Cher
Cher is unable to identify any strengths today. "I just feel empty.” CC Tina encouraged Cher to consider creating a vision statement, a personal statement that summarizes her personal goals and dreams for her future, that reinforces her values, and helps her focus on her action plan for optimal health and growth. After a long pause Cher states, “I want to be a pillar in my community. I want greater control of how my depression affects my time with my family and friends. As a parent I want to teach my children the importance of diversity and inclusion.”
Suggested OEI: With that impressive vision statement, what steps can you take moving forward creating that reality?
What is Stage 2: Establish Vision & Create a Plan?
Member might • Lack recognition of personal strengths • Be hopeful for the future and of change but lacks motivation for action CC Skills: • Explain the importance of a vision statement •Imagine possibilities: Help the member discover their vision of optimal life, health, and well-being by encouraging them to create possibilities
Jack tells his CC, Susan, "I don't think anything will help me. I never finish anything that is good for me. I'm a quitter." CC Susan reflects, "You think you can't be helped, and you may not finish what you start, yet I recall you sharing that you were able to complete that boot camp with your friend last year." Jack replied, "Yeah, that was a really tough 12 weeks, but I did it."
What is Stage 1: Build Trust and Inspire Hope?
Member might • Seem uninterested or only partially interested • Seem apprehensive, fearful, evasive CC Skills: • Reinforce member autonomy: Empower members to acknowledge their options and potential future.
Elvis tells his CC Priscilla that he would like to get out of the house and do more, but he can’t seem to ever make himself do it, so he just ends up sitting in the house. CC Priscilla replies to the member, “I heard you say in our last call that your grandchildren motivate you to want to do more.” Suggested OEI: Tell me what you see when you envision you and your grandchildren spending time together.
What is Stage 2: Establish Vision & Create a Plan?
Member might • Be hopeful for future and of change but lack motivation for action CC Skills: • Imagine possibilities: Help the member discover their vision of optimal life, health, and well-being by encouraging them to create detailed images of possibilities.
CC Eric received a call from Lori stating that she is not sure she has time for the OTP. She has a veggie garden to attend, she must visit her mom daily, and she didn’t like the counselor calling her Ms. Lori. Eric says, first I apologize that Amanda called you Ms. I’m sure we can discuss that with her. Eric reflected; it sounds like you’re concerned about giving up the things that are important to you for the chance to improve your overall health.
What is Stage 1: Build Trust and Inspire Hope?
Member might • Seem apprehensive, fearful, mistrustful, evasive or “too busy” to talk CC Skills: • Display unconditional positive regard: Demonstrate mindfulness, compassion, empathy, curiosity, respectfulness, and belief in capacity for change.
Cher tells her CC, Tina that she hasn’t been back to her therapist. Cher states that she doesn’t understand how continuing to see a therapist will help her lose weight. CC acknowledges how she is feeling. Tina asks Cher, “If you don't mind, tell me some of the things that you have been able to take away from the sessions?” Cher explains that the therapist encouraged her to journal when she was sad, anxious, and depressed. Suggested OEI: How might you connect this to your weight loss journey?
What is Stage 3: Cultivate Action & Develop Self-Efficacy?
Member might • Not have attended or only attended one Ontrak provider visit so far CC Skills: • Coach to and through Ontrak provider sessions: Promote meaningful provider communication. Frequently review provider treatment plan and integrate provider recommendations into the coaching plan and conversations with member.
CC Susan has a call with Jack today. Her plan is to help him discover his vision of optimal life and health. She will also reinforce her beliefs in the members abilities by reminding him of past accomplishments that gave him joy. Suggested OEI: What does good health look like to you?
What is Stage 2: Establish Vision & Create a Plan?
CC Skills: • Imagine possibilities: Help the member discover their vision of optimal life, health, and well-being by encouraging them to create detailed images of possibilities.
Elvis tells his CC Priscilla that he knows that if he continues to do three things, he will keep from having to be admitted to the hospital. Suggested OEI: Tell me more about those 3 things and how you plan to keep doing them.
What is Stage 4: Increase Activation & Complete the Program?
Member milestone • Member identifies at least three self-management skills related to their chronic condition.
On today’s coaching call with Lori, CC Eric celebrated and recognized Lori’s previous takeaways from her last provider session. He also integrated the providers plan to explore Lori’s feelings about how she can take the next steps to reduce her beer intake by encouraging her to integrate her own action plan. Suggested OEI: What might be the next best step for you reduce your alcohol intake?
What is Stage 3: Cultivate Action & Develop Self-Efficacy?
CC Skills: • Deepen the conversation: Remain confident in conversation, dance with resistance, and show appreciation for the member’s unique path. Identify and explore disconnects between the member’s future vision & current behaviors.
Cher tells her CC Tina that she had a session with her provider and wants to continue services after OTP. "I'm finally ready to discover mindfulness to regulate my emotions." CC replied, “You made solid changes to manage your depression by getting a new psychiatrist and being compliant with the treatment.” Cher says, "It was a hard decision but now I know I can make those decisions when I need to and not be afraid.” Suggested OEI: What are some of the "red flags" that you know to be aware of as you continue your wellness journey?
What is Stage 4: Increase Activation & Complete the Program?
Member milestones • Demonstrates ability to set provider appointments as well as navigate the health care system CC Skills: • Connect to appropriate care: Confirm the member’s knowledge, ability, and confidence to independently manage health, health care system, and additional resources.
On the call with Jack today CC Susan noticed Jack has greatly improved autonomy to improve his health. He joined a group to support youth in the community, has lost weight, and reduced his A1C. Since completing his last SMART goal, he now has the tools to manage his chronic and mental health conditions and advocate for his health needs at provider visits. Suggested OEI: Since you’ve been so successful in this program, what’s next for you Jack?
What is Stage 4: Increase Activation & Complete the Program?
Member milestones •Member identifies at least three self-management skills related to their chronic condition CC Skills: • Reflect health vision in goal setting/achievement: Re-focus goal setting. Connect behavior change to their envisioned health outcomes and condition management.
CC, Priscilla, responds to her member, “Elvis” with “I hear you say that you would like to get out the house and do more. ” Elvis replies,Yes I would love to get outside more.” Suggested OEI: I heard you mention that the local park is a favorite spot that you like to visit, what do you enjoy most about going there?
What is Stage 3: Cultivate Action & Develop Self-Efficacy?
Member might • Be unwilling or unable to set SMART goals CC Skills: • Deepen the conversation: Use evocative questions and perceptive reflections. Remain confident in conversation, dance with resistance, and show appreciation for the member’s unique path. Identify and explore disconnects between the member’s future vision & current behaviors.
Lori tells her CC, Eric, that she knows that she needs to make time for exercise and other activities that she enjoys but she doesn’t know where to start due to her busy schedule. Suggested OEI: Paint me a picture of what your ideal schedule looks like that includes exercise and the activities that you want to engage in?
What is Stage 2: Establish Vision & Create a Plan?
Member might • Be able to identify potential broad areas of focus, but still has difficulty establishing specifics or envisioning the long-term plan CC Skills: • Imagine possibilities: Help the member discover their vision of optimal life, health, and well-being by encouraging them to create detailed images of possibilities.
Cher tells her CC, Tina that she believes she is too busy for the program. Cher goes on to say that she is sure she has tried all the program’s tactics anyway and none of it works. Tina replied, “You believe you've tried other tactics in the past that were not helpful.” Cher says “Yes, I bet its all the same.” Tina reminds Cher of their initial call when she shared many skills she has mastered in the past. Suggested OEI: If you don't mind, tell me what you have tried that has helped you?
What is Stage 1: Build Trust and Inspire Hope?
Member might • Seem apprehensive, fearful, mistrustful, evasive or “too busy” to talk • Feel that they have tried but have not been successful in the past CC Skills: • Use open-ended questions to discover what motivates. Explore the member’s backstory. Help foster new perspectives and allow self-discovery.
CC Susan talked with Jack today about reconnecting with his NS. He is disappointed he doesn’t see weight loss progress yet and feels “stuck”. CC Susan guided his attention back to his vision to develop new problem-solving skills. MI: What ideas do you have that you can add to the NS ideas that you received previously?
What is Stage 3: Cultivate Action & Develop Self-Efficacy?
Member might • Be easily discouraged, quits, shows avoidance, displays barriers • Be unable to see connections between their behaviors and overall health status CC Skills: • Foster independence: Empower the member to identify their own goals and action plans. • Enable resilience: Pause and address when the member is struggling with examining and resolving ongoing or new challenges with their goal(s).
Elvis tells his CC Priscilla, “I have been through 3 failed marriages and the loss of my brother. There isn’t anything that I can’t handle at this point. I'm fine.” CC Priscilla replies to Elvis, “Those must have been some difficult times.” Suggested OEI: “If you don’t mind sharing, how were you able to get through those situations?”
What is Stage 1: Build Trust and Inspire Hope?
Member might • Seem overconfident at times, “I can handle XYZ myself” or “I’m fine” CC Skills: • Build rapport: Use active listening (open-ended questions) to discover what motivates and is important to the member. Explore the member’s backstory, interests, hobbies, purpose, values, passion, and potential goals. Help foster new perspectives and allow self-discovery.
CC Eric is preparing for his call today with Lori. He has listed the achievements she has made while in the program and plans to mention each one. Eric will also encourage Lori to celebrate the strengths and confidence that she has developed to help her continue her progress for change. Although she continues to drink beer, he is excited to commend her for the many challenges she has defeated. Suggested OEI: How has the OTP changed your perspective and how you will manage your wellness into the future?
What is Stage 4: Increase Activation & Complete the Program?
CC Skills: • Evaluate ability to manage health conditions: Explore the member’s capacity to live their optimal life while balancing their condition(s) and treatment. • Celebrate accomplishments and honor challenges: Acknowledge the member’s progress throughout the program. Encourage the member to reflect on and discuss progress made, challenges experienced, lessons learned and overall growth. Reinforce appreciation for the member’s unique path.