There can be nothing more frustrating for a health professional than a patient who just won't take their advice. Why, when told by a stony-faced medic that bad things will happen unless we ditch the junk food, stop smoking or take our cholesterol meds, do we fail to act? A US psychologist thinks he has the answer. "All too often, we give people advice and give them terrific information, but then we expect them to do it alone," says Dr Michael Arloski. "That's why failure occurs."
A professional certified coach and author of Wellness Coaching For Lasting Lifestyle Change , Arloski believes that if health professionals tweaked their interaction with patients, they'd get better results. He says that while doctors are trained to intervene with medical treatment, helping a person to change their behaviour is an entirely different model.
“I think before [health professionals] relied on information and what I like to call ‘medical admonition’,” he says. ‘If you don’t do this, terrible things are going to happen’, and yes, that’s a true warning, but despite hearing it, we know people just don’t succeed at their lifestyle change.”
He thinks health professionals need to look at their communication style before blaming patients. “You might think that patients don’t want to change but that’s not true. They want to improve their lifestyle, desperately sometimes, but they need an ally to help them with a plan, support and accountability.”
That’s where wellness coaching comes in. His course for health professionals and others shows them how to guide and empower patients towards taking responsibility for their own health and adopting long-term lifestyle changes.
The first rule he says is for practitioners to listen to the patient more thoroughly and discuss any barriers to change. “It’s about asking powerful questions that help the patient explore their motivations and what’s really going to work for them.”
From there, he says it’s about building a concrete plan and helping the patient to become accountable for achieving it.
Few doctors, he concedes, have time for such sustained involvement with individual patients. He’s proposing that while physicians should undergo training to be more coach-like in how they interact with patients, they should then refer the patient on for more intensive coaching. “Doctors aren’t going to be able to deliver all the coaching themselves, they don’t have the time, but what they can do is give the patient a ‘lifestyle prescription’, and then hand them off to a wellness coach to have that prescription filled.”
He says while changing habits might sound easy in the confines of a doctor’s surgery, it involves a lot of behavioural change and a big shift in attitude and beliefs. “A wellness coach is someone who is trained in lifestyle behavioural change methodology to be able to help someone succeed at actually accomplishing the goals that they want to accomplish.”
Arloski says statistics that show that wellness coaching works “are only just starting to come out”. Some participants in the course however are seeing results.
South Dublin GP Dr Paul Heslin completed Arloski’s four-day certificate in health and wellness coaching course last year. He says the methodology shows doctors how to work in partnership with patients, “moving away from the old paternalistic style where we tell you what to do. We are more likely to ask patients, ‘What do you want?’ or ‘What do you need to help yourself?’ Heslin says.
“This idea of seeing a GP for 10 minutes and achieving anything life-changing. I mean, you can make small changes within the confines of that but I suppose the whole model has to change.”
Nutritional therapist Suzanne Laurie also did the course. As a director of the Institute of Health Sciences, she was behind bringing it to Ireland. "Since the course, I realise that nutritional therapists are falling into the trap that a lot of health care professionals are . . . telling people a lot of what they already know – and what we are not addressing is finding their intrinsic motivation to change."
She says while some obesity patients know the health outcomes and have had it explained to death, they still can’t find the motivation. “Now that I’ve done the coaching course, I spend more time with individuals finding out what does their health mean to them, when they look in the future, what do they want the outcome to be, and what really matters to them – is it being around longer for their family or being able to get into a particular dress. Working with that as a motivator, I’ve just found it makes such a difference.”
For more information visit instituteofhealthsciences.com
