The Coach Approach Darryl Tonemah Ph.D., M.Ed.. Health Coaching Model RN Directed Physician Centric Multi Disciplinary Health Coaching Constraints on.

The Coach Approach

Darryl Tonemah Ph.D., M.Ed.

Health Coaching Health Coaching ModelModel

RN Directed Physician Centric Multi Disciplinary Health Coaching

Constraints on physician time and resources do

not allow for the in-depth counseling and assistance

necessary for the effective treatment of chronic illnesses

RN gives didactic Telephonic education

Without assessingMember motivation or underlying barriers to

change

Health coaching is aMulti-disciplinary,

Facilitative approachTo enhance members’Ability to self-manage

conditions

Successful Programs:DPP

Look AHEAD

The Health Coaching Model The Health Coaching Model uses a team of health uses a team of health

professionals to assist patients professionals to assist patients in making difficult behavior in making difficult behavior changes to improve their changes to improve their

health.health.

An assigned health coach works An assigned health coach works with the patient and multi-with the patient and multi-

disciplinary team to identify disciplinary team to identify barriers, establish goals, and barriers, establish goals, and work collaboratively with the work collaboratively with the

patient to create a health plan.patient to create a health plan.

• Building Trust

• Facilitating Change

• Valuing Diversity

• Communication

• Gaining Commitment

• Problem Solving

• Building on Success

• Revisiting & Adjusting Goals

Characteristics of a Characteristics of a Health Coach and Patient Health Coach and Patient

RelationshipRelationship

Challenge

Su

pp

ort

Success

Ego BiscuitBoredom

Failure

Creating your circle ofCreating your circle of

SUCCESSSUCCESSDocument & Reward

Set Goals

Create Plan

Follow Through

Individual Plan SheetIndividual Plan Sheet

Date:

Goal:

History:

Strengths:

Limitations:

My Role:

Timeline:

Motivating Change

“The more I hear myself the more I believe myself”

Conceptual BeliefsConceptual Beliefs

• Client– Actively involved in their care– Client verbalizes reasons for change

• “Co-Healers”– The professional doesn’t carry all the responsibility– A collaborative relationship, not adversarial– A way of being; not a series of techniques

• Behavior change– Discussed in safe way– Uses an interpersonal context

• Promotes self-efficacy

Self-Efficacy

Self efficacy is the belief in one’s Self efficacy is the belief in one’s capabilities to organize and capabilities to organize and

execute the sources of action execute the sources of action required to manage prospective required to manage prospective

situations.situations. -Bandura 1986

Where does it come Where does it come from? How can we help?from? How can we help?• Mastery Experience

Successes raise efficacy perceptions; failures lower them

• Vicarious Experience

Watching and learning from a mentor can produce enduring changes on the patient’s self efficacy

• Social Persuasion

Verbal persuasion can contribute to successful performance when the heightened appraisal is

within realistic bounds

• Physiological States

Treatments that eliminate emotional arousal to subjective threats heightened perceived self

efficacy as performance improves

Cognitive behaviorism is a type of counseling that focuses on modifying certain thoughts and behavior patterns to control the symptoms of a condition. Cognitive-behavioral therapy is used to treat a variety of problems, including stress, depression, anxiety and panic disorders, eating disorders, ongoing (chronic) pain, and chronic fatigue syndrome.

• Assists a participant in recognizing, analyzing and managing their beliefs;

• Placing a large emphasis on the client’s belief in who they are and what their strengths are

• Teach, Educate, Teach----giving them the opportunity to re-examine what they have been told (e.g., “you are just going to be big” to what in reality is true about themselves;

• Identifying and practicing skills (e.g., including goal-setting and problem-solving);

• Continuing to do this work on a long term basis after the counseling process is over.

Understand distorted thinking process

Cognitive re-framing

Medicine Wheel

Medicine WheelMedicine Wheel

Spirituality

Emotions

Physical

Mental

Using Motivational Statements

Types & How to Elicit

Eliciting Self-Motivating Statements

• Ask evocative questions• Explore pro’s and con’s• Ask for elaboration• Imagining extremes• Look forward• Looking back

4 Types of Self-4 Types of Self-Motivational StatementsMotivational Statements

• Problem Recognition• Expression of Concern• Intention to Change

• Optimism for Change

Responding to ResistanceResponding to Resistance

What is resistance? What is resistance?

Describe.Describe.

Two Categories for Two Categories for responding to Resistanceresponding to Resistance

1. Reflective Response

2. Strategic Response

Three Reflective Three Reflective StrategiesStrategies

• Simple Reflection• Amplified Reflection• Double Sided Reflection

Strategic ResponsesStrategic Responses

• Shifting focus• Reframing• Agreement with a twist• Emphasize person’s choice and control

Thomas Edison’s teachers said Thomas Edison’s teachers said he was “too stupid to learn he was “too stupid to learn anything.” He was fired from anything.” He was fired from his first two jobs for being his first two jobs for being “non-productive.” As an “non-productive.” As an inventor, Edison made 1,000 inventor, Edison made 1,000 unsuccessful attempts at unsuccessful attempts at inventing the light bulb. When inventing the light bulb. When a reporter asked, “How did it a reporter asked, “How did it feel to fail 1,000 times?” feel to fail 1,000 times?” Edison replied, “I didn’t fail Edison replied, “I didn’t fail 1,000 times. The light bulb 1,000 times. The light bulb was an invention with 1,000 was an invention with 1,000 steps.”steps.”

Be WellBe Well

Thank YouThank You