Sunday, June 10, 2018

Book Alert: Conscious Coaching - by Brett Bartholomew

Quoting a quoted passage- “People won’t care how much you know until they know how much you care.”
I just recently finished reading Conscious Coaching by Brett Bartholomew.

What I really enjoyed about this book is that Brett welcomes you into his personal life to the deepest level.  He had some really challenging obstacles to overcome in his youth which he goes into great detail explaining and makes you want to reach into the book and give him a hug.  I've seen some of his posted videos on social media and he has an engaging personality and a voice worthy of being a radio talk-show host, so it was eye opening to hear of his past and where he has come from.  It also becomes alarmingly apparent that his health issues were severely mismanaged in the healthcare system at the time.  This is tragic and, as a healthcare provider, it made me think about my current patient caseload wondering if I'm doing a good enough job listening to my patients, hearing their concerns, and doing what's best for them... not what I think is best.

One way that I try to remedy this concern is that I ask EVERY new patient the following three questions:
1) What do you think is going on with yourself?  Particularly working at Seattle Children's Hospital where my patients are young kids and often have never had pain or physical therapy before, this is important.  Most commonly - I get very simple answers.  "I sprained my ankle."  "My knee hurts."  Once in a while they have seen another PT or a chiropractor and already have a mindset of "My pelvis is out of alignment."  Asking a patient what they think is going on helps you understand their mindset and helps me determine any beliefs that I may have to address, and leads perfectly into the next two questions.
2) What do you think will help you get better quickest?  If a patient thinks that manual therapy will help them, and I only guide them through an exercise program, the buy-in from that patient is less because I haven't listened to their desires.  This occurs much more often with the older population who has had physical therapy before and has seen what worked in the past.  The younger population generally shrugs at me with a blank look on their face - and I explain how physical therapy works and usually my typical treatment patterns: Range of motion restored first, then strength and stability - along with the concept of progressive overload - which I've previously discussed here. 
3) Have you ever had physical therapy before? This question really should be mandatory for every patient evaluation.  Always.  It gives you the opportunity to explain what you're going to do in your evaluation and in subsequent sessions for those who have never been through PT before.  It gives you a chance to calm any nervous patients - because many of them are anxious and with the children I work with - they've often never had pain before and don't understand that they're about to be touched.  It should go without saying that you have to have permission to touch your patients - so here's an easy way to get that approval.

Back to the book. The global purpose of the book is to help coaches better interact with their clients - to build buy-in.  It comes from a Strength Coach perspective, but can be applied to people interacting with others. Brett breaks the book into three major sections.  The first is a series of ways to identify yourself with 3 stages of Internal Identification: Reflection, Inspection, and Progression.  Included are a series of options for self- testing to determine your personality type including the Myers Briggs, which I had done in PT School and identified me as an ENFJ (Extrovert-Intuition-Feeling-Judging): The Compassionate Facilitator (also considered the protagonist or leader of the pack depending on source).  These pictograms describe my type and appear to be spot-on.  This test, and the others that Brett describes in the book, are meant to help you understand yourself before interacting with others.  Though they all have a fee - I always find it interesting to learn about my own personality qualities and there are tons of abridged versions online that can be taken for free to give you a taste of your own personality.  Along those lines - Brett advises that you "resist the urge to collect resources or data points just for the sake of having them."  I didn't complete all the tests listed to have several personality tests describing me... just the one was sufficient.


This section also examines types of conflict.  "Conflict often leads to conversations that become catalysts for growth by opening up the opportunity for different perspectives and views to be voiced... Conflict keeps us honest."  There can be conflict about a task, when there is disagreement about a task and how to manage it.  There are personal conflicts between people with a need to seek resolution.  And there are different strategies to manage the conflicts that arise.

The next section describes different "Archetypes" or typical descriptions of types of people to help better understand your clients.  Each Archetype is defined with their usual strength and weaknesses, suggested ways of how to optimally interact with that personality type, and then an actual case study describing an interaction with someone of that type.  Every patient or client is different and sometimes it can be very challenging to create an alliance with all those differences.  Reading the book made me consider the complexities of an introvert doing my job on a daily basis - and conversely on how I would feel working in a career that is primarily working alone or that does not regularly interact with others.  I love people and I love talking... those would be challenging!  It also made me wonder which Archetype I would fit into, and if any of my previous coaches or mentors have categorized me and used any of these principles.

The last portion of the book is application and ways to develop trust.  Brett presents 13 Coaching Mistakes to Avoid.  I've faced many of these situations along my career, fortunately avoiding many of them, but the way he presents the concept of "taking things too personally" made me laugh.  He explains "Nobody else wakes up worrying about Brett... refuse to let an action become your identity - you need to understand that experiencing a moment when you have fallen flat on your face or embarrassed yourself does not mean that you are destined to be a lifelong failure."

If you coach athletes - this is a great read.  And if you interact with others on a regular basis, or want to have a better understanding of your own personality and behaviors - you can pick and choose the pieces that apply to you.  Check it out!

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