Sophie Turner
Forum Replies Created
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The transtheoretical model of behaviour change has been a part of my professional career since I started nursing over ten years ago. I have PTSD of very late nights finishing papers on smoking cessation and this model throughout university, I thought Iād be done with it at that point. However, it is one model that I have always relied on when assessing patients in primary care and empowering them in their own healthcare journey.
Iāve always been curious as to what motivates someone to change and where they sit on the TTM and from here how do you support people to continue their change journey. So, it has become a foundation in my client assessment and can guide coaching strategies.
There are two models I instinctively use when assessing my clientās readiness to change. The first is the transtheoretical model, I use this to assess how ready they are to change and the levels of consciousness (opportunist to alchemist). It can be assumed that a client is already at the achiever level if they are coming to coaching, realising there is more out there, and they want assistance in clearing the haze and taking action towards their goals. If the client is not at the achiever level or beyond, then it is more likely they have come to coaching because they have been directed to.
While there are tools, the leadership development profile, for assessing the client, I have been informal and using my own reading and skills to make this call. While I can only make this assessment from my current level of consciousness, I do find it useful. When directly engaging with clients for leadership development I would recommend that these tools be formally used to guide areas for work.
I find understanding my client from the perspective of these two models guides me in the clientās readiness and the language I use and ways I can help the client come to insights that will help.
Finally, when addressing goals of change, I find it useful to establish whether the change can be categorised as technical or adaptive. I found Robert Keganās Immunity to Change, a light bulb moment, which completely shifted my understanding of our ability and difficulty in engaging with the change process. It certainly illuminated some of my own difficulty with achieving goals that are adaptive in nature. I think the process for finding the grit and real motivation for adaptive change goals complements the TTM, giving depth and process to really understanding the clientās goals. What is the goal behind the goal? And in adaptive change what is the goal beyond this.
My experience in fleshing these ideas out is limited to my relatively few hours as the coach but as I continue to grow through the coaching experience I look forward to seeing how these three models continue to work together to support the client through change. -
While I havenāt had any clients in which trauma has arisen the information shared in by Katie Asmus can be applied to my work in nursing. I would like to draw on these experiences and how that would inform my approach to coaching around clients with trauma.
Everyoneās trauma is their own; trauma is a subjective experience much like pain and while we can gain perspective through understanding others trauma, we cannot assume that what is traumatic for one will be the same for someone else. The pandemic, a community trauma, has been felt the world over and the levels of trauma are relative to each country. The trauma felt in Europe or the US vary greatly to that which has impacted the Australian, yet collectively we all feel some sense of loss and challenge in coping in this forever altered world.
As a nurse I have experienced every kind of trauma, from being a first responder to roadside accidents in rural nursing, to the domestic assault victim presenting to emergency and those dealing with the life altering diagnosis of cancer and the trauma that is felt when undergoing treatment. Particularly bone marrow transplants.
I have seen many cases in which survivors of cancer are paralysed by fear to live their lives, terrified that the cancer will return at any moment. Iāve been intrigued the past few years whether there is a place for coaching to help these patients adjust; at this point in their journey, they are often neglected by the health system as a success story. Should they wish to deal with the fear and to recognise it for what it is requires their own awareness and willingness to find the support they need. There are a few studies which have been completed in the UK on small samples which have shown great success, they have offered coaching to patients at the three-to-five-year survival mark. These small studies have shown that through coaching, survivors have been able to move through the fear and trauma accumulated throughout their journey.
What stood out for me during the intensive was the idea of sequencing and I thought that the level of fear/trauma evident in cancer survivors demonstrated the unfulfilled sequencing process. This is evident as not everyone feels the level of fear or trauma that I have discussed above.
Throughout my time in cancer care I utilised resourcing multiple times, the example that comes to mind was a young man, 27, who was at the end of his transplant and developed a medically induced psychosis. While this was intimidating to the nursing staff I was often allocated to look after him and spent my time talking to him, validating his fears and using parts of resourcing to connect with him and holding space. Occasionally, we would have competitions to get him up and mobilising around the ward. A question I often used with him was is it ok to be ok?
I love this question and use it often in my coaching, it is so simple and holds immense power. I worked with the pysch team in providing support to this patient. He was a challenging and rewarding case to be involved with. I ran into him a few months after his discharge when he came for a follow up appointment, he came up and gave me a big hug, he told me that my time and support was hugely important to him being able to gain perspective and come through the other side, it was a very humbling moment. We do not often get to see our patients once they leave the high acuity ward I worked on.
That one example taught me many lessons especially that during the time spent with this patient I sometimes felt it was futile, especially when I have several other acute patients to attend to.
What I will take away from these nursing experiences, and this intensive is the following.
1. Be present and hold space.
2. Utilise resourcing to bring the patient back to the present, ground them.
ļ āResourcing changes peoples livesā
ļ Feel their feet on the ground and breathe
3. Allow the sequencing, it is integral to the process.
4. Maintain awareness of the coaching relationship and when referral to therapy would be appropriate.I look forward to applying each of these in my coaching sessions and in the meantime utilising them in the emergency department. Particularly, in interviewing and assessing victims of domestic violence.
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Summary – will keep checking back should the discussion continue
This discussion holds so much richness in exploring the gestalt principles and cycle of completion. While I naturally lean more to the gestalt style in my own coaching I am aware I’m not great great at idenitifing aspects in the world around me and how that interacts with the people I coach and family/friends. A little exercise for me to take away. Forever awareness building.
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Hats off to you Deanna working with teenagers, I certainly couldn’t do it, I take great pleasure in taking care of them when sick, in small doses but don’t believe I would be very good at helping them through challenging times of growing up. And Gina, your workspace must be very demanding, there must be many great take aways when applying NCC to your work.
Ally, I felt the ignorance going into the intensive but around Parts Work which ended up having a huge impact. So much to gain from both and I do wonder how I might utilise both in the natural setting together, I think a playful mixture of both would really complement each other.
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Summary post – I’ll keep an eye out for responses should the discussion continue but for me, parts work was the biggest earth shaker I’ve experienced in personal development in recent years. I really felt discombobulated through out the intensive, standing on the precipice of safety and what I may learn should I step off. The level of awareness of our inner selves was so much more than I expected to gain from being introduced to PW, I’m so curious to integrate it with my practice and see how it plays out for my clients.
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… finally a chance to read all the posts and very late to the discussion…
Maria – Thank you for your share, I find myself caught in wanting to be able to create and play with a physical mandala, sticky notes on a wall or similar and then out into nature, but your session has made me think of how I might get my clients to create their mandala from things in nature. I’m looking forward to being able to play with parts work with clients in person.
Gina – I love how Gus plays a role in your sessions, I have myself done sessions with a Kinesiologist who has her dog and cat present, they interact with you as you need and I always found it to be very impactful.
Deanna – I love this question comparing parts to neural pathways and whether they can die, this has recently come up elsewhere for me so I was curious to read peoples thoughts.
Jen – your thoughts around the above really resonated, parts are so much more than I certainly gave them credit, when reflecting on the self and parts vs neural pathways I do feel that the parts are always there but perhaps not always getting equal amounts of air time and therefore giving the perception of death.
Leslie – I too have been curious about the interplay between language and our parts. It also reminded me of the empty chair exercise in Gestalt and exploring the inner child, the language differences in that, which then took me to being curious about using the empty chair exercise to further explore the interrelationships of parts.
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PartsWork, possibly one of my favourite tools Iāve come across in coaching, the intensive stretched me and I went deeper and leant more. I felt that there was a space to integrate PartsWork and nature in a generous and impactful way.
And then it stopped. I havenāt focused on integrating PartsWork in my client sessions for various reasons.
1. How on earth do I do PartsWork and nature?
2. I feel like I want to do this in person with a wall and my beloved post it notes.
3. Do I know enough to guide a client through the PartsWork process and follow through for impactful coaching? Forever the student.
4. Gestalt comes more naturally in my coaching style, so I have favoured it.
5. I need to invest more time in my own personal PartsWork.That said I am dying to utilise it more so will address the discussion question around how I would like to integrate PW with the The Wyld Within.
I have a great pull to do PartsWork with the client in person, I would like to offer my clients the opportunity to do a deep dive into PW utilising my 3-5 session packages, however, I want to complete the first session in person. Allowing 3-4 hours, a blank wall, movement and breaks in nature to really flesh out and gain clarity of the clientās mandala. It would be an intensive half day which would be followed by the remaining sessions in person, preferable, or online.
In establishing the coaching relationship, the client would be an existing client or someone who is curious about PW and seeking a carefully curated package focused on PW.
The initial session would be completed in my new home on the Sunshine Coast hinterland, I have purchased a couple of acres, on the ridge line, looking out over forest and national park, the bird life is abundant and while it is close to the village and major centres I canāt see or hear any neighbours once you enter the garden gate and look down into the gardens. There is a beautiful and grounding energy there.
I have a vision of creating a home here, gardens with rooms, building in the views and being able to conduct one on one coaching sessions from here. There is also access to some amazing trails only 500m from my front door. It is the perfect place to dream and create, it is here I think PW will naturally fall into The Wyld Withinās offerings.
Iām now sidetracked, daydreaming of my hinterland wilderness.
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Integrating nature and PW feels necessary to maintain the clientās energy and insights in an intensive first session of guided inquiry. I believe it would remain vital throughout the process, as clients can take a walk in nature with their different parts, noticing how that part interacts with nature, what do the birds want to tell that part, how does that play in the whole, where is Soul in this. What does each part need?
Nature provides a beautiful setting for PW to unfold.
I will take pause here, but I look forward to the creation of my PW offering and sharing those experiences with all.
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Reflecting on Gestalt and parts work Iām feeling eager to connect with my EBI community and feel the burning need to be really present for the next intensive. Returning to work fulltime for short stints has shifted priorities during that period. A transition that caught me unaware at the end of last year, it exhausted me, I reached capacity with what I could mentally and physically take on. So, this period of work Iām trying to realign and prioritise what is important to me. Today it is beginning the long overdue catch up of all things EBI, doing the brain dump of all my thoughts around these assignments which seemed due a lifetime ago. Feeling frustration and guilt, had I just sat down after Iād watched the recordingās I would have submitted the exact same assignment without the preface.
Gestalt is one of my favoured tools in coaching and certainly what drew me to EBI, I feel like Gestalt and nature connection go together, utilising our environments to guide and to listen to ourselves and the environment deeply. I love the way gestalt can be both playful and serious, sometimes at the same time.
When I first read the assignment question, I immediately had a session in mind, it still remains the session I will touch on today.
Background
This was a new client that had reached out via social media wanting to know what I did and how that might help her. She is a nurse and also has a side business in pet photography. She wanted to do some coaching sessions around business development and what holds her back. She opted for five sessions. She had no idea what a life coach did, she had never engaged in any professional development, just felt that she should connect as my content resonated with her. The first session was huge, two hours of contracting, diving in, uncovering, we didnāt have to dig very deep to find some deep-rooted behaviours impacting her life and as usual the session goals ended up being very personal compared to what she was envisioning. It was a massive session with a big shift for the client who came to the next session ready for anything, willing to experiment and be completely present. All via the internet.
Each session with this client was big and in my usual style I gave her the space to explore and learn as we went. The principles of awareness and pausing, holding space are two I utilise in most sessions, I did find though that when being more experimental with gestalt in the threshold I relied on these principles even more. I said less, if this is possible. While holding space, the energy was palpable, the client was uncovering some deep truths, some she liked and others not so much.
I feel that gestalt and nature connection complement each other in the coaching sphere, nature helping to bring more awareness, practicing deep listening, what is happening around us, in nature, what does this mean for me as a whole being, as part of nature. I utilise elements of gestalt in most of my coaching sessions and found that it was the gestalt aspect that led me to find EBI and want to explore nature connection further in my coaching practice.
Utilising both nature and gestalt with my clients feels like a great fit and Iām looking forward to further developing myself as a coach in this space.
I’ll spend the weekend taking in and responding to everyones posts.
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What a great question Jen, the pull to coaching women.
From the outset I was very hesitant to be specific on gender, I aspire to have male clients too, but in really niggling down to my ideal client for the now, and looking around at who I was attracting and thoroughly enjoying working with it was resoundingly women.
I would like to explore this space a little more in terms of what my initial entry mentions but I welcome men at any time and hope to be able to develop my ideal client to attract a client base of both men and women.
Ally, I love your wandering interview – it made me feel like I need to connect and wander with you again soon. I also love your idea of coaching pre and post a ‘quest’, this is something I too would love to develop and build on in the future.
Surprisingly, I find the zoom sessions to be rather simple and easy to incorporate nature, I try to be outside for them or the client is somewhere they feel comfortable. That said all my clients are keen to participate in an adventure q workshop, with a weekend of hiking and camping, I would like to facilitate a ‘rewildling’ next year.
Vanessa, I’m so intrigued by your offerings and would love to know how the mens circle goes. I found myself reading yours a little challenged, as I find some resistance to wanting to explore things on a more spiritual level yet completely intrigued at the same time. Identifying a space for me to further explore and learn in. Thank you š
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Jen you have hit the nail on the head and something that has become much clearer for me over the last few months, the notion that threshold is about being in flow, allows me not to try and put a process around it, to not try and experience it as a checklist that is applicable to each client. I’m at my best coaching when I can be in flow, no trying to intellectualise the process.
I’m looking forward to observing and experiencing more of the threshold when we all meet again, there are so may take aways during those short moments of peer to peer coaching.
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I’ve been caught up in life recently, working full time again, adventuring around islands, exploring my relationship to the ocean and water (I’ve always been a bush and mountain girl), trying to balance the busyness and not to be harsh on myself for not having achieved everything I thought I could before the year is out.
I’ve been procrastinating revisiting the EBI space and closing out my summary posts for foundations. It seems so long ago I was in that space, so distant. I thought I might have been able to arrive here, this evening, and quickly pump out my summary post.
I have however been dropped straight back into the energy and learnings of foundations and smacked in the face with some learnings that have continued to unfold since. Wrapped up in all the time, work hours, adventures on island. The discussion that has unfolded since I have been here is invigorating, providing some clarification and finds me wanting to ask more questions of myself and that relationship. Go deeper.
The bookworm in me instantly grabbed hold of what Ally was reading – “must add that to my list”, and my mind swirls thinking about how I might respond to you Ivy.
My gut feeling to connect people to their heart and nature is to keep it simple, guide people in creating space for them to experience their whole selves within nature, themselves as nature and then be able to be with them in exploring how the learnings/insights may guide their own living, for good and bad. A dance of holding space in nature while simultaneously challenging the client in integrating these insights into their life.
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My ideal client at the moment is the woman who feels like there is something more, they want to connect and understand their purpose, they have seemingly impossible goals and want support and accountability in achieving them, they want to expand their awareness and grow personally and professionally. They are 24-55 years, they are motivated individuals who are willing to get outside, explore and play. At the moment I will work with my clients remotely via zoom which removes barriers of accessibility. I think this wonderful for women who live in rural and remote Australia and allows me to work with people across international borders.
In the future I want to further develop my ideal client to encompass to encompass leadership development and in person workshops and retreats.
I want to incorporate nature in and out of the sessions. I would like to invite my clients to be seated outdoors when we do a session so we may play with what we can notice about nature in the immediate environment. In particular, what are the birds telling you, I really resonated with birds as messengers of the wilderness as described in the Coyote’s Guide to connecting with nature.
Outside of sessions I would like to invite clients to take wanders utilising the sacred questions, offering time at the beginning of the next session to debrief if the client requires.
Many people I admire online don’t integrate any nature connection to their practices, but what I admire of them is their online presence and information shared. I follow a few coaches who coach for the outdoor minded but again there messaging is not consistent with the integration of nature in their practice. For those who do, many books I have read, inspire me to deepen my own connection and understand how I can integrate this with transformational results for my clients.
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I almost changed tangents in my first response and addressed this question Jen. Almost.
I didn’t though, I packaged it back up, taped that box up tight and deposited it safely in the compartment labelled āa nurses trauma ā itās here and hers alone.ā
When I went through nursing, the school of thought was you compartmentalise and then if lucky enough you can unpack it later to sequence through the pain/trauma. However, don’t break confidentiality, you shouldn’t talk about complex patients outside of the hospital, these are important aspects in the hospital code of conduct, as they should be. But it provides the contradiction of being a rock at work, in front of the patient, their familys and then is it unethical to debrief at home.
Should you try and debrief at home, with a loved one or a friend that has not experienced this level of exposure to trauma, their eyes will glass over, they will fidget trying to find an escape.
They often won’t know what to do, they are used to you being the rock, you save lives, you remain calm under pressure, you can direct and manage chaos. This sudden need to debrief challenges their view of you. In their discomfort, they will try and comfort you, pat you on the shoulder, tell you, you just need a hot bath or a good nightās sleep. And we neglect to tell you that we don’t need any of that, we need you to hold space, be there, hear me, try not to fix it. Let me process, let me feel, let me cry.
So nurses often wonāt do any of this, it gets packed away. When it starts manifesting in way that impact work or your personal life you are burnt out.
I have tried all the above, I have burnt out more than once and I have become more equipped to manage.
Thankfully organisations are more aware of the accumulated impact trauma and grief has on employees and the retainment of experienced staff, but I still see the symptoms everywhere I have worked.
My strategy is this.
I live by the mantra that nursing is 24 hours care, while I care for my patients, I need to be able to park it when I leave. I do this through listening to classical music on the way home, taking a walk-in nature or meditating. I know symptomatically when I need to do more, rest, I get anxious, my care factor is low, and I donāt sleep. Self-care is the most important here.
Resilience is a buzz word in health care, how do we foster resiliency in our staff?
You cannot be build resilience without vulnerability. You cannot be vulnerable in the workplace. Learning this completely shifted my perspective on how I manage trauma and made the resourcing I use above more powerful. I started being more vulnerable, little bits here and there, with my friends and family, the postman, my colleagues and most importantly my patients. These small moments of vulnerability with them, being in the moment with them allowed me to sequence through trauma in real time, making me more resilient. Iām still working out how I can do this in small ways during high pressure resus and emergency situations but practicing vulnerability is a game changer.
Itās also f*cking hard.
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Jen, I admire your ability to draw out the readings and apply the science/evidence in you sessions and throughout our intensives. I read a Mindsight a couple of years ago and found the book so slow, and the tone made me disengage, I found it very difficult to want to engage with the content. This was completely at odds with the content itself, I love Dan Siegel’s work and apply use some of these concepts, I ended up diving into podcasts and talks to draw out the concepts. I had completely forgotten about the firing of axons as you have talked about, but do remember reading this bit, or perhaps heard it in a talk and thinking wow.
It wounds like you client has undergone some amazing growth and been able to release those emotions and actions that didn’t belong to her, thats big stuff. We carry that fo such a long time, despite not serving us it can be very difficult to surrender it.
I’m curious how your client when triggered might avoid grasping on to her mothers words/actions, maintain her awareness, and not reengage in the ārecursive and often-destructive patterns in the attempt to avoid uncertainty?ā
“the ultimate observer, without judgement and shame”, “bring the light of awareness” well said, the concept of being able to be a witness in our own lives is so powerful and certainly opens the doors to choice.
I’m inspired to revisit Mindsight, dig it out of storage in the coming weeks.
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The transtheoretical model is the stages of change, it is just how I have always known it. The only difference is in how it is presented, the TTM model present all the stages but in a spiral, very much how Michael was describing to us yesterday. The spiral and relapse are integral to the change process, I like to illustrate it for people to help them overcome the guilt, shame and frustration they feel when undergoing change, allow them the space to understand/externalise the model/process, practice kindness to themselves in the relapse and from that kindness be able to reset and try again.
And for my favourite of all models, you move from opportunist > diplomat > expert > achiever > redefining > transformational > alchemical
The opportunist is the child or someone very egotistical.
The diplomat the pleaser.
The expert knows everything and can’t be taught or receive feedback constructively. These people will often be promoted to middle management but unless they can stretch beyond their existing conscious level, they will often not last very long in the role. The model suggests we need to be challenged beyond our current capability to grow, so if open the promoted expert will move to achiever.
The achiever is a great team leader but often unable to think outside the box. More willing to grow and often people first coming to coaching/personal development will be at this level.
Redefining (individualistic) are volatile, they question everything and will often leave their roles when in this stage.
Transformational ā anything is possible, they understand the organisation and people within. I would expect our cohort to be in the redefining/transformational level.
The alchemist is impulsive, much like the opportunist, but is able to see how everything comes together and how the system works. I worked with someone I would consider alchemist in nature in a project that was trying to revolutionise collaborative healthcare in Australia, so be in his presence was energising, he inspired everyone and empowered you to step beyond your comfort zone in leading and change. He could hold all the balls in the air at once and understand how all the systems between connected and worked.
Organisations want leaders in the transformational conscious level (only 1% of people are alchemists), they want to develop leaders from achiever to transformational and skip redefinition to protect the organisation.
The Global Leadership Profile provides assessments around this model.
My mentor and facilitator from my very first coaching certification is currently doing i=her PHD in developing wisdom, asking the question of how we as coaches, leaders can support people to move vertically from achiever to transformational without the unrest and pain of the redefining stage. So far this is generally accepted to be possible only through trauma or suffering in which we have to step up and be someone we have never been. She is using the GLP as a measurement tool in her research. I love how this model and inherent wisdom is applicable to all styles of coaching, we are ultimately trying to help our clients find their inner wisdom, we sit with many in the difficult periods that exist when we step across the threshold and open ourselves to
I’ve attached an article below it does use some different terms for redefining and transformational. It is far more eloquent than my crude descriptions above. I was unable to find the HBR article in which I first came across this model but this one is also good.
