NBC HWC Exam (Personal Deck) Coaching Presence, Relationships, Sessions. Section 1 of Exam

Neuroplasticity

brain's ability to recognize itself by forming new neural connections and changing its structure and function throughout life.

Forming new pathways and, repeated skills and actions make existing neural connections faster and efficient.

Unused connections fade away or get removed overtime.

Transtheoretical model of change

Views behavior change as a gradual cyclical process of moving through distinct stages rather than a single one time event.

Pre-contemplation (NO)

Contemplation (Maybe)

Preparation (prepare/plan)

Action (do)

Maintenance (keep going)

Motivational Interviewing

4 Tasks:

1. Engaging: create connection, rapport, safe space building relationship

2. Focusing: Clarify client goals, values, specific change they want to explore

3. Evoking (reasons for change) : draw out change talk, strengthen motivation, resolve ambivalence

4. Planning: create clear, realistic plan supporting client confidence and next steps.

** Goal: to resolve ambivalence ( contradictory feelings and beliefs)

Change Talk

statements that indicate desire ability and reasons to make a change

(i want to have more energy to play with my kids)

Sustain Talk:

Statements that support maintaining, arguing against, or barriers to change

(i cannot afford a gym membership, i am too tired to cook healthy after work)

Self efficacy theory:

a person's belief in their own ability to succeed at a specific task or goal.

1. Mastery experiences: past success builds confidence, failure lowers it

2. Vicarious experiences: watching peers or role models succeed helps you believe you can too

3. Verbal persuasion: positive feedback and encouragement from trusted people boosts confidence

4. Emotional states: stress, anxiety, or fatigue can lower your belief in your abilities while calm and positive feelings can raise it.

Social Cognitive Theory

How people acquire and maintain health behaviors through continuous interaction between personal factors, environmental influences, and behavior itself.

cognitive factors: knowledge, expectation, attitudes

environmental factors: social norms, access in community, influence on others (ability to change own environment)

Behavioral factors: skills, practice, self efficacy

Self determination theory:

supporting a clients inner drive leads to sustainable long-term health behavior change.

Autonomy: human need to feel in control of ones life, choices and health goals match personal values rather than outside pressure

Competence: the desire to feel capable and experienced in achieving mastery over health task and challenges

Relatedness: the need to feel a sense of belonging, care, meaningful connection with others

Growth Mindset vs. Fixed Mindset

Belief that abilities and health habits can be developed through effort while a fixed mindset views traits as unchangeable.

Fixed: I am just not a healthy person, I was born a sweet tooth, clients shy away from new routines out of fear of looking foolish, giving up early, obstacles lead to frustration or quitting because talent and willpower seen as it cant grow.

Ex. missing a workout or meal is useful feedback and not a failure (embracing setbacks)

Progress is tied to consistent small changes rather than an innate talent

Openness to feedback: client accepts guidance from their NBC HWC without taking them as personal criticism.

Positive psychology approach:

shifts the focus from fixing what is wrong to building on what is strong, thriving, and working well in a clients life. It is a strengths based focus to identify and celebrate their past success and strengths rather than bad habits. Future and solution oriented

Appreciative inquiry

shifts away from problem solving and explores clients past success, core values, and best experiences. It builds self efficacy and intrinsic motivation by focusing on positive emotions, optimism, and proven capabilities.

5D in coaching

Define: clarify overall focus of topic of coaching inquiry

Discover: uncover past success, high points, existing personal strengths

Dream: envision a positive desired future based on those strengths

Design: create actionable personalized steps like SMART GOALS

Deliver: sustain and embed the new habits and positive changes into daily life.

Self efficacy theory : Mastery experiences

past success builds confidence, failure lowers it

Self efficacy theory: Vicarious experiences

watching peers or role models succeed helps you believe you can too

Self efficacy theory: Verbal persuasion:

positive feedback and encouragement from trusted people boosts confidence

Self efficacy theory: Emotional states:

stress, anxiety, or fatigue can lower your belief in your abilities while calm and positive feelings can raise it.

Self determination theory: Autonomy

human need to feel in control of ones life, choices and health goals match personal values rather than outside pressure

Self determination theory: Competence

the desire to feel capable and experienced in achieving mastery over health task and challenges

Self Determination Theory: Relatedness

the need to feel a sense of belonging, care, meaningful connection with others

A client says, "I've tried exercising so many times, but I always quit."

The coach responds:

"Tell me about a time when you were consistently active and actually enjoyed it. What was different about that time?"

Appreciative Inquiry — focusing on strengths, successes, and what is already working rather than dwelling on problems.

Key clue: "Tell me about a time when..." / "What was working?"

Example Scenario: Improving Physical Activity and Healthy Eating

Client: Sarah, 42, works at a desk job and wants to improve her energy, exercise more regularly, and eat healthier. She has tried several diets and exercise programs in the past but usually stops after a few weeks.

What Transtheorhetical state for change is she?

Sarah is in the preparation stage because she recognizes that she wants to change and is beginning to make plans.

Coach: "You mentioned that you want to become more active. What makes this change important to you right now?"

Client: "I feel tired all the time, and I want to have more energy. I know I need to exercise, but I haven't been able to stick with it."

The coach recognizes that Sarah is preparing for change rather than simply telling her what she should do.

Coach: "What do you think would be different in your life if you were able to exercise consistently?"

Client: "I'd probably have more energy, and I'd feel better about myself."

Coach: "Having more energy and feeling better about yourself seem really important to you."

The coach uses Motivational Interviewing (MI) by asking open-ended questions, expressing empathy, and helping Sarah identify her own reasons for change.

Rather than prescribing a solution, the coach helps Sarah find her own motivation.

Client: "I really want to start exercising again. I think I could walk during my lunch break three days a week."

Coach: "You think three lunchtime walks could be realistic. What would make that easier to accomplish?"

Change talk occurs when Sarah expresses her own reasons, desire, ability, need, or commitment to change.

Sarah is articulating desire ("I really want"), ability ("I could"), and commitment/planning.

Client: "But sometimes I'm so busy at work that I don't even take a lunch break. And when I get home, I'm exhausted."

Coach: "So part of you wants to become more active, while another part is concerned that your work schedule and fatigue will get in the way."

Sustain talk reflects reasons for maintaining the current behavior.

The coach does not argue with the sustain talk. Instead, they acknowledge the ambivalence and explore it.

Coach: "You've successfully maintained a walking routine before. What helped you do that?"

Client: "I walked with my sister after dinner. Knowing she was waiting for me made it easier."

Coach: "That sounds like an important strength. How could you use that experience to build confidence this time?"

Self-efficacy refers to Sarah's belief that she can successfully perform the behavior.

The coach helps Sarah recall previous successes and identify strategies that increase her confidence.

Client: "My sister lives nearby, and she also wants to exercise."

Coach: "How might involving your sister change your environment in a way that supports your goal?"

Client: "We could walk together Tuesday and Thursday evenings."

Social Cognitive Theory emphasizes the interaction between personal factors, behavior, and the environment. Social support and the environment can influence Sarah's behavior.

Sarah changes both her behavior and social environment to make success more likely.

Coach: "Of all the activities you've considered, which one do you actually enjoy?"

Client: "Walking and dancing. I hate going to the gym."

Coach: "Then perhaps the goal doesn't need to involve a gym. What type of activity would you choose if you were designing the plan yourself?"

Client: "I'll walk with my sister twice a week and dance at home on weekends."

Self-Determination Theory emphasizes autonomy, competence, and relatedness.

Sarah has autonomy in choosing the behavior, develops competence through achievable goals, and experiences relatedness through exercising with her sister.

Client: "I'm just not someone who can stick with exercise. I've always been that way."

The coach encourages a growth mindset:

Coach: "It sounds like you've had difficulty maintaining exercise routines in the past. What might you learn from those experiences rather than seeing them as evidence that you can't change?"

Client: "Maybe I was trying to do too much too quickly."

Coach: "That's an interesting insight. What could you try differently this time?"

Sarah initially demonstrates a fixed mindset:

Sarah begins to view setbacks as information and opportunities to learn, rather than proof of inability.

Coach: "Tell me about a time when you felt especially healthy, energetic, or confident."

Client: "Last summer I was walking every evening. I felt great, and I actually looked forward to it."

Coach: "What strengths did you use during that period?"

Client: "I was consistent, and I made exercise something social."

The coach focuses on Sarah's strengths, positive emotions, values, and what is already working rather than focusing only on problems.

The coach helps Sarah identify existing strengths that can be transferred to her current goal.

Coach: "When have you been most successful at taking care of your health?"

Client: "When I walked with my sister and planned my meals ahead."

Dream

Coach: "Imagine it's six months from now and you're feeling energetic and healthy. What does your life look like?"

Client: "I'm active several times a week, eating better, and I don't feel like I'm constantly starting over."

Design

Coach: "What could you put into place now to move toward that picture?"

Client: "I'll schedule two walks with my sister and prepare lunches on Sunday."

Destiny/Deliver

Coach: "What will help you keep those changes going?"

Client: "I'll put the walks on my calendar and check in with my sister each week."

Appreciative Inquiry focuses on discovering what works and building toward a desired future.

The coach might use the 4-D process: Discover, Dream, Design, Destiny/Deliver.

Define - Identify the desired area of change. Client: "I want more energy and want to be more physically active."

Discover - Identify strengths and past successes. Coach: "When have you successfully maintained healthy habits before?"

Dream - Envision the desired future. Client: "I'd love to feel energetic and confident in my body."

Design - Develop practical strategies. Client: "I'll walk with my sister twice a week and prepare healthy lunches on Sundays."

Destiny/Deliver - Put the plan into action and sustain it. Coach: "How will you know you're making progress, and what will you do if you have a difficult week?"

Client: "I'll track my walks and focus on getting back on track rather than giving up if I miss one."

Using the 5D Appreciative Inquiry/coaching framework, the conversation could be organized as:

The coach might finish the session by saying:

Coach: "You've identified that having more energy is important to you. You've also recognized that you've succeeded with exercise before when you had social support and realistic expectations. You've chosen activities you actually enjoy, rather than activities you feel you should do. What is the first step you're willing to take this week?"

Client: "I'll schedule two walks with my sister and prepare my lunches Sunday."

Coach: "On a scale from 0 to 10, how confident are you that you can do that?"

Client: "An 8."

Coach: "Why an 8 rather than a 5?"

Client: "Because I've done it before, and my sister will help keep me accountable."

This final question is particularly useful because it elicits change talk and reinforces self-efficacy, while the overall conversation remains consistent with Motivational Interviewing, Self-Determination Theory, Social Cognitive Theory, the Transtheoretical Model, Positive Psychology, Growth Mindset, Appreciative Inquiry, and the 5D process.