What makes health coaches uniquely valuable among healthcare professionals? The coach approach.
Sufficient coaches work in a collaborative way with clients, rather than donning an expert hat as we see with practitioners in the healthcare industry. This collaborative partnership between coach and client is proven effective in clinical research where studies show that obesity and cardiovascular-related conditions, for instance, are improved thanks to health coaching interventions.
In his revolutionary book, Unconventional Medicine, Chris Kresser explains the differences, plain and simple:
“In the expert approach, the ‘authority’ assesses the problem, delivers advice, recommends solutions, and in some cases, teaches new skills. In the collaborative approach, the coach acts as a partner or ally, encourages the client to discover their own solutions and become their own advocate, and supports them in developing the skills they need to embrace new behaviors.”
There is indeed a place and time for the expert approach, especially when someone is facing an immediate health crisis. In health and wellness coaching, however, it should be used infrequently and “just in time.”
Health Coaches: Let’s identify the obvious and obscured disadvantages of playing the expert card too often. Next, we’ll get clear on what’s involved, and not involved, in an effective coach approach. Finally, we’ll explore how a proven behavior change framework known as Motivational Interviewing (M.I.) can serve as the foundation of authentic, client-centered health coaching.
Drawbacks of the Expert Approach
1. It’s ineffective for behavior change:
One of the most general, yet, far-reaching reasons to resist the expert approach is because telling people to change doesn’t work. And, when health and wellness coaches think and act as though they have the answers, they skip the necessary interactions needed for behavior change.
When you put on the expert hat too often, or too impulsively, you communicate “I’m in control here.” This righting reflex—as they say in Motivational Interviewing—is likely to be met with defensiveness because the client feels snubbed, rushed, or misunderstood. Even though your advice is well-intentioned, taking an authoritative approach has an undesirable effect on the conversation and coach-client dynamic.
2. It leads to rushed action and threatened autonomy:
Coaches also have a tendency to rush clients through the stages of change. If you direct clients at a pace they’re not ready for, it can damage your rapport or even reverse the progress you’ve made together.
Put yourself in the client’s shoes for a moment and imagine you’re being told what to do and when to start doing it. If the coach is lucky, in a sense, you came to the session saying, “I just need to know what to do and how, and I’ll follow exactly what you say.” But most people, most of the time, receive directive advice as a threat to their autonomy—whether subconsciously or not. Why? The expert advice can take on a parental, authoritative quality that makes the client feel lectured or patronized.
When advice or direction is given without request or consent, the client may feel as though their needs are being ignored. In response, they may experience an increased sense of insecurity regarding their ownership in the matter. The result? Feelings of frustration and discord, on both sides, typically resulting in client rebellion.
3. Conversation seems hollow and familiar:
An especially triggering tendency of the expert is to label a client (e.g. “As a type 2 diabetic, you need to be careful with…”), or to use assertive language that suggests they have a “problem” (e.g. “Because of your problem with sugar addiction, your goal is to avoid…”).
This leaves certain individuals feeling defensive and disconnected from the professional.
It helps to assume that every client has presented their challenges to several other experts before seeing you. They’ve seen the doctors, read the books, and tried the diets, yet they struggle with self-motivation and family support. Once they decide to work with you as their coach, they come to the table with certain expectations regarding what you’ll say, or how you’ll direct them (e.g. The client thinks, “I know one of the first things my coach will say is that I need to quit smoking,”) just like every other professional has demanded in the past.
When you heedlessly take on the expert approach, even in an effort to encourage beneficial changes, the client can be reminded of a script they’ve played out many times; both of your actions and reactions become predictable and the result is a disappointing conclusion they’ve endured before.
Instead, coaches are most effective and impactful when they take on a client-centered approach that sees each session, and each client, as a unique interaction requiring compassion, curiosity, and collaboration in order to build trust, spark change, and result in transformative outcomes.
The Coach Approach Is…
- a collaboration between coach and client
- client-centered
- fostering possibilities and self-motivation
- fueled by curiosity and compassion
- more client talk than coach talk
- a coach who practices active listening and reflections
- centered on encouragement and positive psychology
- seeking answers from within the client
- harnessing client strengths and resources
- unfailing protection for client autonomy
- naturally fostered self-efficacy
- challenging clients to set/achieve realistic goals
- guiding sessions in a holistic, dynamic fashion
- meeting clients where they’re at (regarding comprehension, present state, or change readiness)
- learning from the client’s experience and seeking their input
What the Coach Approach Is Not
- delivering unsolicited advice
- assessing and seeking what needs “fixing”
- defining an agenda
- providing all the answers
- generating a know-it-all energy
- talking more than the client
- following a checklist or methodical questions
- being the authority
- using scare tactics or emphasizing risks/danger to motivate change
- prescribing solutions/goals
- making assumptions or drawing conclusions
- disagreeing or moralizing
- thinking about what you’ll say next
- persuading or lecturing with logic
- interrupting or avoiding
- feeling responsible for client progress/health
Mastering the Coach Approach
Coaches who seek to master a transformative coach approach will find the roadmap inside the framework of Motivational Interviewing (M.I.)—a powerful communication method to facilitate personal change.
Just by learning the four key elements of the M.I. spirit, you’ll be spending most of your time in the client-centered approach (that is coaching at its core), and your clients will see you as an invaluable resource that is only superseded by their enhanced degree of self-efficacy.
4 Key Elements of the M.I. Spirit for Autonomy-Supportive Coaching
- Collaboration: The coach partners with the client rather than functioning as the authority. Although it’s likely that the coach has knowledge that the client lacks in certain areas of health and behavior change, this is balanced by the fact that the client has all the knowledge about themselves (life experience, desires, tendencies, etc…).
- Evocation: The coach evokes the client’s desire to change, and ideas for how to change, rather than telling them what to do or seeing their situation as something that needs “fixing.” Fundamental to M.I., the coach believes that the client already possesses everything they need in order to change. The coach’s job is to help bring it to the surface and help uncover the client’s intrinsic motivation and strengths needed to be successful.
- Acceptance: Comprised of four aspects—autonomy, absolute worth, affirmation, and accurate empathy—the coach honors each client’s innate worth and potential as a human being and the decision-maker in their own life. Coaches seek to understand things from the client’s perspective, meet them where they are at, and emphasize their freedom and potential with unconditional positive regard.
- Compassion: With compassion, the coach prioritizes the client’s needs over their own and seeks to help them in whatever way best serves them. Rather than interacting from a place of judgment, the coach seeks to listen without an agenda, and with the sole purpose of sincerity through heart-centered interactions that are guided by the client’s expressed needs.
The coach approach is intended to emphasize one’s strengths and opportunities in the pursuit of self-actualization. As you embark on your health coaching journey, rest assured that this dance of fostered collaboration and positive energy is what fuels the pursuit of transformational change.
