The effective provision of health coaching requires practitioners to integrate three areas:
- Skills techniques and mindset from performance and development coaching: Being able to effectively use general non-directive and directive coaching skills and techniques (e.g. using a coaching model to structure the conversation, supporting the development of options and providing supportive challenge)
- Principles and models from psychology and behaviour change science: Applying evidence based insights, models and processes (e.g. using patient activation, behaviour change models like COM-B and supporting intrinsic motivation)
- Knowledge, skills and expertise of practitioners: Drawing on their own specific knowledge and skills as a practitioner, or lived experience if a volunteer (e.g. their knowledge about local assets, or the condition and treatment options)
For example, a practice nurse may use health coaching to support someone to manage their diabetes through a conversation that integrates his or her clinical knowledge about diabetes through offering guidance and managing risk where appropriate; while applying the principles of behaviour change that relate to improving adherence with a management plan; and structuring the conversation using a coaching model and advanced listening skills to recognise someone’s potential to self-manage.
Or, a social prescriber might use a Patient Activation Measure questionnaire to understand how to tailor their approach with someone who plans to become more physically active; while using coaching skills to discover what is important them and establish meaningful personalised goals, and draw on their own specialist knowledge and experience of local community assets to support a conversation about options about community activities the person could join.
An exception to this general principle of health coaching involving the integration of coaching skills, behaviour change psychology and practitioner expertise, is when practitioners are delivering services with people who have low levels of activation, where a more traditional non-directive coaching approach has been found to be more useful.
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