Using basic coaching skills for behavior change

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

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?

The client finds the answers

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.

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

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

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?

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

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?

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

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

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

Coaching is a dance

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

Nudge toward the positive

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

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

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

Open-ended questions Affirmations Reflections Summary OARS

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

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

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

Rulers for readiness and confidence

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

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

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

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

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