Health Coaching : What Is It?
The term “health coaching” implies that the role of the person delivering the intervention (usually a health practitioner), is to actively assist clients to change their health behaviors in a collaborative and individualized manner, that is, to coach, in contrast to educating, “telling,” or counselling clients regarding which actions to take.
In discussing the health coaching approach.
behavior change theories and models have evolved, moving health education interventions away from the traditional information-based and advice-giving model to one that embraces and addresses the complex interaction of motivations, cues to action, perception of benefits and consequences, environ- mental and cultural influences, expectancies, self-efficacy, state of readiness to change, ambivalence and implementation intentions.
Physiological and behavioral targets of health coaching
The physiological and behavioral targets of health coaching interventions are usually risk fac- tors and/or indicators of chronic disease.
Examples of individual and program goals pursued in health coaching interventions are :
Self-managing chronic diseases or conditions such as diabetes, cardiovascular disease, obesity, arthritis, and chronic pain; managing weight; increasing activity; improving nutrition; managing stress; lowering blood glucose levels, lipid levels, and blood pres- sure; and engaging in specific treatment options for medical conditions, such as immunotherapy for multiple sclerosis.
Definition of health coaching
Although there is no single agreed definition of health coaching, a constant theme among researchers and practitioners is that health coaching is a practice in which health practitioners apply evidence-based health behavior change principles and techniques to assist their clients to adhere to treatment and lifestyle recommendations, for the purpose of achieving better health outcomes or quality of life .
For example, Palmer defined health coaching as “the practice of health education and health promotion within a coaching context, to enhance the wellbeing of individuals and to facilitate the achievement of their health-related goals”.
Similarly, Butterworth et al. defined health coaching as “a behavioral health intervention that facilitates participants in establishing and attaining health-promoting goals in order to change lifestyle-related behaviors, with the intent of reducing health risks, improving self-management of chronic conditions and increasing health-related quality of life”.
Different definitions reflect greater relative emphasis on a subset of the various components most often included in health coaching interventions :
most often included in health coaching interventions :
– provision of health education and information, e.g., disease-specific, treatment-specific, and general health and lifestyle recommendations;
– provision of health behavior change education and information, e.g., understanding change and change processes, tips on decision-making, how to set goals, track progress, and solve problems;
– behavior modification support, e.g., goal setting, action planning, environment modification, and contingency management/reward systems;
– motivation enhancement, e.g., moving clients through readiness-based states or stages of change, and decisional balance assistance;
– problem solving support, e.g., identifying and addressing behavioral, emotional, situational, and cognitive barriers to change, decision-support, and relapse prevention;
– psychosocial support, e.g., brief emotion-management strategies and/or referral to deal with psychosocial aspects of managing health conditions (acceptance, fear, distress, guilt, etc.).
Industry-based health coaching
Indeed, many industry-based health coaching interventions contain an education component, goal setting, and recognition of the need to acknowledge and address client readiness to change [Healthcare Intelligence Network. These interventions are, therefore, cognitive- behavioral in intent (if not explicitly so).
They aim to change cognitive variables such as beliefs, motivation, and self-efficacy in order to induce behavior change.
However, cognitive behavior therapy (CBT) has been used primarily as an intervention. to address emotional or psychosocial aspects of chronic disease.
And infrequently applied to health behavior change impacting directly on lifestyle change. and self-management of health conditions (Butler et al., 2006).
We propose that. given that common clinically observed barriers to health behavior change concern values, priorities, beliefs, expectations, attitudes, and everyday thinking patterns.
It is essential to include techniques that actively identify and address cognitive as well as behavioral, emotional, and environmental barriers to change.
Health coaching contrasts with traditional medical provision of treatment and lifestyle advice, and also with general coaching and counselling modalities.
The Rationale for Health Coaching : The Theoretical Evidence