Ch. 3 Coaching Behavior Change

Contemplation: I May

(**I mights need a strong motivator) Thinking about changing in the next 6 months They may express ambivalence Explore best experiences with change (focus on values and vision)

Action Level of MLC

Behavioral Steps Problem Solving Rewards

ICF CORE COACHING COMPETENCIES (11)

----Setting the Foundation--- 1. Meeting Ethical Guidelines and Professional Standards 2. Establishing the Coaching Agreement ---Co-Creating the Relationship--- 3. Establish Trust and Intimacy with the Client (Precontemp) 4. Coaching Presence (Precontemplation) ---Communication Effectively--- 5. Active Listening 6. Powerful Questioning (Preparation) 7. Direct Communication (Contemplation) ---Facilitating Learning and Results--- 8. Creating Awareness (Contemplation) 9. Designing Actions (Preparation/Action/Maintenance) 10. Planning and Goal Setting (Preparation) 11. Managing Progress and Accountability (Maintenance)

Coaching skills for Maintenance

--Assist these clients to reconnect and appreciate the value of new behaviors in serving their vision and goals --Challenge clients to keep growing --Assist them in establishing social networks --Never lose sight of the motivators that got them here --New motivators if necessary --If lapse happens, quickly get back on track --Avoid judgement at all times --If relapse occurs, go back to preparation and action coaching skills --Develop relapse prevention plan

General suggestions for coaching change in light of TTM

--Assist your client to frequently connect with their positive core: strengths, aptitudes, values and resources for learning and growth --Remind clients that change can be uncomfortable and difficult in the beginning. --Reassure clients that lapses are common during early stages NEVER LOSE SIGHT OF THEIR POSITIVE CORE! You can do it!

Coaching Skills for Preparation

--Concrete plan for change --Write down formal statement --Brainstorm small steps that are actionable and realistic --If they are ambivalent or resistant, help them identify ways to work it out --Coping strategies

Coaching Skills for Contemplation

--Connect them to their strengths and get them excited about change --Connect dots b/t the change they want and values --Personal compelling motivators (strong vision) --Identify real barriers vs. which can be worked out --Small realistic and thinking/feeling goals Small Goals at this stage: involve reading, thinking, talking, listening, discerning and deciding--NOT doing a behavior

Coaching skill for Precontemplation

--Sincere empathy --Use reflections You accept them where they are and do not intend to change a particular behavior

Coaching skills for action stage

--They need support. Help them connect their new behaviors with their strengths, values and social networks (preferred environments) --Target the small successes --Hang out with people like you (encourage them) --Anticipate and prepare for lapses --Reframe a lapse as a temporary setback --Not failure it's feedback --Move away from all-or-nothing mentality Jana. --Avoid high-risk situations that test client too much --Conduct a planned lapse (Great idea) --Develop coping strategies

Readiness to Change flow

1. Explore core, strengths, values and primary motivators 2. Co-identify their stage of change and one or more appropriate behavioral goal 3. Co-design strategies for quick wins and self efficacy 4. Discuss challenges and talk about solutions 5. Elicit client commitment for steps and effort for the week 6. Reconfirm their readiness to change and willingness to more forward

TO MOVE CONTEMPLATION TO PREPARATION TO AXN!

1. Find strong motivators 2. Understand their challenges 3. Identify possible solutions

KEY TTM POINTS TO USE IN COACHING

1. Help your client understand their readiness to change 2. Help your client choose the behaviors they are most ready to change 3. Teach them about the process of change 4. Help them build confidence in their ability to change

5 stages of change are:

1. Precontemplation (Not ready for change) 2. Contemplation (Thinking about change) 3. Preparation (Preparing for Action) 4. Action (Taking Action) 5. Maintenance (Maintaining a good behavior)

Difference between "I may" and "I will" person:

1. Why are you making this change now 2. What do you want to get from making the change? (motivator) 3. What is going to get in the way? (Barriers) 4. What are some the of things you might try to overcome the barriers? (Possible solutions)

when thinking about change, ask 3 basic questions

1. Why do I want to try and change the behavior (pros) 2. Why shouldn't I try to change the behavior (cons) 3. What would it take for me to change the behavior (what's my strategy to overcome my cons)

Processes that describe what people do to change

10 total: 5 are cognitive and 5 are behavioral

COACHING TIMELINE

3-6 months, possibly 12 months probably in contemplation or preparation stage for one or more behavior. may be in action stage

Operant Conditioning

A way to engage client in behavioral process of change: focus on the behavior and its consequences. Learning through positive and negative reinforcement.

Real me of MLC

Best Self

INTERNAL MOTIVATION!

Change for themselves, not external motivators

Most clients are in what stage

Contemplation and/or preparation stage for at least one area and coaching for 3-6 months help them to maintenance phase. As self-confidence grows, they may become ready to move forward in another area

Transtheoretical Model of Behavior Change

Developed by Prochaska is based on more than 25 years of measuring behavior change. This model is a blueprint for effecting self change.

Mount Lasting Change

Drawing from the cognitive and behavioral processes of the TTM, as well as from evidence-based principles of behavioral psychology and positive psychology -- MLCPyramid is graphic metaphor for health, fitness and wellness coaching.

Cognitive Process

Encompasses a wide range of reflective-learning processes in which people are sorting out their thoughts, feelings, and desires regarding a particular health-promoting change. 1. Getting Information: find out the benefits of doing it. 2. Being Moved Emotionally: Taking to heart the benefits and ignite your drive to change 3. Considering how your behavior affects others: ex. what your children see from watching you 4. Self-Image: Connecting the dots between vision-value and behavior to enhance integrity 5. Social Norms: Support group

Vision Level of MLC

Foundation for change. Bottom of the pyramid --Self Awareness & Responsibility --Strengths --Values --Benefits and information --Challenges and Strategies

Precontemplation: I Won't or I Can't

I Won't: Don't think they have a problem I Can't: Would like to change but don't think it's possible

Action Coaching strategies

I am: Relapse prevention plan Substitutions for healthier behaviors rewards Social support (family) Social norms (group) Environmental support (financial plans)

Contemplation Coaching strategies

I may: ambivalent they know barriers--identify possible solutions starting in next 6 months

Maintenance Coaching strategies

I still am: 6 months later early recognition of lapses and just-in-time coping strategies Substitutions Be a role model social support

Preparation Coaching strategies

I will: in the next month Some action has been attempted Brainstorm possible solutions Write down statement (cues) Social norms (groups) Social support (family)

Pre-contemplation Coaching strategies

I won't: use empathy I can't: help them sort barriers

PROGRESS ON GOALS TIMELINE

If they haven't made significant progress on certain goals over 3-4 weeks, question their commitment. May need intervention from dietitian, personal trainer, etc. wake up call

To Reverse a Relapse

It is important to reconnect clients with their strengths, values, resources, vision, goals and motivators. Restart the preparation and action process with judgement free listening, inquiries and reflections.

Maintenance: I Still Am

It's a habit, usually 6 months after started Confidence level to continue is 8 or 9 Self efficacy is high and self-reinforcing Lapses can occur

Results Level of MLC

Lasting Change Relapse Prevention

Mount Lasting Change Pyramid

Made up of 15 blocks, 13 are about thinking, not action. Five levels: 1. Vision and higher purpose for change 2. Preparation Level 3. Action Level 4. Results 5. Real Me

Preparation Level of MLC

Need moderate to high level of confidence need a 7 or higher Commitment Support Plan

LAPSE AND RELAPSE!

Need techniques for challenging situations A lapse is a single slip. Not necessarily a relapse. Success depends on: 1. Individual's response to the lapse 2. Perceived loss of control 3. Social network

Preparation: I Will

Planning to take action in the next month. Have a STRONG motivator They KNOW barriers and have some POSSIBLE solutions

5 stages of change model

Provide coaches with an understanding of how and when behaviors can be altered and why clients may struggle, fail or quit.

Mount Lasting Change Pyramid

The behavior change pyramid provides a guide to what it takes to make lasting changes in behavior, self-awareness, and self-image. 15 blocks: Top Block: being one's best self. 13 blocks: About thinking, not action (Action--3rd level)

Self-Efficacy

The belief that one has the capability to initiate or sustain a desired behavior. Circular relationship between belief and action: the more you believe you can do something, the more likely you will do it. --Nothing succeeds like success

AMBIVALENCE

The existence of coexisting and conflicting feelings. Normal state Assist client to accept ambivalence rather than fight it Doesn't need to be completely gone for client to get started (ex. getting up early to exercise)

TO DO NEW BEHAVIOR SUCCESSFULLY!

The pros have to outweigh the cons. That means early stage people need to find salient, specific, positive pros or motivators to honestly sort out of their cons

Decisional Balance

Weighing the pros and cons Pros or gains for self, gains for others, approval of self, approval of others Cons or losses for self, losses for others, disapproval of others, self-disapproval

Successful Operant conditioning looks for _______

antecedent conditions that may trigger an undesired behavior. (skipping breakfast--irritable--binge

Action: I am

doing the behavior consistently and working to the target level. --This stage lasts up to 6 months. Most coaching in preparation and action stage

Behavioral Process

encompasses a wide range of action-oriented learning processes in which people are experimenting with new health-promoting behaviors and adopting the ones that work. 1. Making a Commitment: write it down 2. Using cues: vision board 3. Using substitutions: carrot for a cigarette 4. Social Support: family and friends recruited 5. Rewards: rewards for weekly action goals