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Applying the GROW Model to Obesity Management



Readers may be quite familiar with my devotion to the motivational interviewing (MI) model of behaviour change developed by William R Miller and Stephen Rollnick, a technique that has become so ingrained in my practice, that it is almost second nature in my approach to patients.

More recently, I have also had the opportunity to familiarise myself with the GROW model of coaching, with is similar but not exactly the same. As some readers may be aware, the GROW model, developed in the 1980s by business coaches Graham Alexander, Alan Fine, and Sir John Whitmore, is one of the most widely used models of performance coaching.

GROW is an acronym for the four steps of the process: Goal setting, Reality check, Options, and Will.

The fours steps of the GROW coaching model essentially describe the planning and execution of a journey: determine where you are going or would like to be (Goal setting), understand where you are (current Reality), determine the paths open to you (Options), and finally, harness the energy and determination (Will) to actually embark on the journey.

Although similar, the MI and GROW models are not exactly the same. Thus, while motivational interviewing places a great deal of emphasis on revealing and exploring ambivalence and developing self-efficacy through the process of engaging, focussing, evoking, and planning, the GROW model, used more in settings of personal and career development, is somewhat less “touchy-feely”, but both models in the end seek to invoke behaviour change (action) that is directed towards specific outcomes.

Both approaches certainly have in common that they are client-centered and non-directive and are largely based on asking questions rather than providing answers.

When applied to obesity management, both approaches also have in common that they describe an ongoing process – or to use the journey analogy, reaching the destination (goal) is not enough, the real challenge is staying there once you arrive (hopefully never to leave again).

Thus, unlike winning a race, or getting a promotion, or losing x amount of weight, the process needs to continue in order to sustain what has been achieved.

Thus, in chronic disease management, it’s not just about climbing to the top of the mountain – the real challenge is camping out on top forever (or perhaps venturing on to conquer the next peak).

@DrSharma
Edmonton, AB

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