Pic 7: The screen transitions to the next example statement “Debate team takes up all of Melanie’s time. She doesn’t have time to exercise.” There are three response examples.

• Could she cut back on debate?
  • This is a leading question that is likely to prompt an answer of “No” or “Yes, but”. Rather than establishing a pattern where you suggest solutions and the parent shoots them down, it might be more effective to ask an open-ended question.
• How much time does she spend on debate each week?
  • This is a closed question that will likely elicit only a one- or two-word answer. Plus, it focuses on reasons not to exercise. An open-ended question like “What benefits might you see?” is more likely to build some momentum toward change.
• What benefits might you see if she could find time to exercise?
  • This is the correct response! A question like this can lead a parent to consider the benefits of change, even if they are skeptical.

Pic 8: The screen transitions to the next example statement “We don’t have time to eat at home, so we have fast food in the car before the kids’ games.”

• Do you know how many calories are in most fast food kids’ meals?
  • This is a closed question that will only elicit a yes or no answer. It also takes a confrontational tone, which might damage your rapport or provoke a defensive response.
• If you wanted to eat better, what would you change?
  • This is a great response! This is an open-ended question that will let you and the family set the agenda for the visit together.
• How many days a week do you eat fast food?
  • This is a closed question with a definitive answer and does not invite further discussion. 

Pic 9: The questions disappear and the screen changes to one with the title “Elicit-Provide-Elicit.” There is a circle in the middle of the screen which has an image of three word bubbles descending diagonally. The first one is light blue and has an arrow inside pointing to the left. The next one is dark blue and has an arrow pointing to the right, and the last is the same as the first.

But sometimes a client does need new information to make an informed decision. To respectfully share information, we use a technique called Elicit-Provide-Elicit. 

Pic 10: The previous images move off the screen. Two circles appear, a health coach figure in one and a regular figure in the other. There are arrows pointing from the regular figure towards the health coach figure. The health coach has a word bubble with a question mark in it above its head. After a moment, the word bubble and arrows disappear and arrows instead come from the health coach towards the regular figure. After another moment, the question bubble appears above the health coach figure’s head again and arrows resume from the regular figure to the health coach figure.

In which professionals with health coaching responsibilities askpermission to share information, then give a small amount of information, and afterward follow upwith an open-ended question to see how the patient interprets the information.

Take a look at this example.

Pic 11: The screen changes to one titled “Example of Elicit-Provide-Elicit.” It has a conversation between a health coach figure and a regular figure through text bubbles, which reads:

Health Coach: (Elicit) Would it be okay if I share some information about food advertisements?

Parent: Yes, that’s fine.

Health Coach: (Provide) Research shows a strong connection between advertising and weight problems. Most children under age six can’t distinguish between fact and advertising.

(Elicit) What do you think about that?

Parent: She does ask a lot about the cereals and stuff she sees on TV.

Eva (voiceover): By asking permission first, you show respect, and, by following up with an open-ended question, you give families the opportunity to voice concerns or respond with change talk.

Pic 12: The screen changes to a new one titled “Reflective Listening.” A circle appears with an image of a blank word bubble, a dashed vertical line, and a word bubble with quotation marks. A arrow points from the blank word bubble to the quote word bubble in an arc above the dashed line.

The final technique is reflective listening, in which we reflect families’ thoughts and feelings back to them. This makes them feel understood and encourages them to continue.

Pic 13: The previous image is wiped off-screen. Two new circles appear, one with a health coach figure and another with a group of three figures. The words “Change Talk” appear between the two circles. Initially, white arrows move from the three figures towards the health coach, but after a moment blue arrows begin to move from the health coach towards the group.

Reflecting change talk, families’ reasons for change, emphasizes those reasons and invites people to expand on them. This lets you use what a family says to guide a conversation in the direction of change while respecting their autonomy.

There are lots of different ways you can use reflections, but for now let’s look at some basic examples. 

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