NWC-CA-2014 WellBeyondGS€¦ · Content is the copyrighted material of Real Balance Global...

6/2/2014

1

“Well”BeyondGoalSetting:AdvancedWellnessCoachingMethodologyForWholeLife

BehavioralChange

DevelopedbyMichaelArloski,Ph.D.,PCC,CWP

RealBalanceGlobalWellnessServices,Inc.TheWellnessCoachTrainingInstitute

www.realbalance.com

Who’s In The Room?

Copyright RBGWS 2012

Deepening Coaching Skills And Competencies

• Wellness & Health Coaches vary tremendously in training and preparation for their work.

• Even with great “basic training” everyone can benefit from learning and growing in their profession.

• True effectiveness goes beyond the basics.


(Chapter 1)

6/2/2014

2

Over-simplification Of The Coaching Process

Health Risk ID

Goal Setting

Accountability


Lasting Lifestyle Behavioral Change Means A New Way Of Living


Simple Goal Setting Is Inadequate To Deal With Barriers

Simple Goal SettingINTERNAL & EXTERNAL

BARRIERS

INTERNAL & EXTERNAL

BARRIERS


6/2/2014

3

• Motivation

• Level of Self-Efficacy

• Lack of social support

• Unhealthy peer health norms

• Negative self-talk

• Belief systems, pessimism, etc.

• Disorganization

• Health crisis fears

• Excessive work or family stress

Advanced Skills Are Needed To Help Clients With Barriers


What What do you want to learn?your Intention ?

• What benefits do you want to gain by participating in this sessioin?

• By the end of the training I want to….

• Areas where I need to advance my coaching skills are…


A Few Advanced Skills For Today

1. Integrating readiness for change theory into coaching.

2. Holistic, yet behavioral change planning

3. Coaching for intrinsic and extrinsic motivation

4. Avoiding collusion in the coaching relationship

5. Self-disclosure and coaching

6. Coaching with metaphor


6/2/2014

4

Transtheoretical Model Of Change(TTM) Prochaska, DiClemente & Norcross

• Life & Business Coaching did not originally include TTM at all

• A thorough and accurate understanding of TTM is a vital part of H&W Coaching

ExplorationExploration

Vision Motivation

Wellness Plan

Wellness Plan

Action Steps & Accountability,

Barriers

Action Steps & Accountability,

Barriers

Tracking, Progress

Clear Outcomes

Tracking, Progress

Clear Outcomes


• Nine Keys To Readiness For Change And Improving Your Lifestyle

• Needs Of Adult Learners

• Lessons From Albert Bandura For Wellness Coaches

• Top Ten Misunderstandings Of Applying The Transtheoretical Model Of Change (TTM) Gained By Teaching The Application Of This Theory To Over 4,000 Wellness Coaching Students.

• Change: The Paradox Of Fear And Attraction

Resources – Handouts by Dr. Arloski -“Well”BeyondGoalSetting:AdvancedWellnessCoachingMethodologyForWholeLifeBehavioralChange


6/2/2014

5

Top Ten Misunderstandings Of Applying The Transtheoretical Model Of Change (TTM) Gained By

Teaching The Application Of This Theory To Over 4,000 Wellness Coaching Students.

1. People are either “ready to change” or “not ready to change”.

People can be at a different stage of change for each and every different behavior!


2. Labeling People “Not Ready To Change”

• Easy to dismiss a person who resists change efforts.

• Or who is non-compliant…

• Instead, a good hard look at “the system” and/or the coaching is needed.


6/2/2014

6

Getting Behavioral About Being Holistic

• Coach in a client-centered manner that respects the whole person and sees them as “naturally creative, resourceful and whole.”

• Help them create a Well Life Vision

• Co-create an integrated Wellness Plan

• Connect every step with a motivational link to wellness

The Wellness Mapping Process is a copyrighted product of RBGWS, Inc.

The Mapping Process

An Integrated Plan

An Integrated Plan

Area of FocusArea of Focus

GoalGoal

Action StepAction Step


Action StepAction StepGoalGoal


GoalGoal

GoalGoal

2012 Copyright Real Balance GWS, LLC.

18

6/2/2014

7

Why am I walking along an irrigation ditch with the wind in my face?

• Motivation?

• Because I set a “goal” with my coach?

• Action Step: walk 3x wk. for at least 30 min. on ditch route

• Goal: Increase Activity Level

• Area of Focus: Attain and maintain a healthy weight


Keep A Motivational Link Connecting All

•Walk 3x/wk. at least 30 minutes


• Increase physical activity

GoalGoal

• Attain and maintain a healthy weight



Coaching For Intrinsic and Extrinsic Motivation


6/2/2014

8

Intrinsic Motivation

• The Intrinsic Exerciser -Jay Kimiecik

• People Exercise Regularly:– Fun, enjoyment, stimulation

– A feeling of accomplishment

– The pleasure of learning

– Concrete benefits (sleeping better, calmer, more energy)Copyright RBGWS 2012

Intrinsic MotivationIs Supported By More Evidence

Drive: The Surprising Truth

About What Motivates Us

• Health Promotion Needs To Re-Think Incentives

• “Carrots & Sticks” don’t work for complex tasks

• INTRINSIC Motivation RULES!


Coaching For Intrinsic Motivation

• Client “Buy-in”

• Self-determined

• See the benefits

• Think outside the box

• Explore the experiential – how does it feel?

• Increase awareness

• “Bonus” benefits


6/2/2014

9

• Collusion occurs when a coach somehow merges with their client’s view of themselves and the world instead of helping their client explore it.

• Most collusion is unintended.

Avoiding Collusion In The Coaching Relationship


What Collusion Looks Like

• Softening of accountability

• Rescuing

• Lack of challenging

• Reluctance to give honest feedback

• Allowing the client to meander rather than explore

• The coach “buys” the client’s “story” and doesn’t help them realize they are not their story

• How can we be authentic and yet

still be very professional?

• Three forms of Self-Disclosure:• Transparency in the present –sharing awareness

• Historical stories – similar content or theme

• Personal biographical information

• A powerful part of human communication and a conscious technique that has been studied in therapy, counseling and coaching since the mid-sixties.

• A “double-edged sword” !

Using Self-Disclosure In Coaching

6/2/2014

10

Self-Disclosure – How Much? How Soon?

• People have a great need to self-disclose.

• As coaches we need to have a rationale for our self-disclosure.

• Cultural differences

• SD is often empathetic.

• SD can build trust.

• SD can reassure and normalize experience

• Sidney Jourard – SD and Groups

• James Gavin – Literature Review:– Some concludes great value

– Some cautions restraint

• Coaches who disclose too little – are not trusted as much

• Coaches who disclose too much – are thought to be incompetent

Research On Self-DisclosureAn Evidence-based Intentional Technique

How To Use Self-Disclosure In Coaching

•Forward the action

•Maintain momentum

•Enhance relationship

•Deepen exploration

Intention & Purposeful Strategy

Intention & Purposeful Strategy

•Recognize and acknowledge the client’s experience

•Then self‐disclose

Brief, to‐the‐point and relevant SDBrief, to‐the‐point and relevant SD

• Tie it back to the client’s story

• Ask powerful question that connects

• Possibly explain rationale for your SD

Connecting Back To The Client

Connecting Back To The Client


6/2/2014

11

Using Metaphors In Coaching


METAPHORS WORK • By linking what is unfamiliar with what we already

know.• New perspective!• Links with internalized thoughts, emotions, beliefs so

change happens more rapidly and holistically.• Directs attention to aspects and possibilities not yet

considered.

Using Metaphor In Coaching

• You or the client can provide the metaphor

• Work with the image inside your client’s mind, not yours!

• Facilitate theirexploration using “clean” language

• Metaphors allow you to create powerful ?’s

To think metaphorically…read!

• Poetry

• Fiction

• Mark Nepo– 2x Cancer Survivor

– Poet

“What is not integrated,

is repeated.”

6/2/2014

12

Available by emailing the presenter:

[email protected]

“Use of Self and Self-Disclosure In Coaching” by M. Shackleton and M. Gillie

“Using Metaphors With Coaching” by Angela Dunbar

ADDDITIONAL HANDOUTS in PDF Form


Life Is Like A RiverSo Keep The Paddle In Your Hand

www.realbalance.com

The Wellness Coach Training InstituteFt. Collins, Colorado, USA

1-866-568-4702

Nine Keys To Readiness For Change And Improving Your Lifestyle Michael Arloski, Ph.D., PCC, CWP

“People don’t change until they are ready to.” James Prochaska Lifestyle improvement is all about change. When it comes to changing our thoughts, beliefs, and our behavior, the big question immediately becomes “How ready are you to change?”. The answer is not a simple yes or no, and extensive theories have arisen around this question. The most important step for the person looking to improve their lifestyle (or the wellness professional helping them) is to ask the question: “How Ready Am I to Change?” If we ignore the factor of “readiness” and forge ahead with a “call to action” we may just fall on our faces. The Transtheoretical Model of change (TTM) or “Stages of Change Theory” (best explored in Changing for Good, by James Prochaska, Carlo DiClemente, and James Norcross) dominates the wellness and health promotion field, as well as the addictions field, and for good reason. This model provides vital understanding of some fundamental aspects of change. For an excellent exploration of it in depth check out this great blogpost by Temple Univ. prof. Jonathan Singer: http://socialworkpodcast.blogspot.com/2009/10/prochaska-and-diclementes-stages-of.html

“Theory is extremely useful, because your theory determines what you can see.” Albert Einstein When I first heard about Readiness for Change Theory and heard James Prochaska speak at The National Wellness Conference, years ago, I was puzzled. It seemed like an elaborate theory for something so simple. “People don’t change until they are ready to.” Stating the obvious? Then it hit me. Wait a minute. In healthcare, and all related fields, that’s not what we are saying to our clients and patients. We’re saying “Change now!” and completely ignoring looking at where they are truly at in this process of change. As I became trained as a professional life coach I realized that the coaching field was ignorant of this theory as well. We were taught to “request action” much too early in the process. Today, competent life coach training schools such as The Institute for Life Coach Training (www.lifecoachtraining.com) and wellness coaching schools such as Real Balance

http://socialworkpodcast.blogspot.com/2009/10/prochaska-and-diclementes-stages-of.html

http://www.lifecoachtraining.com/

Global Wellness Services (www.realbalance.com) have integrated TTM thoroughly into their curricula. “Change is a process, not an event.” James Prochaska So what does “Readiness For Change” theory mean for the “man (or woman) on the street” who wants to improve their lifestyle? Here’s some basics to keep in mind as you work on change and growth.

1. There are six stages of change and it’s important to give each stage it’s due. o Pre-contemplation – Haven’t even thought about change, am unaware of any

need to change o Contemplation – Am giving it some thought o Preparation – Am preparing to change, finding out more information, checking

resources and options o Action – Actually making the change o Maintenance – maintaining the change o Termination (or Adoption) – the new behaviors/thoughts are part of me now, I

don’t need to constantly “work at it”.

2. We can be at a different stage of change for each different behavior. I may, for example, be ready to start improving my activity level and improving my diet, but I’m not ready to quit smoking. Change is not a light switch. We aren’t as a whole person either “ready” or “not ready” to change.

3. The change process is often like a spiral staircase. We ascend up from pre-

contemplation to contemplation and then to preparation, etc. We also can get discouraged, slip and spiral back down to earlier levels where we have to “pick ourselves up, dust ourselves off, start all over again” (to quote an old song).

4. Change is not just about will power and determination. It is a process that takes time to do right. Especially when we are talking about lifestyle behaviors that may have been in place for many years, just getting up a bunch of will power and thinking that we can suddenly change may be a very disappointing route to go.

http://www.realbalance.com/

Instead see it as a process and give yourself credit for moving through each stage of change.

5. If you’re stuck at one stage, get an ally to help. The “forever-contemplating” or “forever-preparing” person may look like they are working on change, but the truth is they are stuck! Talk about it with people who you know will be supportive of your growth, not negative or pushing their own agenda of how you “should” change. Get a coach!

6. To maintain the change keep track of it! Taking action is great, but the key is maintaining it. I’ve had a number of wellness coaching clients tell me “I’m great at losing weight! I just can’t seem to keep it off.” Recording your new behavior, in someway that works for you, is a real secret of successful change. Don’t let it be a subjective estimation. Get serious about self-monitoring and you’ll see more results.

7. Start where there’s motivation, readiness and likelihood of success. Don’t start climbing mountains by choosing the “Mount Everest” of your life first! Go for the more achievable and attainable goals where you are motivated to change first. Gain confidence and self-efficacy there and then take on the more challenging climbs.

8. Nothing succeeds like success! When you’ve achieved real progress in one area of your life, look at how ready you are now to improve your lifestyle in another area. Once you’ve seen success in being more active and eating better, take on getting more sleep or practicing relaxation training, etc. Take yourself through the Stages of Change from wherever you start, on up that spiral staircase.

9. No model has it all figured out. Even the much-revered TTM has it’s critics. We don’t always go through these stages of change in a nice neat manner. Sometimes change does happen as what seems like an event! We’ve all seen times when circumstances and motivation peaked and “cold turkey” success was achieved with great pride! So no single model can explain this incredibly complex phenomenon of change.

Based upon “Nine Keys To Readiness For Change And Improving Your Lifestyle”, Michael Arloski – blog post: http://wp.me/pUi2y-1V Content is the copyrighted material of Real Balance Global Wellness Services, Inc., 2014 and may be used only for educational purposes and only when complete credit is given for its source.

Michael Arloski, Ph.D., Ph.D., CWP, is a psychologist, certified wellness coach and Founder and CEO of Real Balance Global Wellness Services, Inc. and Dean of The Wellness Coach Training Institute.

Michael Arloski, Ph.D., PCC, CWP

www.realbalance.com [email protected] 1-866-568-4702


mailto:[email protected]

Lessons From Albert Bandura For Wellness Coaches Michael Arloski, Ph.D., PCC, CWP “Self-efficacy or belief in one’s ability to perform determines whether behavior will be initiated, how much effort will be expended, and whether the effort will be sustained.” "People with high assurance in their capabilities approach difficult tasks as challenges to be mastered rather than as threats to be avoided." Albert Bandura From ancient philosophers to Sigmund Freud and down to today’s latest psychological research, people have been attempting to understand what drives human behavior. If you were to pose the idea that what we do as human beings is a result of what we think and how we interact with our environment you would get few arguments. Yet such a theory is a very recent development in the study of psychology. Social psychologist Albert Bandura was primary among the people who have helped us validate the idea that our behavior is an interplay between what we observe in the world around us, how we self-reflect about it, and how we decide to go forward with action. “With the publication of Social Foundations of Thought and Action: A Social Cognitive Theory, Bandura (1986) advanced a view of human functioning that accords a central role to cognitive, vicarious, self-regulatory, and self-reflective processes in human adaptation and change. People are viewed as self-organizing, proactive, self-reflecting and self-regulating rather than as reactive organisms shaped and shepherded by environmental forces or driven by concealed inner impulses.” (Pajares, 2002)

Model Of Reciprocal Determinism - Bandura Because Social Cognitive Theory sees our behavior as part of a reciprocal, continually interacting circle, our counseling or coaching efforts can directed at the personal, environmental and behavioral factors.

Behavior

Environmental Factors

Personal Factors

For the wellness professional who works with people to help them improve their lifestyle behavior this is an easy theory to sign on with. We see our clients continuously facing inner and outer barriers that challenge their attempts at behavioral change. Inner barriers include the Personal Factors that Bandura talks about: cognitive, affective and biological events. Or more simply put, the ways in which our thoughts and belief systems limit us; the ways in which our emotions override our logic in self-defeating ways; and our own emotional-biological connection. Outer barriers include the Environmental Factors that add stress and/or support to our lives. In wellness and health coaching (referred to hereafter as wellness coaching), effective methodologies go beyond simple assessment and goal-setting and recognize that what derails the best laid wellness plans are usually these inner and outer barriers. Central to the coach approach is the contention that human beings are accepted in coaching as being “naturally creative, resourceful and whole.” (Kimsey-House, H., Sandahl, P., Whitworth, L., 2011). They are seen as having the ability, with the right support, to positively impact their world and their own lives. “Social cognitive theory is rooted in a view of human agency in which individuals are agents proactively engaged in their own development and can make things happen by their actions. Key to this sense of agency is the fact that, among other personal factors, individuals possess self-beliefs that enable them to exercise a measure of control over their thoughts, feelings, and actions, that "what people think, believe, and feel affects how they behave" (Bandura, 1986, p. 25). Bandura provided a view of human behavior in which the beliefs that people have about themselves are critical elements in the exercise of control and personal agency. Thus, individuals are viewed both as products and as producers of their own environments and of their social systems.” (Pajares, 2002) What wellness coaches observe is that there is often great disparity regarding the degree to which their clients believe that the efforts they make to improve their health and well being will be effective. Do they believe that they can affect their own health, and to what degree? For the wellness coach and client, this is the very essence of “self-efficacy”. “Of all the thoughts that affect human functioning, and standing at the very core of social cognitive theory, are self-efficacy beliefs, "people's judgments of their capabilities to organize and execute courses of action required to attain designated types of performances" (p. 391).” (Pajares, 2002) “Self-efficacy beliefs provide the foundation for human motivation, well-being, and personal accomplishment. This is because unless people believe that their actions can produce the outcomes they desire, they have little incentive to act or to persevere in the face of difficulties. Much empirical evidence now supports Bandura's contention that self-efficacy beliefs touch virtually every aspect of people's lives—whether they think productively, self-debilitatingly, pessimistically or optimistically; how well they motivate themselves and persevere in the face of adversities; their vulnerability to stress and depression, and the life choices they make.” (Pajares, 2002)

http://www.uky.edu/~eushe2/Pajares/efficacy.html

Many clients arrive to wellness coaching having experienced failure experiences which have negatively impacted their self-efficacy. Discouraged by perhaps numerous attempts to quick smoking, manage stress, or attain and then maintain a healthy weight, their belief in the own ability to succeed at lasting lifestyle improvement has been damaged. Yet, as Bandura has shown us, this belief needs to be strengthened for the person to garner the motivation to change and the tenacity to succeed. How do we then build self-efficacy? Fortunately effective wellness coaching methodologies have built into them the very factors that Bandura has found effective. "Reality is not so much what happens to us; rather, it is how we think about those events that create the reality we experience. In a very real sense, this means that we each create the reality in which we live." ~ Dr. Albert Ellis "All that we are is the result of what we have thought; it is founded on our thoughts; it is made up of our thoughts. A man’s life is the direct result of his thoughts… We are what we think. All that we are arises with our thoughts. With our thoughts we make the world." ~ Gautama Siddhartha (Buddha) Though he’s not quoted as saying so, the essence of Bandura’s work would agree with the old saying that “We create our own reality.” Most human motivation is cognitively generated, Bandura argues. We anticipate our actions with forethought and figure our chances of success largely based upon our past experience in this arena. This forms beliefs about what we can and can’t do. We set goals and form plans to realize the outcomes we desire. The way we set those goals is largely determined then by our perception of our past experience and our level of self-efficacy. This combined with our current thinking yields our performance in attempting to reach our desired outcome. Causal Structure Perception of our Past Experience affects our Self-Efficacy. This in turn affects our expectations and the level at which we set our personal goals. This is then filtered through our thinking, or as Bandura puts it, our Analytic Strategies and this combination of Personal Goals and Thinking affects our Performance or outcome. So, if I have a history of failure at weight loss and low self-efficacy about succeeding at another attempt at losing weight I will set personal goals that may be minimal, or may be unrealistic. I then attempt to achieve these goals using strategies that are influenced by my lack of confidence, discouragement, and self-doubt, and my performance, or outcome suffers.

A Coach Approach Difference Let’s say I now have a wellness coach helping me with the process of change. Firstly as I speak to my coach about my Past Experience, and they help me reframe my experience less negatively. I get empathy and support, even acknowledgement for how challenging weight loss has been for me, but I don’t get sympathy. My coach helps me discover what in my past experience was effective. What did work that I can use again? My coach also works with me to improve my self-efficacy (see below) and help me build my feelings of greater self-esteem, self-confidence and helps me recognize and acknowledge my strengths that I can use in this change process. My coach is using the Positive Psychology approach that is inherent in coaching. Together my coach and I co-create a better set of Personal Goals that are optimistic, yet realistic. Through the coaching I discover more of the motivation that I have for improving my life, including losing weight. The coaching helps me see the motivational link between what action I am taking and how it will help me reach my greater desired outcome of living my healthiest, best life. This motivation helps me produce greater effort, push through barriers and, with my coach’s help, strategize though both internal and external barriers. The result is an improved Performance.

• Causal Structure

Past Exp.

• Self Efficacy

Personal Goals • Thinking

Performance

Now, when I look at my recent Performance I am encouraged by at least some level of progress. I now begin the Causal Structure of Change process again, and this time I begin by basing it on my Recent Performance, not my Past Performance. This helps push a higher level of Self-Efficacy within me. I set even better Personal Goals. My Thinking, my Analytic Strategies are more positive and effective and this all yields even better Performance. We are now on a positive circle of action and success that can be repeated, instead of a vicious circle of defeat. How To Build Self-Efficacy Most wellness professionals are already very familiar with the term self-efficacy and set improved self-efficacy as a desired outcome in virtually all of their wellness programming. Wellness coaches seek to help clients have greater belief in their ability, capacity, and confidence in positively affecting their health and improving their lifestyles. The question is “How?”. Bandura (1997) identified four sources of information that affect our self-efficacy:

Mastery Experiences – Self-mastery Vicarious Experiences – Role Modeling Verbal Persuasion – Social Persuasion Physiological Cues

Let’s look at how wellness coaches can help clients improve self-efficacy by working with these four factors.

• Causal Structure

Recent Performance

• Enhanced Self Efficacy

Personal Goals • Thinking

Improved Performance

Mastery Experiences Mastery experience is the strongest and most effective source of building self-efficacy. As we say in coaching “Nothing succeeds like success!” An effective coach helps their client recognize and acknowledge themselves for even the smallest accomplishment. Many clients are notoriously poor at giving themselves credit for what the do accomplish and coaching can help them reframe this. The coach helps their client avoid repeating self-defeating strategies they’ve used in the past and helps them devise more effective experiments at change. As clients set in place a wellness plan that sets out manageable goals and specific (easy) action steps that are in alignment with the client’s “readiness for change” (Prochaska, et.al. 1994) the probability of success is much greater. As the client experiences “mastery” it is very self-reinforcing and self-efficacy beliefs elevate. Vicarious Experiences – Role Modeling A cornerstone of social psychology is that we all learn from one another and this influences our own behavior. Much of Bandura’s work has been around modeling whether it was the famous BoBo Doll Experiment (Bandura, et.al. 1961), or filming people crossing the street against a traffic light just because a well-dressed man carrying a briefcase did so. When we see someone being successful at certain behavior we are more likely to try it ourselves. Thus the omnipresence of fad diets and all the fitness trends we witness. Television and the internet serve to expose us to even more models to imitate. Self-efficacy, then, can be affected by observing what others experience. People who observe a model successfully perform in a challenging situation are more likely to develop an expectation that they can acquire the same skill (Alderman, 1999). So, coaches can encourage clients to find models that will both encourage them and perhaps show them strategies and the skills they need to be successful like their models. What we know about effective models is that they need to be people we feel positive about and can relate to. Most fitness and wellness magazines, for example, forget this and continuously hold up exceptional examples for us to follow. We may find it extremely hard to identify with celebrities, or a seventy-five year old ultra-marathoner who was an All-American track star in college. Models who are seen as having similar attributes (age, gender, ethnicity, etc.) as ourselves and who have struggled imperfectly, but persevered and succeeded at a similar task are most effective. Verbal Persuasion – Social Persuasion The messages we get from others can have a profoundly positive or negative effect upon our efficacy expectations. When one receives encouragement that “you can do it” our belief in our own capacity for change increases. For these positive verbal statements to be effective though, they must be believable and conveyed by someone the person sees as

trustworthy. The term “persuasion” may be a bit misleading for the coach. The reality is that we really can’t “persuade” someone to be well. It’s not a convincing sales pitch that works, but instead the kind of “I believe you can do it, I believe in you!” statements that a coach sincerely makes that go beyond simple cheerleading. At the heart of good coaching is what we call “coaching for connectedness” (Arloski, 2009). A key to successful and lasting lifestyle improvement is coaching with the client to help them consciously develop a system of support that will help them attain and maintain the changes they seek. This social support is a central part of Bandura’s message. When clients find walking buddies, social groups with positive peer health norms, or learn how to ask for the support they need, they are much more likely to succeed. Physiological Cues Individuals sometimes judge their capability to perform a task by their own physical/emotional experience as they face the task or perform it. If they doubt their ability, possibly fear the consequences of failure, etc., they may experience anxiousness, increased heart rate, sweating, etc. Awareness of these symptoms can trigger even more self-doubt and fear and plunge self-efficacy beliefs further down and affect performance. Bandura contends that individuals have the capacity for self-regulation. We can affect our physiological states through our awareness, our thought processes and through techniques of breath and relaxation. Wellness coaches can help their clients to become aware of these patterns of anxiousness and help them seek out methods for self-management. Coaching takes it further by helping clients establish accountability around practicing these self-management techniques. Positive mental rehearsal can also be used to reduce anticipatory anxiety and increase confidence in one’s capacity for positive performance. The coach and client can even rehearse in role play for an upcoming event for the same purposes. Theory and Practice Social Cognitive Theory (formerly known as Social Learning Theory) helps us see ways to be more effective in working with our clients. It also is very validating to the “coach approach” taken by professional life coaches and professional wellness coaches. There is tremendous congruity between what coaches do and what this theory advises. Alderman, M. K. (1999). Goals and goal setting. Motivation for ahievement: possibilities for teaching and learning. New Jersey: Lawrence Erlbaum Associates. Arloski, M. (2009) Wellness Coaching For Lasting Lifestyle Change. Updated Ed. Duluth, MN: Whole Persons Associates. Bandura, A.; Ross, D.; Ross, S. A. (1961). "Transmission of aggression through the imitation

of aggressive models". Journal of Abnormal and Social Psychology 63 (3): 575–582. doi:10.1037/h0045925. PMID 13864605. Bandura, A. (1977) Toward A Unifying Theory Of Behavioral Change. Psychol Rev. 1977 Mar; 84(2):191-215. Bandura, A., (1982). Self-efficacy mechanism in human agency. American Psychologist, 37, p. 122-147.

Bandura, A. (1997). Self-efficacy: The exercise of control. New York: Freeman Kimsey-House, H., Sandahl, P., Whitworth, L. (2011) Co-Active Coaching: Changing Business, Transforming Lives. Nicholas Brealey; Third Edition. THE Coaching “Bible”! Best book on basics of coaching and coaching skills. Naydock, G. R. How Would Bandura Increase Self-Efficacy In Therapy. http://www.slideshare.net/gerdnaydock/how-bandura-would-increase-self-efficacy Pajares, Frank (2002) Overview of Social Cognitive Theory and of Self-Efficacy, Emory University, Archived at: http://www.uky.edu/~eushe2/Pajares/eff.html Prochaska, J., Norcross, J, & Diclemente, C. (1994) Changing For Good. New York, NY: Harper Collins/Quill. 1994 Harper Collins, 2002 Quill reprint. SELF-EFFICACY - http://www.coe.uga.edu/epltt/motivation/con_selfefficacy.htm Content is the copyrighted material of Real Balance Global Wellness Services, Inc., 2014 and may be used only for educational purposes and only when complete credit is given for its source.



www.realbalance.com [email protected] 1-866-568-4702

http://en.wikipedia.org/wiki/Journal_of_Abnormal_and_Social_Psychology

http://en.wikipedia.org/wiki/Digital_object_identifier

http://dx.doi.org/10.1037%2Fh0045925

http://en.wikipedia.org/wiki/PubMed_Identifier

http://www.ncbi.nlm.nih.gov/pubmed/13864605

http://www.slideshare.net/gerdnaydock/how-bandura-would-increase-self-efficacy

http://www.uky.edu/~eushe2/Pajares/eff.html

http://www.coe.uga.edu/epltt/motivation/con_selfefficacy.htm



Top Ten Misunderstandings Of Applying The Transtheoretical Model Of Change (TTM) Gained By Teaching The Application Of This Theory To Over 4,000 Wellness Coaching Students. Michael Arloski, Ph.D., PCC, CWP

The Transtheoretical Model of change (TTM) or “Stages of Change Theory” (best explored in Changing for Good,1994, by James Prochaska, Carlo DiClemente, and James Norcross) is in widespread use in both the addictions field and throughout wellness and health promotion programs. Yet, it is sometimes poorly understood in application. As the field of life coaching developed this theory of change was missing. As life coaching continued to grow and especially as wellness and health coaching developed, the TTM was enthusiastically embraced. In the process of training over four thousand health and wellness coaches around the world, I have observed some of the most common misconceptions held about this model and mistakes made in it’s application. Students in our wellness & health coaching training program are primarily healthcare and wellness professionals, including nurses, health educators, and a wide variety of people working as coaches in disease management, EAP’s, insurance companies and hospital and corporate wellness programs. In most of our classes about half of the students claim to be familiar with TTM and half are not very aware of it. Among those claiming an understanding of it, and even expressing how it is an integral part of the healthcare and/or wellness program they are part of, there are always a number of students who have been mistaken about certain aspects of the theory and it’s application.

1. People are either “ready to change” or “not ready to change”. A basic tenet of the TTM is that people can be at a different stage of change on each different behavior. The middle-aged overweight smoker can be ready to improve their diet and exercise more, but refuses to attempt to cut down or quit smoking. People are not like a light switch in an “on” or “off” position when it comes to change in their life.

2. Clients/patients (hereafter referred to as clients) are sometimes labeled as “not ready to change” when the clients resist the treatment/coaching efforts of the healthcare/wellness professional.

When success is not achieved quickly or a client does not follow a prescribed course of action they are often seen negatively as being resistant, or even defiant. This can be a quick way to dismiss a case instead of looking carefully at how it could have been handled more effectively.

3. Thinking the stage of change can be determined by the coach/clinician in a diagnostic manner.

Still operating out of a treatment-oriented mindset, the coach/clinician tries to figure out what stage the client is in and what “intervention” needs to be used. The reality is, that even with any of the “readiness for change” tools in use, the process is to simply ask the client to rate their own readiness. This is the method, even in research, and even more so in a true helping situation.

4. Failing to use the readiness for change concept as a way to deepen exploration with the client and missing the opportunity to incorporate it more into the conversation of change.

Clients often think of change in ways that work against their own progress, often seeing it as an all or none process involving little more than will power. Conveying even a basic understanding of how change is a process with doable steps can inspire hope and increase self-efficacy.

5. Clients who are resistive are labeled as being in pre-contemplation and considered to be in denial.

Clients are often advised by their healthcare professionals to make certain behavioral lifestyle improvements. When these directives are ignored it is said that the client is in pre-contemplation about that behavior change. Pre-contemplation means the person is not even aware of it. A perfect example is the person who does not know that they have hypertension. Finally getting their blood pressure measured may jolt them out of pre-contemplation and get them thinking about it.

6. Clients are labeled as being in pre-contemplation, when in fact they are thinking about change, just not very actively.

Clients may have been made aware of a needed change, but not only do not take action or prepare to take action, they do not actively explore the possibility of action as they contemplate it. The client “knows” that they “should” do something about their lifestyle, but they keep their thinking about it to a minimum. Technically, they are still in contemplation.

7. A client/patient being in the stage of contemplation about a particular behavior is considered a bad thing, and hurried to move out of contemplation.

Coaches and other helpers often miss a great opportunity here by helping the client to develop greater understanding about he considered change and more insight about it. This is often where motivational links are made that help drive successful change. Adequate exploration leads to improved accuracy in goal setting.

8. The preparation stage is often skipped over as the client is urged to “take action”.

While taking action sounds like arriving at real change, if the action taken is not well-selected through a process of adequate preparation, we often see failure. Jumping to solutions seems attractive yet a more thoughtful approach may provide the information and the acquisition of support and/or skills that allow for maximal success.

9. Credit is not give for movement through the process of change.

Getting the client engaged in action is too often seen as the only positive outcome. Lifestyle improvement (and coaching) programs should be credited for helping clients move from pre-contemplation or contemplation all the way to the stage of preparation. Outcome measures do not neatly co-inside with the change process in real human beings!

10. Not enough attention is given to the maintenance stage and not enough emphasis placed on building support systems that will help maintain change.

Too often success is viewed as getting the client launched into action. However most clients will tell you that they have taken action on changing these behaviors before, perhaps many times. Their primary challenge is maintaining a change in behavior. That is where they need the most help. Also, an effective change program has to recognize that support for the changed behavior will have to come from sources in the client’s life other than the coach or wellness professional. Perhaps the biggest error made, however, is failing to use the concept of readiness for change at all! When coaches rush into “goal setting” without integrating TTM into a comprehensive wellness plan the client is often set up for failure. Starting by setting goals where the greatest readiness for change is present makes tremendous sense. Maximizing the probability of success by taking on goals where the client is already in preparation or already taking some action allows the client to see success sooner and thereby build self-efficacy and confidence in the change process. Content is the copyrighted material of Real Balance Global Wellness Services, Inc., 2014 and may be used only for educational purposes and only when complete credit is given for it’s source. Michael Arloski, Ph.D., Ph.D., CWP, is a psychologist, certified wellness coach and Founder and CEO of Real Balance Global Wellness Services, Inc. and Dean of The Wellness Coach Training Institute.


www.realbalance.com [email protected]

1-866-568-4702



Change: The Paradox of Fear and Attraction Eight Thoughts for Success at Lifestyle Improvement. Michael Arloski, Ph.D., PCC, CWP “Change” is such a powerful and loaded term. The very word brings out any number of wildly disparate responses: fear, anticipation, longing, uncertainty, attraction, loss and excitement. Change in attitude, and belief yielding change in behavior, or more specifically health and wellness behavior is what we’re after. Yet if the very idea of change is at all scary, isn’t that just one more reason not to change? Taking on the subject of change is complex with endless possibilities to explore and many great theories about it. Here’s some thoughts and observations, gleaned from many years of helping people make the changes in their lives that they really wanted to see, both as a psychologist/psychotherapist, and as a professional life and wellness coach.

1. Change means loss. Even positive changes mean giving something up. “My new smartphone has endless features, but I miss the ease of handling that my old phone had.” “I love the new town I live in, but I wish I was still in Wellville.” “I’m so glad I quit smoking, but you know, there’s nothing like a good cigar!” Sometimes change seems to weigh out more negatively than positive right from the start. It’s OK to acknowledge our losses, and to even grieve them. When we don’t fully grieve, our attachment to what was persists and robs us of our full presence in our new reality.

2. Change reminds us that nothing lasts forever. The transience of life is perhaps the only thing we can all be absolutely sure of. Our attachment to what was is the primary source of our suffering according to one of the basic tenets of Buddhism. Letting go of attachment requires real perspective on what is truly important to us. “Everything flows and nothing abides, everything gives way and nothing stays fixed.” Heraclitus (c.540-c.475 BC)

3. Own your choices. When people feel “trapped” change seems impossible, even though it may be greatly desired. I love to teach that a coach’s job is to remind people that they have choices! When someone can accept that they are choosing to remain at a job, in a marriage, or living where they live, for now, until they can improve that situation, everything changes inside of them. Suddenly they can go through the door at work knowing that for now it is the best thing for them, but that they are working on finding either a way to improve that situation or move on to something better. They are free.

4. Change doesn’t always require total abstinence, denial and deprivation. A way to guarantee the failure of a wellness program (at an organizational or personal level) is to make it all about giving up one’s current ways of living. “You folks have to give up your smoking, drinking and eating all of that Bar-B-Que!”

Most weight-loss programs recognize that when people feel deprived of what they truly enjoy (You can NEVER have ice cream again, as long as you are on the planet!) they fail at their attempts to lose weight. Perhaps a 100% abstinence is the right thing for you and your psychophysiology (maybe alcohol or sugar?), but as long a we keep track of our behavior and minimize self-deception, we can ease our way into change incrementally.

5. Change can be joyous! As fearful as we can be of messing with the status quo, the benefits of positive change, especially lifestyle improvement, bring joy to our lives. It’s kind of like what you learn about conflict and conflict resolution. Change is an inevitable part of life. Change is not inherently bad. Change is, in fact, an indicator that an organism is alive!

“He who’s not busy being born, is busy dying.” Bob Dylan

6. Change is not just about “will power”. Determination helps but is far from sufficient for lasting success. This is the classic “New Year’s Resolution” approach to change. Pumped up and poorly thought-out. It’s the reason you can always find an exercise machine readily available at the health club come March or April. If we’re changing old behavioral or cognitive habits they will re-emerge. This is not evidence that we are weak and lack enough “will power”. It’s evidence that we are truly engaged in the process of changing life-long habits that have, in fact, developed powerful neural pathways in our brains.

7. Be true to your own beliefs and values. Make changes that are your changes, not someone else’s. Let celebrities live their own lives, even wellness gurus. Find your own ways of improving your life that are completely congruent with who you are. Discovering more deeply who you really are, what values truly reside in you, may be your most important first step towards effective change. Changes in behavior flow from changes in belief.

8. Sometimes “lifestyle change” means changing your life. Lifestyle changes can be pretty cosmetic at times, yet we struggle even to make those improvements succeed. Maybe it’s not about twenty pounds, or bigger biceps. Maybe it’s about being happy, content, and comfortable inside our own skin. Perhaps it’s about unconditional friendship with ourselves ( to reference Pema Chodron. http://www.youtube.com/watch?v=7s-rRMUl04I). Perhaps it’s about getting some great career guidance, making that move to where you really want to live.

Based upon: Change: The Paradox of Fear and Attraction Eight Thoughts for Success at Lifestyle Improvement. Michael Arloski: blog post: http://wp.me/pUi2y-1P Content is the copyrighted material of Real Balance Global Wellness Services, Inc., 2014 and may be used only for educational purposes and only when complete credit is given for it’s source.

http://www.youtube.com/watch?v=7s-rRMUl04I



www.realbalance.com [email protected]

1-866-568-4702



National Wellness Conference 2014 Coaching Academy "'Well' Beyond Goal Setting: Advanced Wellness Coaching Methodology For Whole Life Behavioral Change"

Michael Arloski, Ph.D., PCC, CWP Real Balance Global Wellness Services, Inc. The Wellness Coach Training Institute BIBLIOGRAPHY & REFERENCES Arloski, M. (2014) Wellness Coaching For Lasting Lifestyle Change, 2nd Ed.. Duluth, MN: Whole Persons Associates. Arloski, M. (2013) How To Influence Lasting Lifestyle Change: The Benefits of Wellness Coaching – Parts One and Two of an Interview with Dr. Michael Arloski On The Art & Science of Coaching. WELCOA’s News & Views – Expert Interview Series. http://welcoa.org/freeresources/index.php?category=16 Arloski, M. (2008) Wellness Coaching and Lifestyle Medicine: Covering The Whole Continuum. Wellness Management, The National Wellness Institute, September 2008. Arloski, M. (2003) “Lasting Lifestyle Change Through Wellness Coaching”. Wellness Management, Spring 2003. Arloski, M. (2002) “The Power of Habit” Unpublished document. Available through the author. Also available at the author’s website: www.realbalance.com Arloski, M. (1999) “Coaching For Wellness.” Wellness Management, The National Wellness Institute, Winter 1999. Chapman, Larry S., Lesch, N., Baun, M.P. (2007) The role of health and wellness coaching in worksite health promotion. American Journal of Health Promotion, Vol. 21, No. 6. (2007) Key: citeulike:5010209 The Coaching Connection - Special Edition of Absolute Advantage: The Workplace Wellness Magazine. The Wellness Councils of America. Oct. 2002, Vol. 1, No. 10.

http://welcoa.org/freeresources/index.php?category=16

Jordan, Meg, and Livingstone, John B. (2013) Coaching versus Psychotherapy in Health and Wellness: Overlap, Dissimilarities and the Potential for Collaboration. Global Advances In Health and Medicine, Volume 2, Number 4 • www.gahmj.com Kimiecik, Jay. (2002) The Intrinsic Exerciser: Discovering the Joy of Exercise. Boston, New York: Houghton Mifflin Co. Kimsey-House, H., Sandahl, P., Whitworth, L. (2011) Co-Active Coaching: Changing Business, Transforming Lives. Nicholas Brealey; Third Edition. Lambert, Michael J.; Barley, Dean E. (2001) Research summary on the therapeutic relationship and psychotherapy outcome. Psychotherapy: Theory, Research, Practice, Training, Vol 38(4), Win, 357-361. doi: 10.1037/0033-3204.38.4.357 Maslow, Abraham. (1962) Toward A Psychology of Being. Princeton, NJ: Van Nostrand. Miller, W.R. & Rollnick, S. (2002) Motivational Interviewing, 2nd Ed.: Preparing People for Change. Gullford Press. Moore, M. & Tschannen-Moran, R. (2009) Coaching Psychology Manual. Lippincott Williams & Wilkins. Optum Health (2011) “Wellness Coaching Best Practices: Exploring Evolving Strategies for Behavior Change” A White Paper. http://www.optumhealth.com/~/media/OptumHealth/Podcast/Pdfs/Publications/pdfWellness_Coaching_Best_Practices.pdf Pink, Daniel. (2011) Drive: The Surprising Truth About What Motivates Us. Riverhead Trade. Prochaska, J., Norcross, J, & Diclemente, C. (1994) Changing For Good. New York, NY: Harper Collins/Quill. 1994 Harper Collins, 2002 Quill reprint. Spotlight On Wellness Coaching: A Positive Focus For Empowering Participants. Interview with Dr. Michael Arloski and Beth Shepard. (2004) Health Promotion Practitioner, Sept./Oct., Vol. 13, Issue 5. pp. 5-7. Watson, Jeanne C. Reassessing Rogers' necessary and sufficient conditions of change. Psychotherapy: Theory, Research, Practice, Training, Vol 44(3), Sep 2007, 268-273.

http://psycnet.apa.org/doi/10.1037/0033-3204.38.4.357

http://psycnet.apa.org/doi/10.1037/0033-3204.38.4.357

http://www.optumhealth.com/~/media/OptumHealth/Podcast/Pdfs/Publications/pdfWellness_Coaching_Best_Practices.pdf

http://www.optumhealth.com/~/media/OptumHealth/Podcast/Pdfs/Publications/pdfWellness_Coaching_Best_Practices.pdf

Williams, P. & Menendez, D. (2007) Becoming a Professional Life Coach: Lessons from the Institute for Life Coach Training. New York: W.W. Norton & Co. Williams, P. & Anderson, S.K. (2005) Law & Ethics in Coaching. Hoboken, NJ: John Wiley & Sons, Inc. Williams, P. (2004) Coaching and the Wellness Industry: A New Gateway for Consumer Awareness. Choice, vol. 2, issue 2. Williams, P. & Davis, D.C. (2002) Therapist as Life Coach: Transforming Your Practice. New York: W.W. Norton & Co. Wolever, R.Q., Caldwell, K.L., Wakefield, J.P., Little, K.J., Gresko, J., Shaw, A., Duda, L.V., Kosey, J.M. & Gaudet, T. (2011). Integrative health coaching: An organizational case study. Explore: The Journal of Science and Healing, 7(1), 30-36, doi:10.1016/j.physletb.2003.10.071.

Wolever, R Q., Dreusicke, M.H., Fikkan, J.L., Hawkins, T.V., Yeung, S.Y., Wakefield, J., Duda, L., Flowers, P., Cook, C., & Skinner, E. (2010). Integrative health coaching for patients with type 2 diabetes: A randomized clinical trial. Diabetes Educator, 36(4), doi . 10.1177/0145721710371523.

Wolever, R.Q., Webber, D.M., Meunier, J.P., Greeson, J. M., Lausier, E.R., & Gaudet, T.W. (in press). Modifiable disease risk, readiness to change, and psychosocial functioning improve with integrative medicine immersion model. Alternative Therapies in Health and Medicine. REFERENCES & RESOURCES – IN MEDIA, Websites, Blogs, etc. (in topical order)

• ICF Code of Ethics http://www.coachfederation.org/includes/media/docs/Ethics-2009.pdf

• Self-Disclosure in Coaching – When Sharing Helps and Hinders. Dr. Arloski’s Blog: http://wp.me/pUi2y-8m

• The Facilitative Conditions of Coaching: The Essence of the Coaching Relationship. Dr. Arloski’s Blog. http://wp.me/pUi2y-6i

• 12 Ways To Avoid Collusion In The Coaching Relationship. Dr. Arloski’s Blog. http://wp.me/pUi2y-6P

• Unconditional Positive Regard: The Being and Doing of Coaching - Part Two. Dr. Arloski’s Blog. http://wp.me/pUi2y-61

• Dancing In The Moment: Awareness of The Coaching Process/Interaction. Dr. Arloski’s Blog. http://wp.me/pUi2y-33

• “The Use Of Metaphor In Coaching.” Simon Maryan http://www.gomentor.com/simonmaryan/blog/321-the-use-of-metaphors-in-coaching.aspx

http://www.coachfederation.org/includes/media/docs/Ethics-2009.pdf



http://wp.me/pUi2y-8m

http://wp.me/pUi2y-8m

http://wp.me/pUi2y-6i

http://wp.me/pUi2y-6i

http://wp.me/pUi2y-6P

http://wp.me/pUi2y-6P

http://wp.me/pUi2y-61




• Nine Keys To Readiness For Change And Improving Your Lifestyle. Dr. Arloski’s Blog. http://wp.me/pUi2y-1V

• Process Coaching: Yes, Coaches “Do Emotions”. Dr. Arloski’s Blog. http://wp.me/pUi2y-dL

• FAVE ! First Acknowledge, Validate and Empathize. Dr. Arloski’s Blog. http://wp.me/pUi2y-bZ

REFERENCES: INSTITUTES & ORGANIZATIONS The International Coaches Federation. www.coachfederation.com The Institute For Life Coach Training. www.lifecoachtraining.com Real Balance Global Wellness Services, The Wellness Coach Training Institute. www.realbalance.com

http://wp.me/pUi2y-1V

http://wp.me/pUi2y-1V

http://wp.me/pUi2y-dL

http://wp.me/pUi2y-bZ

http://www.coachfederation.com/

http://www.lifecoachtraining.com/


NWC-CA-2014 WellBeyondGS€¦ · Content is the copyrighted material of Real Balance Global...

Documents

Transcript of NWC-CA-2014 WellBeyondGS€¦ · Content is the copyrighted material of Real Balance Global...