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Coaching Mild Chronic Conditions

Client Scenario: How do I support a client with a mild chronic condition (e.g. diabetes, or asthma) and few symptoms, in being motivated to lead an active lifestyle to prevent the development of more life-altering chronic symptoms?

You likely entered this field because you have a natural passion for health and fitness, and the connection between the two. You feel called to help people improve their health conditions and quality of life through exercise, and hopefully delay, minimize, or avoid the bad consequences of a serious medical event. You want your enthusiasm to spill over to your clients. You have a strong, internal motivational urge to move your body and you want to help others discover that strong urge. You encourage, educate, and sometimes cheerlead with enthusiasm to inspire engagement in a fitness lifestyle.

Your passion is a wonderful trait – believing in the power of health-giving lifestyles, believing people can get fit, get healthier through a fit lifestyle. It’s invigorating to feel this passion. You are grateful for the work you get to do. While your passion is energizing for your relationship with clients, making it clear that you want to help them, your passion may not always elicit their passion and motivation. Sometimes you are successful and your clients get motivated and jump onto the fitness bandwagon and stay there. Sometimes your passion may be energizing for your clients for a while, or they may engage to please you for a while, but it doesn’t last if they don’t discover their own passion and internal motivation. Sometimes your clients don’t seem to be particularly motivated from the outset. They may not bring a lot of passion to your time together. You are working pretty hard to ignite, motivate and excite them while they are just going through the motions. Following directions.

What coaching inquiries might help you to be more successful in generating client motivation?

Tell me about your fittest and healthiest time(s) in your life. Let’s start by digging up, appreciating and unpacking your client’s past and best experiences with being healthy and fit. What happened to generate these times for you? What did you learn? What did good health and fitness contribute? What was the impact on your energy, sleeping, stress, mental productivity, creativity, and other life aspects? This appreciative inquiry allows clients to reconnect with a positive past in order to ignite possibilities for a positive future.

Describe someone you know and admire who has a chronic condition and has turned it into an opportunity get fitter and healthier. Most human behavior is learned through modeling; from birth we are attuned to the models in our lives for behaviors, ranging from walking to conducting ourselves in social settings. We take our cues from role models and, when they are effective, can adopt the “If he can do it, I can do it!” attitude as a result.

There is an important distinction to make here, however. Behavior change is better influenced by role models than by inspirations. An inspiration seems untouchable. Like an Olympian, or an astronaut, or even you as a fitness expert, success of these role models is so far out of reach that it inspires awe, but not confidence. The success of inspirational role models may seem too unlikely for us to believe that we could do it too.

A role model is one or more with whom we feel a kinship. We see similarities in their character, in their stories and in their struggles. We see their humanity, along with their success. In other words, we can see ourselves in our role models, and therefore our true potential to be like them.

What are you most passionate about, what do you treasure most in your life? Health and fitness is not the end goal for most people, it’s the means to the end that people most desire. Ask, what are you passionate about in your life? What do you treasure most? What do you most enjoy, or look forward to? What do you most want to have happen in your future? Watch for your client’s eyes to sparkle, face to light up, when they discuss what makes life most worth living. This is the energy of their life force, the energy needed to power up positive change.

How might a higher level of health and fitness help you live a life you treasure? Now is an opportunity for your clients to connect the dots between their best experience of being fit and healthy and how greater fitness might enable them to have more of what they love most, or more of what they want most for the future. After fully exploring the positive side, you might also ask: what would your life be like if your medical condition got more serious, how would it impact the things you are most passionate about or care about most?

What are the most important reasons for you to get fitter and healthier? Humans generally struggle to change behavior if the good reasons to change don’t clearly outweigh the good reasons to not change. In today’s world where we often feel overwhelmed, and have no time to pause and reflect more deeply, our self-awareness may be shallow. Have your client develop a list of all of the good things that would likely happen if s/he was to get fitter and healthier. Get out of sales and into fishing, as motivational interviewing trainer Robert Rhode says. Dig deeper, what else would happen? What would that be like? What would you be like? What is good about that?

What source of motivation will help you most in moments of planning and decisions, choosing between a healthy and less healthy option?

Your clients are faced with dozens of decisions daily that impact their fitness and health, take the stairs or not, eat the apple and not the cookie, and on and on. Ask your client to explore and prioritize their most potent source or sources of motivation, the ones that are most likely to generate a health-giving choice when brought to mind in the moment of making a plan or decision. Your client’s best kind of motivation is the one that works best and reliably in the many moments of daily life when she/he plans and makes decisions. Then explore: how could you pause to wake up out of automatic pilot and notice that this is one of those health-generating moments, and then bring your best motivation, summon a good intention into mind just as the moment of choice arrives?

Originally published in ACSM Certified News Coaching Column

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