The primary goal of this new form of lifestyle coaching is to encourage positive behavior changes in areas such as nutrition, physical fitness, smoking cessation and stress management. Although dietitians, personal trainers and psychotherapists provide similar services, what makes the United States’ 4,100 board-certified health and wellness coaches different is not so much what topics they address, but how they address them.
“Health coaches believe a client is already an expert in their own life and their own needs,” said Leigh-Ann Webster, executive director of the National Board for Health and Wellness Coaching, established in 2012, which administers the board-certification exam and has established national standards for the profession. “Often clients know what they want, but haven’t found the motivation within themselves to get where they want to go. That’s where health coaches can make a difference,” she said.
The client-directed approach to health coaching is based on a counseling technique called motivational interviewing. In this technique, health coaches ask nonjudgmental, open-ended questions that provide opportunities for clients to explore their motivation for change and, in collaboration with their coach, develop strategies to change their behavior that are personally meaningful and self-directed.
“Health coaching is about the here and now,” said Barbara Powell, a board-certified integrative health and well-being coach in Minneapolis. “Whereas mental health counselors often focus on the past and how to dismantle traumas that impede present-day functioning, health coaches focus on the here and now, helping clients identify their current strengths to achieve their behavior-change goals.”
That’s how Christopher Werler, 50, a marketing consultant from Monterey, Calif., found a way to motivate himself to exercise. “My coach probed me with questions that focused on my strengths. One of them is never being late for meetings,” he said. Working with his coach, Werler devised a plan to exercise virtually with a friend, which capitalized on his ability to show up on time while providing the companionship that motivated him to work out.
“The biggest focus today in health coaching is stress management, self-care and resilience training,” said Theresa Nutt, co-director of the Integrative Health and Wellbeing Coaching Program at the University of Minnesota. “Health coaches are working with clients to develop skills that foster resilience, so they can live optimally under suboptimal conditions.”
They often take it in incremental steps. Powell gave the example of a client who wanted to create a home-workout space after deciding not to return to her gym once the pandemic hit. “My client was overwhelmed with where to start,” she said. “If she committed to one hour in her home gym every day, she knew she was setting herself up for failure. Instead, we started with brief segments of exercises she could do throughout the day that created a manageable foundation for her to build on and relieve her stress.”
Margaret Moore, chief executive of Wellcoaches and chair of the Institute of Coaching at McLean Hospital in Massachusetts, a Harvard Medical School affiliate, said health coaches can help obese people lose weight and reduce their chances of developing a serious case of covid-19, the disease caused by the coronavirus. “Coaches play an important role in empowering people to cultivate the intrinsic motivation, confidence and habits needed to lose weight and keep it off. Just a 5 percent reduction in body weight sustained over time is significant in improving health,” Moore said.
Rather than replacing a dietitian or physician, a health coach can be part of a weight loss team, said Matthew Clark, a clinical health psychologist at the Mayo Clinic. “A physician can provide medical clearance and provide guidelines for physical activity. A registered dietitian can help you develop an individualized nutrition plan, and a health and wellness coach can help you follow your healthy-living plan,” he said. “Health and wellness coaches are trained in empathy, motivational interviewing and behavioral counseling skills, and can help individuals set realistic goals.”
With so many people out of work because of the pandemic, the question remains: How can those who may benefit most from health coaching afford it? One answer is the increasing number of health insurance companies that provide free health coaching to their subscribers.
Several insurance companies, such as UnitedHealth Group, Aetna and Blue Cross Blue Shield, provide free health coaching to their clients. Amy Meister, chief executive of UnitedHealth Group’s Level2 digital platform, which supports members with Type 2 diabetes, is a strong advocate of health coaching. “Doctors aren’t trained in motivational interviewing. Health coaches are,” said Meister, who is a physician. “Coaches introduce a new level of expertise into the health-care system, and they work closely with our clinical team.”
Kara Lee, a certified health and wellness coach with Kaiser Permanente, echoed Meister’s view. “Physicians are limited with how much time they can spend with patients. I can talk with a patient for 25 minutes at no cost and with no co-pays to the member,” she said.
And if you don’t have health insurance that covers health coaching or are low on financial resources? Some health coaches in private practices are offering group sessions, which can significantly reduce the cost. Sherene Cauley, owner of the Nurtured Life in Orland, Maine, is among them. “Coaching needs to be financially accessible and sustainable for it to have a lasting impact,” she said. “Financial concerns have a deep and subtle impact that can distract from healing.”
Furthermore, “there is the added benefit of community, which we are starving for these days, given how isolated we feel due to covid-19,” said Michael Scholtz, founder of Vistas Life Coaching in Asheville, N.C.
But be aware that the field is unregulated in the United States. Although national standards were created for the profession by the National Board for Health and Wellness Coaching in 2015, there is no law mandating these standards. The organization certifies health and wellness coaches who have successfully met and demonstrated its coaching competencies and who adhere to its ethical guidelines; you can find a list of certified coaches on its website, nbhwc.org.
As for Udell, her health coach educated her about online shopping, so she could safely order groceries; recommended a meditation app for her stress; and suggested exercises to improve her physical and mental health. “My coach not only taught me how to live healthier,” Udell said, “but helped me overcome the obstacles of living under covid-19.”
Lorne David Opler is an adjunct professor of fitness and health promotion at Sault College in Sault Ste. Marie, Ontario, and a certified strength and conditioning specialist. Visit his website at trainerlorne.com.
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