The Wellness Coaching Edge: Boosting Health and Happiness
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All professional and amateur athletes work with a coach—and just as a sports coach helps an athlete develop their athletic performance, a wellness coach helps their clients excel at living their life. Moreover, wellness coaching is especially helpful if they also have specific health goals or a chronic medical condition. A surprising statistic to most people is that 51% of adults in the United States have a chronic medical condition. The wellness coaching process involves two people discussing ideas and issues, but it is different from counseling in that the professional coaching relationship is highly "partner" oriented, the client chooses their goals as well as the strategies on how to arrive at these goals, while the discussion is facilitated by a professional coach trained using specialized coaching methods.
Wellness coaches help clients with a broad variety of health issues, focused on adopting healthy lifestyle behaviors. Examples include maintaining a healthy diet, weight loss, stress reduction, regular exercise, the management of chronic conditions, tobacco cessation, or adjusting to life-altering health events, such as the diagnosis of a serious illness.
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However, my view of wellness goes beyond what most health and wellness coaches focus on, which is why I use the term "well-being" coaching. Well-being is a well-researched field tied to overall life satisfaction. Well-being is a multifaceted construct that is used across disciplines to portray a state of wellness, health, and happiness. A recent 2023 article published by Cambridge University Press reported on 388 papers specifically focusing on well-being, the development of well-being and the assessment of well-being (Bautista, 2023). Although most clients do have wellness goals that include traditional physical health goals, they also have goals that fit the broader, wholistic concept of well-being, such as career well-being, social well-being, financial well-being, and often, spiritual well-being. Hence, the certification training at the post-graduate College of Executive Coaching (an APA-approved sponsor of continuing education) trains coaches on seven aspects of well-being.
Coaches use Motivational Interviewing and the Stages of Change Model
The more highly trained well-being coaches integrate multiple models to assist their clients including the stages of change model (the transtheoretical model), developed by researchers James Prochaska and Carlo DiClemente. They also frequently use motivational interviewing approaches. Motivational interviewing (MI) fits well with the foundational coaching competency of curiosity, as MI is characterized by the coach taking a curious, respectful attitude towards their client while also promoting client autonomy rather than dependance (Miller and Rollnick, 2013).
Coaches use motivational interviewing and the stages of change to help clients identify potential ambivalence about making healthy lifestyle changes and then help them evaluate for themselves the consequences of not making change and conversely, the benefits of following through on their healthy lifestyle goals.
Coaches know that for a client to make healthy lifestyle changes it is important for the client to explore these four elements of changing a behavior to achieve a self-chosen goal:
Preparatory Change Talk
What is the desire, reason, ability and need to change?
Barriers to Change
What may be holding you back from making your contemplated changes? What benefits are you getting from not making this change?
Impact of Not Changing
What will be the consequences of not following through with your planned goals?
Benefits to Change
What will be the benefits of achieving this goal? For you? For important people in your life?
The Difference Between Directing and Coaching
While a physician may say, "You need to lose weight," a trained well-being coach might ask, "How might your life be different if you lost the weight that you're wanting to lose?" The research shows us that people who make healthy lifestyle changes for their own reasons are more likely to succeed when compared with someone telling them what to do. (Krones et al., 2008, Hamann, Cohen, Leucht, Busch, & Kissling, 2007, Kwam, Dimidjian, & Rizvi, 2010. Malm, Ivarsson, Allebeck, & Falloon, 2003; Calsyn et al., 2000.)
Positive Psychology Informed Coaching
Although many forms of psychotherapy have focused on what is "wrong" with people and what needs to be "fixed," a positive-psychology based coaching approach focuses on the attitudes and constructive behaviors that will bring about client-chosen lasting healthy lifestyle habits. Instead of spending much time exploring past pain or trauma, wellness coaching usually focuses on a greater utilization of strengths, seeing challenges as opportunities, developing methods to boost resilience, and cultivating positive emotions. As Mayo Clinic's Dr. Abu Dabrh states, "The aim is to help the client move towards an intentional, mindful and accountable state of taking actions and implementing sustainable, positive behavioral changes in their life."
Is There Evidence that Coaching Works?
Coaching is effective for people managing a variety of health conditions. According to the American Journal of Lifestyle Medicine (2017), wellness coaching "results in clinically relevant improvements in multiple biomarker risk factors (including systolic and diastolic blood pressure, total cholesterol, LDL cholesterol, HDL cholesterol, triglycerides, fasting glucose, body weight, body mass index, waist circumference, and cardiorespiratory fitness) in diverse populations." The effectiveness of wellness coaching led the National Board of Medical Examiners and the National Board of Health and Wellness Coaches to create a Board-Certified Health and Wellness Coaching credential. Increasingly doctors' offices are offering wellness coaching, some insurance companies are covering it, and many organizations offer coaching to their employees in order to lower their healthcare costs.
Is Remote Well-Being Coaching Effective?
Coaching is now usually offered remotely. This provides great flexibility and convenience, as coaching is often conducted over the phone, or via videoconferencing. This also saves on office overhead expenses. Physician Neil Gordon and colleagues (2017) reported on large scale wellness coaching interventions delivered remotely and effectively, including by the American College of Cardiology's CardioSmart patient-centered care initiative and in multicenter, randomized clinical trials funded by the National Institutes of Health. The primary objectives of these wellness coaching programs were to help patients make and adhere to meaningful, evidence-based lifestyle changes in areas such as regular exercise, healthy nutrition, weight management, stress management, tobacco avoidance, and improved sleep hygiene. From a global perspective, wellness coaching studied by these researchers included culturally appropriate wellness coaching services provided in multiple countries and languages, including English, French (Canadian), Spanish, Portuguese (Brazil), Portuguese (European-Angolan), and Thai.
Well-Being Coaching is Rewarding and is Here to Stay
Unlike other health fads that have little scientific credibility, wellness coaching has strong evidence demonstrating that it leads to improved health and overall well-being. My career incorporating well-being coaching has been particularly rewarding to me, because of the meaningfulness of helping people live more satisfying and fulfilling lives, sometimes in a manner that prolongs their lifespan and always the overall quality of their life.
