Health Coaching & Mindfulness

Rahul works as an integrative medical physician, professional coach, mindfulness instructor, and advocate for provider wellness. He is a Certified MBSR Teacher through the Center for Mindfulness to facilitate Mindfulness-Based Stress Reduction Programs and offers this service to both providers and patients. He also is a professional coach accredited by the International Coaching Federation and supports physicians as a consultant for the Physician Health Program of BC. He lives and works in Gibsons, BC and travels throughout the province to speak on the topics of patient self-management and provider self-care.
Rahul is a Clinical Assistant Professor for the UBC Department of Family Practice and recently completed its Clinician Scholar Program. 

Contact

Dr. Rahul Gupta

 

Exploring Health Coaching & Mindfulness as Levers for Transformation in Healthcare:  Stakeholder Perspectives on Sunshine Coast Initiatives

Background

There is evidence that adverse childhood events are directly and proportionally related to future serious health concerns, such as chronic pain, depression, heart disease, substance use, obesity and PTSD. Primary care physicians, especially in rural settings, are often tasked with managing these chronic issues, without possessing sufficient skills or knowledge of how to address the underlying issues of trauma. Patients, often the most vulnerable ones, are left coping with unresolved stressors that lead to ever-growing physical, emotional & cognitive breakdown through pathological arousal and dysregulation of the autonomic nervous system. The costs to patient, provider, and society are high.

Mindfulness (MFN) and Health Coaching (HC) are two behavioral interventions that support recovery from adverse experiences and coping with physical diseases through harnessing internal resources and mechanisms for healing.

Mindfulness practices seek to establish hope towards change through first supporting the patient in cultivating their situational and self-awareness. The result is more accurate appraisal of what is happening and more capacity to be present with their condition(s) in ways that foster compassion, creativity and courage.

Health Coaching integrates embodied awareness, cognitive behavioral therapy, motivational interviewing, and positive psychology in such a way as to generate patient self-efficacy.

Purpose of Study

Just how these modalities can be incorporated meaningfully into rural medical systems remains to be thoroughly studied. Physician-led initiatives have begun on the Sunshine Coast that make these modalities available to populations in need. Anecdotally, the effect has been extremely positive for the community. Exploring how and why these initiatives have been working to build capacity is the purpose of this study.

 
 
 
 
 
 
 
 

Methods

Qualitative participant-engaged constructivist approach. We elicited perspectives from patient participants and their referring physicians through focus groups and large-group graphic facilitation during a one-day event held in September 2018. Thematic analysis of transcripts was completed using Nvivo. Emergent themes were regularly reviewed with co-researchers, and member checked with participants via online videoconferences held at 6 weeks and 4 months post-event.

Graphic Facilitation of AM proceedings by Yolanda Liman during Stakeholder Engagement study Sept 21, 2018

Findings

We identified six main themes contributing to the successful implementation of these programs: 1) accessibility and affordability 2) offering a toolbox of practical skills 3) providing attuned and openhearted care 4) generating hope and self-efficacy 5) experiencing a shared humanity and connection 6) addressing the health of the whole person.

Stay tuned for a full description of the results once the manuscript is published.

Significance

Understanding how these emerging modalities have functioned to serve both patients and providers alike, in a rural setting, may contribute to the rural health of BC in the following ways:

  • Clarify key programs mechanisms of impact and contextual factors
  • Create a template for other rural communities to follow
  • Inform the training of rural healthcare providers with specialized training in coaching and mindfulness
  • Support advancements in health policy that enable new billing codes and remuneration schedules that make these programs more sustainable and widely available

Research team, including graphic facilitator, focus-group facilitators, and study assistant (from left to right): Yolanda Liman, Robert Woollard, Rahul Gupta, Karen Gelb, Ray Markham, Joanne Stanley, Erlene Woollard, Maureen Mayhew, Kim Wilkinson, Marilyn Pederson

 

Co-Lead Investigator, Rahul Gupta during Stakeholder event, held Sept 21, 2018 at Gibsons Public Market

Graphic Facilitator, Yolanda Liman during Stakeholder event, held Sept 21, 2018 at Gibsons Public Market

Research Team

Dr. Rahul Gupta: Physician, Sunshine Coast Division of Family Medicine, UBC Clinical Assistant Professor

Dr. Robert Woollard: UBC Professor and Clinician Researcher, Co-Lead Investigator
Karen Gelb: Qualitative Health Systems Researcher, specialist in Integrated Knowledge Translation

Dr. Maureen Mayhew: Clinician Researcher, Public Health Officer, Associate Professor at the School of Population and Public Health

Marilyn Pederson: Patient Partner, having participated in both health coaching and mindfulness interventions over the last 5 years

Funding

Michael Smith Convening and Collaborating (C2) Fund was awarded in February 2018, along with RCCbc Rural Physician Research Support Project (RPRSP) award in 2019.