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More Than an Encouraging Word
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— July 15, 2018

More Than an Encouraging Word

By Michele Wojciechowski
  • People turn to health coaches for help in making lifestyle changes stick.
More Than an Encouraging Word

On the field, sports coaches help athletes perform at peak levels. 

In a similar manner, various types of coaches help everyday people navigate problems or issues in different areas of life—including ways to make lasting lifestyle changes designed to promote better health and well-being.

Nowadays, there seem to be coaches for everything: Life coaches who help people set and achieve goals in their professional and personal lives; business coaches who help people set and achieve the vision for growing or improving their businesses; and financial coaches who help people learn to change their behaviors regarding money to save more and reduce their debt.

The estimated market value for personal coaching was $1.02 billion in 2016, compared with $707 million in 2011. Click To Tweet

What do the letters mean?

ACC: Associate Certified Coach
BS: Bachelor of Science
BSN: Bachelor of Science in
CCNS: Cardiovascular Clinical Nurse Specialist
CHC: Certified Health Coach
CINHC: Certified Integrative
Nutrition Health Coach
CMT: Certified Massage Therapist
CSBC: Certified Small Business Coach
CWP: Certified Wellness
FDN-P: Certified Functional
Diagnostic Nutrition Practitioner
FNLP: Certified Functional
Nutrition and Lifestyle Practitioner
MA: Master of Arts
MSN: Master of Science in Nursing
NBC-HWC: National Board
Certified Health & Wellness Coach
RN: Registered Nurse

One fast-growing area of coaching involves helping people implement the types of lifestyle changes that promote better health.

Part of this growth is being driven by an increasing emphasis on preventative measures as a way to hold down healthcare costs. Changing demographics also plays a role.

There are more than 70 million Baby Boomers in the US. Click To Tweet

These are people who have reached an age when trying to stay healthy becomes an increasingly important priority.

If you’re thinking about using a health coach, it’s important to know what they provide and what they don’t, what credentials they should have and how to find someone who meets your needs.

Coach/Organization: Chuck Tawney, CHC/Evolve Yourself with Coach Chuck

Location: Baltimore, MD

Certification: Health Coach Institute

Client: Valli Hall, 42; needed motivation for weight loss

“After losing about 120 pounds on my own in about 18 months through proper nutrition and exercise, I found myself stalling out and losing motivation. I felt like I needed someone to help me stay accountable,” says Hall.

“I noticed right away that she was goal-oriented and driven,” says Tawney. “She wanted a little more motivation and a push to the next level—a little extra support and a hard dose of accountability.”

That’s what Hall has gotten. Tawney and his client talk almost daily and have an official session once each seven to ten days. Hall says Tawney “has helped me to see my potential and believe in myself more than I already did. He’s compassionate, yet tough. He has helped me realize that my health is my top priority and a lifelong commitment.”

What Health Coaching Is—And Isn’t

Health coaching isn’t the same as wellness or life coaching.

“Wellness coaching is guidance and inspiration provided to otherwise ‘healthy’ individuals who desire to maintain or improve their overall general health status, which often includes smoking cessation, increased physical activity, eating well, and general weight management,” says health coach Melinda Huffman, BSN, MS, CCNS, CHC, who practices in the Chattanooga area.

Huffman and Colleen Miller, RN, BS, CSBC, CHC, cofounded the National Society of Health Coaches (NSHC), which developed this definition of health coaching in 2015: “Health coaching is the use of evidence-based skillful conversation, clinical strategies and interventions to actively and safely engage clients in health behavior change to better self-manage their health, health risk(s) and acute or chronic health conditions resulting in optimal wellness, improved health outcomes, lowered health risk and decreased health care costs.”

Offering Encouragement

Helping clients focus on the positive aspects of change is crucial.

Part of the definition of health coaching formulated by the International Consortium for Health & Wellness Coaching (ICHWC) says that such coaches “display unconditional positive regard for their clients and a belief in their capacity for change and honoring that each client is an expert on his or her life, while ensuring that all interactions are respectful and nonjudgmental.”

Health and wellness coaches are needed more than ever. More than three-quarters of all clinic and hospital visits are attributed to unrelenting stress and the impact of poor lifestyle choices, according to Meg Jordan, PhD, RN, CWP, ACC, NBC-HWC, who chairs the Integrative Health Studies program at the California Institute of Integral Studies in San Francisco.

Jordan adds that people who desire to make healthy changes in their lives are those who most often seek the advice of health coaches.

“This includes anyone along the entire wellness- illness continuum,” she says, “from people who are undergoing sick care treatment such as cancer treatment or learning to live with cardiovascular disease or hypertension or recover from a stroke, to individuals who have one or two risk factors for chronic disease and wish to begin preventive and health-enhancing measures in line with their core values.”

Coach/Organization: Amanda Malachesky, FNLP, FDN-P, CINHC, CMT/Confluence Nutrition

Location: Petrolia, CA

Certification:Certified Integrative Nutrition Health Coach from the Institute for Integrative Nutrition

Client: Andrea Gray, 39; wanted to reduce anxiety, improve  digestion and lose weight

Gray worked with Malachesky for about six months, meeting every two weeks—first in person and then by video chat.

“The place I always start with clients is to help them connect with their goals and desires. But at a deeper level, I want to help them understand why they want those goals,” says Malachesky. “Andrea wanted to embody a strong, athletic, flexible body, and have more comfort and energy so she could keep up with her boys and be a good role model for them. When people tap into their personal why, making changes is less difficult.”

Malachesky had Gray keep a food diary so that she could get a sense of what her client was eating and where they could make changes.

“Each visit, we would discuss what was currently going on, and create an action plan to help address her concerns or her priority,” recalls Malachesky. “I helped Andrea prioritize self-care. We added probiotics and other digestive supports. Later, Andrea did an elimination diet to test whether gluten, dairy and sugar were connected to her symptoms. Dairy turned out to be connected to her heartburn and gluten to her anxiety.”

“What I like most about working with a health coach is the feeling of having dedicated, nonjudgmental support—someone who is willing to get into the nitty gritty of your life and help you make changes,” says Gray. “My coach helped me discover methods to manage my stress and my health that I use on a daily basis—visualizations, breathing exercises, the importance of magnesium and zinc to help my mood and brain function.”

Coaches and the Healthcare System

Healthcare costs in the US and worldwide are skyrocketing due to the prevalence of chronic conditions such as cardiovascular disease and diabetes.

In 2017, US health care costs were $3.5 trillion—an annual cost of $10,739 per person. Click To Tweet

Huffman believes that in response, the healthcare system is transitioning from a focus on the treatment of illness to an increasing emphasis on wellness and prevention.

This need to pare costs also drives the use of health coaches in workplace settings.

In 2018, more than 90% of large firms and 50% of small employers in the US offered a wellness program. Click To Tweet

As Huffman puts it, the need to rein in costs and keep employees healthy are the primary drivers for companies to use health coaching as an employee benefit “that can also positively affect presenteeism (working while sick), absenteeism and employee satisfaction.”

In addition, Huffman says that a growing number of hospitals, accountable care organizations, home care agencies, outpatient clinics, physicians’ offices and even hospice facilities are using health coaching to “engage their patients and families as a 50/50 ‘partner’ to achieve better health outcomes while also cutting costs.”

Besides such settings in which healthcare practitioners dominate, Jordan says that health coaches are also working in private practice, wellness centers, nonprofit community centers, digital health platforms, insurance companies, chronic care management firms and senior centers, as well as in educational and training programs.

Coach/Organization: Joseph Ison, NBC-HWC, MA/Health Coach Lead at Vida Health

Location: Portland, OR

Certification: Master’s in Integrated Health Studies from the California Institute of Integral Studies

Client: Nancy Williams, 71; wanted to lose weight and change lifestyle

During her yearly physical, Williams discovered that her blood pressure was high. She wanted to try to lower it without using medications. Luckily, her insurance company, UnitedHealthcare, was initiating a pilot program that included health coaching. Williams chose to work with Ison remotely through Vida Health. 

“Our first sessions really focused on wanting to make sustainable and gradual progress, while keeping her goals fun and attainable,” says Ison. “Through our Vida platform, Nancy started logging her daily activities and metrics such as exercise, energy levels, food and blood pressure. This allowed both of us to see how her metrics were trending, and if we needed to adjust any of her goals or approaches. We agreed that consistency with small, weekly goals was going to be the key to her success in losing weight and maintaining.”

What worked for Williams was having Ison check in three to four times a week through text messaging in between their bi-weekly calls. This process kept her accountable and motivated.

At the end of their time together, Williams had lost 27 pounds and her blood pressure was 115/78. She’s determined to maintain her lifestyle changes.

“The lost weight isn’t the only lesson and reward of this coaching journey. I have found a resilience that I think was hiding a bit inside,” Williams says. “Knowing that I can do anything I set my mind to really keeps my motivation high, and that, to me, depends on overall resilience. Joe helped me dig in and relate that to him.”

What to Look For

While a governing body that oversees health coaching certification doesn’t currently exist, the ICHWC aims to hold the profession to a standard.

“At this time, anyone can call themselves a health coach, although not all health coaches have been certified,” notes Leigh-Ann Webster, NBC-HWC, the ICHWC’s executive director.

Jordan adds, “ICHWC provides the national board certification—the first ever for health and wellness coaching—launched in September 2017. The certification is voluntary—there is no state mandate for certification or licensure at this point.”

When looking for a health coach, Huffman advises consumers to ask about the person’s qualifications.

“A certified health coach should have a license to practice in the clinical setting and should practice within their own ‘State Practice Act.’ Health coach certification should be received from a credible organization. People with chronic conditions such as high blood pressure, heart failure, heart disease, diabetes, lung disease, chronic pain and the like should refrain from independently seeking health coaching services of an individual who is not in clinical practice.” 

Webster says to make sure you have rapport with the coach. And beware: “There are plenty of people who call themselves ‘health coaches’ with no training. It’s also very important that people don’t confuse health coaching with health education or personal training—they are very different. Health coaching is nonjudgmental, client-centered, client-driven behavior change. This is what ultimately helps lead to success.”

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