Dijkstra, Arie

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   University of GroningenA Taxonomy Of Intervention Techniques As The Common Or Non-Specific Factors InLifestyle CoachingDijkstra, AriePublished in:A Taxonomy Of Intervention Techniques As The Common Or Non-Specific Factors In Lifestyle CoachingIMPORTANT NOTE: You are advised to consult the publisher's version (publisher's PDF) if you wish to cite fromit. Please check the document version below.Document VersionOther versionPublication date:2023Link to publication in University of Groningen/UMCG research databaseCitation for published version (APA):Dijkstra, A. (2023). A Taxonomy Of Intervention Techniques As The Common Or Non-Specific Factors InLifestyle Coaching. Manuscript submitted for publication. 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For technical reasons thenumber of authors shown on this cover page is limited to 10 maximum.1   Intervention Techniques  A Taxonomy Of Intervention Techniques As The Common Or Non-Specific Factors In Lifestyle Coaching  Arie Dijkstra  Intervention Techniques and Behavior Change Techniques In lifestyle coaching, the coach performs actions and says things that contribute to long-term behavior change. These are techniques that can be divided into two types, namely intervention techniques (ITs) and behavior change techniques (BCTs). ITs and BCTs form the core of coaching. They are evidence-based techniques that the coach applies to contribute to behavior change in the coachee. If you were to record and review a coaching session, you should be able to distinguish and identify at least some techniques. In principle, everything the coach says or does can be classified as (part of) an IT or BCT. ITs and BCTs are the effective elements of coaching; they are the ingredients that work. Without these ingredients, a coach cannot contribute to the coachee's change or might even hinder change. The intervention techniques are described below.  Goals, ITs, and BCTs There are various ITs and BCTs available for coaches to choose from. Each technique is executed and employed in a particular manner to achieve a specific objective. In this context, we distinguish between coaching goals and coachee goals. A coachee outcome goal may be "lose 5 kilograms," which can be achieved through the coachee behavioral goal of "engaging in sufficient physical activity." The techniques are thus employed ultimately to contribute to the coachee's goals. To do so, the coach also sets goals for themselves. For instance, to ensure that the coachee sets specific goals, the coachee must be motivated. Therefore, the coach may establish the coaching goal of "the coachee is motivated," or even more precisely, "the coachee perceives relevant consequences of engaging in sufficient physical activity". The coach must always consider various coaching goals simultaneously. For example, if the coach provides information about the benefits of sufficient physical activity, they must also consider the coaching goal of "the coachee finds the information I provide reliable". The techniques are thus utilized to achieve coaching goals that contribute to the development and attainment of the coachee's goals. The coach continuously monitors whether there is a need for other coaching goals and selects the necessary ITs and BCTs to achieve these coaching goals. This process of monitoring and selection constitutes the ITs; techniques that are continually deployed.  Principles To do this, the coach must understand how psychological and behavioral changes work. These changes occur according to a comprehensible and relatively fixed pattern, which are the principles of psychology and behavior. The fact that these principles are not always clearly visible is because they are complex and psychological states are unstable in some phases. To employ the right BCTs and ITs, the coach needs to understand these principles. BCTs and ITs must seamlessly align with these principles. Many coaches work intuitively and often have their own ideas about these principles. This doesn't mean they're incorrect, but often mistaken ideas can sneak in that don't align with reality. For example, the idea that "external social pressure is always bad," or that "only intrinsic motivation is the right motivation," or that "it's all about believing in yourself." While these sound good, they are oversimplified assumptions that can hinder the coach's effectiveness. Therefore, having a realistic understanding of the psyche and behavior is crucial. The field of Psychology has been nourished and 2   Intervention Techniques  supported by scientific knowledge about psychological principles for many decades. BCTs must target the psychological processes that are active in behavior change. ITs, on the other hand, must target the psychological processes that are active in getting coached.  The Psychological Model of ITs Intervention Techniques (ITs) are employed to support BCTs. The goal of ITs is to make the client receptive to what the coach has to offer. A question that helps understand ITs is, "What is the ideal coachee?" The ideal coachee is capable and motivated to be coached and to accept the coach's offerings. This doesn't just mean "complying with what the coach says" but actively engaging in the coaching process, thinking alongside the coach, and investing in it. Thus, the central aim of ITs is to ensure that the coachee is capable of being coached and is sufficiently motivated to do so. Figure 2 presents a model of the key factors that determine this motivation. ITs target these factors and the motivation itself.  Coaching trajectory The first set of ITs comprises techniques contributing to the design of a feasible coaching offer. The offer must fit individual coachees, in that they feel capable and motivated to follow the coaching trajectory. These ITs involve determining the duration of the coaching, the length of sessions, the number of sessions, timing of sessions, session delivery methods (on-site, video calls, walking, etc.), the speed of initiating the coaching trajectory, and costs. Often a fixed offer is developed but ITs are needed to judge when adaptations need to be made to the design, for example, whether physical consultations must be replaced by video calls. These decisions must always be made against the background of the question: “How does this design or adaptation of a design influence the effectiveness of the coaching?”.  The Relationship The second set of ITs comprises techniques contributing to a "good professional relationship" between the coach and the coachee. All aspects of coaching can be seen from a communication perspective. The coach employs communication with the coachee to support lifestyle change. Everything that occurs in this interaction takes place within the professional relationship they share. This professional relationship must also support the coachee's motivation and capability. This can be achieved by creating an effective relationship with the coachee. This can be through words and body language, and is achieved through convergence: communicating in a way that feels personal, warm, and reliable for the coachee, and that reinforces the professional relationship. In every aspect of communication, every sentence, every word, and in body language, the coach indicates taking the coachee seriously and shows respect. Convergence encompasses ITs—various ways to ensure the coachee feels positively received by the coach—such as smiling, respectfully probing, paraphrasing. Tailoring one’s communication also leads to convergence, for instance, taking into account or just mentioning someone's work situation in plans, or adjusting the protocol based on the coachee's preferences. Thus, regulating the relationship between the coach and coachee is comprised of a cluster of ITs, and ITs are meant to unleash the potential of BCTs. Besides, the relationship can play a role in behavior change in other ways:   Modelling. The coach can act as a general role model in various ways. He or she can show the coachee how to analyse a problem, which questions to ask, how to critically assess their own thinking, how to handle emotions, and much more.  Social support. The coach can provide authentic general social support by offering understanding, interest, and advice. The coach becomes a temporary part of someone's social network. 3   Intervention Techniques   Self-confidence. The coach can work to support or boost the coachee's self-confidence, for example, by offering compliments or otherwise affirming the coachee as a person.  Understanding: Cognitive State The third set of ITs involves techniques contributing to the coachee's "capability" to be coached. These techniques primarily address the coachee's cognitive state. The coach communicates in a manner that the coachee understands well. To understand properly, the coachee must focus the attention on what is being said and process it. The goal is to ensure that what the coach says is truly registered. After all, the coach's task is not about running through fixed rituals but about aligning with the coachee's existing psychological processes, and influencing them in that way. Thus, the coach uses ITs to attract and maintain attention, such as infusing a certain level of energy and intensity into communication. The coach also ensures to be understood well by the coachee. This can involve word choice, the sequence of explaining something, or using illustrations and demonstrations. This understanding and processing of information in a coaching session happens in the working memory. If the working memory has sufficient space, everything will be better processed and understood. What the coach says will resonate more, and the information will be processed more deeply, against the background of a broader activation of relevant contents of the long-term memory. For example, relaxation techniques can be applied to a stressed or anxious coachee to free up the working memory. Additionally, using just the right amount of information or formulating simple and unambiguous questions can optimize the working memory's use. These ITs mostly concern regulating the coachee's cognitive state necessary for executing desired behavior in the context of BCTs, such as reflecting on past experiences or envisioning the next week at the gym. A significant general way to achieve this cognitive state is by "tailoring" various pieces of information so that they fit well with the coachee and are therefore more easily processed, for instance, incorporating someone's type of work into plans or addressing the fact that someone's partner wakes up early every morning while seeking solutions.  Motivational State The fourth set of ITs involves techniques contributing to the coachee's "motivation" to be coached. The coach also communicates in a way that motivates the coachee to cooperate, for instance, to think, imagine, or seek information. Coachees are mostly willing to do many things, and often they are intrinsically motivated, but they always need to know that it is worthwhile, and that they are capable to engage in the task. If the coach applies or suggests a BCT, but the coachee doesn't grasp its significance, we can't expect strong motivation. Thus, the coach must clarify, either directly or through questioning, why something could work. For instance, with the BCT of learning from the past, the coach might say, "Shall we take a look at the last time you tried to lose weight?". If the coachee thinks it is about "rehashing old stuff," the coach can explain why it is quite enlightening and how it will help achieve current goals. This is the essence of the coachee's motivation that we seek to optimize with ITs. Also, when motivating the coachee, "tailoring" is essential—ensuring that everything said applies to this coachee, in this particular situation. The coach should focus on the motives this coachee has and the things he or she finds important. Lastly, the motivation to participate in the coaching trajectory is also related to the motivation to change one's lifestyle. If the latter is low, then the motivation to be coached also decreases. Therefore, BCTs for lifestyle change can also contribute to the motivation to be coached. 4   Intervention Techniques   Figure 1: A model of the key factors determining the coachee's motivation to engage in coaching.  Choice of ITs ITs are thus employed to put the coachee in the right mental state to engage constructively in lifestyle change coaching. ITs are a prerequisite for the effective use of BCTs. Sometimes, ITs are shaped in relation to BCTs. For instance, with each BCT, it should be clear to the coachee why it's being applied. The coach accomplishes this with an IT (supporting BCTs with rationale and effectiveness). However, at times, the execution of ITs is an ongoing process somewhat detached from BCTs, such as maintaining a good relationship. Table 1 lists the key ITs and the goals pursued with them. While the coach selects BCTs based on goals related to lifestyle change, such as "the coachee recognizes significant benefits," the coach chooses ITs based on the goal "the coachee is motivated and capable of being coached", or more specifically, "the coachee has adequate attention." Again, the coach continually assesses the need for, and applies, ITs when necessary. This constant monitoring and assessing the need for applying ITs, but also BCT, is an IT in itself.   Table 1: Intervention Techniques in relation to specific goals contributing to the factors determining motivation to be coached. Goal Intervention Technique 1. INTERVENTION DESIGN Adequate Intervention Format Design Frequency/Duration  Design Intervals/Timing  Design Intensity/Dosage  Analyze Coaching  Evaluate Participant Costs 2. RELATIONSHIP QUALITY Good Professional Relationship Show Respect  Demonstrate Acceptance  Be Authentic  Show Interest  Form Coalition Handling Resistance Well Prevent Resistance  Detect Resistance  Deal with Resistance  Apply Confrontation 5   Intervention Techniques   Elicit Change Talk  Apply Open-Mind Technique Adequate Communication Skills Pose Open Questions  Pose Closed Questions  Summarize  Paraphrase  Advanced Paraphrasing  Regulate Communication Intimacy  Regulate Communication Intensity Optimal Responsibility Perception Activate  Regulate Directness  Share Decision-Making Functional Group Moderation Regulate Social Information  Regulate Social Group Processes  Give Selective Turn  3. COGNITIVE STATE   Adequate Attention Apply Surprise/Movement/Contrast, etc.  Repeat  Make Self-Relevant Adequate Understanding Use Symbols  Illustrate  Demonstrate  Use Clear Language Good Working Memory Hygiene Apply Relaxation  Mindfulness  Problem-Solving  Regulate Associations 4. MOTIVATIONAL STATE Adequate Personalization Assess/Monitor Psychological State  Check Preferences  Check Needs  Adjust BCTs/ITs  Contextualize Adequate Learning Activate Specific Long-Term Memory Content  Guide Meaning-Making  Guide Consolidation  Apply Comparison  Evaluate Effects  Teach Self-Management Positive Expectations Instill Positive Intervention Expectations  Instill Positive BCT/IT Expectations  Explain Own Role  Explain Rationale   6   Intervention Techniques  BCTs and/or ITs In principle, the coach should apply both BCTs and ITs; this grants the coach maximum control. However, that doesn't mean nothing else happens otherwise. This is because some coachees are already actively engaging in their own processes of change (as if BCTs are applied), while others quickly perceive the coaching as highly fitting (as if ITs are applied). Table 2 illustrates what occurs when the coach does or does not apply BCTs and ITs. This table demonstrates that in theory, a coach who correctly employs both BCTs and ITs leaves the least to chance, and is therefore probably the most effective.  Table 2: The combined or separate effects of BCTs and ITs.  Applying BCTs Spontaneous Change Applying ITs The coach applies BCTs and ITs, and the change depends on the effectiveness of both. The coach uses only ITs, and the change depends on the coachee's spontaneous change processes. Spontaneous Fit The coach uses only BCTs, and the change depends on the fit that the coachee spontaneously experiences. The coach doesn't use any techniques, and the change entirely depends on spontaneous processes and experienced fit.          

A Taxonomy Of Intervention Techniques As The Common Or Non-Specific Factors In Lifestyle Coaching

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A Taxonomy Of Intervention Techniques As The Common Or Non-Specific Factors In Lifestyle Coaching

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