September 24, 2020

CP Online Health

Eat Well, Life Well

Health coaching is effective. Should you try it?

In the fall of 2019, my hospital put out word that it was looking for physicians who might wish to undergo intensive training to become certified health and wellness coaches. Having worked with patients who have used health coaching, I jumped at the chance. Their experiences were almost universally positive: many of them had attained health goals that had been otherwise elusive, such as the weight loss they invoked annually — and fruitlessly — as a New Year’s resolution. The few physicians I knew who were also coaches seemed to be able to fuse the different skill sets in a way that expanded their ability to connect with their patients and address their health needs on a deeper level.

What is health coaching?

Just as a sports coach can help an athlete develop and excel at a sport, a health and wellness coach can help anyone excel at living their life, even — or especially — if they have chronic medical conditions. The coaching process is similar to talk therapy in that it involves two people discussing ideas and issues, but it is different in that the person who is being coached is in the driver’s seat, creating their goals as well as the strategies on how to arrive at these goals.

People tend to hire health coaches to help them with a broad variety of health issues, such as weight loss, stress reduction, the management of chronic conditions, improving diet and exercise, tobacco cessation, addiction, and adjusting to a life-altering health event, like a heart attack. There is overlap between what a health coach does and what a life coach does, but a life coach’s domain is much broader, and includes career issues, executive coaching, and professional effectiveness.

Coaches use motivational interviewing techniques

A key technique utilized by coaches is motivational interviewing, in which a coach asks open-ended questions intended to help their client elicit his or her own reasons for change. Instead of the doctor saying, “You need to lose weight,” a coach might ask, “How might your life be different if you lost the weight that you’ve been trying to lose?” The concept, which has been proven effective in many research studies, is that people who are changing for their own reasons, on their own terms, are far more likely to succeed when compared with someone telling them what to do — which is less motivating and is more likely to instill resistance to change.

Motivational interviewing has been creeping into the medical profession as well, with great success. With the intensive focus on it I received in my coaching training, I now put it in the forefront in my interactions with patients, trying to really hear what they are saying and to engage them as much as possible in coming up with solutions for the various health issues that arise. Patients seem to genuinely appreciate this, and while I haven’t conducted a study, this approach certainly seems successful in terms of both my relationships with patients and the results I am seeing.

Positive psychology is a cornerstone of coaching

Whereas traditional psychology has focused on what is “wrong” with people and what needs to be “fixed,” coaching philosophy focuses on what has, can, and will work better for you. This means that instead of rooting around for problems to dwell on, a coach will work with you to harness your strengths, in order to improve the health behaviors you want to address.

Is there evidence that coaching works?

Coaching is effective for people managing a variety of health conditions. According to a recent study, 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.” Coaching has also helped improve health-related quality of life and reduced hospital admissions in patients with COPD. No wonder some doctors’ offices are offering it, some insurance companies are paying for it, and private companies are even starting to offer coaching to their employees in order to lower their healthcare costs.

How are coaches trained and certified?

Coaching is a relatively new field, and it is an unregulated industry, so you do not need any certification to practice as a health coach. There is no strict definition of what a health coach even is, which adds to the confusion. In other words, anyone can hang out a shingle and call themselves a “coach.” However, there are many programs that do train and certify coaches, both in person and online. Among the most popular and well-respected are: The National Society of Health Coaches, The American Council on Exercise, Dr. Sears Wellness Institute, Duke Integrative Medicine, and Wellcoaches School of Coaching (which is where I was trained). It is strongly recommended that you choose a certified coach, to ensure that they have a certain level of training and experience.

What’s the time commitment and cost for health coaching?

The time commitment and cost of coaching are highly variable. Some people do very brief coaching — even one session — for a discrete problem, such as whether or not to accept a job offer, whereas others may participate in coaching for months or years, for something like managing weight, diabetes, depression, or hypertension. The cost varies with the skill and experience of the coach. As mentioned previously, some employers and medical plans may cover this, as there is abundant evidence that, for example, health coaching around issues such as weight loss can significantly lower healthcare costs. It is important to note that coaches take privacy very seriously, and they have a professional code of ethics, but there are not the same HIPAA-level privacy protections as there are when you visit a medical office.

Coaching appears to be as effective when administered remotely by phone or the Internet when compared with face-to-face coaching. This provides great flexibility, as coaching can be performed in person, over the phone, or via videoconferencing.

How can you find the right coach for you?

Coaches’ resumes will often be available for you to review, so see if their interests and experience overlap with the issues you wish to address. Coaches enter the field from a wide variety of different backgrounds, and it might be an advantage to pick a coach who has a background in a health or wellness-related field, though many extremely talented coaches come from careers in different realms. Word of mouth is always an excellent way to find a coach, or you could call your insurance company and, if this is an offered benefit, it’s likely that they have coaches they can recommend.

The bottom line

Unlike health fads that come and go, health coaching has strong evidence behind it backing its effectiveness for improving health and well-being. Becoming a health coach has been deeply rewarding to me, because it is rare in life that you get to promote happiness, build resiliency, save people money, and help people live longer and more fulfilling lives at the same time.

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