1. Using basic coaching skills for behavior change

2. Introductions Tonight’s Presenter Lynn Grieger, RDN, CDE, CPT, CHWC
Health, Food and Fitness coach
Moderator
Heidi Diller, RD
ReShape® Patient Care Manager

3. What do I need to know? What do I know and not know about my client?
What are my client’s goals and objectives?
What else do I need to know to help my client reach their goals?
What do I need to know?

4. The client finds the answers

5. I have enough guilt and shame on my own about my weight; I don’t need anyone to tell me what to do. I know what to do – I just don’t do it.

6. Coaching skills Open-ended questions Active listening
Feedback and reflections
Rulers for confidence and motivation
Coaching techniques for different stages of change
Developing SMART goals using a coach approach
Coaching skills

7. Open-ended questions Instead of yes/no questions
Ask questions that start with:
What
How
When
Where
AbuSabha, JAND, Volume 113 , Issue 5 , 626
Open-ended questions

8. Avoid leading questions
Instead of this:
Ask questions like this:
Avoid leading questions
What do you eat for breakfast?
How much water do you drink each day?
How often do you eat snacks?
What is your morning routine from the time you wake up?
What are your favorite beverages?
How do you decide when you are going to eat?

9. Benefits of open-ended questions
Encourage client to do most of the talking
Encourage client to speak about their feelings, beliefs, experiences
Assist in identifying ambivalence toward behavior change
Benefits of open-ended questions

10. Open-ended questions that lead to a story
Instead of:
Ask this:
Open-ended questions that lead to a story
What did you eat for lunch?
How much weight do you want to lose?
When do you snack?
Tell me about your food choices so far today.
What are your expectations with the ReShape program?
What role does snacking play during your day?

11. Effective open-ended questions
Specific
Ask one question at a time
Non-judgmental
Clarify a previous statement
Effective open-ended questions

12. Active listening
Focus completely on what the client is saying and is not saying
Understand the meaning of what is said in the context of the client's desires
Support client self-expression

13. Keys to active listening
Be mindful of the client’s agenda, not your own agenda
Pay attention to the client’s words, tone of voice, body language
Note the client’s energy levels and enthusiasm
Listen without judgement
Be present in the moment with your client
Keys to active listening

14. Coaching is a dance

15. Feedback and reflections
Summarizes, paraphrases, reiterates, and mirrors back what client has said to ensure clarity and understanding. 
Builds empathy
Helps the client hear their thoughts and move toward change talk
Feedback and reflections

16. Nudge toward the positive

17. Simple reflections Demonstrates you hear what your client is saying
Client: I want to stop eating while I watch TV.
Coach: You’re ready to change your habit of eating while watching TV.
Simple reflections

18. Amplified reflections
Exaggerate what the client said to evoke an emotional response.
Client: Eating while watching TV at night helps me relax.
Coach: The only way you can relax in the evening is eating while watching TV.
Amplified reflections

19. Double-sided reflection
Strategy to point out ambivalence and encourage change talk
Client: I really like to eat while I watch TV, but I know eating late at night isn’t helping me lose weight.
Double-sided reflection

20. Open-ended questions
Affirmations
Reflections
Summary
OARS

21. Affirmations I appreciate that you are willing to meet with me today.
I can see that you’re working hard to reach your goals
Thank you for talking with me about this
I know talking about your weight loss history isn’t easy, and thank you for being honest
Affirmations

22. Reframe Things didn’t work out as planned, and you’re not giving up
You met your goal 25% of the time and that’s progress
Reframe

23. I’ve heard you say that:
We’ve talked about….
Summarize

24. Rulers for readiness and confidence

25. SMART goals Which stage of change? Client driven
Focus on positive action
Tell me your goal for this week
Use active listening to pay attention to the words and tone
Use a ruler to gauge confidence
SMART goals

26. Precontemplation and Contemplation
goals that focus on:
“thinking about”
“learning about”
“feeling about”
Precontemplation and Contemplation

27. Planning and Action SMART goals that
Focus on one specific, measurable behavior
Fill in the blank: ….so that…..
I will drink water instead of soda 2 times this week at lunch so that I decrease my calorie intake and learn to enjoy the taste of plain water.
Planning and Action

28. Looking ahead Third webinar 10-11-16
How to begin a client interaction with a coaching mindset
Using coaching skills in short interactions
Addressing specific client concerns using coaching
Managing expectations
Developing empathy
Motivation
Hunger or lack of hunger
Looking ahead

29. Motivational Interviewing in Health Care by Stephen Rollnick, William R. Miller and Christopher C. Butler
Motivational Interviewing in Nutrition and Fitness by Dawn Clifford and Laura Curtis
Resources