Information Exchange: Elicit-Provide-Elicit and Brainstorming

Information Exchange: Elicit-Provide-Elicit and Brainstorming

The Danger of the "Expert Role"

A central tenet of health and wellness coaching is that the client is the expert in their own life. However, clients frequently ask coaches for information, advice, or education regarding health topics (e.g., "What should I eat to lower my cholesterol?" or "How much water should I drink?").

If a coach immediately launches into a lecture, they inadvertently slip back into the "expert/prescriptive" model of healthcare. This undermines client autonomy and fosters dependency. To navigate this, coaches use structured frameworks to share information collaboratively.

The Elicit-Provide-Elicit (EPE) Framework

Also known as Ask-Tell-Ask, Elicit-Provide-Elicit is an evidence-based communication strategy derived from Motivational Interviewing. It ensures that information is only given when desired, that it builds upon what the client already knows, and that the client has the opportunity to integrate the information themselves.

Step 1: Elicit (Ask)

The coach asks for permission to share information and explores what the client already knows about the topic. This prevents the coach from "mansplaining" or repeating facts the client is already aware of.

• Example: "Would you be open to me sharing some information about sleep hygiene?"
• Example: "What do you already know about the connection between sodium and blood pressure?"

Step 2: Provide (Tell)

The coach provides the information clearly, neutrally, and concisely. Overwhelming a client with a medical textbook's worth of data is counterproductive. Crucially, coaches should provide information using a "menu of options." Instead of saying, "You need to do X," the coach presents a few evidence-based strategies, allowing the client to choose what resonates.

• Example: "Based on current guidelines, some people find success by cutting off caffeine at noon, others prefer establishing a wind-down routine an hour before bed, and others focus on keeping the room cool. These are just a few options."

Step 3: Elicit (Ask)

The final step is arguably the most important. The coach asks the client for their reaction to the information provided. How does the client interpret it? How does it apply to their specific life?

• Example: "What are your thoughts on those options?"
• Example: "How might one of those strategies fit into your current routine?"

Brainstorming

Brainstorming is a collaborative process used when a client is stuck, looking for new strategies, or trying to overcome a barrier. The success of brainstorming relies entirely on a single rule: Generation must be separated from Evaluation.

Rules for Effective Brainstorming

1. No Judgment: During the generation phase, neither the coach nor the client is allowed to evaluate, critique, or dismiss an idea. If the client says "I could hire a helicopter to drop my groceries off," the coach writes it down without rolling their eyes.
2. Wild Ideas Encouraged: Encourage the client to think completely outside the box. Often, a ridiculous idea acts as a stepping stone to a highly practical, innovative solution.
3. Quantity over Quality: The goal is to generate a massive list of options. The more options, the more autonomy the client feels.
4. Client Leads: The client should generate the majority of the ideas. If the coach asks permission to add an idea, they should place it gently among the client's ideas, not elevate it as the "best" option.

The Evaluation Phase

Only after the brainstorming list is exhausted does the evaluation phase begin. The coach reviews the list with the client and asks open-ended questions to help the client narrow it down.

• Example: "Looking at this list, which of these ideas stands out to you the most?"
• Example: "Which of these feels the most realistic to tackle this week?"

Practical Application and Dialogue

Client: "I just don't know what to eat for snacks. Can you just give me a meal plan?" Coach (Elicit): "I hear you're looking for structure. While I don't prescribe specific meal plans, I'd be happy to share some resources or ideas on building balanced snacks, if you're open to that. But first, what kinds of snacks have worked well for you in the past?" Client: "I used to eat a lot of almonds, but I got bored." Coach (Provide): "Almonds are a great source of healthy fats. Some other options people find helpful include pairing a protein with a carbohydrate, like Greek yogurt with berries, or an apple with peanut butter." Coach (Elicit): "How do those types of combinations sound to you?"

NBHWC Exam Tips

• The phrase "Menu of Options" is a massive keyword for the NBHWC exam. It is the gold standard for providing information while maintaining client autonomy.
• If an exam question asks how a coach should respond to a direct request for advice (e.g., "What should I do?"), the correct answer will involve asking permission, exploring what the client already knows, or utilizing Elicit-Provide-Elicit.
• For brainstorming questions, the correct answer will always emphasize withholding judgment and encouraging wild ideas.