Wellness Coaching helps the patient understand why they have a problem and empowers them to do something about it.
Wellness Coaching helps the patient develop their own answers.
The Baraka Institute and Feroshia Knight
This myth came from a plastic surgeon who determined that it took patients about 21 days to get used to their rhinoplasty. It has nothing to do with real behavior change.
“There’s no shortage of apps out there designed to help you form a habit, and many of those are built on the assumption that all you need is 21 days. This number comes from a widely popular 1960 book called Psycho-Cybernetics by Maxwell Maltz, a plastic surgeon who noticed his patients seemed to take about 21 days to get used to their new faces.”(SIGNE DEAN. Here’s how long it takes to break a habit, according to science: You’re gonna need more than will power. Science Alert 24 SEP 2015)
New habits take 66-254 days
“In conclusion, repeating a behavior in response to a cue appeared to be enough for many people to develop automaticity for that behavior. Although consistency in repetition is required, the degree of consistency is not yet known. There was variation both in the maximum automaticity reached and the time taken to plateau.”(Lally p, Van Jaarsveld CM, Potts HWW, Wardle J. How are habits formed: Modelling habit formation in the real world. European Journal of Social Psychology Eur. J. Soc. Psychol. 40, 998–1009 (2010))
Patients change at their pace. We need to know how to help them change. It also takes daily reinforcement.
Our attitude affects the outcome
Front line providers of care are frequently lacking in knowledge on and sensitivity to social and structural determinants of underprivileged patients’ health. Developing and evaluating approaches to raising health professional awareness and capacity to respond to social determinants is a crucial step in addressing this issue. McGill University, in partnership with Université de Montréal, Québec dental regulatory authorities, and the Québec anti-poverty coalition, co-developed a continuing education (CE) intervention that aims to transfer knowledge and improve the practices of oral health professionals with people living on welfare. Through the use of original educational tools integrating patient narratives and a short film, the onsite course aims to elicit affective learning and critical reflection on practices, as well as provide staff coaching.
A qualitative case study was conducted, in Montreal Canada, among members of a dental team who participated in this innovative CE course over a period of four months. Data collection consisted in a series of semi-structured individual interviews conducted with 15 members of the dental team throughout the training, digitally recorded group discussions linked to the CE activities, clinic administrative documents and researcher-trainer field notes and journal. In line with adult transformative learning theory, interpretive analysis aimed to reveal learning processes, perceived outcomes and collective perspectives that constrain individual and organizational change.
The findings presented in this article consist in four interactive themes, reflective of clinic culture and context, that act as barriers to humanizing patient care: 1) belief in the “ineluctable” commoditization of dentistry; 2) “equal treatment”, a belief constraining concern for equity and the recognition of discriminatory practices; 3) a predominantly biomedical orientation to care; and 4) stereotypical categorization of publically insured patients into “deserving” vs. “non-deserving” poor. We discuss implications for oral health policy, orientations for dental education, as well as the role dental regulatory authorities should play in addressing discrimination and prejudice.
Humanizing care and developing oral health practitioners’ capacity to respond to social determinants of health, are challenged by significant ideological roadblocks. These require multi-level and multi-sectorial action if gains in social equity in oral health are to be made.(Lévesque MC, Levine A, Bedos C. Ideological roadblocks to humanizing dentistry, an evaluative case study of a continuing education course on social determinants of health. Int J Equity Health. 2015 Apr 30;14:41).
We must be non-judgmental
“Briefly, this health coaching approach is based on an interactive assessment (both physical and psychological), a non-judgmental exploration of patients’ knowledge, attitudes, and beliefs, a mapping of patient behaviors that may contribute to disease progression, gauging patient motivation, and tailoring health communication to encourage health-promoting behavior change.”(Vernon LT, Howard AR. Advancing Health Promotion in Dentistry: Articulating an Integrative Approach to Coaching Oral Health Behavior Change in the Dental Setting. Curr Oral Health Rep. 2015 Sep;2(3):111-122.)
There is a lot of shame, guilt and emotional baggage associated with dental caries. We must tell them that we believe in them and they are capable of making the change. They need the positive reinforcement in order to be successful. Next time we will look at some strategies I have learned to help patients change.
How about you? Do you implement wellness coaching strategies with your patients?