Essential Skills of Health Coaching: Doug Post, Ph.D.

Learning Objectives Describe motivational interviewing skills. Describe shared decision making skills. Describe health coaching skills. Demonstrate how to develop an action plan in collaboration with a patient. At the end of this session, students will be able to

Motivational Interviewing Skills Ability to assess “stage of change” and conviction and confidence about changing. Expressions of respect for patient autonomy in making a choice. Eliciting the pros and cons of behavior change Listening respectfully to patients statements of resistance or commitment to change, and reflecting them back to patients Collaborating and reaching agreement on goals that match patients’ stage of change, conviction, and confidence. Avoid attempting to persuade patients with low conviction to change behavior Avoid trying to direct or prescribe action plans if conviction or confidence is low.

Motivational Interviewing Skills Simple reflection Double-sided reflection Self-efficacy assessment

The Effective Physician Video Review of Motivational Interviewing

Shared Decision-Making Find out the patient’s understanding of the problem, then share appropriate facts and answer questions Find out what role the patient wants to play in decision-making Find out what is important to the patient: goals, values, etc. Present options that take into account the evidence and the patient’s goals Obtain the patient’s thinking on options and answer questions Give recommendations and discuss the patient’s thinking Arrive at a mutually agreeable plan Discuss possible barriers or problems that the patient sees and work to develop a plan to deal with them

Shared Decision Making Animated Short

The Patient Perspective Y

Shared Decision Making Video Visit DocCom  u/doccom/user/ u/doccom/user/ Review the Video Example in  17 Shared Decision-Making Clarence Braddock MD, Stanford University

Shared Decision Making

Elements of Effective Coaching More listening than talking. More asking than telling. More reflecting than commenting. Not advising how to solve problems. More reflecting than commenting.

Health Coaching Process Assess patient’s current lifestyle Assess patient’s strengths and past successes Assess what is important to the person right now Assess what the patient wants to work on now

Patient Action Plan Strategize to resolve expected barriers. Strategize with the patient to prevent triggers. Assess confidence level What-How Much-When-How Often-How Confident Can be achieved within a target period. Something the patient WANTS to do, not SHOULD do.

Health Coaching Process Conduct a needs assessment Coach the patient to develop an action plan of small steps Guide, support, teach, and link the person to resources Patient tries the action plan Follow up with the patient and develop another action plan…

Health Coaching Example

Health Coaching Example Video

Telephone-based coaching video from OSU: Nutrition

What Happens Next Perform a formative OSCE on health coaching skills Work with a peer on health coaching skills

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