“Life coaching,” or “co-active coaching,”can serve as either an adjunct or an alterna-tive to traditional modes of psychotherapyfor people living with HIV. Coaching, likepsychotherapy, is a professional client-centered relationship that relies on thetransformative possibilities of the relation-ship to move clients toward change in theirlives. The focus is on the present and futureand on concrete action, making it a particu-larly useful approach for providers helpingpeople with HIV deal with the practicalissues they face as health improves.

As medical advances have changed thelives of so many people with HIV, corre-sponding mental health needs have alsochanged. Prior to the advent of combina-tion treatments, clients were most likely tocome to therapy with concerns about fail-ing health, loss of identity, dependency,and death and dying. Clients presenting for mental health treatment today are morelikely to raise issues related to quality oflife, returning to work, re-establishingrelationships, shifting out of an identity as a “patient,” and planning for a future be-yond disability and dying. Within the con-text of these shifts, this article discussessome of the basic concepts of coaching andexamines the pros and cons of coaching incomparison with mental health treatment.

The Coaching ProcessTraditional mental health treatment—

particularly psychodynamic psycho-therapy—seeks to understand currentdilemmas through insights into past expe-riences. The client’s relationship with thetherapist, as well as explorations of his or

her past and present relationships withothers, provides the basis for understand-ing current actions and thoughts. Imme-diate, concrete action may or may not be a goal of psychotherapy. The emphasis ison insight, on making the unconsciousprocess into a conscious one, in this wayincreasing choices and improving a senseof well-being.

Co-active coaching can be defined as “apowerful alliance designed to forward andenhance the lifelong process of humanlearning, effectiveness, and fulfillment.”1

It provides an avenue for action for thosewho are grappling with how and where tomove in their lives and for those whowant to focus more on the present than on the past. Coaches are trained to assistpeople in “optimizing their performanceand deepening their satisfaction in life.”2

In a coaching relationship, the coach actsas a peer whose job it is to help move theclient forward. The client is expected to be aware of what he or she needs and to beable to ask for that from the coach. Struc-tured exercises and interventions, com-bined with active listening and questioning,provide the basis for the work betweenclient and coach. The coach and clientdesign their relationship intentionally and cooperatively, agreeing on everything,including the length and time of sessions,the most effective ways to interact, con-crete goals, tasks the client will accomplish,and the method the client will use to reportback to the coach. In this context, clientaccountability is an essential tool.

Coaching relies heavily on basic coun-seling techniques, most notably, activelistening, which offers the healing poten-tial of being listened to in a focused way.Coaches are trained to listen to content as well as process and are encouraged tocomment on both. Interventions consist of “powerful questions” and “inquiries,”questions or observations designed to

OOCCUUVolume 15 Number 12 November 2000

FF A Guide toAIDSResearch and Counseling

SSCo-Active Coaching: An Alternativeto HIV-Related Psychotherapy Miriam Garfinkel, MA, LMFT

enhance clients’ understanding or senseof themselves. Coaching also applies theself psychology notion of internalizedself-objects through the concept of “grem-lins,” the internal voices or self-concep-tions that impede the ability of the clientto expand his or her sense of self.

The Foundations of CoachingAt the foundation of coaching are three

principles: fulfillment, balance, and pro-cess. Fulfillment refers to a feeling ofharmony—a sense of consistency withone’s values and with a vision of a future.Fulfillment coaching involves helpingclients discover what is truly important tothem, to understand which areas of theirlives they need to enhance, and to movethem in that direction of change. Thegenesis of the values is not particularlyimportant. Values clarification exercisesmay include prioritizing aspects of lifethat are important to a person or doingguided visualizations of the future.

Balance refers to the dynamic process ofcontinuously making choices that allow a

person to maintain a sense of equilibrium.Balance coaching examines the aspects oflife in which clients want to make changes,but about which they feel powerless to doso. Exercises for balance coaching mayinclude designing a “wheel of life,” a circlethat inventories the various aspects of aperson’s life by dividing the pie into com-ponents such as relationships, family, fun,spirituality, and work, and assigning aranking to each slice according to level of satisfaction. Powerful questions, a termused to connote queries from the coachthat provoke thought, affect, and under-standing, can then be used to help clientsdevelop plans to recalibrate the parts oftheir lives that are out of balance. Unlikepsychotherapy, explorations of the reasonsfor the feelings of powerlessness havelittle importance. Insights into the originsof the imbalances are important only in so far as they forward the action towardresolving them.

Process coaching is the closest of thecoaching approaches to traditional coun-seling. Process coaching refers to focusing

FOCUS2 November 2000

Psychotherapy as a formalapproach is barely more than100 years old, so it should be asurprise to no one that it keepsevolving and branching out,backtracking and leaping for-ward, rethinking and rejectingaccepted tenets. In the last 50years or so, psychotherapy hasgrown from hidden (and shame-ful) to commonplace.

Sprouting like an aspen forestfrom the mother tree, other“talking cures” have grown fromthe root stock of traditionalpsychotherapy. While our cul-ture has not rejected the ideal ofthe silent, self-sufficient hero, itno longer recoils from the char-acter who shares his or her pain,and such sharing happens every-where now.

Out of the crowded forestcanopy has peeked a relativelynew approach: co-active or lifecoaching. In this issue of FOCUS,Miriam Garfinkel and EileenBlumenthal describe the princi-ples and strategies of coaching

and discuss how this approachcan be applied in the context ofHIV. Garfinkel focuses on individ-ual clients and makes a cleardistinction between coaching andpsychodynamic psychotherapy,explaining the context andstrengths of each. Blumenthalsuggests an application for coach-ing in terms of organizationaldevelopment and the challengesfacing AIDS service organizations.

Therapy Lite?Coaching—like brief or time-

limited psychotherapy andphilosophical counseling—maybe seen by some as “therapylite.” It consciously emphasizesan exploration of the presentover the past, de-emphasizes therole of transference, and focuseson “forwarding action” towardspecified goals. It does notignore psychological barriers,but seeks practical solutions tothem. In this way, it seems well-suited for some of the tasksfacing people with HIV as the

epidemic shifts and as healthimproves: making decisionsabout treatment and makingplans for the future.

Unfortunately, “lite” alterna-tives to traditional psychothera-py have been tainted by anassociation with managed careand the financial limits of treat-ment. Since managed care cancripple traditional psychothera-py by restricting the type andlength of treatment, it hasforced providers to employ lessintensive and less sufficientapproaches to more seriouspsychological distress rangingfrom depression to trauma. Butthere are appropriate applica-tions for these approaches, andfor some people facing someproblems, more practical strate-gies may be less threatening,more consistent with their out-look, and more effective.

HIV-related care has alwaysbeen associated with flexibilityand evolution. It is useful toremember that in the grandscheme of things, psychothera-py is also youthful enough tobend and grow, to benefit frombeing eclectic.

Editorial: Forward ActionRobert Marks, Editor

FOCUS3 November 2000

on emotions that arise for clients duringcoaching. The exploration of these emo-tions is important as long as it forwardsthe action. A coach’s willingness to allow a client to experience these feelings isessential, but, again, the origin of thefeelings is less important than theirexpression and the movement throughthem toward change. In this area, in par-ticular, coaches are trained to understandthe limits of their scope of practice and torefer clients to formal mental health treat-ment when intrapsychic factors surfaceand impede forward movement.

An important difference between coach-ing and psychotherapy is the de-emphasisof transference. According to coachingtheory, the emphasis on the client and theclient’s agenda precludes the usefulnessof transference in thecoach-client relationship.The coach’s role is toserve the client by sup-porting the client’s agen-da; the client’s role is todesign that agenda. Whileit can be argued from amental health perspectivethat transference is anunavoidable byproduct ofthe counseling process,coaching theory holdsthat transference neednot become a focus. Asuccessful coaching rela-tionship is thereforedependent on a client’sability to separate thedevelopment and pursuitof goals from theinevitable transferentialexperience. This is alsoconsistent with the coach-ing focus on the presentversus the past and on the main goal ofaction and forward movement. The hypo-thetical case of “Robert” and his coach“Tom Rosen” illustrates the coaching pro-cess, its distinction from psychotherapy,and its application to HIV.

The Case of Robert: Embracing the FutureRobert, a 50-year-old gay man of

European American descent, has beenliving with HIV for 15 years. He hasworked in the design department of amajor retail store for the past 25 years.Robert, the middle child of three siblings,grew up in a working-class home with analcoholic father and co-dependent mother.He lives with his current partner of eightyears, who is also HIV-positive and in poor

health. Robert lost his prior partner of 10years to AIDS.

Robert describes himself as a “simpleguy” who loves to work with his hands. Hehad figured out many years ago that thefinancial security, health insurance, anddisability benefits afforded him by his jobwould be important when he became ill.Robert began taking combination antiviraltreatment about five years ago. His healthhas improved, and his doctors have toldhim that he could remain healthy for along time. Robert comes to coachingbecause he realizes that he does not likehis job, and has not for a long time, andthat he cannot count on leaving, as herealizes he once did, due to failing health.

After helping Robert define his goals forcoaching, his coach, Tom Rosen, negoti-

ates frequency ofcontact, methods ofcontact (telephoneversus in-person), andlocations of visits, andasks Robert about thetypes of interventionthat have helped himin the past. Rosenthen uses active lis-tening and powerfulquestions as well aspositive reinforce-ment and “champi-oning”—encouragingRobert and expressingfaith in him—to helpRobert explore and re-evaluate who he isand who he wants to be. For example,Rosen asks Robert toask himself powerfulquestions such as:“What does it mean to

decide to live?” “Who am I becoming as Igrow older?” “How have I withheld myselffrom life?” “What do I like or not like aboutbeing a ‘simple guy’?”

As Robert begins to think about himselfin a broader way, Rosen suggests lookingat the question of balance in Robert’s life.He asks Robert to complete a wheel of life,helping Robert define those aspects of hislife on which he would most like to focus.Work remains the central focus, butfriends and fun surface as other areasRobert has not previously made a priority.Rosen leads Robert in a guided visualiza-tion, having Robert imagine himself andhis values 25 years in the future. He asksRobert to think back to a time when hefelt excited and fulfilled: “What were you

References

1. Whitworth L,Kimsey-House H,Sandahl P. Co-ActiveCoaching: New Skillsfor Coaching PeopleToward Success inWork and Life. PaloAlto, Calif.: Davies-Black Publishing, 1998.

2. Kimsey-House H,Whitworth L, Kimsey-House K. The CoachesInstitute TrainingManual. San Rafael,Calif.: The CoachesTraining Institute,1995.

A successfulcoaching

relationship isdependent on a

client’s ability toseparate the

development andpursuit of goals

from the inevitabletransferential

experience.

Authors

Miriam Garfinkel, MA,LMFT, has worked withpeople with HIV forthe past 12 years in avariety of direct careand managementpositions. She current-ly works part-time asa Senior Trainer withthe UCSF AIDS HealthProject, developingcurricula and train-ings for HIV providersthroughout California.Ms. Garfinkel main-tains a psychotherapypractice in SanFrancisco and hascompleted extensivecoursework at theCoaches TrainingInstitute in San Rafael.

doing?” “Who was around you?” “Whatimpact were you having on them?” Theseimages help provide Robert with a guidefor making choices today.

During each session, Rosen encouragesRobert to develop action steps related tohis chosen goals, priming Robert to thinkabout how his goals relate to what isimportant to him and his values, as wellas how he can maintain a sense of bal-ance. Their sessions frequently end withRosen and Robert agreeing to action stepsthat Robert will take between sessions andto methods of accountability. For example,Robert realizes that a sense of autonomyis important to him, that he no longerwants to work in retail, and that maintain-ing benefits is essential. He has someideas about other types of jobs, specifical-ly, cabinetmaking. Rosen asks Robert if hewill agree to call three people who mightbe able to help Robert make this decisionand to e-mail Rosen every time he makes acall, an intervention that will help Robertfulfill his commitment. If Robert says “no,”Rosen may ask him what would workinstead. If Robert cannot keep his commit-ment, the pair will talk about what did notwork for Robert and use that informationto formulate a new commitment.

In addition, Rosen helps Robert namehis gremlins, the parts of him that doubthis abilities or potential. One of Robert’sgremlins generally appears as Robertbecomes excited about the possibility ofgoing into business for himself: Robertbegins to list all the obstacles. While dis-cussing the ways in which Robert holdshimself back and what it would mean forhim to accept the excitement, the processuncovers gremlins from Robert’s familyhistory: the voices that say he should begrateful to pay his rent, that ask him whohe thinks he is to consider having his ownbusiness. It also uncovers present-daygremlins, those grounded in concernsabout benefits and security. Rosen asksRobert to give his gremlins a name, there-by externalizing these voices and enabling

Robert to both acknowledge them and setthem aside.

Throughout the coaching process,Rosen devotes time and attention to feel-ings that come up for Robert. Robert criesas he talks about his family’s financialstruggles when he was growing up and theimpact of his father’s alcoholism. Hespeaks of his terror in thinking aboutleaving his job. Robert is surprised to findhimself crying as he talks about becomingolder and remembers the friends andlovers he has lost to HIV. Rosen listensand asks powerful questions: “What is itlike to lean into this fear?” “What doesabundance mean to you?” or “What wouldyour friends or lovers want for you as anold man?” In each of these cases, Rosensustains the focus on Robert’s agenda andactions that will achieve the agenda.

Rosen is vigilant about the apparentsymptoms of major depression, and consid-ers referring Robert for a mental healthevaluation, particularly if Robert becomesunable to take concrete actions, is paralyzedby fear or grief, or is unable to use his emo-tional expression as a tool to forwardaction. Rosen is also aware of the potentialfor Robert’s transferential experiences withRosen—either positive or negative—to com-plicate the coaching relationship andrequire referral to a psychotherapist.

ConclusionAn HIV diagnosis can cause some people

to question lifelong assumptions, to re-evaluate aspects of their lives, and to decideto move forward with intention and choice.For such individuals, coaching can be ahelpful tool. It may be an optimal choice forthose people with an orientation towardsmovement and action and little interest inthe process and premise of psychodynamicpsychotherapy. Psychotherapy may be moreappropriate for those who wish to explorelongstanding family or relational issues,people who have historically had difficultywith moving forward or who are strugglingwith depression or anxiety.

FOCUS4 November 2000

ResourcesThe Coaches Training Institute, 18792nd Street, San Rafael, CA 94901; 800-691-6008; 415-460-6878 (fax);http://www.thecoaches.org (web site).Coaches training program and coachreferral service.

Coach University, P.O. Box 25117,Colorado Springs, CO 80936-5117; 800-482-6224; 800-329-5655 (fax);http://www.coachu.com (web site).Coaches training program and coachreferral service.

The International Coach Federation,

1444 “I” Street NW, Suite 700,Washington, DC 20005; 888-423-3131;888-329-2423 (fax); http://www.coachfederation.org (web site). Thelargest professional group; accreditscoaches and training programs.

Mentor Coach, 4400 East WestHighway, Suite 1104, Bethesda, MD20814; 301-986-5688; 301-913-9447(fax); http://www.mentorcoach.com

Clearinghouse: Coaching

FOCUS5 November 2000

Since change in the HIV epidemic hasalways been a hallmark, AIDS serviceorganizations face the considerable chal-lenge of remaining relevant and effective.The success of recent advancements in

the treatment of HIV diseasehas yet again altered the land-scape of the epidemic, and as aresult, many organizations arestruggling to adjust.Essentially a tool for generat-ing action that is consistentwith personal and organiza-tional goals, coaching offersnew resources for organiza-tions to remain fluid anddynamic in the context ofthese extraordinary times.

Coaching can help organiza-tions clarify values, create a shared vision, and provide a pathway for realizing thatvision. It can help developmanagers who challenge,champion, and inspire action.It can create an organizationalclimate in which accountabilityis expected and rewarded,staff are highly motivated, andclients have the resources andcapacity to make informed

decisions. In the face of constant change,coaching can restore an organization’sfocus, help it to thrive, and most impor-tantly, help it help people affected by HIVmanage change.

The Coaching ModelConsider an AIDS service organization

in a city at the HIV epicenter. Infectionrates are increasing. Federal funding isdiminishing. Antiviral treatment protocolsare complex and confusing. Staff turnoveris on the rise as people who have workedwith HIV move on and others are wooedaway by increasing opportunities in theprivate sector. The agency’s board ofdirectors, confused about its role, haslittle knowledge about emerging HIV-

related trends and limited facility in artic-ulating organizational vision. Managers,while experts in their fields, lack theexpertise or the will to improve the per-formance and satisfaction of staff theysupervise. The question of how to thrivedevolves into the crisis of how to survive.

Traditionally, a non-profit agency mightturn to an organizational developmentexpert or other consultants to respond to this situation. A consultant would helpthe agency assess the problem, design aresponse, and manage the implementationand, perhaps, the evaluation of theresponse. The agency would rely on theconsultant’s experience and expertise inthe field. By contrast, a coach’s role wouldbe to help individuals or a group articu-late and achieve very specific goals in avalue-based, sustainable context. Thiscoaching relationship is confidential, and the coach primarily asks provocativequestions, provides a structure for focus,and holds individuals accountable fortaking action and achieving results. In thismodel, the coach is not an expert impart-ing knowledge or managing a project, butrather, a resource who works with individ-uals to develop an agenda, commitment,effectiveness, and personal fulfillment.

In his book, Masterful Coaching, RobertHargrove writes, “Transformational coach-ing within organizations involves unleash-ing the human spirit and expandingpeople’s capacity to achieve ‘stretch goals’and to bring about real change.”1 An orga-nization grounded in a coaching model is characterized by: clarity regarding thevalues that drive the organization; ashared vision rooted in organizationalvalues; a strong connection between val-ues, vision, and action; a deep and palpa-ble commitment to unearthing people’spassion; a culture of high performance andhigh accountability with continuous learn-ing; and a management approach designedto elicit commitment, expand capacity,inspire action, and champion effort.

Applications of CoachingOne of the most important applications

of coaching is conceptualizing the roles of the key players in an organization. This includes everyone from the board ofdirectors to front-line staff and can extendto collaborating agencies.

Coaching AIDS ServiceOrganizations Eileen Blumenthal, JD, EdM

While it maynot change the

epidemic,coaching can

help an agencybecome more

dynamic,innovative, and

successful infulfilling its

mission in themidst of change.

Boards of Directors. Rather than gettingentrenched in an organization’s dailyactivities, ideally a board of directorsfocuses on the larger perspective, identify-ing emerging trends and setting overallstrategy. Coaching can help a board man-age itself by defining its role, helping itremain within these bounds, evaluating itsown performance, and holding staff, par-ticularly the executive director, account-able for achieving the organization’s goals.

Executive Directors. Coaching can helpexecutive directors become deliberateabout building relationships and inspiringcommitment. Executive directors makeconnections between the concerns of the organization and the staff. Coachingencourages executive directors to culti-vate a climate that values continuouslearning and “purposeful action,” and toinfuse staff with a sense of possibility. It helps them model and awaken “break-through thinking,” and fashion a work-place that fosters a commitment to greatwork and a comfort in disagreeing, ques-tioning, and raising concerns.

Managers. Coaching can help managersevolve from problem solvers to catalystsfor helping staff solve their own prob-lems. Coaching encourages managers to use questions to evoke clarity, action,discovery, insight, and commitment. Thisenables managers to work with staff to set meaningful, achievable, and inspiredgoals. In doing so, managers help staffarticulate direction while actively moni-toring staff progress, rather than directingor manipulating staff. By challenging andchampioning staff—and holding themhighly accountable—managers seek todevelop staff members who do their jobsbetter than the manager could.

Front-Line Staff. Front-line staff can usecoaching to facilitate relationships withclients rather than managing them as part of a caseload. As coaches, staff help clientsdefine their own agenda. In their book Co-Active Coaching, Laura Whitworth, HenryKimsey-House, and Phil Sandahl suggestthat the coach “let go of his or her ownopinions, judgments, and answers in sup-port of the client’s fulfillment, balance andprocess.”2 They suggest that the coachbecome “invisible” and follow the client’slead. Implicit in this approach is that thestaff member, as coach, engages in powerfulquestioning that helps clients clarify theiragendas, intervenes when clients are stuck,and constantly reframes so clients gain newperspectives. In this way, staff can help cli-ents create practical ways to achieve goals,can acknowledge and champion their cli-

ents, can challenge clients to reach beyond

assumptions and limits, and can help clients

act in ways consistent with their well-being.

Strategic Planning and Collaboration.

Coaching designs the ideal circumstances

for strategic planning, through which ini-

tiatives emerge from within a group of

organizational stakeholders—including

staff, clients, volunteers, and representa-

tives of collaborating organizations—rather

than being driven from agency leadership.

It begins by creating trust and designing

alliances among the people involved in the

process, ultimately building shared under-

standings. This ideal of alliance is also

relevant to collaborations between agen-

cies—an act of expanding capacity in the

pursuit of a clear and common goal.

Conclusion

The coaching model anticipates and

helps prepare for change. While it may

not change the course of the HIV epidemic,

coaching has the potential to help an agen-

cy become more dynamic, innovative, and

successful in fulfilling its mission in the

midst of change. In the process, coaching

can help individuals within organizations

revive personal commitment and passion

for their work, and can be a tool for ex-

panding their effectiveness and fulfillment.

FOCUS6 November 2000

References

1. Hargrove R.Masterful Coaching:Extraordinary Resultsby Impacting Peopleand the Way TheyThink and WorkTogether. SanFrancisco: Jossey-Bass/Pfeiffer, 1995.

2. Whitworth L,Kimsey-House H,Sandahl P. Co-ActiveCoaching: New Skillsfor Coaching PeopleToward Success inWork and Life. PaloAlto, Calif.: Davies-Black Publishing, 1998.

Authors

Eileen Blumenthal, JD,EdM is a certifiedProfessional PersonalCoach with her ownbusiness, RocketScience Coaching &Consulting. She is afounding boardmember of theCoaches TrainingInstitute (CTI), andcurrently supervisesstudents in CTI’scertification program.Prior to becoming acoach and consultant,Ms. Blumenthal wasDirector of VolunteerServices for the SanFrancisco AIDSFoundation.

Comments and Submissions We invite readers to send letters

responding to articles published inFOCUS or dealing with current AIDSresearch and counseling issues. Wealso encourage readers to submit arti-cle proposals, including a summary ofthe idea and a detailed outline of thearticle. Send correspondence to:

Editor, FOCUSUCSF AIDS Health Project, Box 0884San Francisco, CA 94143-0884

*Modified and repro-duced by specialpermission of thepublisher, ConsultingPsychologists Press,Inc., Palo Alto, CA94303 from Co-ActiveCoaching: New Skillsfor Coaching PeopleToward Success inWork and Life by LauraWhitworth, HenryKimsey-House, PhilSandahl. Copyright1998 by Davies-BlackPublishing, an imprintof Consulting Psycholo-gists Press, Inc. Allrights reserved. Furtherreproduction is prohib-ited without the pub-lisher’s written consent.

†Reprinted by permis-sion of Jossey-Bass, Inc.,a subsidiary of JohnWiley & Sons, Inc.,copyright 1995.

FOCUS7 November 2000

There is little written about coaching inthe context of HIV or as an adjunct to psy-chotherapy. Below are excerpts from twocoaching “texts,” providing more informa-tion on coaching goals, the coach-clientrelationship, and coaching in organizations.

Co-Active Coaching BasicsWhitworth L, Kimsey-House H, Sandahl P. Co-Active Coaching: New Skills for Coaching PeopleToward Success in Work and Life. Palo Alto, Calif.:Davies-Black Publishing, 1998.*

The term co-active refersto the fundamental nature ofa coaching relationship inwhich the coach and clientare active collaborators. Inco-active coaching, this rela-tionship is an alliancebetween two equals for thepurpose of meeting theclient’s needs.

There are four corner-stones that form the founda-tion of co-active coaching: 1. The client is naturallycreative, resourceful, andwhole. 2. Co-active coachingaddresses the client’s wholelife. 3. The agenda comesfrom the client. 4. The rela-tionship is a designedalliance.

The primary building blockfor all co-active coaching is

this: clients have the answers or they canfind the answers. From the co-active coach’spoint of view, nothing is wrong or broken,there is no need to fix the client. The coachdoes not have the answers; the coach hasquestions. Sometimes, clients don’t thinkthey have the answers; sometimes, they’drather believe someone else—an expert—has the answers for them. . . . In some casespeople have a powerful sabotaging voicethat tells them, they don’t have theanswers. But co-active coaching stands onthe certainty that clients really do know.When they look inside, with the help of acoach, they’ll find they do know them-selves, their strengths, and their limita-tions. They’ll also discover what they want,what they fear, what motivates them andwhat holds them back, their purpose andtheir vision, and where they sell out. . . .

In co-active coaching, power is grantedto the coaching relationship—not thecoach. The client and the coach worktogether to design an alliance that meets

the client’s needs. In fact, clients play animportant role in declaring how they wantto be coached. In co-active coaching,clients don’t buy a prepackaged program.They are involved in creating a powerfulrelationship that fits their working andlearning styles. The relationship is customtailored to the communication approachthat works best for them. The process ofdesigning the alliance is a model of themutual responsibility of client and coach.Clients learn that they are in control ofthe relationship and ultimately of thechanges they make in their lives. . . .

Coaching works for many reasons thatoverlap and intertwine, but one of thestrongest threads in this weave is action.In fact, it’s the cycle of action and learn-ing, over time, that leads to sustained andeffective change. Clients take action andlearn, which leads to more actions basedon what they learned, which leads to morelearning, etc. Coaching is ideal for thisprocess because the relationship is ongo-ing and is designed to focus on this inter-related pair. All of the coaching skills areused to forward action and deepen theclient’s learning. The action component isthe most visible and is often what drawsthe client to coaching. They may be com-petent and successful in many phases oftheir life, but there is one area where theycan’t seem to make the changes that theywant. By themselves they’re just not get-ting it done, and they want the structureof a partnership to help them get intoaction and stay in action toward theirgoal. But it’s the learning that makeschange possible and sustainable. . . .

One of the defining qualities of coachingis that it creates accountability: a measur-ing tool for action and a means to report on learning. Accountability isessential for forwarding the action anddeepening the learning in co-active coach-ing because the coaching session is morethan just a conversation: it is a conversa-tion that leads to some form of action. Inco-active coaching, accountability is morethan simply a tally of task done or notdone. . . . To be accountable means simplythat: to give an account. What worked?What didn’t work? What happened? Whatwould you do differently next time?

Masterful CoachingHargrove R. Masterful Coaching: ExtraordinaryResults by Impacting People and the Way TheyThink and Work Together. San Francisco: Jossey-Bass/Pfeiffer, 1995.†

Masterful coaching involves helpingpeople in groups transform themselves,

Coaching worksfor many reasons,

but one of thestrongest threadsis action. It’s the

cycle of actionand learning, overtime, that leads to

sustained andeffective change.

Recent Reports

FOCUS8 November 2000

their communities, and their world. Itinvolves impacting people’s visions andvalues as well as helping them reshapetheir way of being, thinking and actions. Itinvolves challenging and supporting peoplein achieving higher levels of performancewhile allowing them to bring out the best in themselves and those around them. Itmeans going through a deep learning pro-cess that results in embodying new skillsand capabilities. In the simplest, day-in,day-out terms, masterful coaching involvesexpanding people’s capacity to take effec-tive action. It often comes down to makingit possible for people to succeed in areaswhere they are most stuck or ineffective. . . .

A masterful coach is one who can trans-form the situation by encouraging peo-ple’s noblest aspirations and teachingthem new skills while at the same timelaunching breakthrough projects thatdemonstrate the power of collaborativeaction. This starts with transforming theunderlying structure of conversation fromtrying to persuade and convince others in order to win to building shared under-standing or a sense of community acrossdifferences. On a very human level, itrequires authentic communication. . . .

One of the most important compasspoints of masterful coaching is helpingpeople to take effective action. In manyorganizations, the effective person is rare.People work at jobs where there is a mis-match between their personal qualities ofexcellence and the slot they fill. In mostgroups, people set goals that do not stretchtheir minds or skills or inspire extraordi-nary levels of commitment. The level ofthinking and communication at team meet-ings seldom leads to the ability to takecoherent action. There are not many peoplewho can create something that never exist-ed before or produce results in difficult orimpossible situations. Learning is a sepa-rate activity, an abstract training program,not something that happens in the contextof doing the job.

Coaching people to be more effectivestarts with what Peter Drucker, in his bookThe Effective Executive, calls “makingstrengths productive.” There is somethingthat each of us was born to do and, if wecan find the arena that fits our value sys-tem and a job where we can do it, our levelof effectiveness will be greatly enhanced.According to Erich Weber, a masterfullife/career planning coach and founder of Job Design in Switzerland, “The key isasking people about what it is they reallywant to do. What is their personal calling?What kind of work do they find fascinat-

ing? Until they can answer these questions,finding the right job is like looking for abutton in a box. Even if they come acrossit, they would not necessarily recognize it.”

The next area that comes into play incoaching people to be more effective, aswell as making sure that people are coach-able, is setting challenging stretch goalsthat people are excited about and havesomething at stake in. It is amazing howmuch more effective people will be insituations that look difficult or impossiblewhen they really do care and when theyreally do have something at stake. It isthen that they discover the source of theirown creativity and effectiveness and comeup with new ideas, fresh approaches, andinnovative solutions.

Coaching people to take successfulaction not only involves setting goals butalso observing people on a daily basis,honestly acknowledging breakdowns, andintervening in some way with the idea ofhelping people to learn and improve. Thereare two ways to do this. The first involves a repackaging (more, better, or different) ofwhat they are already doing. The secondinvolves helping people learn to do some-thing that is fundamentally different. Amasterful coach is always asking penetrat-ing questions: “What unintended resultsare you getting? How are you contributingto them? Where are you stuck in an oldpattern? How could you look at the prob-lem or solution in a different way? What’smissing that could make a difference?”

Next MonthNext month, FOCUS publishes its

annual book review issue, includingdiscussions of several books pub-lished recently.

Among these books are: Putting Riskin Perspective: Black Teenage Lives inthe Era of AIDS, reviewed by FredAllen Vanhoose, PhD; Dying to Care?Work, Stress, and Burnout in HIV/AIDS,reviewed by Michelle Cataldo, LCSW;Working with Families in the Era ofHIV/AIDS, reviewed by Susan W.Haikalis, LCSW; Mortal Men: Livingwith Asymptomatic HIV, reviewed byGeorge Harrison, MD; Families andCommunities Responding to AIDS,reviewed by Marshall Feldman,LCSW; and Psychosocial and PublicHealth Impacts of New HIV Therapies,reviewed by Dan Karasic, MD.

Executive Editor; Director,AIDS Health ProjectJames W. Dilley, MD

EditorRobert Marks

Assistant EditorAlex Chase

Founding Editor; AdvisorMichael Helquist

Medical AdvisorStephen Follansbee, MD

DesignSaul Rosenfield

ProductionCarrel CrawfordCassia StepakSaul Rosenfield

CirculationCarrel CrawfordCassia Stepak

InternsCarla Stelling

FOCUS is a monthly pub-lication of the AIDSHealth Project, affiliatedwith the University ofCalifornia San Francisco.

Twelve issues of FOCUSare $36 for U.S. residents,$24 for those with limitedincomes, $48 for individu-als in other countries, $90for U.S. institutions, and$110 for institutions inother countries. Makechecks payable to “UCRegents.” Address sub-scription requests and cor-respondence to: FOCUS,UCSF AIDS HealthProject, Box 0884, SanFrancisco, CA 94143-0884. Back issues are $3each: for a list, write to theabove address or call(415) 476-6430.

To ensure uninterrupteddelivery, send your newaddress four weeks beforeyou move.

Printed on recycled paper.

©2000 UC Regents: All rights reserved.

ISSN 1047-0719

FOCUSA Guide toAIDSResearch and Counseling

DID YOU KNOW?FREE searchable archive

You can access a FREE searchable archive of back issues of this publication online! Visit http://www.ucsf-ahp.org/HTML2/archivesearch.html.

You can also receive this and other AHP journals FREE, at the moment of publication, by becoming an e-subscriber. Visit http://ucsf-ahp.org/epubs_registration.php for more information and to register!

ABOUT UCSF AIDS HeAlTH PrOjeCT PUBlICATIOnS

The AIDS Health Project produces periodicals and books that blend research and practice to help front-line mental

health and health care providers deliver the highest quality HIV-related counseling and mental health care. For more

information about this program, visit http://ucsf-ahp.org/HTML2/services_providers_publications.html.