Health and Wellness Coaching: How to Help Patients Determine Goals

Once a patient has identified what they would like to focus on in their healing plan, have them brainstorm what they specifically want to change or improve. If they feel unsure or are apprehensive, a good tactic is to allow the patient time to journal or write out everything they want to accomplish, big or small, as well as the known steps or tasks it will take to get there. This process should not be structured and should instead be an opportunity to thoroughly reflect on how they can act on their core areas. Refining this brainstorm occurs during the goal setting process.

The following table can help engage the patient in the brainstorming session:

Health coaching often centers on two main techniques for patient communication and education: ask-tell-ask and teach-back. While working with the patient to determine goals and create action steps, these tools are invaluable for ensuring the patient understands their role in the healing process.

Ask-Tell-Ask

The American Medical Association denotes ask-tell-ask as the basis for all health coaching. Rather than telling patients a lot of information, providers ask the patient what they know and what they want to know; tell the patient what they want to know; and ask them if they understand and what else they want to know.

Teach-Back

Teach-back ensures the patient understands the care plan recommended by the provider. The provider asks the patient to repeat back the information about what the patient understands in his or her own words. If the patient doesn’t state the information correctly, the process is repeated until the patient is able to verbalize what to do. Teach-back is a recognize national standard of care by several national agencies and associations, including the American Academy of Family Physicians, American Hospital Association, and The Joint Commission.

Core Areas

Before establishing goals and action steps, work with the patient to refine their core areas, or the specific areas of their life that they would like to improve. These core areas may be very similar to, and at the very least should consider, the patient’s values and vision. Some examples of core areas include:

• Health
• Family
• Relationships
• Career
• Spirituality
• Finances
• Recreation

Once a patient has identified what they would like to focus on in their healing plan, have them brainstorm what they specifically want to change or improve for each core area. A good tactic is to allow the patient time to journal or write out everything they want to accomplish for each item, big or small, as well as the known steps or tasks it will take to get there. This process should not be structured and should instead be an opportunity to thoroughly reflect on how they can act on their core areas. Refining this brainstorm occurs during the goal setting process.

As with the patient’s values, order each core area by importance. A reasonable approach is to tackle one core area at a time, breaking each focal point into smaller, tangible goals as part of an ultimate plan of action. In the beginning, the patient is more likely to work on what immediately interests them or is easily attainable. As they move forward and celebrate several small successes, they will be more motivated and engaged to take on bigger challenges. 

Editor’s Note: This is an excerpt from the e-book, A Six-Step Approach to Health and Wellness Coaching: A Toolkit for Practice Implementation. To access the full text, click here.