Essential Skills of Health
Coaching:
Doug Post, Ph.D.
Learning Objectives
At the end of this
session, students will be
able to
 Describe motivational interviewing skills.
 Describe shared decision making skills.
 Describe health coaching skills.
 Demonstrate how to develop an action plan in
collaboration with a patient.
Motivational Interviewing Skills
 Ability to assess “stage of change” and conviction and
confidence about changing.
 Expressions of respect for patient autonomy in making a
choice.
 Eliciting the pros and cons of behavior change
 Listening respectfully to patients statements of resistance or
commitment to change, and reflecting them back to patients
 Collaborating and reaching agreement on goals that match
patients’ stage of change, conviction, and confidence.
 Avoid attempting to persuade patients with low conviction to
change behavior
 Avoid trying to direct or prescribe action plans if conviction or
confidence is low.
Motivational Interviewing Skills
 Simple reflection
 Double-sided reflection
 Self-efficacy assessment
The Effective Physician Video
Review of Motivational Interviewing
Shared Decision-Making
 Find out the patient’s understanding of the problem, then share
appropriate facts and answer questions
 Find out what role the patient wants to play in decision-making
 Find out what is important to the patient: goals, values, etc.
 Present options that take into account the evidence and the patient’s
goals
 Obtain the patient’s thinking on options and answer questions
 Give recommendations and discuss the patient’s thinking
 Arrive at a mutually agreeable plan
 Discuss possible barriers or problems that the patient sees and work to
develop a plan to deal with them
Shared Decision Making Animated Short
The Patient Perspective
 http://www.youtube.com/watch?v=XPm5iEDEI8
Y
Shared Decision Making Video
 Visit DocCom

http://webcampus.drexelmed.ed
u/doccom/user/
 Review the Video Example in

17 Shared Decision-Making
Clarence Braddock MD, Stanford
University
Shared Decision Making
Elements of Effective Coaching
Not
advising how
to solve
problems.
More
listening
than talking.
More
More
reflecting
reflecting
than
than
commenting.
commenting.
More asking
than
telling.
Health Coaching Process
Assess patient’s current lifestyle
Assess patient’s strengths and past successes
Assess what is important to the person right
now
Assess what the patient wants to work on
now
Patient Action Plan
Something the patient WANTS to do, not SHOULD do.
Can be achieved within a target period.
What-How Much-When-How Often-How Confident
Assess confidence level
Strategize with the patient to prevent triggers.
Strategize to resolve expected barriers.
Health Coaching Process
 Conduct a needs assessment
 Coach the patient to develop an action plan of small
steps
 Guide, support, teach, and link the person to
resources
 Patient tries the action plan
 Follow up with the patient and develop another
action plan…
Health Coaching Example
Health Coaching Example Video
Telephone-based coaching video from OSU:
Nutrition
What Happens Next
 Perform a formative OSCE on health coaching
skills
 Work with a peer on health coaching skills
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