What is health coaching?
Health Coaching is useful for any health practitioner working with people who have long term conditions or those who have a role in encouraging people to take more ownership or responsibility for their wellbeing. It involves having conversations to find out what’s important to an individual, and what they want (or don’t want) to work on. This is very much a person centred approach. The professional takes a curious stance, they encourage the person to reflect on their situation and think realistically about where they’re at and where they want to be. From that, discussion then covers what’s achievable and realistic, what options there are for them and what’s a practical way forward.
Within physiotherapy we use a lot of aspects of coaching in our work because these skills are important when encouraging people to do difficult, challenging or painful things. When I first attended health coaching training, I left thinking that all physios should do this. Thinking back across my career so far it would have been really useful in a variety of different clinical areas and situations. When I received coaching whilst we practiced during the training, it helped me to feel more positive, capable and motivated about my goals. On one occasion I also left with a valuable realisation that I hadn’t been ready to tackle certain things and so was then able to focus my efforts to more fruitful tasks.
Health coaching in physiotherapy
Working as a physiotherapist, the health coaching training I’ve had and my experience using it has really helped me to develop my skills in helping people take more ownership of their health, particularly when things feel stuck. I’ve learnt useful techniques and frameworks to help direct these conversations and how to frame language in a less directive way to encourage them to take more responsibility.
These conversations provide useful insight into what that person is thinking, what their preferences are and how they’re feeling. This can help build rapport and help the person receiving the coaching to develop ideas about what will and won’t work for them. This can be very empowering for them and can help them structure plans and goals that are more meaningful and hopefully more successful with them feeling more in control.
Health coaching involves facilitating and encouraging a person to come up with ideas and plans themselves. One of the challenges in using this approach is that it can be very difficult to step back from a more traditional role in healthcare as a problem solver. This non directive approach can also be a bit unsettling if it alters the usual power dynamics or if it hinders our ability to achieve what we feel we should be achieving as therapists. But this can also be a useful process to help us consider whose agenda we are working towards and to think about the impact on the outcome of care if the young person’s agenda isn’t prioritised or considered as much as it could be.
One of my biggest learning points from this process has come from insight into how ready a person is to tackle challenges, make progress or achieve sustained behavioural change. This is invaluable information for how best to proceed, what approach might be more effective and where to put more effort. It can provide clarity early on about what isn’t important as much as what is to help prioritisation and focus time and efforts in an optimal and constructive way. This reflection has also helped me to develop better perspective and understanding of how much a person’s readiness to change contributes to a lack of progress in relation to how effective the intervention is or to my own limitations as a therapist. Overall I have found health coaching to be interesting, useful and a valuable skill to learn and I’d encourage others to look into it.
Rachel Naunton, Specialist Paediatric Physiotherapist and Me first Practice Facilitator