Coaching Psykologi

The Danish Journal of Coaching Psychology Volume 2, Edition 1 October 2012 Page 91 CCoaching psykologi www.coachingpsykologi.org

Multimodal coaching and its application to workplace, life and health coaching

Af Stephen Palmer

Abstract This article highlights how the multimodal approach (Lazarus, 1989) has been adapted to the field of coaching and coaching psychology. It covers the basic theories underpinning the multimodal approach and illustrates the link between the theory and practice. Key multimodal strategies are covered including modality profiles, structural profiles, tracking and bridging.

Keuwords: multimodal coaching and therapy, workplace coaching, health coaching, Arnold Lazarus, modality profiles, structural profiles, tracking, bridging.

Development of the multimodal apy which focuses on seven discrete but interac- approach tive dimensions or modalities which encompass THE MULTIMODAL APPROACH was devel- all aspects of human personality (Lazarus 1971, oped by a psychologist, Arnold Lazarus (1989, 1973). 1997) in the 1970s. He believed that no one system The multimodal approach has been adapted and of therapy could provide a complete understand- applied to executive coaching (Richards, 1999), ing of either human development or condition. and to personal/life coaching, stress management By following-up counselling clients who had re- and health coaching (Palmer, 2003; Palmer et al., ceived behaviour therapy he found that many of 2003; Palmer & Gyllensten, 2008). It pre-dates them had relapsed. He noted that when clients cognitive behavioural models such as SPACE had used both behaviour and cognitive techniques (Edgerton & Palmer, 2005). Successive surveys of more durable outcomes were obtained. Hence he coaching psychologists have found that about 10 started using a broad range of cognitive-behav- per cent of respondents use multimodal coach- ioural techniques applied systematically and finally ing (see Whybrow & Palmer, 2006a, b; Palmer & this led to the development of Multimodal Ther- Whybrow, 2004, 2007).

The Danish Journal of Coaching Psychology is a joint project of the Coaching Psychology research Unit, Dept. of Communication and Psychology at Aalborg University and the Coaching Psychology Unit, Dept. of Exercise and Sports Science, University of Copenhagen. This document is subject to copyright and may not be reproduced in whole or part in any medium without written permission from the publishers.

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Basic theory and practice and conditioning, physical environment and ge- The Multimodal approach is underpinned by a netic endowment. broad social and cognitive learning theory (Ban- The combination for each individual is unique dura, 1977, 1986), although it also uses group and and although they may share similar problems with communications theory and general systems theory their colleagues and friends the solution may be as necessary (Lazarus, 1989). It assumes that people different. Coachees often use some of the BASIC are: ‘essentially biological organisms (neurophysi- I.D. modalities in preference to others, Depend- ological/biochemical entities) who behave (act and ent upon the modality they prefer, the coachees are react), emote (experience affective responses), sense referred to as ‘imagery reactors’ or ‘cognitive reac- (respond to olfactory, tactile, gustatory, visual and tors’ or ‘sensory reactors’. For example, an individu- auditory stimuli), imagine (conjure up sights, sounds al may think in pictures and images. The coach may and other events in the mind’s eye), think (hold be- note that in conversation the person states, liefs, opinions, attitudes and values), and interact ‘I can see me doing a good job on that task’. This with one another (tolerate, enjoy or suffer in various may suggest that this coachee may find imagery interpersonal relationships). These dimensions of per- techniques more effective than cognitive techniques sonality are usually known by the acronym, BASIC in addressing issues relating to stress and perfor- I.D. derived from the first letters of each modality, mance. It is worth noting that ‘Multimodal coach- namely Behaviour, Affect, Sensations, Images, Cog- ing’ per se does not exist, as multimodal coaches, as nitions, Interpersonal and Drugs/biology (Palmer, technical eclectics, apply theories and techniques 2006, pp.322–323). The BASIC I.D. modalities of- from other approaches as necessary. However, there ten interact with each other and may exist in a state is a multimodal framework or structure. of reciprocal transaction. For example, an Image in one’s mind of performing badly at work could trig- Techniques and strategies ger a Cognition ‘I’m a failure’ which could subse- An extensive range of cognitive and behavioural quently lead to an Affect (emotion) of depression. techniques/strategies are used in multimodal Coachees presenting a number of issues or prob- coaching including others which have been tak- lems for coaching may need a range of strategies en from a variety of diverse approaches (e.g. the and techniques to deal with them. In multimodal empty chair taken from the Gestalt approach). coaching the seven BASIC I.D. modalities may be Table 1 illustrates some of the techniques are used examined if necessary when developing a coaching to deal with issues that arise across the seven mo- programme. Multimodal practitioners take Paul’s dalities. In the workplace when using the mul- (adapted 1967, p.111) mandate seriously: timodal approach for executive, business and/ ‘What intervention, by whom, is most effective or performance coaching, eliciting Performance for this individual with that specific problem and Interfering Thoughts (PITs) and the development under which set of circumstances?’ Although re- of Performance Enhancing Thoughts (PETs) is of- search may indicate a specific technique or skill ten seen as important depending upon the issues may be effective, the coach will still consider if it is the coachee is bringing to multimodal coaching the best one for this particular coachee at this mo- (Palmer, 2003). Whereas in multimodal health ment in time. The coach may refer the coachee onto coaching, eliciting Health Inhibiting Thoughts or another practitioner if he or she believes that would Beliefs (HITs or HIBs), and the development of maximise the coaching outcomes for the coachee. Health Enhancing Thoughts or Beliefs (HETs or Multimodal coaches may adapt their interpersonal HEBs) is seen as more crucial to help the coachee style to enhance their relationship with the coachee overcome blocks to change, reduce relapse and and improve the coaching alliance. For example, improve the ability to maintain health goals (see they would monitor whether the coachee prefers a Palmer et al., 2003; Palmer, 2004). Similar to cog- formal or informal approach, responds positively nitive behavioural coaching, bibliotherapy, ie the to humour and so on. This is known as being an use of books, information leaflets or other ma- ‘authentic chameleon’ (Lazarus, 1993). Coaches terials such as CDs, DVDs, to aid development assist the coachee in developing their own be- and learning is used in multimodal coaching. A spoke coaching programme as human person- range of books have been written by multimodal alities stem from interplay among social learning practitioners for this purpose (e.g. Lazarus, 1985;

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Lazarus & Fay, 1975; Lazarus et al., 1993; Palmer DRUGS/BIOLOGY et al., 2003). Lifestyle changes, Stop smoking programmes, Nutrition, Weight control, Exercise, Medica- Table 1. Frequently used tion, Referral to specialists. techniques and strategies. Modality profiles BEHAVIOUR The techniques are applied in a systematic manner Behaviour rehearsal, Time management, Pri- depending upon the coachee qualities, coach qual- oritising skills, Modelling, Self-monitoring and ities, coach skills, coaching alliance and technique recording, Shame attacking, Empty chair, Fixed specificity. Through discussion during the first and role coaching, Response prevention/cost, Stim- sometimes second coaching session, a Modality ulus control, Paradoxical intention. or BASIC I.D. Profile is developed in which the particular issues or problems are divided into the AFFECT seven modalities. The coach and coachee develop Anger expression, Anger/anxiety management, a proposed coaching programme to address the Feeling identification. individual issues that have been discussed. Case Study 1 (overleaf) provides an example of Modal- SENSATION ity Profiles which illustrates a performance coach- Biofeedback, e.g. GSR, biodots, Hypnosis, ing programme (Palmer et al., 2003, pp.91–92). Relaxation training, Meditation, Momentary relaxation, Relaxation response, Multimodal Case Study 1 relaxation method. Michael has been asked to give a presentation at the next team meeting. Michael finds giving presenta- IMAGERY tions very stressful and avoids them as far as pos- Coping imagery, Time projection imagery, sible. However, on this occasion it is important he Anti-future shock imagery, Mastery imagery, presents, as it could impact on whether or not he is Positive imagery, Thought stopping imagery, promoted. Below is an example of how he used the Aversive imagery, Associated imagery, Motiva- various techniques and strategies to deal with his tion imagery. stress. © Palmer et al., 2003.

COGNITIVE Bibliotherapy, Cognitive rehearsal, modifying unhelpful beliefs, Problem solving, Challeng- ing faulty inferences, Constructive self-talk, Thought stopping, Eliciting Performance In- terfering Thoughts (PITs), Developing Perfor- mance Enhancing Thoughts (PETs), Eliciting Health Inhibiting Thoughts (HITs), Develop- ing Health Enhancing Thoughts (HETs). Pro- vide information.

INTERPERSONAL Assertion training, Contingency contracting, Fixed role coaching, Communication training, Friendship/intimacy training, Social skills training, Role play, Paradoxical intention.

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Modality Problem Coaching programme

Behaviour Procrastination: Avoids writing Use time management techniques; the presentation by doing other challenges unhelpful belief about be- tasks such as tidying up files ing a failure.

Affect/Emotional Feels increased anxiety Use feeling identification to Ascertain helpful (concern) versus unhelpful (anxiety) emotions.

Sensory Feels sick before giving Use relaxation techniques presentation before presentation.

Imagery Can only see myself Use coping imagery. delivering a poor presentation

Cognitive/thoughts/ideas I must give an excellent Dispute unhelpful beliefs by identi- presentation fying thinking errors and employing (Demandingness) otherwise appropriate thinking skills, includ- I will never get promoted ing self-acceptance training (All or nothing) and Complete an Enhancing I will be a failure (label). Performance Form.

Interpersonal Poor communication skills. Practice and develop communication skills.

Drugs/biological Experiences palpitations Reduce caffeine intake. and drinks excessive coffee as a Will alternate drinks with way to relax. decaffeinated coffee.

Other strategies used in • Sensation: How ‘tuned in’ are you to your multimodal coaching bodily sensations? Structural Profiles • Imagery: How imaginative are you? Do you To obtain more information and also general goals often visualise people and situations in your for coaching, a Structural Profile can be drawn mind’s eye? (Lazarus, 1989). It is particularly useful when • Cognition: How much of a ‘thinker’ are you? working with coachees interested in improving Are you analytical? their health and reducing stress. This is developed • Interpersonal: How much of a ‘social being’ are by asking coachees to rate subjectively, on a scale you? Do you like attending social gatherings? of 1 to 7, how they perceive themselves in relation • Drugs/biology: To what extent are you health- to the seven modalities. The coach can ask a num- conscious? Do you take nutrition and exercise ber of different questions that focus on the seven seriously? modalities: In the coaching session the coach can illustrate • Behaviour: How much of a ‘doer’ are you? these scores graphically by representing them in • Affect: How emotional are you? Do you get the form of a bar chart on paper (for examples, see wound up easily? Palmer & Dryden, 1995). Then coachees are asked

The Danish Journal of Coaching Psychology can be found at www.coachingpsykologi.org The Danish Journal of Coaching Psychology Volume 2, Edition 1 October 2012 Page 95 in what way they would like to change their struc- overcoming. It is used when the initial coaching tural profiles during the course of coaching. Once programme has had limited success. Case Study again the client is asked to rate subjectively each 2 provides a typical health coaching example modality on a score from 1 to 7. Structural profiles (Palmer at al., 2003, pp.93–94). would seldom be developed for brief coaching contracts consisting of a couple of sessions. How- Case Study 2 ever, in multimodal developmental coaching, per- Jayne had tried on three occasions to stop smok- sonal/life coaching, stress management and health ing. The first two times she started smoking again coaching structural profiles are more useful. only after a couple of weeks. On her last attempt, she was progressing well until she hit a crisis at Second-order BASIC I.D. work. As soon as the pressure was on, she just ‘had Second-order BASIC I.D. is a modality profile to have a smoke’. She was determined to give up which focuses on one particular issue or prob- this time. However, more preparation had to be lem that the coachee is experiencing difficulty in done to help her deal with the possible causes of lapse. © Palmer et al., 2003. Modality Problem Proposed technique

Modality Problem Proposed technique

Behaviour Smokes at meal times. Use stimulus control techniques by removing lighters from the house. Select a Stop Smoking Day. Cut down smoking to 10 per day for one week prior to the Stop Day.

Increases smoking when under Learn a range of strategies to stress. manage my stress.

Affect/Emotional More easily irritated and quick to feel Learn to count to five and breathe angry when not smoking. slowly when in stressful situations.

Sensory Unpleasant feelings of Remember, with time this will tension when not smoking. pass. Start practicing relaxation training before the Stop Day to help me cope with the tension when it occurs.

Imagery Can picture parents who When this picture comes to mind both smoked. imagine my parents not smoking. When I thing of smoking again, Picture of father dying in remind myself of my father dying hospital of lung cancer in hospital.

Cognitive/thoughts/ideas I must have a cigarette Dispute unhelpful beliefs: when I want one Why must I have a cigarette? (Demandingness). Just because I want one doesn`t mean I must have one!

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Modality Problem Proposed technique

I can`t stand unpleasant feel- This is not true, I don`t like it but I`m living ings and tension. proof I can stand these feelings. I stood not smoking for four weeks the last time. I can`t stand not smoking. Perhaps I can do better next time.

If I have one cigarette, Just because I have one cigarette, it doesn`t Then I`ve blown it. mean I`ve blown it. I don`t have to give in. What`s the point! (All or nothing thinking).

Interpersonal Smokes in social situations. For the first six weeks avoid social situations with friends/colleagues who are smokers. In role play at home, practice being assertive and saying, ´No thank you. I don`t smoke.´ Only when I`m adequately prepared, enter social situations.

Drugs/biological Smokes 40 cigarettes a day Stop smoking programme. Remind myself of the damage it is doing to my body. Smoker`s cough Check this out with GP in case of undiag- nosed problems. If I stop smoking, it may be a good idea to in- Lack of exercise crease daily exercise as I do not wish to put on additional weight. I can walk up the stairs at work instead of using the elevator. Take a 30-minute walk during my lunch break.

Tracking as time management, problem solving, solution- Tracking is a technique that is used in multimod- seeking, prioritising, and communication skills. al coaching in which the ‘firing order’ of the dif- These techniques, skills and approaches have ferent modalities is noted for a specific problem. been shown to be effective for a range of issues Then the coaching interventions are linked to the relating to enhancing performance and confi- sequence of the firing order of the modalities. dence, reducing stress and improving health.

Bridging Multimodal coaches may use a ‘bridging’ maneu- Conclusion ver to initially focus on a coachee’s preferred mo- Multimodal coaching has been used for a range of dality (e.g. imagery), before exploring a modality issues within a variety of coaching settings and con- (e.g. affect/emotion) that the client may be avoid- texts. In addition, the techniques and strategies can ing (Lazarus, 1997). be integrated within other approaches. For further information on the multimodal approach, a self- Evidence based approach? help multimodal coaching book provides details Most of the strategies and techniques used are regarding many of the multimodal techniques and taken from cognitive and behavioural approach- includes how to develop a Modality Profile (Palmer es. In addition, management skills are used such et al., 2003). Fra DJCP takker vi British Psychologi-

The Danish Journal of Coaching Psychology can be found at www.coachingpsykologi.org The Danish Journal of Coaching Psychology Volume 2, Edition 1 October 2012 Page 97 cal Society for tilladelsen til at bringe denne artikel Palmer, S. (1996). The multimodal approach: fra The Coaching Psychologist, 4, 1, 2008 og Henri- Theory, assessment, techniques and interven- ette Ernst for hjælp til korrektur og opsætning. tions. In S. Palmer & W. Dryden (Eds.), Stress management and counselling: Theory, practice, research and methodology. London: Cassell. Korrespondance Palmer, S. (1997). Modality assessment. In S. Stephen Palmer Palmer & G. McMahon (Eds.), Client assess- Coaching Psychology Unit, ment. London: Sage. Dept. of Psychology, Palmer, S. (2003). Multimodal coaching. Paper London City University presented at The Psychology of Coaching Con- Northampton Square, ference held by the Coaching Psychology Fo- London EC1V 0HB. rum at the British Psychological Society’s Lon- E-mail: don offices, 15 September. dr.palmer @ btinternet.com Palmer, S. (2004). Health coaching: A developing field within health education.Health Education Journal, 63(2), 189–191. References Palmer, S. (2006). Multimodal therapy. In C. Bandura, A. (1977). Social learning theory. Engle- Feltham & I. Horton (Eds.), The Sage Hand- wood Cliffs, NJ: Prentice-Hall. book of Counselling and Psychotherapy. Lon- Bandura, A. (1986). Social foundations of thought don: Sage. and action: A social cognitive theory. Engle- Palmer, S. & Dryden, W. (1995). Counselling for wood Cliffs, NJ: Prentice-Hall. stress problems. London: Sage. Edgerton, N. & Palmer, S. (2005). SPACE: A psy- Palmer, S. & Whybrow, A. (2004). Coaching psychological model for use within cognitive be- chology survey: Taking stock. Presented at the havioural coaching, therapy and stress manage- British Psychological Society Special Group in ment. The Coaching Psychologist, 1(2), 25–31. Coaching Psychology Inaugural Conference, Lazarus, A.A. (1971). Behaviour therapy and be- held on 15 December, 2004, at City University, yond. New York: McGraw-Hill. London. Lazarus, A.A. (1973). Multimodal behaviour ther- Palmer, S. & Whybrow, A. (2007). Coaching psy- apy: Treating the BASIC ID. Journal of Nervous chology: An introduction. In S. Palmer & A. and Mental Disease, 156, 404–411. Whybrow (Eds.), Handbook of coaching psy- Lazarus, A.A. (1985). Marital myths. San Luis chology: A guide for practitioners. Hove: Rout- Obispo, CA: Impact Publishers. ledge. Lazarus, A.A. (1989). The practice of multimodal Palmer, S & Gyllensten, K. (2008). How cogni- therapy: Systematic, comprehensive and Effec- tive behavioural, rational emotive behavioural tive psychotherapy. Baltimore, MA: Johns Hop- or multimodal coaching could prevent mental kins University Press. health problems, enhance performance and re- Lazarus, A.A. (1993). Tailoring the therapeutic duce work-related stress. Journal of Rational- relationship, or being an authentic chameleon? Emotive & Cognitive-Behavioral Therapy. Psychotherapy, 30, 404–407. Palmer, S., Tubbs, I. & Whybrow, A. (2003). Health Lazarus, A.A. (1997). Brief but comprehensive coaching to facilitate the promotion of healthy psychotherapy: The multimodal way. New York: behaviour and achievement of health-related Springer Publishing Company. goals. International Journal of Health Promotion Lazarus, A.A., & Fay, A. (1975). I can if I want and Education, 41(3), 91–93. to: Change your thinking, change your behav- Palmer, S. Cooper, C. & Thomas, K. (2003). Creat- iour, change your life. New York: Quill, William ing a balance: Managing stress. London: British Morrow. Library. Lazarus, A.A., Lazarus, C.N. & Fay, A. (1993). Paul, G.L. (1967). Strategy of outcome research in Don’t believe it for a minute! Forty toxic ideas psychotherapy. Journal of Consulting Psychology, driving you crazy. San Luis Obispo, CA: Impact 331, 109–118. Publishers.

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The Danish Journal of Coaching Psychology can be found at www.coachingpsykologi.org