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COACHING AND COUNSELING
Clinician advice has been consistently shown to stimulate attempts to improve health-related behaviors. But, unfortunately, advice alone seldom results in long term success. Many patients want to change, but just don’t know how. Patients who are counseled in behavior change strategies have a much greater chance of success. However, clinicians face multiple barriers in providing such counseling, including lack of time, insurance disincentives, and lack of confidence in their ability to counsel and the patient’s ability to change. Consequently, few patients receive effective behavior change counseling.
This situation can be improved by several changes in office systems and provider practices. One promising development is the growth of health "coaching”. It is a simplified type of counseling that focuses strictly on developing and supporting a behavior change plan that the patient believes in. Patients with underlying psychological issues or more complex behavioral issues (e.g., addictions) require credentialed counselors or therapists. But, for many patients, a simple coach is sufficient. The advantage of coaching is that non-clinical staff can be trained to provide it, thus it serves well as a complement to physician advice.
The Coaching and Counseling Time Tool developed by the American College of Preventive Medicine is an innovative educational tool designed to assist the clinician in a more systematic approach to behavior change interventions. The tool includes a practical approach for a clinical visit using an assistant in a "coach” role; it also includes a robust clinical reference document delineating behavior change strategies, guidelines and recommendations, overcoming practice barriers, office system enhancements, along with additional tools and resources, and a patient handout.
· Describe barriers that must overcome to improve the delivery of behavior change interventions
· Describe strategies to improve the number of patients who are coached in behavior change
· Assess the readiness of a patient to consider a behavior change
· Describe principles of motivational interviewing
· Describe the 5A model for counseling on behavior change
· Assess the practice to identify ways to enhance office systems regarding behavior change
To earn CNE credit for this educational activity:
· Linda Turner, RN
Procter and Gamble
· Phyllis Symuleski, RN
Procter and Gamble
In the interest of providing an educational experience free of commercial bias the American College of Preventive Medicine was responsible for decisions regarding educational content and allocation of funds. All individuals involved in the planning, development, and delivery of educational activities are required to sign a conflict of interest statement in which they disclose any relevant financial interests or other affiliations with industry or other associations which may have direct and substantial interest in the subject matter of the CNE activity. Such disclosure allows program participants to better evaluate the objectivity of the information presented in the program.
The AAOHN’s support of this Time Tool for CNE does not imply any endorsement by the AAOHN of ACPM or its products/services.
ACKNOWLEDGEMENT OF SUPPORT
This ACPM Time Tools series has been funded through an unrestricted educational grant provided by MDVIP.
Copyright 2010 American College of Preventive Medicine. All Rights Reserved.