In mid-2021, after several years of major life transitions, heartbreaks, a heavy workload, and a global pandemic thrown in just for good measure, I found myself experiencing a high level of stress, apathy, and what I would later learn was burn out. I lacked the tools to deal with what I was feeling — which felt oddly like having no emotions at all. Nor did I know where to begin seeking help.
I was lucky enough to connect with an integrative health coach and Licensed Professional Counsellor (LPC) who helped me start the long journey back to myself. I chose coaching for its focus on what lies ahead, versus that of therapy, which is more retrospective. I needed help figuring out the path forward, not so much reflecting on how I got to where I was.
A great deal of good came of the dozens of hours I spent working with my coach. I was able to identify both what I did and did not want my future to look like. Without worrying so much about letting people down, I learned how to have both personal and professional boundaries. I took strong action on things that scared me deeply and that I had been subsequently avoiding.
One of the tangible fruits of my time working with a coach was leaving the business I had co-founded after 13 long years. It was a scary and even painful decision, but ultimately the right one for what I wanted for my life and future. Having a supportive, knowledgeable integrative health coach in my corner made all of the difference during that process.
Studying health & well-being coaching through Duke Health
I was very enthralled by the work of health coaching. Wowed by the results that in a few short years it had yielded for me, I thought of the possibilities that this kind of work could have for others should they be granted the same opportunity as I. I was excited, thinking that maybe, with training, time, and practice, I could sit on the other side of that table.
However, I was wary of going into a field that seemed to be rapidly filling with ego-driven grifters peddling pseudo-scientific programs, devices, potions, and promises that would be impossible for even a trained professional to achieve (never mind a self-professed “guru.”) If I went into the coaching field, I wondered, would I be supporting an industry that did more harm than good?
Separating the pros from the wannabes
My coach had never given me fraudster vibes. In fact, he had really, profoundly helped me. So much so that I considered it the best investment I had ever made in myself. He did not try to sell me on a lifestyle or any one way of doing things. In terms of marketing, he didn’t even really have an active Instagram or website. In terms of professionalism, I never learned that much about him, even after working together for years.
This felt very different from some of the “coaching” I was seeing on social media where people were essentially shouting into the void about themselves: how they had mastered life/business/etc., how many figures they were earning monthly, how you could too! All of this, ostensibly, to show their authority and value.
I realized a few things that set these folks apart from my coach (and others with very professional practices) were formal education, third party certification, adherence to coaching regulations and norms, and a decision to show up differently in the online space. Coaching isn’t the only field where amateurs impersonate experts. Yet when the above characteristics are present, there seems to be far more integrity, and far fewer wild and empty promises.
Taking the leap
So with the support from my coach, family, partner, and friends, I decided to stretch myself and go back to school to study the health and wellbeing coaching field. After a great deal of research, I opted to study with Duke Health’s program in Health & Well-being Coaching due to its heavy lean on psychology and the scientific method in its teachings. Furthermore, I had the intent to obtain the National Board for Health & Wellness Coaching certification. If I was going to do it, I figured I might as well take it across the finish line.
So what exactly is health coaching?
Health coaching is a relatively novel field, where the coach is a professional partner and helps the client work on prevention and/or management of health-related issues and conditions. The coach assists with information and education if applicable (or, understanding information from other providers), creating a plan of action which is both realistic and time-bound, and providing support and accountability as the client begins taking steps forward.
Health coaching can have several names. It’s not uncommon to hear it referred to as integrative health coaching or holistic health coaching. It even overlaps with what is known as life coaching. All of these terms aim to explain important concepts about the profession.
Integrative health coaching
This refers to the health coach working as a kind of “case manager” to help the client integrate the various components of their health into one cohesive set of goals with tangible action steps. This could include plans or recommendations from other health care providers (primary care doctors or nurses, physical therapists, mental health therapists, nutritionists or dietitians, personal trainers, career counselors, etc.) that the client may also be working with.
In our society, it is fairly normal for health care professionals to have no idea what else their client may be working on or dealing with. Thus, the client is, for all intents and purposes, on their own when it comes to prioritizing and making forward progress on what could be multiple, sometimes competing goals. Since no component of health exists within a silo, this model doesn’t make that much sense if we want to see the health systems in place work with efficiency and the clients’ best interests in mind.
Holistic health coaching
This term is similar to integrative health coaching. It purports that a coach’s job is to help the client audit and prioritize goals based on their whole-personal health. That is, one’s health is not defined solely by their weight, their blood sugar level, or their state of wellness or dis-ease.
Rather, it is defined by the myriad of factors in their life, including but not limited to: physical fitness, sleep and rest, nutrition and lifestyle, physical environment, fulfillment and purpose, mental and emotional wellbeing, community, and mindful awareness. Moreover, these components work together in harmony (or disharmony if something is off) and affect nearly every other part of the person’s health.
Life coaching vs. health coaching
Life coaching and health coaching have much in common and it can be hard to clearly distinguish between the two. Harvard Health explains the difference: “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.”
In Duke’s Health & Well-being Coach program, we learned that every single area of your life affects your health and wellness. Thus for any goal that you want to work on with the help of a life coach, you could probably experience success working with a trained health coach, specifically if it is addressed through the lens of wellbeing.
How does it work
Health coaching is a client-centered process which pulls from multiple disciplines including positive psychology, social psychology, and self-determination theory, to name a few. Coaches help their clients identify their values and vision and utilize them to inform areas in which they would like to focus their efforts.
Through the process, clients are able to choose meaningful goals and work towards them via tangible action steps in a pre-identified time frame. By 2024, the health coaching discipline has amassed significant scientific study to back up its efficacy and overall popularity. So much so that many in the healthcare industry such as hospital systems, insurance providers, and tech companies are hiring health coaches to help support metrics like their overall success rate, cost savings, and client health outcomes.
In the health coaching model, the client brings the content and the coach owns the process. Through inquiry and reflection as well as listening and helping tease out feelings, information, and ideas that the client may have, the coach can guide the client (steadily) toward sustainable behavior change.
What it is not
It is important to discuss what health coaching is not, because this can be what separates the qualified from the unqualified. In an industry where anyone can call themselves a coach, it is important to be discerning.
Here are a few coaching “red flags”:
- Telling the client what to do or giving unsolicited advice
- Overburdening the client with the coach’s story (what worked for them, their life decisions/successes/trials)
- Trying to extract from the client or upsell them on other “products”
- Wearing the expert hat*
*There are coaching disciplines in the world where the coach is the expert (think sports coaches, financial coaches, etc.), and is hired to give information, advice, and even formulate a plan for the client to follow.
Yet when it comes to health, there is no one expert that knows the client’s whole story, value system, goals, and competing priorities better than the client herself. Thus, for any health-related coaching relationship, the client is considered the expert in their own life and health. The coach is there to hold the behavior change process.
Why health coaching is important
We live in a world where technology and information sharing are making it more possible for people to be at the helm of their own health, and where health care systems are increasingly overwhelmed. For that reason, it is a very effective strategy for the client to have a trained, experienced, and empathetic professional in their corner to help them make decisions, weigh priorities, and make plans of action in order to make significant forward progress on their goals.
Accountability is cited as one major reason for health coaching’s success. Humans are social creatures, and having a modicum of social pressure works wonders for helping the client stick to their self-professed goals. Another major reason is support. When we feel supported, we feel empowered. When we feel empowered, we are able to develop in a way that aligns more closely with our values and vision.
I believe the health and wellness coaching movement is a simple yet important addition to health care, and I am proud to be a part of it.
