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How to Succeed at Online Health Coaching

The secret to virtual coaching success may surprise you.

Online health coaching

When discussing ways to make online health coaching successful, there’s a tendency for coaching pros to zero in on the “online” aspect as the key determinant of success. When this happens, their energy and resources turn toward tools typically associated with establishing an online business. And that can lead them astray.

Google “How to Make Online Health Coaching Successful” and you get more than 340 million responses; understandably, that can be confounding. Many people true of heart and purpose are drawn into the proverbial “cart-before-the-horse” trap and soon find they are sinking in monthly fees for various online platforms, SEO/marketing costs and a never-ending “funnel” of follow-me-to-the-land-of-6-figure-income gurus. However attractive, the idea that you can buy the right technology or the perfect, easy method to make health coaching successful is spurious, if not wholly untrue.

What clearly is true is that even before the COVID-19 pandemic, businesses across all domains were moving increasingly into the online realm. You didn’t need keen insight to notice the crumbling of the brick-and-mortar retail space. Within the fitness world, a “multichannel” approach was already a growing reality: In seeking to expand beyond its walls and to augment the user/guest/client experience, the industry was turning to technology to increase engagement and provide a frictionless approach to delivering added value. Twin goals were to improve retention and boost profitability.

In the fitness field, group fitness instructors and personal trainers can do especially well delivering their services using a hybrid model—partially online and partially in person. However, to fully replicate the client experience in the purely virtual model remains uniquely difficult. Conversely, in the field of health and wellness coaching, the professional’s skills and experience are wholly transferable into the online realm. With ubiquitous video platforms facilitating full communication, both verbal and nonverbal, there is essentially no deterioration of the client experience. Moreover, research is telling us that telemedicine and online coaching have real benefits. A great opportunity therefore exists for health and wellness coaches who are ready to embrace the online/virtual environment.

Research Indicates Online Success

Understanding the rise of telemedicine can help health coaches to shape their skills in ways that foster current and future success. Evidence that telemedicine can be effective in delivering home-based interventions has been steadily growing. In just one example, activity-based training for survivors of stroke proved to be as helpful when delivered via telemedicine as when offered through in-clinic programs (Cramer et al. 2019). Moreover, a recent article in JAMA Neurology suggested that accelerated delivery of remote care for people with chronic conditions was a silver lining of the COVID-19 crisis (Bloem, Dorsey & Okun 2020).

With the medical field moving more to using online services for consultation and care, we are likely to see adoption of the virtual domain as a viable, even preferred, path to other aspects of health and wellness, as well. Health coaching is ripe for this. Plus, we already know from the nonvirtual world that health coaching can partner effectively with medicine. Here are two examples of that:

  • A study reported in The Journal of Clinical Hyper-tension used a multicomponent intervention, including phone-delivered health coaching, to help patients with hypertension adhere better to their medication. The researchers determined that this was a clinically applicable way to boost adherence, thereby reducing systolic and diastolic blood pressure levels (Wu et al. 2018).
  • Similarly, a randomized controlled trial in the Annals of Family Medicine showed that patients with COPD who received 9 months of health coaching (through in-person and phone contact) reported greater improvements in taking their inhaled medications. Study authors noted that this approach may provide a scalable model that could improve care for people living with COPD (Willard-Grace et al. 2020).

See also: Starting A Health Coaching Business

Relevance to Online Health Coaches

Why are findings like these important to health coaches seeking success online?

First, we have the serendipitous publication of highly regarded studies extolling the quantifiable benefits of health coaching on chronic, costly and deadly diseases. How deadly and costly? In the U.S., the estimated direct and indirect costs of hypertension for 2012–2013 were $51.2 billion, and they may increase to $200 billion by 2030 (Kirkland et al. 2018). COPD is predicted to be the third-leading cause of death by 2020. Direct healthcare expenditures for this chronic disease account for more than half ($30 billion) of the national projected economic cost for COPD (Patel et al. 2018).

Second, the virtual realm has always offered health and wellness coaches freedom from geographic limitations and relief from the costly overhead of brick-and-mortar business. Now, it also offers a practical and safe solution to meeting clients in a time of pandemic.

Taking Coaching Into the Future

Health coach

Experienced experts highlight the coaching competencies outlined in what many consider the tipping-point research report on this topic.

Being aware of the leap forward in telemedicine services and of the published evidence of health coaching’s effectiveness allows qualified health coaches to shape their skills to where the online opportunity is going to be, not where it has been. We asked two experts for their advice on how to do that. Both are highly experienced, exceptional health and wellness coaches in many domains, including online/virtual.

Have a Mantra, Have a Plan

Laura Matteliano-Madu, MA, NBC-HWC, is a senior health coach with Better Therapeutics, headquartered in San Francisco. The company develops digital therapies for treating serious cardiovascular and metabolic diseases by helping people change the behaviors that are the root causes of disease. Matteliano-Madu shared two key tips she uses as a health coach:

Have a mantra. By having a mantra, she says, “I alleviate worry over my own performance as a coach—for example, whether I’m asking the ‘best’ question or having ‘great reflections.’ Worrying is natural because we care!” Her own mantra is Every person wants to be heard, treated with respect, and their experience honored.

“Having a mantra has really helped me to ground myself in the bigger purpose of coaching and focus on the therapeutic alliance, which is the most important component of coaching,” says Matteliano-Madu. “Otherwise, it doesn’t matter how great my questions or reflections are—if the person doesn’t feel listened to or respected, they aren’t going to hear my questions anyways.”

Have a plan. “I know this may be a bit provocative to say in a field where the client is in the driver’s seat and we are attending to their agenda,” Matteliano-Madu says. “While that’s true, if the metaphor of the client being in the driver’s seat and the coach being the co-pilot is played out, then in certain circumstances the coach will tell the driver, ‘Hey, there’s a speed trap coming up so you might want to slow down’ or ‘The right turn coming up is hidden by trees, so it will be easy to miss.’ Having a plan simply means acting in the best interest of the client.”

See also: The State of Health and Wellness Coaching

Set a Place of Grace

Michael Scholtz, MA, PCC, NBC-HWC, owns Vistas Life Coaching (vistaslifecoaching.com) and is a faculty member with Wellcoaches® (wellcoachesschool.com). Scholtz has more than 30 years’ experience in the healthcare field, including 10 years at the Duke University Diet and Fitness Center. As a successful telephonic health and wellness coach, he developed a nuanced skillset for developing a trusted partnership with a client. (Telephonic coaching remains the most common coaching format, even with the rise of online video coaching.)

Scholtz emphasizes the need to create “a growth-promoting relationship that invites the client into a space where they can thrive.” He approaches his coaching with “a model of intention, attention and attitude. These are not steps; they work simultaneously in a mindful way. By paying attention with intention, I come into a place of awareness, almost like I am watching myself do it. My attitude is curiosity, nonjudgment and grace, [and this allows me to] create a space of trust. When I set a place of grace, my voice is warmer, and my tone and cadence convey and signal to my client that trust exists.”

Accept and Respect the Client

In Motivational Interviewing: Helping People Change, authors William Miller and Stephen Rollnick emphasize that conveying acceptance and respect is critical when working with clients (Miller & Rollnick 2013). Both Matteliano-Madu and Scholtz place value on establishing trust and relationship with their client. In both cases, they do this by conveying acceptance and respect for the person they are coaching. It’s really no surprise that these experienced experts highlight the coaching competencies outlined in what many consider the tipping-point research report on this topic. In 2013, Wolever and colleagues published a systematic review of the health and wellness coaching literature. In defining an evidence-based approach to health coaching, they identified and operationalized competencies such as encouraging self-discovery and supporting accountability.

Two years later, a study in the Journal of Diabetes Nursing concluded that the coach’s nonjudgmental stance and empowerment of the client may have assisted participants in moving toward increasing responsibility and power in relation to health (McGloin et al. 2015). Telephone coaching emerged as a cost-effective way to assist with behavior change in people with type 2 diabetes.

A Genuine Opportunity

Health coaching online

Leverage the power of new health coach certifications to transform disaster into opportunity.

Last spring, the COVID-19 pandemic shut down all but essential businesses in the U.S. Jody Sorey, co-owner of Anytime Fitness in Kannapolis, North Carolina, and an ACE-certified health coach and personal trainer, leveraged the power of her new health coach certification to transform disaster into opportunity.

“I was newly certified as a health coach and living through the COVID-19 shutdown of the gym I co-own. I found myself coaching telephonically and via FaceTime, neither of which I ever considered doing before we had to shut down. It has been amazing! Health coaching engages and motivates people in a way that I have not been able to do as a CPT in the gym. Members want and need to be heard, and most have decided to continue on with me for either another 21 days or 3 months. Being compassionate, empathetic and present for my clients, partnering with them as they get to a healthier place, has made all the difference.”

As you prepare yourself to serve people through the power of health coaching, resist the urge to invest money, time and effort in costly platforms and programs and, instead, hone your skills in the art of health coaching. The brush is not what made Rembrandt, nor the golf club Tiger, nor the shoes Michael; it was skill and commitment.

See also: Health and Wellness Coaching: The New Fitness Career?


Visit these sites for information on training to become a health coach:

  • American Council on Exercise: acefitness.org/fitness-certifications/health-coach-certification/default.aspx
  • Dr. Sears Wellness Institute: drsearswellnessinstitute.org/
  • Duke Integrated Medicine: dukeintegrativemedicine.org/integrative-health-coach-training/integrative-health-coaching/
  • Functional Medicine Coaching Academy: functionalmedicinecoaching.org
  • Point Loma Nazarene University: pointloma.edu/graduate-studies/programs/kinesiology-ms-integrative-wellness
  • Wellcoaches®: wellcoachesschool.com/national-certification


Bloem, B.R., Dorsey, E.R., & Okun, M.S. 2020. The coronavirus disease 2019 crisis as catalyst for telemedicine for chronic neurological disorders. JAMA Neurology, doi:10.1001/jamaneurol.2020.1452.

Cramer, S.C., et al. 2019. Efficacy of home-based telerehabilitation vs in-clinic therapy for adults after stroke: A randomized clinical trial. JAMA Neurology, 76 (9), 1079–87.

Kirkland, E.B., et al. 2018. Trends in healthcare expenditures among US adults with hypertension: National estimates, 2003–2014. Journal of the American Heart Association, 7 (11).

McGloin, H., et al. 2015. Exploring the potential of telephone health and wellness coaching intervention for supporting behaviour change in adults with diabetes. Journal of Diabetes Nursing, 19 (10), 394–400.

Miller, W.R., & Rollnick, S. 2013. Motivational Interviewing: Helping People Change. NY: Guilford Press.

Patel, J.G., et al. 2018. COPD affects worker productivity and health care costs. International Journal of Chronic Obstructive Pulmonary Disease, 13, 2301–11.

Willard-Grace, R., et al. 2020. Lay health coaching to increase appropriate inhaler use in COPD: A randomized controlled trial. Annals of Family Medicine, 18 (1), 5–14.

Wolever, R.Q., et al. 2013. A systematic review of the literature on health and wellness coaching: Defining a key behavioral intervention in healthcare. Global Advances in Health and Medicine, 2 (4), 38–57.

Wu, J-R., et al. 2018. The effect of a practice-based multicomponent intervention that includes health coaching on medication adherence and blood pressure control in rural primary care. The Journal of Clinical Hypertension, 20 (4), 757–64.


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