How to Deliver Brief Advice for Health

Delivering Brief Advice is easy when you know how. Follow the simple structure below to get it right first time, but before that check you know how to listen, question and reflect.

LISTEN with all your attention and don't load up solutions, questions and answers whilst you are listening. Make a note of these for later, but for now listen without judgement, listen for clues, listen for repeated words, listen for feelings, listen with your whole body and signal for encouragement. Listen some more and then listen again. Push yourself to get used to uncomfortable silences and pauses. You may feel awkward, but your client is using this space as valuable thinking time in which they will be able to self-reflect and start to come up with their own solutions. This thinking space is crucial as people are much more likely to make changes if they are the ones solving their own problems.

Don't ask too many QUESTIONS. Questions redirect the conversation somewhere else and if you're the one asking all the questions then guess what? You're directing the conversation. This is particularly hard for healthcare professionals as they have been taught to be the expert and question, question, question. This means they often fall into the expert trap and stop clients spending as long as they need to on the finer details of the subject that's being discussed and ultimately thinking for themselves. Within a 5 minute conversation you shouldn't be asking more than 3 questions.

REFLECT as much as possible. Reflecting back what someone says to you is one of the most powerful things a listener can do. This tells the speaker 3 things. First it shows you are actually listening and not thinking about your commute or what to have for dinner. It shows that you are fully present, in that moment for that person, walking side by side. Even if you reflect back the wrong meaning the speaker will correct you and will see that you are trying to understand what they are saying at a deeper level. The second thing reflection does is enable the speaker to hear what they have said to you. When we speak we don’t tend to really listen to what we are saying, so when someone repeats back to us what we’ve said it can often feel like the first time we’ve heard the thing we said. When you get really good at reflecting your client will often think you are the one coming up with all the answers and doing all the problem solving, when in fact you have simply built verbatim and complex reflections into your conversation at a level that feels natural and not forced or repetitive. The third thing reflecting does is encourage your client to elaborate. By repeating back what someone has said to you (and the trick is to know what bits are important and worth repeating back) you are pushing the topic back to them so they can explore their thoughts and feelings more fully than if you kept firing question after question at them. And when you reflect and pause? Well, that’s when the magic happens.

Brief Advice Framework (10-20mins)

Start with an Affirmation – “You’ve recently started exercising…you’ve cut down on fizzy drinks…you haven't drunk alcohol for 6 months...you've maintained your tenancy for well over a year...”

Ask Permission – “Do you mind if we talk…is now a good time...it's says in your support plan that you have a Type 2 Diabetes, would you like some information about how physical activity can regulate blood sugar levels?”

Initiate a Change Talk – “What would you like to see different about your current situation? How would reducing alcohol benefit you…are you happy with the amount you smoke...if I could wave a magic wand what would be your perfect weight?”

Reflect Back – “You would like to smoke less…you’re unhappy with how alcohol affects relationships…you're concerned about your health...you think your weight might be an issue...you've become more concerned about not being active enough.”

Question Change Scales – “On a scale of 1-10 how important is this change? On a scale of 1-10 how committed are you to making this change? On a scale of 1-10 how ready are you to start making this change today?” Be prepared for each scale to be different and when your client gives you their score don't try and push it up immediately as this will undermine the score they gave you. Ask them what makes it a 5, ask them what the score was last week and if anything has changed. This will provide insight into wider issues they might be dealing with and other motivating factors or barriers to making the change.

Ask Open Ended Questions – “How have things been with…what have you found challenging...what's been your biggest achievement this week...what are you most proud of?”

Normalize Fears – “Many people make several attempts…lots of people struggle to quite the first time.” Be careful with your tone here. It doesn't matter if thousands of people have struggled before, the person in front of you is struggling for the first time.

Encourage Self Belief – “Tell me about a time you’ve made a successful change…give me an example of something you are proud of...tell me about something you enjoy doing.”

End with an Affirmation – “It’s clear that you’re committed to this…this is obviously something that is very important to you...this change really means something to you.” Learn the difference between an affirmation and praise. Praise is paternalistic and wrapped up in your own judgement. Saying "well done, or, I'm proud of you" sounds fine to most people but for someone who is struggling to make a change to their identity or lifestyle praise may put too much pressure on them to succeed, which is a higher place to fall from when relapse occurs. It will also remind them of the power imbalance between them as the 'client' and you as the 'professional'.

 

 

Don't make resolutions, create a plan for change

Resolution, resolution, resolution. We’re ripe for change in early January, but we often fall at the first hurdle simply because we don’t know how to turn ideas into goals and goal into habits. Luckily for us psychologists and behaviour change specialists have been studying this for years and have come up with some simple, yet highly effective tools for making changes that work.

To make successful changes you need to set goals and make a plan for change. The first thing you need to do is ask yourself some important questions;

  1. What specifically do I want to change?

  2. Why do I want to make this change?

  3. On a scale of 1-10 how important is this change to me?

  4. On a scale of 1-10 how committed am I to making this change?

  5. On a scale of 1-10 how ready am I to make this change?

  6. What’s stopped me making this change in the past?

  7. Why is now the right time to make this change?

  8. What resources do I need to make this change?

  9. How can I get the support and resources to make this change?

  10. Who else will this change affect?

  11. What or who will be a barrier to making this change?

  12. Who might help me maintain this change?

  13. What’s one thing I can do today to start making this change?

  14. How will I know I’ve been successful?

  15. How will I feel if I don’t achieve my goal?

  16. How will I feel if I am successful?

  17. What will life be like in 3 years if I am successful at making this change?

Take the time to answer each question honestly and write down your answers. From these you will be able to identify what has stopped you in the past, what’s motivating you now and who might be a barrier or support to making this change. This is the start of making a plan for change. Only work on one change at a time and take yourself through these questions for every single change you want to make.

The next blog will give you tips on how to make changes easy, build changes into your routine and turn changes into habits.

Jazka Atterbury, Behaviour Change Specialist, Professional Coach and Trainer

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Motivational Interviewing Techniques in the Workplace

Pushy managers and creepy sales techniques are thankfully a thing of the past. We now know that to reach people, the first thing we need to do is understand what makes them tick and to do that we need to learn how to listen and ask the right questions.

But what are the right questions and how can we show others we are listening?

Motivational Interviewing Techniques have successfully moved people from ambivalence or resistance to thinking about and embracing change for over 20 years. Sustained change is achieved by a series of questions and reflections that create a collaborative and supportive environment in which to facilitate change. You can successfully use Motivational Interviewing in a number of workplace interactions including team meetings, staff supervisions, training, health chats, employment tribunals, sales meetings, pitches and prospective calls for new business.

The key to Motivational Interviewing is to create an environment where others feel truly listened to and understood, whilst at the same time directing people to come up with their own ideas and solutions. People are much more likely to change if they are able to identify and commit to their own choices and make informed decisions based around these.

Try using the Motivational Interviewing Framework designed by Free Range Professionals to enhance your interactions with others and notice the difference this makes. You can adapt the sections to reflect more and question more, but make sure you use each section at least once.

Ask, Affirm, Question, Reflect, Clarify, Summarise

1. Ask Permission – always ask for permission from the person you want to talk to, don’t just assume they are free to interact. You could lead with one of the following;

“Is now a good time to talk a bit more about what we do at xxx?”

“Are you in the middle of something or is now a good time to talk?”

Would you mind if we had a brief chat about your progress on xxx?”

2. Give an Affirmation – highlight something positive about the company or person and affirm this.

“I wanted to tell you how impressive your web layout is.”

“From what I’ve observed your company really has a handle on xxx.”

“I found your presentation on xxx really informed and thought provoking.”

“it’s clear you have taken on your new role with real commitment and enthusiasm.”

3. Ask Open Questions – don’t ask too many questions but when you do make them count. Ask questions that elicit meaningful information from your prospect.

“What challenges are you currently facing with xxx?”

“If you achieved what you wanted with xxx, what would success look like to you?”

“I’d really like to understand your requirements, can you elaborate for me?”

“What would put you ahead of the competition?”

4. Reflect – this shows the person that you are listening to them and also gives you a chance to clarify the hidden meaning of what they are saying. The trick with reflection is not put words in the person’s mouth, which will really annoy them, but rather test for meaning based on what they say to you.

“You are finding it difficult to drive customers from Facebook to your site.”

“Your current provider can’t give you the detailed analytics you require.”

“You want to try something different.”

“You’re struggling to find the time to delegate your work effectively.”

5. Clarify – always clarify what a person says to you. This gives them a chance to correct you or add anything else that’s important. You want people to know you are listening to them, but you also want to understand exactly what they mean by what they are saying.

“So just to make sure I’ve understood correctly you would like to achieve xxx with your product?”

“To clarify, you are happy to go ahead with the next stage of the project?”

“So to clarify, you would like more time to find out what our competitors can offer and I’m going to contact you in a week to revisit this conversation?”

“Do correct me if I’m wrong, but you would like to move to the second phase of this project and test our service at one of our centres within the next 2 weeks?”

6. Summarise – you should always end every conversation with a summary of key points. This should be easy to remember if you reflect and clarify throughout the conversation. Ideally a summary should end in an action agreed by the person you are talking to, even if it’s simply agreeing to speak to your technical team, or have a few days to think over your proposal.

“To summarise our conversation today. You are facing a number of challenges with xxx. You are looking for a new way of working and currently exploring a number of providers in this area. You are happy for me to set up a meeting between us and our VP’s to explore how we might be able to provide the solutions you are looking for?”

“In sum, you are happy with what we are able to offer you, but you’d like to speak to our technical team to find out a bit more about the specifics of the issues you’ve shared with me to see if we can fully meet your requirements?”

“Just to summarise, you would like to find out more about our service and are happy for me to send you a copy of our latest annual review. We have also agreed to have a conversation on xxx date?”

“So we’re both clear on our actions, you will try out the new techniques we discussed today when managing xxx and let me know how this goes over the 2 weeks or so?I

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Managing Introverts

Being introverted does not necessarily mean lacking in confidence, but historically extroverts have loudly assumed that not pushing in to speak first and needing to talk through every task is somehow a lack of confidence. It’s not, it’s just a different way of processing information and communicating.

Nowdays, most organisations recognise the value introverts bring to teams. In fast-paced work environments introverts can be a vital source of calm and rational problem solving. Every team or collective needs a balance of personalities, skills and experiences and personal goals. Just as every team needs a healthy dose of introverts and extroverts.

It is estimated that 50% of the population are introverts. However, many people force themselves to become extroverted in early adulthood to fit in to social circles and get ahead in the workplace. This means that some of your team or peers who are fantastic in a customer facing role, confident and energetic might also respond well to introvert friendly work tasks and activities.

So how can you find out if someone you manage is naturally introverted? Try out different ways to inform, communicate, reflect and reward. Do this with your team, as a whole group and as individuals. Watch how people respond and make a note of your team’s individual comfort levels then tailor your management style to suit their needs. Most people have a healthy dose of introvertism and extrovertism, but when you need to get through to people you need to play to their comfort zones. Learn people’s language and miscommunication issues will melt away.

Here are some tips for managing introverts:

Introverts may respond better to detail oriented activities which give them time to reflect before engaging.

Introverts may prefer problem solving tasks that need to be worked through quietly and without distraction.

Introverts often prefer the opportunity to plan for meetings and events and contribute to the agenda in advance.

Introverts might also respond better to email requests rather than instructions shouted across the office or thrown down on their desk when you’re passing through.

Introverts like 1-1, meaningful contact with colleagues and bosses and can struggle in noisy, chaotic work environments dominated by loud extroverts.

Introverts may find it harder to join the group on nights out or need a social lubricant to let loose and relax. So try team building activties tha involve games or problem solving instead of the pub to take the pressure off having to fight extroverts for the talking stick.

In the words of a recent coaching client, “I can’t believe it, what you have told me [about how to manage introverts] is like being given the answers to a test!”

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Catching up on old blogs for the new website

4th July 2018

Smile

Smile, it will change your brain and your body will respond. Every time you smile Dopamine, Endorphins and Serotonin are all released into your bloodstream, making not only your body relax, but also work to lower your heart rate and lower blood pressure. Humans are also pack animals who mirror each other so smiling is contagious. I just left a really successful coaching session, as my client had a real breakthrough and I tested out some new techniques that really worked. Beaming with a broad smile upon leaving her office I strolled through the city and everyone smiled back. I felt light and confident, motivated and happy and people felt that. There's another really important trick to smiling, if you force yourself to smile when sad, angry or not happy your body will STILL RELEASE HAPPY HORMONES just because you mimicked smiling. This can stop anger and frustration escalating. Even a grimace will work. You don’t have to feel happy to reap the benefits of smiling simply because your body will respond to the physical act of a smile…even if it’s forced!
 

12th June 2018

What's inside your gut?

Over 60% of your immune system is located in your stomach so what you put in your mouth literally fuels your body. You could compare it to filling a car with low grade oil and expecting it to run like a dream and never break down? That isn’t going to happen so why expect your body to be any different? Feed your stomach with living foods filled with vitamins and minerals, natural enzymes and water to hydrate and help do all the magic stuff that keeps you alive and thriving. You will get less colds and flu, lose weight and keep your weight at a healthy level. You will also reduce your risk of cancer and circulatory disease, feel fitter and stronger and have a clearer head and more motivated mind-set. Start with one healthy meal a day and notice how it makes you feel. Add more fresh fruit to your diet and swap processed carbs for complex carbs. Drink lots of water and slowly reduce coffee, sugar, alcohol, processed foods, ready meals and meat. Shift the balance from unhealthy beige processed food to healthy brightly coloured food that looks and tastes alive.
 

26th May 2018

Leave the car, start walking, get running

You could do a park run, 10k, half marathon or marathon. You could get a pedometer, walk to the shops, walk the school run or walk the dog. You could walk to the pub, hike in the hills or along the beach, walk to work or power walk in your lunch break. You could get of the bus, or train or tube one stop earlier and walk the rest of the way. You could walk up the stairs instead of using the elevator or walk up a hill or take the long way round. You could walk on the spot whilst watching TV or walk around the garden for a few minutes every day. You can do anything as long as you are warm and slightly breathless for 10 minutes twice a day. You don't have to find extra time, just tweak what you're already doing. This is called Functional Fitness and Active Travel. If you do this you can stop Mild to Moderate Depression in its tracks, manage blood sugar levels, reduce pain and joint inflammation and reduce your risk of many cancers by up to 30%. Research also shows that smokers who run are less likely to develop cancer so even if you’re not ready to quit or cut down you can reduce your chances of heart disease, cancer and stoke but increasing your physical activity levels. Think about it next time you jump in the car to save time. Walking and running can save your life, ease pain, rebalance mental health and reduce your risk of lifetsyle related illness, disease and death.
 

22nd April 2018

Daily Wellbeing

The world is a difficult place to live in these days with war, bullying, mass inequality, poverty, unaffordable housing, race hate, internet peer pressure and a never ending pile of work that just keeps growing. It's all-consuming and scary and we need to take care of our mental and physical health more than ever before. We can use the 5 Ways to Wellbeing approach to make sure that every day we connect, notice, learn, give and are active. This helps to keep ourselves safe, feel valued, integrate in society and feel strong enough to tackle all that life throws at us. But there's more yopu can do…

1. Limit the time you spend reading the news. It's never good and can often end up making you feel angry and hopeless.
2. Schedule in empty time every day. This could be 10mins of sitting quietly or gazing out of the bus or train window or even driving listening to calming music. If you're having a particularly stressful time then you'll need more time to let yourself recharge and get back on an even keel. Stress is one of the biggest causes of mental health problems so keep stress in check and rebalance manic moments with a calming balm.
3. Limit social media time and take up a hobby which gives you an outlet rather than constantly taking information in. Find something simple you can do in down time that let's your mind wander or focus on solving puzzles or planning. Board games, cards, gardening, DIY, colouring books or painting, singing or dancing, running or hiking, waking your neighbours dog or sanding your floors. It doesn't matter what you do as long as it feels like you're doing something, this is what we call Moving Meditation.
4. Bring physical and human contact back into your life. Touch the forearm of the person you are speaking to. Hug your family more than once a day. Make eye contact with a stranger you pass on the street and give them a contagious smile. Be brave with yourself and be kind to yourself.

 

18th March 2018

Listen

There is a voice that doesn’t use words. Listen. Rumi

There is a skill, an ability we all have but few have mastered. We listen to respond not to hear. We are already planning what to say next when someone is speaking to us. We want to help, to provide answers, relate, give our opinions or judge and we forget to stop and listen. Most people have the answers to their questions they just need someone to hear them, someone to reflect back what they say with empathy and patience. Most people can be led to finding their own solutions, they can calm themselves down if they are listened to. Next time someone has something important to say to you try and only reflect back what they say and ask just one question. Give them the space to talk, encourage them to tell you more and reflect back key points of their issue. Don't make it about you, be generous enough to give someone 10 minutes to talk about themselves; how they feel and what's important. If you have comments or advice you think are important write these down and share them when it's your turn...they'll most likely have come up with the same observations and solutions by the time they have finsihed talking anyway. Most often people just need someone to listen to them.

 

7th February 2018

Building Resilience

I am not a product of my circumstances I am a product of my decisions. Stephen Covey

It's easy to get trapped in the blame and complain cycle. It's my parents fault, it's because I never have any money, I just can't seem to catch a break, I put on weight just looking at cakes, I always pick the wrong people to get into relationships with, I just don't have the time to exercise, I never get recognised at work...it's not your experiences that shape you but how you respond to them. Build exercise into your daily routine using functional fitness, learn to be an extrovert at work to get recognised, create 5 non-negotiables for all personal relationships, seek counselling for childhood trauma, think positively about food and learn to balance treats and nourishment, write down everything you eat for a week and make a note of how you feel every time you eat, leave your debit and credit cards at home for one month and only use cash to spot bad spending habits, learn to say no, learn to say yes and most importantly learn to ask for and accept help. If nothing changes everything will stay the same. What's more moving into the new or unknown shifts your brain from autopilot into thinking. You notice more, react more strongly and can find out more about your strengths and limitations than at any other time. Take yourself out there today and talk to a stranger, walk a different way home from work, try a different style of food, clothing or music. Dance in the kitchen, talk to a mum in the playground, do that presentation or contact a company you love on spec just to connect. Be wild for a few minutes. I guarantee you won't regret it.

 

4th January 2018

Setting, Achieving and Maintaining Goals

Every day in every way I’m getting better. Emile Coue

Big dreams need small achievable goals to use as steps to get you where you want to go. Want to run a marathon but can't even run for the bus? Get a pedometer to set daily walking goals, start power walking a few days a week and when you're ready lift your knees and try a light run. Your overall goal might change over time but what you're doing is getting yourself started with realistic goals that give you a win. Success breeds motivation. Start small, dream big. It really is the little things. Setting small achievable goals every few week’s works. The more regularly you practice the more you're turning those goals into habits. Slow and steady like a tortoise. Small wins create big success because behaviour change has a snowball effect and the more you exercise willpower in one area of your life the more you will develop the strength to challenge yourself in other areas. Think of willpower as a muscle.

Career goal date looming? Tempted to push it back? Starting something doesn't mean to complete it means to START. Do one small thing. Start with the easy stuff, the stuff you're good at, the stuff you enjoy. That will motivate you to tackle the more difficult tasks later on. Don't ignore those tasks and delegate if you can. Ask your partner to do your accounts. Ask friends to share your info with decision makers at their company. Hire a student to build your website. Don't underestimate the value of research, networking and planning, this is important work. Set time aside to do one thing every day, no matter how small. Be your own boss breathing down your neck and keep a vision of success in mind.

When you think about quitting ask yourself why you started? Look back at each stage of the goal or project. Take time to reflect on what your life was like when you started and any key issues that prompted you to start. Do this even if you're not faltering, make this part of the journey, part of the learning process. Even if quitting is the best option looking back will help you rationalise your decision, especially if you're done with a project.