Ineffective Path:
COACH: Let’s get back to your conversation with Kevin. You’ve been able to discuss his motivations, now use the skills you’ve learned to discuss his barriers to change and collaborate on a plan.
SUSAN: You should join the MOVE! program. Do you know what that is?
COACH: Rather than telling Kevin that he “should” join the MOVE! program, which is directive and has a judgmental tone, try to avoid the use of “shoulds” and instead ask Kevin about his understanding and interest in a weight management program.
KEVIN: Uh, I don’t know much about it. I know it’s some weight loss group for vets, right?
SUSAN: It focuses on health and wellness; mainly through diet, physical activity and behavior change. But the big thing is it’s customizable, meaning it can be tailored to your own goals and preferences. How does that sound to you?
KEVIN: Look, I’m all for losing weight, but like I mentioned before, one of my biggest problems right now is time. Which any kind of “program” sounds like it’s going to take a lot of.
SUSAN: It’s very important for your health that you participate in some sort of weight loss program. I’m sure you’ll be able to figure out how to fit it in your schedule.
KEVIN: I’m sorry. This, this program’s just not for me. I think I’m done for today. Maybe next time we can figure out something else.
COACH: Kevin felt you were pushing him to do something he is not ready to do, so he pushed back and ended the conversation. Go back and try another choice instead.
SUSAN: The MOVE! program will help you lower your weight while using your time efficiently.
COACH: While the MOVE! program can help with weight and time management, it’d be more effective to first ask for permission to share information.
KEVIN: I... I don’t know. I’m just not feeling too good about this.
SUSAN: For example,
SUSAN: Setting up a 1:1 call with a clinician, rather than having to go and see someone in person.
KEVIN: Hmmm, that does save me on commuting time.
SUSAN: There are evening sessions, so you wouldn’t have to take any time out of work.
KEVIN: Well, I can’t take any time out of work, so that’s pretty much a must have. Still, glad to hear that’s the case!
SUSAN: Do any of these features sound like the program could be helpful?
KEVIN: Hmmm, maybe, maybe. They definitely sound like time savers.
SUSAN: Sounds like you’re already on board with making a plan to link up with the MOVE! program?
KEVIN: Well, not sure if I’d say “complete” one yet, but maybe “try”? You did bring up some interesting points.
COACH: It would be more efficient and effective to respectfully explore Kevin’s understanding and motivation before trying to push ahead with the MOVE! program. Asking about desire, ability, reasons, and need (DARN) might even evoke change talk and build Kevin’s motivation.
SUSAN: Losing weight can help lower your A1C levels.
KEVIN: I mean, I figured, but how much weight exactly?
COACH: It is true that losing weight can help reduce A1C levels, though it may be better to ask Kevin for permission before sharing this information.
SUSAN: Losing just 5% of your body weight can help get those A1C levels lowered. So at 256 pounds, we’re looking at around 13 pounds. You’d be less tired, and,
SUSAN: do what you want to be able to do at work!
SUSAN: How does that sound?
KEVIN: OK, I guess.
SUSAN: Let’s work on setting a goal together.
KEVIN: OK.
COACH: Though your choice to set a goal is valuable, you missed an opportunity to collaborate with Kevin on setting a SMART goal, one that is behaviorally Specific, Measurable, Action oriented, Realistic and has a Timetable to complete.
SUSAN: Is there a goal in mind you’d like to achieve?
KEVIN: Uh, talking with someone from MOVE! at, uh, some point?
SUSAN: Sounds good to me!
KEVIN: All right. Goal set. Easy.
KEVIN’S THOUGHT: Since she didn’t give me a time frame or anything, this should be a piece of cake.
SUSAN: Nice work. Well, I guess we’re all done here.
KEVIN: Thanks for your time. I appreciate it. I’ll remember what we talked about here today.
SUSAN: That’s great to hear Kevin. I’ll put in a consult to MOVE! and have them give you a call.
KEVIN: Thanks!
SUSAN: No problem! See you in three months at our next appointment!
KEVIN: See you then!
COACH: Kevin decided to work on his weight, and set a goal to connect with a clinician from the MOVE! program to identify options that fit with his schedule. Three months later at his next visit, Kevin reports that,
COACH: He has MOVE! telephone counseling sessions and exercises a few times a week, but hasn’t improved his eating habits. He lost 2.5% of his weight, less than he planned, but he’s making progress and motivated to make more. Next, look at your Performance Dashboard for feedback on your choices.
Effective Path:
COACH: Let’s get back to your conversation with Kevin. You’ve been able to discuss his motivations, now use the skills you’ve learned to discuss his barriers to change and collaborate on a plan.
SUSAN: What is your familiarity with how the MOVE! program can help manage your weight?
COACH: Good job asking Kevin what he already knows about the MOVE! program before sharing information with him.
KEVIN: Uh, I don’t know much about it. I know it’s some weight loss group for vets, right?
SUSAN: It focuses on health and wellness; mainly through diet, physical activity and behavior change. But the big thing is it’s customizable, meaning it can be tailored to your own goals and preferences. How does that sound to you?
KEVIN: Look, I’m all for losing weight, but like I mentioned before, one of my biggest problems right now is time. Which any kind of “program” sounds like it’s going to take a lot of.
SUSAN: Time is an issue for many veterans. Would it be OK if I shared some aspects of MOVE! that might help you with your concern about time?
KEVIN: Sure.
COACH: Great! Because you started with a reflection and asked for permission to share info about the MOVE! program, Kevin was receptive to what you had to say.
SUSAN: There are evening sessions, so you wouldn’t have to take any time out of work.
KEVIN: Well, I can’t take any time out of work, so that’s pretty much a must have. Still, glad to hear that’s the case!
SUSAN: Setting up a 1:1 call with a clinician, rather than having to go and see someone in person.
KEVIN: Hmmm, that does save me on commuting time.
SUSAN: You can even use a mobile app to access MOVE! content that you supplement with calls or texts!
KEVIN: An app?! Now that’s useful, especially if it’s anything like my banking one. I must have saved myself days reviewing info on my own and talking to my rep remotely.
SUSAN: Do any of these features sound like the program could be helpful?
KEVIN: Hmmm, maybe, maybe. They definitely sound like time savers.
SUSAN: That’s great, Kevin. Perhaps I can share how losing weight and keeping it off can help you lower those A1C levels and reach your goals?
KEVIN: Now that’s something I would love to hear.
COACH: Great! You asked for permission before sharing information. As a result, Kevin is more receptive to hearing what you have to say.
SUSAN: Losing just 5% of your body weight can help get those A1C levels lowered. So at 256 pounds, we’re looking at around 13 pounds. You’d be less tired, and,
SUSAN: do what you want to be able to do at work!
SUSAN: How does that sound?
KEVIN: Huh. When you put it that way, not too shabby.
SUSAN: Sounds like you’re willing to consider working on your weight, especially if you can participate in a way that addresses your preferences and needs.
KEVIN: Yeah, that sounds about right.
SUSAN: We can work on a plan that’ll help you with your weight management AND caters to your preferences by using “SMART goals.” Would it be OK if I explained what a SMART goal is and maybe we set one together?
KEVIN: Sure.
SUSAN: Each letter of “SMART” stands for something about the goal. Specific, measurable, action oriented, realistic, and time based.
KEVIN: Well, I like the realistic part.
SUSAN: OK, well, what’s something you think might be realistic then?
COACH: Good job! You asked Kevin for permission to share information, which respects Kevin’s autonomy and encourages collaboration. In addition, you took the time to explain SMART goals to help Kevin succeed in making a change.
KEVIN: Uh, maybe just talking with a MOVE! person in the next week or two?
SUSAN: Great!
KEVIN: And I can make time to be more active by,
KEVIN: watching my sports on the weekend, so I can maybe actually play a little sports during the week.
KEVIN: It’s worth it to lose some weight. Feel less tired. Especially if losing weight means,
KEVIN: I’ll be up for any physical work my job needs me for.
KEVIN: If that’s the case then sign me up!
SUSAN: You seem pretty confident that you’ll keep to this goal.
KEVIN: Well, you’ve got me thinking it’s worth devoting some effort to.
SUSAN: Nice work. Well, I guess we’re all done here.
KEVIN: Thanks for your time. I appreciate it. I’ll remember what we talked about here today.
SUSAN: That’s great to hear Kevin. I’ll put in a consult to MOVE! and have them give you a call.
KEVIN: Thanks!
SUSAN: No problem! See you in three months at our next appointment!
KEVIN: See you then!
COACH: Kevin decided to work on his weight, and set a goal to connect with a clinician from the MOVE! program to identify options that fit with his schedule. Three months later at his next visit, Kevin reports that,
COACH: He has had MOVE! telephone counseling sessions and he is eating better and getting regular exercise a few times a week. He has lost about 5% of his weight so far, about 15 pounds, and he’s motivated to lose more! Next, look at your Performance Dashboard for feedback on your choices.