Conversational skills shown
The traditional provider-patient exchange can result in misunderstanding and a patient’s incomplete knowledge of what he or she needs to do to maintain better health, one expert says.
With the evidence-based health coaching (EBHC) approach, combined with motivational interviewing (MI), a patient will gain a more complete understanding of what he or she is expected to do, according to Melinda Huffman, BSN, MSN, CCNS, CHC, co-founder of the National Society of Health Coaches, and principal, Miller & Huffman Outcome Architects in Winchester, TN.
The National Society of Health Coaches website at www.nshcoa.com contains additional information about how EBHC and MI work.
Huffman provides the following sample of how an EBHC with motivational interviewing works:
Traditional approach
Patient: I think I might be able to give myself the insulin shot we talked about.
Case Manager: Good for you! I knew you could do it!
Then the provider goes on about his/her business of the day.
EBHC w/ MI approach
Patient: I think I might be able to give myself the insulin shot we talked about.
Case Manager: “Might be able to.” (As a reflective statement, not a question; so the patient hears what he has said.)
Patient: Yes.
Case Manager: Explain “might be able to.” (Open-ended response that encourages patient to expound.)
Patient: If I had more practice.
Case Manager: Tell me about the concerns you have so we can address these in practice? (Open-ended questions allow patient to explore and think about it.)
Patient: Drawing up the right amount.
Case Manager: What troubles you most about it? (Open-ended questions allow patient to explore further.)
Patient: Being able to see the little marks on the syringe.
Case Manager: Would you like to look at the syringe together now and talk about it? (Asking permission that empowers the patient in the relationship.)
Patient: Yes, I would.
