Table 4.

Exemplars for Active Listening and Inviting Patients to Articulate Learning.

1a. Coach inviting insight through reflection

Patient asked for help and found she could overcome a barrier she was experiencing. Coach amplified this through reflection.Coach: Well I bet … that is an interesting awareness that you had. You understood for yourself, having that piece in place, that support, if you needed it, would enable you to take this step.Patient: Right, yeah. YeahCoach: YeahPatient: I … it was kind of strange… it’s like, ok, well … (laughs) … if that worksCoach: Yeah, yeah. So … so what do you think? What did you make of that … that you understand that about yourself now? That if you had that support, whether or not you need to use that support very much, but just knowing the support is there … it propels you forward.Patient: Right. And … I don’t know, I guess I just, you know, probably, um, I haven’t felt that I’ve ever had a lot of supportCoach: Mmmmm. Mm hmmPatient: … just feeling I have supportive people around meCoach: YeahPatient: … changes me. I feel safer. I feel more trust in myself.

1b. Coach inviting insight through open-ended questions

Coach: So tell me what, for you, has felt the most different [participant’s name]?” Patient: You know, for me, you know like I said I’m only 2 weeks into the program, but I think even around the house, you know I got a 24-year old son that I get, it’s not too uncommon for me to get a little bit excited or get on his case, or, you know ride him just a little bit because I think he should be (inaudible). I feel like I’m being a little bit more patient, I think. Around the house, and you know, trying not to be so judgmental and you know, trying to take a deep breath every now and then before I go off the deep end. That’s a big improvement.Coach: (Ah ha. Mmm. Oh—) Well, I was just gonna say, that’s no small thing for anybody, [subject’s name].Patient: No it’s not. I mean I got home last night from a class and there’s a riding lawn mower sitting in the front yard with the front end busted completely, and I was like (laughter) well, you know, I can’t blame it on him, you know he did nothing wrong, he was driving it, and you know, I weren’t happy about it, but that’s just the way it goes, but you know, I had technical difficulty on the lawn mower last night. Yeah, but I’m thinking, looking back, I’m probably…would be a little bit more upset, but you can’t—nobody’s wrong. Nobody’s wrong.Coach: (laughter) Mm hmm. Ahhh. Ah ha. Ah ha. (positive utterance) So it—so here’s what I’m, I’m hearing in it, and so you correct me if I’m wrong, and that is that the mindfulness is, is really giving you a little more time and space to step back and say ok, what’s present here, and how do I wanna respond. What’s the best way to respond. And--Patient: That’s a fair assessment, definitely.

1c. Coach inviting insight by asking patients what they learned or valued

Coach: We really did. So just want to touch base with you to see, you know, in all that territory that we covered, what felt most important for you and maybe what feels most important for us to continue talking about today?Patient: Um, well we did cover a lot (laughs)—let’s see what was most important—you know, I think the one thing that really resonated probably the most was the whole letting go—Coach: Mmm (positive utterance)Patient: You know just in general—kind of a catch phrase for a lot of things but I’m finding that I’m actually using that.Coach: Mmm (positive utterance)Patient: And its funny—you know, again one of these observations—in the past, I would always have my laptop on or if I didn’t, I would be checking my blackberry before I went to bed, or actually, even every hour.Coach: Mm-hmm (positive utterance)Patient: And lately, I’m just like, you know what? It will be there tomorrow. It can wait.Coach: Mmm (positive utterance)Patient: And I’m finding, just let it go. I say it in my head—just let it go.Coach: Excellent.Patient: Um—Coach: So what have you noticed, [subject’s name], that’s different—when you’ve been able to say that, you know “just let it go,” and following through?Patient: It just feels so much better.

2. Pattern of tinnitus

Patient: And it felt that way when it gets loud, because I don’t have any control and this loud noise that cannot stop, there is no silence and it just didn’t feel like it’s ever gonna be quiet again. But then you know the layer, the way you deal with it, I think it’s helped, taken away some of the. . . not being as stressed which they would say, the medical doctors would say that’s gonna, you know, that brings it on, that makes it worse and you just felt like you’re in this vicious cycle.Coach: Sure, absolutely. And so you’ve interrupted that vicious cycle. Patient: Yeah, I like to think of it that way too, like I’ve taken more, more control.Coach: Mm-hmm. And isn’t that amazing that the way to really take more control is to be more accepting of it.