Addressing Client Misconceptions with Ask-Offer-Ask

You have probably been in this situation before: You are leading a group or meeting with a client one on one, and they share a fact that just isn’t true.

“I can’t eat carbs because of my diabetes.” 
“I avoid fruit because all that sugar makes you fat.” 
“I don’t lift weights. I don’t want to get bulky."

Engaging clients in a collaborative relationship can happen quickly and easily during just a few coaching sessions. When a trusting coaching partnership is established, there is a high level of comfort and familiarity between coach and client. This strong bond has many benefits, but it can also present some challenges.

The more connected your clients feel to you, the more likely they are to feel safe enough to share what they have heard and learned. At other times, even newer clients can share strong emotions as they verbally process what they hear and believe from other sources. Ultimately, coaches want to be effective guides who empower clients to transition to the maintenance stage of change. As your clients become more independent and confident, they may begin to conduct their own health research, and they may be excited to share information with you and even question the information you share if it is different from what they have learned from other sources. This is a good thing!

But it can also put you in the position where you need to correct misinformation.

When you discover that a client is relying on incorrect information, this situation needs to be handled delicately. You have an ethical responsibility to correct misconceptions with your clients and share neutral, evidence-based information and resources, with permission.

Fortunately, strategic use of OARS interviewing skills and evidence-based coaching skills allows you to maintain professional communication with your clients in response to these challenges. It is critical that you keep the fixing reflex at bay in these situations. You do not want to create defensiveness or resistance or otherwise embarrass your client when correcting misinformation.

Let’s examine a process that can help correct misconceptions while being grounded in appreciative inquiry, the spirit of motivational interviewing and, more specifically, the ask-offer-ask approach.

Consider these five steps:

• Step 1: Make an appreciative statement like, “Thank you for bringing up this topic.”
• Step 2: Acknowledge that there is conflicting information: “The information on this topic can be conflicting and create confusion.”
• Step 3: Ask permission to provide additional facts by saying, “There is some reliable, science-based information you might find interesting. Would you like me to share that with you now?”
• Step 4: With permission, offer the correct information in a factual, neutral manner. This means avoiding pronouns and imperatives that suggest the information is tied directly to the needs of the client’s personal situation (e.g., Research shows…., Science says…, This study finds…, Evidence reports…, The American Heart Association recommends…).
• Step 5: Ask an open-ended question to invite the client’s feedback about the information shared. “What do you think about this information?”

It is also a good idea to offer to provide your client with resources where they can review the correct information themselves if they are interested. This could be looking at a website together during a coaching session, providing resources for them to take home or emailing later after a coaching session. Then, the ask-offer-ask process continues with the next “ask” at the next coaching session. For example, “I shared some information from the American Diabetes Association on how carbohydrates impact your insulin levels via email last week. What questions do you have after reviewing that article?”

Let’s look at this process again and plug in a scenario about a client who shares concerns about lifting weights. 

Client: “I don’t lift weights. I don’t want to get bulky.” 

Coach: “Thank you for sharing this. It sounds like you are considering ways to exercise that make you strong and lean.” 

Client: “Yes, I want to be fit and lean. I am walking now, but not sure what else I can do.” 

Coach: “You are considering some options for exercises you could add to your routine that would build a fit, lean physique. Would it be okay if I shared some information on strength training?” 

Client: “Please."

Coach: The World Health Organization recommends a minimum of 150 minutes per week of moderately intense physical activity, along with muscle conditioning of all muscle groups a minimum of two days a week. These types of exercises can contribute to strong, but not bulky, muscles and provide numerous health benefits. I’d be happy to send you more information on this if you’d like.

Client: “I would like to read more. I didn’t realize incorporating weights was recommended.” 

Coach: “Great, I will send you some additional resources. What do you think of this information so far?” 

Client: “I am glad there are ways to lift weights that won’t make me look really bulky. Can we talk through some of those options now?” 

Coach: “Of course…” 

Final Thoughts

When you rely on open-ended questions, reflections and respectful informing skills, you honor the client’s autonomy, stay within the health coaching scope of practice and empower the client to make choices based on science. Utilizing ask-offer-ask is a collaborative way to exchange information with clients to explore what they already know about a topic from their own experience and frame of reference and to share relevant additional information when given permission to do so. Effective coaches can use this technique to navigate client misconceptions while reducing defensiveness and maintaining client autonomy.

If you are interested in learning more about how to guide individuals to make meaningful, lasting changes in their lives, consider the ACE Behavior Change Specialist Program (worth 2.5 ACE CECs). This program provides you with the expertise to make a profound impact on clients' health and well-being by addressing the root of counterproductive behaviors and fostering sustainable, positive habits.