In my last blog I explored the TGROW coaching model. Now here’s an example of how it can work in practice    

Meet Mrs A. She’s a 53 year old who has been admitted to a local district general hospital. At five foot two tall and with a weight of 232 kg, she’s morbidly obese. That’s resulted in a number of issues, from a history of falls, to anaemia, cellulitis, vitamin D deficiency, and even community acquired pneumonia. 

Now meet Mrs A’s bariatric support team. They include a consultant, physiotherapists, physiotherapy assistants, and the manual handling advisor for the healthcare trust. They’ve also been training in a whole team health coaching approach, and together they’re using those skills as they look at the care Mrs A is receiving –in particular around her rehabilitation. 

Listen and discover 

In employing their health coaching training, the team’s approach involves working with Mrs A to find out what she wants to achieve from her treatment. This involves using the TGROW model (Topic, Goal, Reality, Option, Way Forward/Will) which I explored in my previous blog. This, the team felt, would not only give Mrs A structure and consistency in her treatment, but also provide the same support for the team themselves.  

Mrs A knows that she needs to reduce her weight and has agreed to work with a clinical psychologist and dietician towards this goal. Her family are also part of this conversation, and they too become a vital part of the process. Coaching involves chatting to them generally, getting to know them, asking questions, and listening – not telling them – so that their own role in Mrs A’s treatment can be established. 

From this, the team discovers that Mrs A’s real goal is to walk again, something she’s not been able to do for a while. She wants to be able to walk again to share more time with her grandchildren.  So with the help of the consultant, physiotherapist and the manual handling advisor, Mrs A sets some small goals towards the achievement of her greater goal.   

It’s not an easy journey. This is where ‘reality’ becomes important. Mrs A opens up one afternoon to her physiotherapy assistant. She’s in tears about her situation, talking about her weight and how she feels trapped by the situation she is in. In listening to Mrs A speak, the assistant finds out how Mrs A now feels able to speak about her situation and her options, and how she feels that she and what she wants as an outcome both matter – she feels supported in working towards her goals. 

In a few weeks the team and Mrs A see real progress, and when it comes to her discharge from the unit, she walks to the ambulance which is to take her home. Two weeks later, her physio assistant is able to report that Mrs A is walking in her house and keeping up the exercises designed to help her focus on her newly won mobility. 

Not only is this exciting news for Mrs A, but the team treating her gets a real boost. They are now even more motivated by the TGROW approach, but also feel excited, and more purposeful and cohesive as a team. In addition, Mrs A’s stay in hospital has been shorter than expected for patients in her same bariatric category. That means a direct cost saving in terms of bed days and of having to hire bariatric equipment to support her care. 

Mrs A really does exist – as does the team at the healthcare trust. Which means that what both patient and team have learned together from the application of TGROW, is  very real – and very valid. 

Benefits to team and patient 

So what are the learning points from this study in using TGROW? 

The team has learned to share and work much more closely together. The skills, not least in communication, have all been boosted and their confidence as a team is higher than before. Their morale is also higher, as they can clearly see that the training is able to make a real and positive difference. Finally, their mind-set is now that of enablers, not merely individuals trying to fix things. 

For the patient, the care is now personalised. It’s not just one of patient and professionals, but an environment where both are experts with skills and knowledge to share. The patient is now directly involved in their own care – and it’s their choice that really matters. They’re not just having things done to them, but share the decisions on just what that treatment needs to involve. The patient experience is also consistent with a clearly outlined approach. Finally, because they are so closely involved, their confidence in the treatment approach is also increased. 

To find out more about TGROW, whole team health coaching and how it might benefit your team, contact us now at or visit our website at