Are you a Coach or an Instructor?

Are you a Coach or an Instructor?

Every now and again, you have that one guy; that one guy that’s on a mission to save the world and leave a legacy.  However, more times than not, these guys are fuelled by greed and arrogance.  What is worse?  Perhaps an out of control, caffeine injecting person pumping orders at you?  What is it that makes us cringe at these people? Well it’s definitely not their charisma so I suggest their approach.  Just like a comedian, actor, or even myself writing this blog; a proper delivery is essential to the receiver.  Poor communication is regarded as one of the top errors in business operations.  What is good communication?  Well to answer this I suggest we look at what a coach is and what a leader is.  They both have benefits but as with the delivery, timing is critical to proper usage.

I Consult that Book No One Ever Uses (The Dictionary)

The definition of instructor (coming from the Encarta Dictionary) is someone who teaches something such as a sport or practical skill.  The definition of a coach is someone who trains a person in a specific area, sport, or skill.  Sound similar?  Externally it is.

Internally, it’s much different.  I suggest some lateral thinking at this point.  An instructor is a person who leads through straight answers or direct instruction (hence the name instructor).  They remove the problem by solving it themselves.   A coach, on the other hand, is a person who leads by action and relationship.  I imagine it like this:

  1. Instructor: Teacher, Dictator, Politician
  2. Coach: Little League, A leader you respect, Anthony Robbins

Now I am not suggesting all coaches are like Anthony Robbins, but you have to admit the guy has a bit of charismatic authority.  What’s most important with a true coach is their ability to make their coaching a life long impact.  This is done through multiple routes but we will find they are all paved with motivation.    Motivation happens over time, Influence doesn’t.  Influence is easy (smile, remember names, listen, and ask questions about them), motivation isn’t but has higher rewards.

Now I ask you, what team are you on?

Here is a quick way to find out.  I adapted this from Jo Owen best of all it’s so easy and effective.

The five O’s of coaching:

  1. Objectives
  2. Overview
  3. Options
  4. Obstacles

If you have a clear view of what you are trying to achieve, consider yourself on the right track.  Let’s speak about spinal pain.  Clear objectives are letting the patient now why they are having the trouble and what a positive outcome would look like (outcome assessment).  The patient isn’t a doctor, that’s why they have you.  During this phase you may take on a slight instructor role (especially with the mechanism of injury part) however, coach them with the outcomes.  They should have a realistic and reassured understanding of the issues at hand.  In my clinic one of the forms we use is the Lower Back Disability Index (Revised Oswestry) to determine initial paper goals.   However, our actual physical goals may vary.  Complex loading tasks with no pain may be the longer term goal but quick improvement in a revised oswestry is reassuring, none the less.  Set short-term outcomes and longer term outcomes with your patients.  Remember to be realistic.  An overly optimistic outcome, if not reached, causes disappointment and a loss of trust.  An overly pessimistic outcome causes negativity which leads to all sorts of downstream problems with recovery.

Overview is about letting them voice their concerns.  In the clinical setting, I want the patient to tell me if they are frustrated, upset, annoyed.  These things are good to get out.  Because we get it out in the open, it will save me major headache in the future if the patient has a mini-meltdown.  Secondly, the patient appreciates your empathy.  They like to know you are genuinely interested and concerned, not only about their spine (for instance) but their mental status as well.  Have them tell you what a reasonable outcome is.  If it’s flawed don’t tell them it’s flawed but suggest a different perspective.

Now that the patient is on track, give them options.  This has application across the board.  From treatment to outcome to follow-up, it doesn’t matter, options rule.  You are more likely to gain compliance by giving options.  When the patient sees two or three ideas and not something you are instructing them to do, the odds are they do it because they choose it. J  My friend Bee Lim who is doing her thesis in positive psychology gave me a brilliant idea.  She said, “Let your patients choose their exercises.”  It was like a huge light bulb when off in my brain.  “Of course” I said, with exclamation.  The next day I started organizing and categorizing my exercises so the patients could choose.  Patients love it.  They love being able to have options.  If they don’t feel like doing the single leg squat, that’s fine, they can do a lunge!  It is so brilliant, simple, and effective.  Even better, it reduces stress on me.  The only option prior to this was the patient not doing it if they didn’t like it.  Now they have another option.

Keeping on track with the patient examples we find ourselves coaching obstacles.  What is going to be an obstacle for the patient?  In the case of lumbar pain, flare ups, is a great obstacle to coach.  Letting the patient understand that flare-ups may occur and are not problematic is important for two reasons.

  1. It reduces their fear and anxiety when it happens
  2. They will be ready to combat it

Reassurance for obstacles is key but what is even more important is prepping the client/patient for the tribulation.  Ask them, “What may stop the flare up from happening?”  Help them prepare for this challenge and you will be delighted with the reward.  For an example, I often find that patients with a simple back ache that is flexion biased, back (glute) bridging is very effective for reducing flare ups.  They only need to do 6-8 repetitions and they feel much better.  Other alternatives are McKenzie stretches, bracing, or the cat-camel.  These are all ideas worth looking into.

How do we know we are still on track?  How do we know if there is anything to correct further or tweak?  Outcome assessment is the key.  I know too many practitioners that do absolutely no outcome assessment.  This scares me.  Outcome assessment should be a summary of progress to date.  After outcome assessment is completed, it is possible to address weak points by starting at objectives and working back through the coaching O’s.

Open or Closed?

Remember when they used to tell you (if you are doctor or trainer from the “old school”) to use a larger ratio of close ended questions?  Times have changed since and the reverse is true.  I assume it will reverse somehow in the future but I personally find an even and meditated mix of open to closed questions works quite well.  Open questions do exactly that, they open the patient’s mouth.  As much as it kills you to listen sometimes (tangents are made quite easily by patients) do it.  You have two ears and one mouth for a reason.   A fatal error to open-ended questions is following the open-ended with a close ended.  This happens more than you think.  Psychologically, it probably happens because we truly don’t want to hear a long-winded answer.  It’s like covering your mouth when someone else is speaking; subliminal body language.  An example:

“Tell me Mr. Smith, how are you feeling today? Are you feeling better?”
“Mr Smith what have you been doing to keep your motivation levels up?  Are you sleeping well?”

Open/Closed don’t do it, end of story

Final Thoughts

Coaching is important and involves the core basics of communication.  Listening, Reflective Listening, and Listening some more.  If you fail to do so you fail to understand why the person you coach is failing.  Sound confusing?  Then you probably need to listen a bit better.  Example: helping motivate a client to understand why they need to change and how you may be of benefit.

Instructing is important at specific times.  There are times when you need to provide clear-cut leadership through instruction.  Example: helping a client understand how to squat (which may be frustrating).

Figure out when to be a coach and when to be an instructor.

Gold Nugget: If you are having trouble listening or seem to space out while someone else is speaking (trust me we all do it) try the following:

1.  When there is a natural pause in the conversation don’t speak (like you want to), paraphrase what they just said back to them.

2.  When they finish talking, ask an open question.  I know for most guys, this is crazy talk but just do it and reap the result.

3.  “The sweetest word in language is a persons own name”  This is true.  Be involved in them and what they are doing.  Interjecting your own opinion doesn’t get you far.  Even if you do, what did you really change?

Mandatory Reading

How to Lead: 2nd Edition: Jo Owen


About doctoranthony
As a spinal rehabilitation specialist with over 7 years clinical experience in the areas of - Spinal Manipulative Therapy, Active & Passive Spinal Rehabilitation, Functional Movement and Orthopedic Assessment, Strength and Conditioning Coaching, Fitness Programming, Business Development, Cognitive Behavioral Therapy, Motivational Interviewing and Consultancy - you can feel safe knowing that I understand the worry and concern surrounding spinal pain. This is why self-efficacy lies at the heart of my practice. For more info:

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