Learning Objectives for this Lesson:
- Name and discuss the five basic principles of appreciative inquiry (AI)
- Name and discuss types of AI used in coaching
- Demonstrate the skill of positive reframing within a coaching conversation
- Use AI to facilitate the development of a client’s positive vision (or desired future) within a coaching conversation
- Use AI to co-create goals and action plans in the service of that positive vision (or desired future) within a coaching conversation
- Keep coaching conversations light, interesting, and engaging.
- Use AI to improve and transform the coaching relationship
What is the Appreciative Inquiry approach?
In this lesson, we will continue to expand on coach role-playing, using more reflection and intuition. The objectives for this lesson will include learning more powerful coaching techniques that tap into your intuitions and allow you to truly understand what you are hearing from each client. One of the “doing” skills in wellness coaching is the art of asking open-ended questions and this will serve as the transition into our introduction to appreciative inquiry (AI). AI is such a big part of our daily activities as coaches because as you will see, it’s a big part of imagining the client’s vision for change. AI is also described as a way of clarifying what the client wants or where they are looking to go. We want to talk to our clients so we can learn more about how to direct or guide them to create a vision of their wellness. This includes where they want to go and what they want to accomplish.
The wellness vision. We want to really help each client find their own unique and powerful motivators. We also must learn our client’s global or personal motivators. We want the client to think of both types of motivators. The role of the coach in this process is to help the client find both of those when they are trying to guide them through a behavior change. We will also use this lesson to introduce motivational interviewing (MI), which is very similar to AI. There are several different areas of MI that we will learn for practical application, making the content of this lesson extremely important, as these techniques will set the foundation for all of the specific tools that we will start using. There is no other way to put it… every coach must have a good grasp of MI and AI to be effective and to give the client what they need from you. It’s an essential function of your job.
What do you think? What kind of impact do reflection, motivational interviewing and appreciative inquiry have on your coaching interactions toward the end goal of getting at your client’s vision? Using reflections and clarifying through conversation takes a lot of pressure off of the coach. Attempting to help the other person by getting permission and then moving through specific questions can seem more relaxed if we are being mindful of its very relaxed; by asking questions, we are checking for corrections and making sure they’re on the right path while we’re sharing the responsibility of the interaction flow, you’re the change facilitator; it is not all on your shoulders.
While this is a big part of our work … it’s the client’s work. The coach only needs to just listen and share back what you are hearing; it also takes the pressure off you, you are not in the hot seat, so to speak. One reason this works well as a tool is that you will have to stop at intervals to verify or check what’s been said -that is what the reflecting part of coaching is; you are checking back. That is all there is to it. The client can then confirm or pull you back into alignment.
Consider it a checkpoint. This will benefit the client -it allows the coach to know more about them. It indirectly helps the coach to ask better questions. It’s also a window or view of how they act or what they are saying. You can be more proficient at determining the client’s worldview. It also helps clients to put their thoughts or objectives into specific terms. Sometimes clients miss hitting their goals because they are not clear. With a coach, the target becomes clearer and more concise. The coach directs the conversation with reflection. The coach might ask, “‘Okay, let’s look at this a little closer, and describe it better”. It’s a great way to direct clients to focus more on their needs and on what they’re really looking for.
Within the coaching dynamic, coaches should become comfortable giving in to their intuition. Saying “You know, I’m wondering if what you’re saying is…..” or “I wonder if this is related at all to ……This is good to mention here because using intuition is another way to direct the client’s focus; and since it’s an informal checkpoint, the client can then say ‘Well, that’s right” or “I’ve never thought about that before! “This can be extremely challenging. Coaches walk a fine line because they may be apprehensive and feel that they are about to jump to conclusions, but we are also leading the client in this process. We are trying to trigger responses or thoughts. Therefore, even if our intuition is a little off, it’s still a great skill to use when coaching clients. It doesn’t have to be RIGHT.
It’s also a part of the coaching experience that the client can control from their vantage point. For example, saying, “You’re really disappointed you didn’t lose any weight….how will that affect you for the next week?” demonstrates how the coach has used intuition to suggest that the client’s missed attempt might become a barrier. But the client may redirect the coach at that point, saying something such as “No, I know it was a rough week, but I am really on track to hit my goal this week”. Then all is fine with this client and this conversation; but remember -use intuition carefully and only in a non-judgmental way. This also shows that the coach is caring and empathetic. We want the client to have a positive inner dialogue at this point, saying things like “Wow, this person is really thinking about me. They are concerned with what I am facing and pointing out different scenarios that might be important for me. “At this point, it is also important to remember your active listening skills –by silencing our own voice and agenda not thinking what you’re going to say next. It means pausing, slowing down in your dialogue, listening for facts and emotions, and taking in their body language.
Since we know that reflections are a significant part of active listening, we can demonstrate great active listening skills by just reflecting using our intuitions back to the client once again. “I have a sense that you’re a little disappointed. Is that right?” In this statement, we are providing the client with an opportunity to realign our understanding. This is just as easily accomplished by saying “Can I check something out with you?” The goal of the following interactions is to allow you to practice listening and ponder what reflections you might use. If you can use your intuition to introduce your thoughts, that is even better. Be mindful of using pauses, practice reflection types, and remain focused on listening.
Your client comes to you with a health concern(smoking).
- Coach: “How are you doing today?”
- Client: “Outstanding.”
- Coach: “Great, glad to hear that. I know that you had mentioned wanting to maybe ease off on your tobacco habit last week. Do you mind if I ask where you are at with that this week?”
- Client: “I’m still thinking about what my next steps will be. I see my doctor in three months and I know he’ll hassle me about that, and my blood pressure, but I don’t feel that I’m ready to do anything right now”
- Coach: “So you’re going to be seeing the doctor and it sounds like you feel as if he might bombard you with a lot of issues?”
- Client: “Well I know what he is saying is correct, and I feel like a little kid sitting there with my hands in my lap, like I’m at the principal’s office.”
- Coach: “…..and I know you said you were really not ready to do anything. I can imagine how you would feel -and that you feel that you’re not ready but that kid sitting in the office -he feels uncomfortable sitting there. Is that right?”
- Client: “Yes.”
- Coach: “But, you’re still going to the doctor, is that right?”
- Client: “Well, I have an appointment……”
- Coach: “Is that a regular check-up or were you planning to talk about tobacco cessation?”
- Client: “No, it’s to follow up on my blood pressure.”
- Coach: “One of the things we always say is that it really is your decision. it might be uncomfortable -I hear what you’re saying –it’s uncomfortable to be sitting there when you don’t want to take any action. But we also both know that it really is your choice. In the meantime, I hope we can check in and follow up with your health or wellness in general.”
- Client: “That would be great”.
In this example, you can see that the coach went right to rely on an intuition that the client might be going to the doctor for another issue. Is the client reluctant to go to the doctor, to quit smoking –or, is it the impending bombardment of issues from the doctor that they are not looking forward to
You will want to use your own coaching intuitions to determine when you can or should interact using intuitive reflections. It can be off the mark or spot on…. the client will, once again, redirect the conversation by confirming or clarifying if your reflection is correct or not.
Here is another example of a coaching dialogue, where the client is seeking the coach’s help to quit using chewing tobacco.
- Client: “I use tobacco and “chew”; I know it’s not good for me; I was visiting my brother and he was doing it, and I know it’s not good for me, but I just started using it one day. Since I know it’s not good for me, I want to stop using it because I don’t want to get addicted to it.”
- Coach: “So you feel that you don’t want to do it because you feel that it’s not good for you? Is that what you’re saying?”
- Client: “Yes, I know it’s not good for me, and I don’t know what to do … to help me stop using it before it becomes an addiction.”
- Coach: “When you do it now, what are the circumstances? Are you doing it because you are with your brother? Is that what I’m hearing?”
- Client: “Well not anymore. Now I’m back home, so I do it when I have a little downtime at night, away from everyone; my wife doesn’t like it, and I try to do it without her catching me.”
- Coach: “So it’s out of a sense of boredom or is it more enjoyable?”
- Client: “Well, maybe it’s more likely that. But I see it more as a time when I can relax.”
- Coach: “Well, what did you used to do in order to relax or to unwind, before you used tobacco?”
- Client: “I would just kind of do some exercise, and do some stretching, things like that. That was kind of relaxing for me. I stopped doing that though. That’s not good either.”
- Coach: “So I’m hearing you say that you are replacing your exercise, which was good for you, with something that you feel is bad for you. And you don’t want it to become a habit”.
This interaction includes a lot of coaching points we’ve discussed up until now. It starts with a summary reflection; the coach then focuses on the curiosity related to the comments made and then restates quitting in terms of advantages instead of providing expert advice on what might happen if the client keeps smoking. The coach uses intuition to tap into what they perceive as important to this client, by stating “you don’t want it to be a habit, and you feel that it’s not good for you, etc.).
This is what the coach wants the client to grasp onto. Notice that throughout the dialogue, the coach didn’t say anything that the client hadn’t already said. Is there any ambivalence from the client in this interaction? Can you find any conflicted feelings in this interaction? This conversation suggests that there is a higher degree of difficulty in decision-making for the client, perhaps more than anything else. It can be hard to see the truth of some of your client’s decisions. But when they are stated by the client, there are advantages that we can explore as they are client-directed or chosen by them. The coach’s statement “Well, is it boredom?” is an example of intuition from the coach, who skillfully wrapped up a lot of coaching skills in one interaction by using a variety of reflections used. Appreciative inquiry-When you hear this term you should think of “open-ended” questions. We know what questions of this type a real ready -those that cannot be answered by a simple yes or no. Often, they turn out to be the WHAT questions, or HOW questions that we ask in coaching interactions.
For example, a coach could ask these open-ended questions: “How did you feel about” or, “What do you think would happen if….?”
Open-Ended Questions: What or How Questions
When we are talking, the questions should be positive, curious questions, asked in a non-judgemental tone. We want to really get at the client’s opinions, not just facts. Using exercise as an example, how did the client feel about exercise in the past?
We also have to note here that sometimes WHY questions don’t work.
Closed: “Did you exercise last week?”
Now, consider these open-ended variations, which are intended to elicit a more meaningful response:
“What did you do for exercise last week?“ Tell me about your exercise for the past week.” “How did your plan to exercise go last week?” “What kind of training do you think would be best for your goals?”
Since yes or no questions do little to promote dialogue with a client, we must find better ways to draw information while being careful and respectful. Simply asking “Do you know that smoking increases your blood pressure?” will not get us a favorable result for a couple of reasons. It is judgmental in that it assumes that the client does not know this already and it also can be a terminal point in the conversation with a yes or no answer. So, there are times when some questions don’t work well with clients.
Another unintended side effect of closed-ended questions means that if a client does NOT know an answer, we ask in a closed-ended type of inquiry, they may feel belittled or like we are trying to quiz them. Furthermore, asking “What do you know about the health risks of smoking?” instead of “Why do you smoke?” is a clear example of what the coach should NOT say. Perhaps “It could be helpful to know why you smoke if we are going to try and launch an effort to quit” would be better received by the client. Therefore, you can see that we have to be aware of how we formulate good questions and how they affect what the client feels. Being both thoughtful and careful about our questions to our client means that we also get to learn what the client knows.
Sometimes coaches fall into the automated type of behavior whereby they use their language to unconsciously influence their client without meaning to be judgmental. “I switched to Greek yogurt years ago” would seem to be a simple, non-judgmental comment but still it may be not the right thing to say at that time with the client. What if, instead, the coach asked a more curious type of question, such as “How would you feel about trying nonfat yogurt instead of ice cream?” or perhaps, “Why is walking enjoyable for you?”
So, what we say and how we say it becomes very important. General rules for coaching conversations:
- Talk less than the client
- Ask one question or reflection at a time (or make sure you have balanced questions with reflections)
- Be aware of sounding like an inquisition
- Affirm strengths
- Celebrate successes!
- ALWAYS getting permission
- Show empathy and non-judgment
There will still be times when coaches are asked for their ideas on when to give advice. In these situations, permission is implied by the question originating from the client. But when can a coach go beyond the question? Only after asking permission from the client to do so. This process is also non-negotiable for coaches. Examples might include “May I share with you something that I know?”, or “Would you like to know more about that….?”
These are two great ways to get permission from the client or subject you are coaching now. This part of it must be comfortable for you, too. It is therefore best to develop your own style of stating this request when you are before a client so that it seems natural, and not contrived.
What about those consults where permission is implied? This does happen, but only after a period of exposure to a client who has stated that you no longer need to ask each time. In this case, asking for permission might begin to annoy the client. So, it is a situation-dependent dynamic, and it will depend on your own style and what your client prefers. It also requires a fair amount of practice for coaches, who need to “develop into a relationship” and have these conversational flow items available in their skills collection. In the beginning, getting permission from a client to speak openly might be awkward, but with practice, it becomes less so. Client consults are much more connected if the conversation flow does not come off as contrived. Without the proper sequence of steps in an interaction, coaches put themselves at risk for going right to problem-solving -when it may not be appropriate yet. This will evolve with experience.
Coaches are masters at reading, feeling, watching, and reflecting -but clients don’t always respond with the intended resulting actions. Coaches can rely on their intuition, once again, to assess how the client is responding to the conversation. This is one of the communication skills that become a tool -and it’s just one of many that need to be mastered or clients could easily pick up on your strategies and influence the results or block the intended approach with their own agenda. Knowing how to sort through this dynamic comes with experience. This skill is a refined coaching behavior. Appreciative Inquiry–the textbook definition: Appreciative Inquiry (AI) is a client-centered collaborative coaching method intended to motivate change by exploring and amplifying strengths. It is always very positive in its nature.
What are the 5 components of Appreciative Inquiry?
There are five principles that will help you better understand AI.
- The first principle is the CONSTRUCTIONIST principle which develops through inner dialogue and conversation with others (constantly being constructed and reconstructed) and then developing a relevant meaning around these conversations. This principle states that some of the conversations we have can ENHANCE or DIMINISH our abilities.
- Next is the POETIC principle. Think about poetry and art, and how we can see it from many different perspectives. You may be inspired in one way by a work of art while it affects others in different ways. There are many ways to interpret where clients are coming from. Finding out their perspectives means that we’ve got to inquire about them!
- The third principle, the POSITIVE principle, suggests that change and personal growth are accelerated by focusing on strengths. As an example, during a job review, if your manager lists a lot of action items, it can diminish your energy, motivation, or will because they were not presented in a positive perspective. There is a very significant part of AI that is rooted in positive psychology.
- The next principle is SIMULTANEITY. Think of simultaneity in this way: When we ask the right questions before we make an important choice, we tend to be automatically directed away from repetitive cycles and toward deliberate focused steps to take — steps that will lead your client toward what they desire. On an interpersonal level, the RIGHT questions will lead you to penetrate your denial systems and wake you up. Sometimes we have to coach our clients to do this. Inquiry creates change and the moment we ask a question; we begin to create a change. In this way, the simultaneity principle states that change and inquiry occur simultaneously. The right questions are vital in order to make it happen.
- The ANTICIPATORY principle states that the best way to predict the future is to invent it. In a way, this is like the prescriptive mentality people have come to expect from wellness coaches who jump in and try to solve everyone’s problems with a dose of something great -this doesn’t work because it is prescriptive, and tends to shine the light on the risks of a behavior. AI shines the light the other way, in the direction of the client by asking “What do you want to anticipate? Or, “What do you want to create out there?”
Fundamentals of Inquiry
We have to show appreciation for the client by APPRECIATING them in some manner. We accomplish this by talking about the good attributes in any situation. “What available learning is there? “How will you be different or stronger when you hit your outcome goal”. This also involves positive possibilities that can be part of a vision. The client’s wellness vision is also tied very closely to the imaging portion of establishing foundations with the client, as you can probably see that it is important for your client to get to a point where they can imagine positive outcomes. It’s also a great way of getting more clarity on what the client wants or where they are now.
The last fundamental of inquiry is ACTING (or ACTION), as in the actual behavior or actions of your client. Is there some congruence with the wellness vision you’ve discussed with your client and their actions? In terms of making an inquiry based on actions, we might say “What ACTIONS are you wanting to try to lose weight?” Some sample dialogues follow to help coaches master the idea of AI. “What is good about the situation you’re in right now?”
In real co-active situations as coaches, we can all think of a situation where we can learn from asking this type of question! We also give the client a positive format to launch from. When inquiring with an emphasis on IMAGINING, try asking “What do you most want to have to happen?” This makes the client stop, and think… and they may have better clarity in their response because they are reflecting on their reply. The ideal goal here is to help the client understand the positive elements of the situation you are talking with them about.
Using ACTION as a foundation is also simple if you just remember to use it during your conversation. It also can be used to get a commitment from the client. Ask your client, “What action do you see yourself taking to move closer to what you want?” You now have something that you can follow up with during a later consult. This type of comment can also give you a lot of information on the client’s stage of readiness. Don’t be afraid to put the question in the client’s court. What is the goal, what do you need to do to get there, and what changes are needed to accomplish it?
The client will come up with all the information they need on their own, and later, they will also do all the work. It takes the pressure off the coach. You aren’t making demands of the client. Sometimes your client may want a prescription type intervention-they may want the challenge you suggest for them. But this is part of another dimension of coaching and will be covered later.
More than anything, however, AI is based on VISION. Therefore, we play a very important role in helping clients to paint the picture of their wellness vision. Where does the client want to go with it? What does it look like? Obviously, we know now that it is not just about health metrics, weight, etc. How does the client’s vision fit into his or her relationships at home or socially? Or with their jobs? We must clarify all of this with the client. We want to help clients create a vision that is about them because this also ties to client motivation.
The vision is also tied to the anticipatory principle of AI. Clients need to know what they can anticipate when they hit their outcome goal. First, what goal is it that they want to obtain? As coaches, our mission is to find out what our client really wants to create as part of their vision. At one point we need to also know WHY it is so important to them. This is simply another way to get the client to talk about their own perspectives and experiences. If the coach is effectively questioning and motivating, he or she may also be able to learn how client experiences have made their visions more compelling to fulfill.
Helping the client develop a wellness vision requires that we clarify the vision as a way to get a better understanding of the deeper levels that influence the wellness vision. It’s natural for coaches to be eager and jump into dialogue that might be outside of what you’re learning to do in these conversations thus far. It is tempting –sometimes you really want to step in and just tell the client how it is. But we know that this isn’t the best way. It is important to let the client come to their vision on their own, without being influenced by the coach. In this manner, it’s more likely to be about what is important to them and not the coach.
When we are asking questions and trying to get at our client’s emotional values, the client doesn’t always have to reveal everything to the coaching in order for things to fall into place. The client may not have it all figured out during the consult. If nothing else, however, the coach sets the wheels in motion for the client to think about their wellness vision. We are really trying to help the client reveal motivators and sometimes, they don’t know these motivators themselves –but with good questions from the coach, they can begin to see things with clarity. There are two main motivators that we need to understand. Global motivators generally apply to a group or the population.
An example would be a client who simply states, “I want to exercise and live better.” Most anyone who would make this sort of change would benefit from these changes. It’s not necessarily an individual benefit specifically for your client. But then there are also the personal motivators –and these are the motivators that benefit our client directly, along with any consequences that are directly tied to the client.
An example for this would be the client who states that “I want to lose weight so that I will feel more confident”, or “I want to stop smoking so that I can save money and buy my wife a safer car”. The coach may intuitively feel that this is also a time to get the wheels spinning (or to plant the seeds), once again with the client. It may not be apparent or revealed initially. One way to get to the personal motivators is to ask, “What will you be doing in the vision you’re seeing?” or “What do you value most about this vision that you have?”
Clarifying has its place in this part of the process as well. In fact, all tenets of active listening will be a large part of this dialogue with your client. The questions you choose can serve to open the client’s mind further to change. Even though this is great information, the coach still needs to know what motivates the client. “How will doing that help you?” This is like peeling an onion, getting to the deeper levels of where the client is coming from.
We could describe Motivational Interviewing as a way of getting a client ready, willing, and able. Being willing relates to the importance of the change. When clients view something as important, they also become more willing to make a change. Getting clarity will also help clients see where they are and where they want to go. This is the role of the coach to navigate and lead the client. The ability factor in motivational interviewing ties to the ability of the client to make a change. Do they have the skills and resources to be able to change? What is the client’s level of self-efficacy? If the coach is skilled enough in motivational interviewing, the client’s abilities tied to self-efficacy will be apparent. What are the client’s priorities?
There are 4 areas of inquiry with regard to motivational interviewing that we use to determine a client’s priorities.
- Disadvantages of the status quo? This involves questioning the client about the disadvantages of where they are currently. When the client states what disadvantages are present, it is vital for the coach to reflect to the client what has been said. An example: “What makes you think you need to do something about your blood pressure?” “How has this interfered with what you want to do in your life?” “What do you think will happen if you don’t lose weight?”This type of questioning will reveal the disadvantages as perceived by your client.
- What are the advantages of making a change? This can seem pretty simple. Try simply asking about how the client sees a benefit from successfully completing a change in their health habits. “What will you appreciate most when you are able to lose the weight?” “How will you benefit when you make a change to your weight?” How will things be different when you quit smoking?” This will reveal what the client perceives as a benefit to changing a certain behavior.
- Does the client express any optimism about making a behavior change? How does the client feel about making a change in general? What is your intuition saying? Is it congruent with what you hear from your client? Think about this statement: “What about yourself or your situation will help you most to succeed?” “How confident are you that you’ll be able to quit smoking?” “What are your strengths in this area of change?” This will reveal the client’s confidence level. Confidence also relates to self-efficacy and self-esteem, as we have already learned.
- What is the client’s intention to change? What does the client plan on doing to reach his or her wellness vision? This is easy to do but often overlooked however it’s very important to include this question: “What do you think you will do?” It starts the suggestion that the efforts about to begin are coming from the client and not the coach. There is an implied separation. “Of the options we’ve discussed, which option do you think will help you most?” If you find that your client cannot answer definitively, the coach may also see that the client is missing this part of making a successful change effort and represents a coaching opportunity. It doesn’t mean we provide an intention for them, but we note where they are at in the process.
The very properties of dialogue we use as coaches are very important in motivational interviewing. While describing the advantages of change, it is also important to ask the client about the “status quo”–especially if they are resistant to the coaching process or change, overall. This is accomplished by asking “What will happen if there is no change made?”
Tools for coaches now include some interviewing techniques that are aimed at getting to know our clients better. Motivational interviewing is client-centered, and directive, and in coaching, it is a method for motivating change by exploring and resolving ambivalence. Use both appreciative inquiry and motivational interviewing techniques with clients with powerful questions during coaching sessions. We have added new skills to our coaching model –while still operating within the CLIENTS agenda. Give your client the chance to fill in the information you seek and define what they want. It is their agenda. Our coaching model so far:
- A methodology designed to foster personal responsibility
- We acknowledge the client’s WHOLE LIFE
- We operate within the client’s agenda
Assessing Readiness to Change
Our job as coaches is to elicit change talk. This involves getting our clients to think about change or to contemplate aspects of change. Change talk could be anything that has worked in the past, or even might be what is holding your client back. For many coaches, it may be a case of the client not even. thinking that they need to change. It’s also not about pinning a client down to commit to change. In our passive coaching model, we let the client determine the changes made. They are not necessarily even committing to any change currently, and that is okay.
In this lesson, we are discussing the items inside of your coach toolbox so that you have some strategies to draw from, and change talk is one of them. These tools can be used on all clients but remember that these tools are not a complete set. They are not the only tools that you will use when you coach clients, as this would include variables that depend on the relationships you have with each client. Still, it is good to know that you can draw from some of these ‘tools’ when you are coaching, or when you are actually helping someone through the process of change -because as we all know by now, change is HARD.
These tools are not a guarantee for success with our client’s behavior change efforts. Ultimately, we let our CLIENTS assume responsibility for their changes. People will only change when they are ready. We have mentioned how confidence is an important part of making changes – so we might use the confidence ruler and explore or practice some of the things that you have seen when you are out in the field.
As coaches, we can –and should -reflect on how important these things are to both our client and our actions as their coach. Decisional balance-Decisional Balance (DB) was a strategy presented in our original Wellness Coach Certification. You may remember that it is the consideration of both the pros and cons of change. The entire concept of DB will become even clearer as we spend more time perfecting this part of our coaching model or approach. The whole core of our job is to promote change. We are trying to provide some health education, too. But when it comes right down to it, we are really trying to promote and assist a person with their behaviors. To change their lifestyle. To help them reduce their health risks, and improve the quality of their lives.
Sometimes, as a coach, it can be helpful for you to think about the change from different perspectives.” What would Ido?” “How would I approach change? Do I just need the answers, as in how or what to do, or do I really have to consider and weigh out a lot of items or factors?”
How do YOU approach challenging tasks? Or, when you are required to make a change or an adjustment -maybe at work, or in your personal lifestyles or habits -how do you approach these kinds of tasks? For a lot of us, we think “I’ll just make myself do it” until a habit is formed. For most of us, it becomes an intentional brain game. You force yourself to focus and remember the IMPORTANCE of doing something that you want to do. One of the things that can be a challenge when we’re looking at using these new skills is to see them as helpful during consults and yet DB is a part of our skills that specifically addresses that MIND GAME that we all tend to play. Your clients are likely to be playing these brain games, and just because you tell them that making changes will help them in the larger scheme of things, this does not imply that they are ready to do anything about changing behavior when you are talking to them. There is a whole different skill set required to be able to assist and not be a part of that same mind game. This tool, of being aware of our OWN perceptions tied to changing our own unwanted behaviors, is valuable in our toolbox of skills.
Still, there are all of those great things that you may know about staying fit and healthy and all of the physical dimensions of wellness, but in reality, how much of that knowledge applies to the change needed in the client? How well can clients apply YOUR expertise? This is just one more reason why it’s more appropriate to keep the approach client-centered and to allow change to occur within the client. So, one of the core foundations of wellness coaching in these situations becomes that we know all of the different tools and how they are used in the coaching process.
As coaches, forward vision, and something to look forward to are important parts of the coach job description. What’s in it for the client? In the sample dialogue that follows, we will see that, at the very least, the client has revealed something she learned about herself. That is the kind of strategy we deploy as coaches. We strive to teach clients how to learn these things for themselves. Clients may ask you about health and fitness information and yet still, not be ready to make changes. The coach needs to know, therefore, how they can assist a client in this stage of readiness to change. This is done with careful MI and AI tactics. What we need to come to understand first is what helps US when we try to make a change as a reference point, and learn the different theories tied to behavior change. But we also must learn the practical applications in the field, as well. This includes making each client.
The psychology of where people are in their life can influence their readiness to change. This requires that we make goals unique for each client toward their change efforts. Consider a client who has a hard time doing anything for him or herself. The client feels guilty, and it takes time for them to be the caretaker. The causative factor is fundamental, which is the real area to address, and this would be that it is best to give clients permission to accept themselves as a priority and to remind them that they can stop playing caretaker to everyone else and move on toward working with you on changing a certain behavior. Many coaches have encountered clients who present as being stuck and not doing what they may know already. Your client’s psychology is a big part of behavior.
Coaches work to provide an opportunity for the client to feel comfortable making changes. It becomes easy then to see how different clients will open up in different circumstances. Again, our own judgments and perceptions cannot be part of the coaching we provide. We must step outside of that mindset. We are here for the client, instead. Now that we know more about how important communication is, and that it must be geared toward the individual, we can also say that it is yet another tool that we have, as coaches, to set the stage for powerful interactions to occur.
What is also hard for some health and wellness coaches coming from the world of fitness are generalizations of the population applied to clients. Yet we know that everyone is an individual and each of us as humans as “layers” that cover our true selves. It would be ad is service to our client if we were left to think that a client lacks the self-awareness or the skills of reflect onto ask themselves “What is important, why is it important, what is within me that I either need to use as a strength or what is it about me that is an obstacle?
As humans, we must give clients enough credit that they can go to these levels of change successfully. But it’s true – working with clients on fitness goals and within different levels of client readiness can help us now to work at different levels as coaches, too, and it’s a transferrable skill set that we share with those who work in the fitness industry. If we are to be successful as coaches, we must master working at different levels with different clients at different stages of readiness.
Many times, interactions open other doors, and transition into ‘wellness’ concerns. It is okay if you happen to have a background in the physical sciences. As a coach, this should be viewed as one of your strengths. But we’ve also made a case for that not being the only skill you’ll need to be a successful health and wellness coach. As a health and fitness professional, drawing from the strengths of your background and seeing how these behavior-change skills fit with coaching, you can envision how this ties in pretty nicely with helping clients to change behaviors. From the dialogue below, try to determine what stage of readiness this person is in, as they talk to the coach about their health.
- Client: “You’ll be so proud of me, I want to quit smoking!” Most of us have heard this statement from a client at one point in time. Now let’s look at what can be done with such a comment.
- Coach: “Wow that is great. How did you come to that decision?”
- Client: “Well my boyfriend has a health condition and it would be best for him to not be exposed to it.”
- Coach: “Okay, so besides wanting to do this for someone that you care about, is there something about this change that is coming from part of you, and that you want for yourself?”
- Client: “Yes, I’ve been really trying to take better care of myself, drinking more water, increasing my exercise, etc. I’m losing some weight and I want to further improve my health by quitting smoking.”
- Coach: “What makes you think you can do this?”
- Client: “I never thought I could lose weight, but I did; I never thought I’d ever want to stop eating fast food, and I’ve done that; I think I’m capable of more than I thought I was in the past.”
- Coach: “I completely agree with you, you have worked hard to get where you are now and the changes are significant. Quitting smoking is a tremendously hard task. On a scale of 1-10, how serious are you about making a change?
- Client: “I’m at about a 7”.
- Coach: “How come a 7 and not say, a 2?”
- Client: “Because I’ve realized what it’s doing to my health, and how my habit is affecting my boyfriend’s health. I finally feel that this is something that I can accomplish.”
- Coach: “I think you can reach this goal. How can I help you to reach a 10in terms of being serious about making this change?”
- Client: “I need information on what I should do to try to quit. I need to know what to do.”
- Coach: “I’m going to have you make a list of the reasons you want to quit and the triggers that make you smoke. Do you think you can do this by my next visit?”
- Client: “YES!”
- Coach: “Okay, I’m going to ask you to do some homework; just so I’m clear, you have some lists that you are going to make, and we can meet up another time to discuss those if you want. I would also like you to start thinking of a quit date. I want you to think about committing to a date, hopefully by the next time we talk. How does that sound?”
- Client: “That sounds good.”
- Coach: “Alright, we can make some plans on how to move ahead with quitting so that we can be on target to hit your quit date. Does that sound good to you?”
- Client: “Yes, that does.”
- Coach: “I’m glad you asked for my help. This is the first step and you should be proud of yourself for taking this first step.”
What are some of the essential skills we can use when elements emerge from a client who is in the preparation stage of readiness? In this example, the coach has used questions to determine how prepared the client is. “Why do you think you are at a 7 and not a 2?” is a way for the coach to access where the client is. It also gives the client a chance to really talk about their and the benefits of quitting. As a tool, you don’t always have to use 1-10 numbers, but just following up when a client states they are ready to make a change can allow the coach to continue asking for more.
- Coach: “How ready would you say you are?”
- Client: “Oh, I’m REALLY ready.”
… you might see, has the same effect. It is the client’s way of telling the coach what is important to them. With interactions like this where the client initiates a discussion on behavior change, coaches have to see that it’s an opportunity for the client to reveal their motivators to the coach; obviously, this coach has also given the client a lot of encouragement-and the coach also is able to assign homework to the client! What follows is another interaction between a coach and a client. In this situation, the client is indicating a desire to do more physical activity but finds it difficult due to working long hours.
- Client: “I used to exercise every day before I started working such long hours. I’m starting to feel sluggish and not feeling as good as I used to, now I know I have to find time to start.”
- Coach: “Okay, on a scale of 1-10, with 10 being COMPLETELY ready to start an exercise program, where do you scale yourself?”
- Client: “I’m an 8.”
- Coach: By giving yourself an 8, it seems like you are really ready to take the steps to change. What is the reason you want this now?”
- Client: “Well like Is ay, I felt better when I used to exercise; I had more energy and motivation. I think if I can exercise more regularly, I’ll feel better and that can also keep me motivated to stick with it.”
- Coach: “What are some of your goals and ideas for exercising? How often do you want to exercise?”
- Client: “Well, I do have time in the morning; if I get into that routine, then that could be possible.”
- Coach: “I think this is a great first step in developing a regular exercise habit for yourself. Having a set routine is more likely to stick for you. How can I help you hit this goal?”
- Client: “Someone checking on me from time to time would be useful”.
You may have observed the concise nature of the coach in their words and questions. The coach clarifies by asking “How ready are you?” This question allows the person to open up and talk about why it’s important for them to take action on a behavior change and what benefits they know of as part of making a change to begin an exercise routine. It also puts the ownership back to the client, by asking “What ideas would work for you?”
One of the essential elements in the preparation stage is to dig a little deeper to uncover motives and to find out how ready the client really is. This is accomplished by following up with “What works for you?”, or “What do you think would be the best way for that to happen?” Again, powerful questions will help the coach to direct the change effort. Coaching in the preparation stage includes essential elements of interaction that warrant exploration.
This includes discussing all of the following with your client:
- importance of change
- allowing the client to state intentions
- defining a plan (provide information on a follow-up plan)
What is change talk? There is more to learn about our clients than simply identifying them as being in a particular stage of readiness. Change talk can be anything where a coach is involved in helping a client explore their motivation and to boost the client’s confidence. It’s an opportunity to take everything from the client and sort through it. Change talk is the core of a client-centered directive method and is often used by coaches for enhancing intrinsic motivation to change by exploring the opposite of readiness –the ambivalence to change.
This part of coaching can be more abstract as it is more about exploring motivations–and each client will have their own unique set of motives. It can also be the facilitation of the client exploring the parts of their lives that may motivate them or aid the client in finding what works for them. Resolving ambivalence requires that we understand what the client’s motivators are and improve the client’s level of confidence. At this point, we are just creating an opportunity to put everything before the client to consider. This may inspire change in itself. We are giving the client an opportunity to feel comfortable with us as their coach and the change efforts they seek as one entity.
We have to elicit change talk and when we hear it, we need to reinforce it. Change talk is not just someone saying, “I’m ready”. While this is important, the coach has a defined role in each stage of coaching and here we want to reinforce this behavior coming from the client. We also need to be able to respond to resistance when it is present because we need to eliminate it. It can be resistance to change or resistance to the coach and his or her presence. Overcoming resistance will be covered in greater detail later. When ideas of change emanate from the client, we find ourselves in an ideal situation with them. Remember that we want the client to say these ideas because they are more likely to accept what is being discussed. After all, who is arguing for change? The client!
While we are not necessarily pushing for change, we still have to recognize that there is a benefit in reflecting back to the client what has been stated. This encourages the client to talk openly and allows the coach to inquire further or to clarify and summarize. Coaches should try to be selective in what they respond to when the client is talking about change, because some clients will see both good and bad in change. If the coach is selective in what is reflected back to the client, the negative statements tied to change should not be the focus of your discussion. Instead, reflect the positive elements of what has been said. Furthermore, we can elicit change talk by exploring discrepancies that we hear from our clients related to where they are versus where they want to be.
Coaches can be even more effective when they are able to explore discrepancies between the status quo (leaving things as they are with no change) versus the desired goal. “How does smoking factor into your values?” “How does smoking conflict with the image of who you want to be or what you want to do?” Don’t forget to tie your questions to the stated values of your client. The last aspect of the coach’s role in change talk requires that the coach explores the perceptions and values of the client, and the relationship the client has to the current way they are living compared to their desired behaviors. This will provide even more clarity in the intrinsic values and personal motivators of the client’s importance and confidence rulers.
The Importance Ruler- Here’s an example of the importance ruler: “How important is it to quit smoking right now?” This is just a simple example -yet it’s going to tell us if what the client is stating is very important, not important, or somewhere in the middle and how they feel at that time about changing behavior. “Where on the scale are you?” the coach asks. The client may voice their concern about the behavior. And this is important because we want to elicit their change talk and recognize that decisions have to be reached according to the client’s desires.
When we find out what those desires are and how important they are to the client by clarifying questions, we continue to encourage or elicit this communication from the client–in this way you may recognize that clarification is not always a reflection. Another example of the importance ruler is how a client may state that they need to stop smoking because their doctor has shared the potential long-term consequences of smoking. The goal we push for here is to have the client reach the conclusions they seek for themselves, not from the urgency from his doctor (or other important people in their life) to encourage a quit effort. It’s possible that this is coming from a pure and simple motive – perhaps nothing more complicated than the affirmation of better health, steering the client to decide to better their health. The coach must be there to reinforce that decision.
Picture how you’d feel if you were NOT present currently. You would hopefully feel that your client would benefit from your positive words and supportive actions as part of your coaching style. Be sure to use reflections when assessing how important something is to your client. This is a way to reinforce the client’s change talk. Sometimes a spouse or doctor doesn’t have the same effect on the client’s importance ruler but if the client has stated how important it is to them uniquely, it does make a significant difference in their motivations and just may be considered more ‘important’ to them.
The Confidence Ruler
What is a confidence ruler? In a way, you will see that the confidence ruler is a way for clients to affirm their beliefs or decisions. Again, it is like a checkpoint. Let’s consider a real-life example, whereby a client may have some doubts about losing weight but lacks the confidence to stick with the change effort, like making the right food choices and adhering to a diet. This statement is the client’s chance to express his confidence parameters to further his goal to lose weight.
Now the coach can do some motivational interviewing to find where some positive reinforcements may be hidden in the client’s words when they are faced with understanding the pros and cons of a certain situation. “How confident do you feel about sticking to your diet? What makes you feel more confident about sticking to your eating plan?”’ Looking at the advantages gives the supporting thoughts that our client can then confirm as being part of their own decision. The client is the one who makes all the decisions; they have control for the whole transformative journey that they’re taking with you as their guide or leader. The features of the confidence ruler are another tenet related to change talk -this results from us trying to bring our clients to explore their decisions more deeply through powerful questioning. The role of the coach becomes one of facilitating open discussion and reinforcing positive statements (In our example, quitting smoking was a positive statement coming from the client).
That said, each coach has their own style.
We must try to align ourselves with the perspectives of our clients. Let’s look at another example. Our client enjoys chewing tobacco. The client has been looking at options and would like to quit but would now like to learn more about why he keeps starting up again. After making excuses he feels that perhaps working out would solve his problem. A lot of people replace their less-than-ideal habits with a positive change -in this case, adding exercise to their lifestyle and ruling health as more important. You don’t even have to be a coach to know this about human nature.
This exploration into change talk is all about learning and being more aware of the options of coaching, using both positive and negative aspects in approaching a problem. We gain knowledge of action and support our clients more completely when we understand all the tools of motivational interviewing and apply them appropriately. Guiding interactions also play a big part in those situations where our client is asking for help. It’s very easy for a coach to see that a client might need additional help in their change effort, and we can then use the rulers along with the client’s readiness to approach the client directly.
Since the confidence ruler is so important to confirm ideas from your client, let’s look at some more ways that the confidence ruler works. We have suggested viewing the confidence ruler as a checkpoint. How might the confidence ruler be a factor in this statement from a client:” I’ve been thinking about going on a diet but I’m having some doubts about being able to stick to it long enough to make it a habit”? After clearing the issue of permission to discuss this with the client, a coach would simply ask “How confident are you in this diet as being right for you?”
This confidence checkpoint is now going to be used as reinforcement for the client. If a client says that they want your help, follow up by asking how confident they are! “How confident are you in this diet –would you say ‘very’ or ‘less than very’? The next comments from the client are important and the coach needs to reflect on those reinforcements. If the client says, “I’m about 50-50 or still on the fence about the whole thing”–then you can ask, “What would make you feel more confident in your effort to do well on this diet?” This is reinforcing change talk because the answers will be more positive comments from your client.
- Coach: “So you feel that since you’ve done some great transformations before, you feel ready to take this on?”
- Client: “Well I tried before for six weeks and even though I did okay with things, I did not like the food choices.”
Here the coach needs to reflect. The client has given you some great information.
- Coach: “So you’ve stuck with this diet successfully before that you can do it again, but you’re concerned that the food choices will be hard for you? But –not liking the food choices may make it hard for you to stick with the plan. Is that right?”
- Client: “Yes, that is right.”
- Coach: “Then is it the food choices that make it hard for you to feel more confident?”
- Client: “Yes, and the fact that I can’t trust myself to have the amount of discipline to lose weight.”
- Coach: “It sounds like if the food choices were better, you’d be more confident”? How do you feel about working with me on some alternate food choices to fit in your diet but also those that match your preference?”
This interaction is good for the client to hear the coach’s feedback on what they’ve heard and spoken. If necessary, the coach has guided the conversation in a way that the coach would also now be able to add suggestions once statements have been clarified. But another dynamic has begun to take shape here. We’ve successfully brought the client to a point of opening up to us and when we ask simple questions to clarify what we’re hearing, oftentimes it will result in even more information flowing from the client. In this case, it turns out that it wasn’t just the structure of a diet that caused concern for the client. Only after good questions were presented did the client offer up their true concerns (food choices). This is an ideal way for conversational flow to occur.
Motivational Interviewing Skills
We have even more motivational interviewing skills to draw from our toolbox. These skills are important for the coach as they are specifically geared toward providing meaningful reflections, they incorporate AI skills and yet still allow for coaching to occur based on the core values of our client. All our coaching tools will come from those areas of emphasis or focus. Consider the disadvantages of the status quo and elicit this from the client. What is the client’s intention regarding change?
“What do you intend to do to succeed with this change?” The decisional balance using tools of evaluating pros and cons of (ex: smoking) regarding the concerns the client can help. Decisional Balance (DB) also means that we can get the client to consider the concerns they may have if there is no change attempted. During this time, we might find that our client is not quite ready to change. The results of completing an entire DB exercise don’t mean that we must make our client write this out, we can guide them as their coach in conversation by asking, “Okay, what are your concerns about changing?”
Conversely, we could explore the pros of NOT changing. As a coach, you would need to reflect on the ideas you hear based on where the client’s thoughts take the conversation. Again, a common example includes smoking cessation. This can be easy for the coach (although quitting smoking is never easy for our client) as we have the client share the cons of quitting from their perspective. It could be the potential of withdrawal symptoms, or even feeling the power of being in control of them not quitting. This gives the client the chance to consider the options. The coach, knowing that the client wants to quit, might use their intuition as to understand how the client feels about quitting. But overall, this is a chance for the to put all the pieces together to view the options. We’re not pushing for change. Instead, we’re just exploring the changes they may encounter. This is truly changing talk. Whenever possible, we should try to reinforce the pros of changing by addressing the positive comments we hear from our clients–they will tell you what they believe are the positive aspects of changing behavior.
Some overlapping in the use of specific MI skills include;
- Coaching around values
- Bringing up a client’s strengths
- Using Decisional Balance
Coaches are most effective when they can get their clients to contemplate the meta-view. Asking “What are the good things about your behavior?” is an informal, easy way to step into this exercise with the client. In the opposite direction of thought, ask, “What are your concerns or what do you imagine being a concern down the road”? The coach may then also turn the reflections and information from the client into a summary that actually focuses on changing behavior. It isn’t always about just the pros of changing but the cons of not making a change. When mapping out a DB exercise, the pros of changing behavior will mirror the consequences of not changing. Providing a client the opportunity to grasp all the aspects of change is what change talk is intended to do. It’s a simple concept but can be complex for the client to look at all angles.
We don’t necessarily engage a client in a decisional balance exercise to push for change but we’re simply trying to get them to explore what’s possible. In this way, we support the client in a way that eliminates resistance, because the comments and thoughts are coming from the client. This is also a great way to help clients in the pre-contemplation stage of readiness. Diminished reflections/amplified reflections-To be as complete as possible, we must know that there are two more quick points to be aware of with respect to reflections. In the first example, we see the coach attempting to clarify or determine importance by intentionally diminishing the emphasis of the words used by the client.
- Client: “I feel especially self-conscious when I need to speak at a meeting.”
- Coach: “You feel a little uncomfortable speaking at meetings?”
Notice here that the coach has restated the client’s words but changed the emphasis of “especially” to “a little” uncomfortable. This is an example of a diminished reflection. This allows the client a chance to both reiterate and emphasize what they’ve said by saying something that reasserts their beliefs. This also gives the coach a chance to see how important reluctance is.
What follows is an amplified reflection. Coaches are cautioned to use this type of reflection with great caution as it can come off as condescending.
- Client: “I don’t have time to exercise.”
- Coach: “So, your work is the most important thing right now.”
The coach has amplified the client’s words by saying that it is “the most important” but that is not what the client has stated. This is intended to allow the client to clarify once again. The coach is always seeking clarity, and this has to come from the client.
- Client: “Well, no, a lot of things are important, my health is important, but I feel that work has to come first.”
Give the client time to give clarity and avoid being condescending to the client. Coaches should be aware of how choosing a word that overstates the client’s feelings may cause the person to stop talking or back away from the experience. Using a word that understates the intensity of the feeling tends to cause the person to continue experiencing and discussing it. Listen and support both actions and learn self-awareness through reflection. We are eliciting conversation and supporting the client in the process. We are fostering personal responsibility. We really make it the client’s job. We can’t help to hear about their whole life, and we are operating in their agenda.
Of course, there is much more to this topic. Yet, this will point you in the right direction.
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