Communicate and Work Effectively in Health

Introduction

As a Truly Heal coach your job is to help and to guide people during their disease process. To help them to understand their disease, find the cause, connect with health professionals and educate them about the right life style choices.

To do your job well, you need to know about work ethics and standards and how to relate to clients, coworkers, and employers. The purpose of this chapter is to help you communicate and work effectively in your job and your profession, either as a Truly Heal Coach working from home, working in a clinic or as the owner of a Truly Heal Coaching business where you employ staff.

Work Ethically

Duty of Care

The idea of duty of care is very important in health coaching and other health professions. Duty of care means that you must take reasonable care not to do anything that will harm your clients or put them in danger. It’s part of your job to look after the safety and wellbeing of the people who are in your care. If you know (or should know) that something you do will cause harm to another person, you must not carry out that action.
Your duty of care includes the advice you give as well as the actions you take.

As a Truly Heal coach it is not within your scope of practice:

• to diagnose or proclaim the presence of any condition, disease or illness.
• to treat a client via supplementation, medication or medical treatments.
• to change, remove or alter the use or intake of any prescribed supplement, medication or treatment.

The application of the above list will change from one degree to another depending on pre-existing qualification/accreditation/ licensing.

If you are an employer you have a duty of care to your employees as well as your clients. Each employer has the obligation to identify hazards and do something about them.

As an employer you must make sure your employees are safe at work, physically and psychologically. This means that you must take steps to make sure hazards, including work-related stress and bullying, do not put your employees at risk.

Confidentiality in the Workplace

Confidentiality is very important to your relationships with your clients; without it your clients will be less willing to share the personal information that you need to know in order to help them. An atmosphere of safety and confidentiality will help your clients relax and open up to you.
As a Truly Heal coach you must keep your clients’ sensitive information private.

Practical Example

This means, for example, that you may not give out information to a client’s partner or other relative without the permission of the client.
Sometimes you have to balance privacy and confidentiality against competing responsibilities such as duty of care and the needs of clients. You may decide, for example, that it is in the best interest of your client for you to discuss his or her private information with another health care provider. In this case, you can ask the client’s permission to discuss their issues with another health provider. It will be up to you to weigh the pros and cons in each situation.

Privacy Laws

There is a definitive legislation about protecting clients’ privacy and confidentiality.
In presenting case histories, research work, articles in journals, magazines etc it is common practice to use assumed names or just use initials to identify clients. For example ‘Mrs A.A. a 43 year old woman came to me for help with... or ‘Mr Bruce a 22 year man... not patient’s real name.
You are not allowed to publish photos or images of a client without their express permission- this particularly applies to marketing brochures or posters.

Websites

When you are dealing with your website, there are new laws relating to the privacy of people who access your website. For example, if people enter their name and email address, they have certain rights. They have the right not to receive spam and they must have the ability to ‘Unsubscribe’ from the website. You are not allowed to sell their e-mail address to a 3rd party. You have the obligation to protect their credit card details when they purchase from you.

Consent to consult

This is a very important issue in health care. Clients must be able to make their own decisions about their care. You cannot force someone to follow your instructions, you can advise them but the final decision about what they do is up to them.
It is assumed that when clients come to you, they consent to giving you personal information and receiving guidance how to deal with their disease and how to implement lifestyle changes. However if you intend to do any procedure on them, you need to check at least verbally that they consent.

Conflict of Interest

You may at times want to recommend a product for a client. But if you have a financial interest in selling this product, you may be tempted to recommend it just to make money rather than the client really needing it. This is called a conflict of interest. You must be careful to make ethical decisions based on client need rather than your income to safely look after your clients.

Morals, Attitudes, and Values

As a health care worker you can do your part to uphold these values by:

• Being concerned about and respecting other people (including clients, coworkers, and employers);
• Being fair, honest, and trustworthy;
• Keeping confidentiality;
• Not taking unfair advantage of other people or the system;
• Keeping up-to-date on changes in the field of holistic health;
• Doing good and preventing harm (your duty of care); and
• Doing your job to the best of your abilities.

The Client-Centred Approach

If you have already worked as a health coach—or even tried to give a friend advice—you know that giving someone information or advice doesn’t necessarily mean they will follow it. A client-centered approach to coaching and counseling means you do more listening than talking. You ask open- ended questions—questions that have no right or wrong answers and that lead people to think about their needs and desires.

Ask questions like:

• What does it mean to you to have cancer, diabetes...
• How does it make you feel?
• What would you like to change?
• How can you make the changes you want?
• What’s holding you back?

Ask one question at a time, leave plenty of time for your client to answer, and reflect back what you hear. Your job as a coach is to get your clients to think about their situations and help them to come up with solutions that will work for them.

When you treat your clients with respect, support, and understanding you help them find their own paths to health.

As a Truly Heal coach you will probably work with many different types of people. Listen well and ask questions if you are not sure you understand. Learning about the different ways people communicate helps us understand people who are different from us, and helps everyone work together better. It also makes our lives richer when we know people and cultures that are not like us.

Developing rapport with a client

Remember any time you have had an appointment with a health professional. Everyone is a little bit nervous about meeting a new person for the first time and we can also be nervous about whether the professional will understand our needs and be able to help us.

So the first step with meeting a new client is to put them at ease. Be friendly and welcoming and put any of your own personal worries to the back of your mind. Give the client 100% of your attention.

Make sure they are comfortable and introduce yourself by name. Then the most important thing is to listen. Let the client tell their story in their own words first before asking any questions. You will get more experienced at moving things along when people are long-winded.

Active listening is when you focus 100% on what the client is saying and look for specific clues to the problem. The client may hint at a psychological problem or gloss over a family situation which is making healthy living difficult for them. You can note these comments. You may find that the first consultation is all about finding out about the clients problem rather than solving it. That’s why it’s important to encourage the client to commit to several sessions rather than just 1.

It is vitally important as a Truly Heal coach that you maintain a professional attitude to dealing with clients. You should treat all clients the same and have the same friendly, welcoming attitude whether you feel like it or not. Especially when you are running your own business. Clients will pick up on an atmosphere and will not come back to you if they don’t feel welcome.

The great thing is it doesn’t take much to make clients feel at ease. Smiling and eye contact is very important during the introductions and a little bit of chit-chat puts clients at ease before you start.

Your body pose can also be welcoming. Someone who is relaxed and confident has an open stance with arms open by your side or on the arms of your chair. Folded arms can be defensive or seem closed and un- communicative.

When you are listening to a client there is a convention in Western society that the listener makes eye contact with the speaker. This shows that you are actively listening and paying attention. You know how disconcerting it can be when your doctor spends the whole consultation peering at the computer and you wonder if he or she is really listening. The speaker on the other hand does not have to maintain eye contact and may look into the distance, or up or down when speaking.

Communication Styles

When you are dealing with a client there are many ways you can facilitate the client talking about their problem.

Active listening and Open-ended Inquiry

As we said before this is about listening hard for clues which will point you in the right direction of the problem. Open-ended inquiry involves asking questions to which the answers are anything but"yes" or "no". These questions or conversations typically start with: "What", "How/How come," "Tell me about," or "Describe your situation/symptoms."

Through open-ended inquiry, the client reflects on thoughts and feelings. They share their unique perceptions and generate their own solutions.

Examples of open-ended questions a coach could ask:

When did you last feel really well?

What happened then?

Was there anything going on in your life at that time, which might have triggered the illness, pain, symptom?

What impact have your symptoms/problems had on your life?

What do you want to do?

What are you ready to do?

Would you like help, hear a suggestion?

Where would you like to be in 5 or 10 years?

What brings you joy and contentment?

What gives you meaning and purpose and makes life worthwhile?

Mirroring

This involves copies the other person’s gestures or facial expressions to facilitate the conversation. So you might frown or smile in response to the client doing so. This encourages them to feel more relaxed and open up. If they start talking in a style such as using sporting analogies, joining in cements the relationship.

Summarising

When listening to a client , summarising what has been said before helps to clarify understanding of the problem.

Reflecting

This is reflecting comments back to the client – perhaps repeating what they said to emphasise it and encourage them to go on.

Reframing

This is summarizing a problem in different light. It’s the old glass half full or half empty scenario. Often clients get obsessed with a problem so that they can’t see the big picture. So reframing the problem taking in a bigger framework helps them put it into perspective and move on.

Confronting

This involves challenging the client about their beliefs or how they see a problem. This has to be skillfully used as it could destroy your relationship with the client. However we will go into more detail about using confrontation to challenge a clients fixed belief in the Red Zone.

Client records

It is vitally important that you keep notes about your consultations with clients. So before you start, work out a system of recording notes either on paper or on the computer. Make sure you back up your computer files so they are not lost. You must keep their notes in a safe place like a lockable filing cabinet or a password-ed computer to ensure the clients confidentiality.

Mentoring

The mentor helps the client decide on the best course of action. A mentor does not dictate what is to be done or tell people what to do. We all know that that doesn’t work. What we are trying to achieve is that the client comes to realise what is holding them back and makes the decision to move forward themselves. They decide what they will do and when and how. The mentor merely helps and guides them along the way.
If the client expects you to do all the work or the opposite – is resistant to working on their issues then you will fail miserably.

Clarification

It’s important to clarify what the client expects from the consultation – what do they want to achieve and what do they want from you. They may be reluctant to talk about themselves or emotional issues so it may take a few visits before they fully open up. That’s why developing a trusting relationship is so important.

Ending the relationship

Agree with client that either of you can terminate the relationship if you feel that it’s pointless going on. But if you remain totally client focused you’ll find that clients appreciate your interest and support and if they’re achieving their goals they’ll stick with you to the end.

Communicate with Other Professionals

Your clients will need the help of many different health care professionals. The better you can communicate with other professionals the better care your clients will receive. When health care professionals work together services become better integrated and people are less likely to fall through the cracks.

As a Truly Heal coach you may need to speak with physicians, nutritionist, allied health practitioners, teachers, pharmacists, and other professionals. They all will have expertise that can be helpful to your clients. That’s why it’s important to communicate with them clearly and respectfully.

You must also remember that a client has the right to choose whether they attend another professional or not. You cannot force the client –you can only advise them. Ask the client’s consent before writing the referral and check whether you can add sensitive information or not. Keep a copy of the referral letter with your notes in a safe place – in a locked filing cabinet or password-ed computer.

It will be really helpful for you to develop relationships with other health care workers in your area. Get business cards made up and visit your local doctor, acupuncturists, massage therapists, naturopaths and nutritionist. Let them know what you are doing and let them know you would like to send clients to them for further help from time to time.

Practice writing referral letters. Here is a sample letter below:

Truly Heal Coach

ABN Telephone Fax
Shop 3, Local Strip Mall, Busytown

To Dr Accupuncturist
Busytown General Practice
Dear Dr Ben

I recently saw one of your patients.  Mrs Breast Cancer came to see me for help with lifestyle changes. I noticed that her adrenal energy was very low and I wondered if you could treat her for adrenal fatigue and general stress relief.  I have asked her to make an appointment with you.

I am continuing to see her and give her support with her recovery and would be very happy to collaborate with you in this matter.

If you need any further information, don’t hesitate to get in touch.

Yours sincerely

Trisha Best

Truly Heal Coach

Set realistic goals

Sometimes people have unrealistic goals. We can guide them to realistic goals. If they choose an unrealistic goal then they will fail and you will fail – so nobody wins and your reputation is on the line. If you can’t get them to choose realistic long term goals, then try to agree on a realistic short germ goal that you can both achieve.

Measures of success

The next step is to assist the client to develop her or his own measures of success. This might be not eating cereals for breakfast anymore, not having takeouts, having 3 servings of vegetables, drinking fresh water instead of sodas....

Intermediate steps

Now we need to set those markers or steps of success along the way. So if the client wants to change his diet from fast food to a healthy organic unprocessed diet than little steps can be already success on the path. Something as simple as – ‘I didn’t have any sweets this week’. Small achievable goals.

We humans are not very good at celebrating success. We focus on our failures and fret about those rather than our successes. Say you’re working in a pizza parlour and you serve 30 customers on a busy night. One customer complains about his pizza, that you did a bad job, it was cold, too greasy or whatever. You go home upset and depressed about the customer, when what really happened was 29 customers were really happy about their pizzas. But you’ve completely forgotten about them and are focusing on the only failure – if it even was a failure and not just a grumpy customer.

So each step needs to be defined and each little success celebrated and noted. The client can celebrate the success with things he loves, for example having a massage, buying a bunch of flowers, going out for tea, watching a movie........ ‘The climb of a thousand steps starts with the 1st step’

Monitor progress

One of your own roles is accountability. You provide a system of accountability for clients who decide to make changes. So you can say ‘This week you planned to reduce your chocolate eating to one bar over the whole week. How did you go with that? What hindered you from completing the task? You shouldn’t be too aggressive in your approach with this, otherwise the client may not come back, however you do need to be firm and reflect back to them what they committed to do.

When they have stuck to the commitment then again great congratulations should be made – as who doesn’t want to be praised for doing the right thing and sticking to the plan.

Confidence Building

Keep reminding clients of previous success especially when they feel down about progress. Very often clients blame themselves for failures and get downhearted, playing down the successes as not significant. Your job is to bolster their confidence by pointing out successes and areas where confidence is low. Activities to strengthen confidence in that area can show clients they can be successful. For example, some clients feel they can’t resist chocolate. Well, a goal might be to change to another type of chocolate – like dark organic chocolate. A small piece can be eaten every day, thereby eliminating the need to give up chocolate all together.

Some clients hate exercise, so focusing on small exercise tasks like walking to the end of the street can quickly build confidence as exercise tolerance increases.

Creating a Meaningful Connection

In a client-centered relationship, a coach acts both as a teacher and the student, the leader and the follower. In other words, both the client and the coach benefit from a high-quality meaningful connection that their relationship provides. Open-ended inquiry, together with non-judgemental listening provides coaches the opportunity to hear what the client needs.

Personal Standards

Dress Standards

The place where you work may have a dress code for you to follow. In general, you should dress in a neat and professional manner that reflects the standards of your organisation and your profession. Most work settings require clothing that is more formal than casual.
Depending on where you work you may also have to wear clothing for safety or hygiene purposes. It’s a good idea to wear flat or low-heeled shoes. Avoid sneakers or joggers, strappy sandals, high heels, or heavy platform shoes unless you know your organisation approves them.

Home Business

If you are running your own business at home it is still important to have a dress code for yourself when you see clients. If clients are paying money to get your advice they want to see a professional who takes their job seriously. While we can be pretty relaxed about dress codes today, no-one wants to visit a health care worker who is still in their sweaty gym clothes or old shorts and T-shirt.
Develop a dress style that says something about you – that you are professional. Get a T-shirt with your business name and logo printed. That also helps your mindset – going into professional mode as soon as you put the shirt on. It also helps to fix your business in the client’s mind. Make sure your consulting room is clean and tidy and there are no interruptions from phone calls and children.

Personal Hygiene

As a TRULY HEAL coach, it’s very important that you are always neat and clean.

Keeping your hair and nails clean and well groomed will set a professional image. Stale breath and body odour can be off-putting for clients, so make sure you drink plenty of fluids and have mints handy after lunch. Men who have facial hair should keep their beards and moustaches neatly trimmed.

Please limit the use of perfume and other artificial fragrances as first of scents may set off allergic reactions in some people and second of all they are toxic. Try to be a perfect example for your clients in respect of your own lifestyle choices.

Continued/Lifelong Learning

Lifelong learning is an on-going part of being a professional—you must keep up with advances in your field and further your knowledge throughout your career. It’s useful to develop personal goals within your organisation to improve your knowledge or skills every year.