1 Using coaching techniques in typical client interactions

2 Introductions Tonight’s Presenter Lynn Grieger, RDN, CDE, CPT, CHWCHealth, Food and Fitness coach Moderator Heidi Diller, RD ReShape® Patient Care Manager

3 Today’s topics Using a coach approach in: Short interactionsMotivation and non-compliance Hunger and fullness Setting and reaching goals Today’s topics

4 Put on your coaching hatMindfulness – set your intention Develop empathy Open-ended questions Active listening Client-driven Put on your coaching hat

5 Short interactions

6 FOCUS First ask permission Offer ideas Concise Use a menuSolicit what the client thinks Rosengren  Building Motivational Interviewing Skills: A Practitioner Workbook FOCUS

7 Discussion options What and when to drink Meal times vs grazingEating out hydration Portion sizes

8 Instant Influence: 6 stepsWhy might you change? How ready are you to change? Why didn’t you pick a lower number? Imagine you’ve changed. What are the positive outcomes? Why are these outcomes important to you? What’s the next step, if any? Pantalon, Instant Influence Instant Influence: 6 steps

9 Step 1: Why might you change?Create empathy and trust Use open-ended questions Focus on the positive WIFM Use conditional words Might Would Could Perhaps Try Reflect resistance Step 1: Why might you change?

10 Step 2: How ready are you to change?Use a ruler to gauge readiness to change Focus on one specific step within a set timeframe Step 2: How ready are you to change?

11 Step 3: Why didn’t you pick a lower number?Part of you wants to make this change The number itself isn’t important The importance is the reasons for making a change Step 3: Why didn’t you pick a lower number?

12 Step 4: Focus on the positive outcomesImagine you’ve made the change. What benefits will you see? Suppose you can wave a magic wand and suddenly the change occurred. How would you benefit? Step 4: Focus on the positive outcomes

13 Step 5: Why are these outcomes important to you?

14 Step 6: What’s the next step, if any?

15 Motivation or Non-compliance?“Noncompliance: Failure or refusal to comply. In medicine, the term noncompliance is commonly used in regard to a patient who does not take a prescribed medication or follow a prescribed course of treatment.” Motivation or Non-compliance?

16 Health care approach Give them insight Give them knowledgeGive them skills Give them a hard time Health care approach

17 Client: I just don’t like the taste of plain waterClient: I just don’t like the taste of plain water. RDN approach: Have you tried flavoring water with cut-up fruit or vegetables? Many of my patients really like making infused water. Your turn: type into the question box a coach approach reflection you might use instead of the RDN approach. Your turn!

18 Client: I’m just so busy in the morning, I don’t have time for breakfast. RDN approach: I have a list of breakfasts that you can make in less than 5 minutes that you can use this week. Your turn: type into the question box a coach approach reflection you might use instead of the RDN approach Your turn!

19 Coach approach Meet with compassion and empathy Non-judgmentalActive listening Use your OARS Focus on the positives Build self-esteem and self-efficacy Coach approach

20 Am I Hungry? Body-Mind-Heart Scan from Michelle May, MD PauseBody scan Mind scan Heart scan Am I Hungry?

21 Pause

22 Body scan Look for tension, discomfort, painIs my stomach rumbling, empty, growling? Do I feel light-headed? Low energy? Body scan

23 Mind

24 Heart

25 7 types of hunger Eye hunger Nose hunger Mouth hunger Stomach hungerCellular hunger Mind hunger Heart hunger Jan Chozen Bays MD Mindful Eating 7 types of hunger

26 Develop empathy Approach each client with deep curiosityBe mindful and present Listen actively and without judgement See the world the way your client views it “it sounds like you’re in a difficult place right now” Communicates the message that we understand and you’re not alone Develop empathy

27 Motivational Interviewing in Health Care by Stephen Rollnick, William R. Miller and Christopher C. Butler Motivational Interviewing in Nutrition and Fitness by Dawn Clifford and Laura Curtis Instant Influence by Michael V. Pantalon Mindful Eating by Jan Chozen Bays Resources