Essential Skills of Health Coaching:

Doug Post, Ph.D.

Learning Objectives

Describe motivational interviewing skills.Describe shared decision making skills. Describe health coaching skills.Demonstrate how to develop an action plan in

collaboration with a patient.

At the end of this session, students

will be able to

Motivational Interviewing Skills Ability to assess “stage of change” and conviction and

confidence about changing. Expressions of respect for patient autonomy in making a

choice. Eliciting the pros and cons of behavior change Listening respectfully to patients statements of resistance or

commitment to change, and reflecting them back to patients Collaborating and reaching agreement on goals that match

patients’ stage of change, conviction, and confidence. Avoid attempting to persuade patients with low conviction to

change behavior Avoid trying to direct or prescribe action plans if conviction or

confidence is low.

Motivational Interviewing Skills

Simple reflectionDouble-sided reflection Self-efficacy assessment

The Effective Physician Video Review of Motivational Interviewing

Shared Decision-Making

Find out the patient’s understanding of the problem, then share appropriate facts and answer questions

Find out what role the patient wants to play in decision-making Find out what is important to the patient: goals, values, etc. Present options that take into account the evidence and the patient’s

goals Obtain the patient’s thinking on options and answer questions Give recommendations and discuss the patient’s thinking Arrive at a mutually agreeable plan Discuss possible barriers or problems that the patient sees and work to

develop a plan to deal with them

Shared Decision Making Animated Short

The Patient Perspective

http://www.youtube.com/watch?v=XPm5iEDEI8Y

Shared Decision Making Video

Visit DocCom http://webcampus.drexelmed.ed

u/doccom/user/

Review the Video Example in 17 Shared Decision-Making

Clarence Braddock MD, Stanford University

Shared Decision Making

Elements of Effective Coaching

More listening

than talking.

More asking than telling.

More reflecting

than commenti

ng.

Not advising how to solve

problems.

More reflecting

than commenti

ng.

More reflecting

than commenti

ng.

Health Coaching Process

Assess patient’s current lifestyleAssess patient’s strengths and past successesAssess what is important to the person right

nowAssess what the patient wants to work on now

Patient Action Plan

Strategize to resolve expected barriers.

Strategize with the patient to prevent triggers.

Assess confidence level

What-How Much-When-How Often-How Confident

Can be achieved within a target period.

Something the patient WANTS to do, not SHOULD do.

Health Coaching Process

Conduct a needs assessment Coach the patient to develop an action plan of small

steps Guide, support, teach, and link the person to

resources Patient tries the action plan Follow up with the patient and develop another

action plan…

Health Coaching Example

Health Coaching Example Video

Telephone-based coaching video from OSU: Nutrition

What Happens Next

Perform a formative OSCE on health coaching skills

Work with a peer on health coaching skills

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