If you coach people on any health-related dimension, it can be hard to remember that the coaching goals aren’t really yours to set. As professionals, we know the recommended biometric levels, the “right” weight or the guidelines for activities, and we always want our patients or users to get there. But there are two different forces going on that might make those goals inappropriate:
- People don’t want health for its own sake, but rather as a means to other ends they value
- Getting to the clinically valuable goal is often intimidating for people, who are content to focus instead on an intermediate milestone
Health is a means to an end
People want to be healthy, sure. But health is an abstract concept. It’s really hard to make sacrifices in the moment in order to achieve some nebulous status of “healthy” sometime in the future. And it’s even harder to make those sacrifices for something like an A1c under 7 or a total cholesterol under 200. Those milestones don’t make your body feel different–heck, you need to give blood to see if you did it. For many people, they probably seem pretty arbitrary.
People do value their quality of life. They have things that are important to them to be able to do without pain or discomfort, whether it’s a job, a favorite hobby, or getting down on the floor with the kids. People also dream of specific future events, such as vacations, weddings of loved ones, or sitting in adjacent outdoor bathtubs with a spouse (sorry. Can’t ever resist an opportunity to poke fun at that).
When you talk to someone who you’re trying to coach, then, adopt their goals to explain why behavior change is important. Use their language to put a context around some of the very hard behaviors you’re asking of them. Someone who’s being asked to start an exercise habit after decades of inactivity is going to feel a heck of a lot more motivated by visions of his daughter’s wedding than by some numbers on a blood test. Yes, doing this requires a level of conversation that may be new to you (especially if you’re a medical professional), but it could pay dividends.
The clinical goal is too hard
Some people come in to coaching needing to make very big changes. Maybe they have tens or even hundreds of pounds to lose, or have a chronic condition that’s been poorly managed for years. For these people, talking about the ultimate clinical goal of a healthy weight or an ideal biometric result is intimidating and scary. Even for people determined to make it all the way to the end zone, success may be so far away that it’s easy to lose motivation along the journey.
As a coach, there are at least two things you can do to help people who are a long ways away from their clinical goal:
- Set intermediate milestones to help build self-efficacy and a sense of progress along a long process (i.e. support competence)
- Celebrate small successes along the way, focusing not on the weight left to lose or the changes yet to come, but on the great work already done
(I was glad to see that the American Academy of Family Physicians adopts similar recommendations around milestones and finding personally meaningful goals in their guidance for members.)
Breaking an intimidating goal into more manageable segments will help sustain motivation over time. It gives people evidence that change is possible. From a coaching perspective, it’s also important to remember that moving someone closer to the clinical goal, even if they don’t achieve it, is progress.