1. Whole Health Coaching
Welcome to Week 2, Day 2

2. https://youtu.be/XHefxlDUinE
VIDEO
This is Water
As the group – what are the advantages for being in a group

3. Review of Strategies

4. Brainstorming Dyad Exercise
Invite partner to generate ideas
Explain brainstorming process to client
Take turns, coach records ideas
Keep it light and fun!
No judging/evaluating/assessing ideas
How long? Could be timed or by number of ideas/energy
Then…. what is most appealing/doable?
Again, notice the coach is not offering ideas or advice unless Elicit, Provide, Elicit is used.
What do you notice about the questions on brainstorming and resources?
Optional activity:
Guided reflection on an area where client feels stumped and could use some new ideas. (Examples: Finding walking group/ideas for exercising with others. Ideas for snacks. Ideas for getting household chores done. Ideas for sitting at desk all day. Ideas for dealing with commute. Ideas for child/elder care. Ideas for resting eyes related to screen time. Ideas for decompressing before bed.)
Pair up in dyads.
Coach asks client for area to address.
Coach describes the process of brainstorming.
Coach guides the process of brainstorming through completion (what’s on this slide).
Ideas are captured throughout by client. (Coach may want to capture as well.)

5. Elicit—Provide—Elicit
“What do you know about…”
Reflect what they know!
Provide
“May I share what I know?”
Offer information in small doses
“What are you taking away?”
“How does that sound? Compared to what you already knew?
#1 Elicit. It’s important to assess what the client already knows. There is no use offering them information they already know! Also, this allows you to choose the information that is most appropriate for them.
Don’t forget to REFLECT what they know!
#2 Provide. Ask permission. Then don’t overwhelm with too much information at once. Remember, small doses!
#3. Elicit. It it often surprising to learn that what you say (or think you said) is different from what someone “hears.”

6. Possible Questions: Perspectives How might someone else see it?
What might you tell someone else?
How might your older/wiser-self view it?
What might a child say?
What might be a complete opposite belief?

7. [TRIAD #5 ASSIGNMENTS HERE]

8. When and How to Refer in Coaching

9. Preparing for Potential Referrals
Have professional colleagues with whom you can discuss potential referrals
Be clear on your supervisory chain and to whom you will share concerns
Be familiar with referral resources
Recognize that not all client issues are appropriate for coaching
Become familiar with behaviors and signs that might suggest additional resources are needed

10. When to Refer – Some Guidelines
Client expresses intent or thoughts of doing harm to self or others
Client shows signs of depression
Client shows signs of high anxiety
Client is unable to make progress in desired area of change
You seem to have conflicts/value differences with client that are impeding your relationship
Trust your intuition

11. How to Refer
Establish in first session that referral may be part of the coaching process
Discuss with client first before making a referral
Use Elicit-Provide-Elicit format when discussing referral with client
If you have other clinical credentials, be clear with client which role you are assuming
Offer to continue to provide coaching if that is desired by client

12. Whole Health Coaching and Suicide Prevention

13. I’m Good. But Are You Ready To Listen?
VIDEO
I’m Good. But Are You Ready To Listen?

14. Whole Health and Suicide Prevention
Whole Health is an approach to health care that empowers and equips people to take charge of their health and well-being and to live their life to the fullest. This approach partners with Veterans to explore their mission, aspiration, and purpose. A Whole Health approach is an integral and proactive element of suicide prevention.
A focus on health and wellness can enhance Veterans’ reasons for living in a way that could buffer against the impact of stresses, problems, or conditions that may lead them
to consider reasons for living.

15. Whole Health and Suicide Prevention
Increasing the availability of problem solving training and other strategies such as mindfulness can increase the Veteran’s skills in responding to stressors and therefore decrease the risk of stress negatively impacting mental health or exacerbating existing mental health disorders.
The increased availability of resources supporting self-help makes interventions available to those who
would otherwise resist care.

16. Whole Health and Suicide Prevention
Increasing the availability of care for patients with chronic pain and insomnia addresses risk factors for suicide that go beyond mental health conditions.
Defining stepped care strategies, ranging from self-care through guided self-care and brief treatment to specialty care for PTSD, depression, and substance-related conditions, enables Veterans to begin care earlier, with milder symptoms, and with less risk of stigmatization than current approaches, while, at the same time, ensuring that there are mechanisms for modifying the level of care when necessary

17. Whole Health and Suicide Prevention
Enhancing communication and trust will increase the likelihood that patients will disclose stressors and symptoms to their providers, and the likelihood that they will accept recommendations for care.
Providing care to those who report significant stressors and those with symptoms that are below the threshold for making a mental health diagnosis will extend the reach of effective interventions to large numbers of additional patients

18. WHC for Suicidal Ideation
Recently completed pilot study*
Based on VHA’s model of Whole Health, Whole health coaching emphasizes the interconnectedness of all aspects of health
Whole health coaching for suicidal ideation (WHC-SI) uses reflective listening, motivational interviewing, assessment, and accountability strategies to facilitate client goal-setting, articulation of action steps, and goal achievement

19. Recently Completed Pilot Study*
8 week intervention conducted over the telephone with recently returning veterans with recent suicidal ideation (n=22)
*Supported by the Department of Veterans Affairs, Veterans Health Administration, and the American Foundation for Suicide Prevention (AFSP) Project PRG (PI: Lauren M. Denneson, PhD)

20. Study Findings
Significantly increased psychological well-being; significantly reduced depression, perceived stress, anxiety, and PTSD symptoms
Effects were maintained 2 months after completion of the intervention

21. Qualitative interviews
Demonstrated participants’ positive experiences with the Whole Health Coaching intervention (n=18):
“Best experience I’ve had at the VA. Hands down. Nothing compares… My life is completely different from where it was [8 weeks ago], in a good way.”
“It’s liberating. It’s something that’s self-improvement. It’s hopeful, not hopeless.”

22. Qualitative Interviews
“You’re getting to know who people are as individuals; what makes them tick, what makes them what they are. You’re not doing this in a psychiatric way and that’s a beautiful thing. It’s adding encouragement, it’s exhorting one another and boosting each other up. It’s being a positive sounding board to encourage people that they have a purpose, that they have drive. I think you guys are doing that to an awesome level.”

23. Qualitative Interviews
“I got a direction I’m going in now, and I got a path to look forward to now. Whereas before, I didn’t see that. I guess you could say it illuminated the path.” “I’m in a lot better place. I’m not drinking and using drugs, I’m not sitting on the couch. I’m back to who I was before…I think [the program] is going to change Veterans’ lives, and I hope I can look back ten years from now and go ‘That program saved my life.’ And it really did, so thank you guys.”

24. Veterans Crisis Line—After The Call
VIDEO
Veterans Crisis Line—After The Call

25. Discussion
What are your thoughts on the impact of the Whole Health approach on a Veteran with suicidal ideation?
Make sure to have the group stand up and greet each other before departing. This is essential and is effective 100% of the time to shift the energy and increase community

26. LUNCH!

27. Whole Health Coaching
Group Coaching

28. Advantages for the Client
Learn from each other Support each other Reduced cost
As the group – what are the advantages for being in a group

29. Advantages for the Coach
Examples from other group members Greater number of clients served Education sessions Resource sharing from group members
Solicit from participants what the advantages are for the Coach in a group?

30. Advantages for Organization
Greater numbers Team building Cost
Reduced Costs
Reach a greater number of employees/clients
Create cohesive workforce
What is the benefit to an organization to have group coaching sessions?

31. Group Coaching Challenges

32. Group Coaching Challenges
Group/Individual /Interpersonal Dynamics
Different Health Issues
Confidentiality
Defusing negativity
Absences

33. Group Coaching Considerations
Open or Closed Group
Telephonic or in-person
Single-themed or multiple themed groups

34. Group Coaching Considerations
Process Model Considerations
Timing
Group Size
Giving each person equal time
People in different stages

35. GROUP PRACTICE