An introduction to
Coaching for Health
1
Effectiveness of Health Coaching
• Smoking cessation (McAllister et al, 2004)
• Obesity (Petersen et al, 2008)
• Cardiovascular disease (Vale et al, 2003)
• Physical & mental health (Butterworth et al,
2006)
• Diabetes (Fera et al, 2008)
• Medication adherence (Melko & Terry, 2010)
What is Coaching?
Definitions: Coaching is…
“…unlocking a person’s potential to
maximise their own performance;
helping them to learn rather than
teaching them”
Timothy Gallwey
“…building awareness, responsibility
and self-belief”
Sir John Whitmore
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Definitions: Health Coaching
“A behavioural intervention that facilitates
participants in establishing and attaining healthpromoting goals in order to change lifestylerelated behaviours, with the intent of reducing
health risks, improving self-management of
chronic conditions, and increasing healthrelated quality of life.”
Van Ryn & Heaney (1997)
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Shared Decision Making
“A process in which clinicians and patients
work together to clarify treatment,
management or self-management support
goals, sharing information about options
and preferred outcomes with the aim of
reaching mutual agreement on the best
course of action”
Expertise
Clinician’s Expertise
Patient’s expertise
• Diagnosis
• Experience of illness
• Disease aetiology
• Social circumstance
• Prognosis
• Attitude to risk
• Treatment options
• Values
• Outcome
probabilities
• Preferences
Telling
Instructing
Giving advice
Pull – Helping someone
solve their own problems
Offering guidance
Directive
Push – solving someone’s
problems for them
Making suggestions
Providing feedback
Non-Directive
Paraphrasing / summarising
Reflecting back
Asking questions that raise awareness
Listening to understand
t – G.R.O.W
Myles Downey
Coaching Framework
1. (t – Topic)
2.
G – Goal
3.
R – Reality
4.
O – Options
5.
W – What next?
G.R.O.W
R.G.O.W
T-GROW – Myles Downey
Telling
Instructing
Giving advice
Pull – Helping someone
solve their own problems
Offering guidance
Directive
Push – solving someone’s
problems for them
Making suggestions
Providing feedback
Non-Directive
Paraphrasing / summarising
Reflecting back
Asking questions that raise awareness
Listening to understand
Directive
Non-Directive
Directive v. Non-directive
• Directive = “you should try this solution”
• Non-Directive = “which solution would work best
for you?”
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Directive
• When will you address the issue directly?
• What could you do about it?
• What do you think the best thing is to do?
• Can you describe the situation?
Non-Directive
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Directive transformations
Useful principles:
• De-personalise – take the ‘subject’ out (or replace
‘you’ with ‘we’)
• Start at the Non-Directive side of the spectrum
• Provide your own options (Directive questioning)
• To generate a Directive question, simply turn the
statement directly into a question
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Directive transformations
• “Tell me what you did wrong.”
• “I’m starting you on a new drug.”
• “You need to have a healthier lifestyle.”
• “You’re procrastinating, you should just get on
and do it.”
Overview of Full Course
1. Mindset
2. Skills
3. Frameworks
Arnstein’s Ladder
Listening
t-GROW
Values & Beliefs
Questioning
Transactional Analysis
Behaviour change
Reflecting back
Resources – Barriers
Coaching Principles
Challenging
Motivation
Evaluation Findings
• Over 400 participants have completed the 2 and 3 day
trainings since 2011
• 98% would recommend the course to others, 95% have
already done so and 78% have already shared the
learning with colleagues
• After three months, 53.3% of participants said they were
using their skills "All or most of the time“, and 31.4% said
they were using them "Some of the Time"
Thank you!
nick.nielsen@osca.co
dougjhing@gmail.com