Motivational interviewing is a powerful tool to support clients in being active leaders of their own health and wellness journey.
While asking your clients questions, not only are you learning more about them, you are creating a safe space where they can think about past experiences and current health behaviors.
The power of motivational interviewing to empower clients over their doubts is among the best and most effective outcomes of motivational interviews. Doubt can be a normal experience for people who desire to make changes in their lives or adopt new behaviors. However, they are also aware of the personal and environmental obstacles that could prevent them from doing so.
We have six prompts for you to ask your client to get them talking about self-doubt.
What is Motivational interviewing?
The technique of motivational interviewing allows clients to freely share their opinions and knowledge with you. The coach becomes more sensitive to the individual experiences and problems of clients. Clients are able to express themselves more clearly and find deeper motivators.
You ask the client questions such as what are their current health patterns, why they created them and if/how they think they can change them. When you don’t hold judgment as they answer, they feel validated and heard, and this builds a sense of trust in the coach-client relationship.
If appropriate, ask your clients to tell you what information they'd like before you give it. Coaches should ask permission to give information to clients. This can increase their openness to receiving useful information.
You can learn more about motivational interviewing, including the fundamental principles and core skills, here.
The Role of Doubt in Some Health Behavior Change Frameworks
Health behavior change frameworks are extremely useful for helping to understand how people adopt and sustain healthy behaviors that are conducive to wellbeing. It is also helpful to identify the factors that can hinder individuals' ability to change from one stage of behavior to another, which helps them to be more successful in adopting new healthy habits.
Just as choice can only influence one aspect of health, so self-doubt may be a factor in preventing individuals from changing their behavior to improve their health. You may also doubt your ability to trust your healthcare provider or whether the environment will support you in making changes in health behavior.
The Role of Doubt in the Transtheoretical Model of Behavior Change
The transtheoretical model was developed by Prochaska and DiClemente with the goal of summarizing the unifying factors of several behavior change theories. The transtheoretical stages of change model, which is pictured below and described in detail in the complete blog about health behavior change theories, is summarized in five main stages:
The movement of an individual along the five stages is considered progress toward desired change. A person can fall back to the previous stage at any stage.
What causes a person to relapse? There are several reasons, including:
- A lack of social support
- A lack of access to healthcare services
- Changes in priorities
- Changes in health goals
- Change in health status
- Changes in or an underestimation of the power of social, environmental, and psychological determinants of health
Self-doubt is considered one of the psychological or cognitive determinants of health. Health coaches have an important role in understanding and supporting clients in modifying their mindset that may be impeding their progress from one stage to another.
The Role of Doubt in the Health Belief Model of Behavior Change
The Health Belief Model is one of the most widely used health behavior change frameworks. This model is one of the most well-known in Western society. There are many studies supporting its use.
Health Belief Model examines the psychological determinants that affect health behavior. The psychological determinants include:
- Perceived susceptibility to developing a health condition
- Perceived severity of the health condition
- Perceived benefits of taking action to prevent or reduce the risk of the current condition
- Perceived barriers to taking action
- Cues to action or events that occur that motivate a person to do something differently
- Self-efficacy or the confidence in a person’s ability to take action
The psychological determinants are interconnected, and they are informed by trauma. Here is the Health Belief Model diagram showing how these psychological factors interplay.
Self-efficacy can be defined as the opposite of self doubt. So, when health coaches want to help clients overcome self-doubt, what they should be aiming to do is improve the clients’ sense of self-efficacy.
Characteristics of Self-Doubt
Beata Souders, a candidate for a doctorate in psychology, identifies several characteristics that people with self-doubt or a lack of self-efficacy may have.
- Avoiding accepting challenges in fear of failing
- Believing that they are incapable of change or of performing complicated tasks
- Focusing on adversities and past failures as character traits or personal shortcomings
- A lack of sense of commitment
6 Motivational Interviewing Question Prompts to Help Clients Overcome Self-Doubt
Note: Remember to follow the principles of motivational interviewing when using these question prompts in your practice.
I would love to hear about the time you made an important change in your own life.
Clients may think that you only talk about their progress toward their goals when they come to a session of health coaching with you. If a client is feeling self-doubt about their ability to alter health behaviors, it's possible for them to forget that this can be something they can change.
Your clients might find it easier to shift the emphasis from their health behavior, which can be the subject of dispute, towards positive past experiences. This will help them to remember situations in which they have overcome difficulties.
Some follow-up questions you might want to ask include:
- What do you think made that situation different from other moments where you faced adversity?
- Is there a time when you felt the need to make changes and you did?
- Is there a time when a sudden change brought about a positive outcome that you were happy with?
Which personal skills do you possess that could help you reach your health goals and achieve them?
It is possible that your client may respond that they don’t have any of the skills they need to achieve their health goals. This is a case where you may want to move on from talking about health goals. They might be feeling vulnerable or uncertain at the moment. You can instead ask them about their past professional or personal goals. For those who have trouble coming up with ideas, they can offer examples such as achieving a high-school or college degree, obtaining a certificate or landing a job.
Next, you can ask them for their personal strengths that helped them achieve this goal. If they are still having trouble vocalizing their strengths, you can ask permission to share what you perceive are your client’s strengths based on the information they shared with you. Some adjectives you may want to consider using, when applicable, include:
You can ask if they agree with those descriptors and explain how their past actions reveal those traits. The next step is to ask if these traits can be applied in achieving their health goals. You could even imagine what that would look like.
How do you feel encouraged and inspired?
But, you don't have to focus on the client's health goals. If you choose to apply it to your client’s health goals, it will help to highlight perceived benefits and cues to action of the Health Belief Model.
It may help some clients to share more of their inspirations and encouragers with you, so it is a good idea for them to do this. You can then ask clients whether they believe the elements, people or feelings they have mentioned, are applicable to their health and goals.
It might be a good idea to inquire if they would like to change their goals for health so they can rely on the things that inspire and motivate them.
Is there anything you can gain from making the change?
The question allows clients to reflect on what they believe the health benefits of making a change in their behavior. Clients often view the benefits of changing their health behavior as something that happens only after the ultimate goal has been reached. This is one of the many advantages of this question. You can also provide information on how small changes could bring benefits, if necessary.
For example, if your client wants to meet the minimum physical activity guidelines (30 minutes of moderate exercise a day, five days a week) as part of a strategy to lower their high blood pressure, you can inform them, with their permission, that even a few minutes of movement during the day is beneficial to their heart health.
These conversations provide a safe place for clients to talk about their progress and to forgive themselves.
You need support to make this change.
It is easy to overlook the importance of support from others in conquering self-doubt. The human race is naturally social and can thrive in close-knit environments. Family members may be considered social support, but they are not always necessary. It could also include colleagues or friends.
You may be someone your client looks up to for support in making a change. If this is the case or your client struggles to find people they can trust, you should offer all your support. Ask them how they'd like it to be.
Remember, however, to reinforce your professional boundaries so you don’t experience burnout.
How can I help you to feel the same progress that I've made?
Be sure to ask the client permission before you start asking them this question.
With their permission, lead with a concrete observation or example of the progress you’ve perceived and recall traits related to self-efficacy.
Here is an example of how you might want to use this question:
Since we first started meeting, I’ve noticed that you have [make a positive observation about their progress]. This shows great [mention traits or characteristics]. What can we do to work together and modify your goals?
The purpose of this question is to reevaluate the coaching plan or your client’s health goals. It is possible that they feel the original goals were too lofty. This can help them gain self-efficacy and allow them to reach their health goals.
Self-doubt is a common issue when people desire to make a change in any aspect of their lives. A health coach has the best knowledge and experience to help clients to overcome their self-doubts and to change positive behavior.
One way to examine the various components of health beliefs and how they influence individuals' progress towards health behavior change is motivational interviewing. When the question prompts in this article are integrated into a larger coaching strategy, your clients can begin to feel more self-efficacious while also understanding that the health coaching space is a safe space.