Prevention 2012 Conference, Orlando

Health Coaching in Real Life

2/22/2012

Eddie Philips, MD

Margaret Moore
(margaret@wellcoaches.com)

Introduction to Health Coaching

• Review of lifestyle medicine competences from JAMA 2010:202
• Today review competences #5, 6, 9
• Behavioral change pyramid: vision, preparation, action, results, best selfSee webinar by Coach Meg
• Goal: to provide insight for the patient
• Create conditions for this to occur in your patient interactions (be the catalyst)
• Twin engines for change: desire to change; believe that it is possible
• Resilience is the key to satisfaction of life: positivity ratio will determine success in change
• Being objective and less subjective is one of the components in changing
• "Insight to action" leads to an upward spiral of positive change
• Imagine the impossible: coaches see the butterfly in the chrysalis

Www.ncchwc.org National Consortium for Credentialing Professional Health and Wellness Coaches

• Coaching research studies: Am J Phys Med Rehab 2011:1074
• Outcomes to measure: performance, skills (the know-how to change), behavior, psychological resources

Coaching mechanisms of action:
1. Growth-promoting relationships: includes empathy, sharing of positive experiences
A) create mindfulness: be calm, positive, engaged
B) create empathy: physician empathy improves clinical outcomes. Academic Medicine 2011:359 (A1c scores among empathetic physicians)
C) foster self-empathy: be accepting, non-judgmental to self and others
D) recognize that autonomy is a universal, biological drive: we hate being told what to do
E) use open-ended questions: listen and not think about what you will say next; reflect what you heard
Be the facilitator (coach) not the expert (do not give advice right away); put your patient in the drivers seat

2. Self-motivation: build confidence(self efficacy) to unleash your motivation; motivation (importance of a certain behavior) and confidence are co-dependent; build confidence first

3. Capacity to change

4. Process or journey to change
Self-determination - the drive to thrive

Core universal biological drives
1. Autonomy
2. Competence
3. Connection: I care about others and feel cared for

Use your character strengths
Www.viacharacter.org to determine your key strengths

"what strengths can you use to achieve your vision?"

Increase self-efficacy
- start with behavior that has highest confidence score
- leverage strengths
- cultivate positive emotions
- a little is better than nothing
- fake it until you make it
- match skills with challenge, a little stretch
- set realistic behavioral goals
- celebrate success