My name is Ken Kiser and I am an ADAPT Certified Functional Health Coach from the Kresser Institute. Since health coaching is a relatively new profession, it is important to ask, What exactly, does that mean?
As Chris Kresser states in his book Unconventional Medicine, the ADAPT model consists of three elements:
- A functional medicine approach to preventing and reversing illness and chronic disease.
- An ancestral diet and lifestyle which is more in line with our evolutionary needs.
- A collaborative practice model which better supports clinicians in providing functional medicine and ancestral diet, lifestyle, and behavioral interventions to patients.
As an ADAPT certified Functional Health Coach, my role in the collaborative model is to help patients implement their health plan by focusing on closing the gap between knowing what to do and having the motivation to actually do it. Basically, the coach helps the client make the changes necessary to implement their health plan into their already busy lives.
The ADAPT coaching style for Functional Medicine is broken down into several components. The first component answers the question,
HOW DO WE AS COACHES AFFECT CHANGE?
Health Coaches are able to be “change agents” by using the following 3 communication methods: Motivational Interviewing, Positive psychology through appreciative inquiry and The Trans-theoretical Model or 5-stages of change.
The basic premise of Motivational Interviewing is that motivation has to come from within in order for lasting change to occur. It is a collaborative conversation style that helps
strengthen a person’s own motivation and commitment to change. Through open-ended questions and deep, empathetic, reflective listening, the client is able to find his
or her own reasons to change.
The goal is to set up the coaching conversation, so it’s the client who is making the case for change and not the other way around.
Positive psychology and appreciative inquiry work from the premise
that a coach can better affect more long-lasting change by focusing on the things that are
working well for a person, rather than to give more attention on the things that aren’t.
Positive psychology and appreciative inquiry puts the focus on a client’s strengths rather than on a client’s weaknesses. The coach gets curious about what is working rather than what isn’t, and then builds on it with the client.
Stages of change, also known as the trans-theoretical model, recognizes that change
is a process with different stages. The stages of change are pre-contemplation, contemplation, preparation, action and maintenance. Understanding which stage a client is on allows the health coach to adjust their approach based on the current stage of the client. The coach is then able to meet people where they are.
The second question to answer is:
WHAT DOES AN EFFECTIVE COACHING CONVERSATION LOOK LIKE?
The basic framework of an ADAPT coaching session has 6 components: Engaging, Focusing, Evoking, Pausing before Planning, Planning and Closing.
Engaging is the first part of the conversation that helps to create rapport between the client and coach. During this phase of the conversation a foundation of trust is built and a partnership is created. With engaging, the client and coach build a respectful curiosity that allows for better understanding of the client’s current perspective and situation. Engaging is based on the premise that the relationship is the foundation of coaching.
Focusing allows for the coaching conversation to have a purposeful direction. A
focus is necessary to clearly address the needs and goals of the client. Setting an agenda is a
collaborative process and changes as the needs and goals of the client change. Without a clear focus, the coach is unable to guide the client effectively.
Evoking is the part of the conversation that allows for exploring, discovering and deeper investigation of reasons for making a change. These open-ended questions allow for the client to get a better understanding of the intrinsic motivations of why change is important.
Pausing before planning is a brief check-in that determines where the client wants to go after gaining clarity of their intrinsic motivations for change. It is a part of the conversation that tests the client’s readiness to plan. It also determines whether there is still ambivalence that needs to be resolved or additional information needed before shifting into action.
Planning is the set of action steps to be taken in between sessions that allows the client to stay in line with their vision and goals. The level of action depends on the stage of change of the client. The coach and the client create SMART (Specific, Measurable, Attainable, Relevant and Time Sensitive) goals that get the client closer to their long-term goals. Planning, movement, support structures. During this phase of the session, the coach facilitates the clients ability to identify and put into place any support and accountability necessary to complete the weekly action steps.
Closing the conversation brings an intentional end to the session by asking the client to summarize her key takeaways and action steps. This is also a time where the coach can positively acknowledge and affirm the client’s strengths, efforts, and intentions.
The third component of the ADAPT model is what are known as the core competencies, those basic skills and building blocks that make a coaching conversation effective. The core competencies stem from the competencies used by the International Coach Federation (ICF), the National Board for Health & Wellness Coaching (NBHWC), the Motivational Interviewing Network of Trainers (MINT).
These skills are foundational and are broken down into “being skills” or
Being skills encompass presence, empathy, the coach’s ability for acceptance and partnership, and the capacity to not just listen but to actually hear, sometimes between the words, what another is saying.
Doing skills include behaviors such as asking open questions, deep, reflective listening to help expand awareness and understanding, affirming the strengths, efforts and intentions of your client and sharing information where more client knowledge is needed.
The final component to the ADAPT coaching method is a broad, basic understanding of Functional Medicine. Upwards of 50% of teaching time is dedicated to subjects such as a nutrient dense diet, macro-nutrients, gut health, hormonal health, heart health, brain health, sleep hygiene, stress reduction, movement and the reduction of environmental toxicity. Training includes practice coaching using case studies of real health plans. The combination of understanding the key components of a client’s health plan as well as the skills necessary to foster behavior change, prepares an ADAPT Health coach to become a valuable partner in a collaborative practice model.