The importance line indicates the point at which the patient has taken ownership and control – when they’ve identified what’s most important to them right now and are able to recognise that they have choices and that they are the one who can make that choice. This is where they are ready to drive their own goal-setting and problem-solving with the support of the coach.

We’ve seen that, without ownership, goal-setting can be an uphill struggle for both the coach and the patient - and can even risk creating or exacerbating a sense of failure in the patient; conversely that there is no limit to what patients can achieve once a sense of ownership has been established.

The model also recognises that it’s the process rather than any particular outcomes that is important in the first instance.

Once the patient has internalised the process, they can apply it to anything.  It is due to this dynamic that quite extraordinary outcomes are often achieved as a result of the intervention.  As one of the coaches responded when asked whether she is often surprised by what patients achieve:

“I think they are often surprised by what they achieve.”