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Health Coaching - a growing part of the healthcare extender model

Mar 30, 2021 9:23:59 AM / by Andrew L. Brewer, MS, NBHWC

We hear the term health coach more and more these days so I wanted to explore the role of the health coach in this blog post. A health coach is a coach for people who want to or who are contemplating making behavioral changes that result in a healthier lifestyle. A health coach is a type of healthcare extender trained to help others set goals and be accountable for themselves as they begin a journey to improve their overall health and quality of life.

What are healthcare extenders?

Chronicdisease.com says "Health care extenders are non-physician health care professionals who help people take actions to prevent and manage their health conditions. They include nurse practitioners, medical assistants, community health workers, pharmacists, social workers, and registered dietitians."

One of the ways in which healthcare has shifted over the years is reaching people they live, work, and play instead of using the emergency room for the front door to healthcare. FaithHealth Community Connectors at Wake Forest Baptist Health is an example of a non-clinical health care extender and serve as community level healthcare connectors in the region and across the state. The same way NPs, CMAs, and pharmacists extend services in a clinical setting, a CHW role extends services at the community level. A community health worker may provide, for example, a home visit to survey for potential environmental hazards, and may work with clergy and congregations to distribute health information throughout a neighborhood or region.

A health coach is another example of a healthcare extender to serve as guide, mentor, and of course coach to those individuals and groups who want to make a healthy lifestyle change.

What is a coach?

A coach is someone who works with a client to help them grow into a better version of themselves to thrive and reach their goals. A coach is different than a personal trainer who works directly with a client in specific fitness and exercise training, but a personal trainer can serve in a coaching and certainly motivational role. A coach is also not a counselor or therapist: they don’t work to uncover problems and issues but rather work with clients to help them find and work through the solutions.

Coaching in general provides motivation, accountability, mentorship, and guidance to clients in various states of their growth journey towards a healthier lifestyle. Much of coaching is communicating with the client through proven coaching techniques to help the client find the motivational factors for their own behavioral change and create an action plan to reach their goals. A coach does not prescribe activities, medication or diets, but works directly through interviewing, active listening, and affirmation to tease out the clients own actions and behavioral changes that will lead to better health. It is a recognition that only the client themselves have the power to create the will to change and the coaching role is to help them find it.

There are many types of coaches and coaching styles and there seems to be a never ending stream of books, blogs, and podcasts on coaching methods and philosophies for pursuing greater wellbeing. Tony Robbins, Jay Shetty, Brene Brown, and Steven Kottler are some big names in the coaching world that come to mind.

Goals of health coaching

Again, the health coach is trained to help clients create lifestyle change through coaching techniques such as active listening, motivational interviewing and other methodologies to create a goal for specific health metrics in a person's life habits. Usually the lifestyle changes are focused on nutrition, tobacco/alcohol/drug cessation, and activity. Making just one or two small healthy lifestyle changes such as eating less sugar and processed foods or walking 20 minutes each day can make a huge difference in a client's quality of life and reduce their medical needs over time, thus reducing healthcare system costs and increasing human potential.

A health coach helps their clients come up with very specific goals that are realistic and measureable and create accountability so that progress, or lack thereof, can be assessed. An example of a specific behavior change goal might be drink one less soda each day for a week. The coach and client then follow up to see how this change went and what the next specific goal will be to keep the momentum.

Are Wellness coaches the same thing?

A wellness coach is much like a health coach but is a bit more holistic in that they include mental, emotional, and spiritual areas in a client's life. Wellness coaches work with individuals and teams to help create higher level performance by identifying resistance and blocks to optimal health and overall wellness.

What about a Life Coach?

Certainly life coaching can include health-related topics, but life coaching is more focused on one's overall personal growth and may specialize in relationships, leadership, finance, parenting and other and prosperity while health coaching focuses more narrowly behavioral changes related to physical health. Many life and wellness coaches pursue health coach certification and vice versa since they do complement each other.

How does health coaching work?

In clinical settings, health coaches lead group and one on one sessions with clients referred by their PCP or other provider to help create lifestyle change based on a clinical condition that can be improved though behavior modification. Health coaches can also be affiliated with fitness centers offering additional services beyond exercise classes and equipment. Many health coaches work independently and promote their services through content marketing and word of mouth. Coaching requires a level of trust between client and coach which is built through rapport, affirmation, acknowledgement and genuine care about the client’s desires to become healthier and helping them find ways to overcome the obstacles they might encounter along the way. The successful coaching relationship will span a period of time defined by the goals of the client, and the coach will stay connected with the client to help refine and measure success.

How to become a health coach

It seems everywhere you look there is a coaching certification program of some sort. Big names in the personal growth industry fetch large sums for their programs and many find these the fit their needs well. In order to become a legit certified health coach (Certified by the National Board for Health and Wellness Coaching NBC-HWC) one must complete an approved health coaching program that includes live instruction (most are virtual now of course) with another large block of self-study requirements many of which include related Continuing Education activity credits. Most programs require a volume of documented practice so you will work with volunteers for mock coaching sessions and record them. Once completed, the graduate then prepares for the Board certification exam which can be done on one's own or through a certified test preparation program such as ACE. Once you've passed the test you are officially certified and can practice as a health coach. Current healthcare professionals that become certified health coaches can increase both their practice and their income by including individual and group sessions in a clinical setting or branch out into private practice themselves. In our current state of the pandemic world it seems the demand for health coaches is increasing.

Acts of service

Health coaching can be a great way to give back to your community and society with the goal of helping people improve their lives. If you are a good communicator, care about the health of society and the people you encounter, and love to help, becoming a health coach might be a pursuit worth exploring.

Tags: telehealth, engagement, instruction, training, Wellness, public health, mental health, CME, Healthy Opportunities, culinary medicine, healthy eating, food, Community, health careers, respiratory care, behavioral health, Health coach

Andrew L. Brewer, MS, NBHWC

Written by Andrew L. Brewer, MS, NBHWC

Instructional Technologist at Northwest AHEC, Nationally Certified Health and Wellness Coach

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