Health Coaching Applications Using the HCA Model
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- Marlene Gardner
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1 Health Coaching Applications Using the HCA Model Presented by Janette Gale, Health Psychologist, Managing Director Rebecca McPhee, Dietitian, Training Director
2 Patient Health Conditions & Risk Factors Evidence-Based Treatment Recommendations Clinical Consult Health Practitioner Facilitates Health Behaviour Change Patient Readiness, Willingness & Ability to Follow Recommendations Change Thinking & Planning Change Behaviour Adhere to Treatment Recommendations Achieve Evidence-Based Physiological Targets Patient Better Health Outcomes Page 2
3 What is Health Coaching? A practice style used by growing numbers of health practitioners Includes targeted health education and health behaviour change assistance for better health outcomes and decreased health costs A variety of health behaviour change / health change models are being used by practitioners and programs Programs usually focus on chronic disease prevention or self-management and are additional to usual clinical practice The same health change techniques can be used in usual clinical practice for any desired patient health change Page 3
4 The Health Change Spectrum Where does Health Coaching Fit? Traditional medical and allied health clinical consultations Clinical medical and allied health consultations using health coaching Health coachingbased chronic disease & lifestyle management programs Wellness counseling and coaching interventions General counseling & coaching interventions Focus on individualized treatment advice and/or education for specific conditions Focus on individualized treatment advice and/or education for specific conditions + health behaviour change assistance Focus on general recommendations and education for disease management and/or lifestyle change for better health outcomes + health behaviour change assistance (health practitioners) Focus on recommendations and education for general health and wellbeing + health behaviour change assistance (not necessarily conducted by health practitioners) Focus on improving general wellbeing and mental health + behaviour change assistance (not necessarily specific to health or conducted by health practitioners) Health Coaching Biomedical focus health change focus psychosocial focus Greater proportion of medical or health advice Greater proportion of behaviour change assistance Page 4
5 The HCA Model of Health Change The HCA Model is a system of evidence-based principles and techniques that have been built into a structure that guides health professionals in how to facilitate health behaviour change in their patients or clients, for better health outcomes The processes actively identify and address behavioural, emotional, situational and cognitive barriers to change and build patient skills in decision making, problem solving and planning Page 5
6 Health Change Goals Chronic Condition Management ~ Disability ~ Rehabilitation ~ Disease Prevention ~ Health/Wellness 6 Knowledge & Skill Sets 1. Health Conditions & Health Promotion Knowledge 2. Health Behaviour Change Frameworks 3. Health Behaviour Change Interviewing Skills 4. Behavioural Change Facilitation Skills 5. Cognitive Change Facilitation Skills 6. Emotion Management Facilitation Skills Generic Health Behaviour Change Processes Applicable across the spectrum of health goals (HCA Model) Theory Base (Health Behaviour Change) Collaborative Working Alliance (patient-centred) Biopsychosocial Model Readiness to Change Autonomy & Choice Self-efficacy Solution Focus Barriers to Change Trial & Error, Learning & Reinforcement Hope theory Motivation, Volition Self-regulation Positive Psychology Etc. Guiding Structure (10 Step Process) 1. Identify Health Issues, Treatment & Lifestyle Change Options 2. Set an Agenda 3. Explore Motivation (Ask RICk!) 4. Client Makes a Decision 5. Generate Specific Goal Options 6. Select & Refine Specific Goal 7. Create Action Plan 8. Identify & Address Barriers 9. Ask RICk! Again 10. Review & Referral Ask RICk is a registered trademark of HCA Page 6
7 The Role of a Health Practitioner Using the HCA Model 1. To provide professional advice and education as required and correct misinformation, in an appropriate way (knowledge) 2. To help clients to make the decision to follow health recommendations (motivation), and 3. To develop problem solving skills to increase the likelihood of success after a client decides to make changes (self-efficacy) Page 7
8 HCA 10 Steps to Health Change Consultation Preliminaries Identify Health Issues & Treatment & Lifestyle Change Options Set an Agenda & Explore Motivation (Ask RICk!) Decision Line Client Makes a Decision Generate Specific Goal Options Ready to change Select & Refine Specific Goal & Create Action Plan Identify & Address Barriers & Ask RICk! Again Readiness (to adopt particular behaviours) Review & Referral Motivational Interviewing Solution-focused Coaching RICk = readiness, importance, confidence, knowledge Ask RICk is a registered trademark of HCA Page 8
9 What s the Evidence? The HCA Model draws on evidence-based health behaviour change principles and techniques Health behaviour change literature Brief motivational interviewing Solution-focused counseling & coaching literature Cognitive behavioural counseling techniques Health coaching literature and CDSM programs The HCA Model bridges the gap from theory to practice. It adds guidance and efficiency HCA works with organizations to develop, implement & evaluate health coaching programs Page 9
10 Australian Settings & Applications - 1 Community Health (EICD, HARP, CDSM Teams, Chronic & Complex care, Home & Community Care) State-based CD risk reduction & CD prevention programs (Victoria Workhealth, NSW/ACT/Tas Get Healthy, NSW Live Life Well Diabetes Prevention, NSW Severe CD Program) Corporate health insurers (pregnancy, CDSM, healthy lifestyle/cd prevention health coaching programs) Disability and Aged Care services (Anglicare) Page 10
11 Australian Settings & Applications - 2 Rehabilitation programs (injury, cardiac rehabilitation, workers compensation) Mental health services Corporate employee health programs (e.g., mining companies) Pharmaceutical industry (adherence & healthy lifestyle programs) GPs, PN & Allied health services (private & public physio, dietetics, exercise phys, OT, Diabetes educators etc.) Page 11
12 Victorian DHS 2007 Statewide report into self management Flinders Stanford Motivational Interviewing Health Coaching Trained Using Trained Using Trained Using Trained Using % 66% 71% 78% Page 12
13 Summary There are legitimate reasons why people don t adhere to treatment and lifestyle recommendations Patient-centred health coaching can increase adherence rates and improve patient self-management The HCA Model of health change can guide practitioners in applying patient-centred care in a time efficient manner, to address barriers to change and achieve better patient health outcomes The model can be used in clinical consultations and health coaching programs Page 13
14 Thank You For your Participation! Download health coaching case studies, practice guides & worksheets at For training information contact The Institute for Optimizing Health Outcomes Page 14
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