One of the foundational principles of coaching is that an individual will almost always follow through on their own ideas more consistently and with greater success than they will follow through on the recommendations of other people. Your role as coach is to "lead from behind" and help patients become clear on their personal health values, vision and goals.

Dealing With Ambivalence

When we speak of coaching and motivating patients, we must acknowledge the power of ambivalence. Whether they realize it or not, most people have some degree of ambivalence about making health and lifestyle changes because they have competing goals. Yes, they want to be able to easily walk up three flights of stairs, but they don't want to spend time building up their stamina.

You can identify ambi-valence during coaching conversations by listening for the "but" in the middle of sentences. For example, if a patient says, "I really do want to exercise, but I don't have time," the "but" cancels out whatever came before it, and so nothing changes. Here are some coaching questions you can use in that situation:

• What is holding you back or standing in your way?
• How / why is that holding you back?
• What would make this the right time to take action?
• What would it take for you to be ready to change?
• What motivator is important enough to help you reach this goal?
• Which has more weight right now, the pros or the cons of making changes?
• What would make the pendulum swing over to the pro side?

Working with ambivalence is a part of the coaching process. Try not to get frustrated and know that oftentimes, it's two steps forward, one step back for patients who are changing old habits.

Avoid Potential Landmines

There are a few caveats related to using coaching with patients. First, be sure to have a patient's permission before delving into conversations that go beyond the reason they are in your office. Going down a road with a patient who is not ready to discuss a particular issue will come across as judgmental and compromise the process.

Second, it's important to phrase questions so you don't come across as judgmental. When a patient confides that they routinely have three or four alcoholic drinks daily, there's a big difference between asking, "Why do you think you drink too much?" vs. "What do you feel would be a reasonable goal in terms of alcohol consumption?"

Other landmines associated with coaching involve putting your own agenda ahead of the patient's, asking leading questions, and giving advice when you should be letting the patient come up with their own ideas. Be aware of these missteps as you venture into coaching conversations.

You're Part of the Solution

Are you ready to help close the gap for people who say they want to be well, but live with the consequences of modern life and a medical model of "fix what's broken"? If you are committed to being a leader in the current trend toward chiropractors being seen as the "go-to" practitioners for wellness, the time and energy you invest to become proficient in coaching will be worth the effort.

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Click here for previous articles by Shelley Simon, RN, DC, MPH, EdD.