The Coach Approach Darryl Tonemah Ph.D., M.Ed.

Health Coaching Model 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 assessing Member motivation or underlying barriers to change Health coaching is a Multi-disciplinary, Facilitative approach To enhance members’ Ability to self-manage conditions

Successful Programs: DPP Look AHEAD

The Health Coaching Model uses a team of health professionals to assist patients in making difficult behavior changes to improve their health. An assigned health coach works with the patient and multi-disciplinary team to identify barriers, establish goals, and work collaboratively with the 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 Health Coach and Patient Relationship

Challenge Support Success Ego BiscuitBoredom Failure

Creating your circle of SUCCESS Document & Reward Set Goals Create Plan Follow Through

Individual Plan Sheet Date: Goal: History: Strengths: Limitations: My Role: Timeline:

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

Conceptual 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 capabilities to organize and execute the sources of action required to manage prospective situations. Self efficacy is the belief in one’s capabilities to organize and execute the sources of action required to manage prospective situations. -Bandura 1986

Where does it come 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

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-Motivational Statements Problem Recognition Expression of Concern Intention to Change Optimism for Change

Responding to Resistance

What is resistance? Describe.

Two Categories for responding to Resistance 1.Reflective Response 2.Strategic Response

Three Reflective Strategies Simple Reflection Amplified Reflection Double Sided Reflection

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

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

Be Well Thank You