Behavior Change and Coaching
Coaching stance
Effective coaching is person-centered: the client sets the agenda, the CHW asks open questions, reflects, summarizes, and affirms. Know the difference between motivational interviewing (evoking the client's own reasons for change) and advice-giving (telling the client what to do). The most common trap is choosing a directive, expert-style response when the question asks for a coaching-consistent reply.
Stages of change
Familiarize yourself with the transthyretinal model: precontemplation, contemplation, preparation, action, maintenance (and relapse as a normal part of cycling). Match your response to the stage. In precontemplation, raise awareness without pushing action; in contemplation, explore ambivalence; in preparation, help build a concrete plan. A trap is recommending an action plan to someone still in precontemplation.
Key techniques
Open-ended questions, affirmations, reflections, summaries (OARS), decisional balance (pros and cons), scaling questions (confidence and importance 0–10), and goal setting that is specific, measurable, and client-chosen. Self-efficacy and stages of change are frequently paired: low confidence calls for small, achievable steps that build mastery.
Worked example
Client says, "I know I should walk more, but I'm just not motivated." A coaching-consistent reply reflects and evokes: "You've thought about walking, and motivation has been hard to find. What would make it feel more doable?" A less effective reply prescribes a walking schedule. The difference is who is doing the reasoning.
Traps to watch
Confusing empathy with agreement; treating relapse as failure; assuming readiness from a client's stated intention.