HES 3543 Final
Why set SMART goals?
-A SMART goal is one that the client is fully in charge of achieving and success is accountable to their efforts: -Assists clients in being specific about the steps and actions they are committing to. --Turn chaos into clarity -Helps clients to focus and mobilize their motivation around realistic and meaningful steps and actions
How does the process of brainstorming work?
-Encourage bold, creative ideas -Be positive and energizing -Be visual and specific -Go for quantity: --"What else could you do about this challenge?" --"Who else can support you in your efforts?" -Use summary and reflections to insure you are clear on what's being generated --Reflect those ideas that seem to really charge or energize your client -Examine multiple possibilities to help the client see that there are more options for success than they may have previously thought: --builds confidence -When appropriate and helpful, disclose information about the wide range of options and experiences of other patients -After multiple possibilities are generated, clients should identify which idea(s) they are most confident to use based on their resources.
What are the benefits of joining a professional organization?
provides professional support provides professional resources makes you more attractive to employers
Upon what are core values based?
self-worth competence autonomy relatedness Spirituality
What is brainstorming?
the rapid generation of ideas and possibilities that will help a client reach their vision
which motivational interviewing (MI) skills are designed to create a safe space for clients to explore ambivalence?
-Express empathy -develop discrepancy -Come along side the client -Roll with resistance -support self-efficacy
What are the tips for success when exploring motivation?
-Help your client identify motivators that: reflect core values in behavior reflect positivity are intrinsic outcome-oriented motivation should NEVER be a reflection of fears or cons about not changing
what are the reasons for becoming certified?
-Makes you more attractive to employers >Insures to employers that you have the minimal core competencies necessary to function in the capacity of a coach or to utilize coaching skills in your prospective position. >Insures consistency with a specific paradigm of health coaching >Shows your ability to commit to a task and follow through with that commitment >Shows your knowledge of and commitment to the recognized credentials of your chosen career discipline >Allows you to meet employment qualifications
what are the behavioral signs of resistance?
-Negative Talk -Distracted, or not engaged during session -Conflicts with coach -Deflecting responsibility
Which coaching skills and techniques are useful when exploring challenges and solutions in a positive way?
-OARS, especially perceptive reflections -Decisional Balance -Deep Scaling -Perceptive reflections -Brainstorming -A Typical day. . . -Cognitive-Behavioral Therapy Techniques --Stimulus control --cognitive rehearsal
What are some other tools for addressing lapses?
-Revisit your client's 3-month goals and their wellness vision to insure they are still relevant, especially when it's apparent that the goals and/or vision are no longer relevant --Regardless of a lapse, this should be done every few weeks -Use perceptive reflections to illuminate and/or act on "Aha!" moments that may assist clients in identifying the underlying cause of a lapse -If the lapse is even partly your fault (for example, you persuaded the client to choose an activity that they were only eager to do because you suggested it), take responsibility
What exactly does the acronym SMART stand for?
-Specific: address ONE behavior or outcome -Measurable: Measurement of goal achievement is central to showing your client their success. -Action-Based: wellness coaching goals should not be based ,on feelings, emotions, moods, attitudes, etc. -Realistic: goals are achievable but challenging so clients feel a sense of accomplishment when they are met -Time-line: gradual change leads to permanent change.
Why do coaches explore the highlights of the past week at the beginning of a weekly follow-up session?
-Triggers positivity right from the start of the session. -May help clients remain open to a productive discussion and creativity, especially if they have not been successful with their weekly goals
what are the benefits of resistance?
-When a coach effectively engages their doing and being skills, especially perceptive reflections, some resistance can actually provide the kind of energy in a coaching session that generates: --Relational flow --"Aha" moments --deeper rapport --a spark that moves a client to the next stage of change
how do you know you've got it right when using the typical day coaching tool?
-You are doing very little talking -The client seems engaged in their story -You are learning lots of interesting information, both verbal and non-verbal, about the client, their situation, their perceptions, etc.
What are the benefits of brainstorming to the client?
-enables clients to: --develop creativity in their approach to change --design the most successful plan for change. --see challenges they may face as having multiple possible solutions ---↑ Self-efficacy Reinforces rapport because coaches and clients co-generate a wide variety of possible ideas for consideration.
what are the "don't's" when using the typical day coaching tool?
-fire a series of investigative questions at a person -Interrupt a client during their recall to pursue a "problem" in more detail -Force the acquisition of "thorough" details about their typical day
What steps does Wellcoaches suggest you take if you suspect your client is self-sabotaging?
1. Level with the client about your perception that the client is self-sabotaging with a non-judgmental question 2. Get the client to acknowledge the self-sabotage 3. If your client is still in denial, recommend that the client see a therapist or support group. The client can work with you and the therapist concurrently. 4. You can also revisit the "am I ready to change" quiz and go over the pros and cons for the behavior. 5. We can't help everyone, and letting go of an uncooperative client who is unwilling to work on the deeper issues may beinevitable.
Can 3-month goals be based on outcomes? If so, what must weekly goals include?
3-month goals are based on bringing a client closer to some aspect of their overall wellness vision: If goals are outcome-based, weekly goals MUST reflect the actions or behaviors that will lead to their desired outcome
what are the tips for success when assisting clients to resolve challenges to change?
>Keep the solutions simple >Empathize, but don't awful-ize a challenge >Assess and Reassess Confidence >Affirm situations where self-efficacy is high >Explore situations where self-efficacy is low, looking for opportunities to increase it
what are the challenges associated with group coaching?
>Maintaining consistency of groups with a fixed program start/end date --limits availability >Open groups with no set program start/end date increase availability and consistency -newcomers may not feel welcomed dynamics shift overtime making cohesion difficult
what are the reasons for becoming a nationally board certified health and wellness coach?
>National standards and board certification are based on extensive research. >is accelerating the professionalization of health and wellness coaching, and enabling the growth of an evidence base. >has identified reputable coach training and education programs to prepare for the board certification. >allows proficient coaches to stand apart from coaches who have not received adequate coach training or assessment of their coaching skills and knowledge.
what are the benefits of using the typical day coaching tool?
>Provides a wealth of information about the client's world >Can be used at any point in a coaching session but works well in the challenge discussion >Facilitates exploration of both challenges and solutions in a naturally flowing way >Can illuminate faulty perceptions about challenges >Leads well into the brainstorming process
What are the elements of a typical group coaching session?
>Start each session with a declaration of the group guidelines, especially if there are new members attending >Check-in with each member asking them to share what went well/what's the best thing that happened in the past week >Identify a common theme or coaching question to discuss for that session. >Theme discussion-once identified, ask specific questions related to the session's theme inviting each group member to respond and discuss
How should a coach address a lapse?
>Thoroughly explore the lapse to understand why a weekly goal was not met >Define new strategies, or re-explore old ones, when its evident the initial strategies did not or no longer work.
What are the benefits of group coaching to the coach?
>cost-effective >smaller time commitment overall >can be just as effective as individual coaching >amplifies and strengthens coaching skills
What are the benefits of group coaching to the client?
>more affordable >increases access and potential population impact >the energy and dynamics of a group environment provides opportunity for shared ideas and learnings >encourages creativity and courage to try new things >creates a sense of community/belonging that empowers change >provides opportunity to network
why do coaches use a 3-month timeline when coaching clients?
A three-month timeframe is short enough to provide a sense of urgency about achieving weekly goals, but long-term enough to allow time for internalization of change
Why do we encourage clients to create a wellness vision?
A wellness vision, is the foundation for change. It answers the question, "Who do I want to be?" With the assistance of a coach, the client creates a clear picture of their best self and everything that contributes to making that picture real and alive.
How should a coach help clients in the action and maintenance stages define new strategies to prevent relapses?
Brainstorming Cognitive rehearsal
What things should be communicated to a client when establishing rapport and trust?
Coaching Policies: -Informed consent -Confidentiality -Referrals -how and when •Definition of coaching: Clearly explain what it is . . . -Growth-promoting relationship, building a new mindset, empowering change -and what it's NOT •Coach telling the client what to do and how to do it •Discuss "Establishing Rapport and Trust" hand-out
What can cause the confrontational trap?
Confrontation may be the result of a client perceiving a threat to their autonomy: -Can trigger an unconscious need to defend their position, regardless of its validity.
when reviewing each weekly goal with a client, what do coaches discuss first?
Discuss successes FIRST Keeps up the positivity level and the ability to engage in a generative dialogue that is more productive
what is extrinsic motivation? (Be able to recognize an example of this type of motivation)
Driven by external core values such as one's need for relatedness, adaptation to environmental factors and external rewards Based on: external regulation (someone telling you what to do) and external rewards (fitting in a dress)
why is good rapport essential?
Essential for: -an honest discussion -constructive understanding of clients' behavior -Creating openness to change/stage of change -Creating trust-Thorough exploration
what are the types of resistance that can be caused by the coach?
Expert Trap --provides direction or suggestions to the client attached to the end of an open question without first allowing the client to explore his or her own choices. Premature Focus Trap --Did not explore assessments, vision, values, strengths, etc. thoroughly or deeply enough ---Did not thoroughly brainstorm options for goals, overcoming challenges, finding solutions or supportive relationships --Did not check confidence often enough Labeling Trap --assumes rather than assesses a client's stage of readiness, attitudes or perceptions about change, etc.
How can coaches avoid triggering the types of resistance?
Expert Trap >>Support Autonomy AT ALL TIMES: keep your exchanges focused on the client's ideas, choices and control whenever possible Premature Focus >>Check the accuracy of your formal assessments >>Effectively use all your doing and being skills >>NEVER settle for the first idea, value, motivator, solution, etc. ALWAYS go for deep exploration >>Check and re-check confidence and motivation throughout the session Labeling Trap >>Engaging all your being and doing skills, especially active and reflective listening, helps insure accurate assessment of the client >>Check your judgments at the door.
What are the keys to reducing challenges?
First, set SMART goals (Simple, Measurable, Actionable, Realistic, Time-lined) Connect the client's vision, motivators, desired outcomes, and goals to the process of addressing challenges: personal strengths, importance/values, exposes ambivalence and confidence issues that could impede success
Which processes of change are effective in preventing relapse when working with clients in the maintenance stage? (Be able to recognize examples of the use of these processes of change)
Helping Relationships = Supportive Relationships Processes that come from CBT: ---Counterconditioning ---Contingency management-also called reinforcement management or operant conditioning ---Stimulus Control
What might be the consequence of a coach engaging in the confrontational trap?
If this argument escalates or continues for too long, it can cause irreparable damage to the trust and rapport between a coach and a client
What is NOT considered group coaching?
Individual coaching with more than 1 person Health behavior education Group therapy
Upon which type of motivation is integrated regulation based?
Intrinsic motivation
Why should you assess and reassess confidence while exploring challenges and solutions?
Levels of confidence will vary throughout the process of identifying solutions to their challenges. Helping a client to stay aware of their confidence levels will assist them in identifying the most effective solutions to challenges
What is the relationship between confidence and self-worth?
Low self-worth can underlie a low confidence level Success with small changes can not only enhance confidence, it can have a positive impact on self-worth
What is intrinsic motivation? (Be able to recognize examples of this type of motivation)
Motivation that is based on internal core values such as autonomy, competence and self-worth that is internally driven
Why is it important to set realistic goals?
Realistic goals can increase confidence Realistic goals are achievable but challenging so clients feel a sense of accomplishment when they are met increases self-efficacy -> increased motivation
What strategies can a coach use avoid the confrontational trap? (Be able to recognize the use of these strategies use)
Roll with Resistance Shifting Focus Develop Discrepancy Use perceptive reflections >>amplified reflection >>Double-sided reflection
Who would make an appropriate social support? (Be able to recognize different examples of social support)
Social support can be provided by professionals (e.g., trained coaches), peers, friends, or family members. --Peers can be strangers, or existing members of the same social network.
What is the purpose of identifying social support?
Social support is an intervention component geared towards: -Directly supporting specific behavior changes. -Creating an environment that is helpful to individuals in making behavior change -Developing skills to build support.
what are the steps to establishing rapport?
Step 1: get yourself into the right mindset Step 2: Greeting Step 3: introduce yourself Step 4: find your clients initial perspective on coaching Step 5: define coaching and the coaching process Step 6: explain your objectives for the first coaching session
What is group coaching?
The application of coaching principles applied to a group of participants working towards a common purpose
What elements make the best wellness vision?
The best wellness visions: -support and promote core values -are based on strengths and resources, NOT on deficits or, what they DON'T want -are written in action words, as if the client sees it happening in their future -are written in the client's voice
when are group coaching sessions most effective?
There is a common theme among group members >Weight management >Smoking cessation >Healthy eating >Stress management Member numbers are no less than 6 but no more than 10 The number of group members are even >Allows for buddy peer coaching between group sessions They are kept to 60-90 minutes in length >Keeps group energized The group meets at least bi-weekly >Allows for buddy peer coaching between group sessions.
what are core values?
Those elements in a client's life that define them and make life worth living
Be able to tell the difference between a vague 3-month or weekly goal from a specific 3-month or weekly goal and be able to rewrite each to be specific if asked.
Vague - I will be exercising more. Specific- I will be walking at a moderate pace at the gym five days per week for 30 minutes. Vague - I will be eating less fast food. Specific- I will only be eating fast food lunch meals 2 times per week. Vague - I will be eating more healthy Specific- I will be eating 2 servings of vegetables for lunch and 1 serving of vegetables for dinner every day.
What is resistance?
Verbal exchanges and/or behaviors that indicate a client is ambivalent or conflicted about changing.
Why do coaches continually assess confidence throughout the SMART goals process?
a client's confidence levels are dynamic and specific to each goal
Should weekly goals be action-oriented or outcome-oriented? Why or why not?
action-oriented weekly goals must be behavioral steps
What causes resistance?
anxiety fear apprehension about change, inner conflict low-self-worth low-self-efficacy
What is self-efficacy?
confidence that one can engage in the goal behavior(s) or achieve the desired outcome(s) in the face of changing, challenging or tempting situations
Why is the first session typically the longest?
due to content: Establishing rapport Review of Policies and Procedures Discussion of assessments Exploration of motivation, resources and wellness vision for the future, setting of long-term wellness goals
What is the benefit of a lapse?
every lapse is an opportunity to learn more about what works, what doesn't work, and adapt themselves and their plan accordingly
Why should you scale confidence after each goal is defined?
exploring why confidence is not higher should illuminate challenges to goal attainment
What is the role of the coach in group coaching?
facilitate discussion and group support, Guide group dynamics wear their coach hat at all times
Upon which type of motivation is introjected regulation based?
form of intrinsic motivation driven by self-imposed expectations
What is the benefit of using contingency management to overcome a lapse?
gets clients to focus on the relationship of a behavior and its consequence
why do coaches ask the client for feedback at the end of every session?
important both for your own learning and for your client's growth
why do coaches conduct a monthly review of a client's 3 month goals?
in order for the weekly goals to stay connected to the client's larger vision and purpose. It is motivating and empowering to connect the dots between success with smaller, incremental steps and larger life goals.
What is integrated regulation?
intrinsic motivation based on the value of the outcome, regardless of enjoyment or interest: the behavior is performed for the sake of the outcome
What is introjected regulation?
intrinsic motivation based on the value of the outcome, regardless of enjoyment or interest: the behavior is performed for the sake of the outcome
Once a good rapport is initially established, is it established once and for all?
no, they can be earned, or lost during every moment of every coaching conversation.
