Natalie: 0:00

On today's podcast. I talk with my friend Angelique and nationally board certified health coach about strategies for making small, sustainable changes. We also went on to chat about her own story of going through pelvic surgery, and that conversation will be available in a later episode. Angela provides so many great tips in this episode. I'm happy to have the opportunity to share them with. I'm Natalie. And you're listening to the resource, do a podcast, a place where we provide information to help you make informed healthcare decisions for yourself and your family hello and welcome. I'm Natalie. And I'm looking forward to talking with Angela Garney and nationally board certified health coach about behavior change and how health coaching can help you reach your goals and a little bit about her own journey through pelvic health challenges and surgery as well. Angelina, can I go way back to the start of my exercise career about eight years ago now? So angelic attended the university of Alaska Anchorage on a debate scholarship and studied journalism and biology. She became an ACE certified personal trainer in 2001, and then went on to become yoga fit certified as well as a clinical exercise specialist. She started as a health coach in 2008 where she did biometric screenings, nutrition, education, and demos. Angela started teaching Rolfing based Pilates and Barre classes where she co-taught postnatal and healthy back and joint classes with physical therapists. And she also co-taught prenatal Pilates with me. She then started health coaching in a primary care clinic in collaboration with doctors to help support patients with behavior change, to help improve their health. She became nationally board certified with the national board of health and wellness coaches in 2017. Welcome Angelique. I'm so excited to have you on the podcast today.

Angelique: 2:06

Hey, thank you, Natalie. I know it was a highlight to get to teach with you, um, way back when we were teaching prenatal Pilates together.

Natalie: 2:15

I know it feels like a lifetime ago.

Angelique: 2:20

Oh yeah. I mean, it's, it's really adding up how, and you have really taken off with, you know, your passions and interest in exercise and women's health. Um, so it's really cool to see how far you have come, but it was really special getting to, you know, to work with you when you were just starting out. And I, I really hold that memory, dear, who was a real fortunate thing for me to get to, you know, be with you in that process.

Natalie: 2:47

no. You're gonna make me cry

Angelique: 2:50

I know I was kind of tearing up a little bit too. I don't think there's no crying on your podcast though.

Natalie: 2:55

There can be, you can cry on my podcast. That's all right,

Angelique: 2:58

good. What are you leave? Okay,

Natalie: 3:02

so let's dive right in. Can you just talk about what aspect of your health coaching career you're most passionate about?

Angelique: 3:12

great question. Um, and I think having passion for what you do is really important. And my passion around health coaching is to support people that are trying to change behaviors specifically when they've tried the behavior change over and over again. And it kind of spirals them into this self defeat shame, um, getting angry at themselves and feeling very defeated.

Natalie: 3:43

Hmm.

Angelique: 3:43

can be kind of this all or nothing cycle. Um, and I find that to be really common. So I love to work with people to give them permission, to make slow small changes. And then also to examine when that, um, if they haven't done something perfectly and they start to spiral into kind of beating themselves up or whatever behavior comes from that, um, kind of getting them aware of that behavior and then offering solutions for it.

Natalie: 4:16

Wow, that that is comprehensive. I been there done that with behavior change. Um, I'm curious about some strategies that you use, just like, what does it look like when you first meet with someone? How do you plan out your, you know, your plan of care?

Angelique: 4:36

Oh, great question. Um, so when I first meet with someone, I really like to get them talking as, as soon as possible so I can meet them where they're at. Um, so I ask a variety of questions in terms of what they want. What does it look like? What does it feel like? Have you ever had it before? What's motivating you? Um, why is it important? Um, how might it align with their core values? I like to kind of figure all of that stuff out and factor it in. And then we talk about, uh, you know, what types of behaviors would they want to, um, target to reach that end, that they have a wanted.

Natalie: 5:23

Okay. Is there like a really common behavior that people are, are seeking your guidance?

Angelique: 5:30

Um, there's I coach a lot of people around, um, weight loss, um, stress reduction. I found that since the COVID-19 outbreak, a lot of people are very stressed in ways that they haven't been before. Um, they've also like people that had good habits before the pandemic have really struggled to maintain those habits. And then now that things are opening back up, uh, people are struggling to like, Hey, I know I should get back to the gym, or I really do much better when I'm accountable to a group for exercise. Uh, so it's, it's kind of naming what they want to do and why it worked in the past and then making a plan.

Natalie: 6:16

Okay. I like that.

Angelique: 6:18

Yeah. Um, and then also, I, I tend to have a lot of patients with, um, ADHD and with those folks, it's interesting because they are so brilliant and I have so many thoughts that it can be this overwhelming amount of like things they feel like they should be doing. And, um, and it can be kind of paralyzing for them. Um, so sometimes it's about paring down the list of things to do and having fewer things to focus on.

Natalie: 6:53

You mean, my to-do list of like 57 items is probably not productive.

Angelique: 6:59

Well, you know, when it kind of depends on, on what the result is for you. Cause some people are very goal-oriented and having a list of things to do. And knowing that it's going to take a little bit of time to get there, or even the ability to like I'm going to capture these things that I keep thinking about that I need to do. So I can take action on them at the appropriate time versus people where the thought just kind of spins out of control and they kind of lose it and they can't kind of hold onto one thing to really focus on it and be productive about it. You know? So it's like a big to-do list is great. Um, unless it produces anxiety for you, if that makes sense.

Natalie: 7:41

Yeah, totally, totally makes sense. I have actually been working on pairing down my to-do list personally. Yeah. And categorizing. That is something that has been helpful for me.

Angelique: 7:53

Okay. Yes. Yes. That's a great, that's a great technique. Yeah. Um, and for patients like that, I really liked the Eisenhower matrix,

Natalie: 8:03

Okay. Tell me more.

Angelique: 8:05

where you, and it's kind of like a quadrant where you put things that are important and urgent, um, and you, you categories them as like, is something important, but not urgent or is something urgent but not important. Um, and if it's not urgent or important, then it kind of falls off the list, but if it's urgent and important, that goes to the priority, um, item.

Natalie: 8:30

I like that.

Angelique: 8:31

So yeah, the, and if you Google Eisenhower matrix, you'll, you'll see it. And, um, and that is how Eisenhower, um, organized, uh, his workload.

Natalie: 8:42

Okay. Hmm. That's exciting. I'm I knew that I would learn a lot of new things today. I want to hear more about how health coaching integrates with primary care, because I think a lot of people don't necessarily realize that that's an option or something that could be provided to them through their primary healthcare clinic.

Angelique: 9:04

Yes. Great question. Um, so coaching is integrated into primary care, um, to help support patients with behavior change, to improve their health and wellness. So like, let's say a patient comes in and they get a new diagnosis of like, Hey, you're borderline diabetic or you are hypertensive. Um, or you need to change your eating habits or you need to get more sleep, um, to improve your health. So you get these recommendations from your daughter. Um, then they can, uh, introduce the patient to the coach who can help a patient come up with strategies to achieve the behavior change. That's indicated. Um, the way that, um, that I have been trained in my setting is that the patient is the one that chooses to change the behaviors and work with a coach. Um, so for instance, let's take a patient that has been diagnosed as pre-diabetic. They get a referral to a nutritionist, they get a whole download of information that is overwhelming on all of the dietary changes they need to do, and they feel overwhelmed. And like, this is impossible. Um, a health coach can work with that patient to really sense where they're at. And it's like, okay, Hey, this is overwhelming. What would be a small step forward that you would like to take? And, um, in, in my practice now I have a patient, um, you know, like they've just had their, their biometrics down. They've had their labs done. Let's say, you know, for like high cholesterol or diabetes, uh, it's, it's relevant to get another A1C or lipid panel done in about four to six months. So it's like, Hey, in four to six months, if we were to work on this, what would you like to achieve? Um, and you know, what strategies would you like to use? And you just had all this information. Most people kind of know what they need to do for themselves. Um, but it's like, Hey, let's pick like, what's one thing you want to start with. And then imagine yourself in six months, what do you want to be achieving? And then each time I would meet with a, with a person around this topic, um, we'd celebrate what had gone well, and then we talk about where they are at that particular session and then what they want to check back with next time.

Natalie: 11:30

Okay. That it feels like the future to me, like this is what healthcare should look like.

Angelique: 11:37

Yes. I, I so agree. It's, it's a really nice to have that support and, um, the metrics around patients that use health coaching really tends to produce much better health outcomes for patients. So the company that I work for, um, is really progressive and cutting edge in the way they utilize, um, health coaching and the way that they have that collaborative, um, relationship with the provider and the health coach.

Natalie: 12:09

That is awesome. I feel like so many people need that. Like it's overwhelming to get a new diagnosis or even just, oh, it looks like your labs are a little out of whack work on that and we'll test them again. Like that's not enough, not enough guidance. I feel like, and the doctor doesn't have that much time either. And so what a cool way to step in and be that the guide on the side, right. To

Angelique: 12:33

Yes. I love that guide on the side. Yeah. It really kind of offloads some of that burden from the provider, but it also offers a ton of support for the patient. And even if a patient feels like they're not being heard or they're struggling with a transition, like a new diagnosis, um, I really have in my, in my personal belief, but also for patients, I think it really pays to have a team of people caring for you and helping you achieve what you want with your health goals.

Natalie: 13:06

agreed.

Angelique: 13:07

Yeah.

Natalie: 13:09

How often do you tend to meet with people for health coaching sessions?

Angelique: 13:14

So we, and in the setting I work in now, um, we let the patient decide, but what I typically say is that I see a lot of patients weekly, um, and then make, they tend to, um, do it every other week after a certain bed. And then sometimes they'll go down to once a month.

Natalie: 13:33

Okay. Kind of, depending on like their own goals and how they feel like they're doing.

Angelique: 13:38

Exactly. And then I did have one patient who was really, she knew herself so well. And she had been like a weight Watchers person and had done a lot of dieting and been very successful. And she said to me, and I really just was struck by this because it was really brilliant. She said, you know, I do a great job of losing weight. And then when I kind of hit my goal in plateau, that's when I really need the support because I go back to old habits, but I'll lose 20 pounds and then I'll feel good and I'll celebrate. And then I'll gain it all back plus five. So she's like, I want to start off once a month with my diet process. And then when it comes to maintaining, then I want to see a weekly. So it's really all about the patient's need for support, because you want to be, you want to have time to work on your goals and feel like you can make progress. Um, but you also want to pair that with having enough support.

Natalie: 14:35

Yeah. And that accountability that you have to talk to Angelica next week.

Angelique: 14:41

Right. Right. And, you know, and, and there's kind of that like a slippery slope of like accountability versus support, you know, like some people, it really helps to know that they've got to address this. And I like to think of as kind of pulling somebody's focus back to what's most important to them. I also like people that tend to spiral down if they haven't had just incredible success for whatever reason, um, it's nice to get those people in touch with what they are doing well, and then giving that them that opportunity to kind of reset and be like, Hey, you have done some good things. Now let's focus on what's next instead of what went wrong. So it's kind of reframing and getting people to focus on their achievements. Um, first is getting really hung up and bogged down on the difficult.

Natalie: 15:33

You know what that reminds me of when we first learned to queue in Pilates, you never just give the person a million different things to think about at once because that's discouraging and overwhelming. You focus on what they're doing. Well, how they're moving their body well, and into that whatever position it might be. And then we work one by one on corrections and adjustments.

Angelique: 15:58

Yes. And also like killing the dues and not the

Natalie: 16:03

Yes. Yeah. Cause as soon as you say don't clench your butt, what is everybody going to do?

Angelique: 16:08

Oh my gosh. I'm clenching my butt right now. Yeah. And it's kind of like that compliment sandwich type, um, approach, you know, where it's like positive, positive growth, positive, positive.

Natalie: 16:23

Okay. So I'm assuming that there's research on the compliment sandwich and positive reinforcement and positive feedback to make better changes.

Angelique: 16:33

Yes. And there's also a spectrum, you know, some people prefer more direct feedback and some people really take a long time to come back to set point after they receive more negative feedback.

Natalie: 16:47

Oh,

Angelique: 16:48

there's like a whole scale of that. Yeah. Um, and I, it's something that I've learned in my training, but it's been a while. Um, but yeah, you can kind of test to see, and you can ask somebody that you're working with too. Like, how do you like to receive feedback? How do you do with negative feedback? Um, you know, and Hey, it's okay to tell me it's not a good time for feedback. You know, I always like to keep an open communication channel with that.

Natalie: 17:15

Nice. So can you define setpoint for us?

Angelique: 17:20

Yeah. Set point would be like where you're feeling kind of normal and, and, and that kind of assumes that normal is functional.

Natalie: 17:27

Got it. What of normal is not functional.

Angelique: 17:30

Yeah, so well, and so this is something too that comes up. So I'm lucky that I get to work alongside a behavioral health clinician at my, at my clinic. And if, if set point isn't, you know, functional, it's like if someone is overwhelmed, um, if someone is, is not ready to make forward progress, that's kind of a good sign that, that you need maybe behavioral health counseling. Um, and, um, and I explained this a lot in practice because you know, some people don't know what the right thing. So a behavioral health counselor is like an archeologist where they would assist a person to, you know, dig up what's been going on and to process through that. So they really get a good understanding of what has happened. And then when they're ready to move forward, a coach can be like an architect where, you know, you're, you're in this pit, but you're ready to take some steps forward. So a coach is going to work with a patient to design a step-by-step, um, bridge to get out of that place that has been dark or, you know, dysfunctional for them.

Natalie: 18:44

What a cool analogy. I really liked that one.

Angelique: 18:48

Yeah, and I totally stole that from somewhere. I can't remember, but yeah, it's kind of a neat, it's neat analogy.

Natalie: 18:53

Yeah.

Angelique: 18:54

Yeah. And it's really good to partner with, um, with a counselor, you know, cause um, some people are like, they're so overwhelmed and they need counseling and counseling is a lot of work, you know, for the patient to, to do the things and, and work through the things. And sometimes that's all they can do on the other hand sometimes. Uh, counselor will give a patient tools to use in certain situations. Um, and a counselor can be someone that's maybe has fewer touch points with the patient. Um, so you might see your counselor once a month or, and counseling is kind of hard to get, you know, it's expensive. It's, um, sometimes there's a wait list for it. Um, you know, it's, it's a, um, you know, it's hard to get it's in such great demand that it's, it's not, um, as available as it should be. So a coach is someone that a patient can, can walk away from their therapist with tools, um, and then they can talk through how do you want to use those tools? What result do you want from using those tools and how do you plan to do that?

Natalie: 20:07

It sounds like a really holistic model of care and that's what I'm all about.

Angelique: 20:12

Yes. Agreed. I do. I feel like it's a really part of a holistic plan of care where a patient isn't just like, Hey, you do all these things. See you in six months. Um, you know, it's like, Hey, this is the support that you need taking each step one at a time.

Natalie: 20:28

And it really puts the patient, you know, the client in the driver's seat and they get to determine where they're going, how they're going to get there, um, who they'd like to bring along the way.

Angelique: 20:40

Yes, exactly. And I think that that's a really, really important notion that a patient should feel clear about being able to advocate, um, you know, cause you haven't asked me about this yet, but I would say that, you know, with the different forms of coaching that are out there, some coaching is designed around, um, product sales or predetermined behavior programs, um, where if you're not kind of on board with that train of like, Hey, you're going to use our products and get this result. Um, it can kind of, you know, it's not really about the patient. It's about the program. That's kind of a, maybe a cookie cutter program.

Natalie: 21:24

Okay, that seems highly inefficient anyways.

Angelique: 21:30

Well, I mean, for some, for some patients, at times in their lives, it can be really effective. You know, like if they buy into a weight loss program and then they get the support, they need to achieve their goals and they use it, you know, and then they might use it more infrequently once they've hit their target. Um, and it can really be in alignment with where they're at. Um, for some people, like if there's ever a coaching program where you're paying out a lot of money and investing a lot, and then you're not really being heard or recognized or having the coaching program adapt to where you are. Um, then that becomes, you know, not so productive, not such a good experience for the patient.

Natalie: 22:19

so is there a way to determine prior to signing up for a health coaching program, what type of program they're they're giving you? Is there like. Uh, directory online somewhere where you can find the right coach for you.

Angelique: 22:35

Um, you know, there's a, well, there are a lot of specialized coaches too. So some coaches offer expert coaching where they're going to give you information. Um, and typically the, the scope that's proper is that a coach is only going to give you, um, information. Like this is what you should do. This is the protocol when they are nationally certified in that area of focus. Um, Some coaches are affiliated with a certain product, you know, like a dietary product. Um, some coaches are affiliated with certain behaviors. Like one of the, um, one of the coaches that I've worked with has, um, become a travel coach as a subset, you know, practice. And, um, and so she coaches people into getting ready and doing what they need to do to have a successful travel. Um, our trip, um, some coaches are registered dieticians or nutritionists, and then they have, um, you know, all that background where they will work with a person to really change their behaviors and offer them tools based on their education, um, and certifications or education with nutrition. Um, some coaches are, um, a lot of claims of how they get patients or people results. And they'll ask for a really big buy-in. So my advice to a person seeking a coach would be, you know, what are your goals? Is this coach really aligning with my goals? Will they give me the opportunity to interview them? You know? So if something was considering coaching that they were paying for, I would say, you know, interview your coach, get a list of questions that are important to you. Um, and then if you are buying in upfront, Th that does kind of lend some buy-in or accountability for the patient to get their money's worth, but really see how that invests in, you know, how that investment can I get my money back if I'm not satisfied with the program, um, you know, what am I getting for my money? Um, are you pushing me in a certain direction or am I directing myself? Um, those are good questions. Um, the, the national board certification that I have, their website is pretty good. They offer a, um, kind of a directory of nationally board certified health and wellness coaches. And it's called, um, N B H wc.org. Um, and, and so we are all accredited board certified and do. Um, recertifications every three years to keep that certification. That's, that's a gold standard in the industry of coaching. I would also ask about, you know, whatever coach you were considering hiring what their credentials are. And that's a pretty good credential.

Natalie: 25:51

Yeah, good tips. Yeah. Well, thank you so much for having this conversation with me today.

Angelique: 26:00

Yeah, absolutely.

Natalie: 26:02

I hope you enjoyed listening to this conversation as much as we enjoyed having it. My top takeaway from this episode is to really take a hard look at what your specific goals are and how you can set up a framework to help you achieve them. Whether that's by hiring a health coach, pairing down your to-do list or practicing some mindfulness, go and make it work for you. Please remember that what you hear on this podcast is not medical advice, but remember to always do your own research and talk to your provider before making important decisions about your healthcare. If you found this podcast helpful, the greatest compliment is sharing it with a friend. Thanks so much for listening. I'll catch you next time.