CMSA Today - Issue 2, 2014 - (Page 12)
Evidence-Based Health Coaching
The New "In" of Health Teaching
Engaging Patients through Evidence-Based
Health Coaching and Motivational Interviewing
BY MELINDA H. HuffMAN,
BSN, MSN, CCNS, CHC
vidence-Based Health Coaching (EBHC)®
with Motivational Interviewing (MI) is
gaining national attention as the latest
trend in patient and family engagement to
achieve better outcomes at a lower cost
through health behavior change, as well
as patient and provider partnering. As a
consumer-centric collaborative process,
case management aligns perfectly with the
constructs of this new approach. What is the
EBHC with MI skill set that makes it so special?
How does it work in case management? How
will the ever-increasing use of technology
enhance or diminish the effectiveness of this
highly personal intervention?
EBhC WITh MI DEFINED
EBHC with MI is described by the National
Society of Health Coaches as conversational
skills and interventions used by health care
providers to actively and safely engage clients/patients in health behavior change and
enhanced self-management of health conditions resulting in improved health outcomes,
lowered health risk, and decreased health
This approach gives health care providers a framework of engagement in which
they can guide and partner with patients
to identify the patient's own values, beliefs,
and concerns that support or hinder lifestyle
change needed to improve health, wellness,
or recovery. As opposed to a more traditional
health care model in which the patient is
asked to simply mimic the caregiver's
instructions with little regard to their feelings, EBHC with MI helps the patient explore
any ambivalence they may have reagarding
health behavior change.
Issue 2 * 2014
NShC Clinical Model of EvidenceBased health Coaching
EBhC, MI, AND
hEAlTh BEhAVIOR ChANGE
The introduction of a new prescription,
access and use of new services, or followthrough with treatment plans requires some
type of behavior change no matter how small
the change may seem. Behavior change
requires development, adoption, or adaptation to a new habit, commitment, goal, or way
of life. Generally, behavior change isn't easy.
We only have to think of the health behaviors
we ourselves have tried to change or have
changed to bring this sharply into focus. Dr.
Susan Butterworth of Oregon Health and
Sciences University performed research that
revealed the most common reasons why
people don't change behavior:
* Their values don't support it.
* They don't think it's important.
* They don't think they can.
* They haven't worked through
* They aren't ready for it.
* They don't have a good plan.
* They don't have adequate social support.
Notice that "lack of knowledge" is not
listed. A few years ago, I gained the motivation to change my exercise level and dietary
habits to address my high cholesterol, which
I built through a realization of the condition's
implications on my life, rather than my knowledge about its potentially detrimental effects.
I enjoy eating and initially didn't want to give
up the foods I love; however, regular exercise
only dropped my total cholesterol by nine
points and barely budged my HDL/LDL. I was
disappointed and torn between choices. Such
is the difficulty with health behavior change.
Miller and Rollnick (2013) suggest that people have difficulty with changing behavior not
because they don't understand its downside,
but because they have conflicting feelings
about it. Consider these examples:
* "I would exercise, but I'm just too tired
when I get home."
* "I know that I should eat more fruits and
Table of Contents for the Digital Edition of CMSA Today - Issue 2, 2014
Cmsa Corporate Partners
The New “in” of Health Teaching
The Information Technology Factor
Index of Advertisers
CMSA Today - Issue 2, 2014