Clinical Coaching

Jeremy Clorfene, Ph.D.Head Psychologist Advocate Weight Management

Rebecca Lepoff, LCSWBehavioristAdvocate Weight Management

Typical Patient Issues / Typical Clinician Issues

• What do you (we) experience and see everyday in our practice that blocks/inhibits a patient’s progress?

• Where do they resist? What are their obstacles? • Why is the change so hard when it is so good for

them? • What are our (clinician) challenges in better

serving our pts?

Major/Global Problem Areas For Patients:

1. Avoidant/denial of medical issues assoc. with wt.

2. Clinical Depression: major family, marital, financial, job, biochemistry issues.

3. “Food Addiction” / Binge Eating disorder

4. Motivation: staying committed

5. Compliance (non-compliance) on meal plan

6. Emotional/Stress eating

Major (specific) Problem Areas:

1. Night-time eating

2. Drive-thru eateries

3. Unrealistic weight goals

4. Constant excuses

5. Constant negativities

6. “Self-sabotage”

7. Social eating

8. Can’t exercise

Clinician Problem Areas

1. Frustrations towards patient’s lack of compliance

2. Compassion fatigue: poor results draining

3. Difficulty confronting patient…

“don’t want them angry with me”

4. Projective negative judgments… “lazy”

5. Taking too much ownership of their behavior

6. Managing pt’s anger with you or at staff

Discussion-Problem Solve

• What patient issues do you see most?• What patient issues you (we) get stuck on?– Examples? (note cards)

• What clinician (your) issues concern your most?• What clinician (you/staff) issues need to be

improved?– Examples? (note cards)

Key Point

• We are not fixing them!

• We are guiding, teaching, supporting, caring!

The Tools• Ask the patient what the solution is• Ask the patient what has worked• Ask the patient what they are truly willing to do• Write down on note card their goals• Write down what it means to achieve their goal(s)• Can you increase frequency of visits• Refer to your network of good resources• Compassionate/patience/persistence