengths and abilities.

Affirmations help to acknowledge behaviours that are directed towards positive change, no matter how big or small. They can help a patient to build a sense of self-efficacy and increase motivation and confidence in achieving change. It is important that affirmations are expressed genuinely.

Question 20

What is reflective listening in motivational interviewing?

Answer 20

The practitioner also reflected back the ideal aims the patient was 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

Question 21

What are summaries in motivational interviewing?

Answer 21

Convey to patient that they have been understood, help you to check that you have understood correctly/give patient an opportunity to correct you if you haven’t

Question 22

What are the tips for effective questions?

Answer 22

• Keep questions open and short
• Avoid double, triple and quadruple questions
• Start questions with a “what” or a “how”, rather than a “why”
• Pause

Question 23

What are the four processes for motivational interviewing?

Answer 23

1) Engaging - building connection and rapport with patients.
2) Focusing - Helping patients to identify a health behaviour-related goal that they can then focus on during the coaching interaction.
3) Evoking - Supporting patients to explore their situation further, evoking their own thoughts and feelings about their goal.
4) Planning - Supporting patients to identify possible options, opportunities and resources available to help them achieve their goal.

Question 24

What are the SMART goals?

Answer 24

Specific: Well defined and clear
Measurable: Use specific criteria to enable you to measure your progress towards achieving a goal.
Achievable: Possible to achieve
Realistic: Relevant to your context and achievable resources time
Timely: With a clear timeline including including the to start and when to you plan to achieve your goal

Question 25

What is rolling with resistance?

Answer 25

When patients are struggling to move forward with their issue, you may notice this as resistance during the conversation. A key skill in this situation is what MI practitioners term ‘rolling with resistance’. This involves expressing empathy, emphasising the patient’s autonomy, avoiding arguing and advice-giving, and instead drawing on the skills above to create trust and work collaboratively with the patient, strengthening their belief in their capacity to change.

Question 26

What is change talk?

Answer 26

Change talk in general refers to clients' statements about their desire, ability, reasons and need for change, whereas commitment language represents a more assertive declaration about commitment/actions to change

Question 27

What are some examples of change talk?

Answer 27

* 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?

Question 28

What questions may be useful to help a patient plan their next step?

Answer 28

* 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?

Question 29

What is the COM-B model?

Answer 29

Behaviour is a result of: • Capability (both physical, including the skills required, and psychological, including knowledge required to take steps towards behaviour change) • Opportunity (both physical, for example time and cost considerations, and social, for example the presence of a supportive companion or group) • Motivation (both reflective, through considering the long term benefits of the behaviour change, and automatic, through using this reflection to see the behaviour change as a ‘want’ and not just a ‘need’).