The State of Health and Wellness Coaching
Explore the game-changing work of a health and wellness coach, and learn how to become one.
In 2017, the Global Wellness Institute launched an initiative called the Wellness Moonshot, seeking a collaborative effort between the wellness and healthcare communities to rid the world of chronic, preventable disease (GWI 2017). According to the World Health Organization, cardiovascular disease, chronic respiratory disease, diabetes and cancer—all of them noncommunicable diseases—account for more than two-thirds of premature deaths worldwide (WHO 2018). These alarming statistics point to a desperate need to identify innovative interventions that can reach broad populations in a cost-effective manner, while empowering people to take an active role in their health and wellness journey.
On the positive side, there is hope for a solution. “We know that the six pillars of lifestyle medicine—physical activity, diet, sleep and stress management, smoking cessation, avoidance of other risky substance use, and building supportive social relationships—can play a major role in the prevention, management and even reversal of chronic diseases,” says Beth Frates, MD, director of medical student education for the Institute of Lifestyle Medicine. “The question is, how do we encourage individuals to adopt and sustain these behaviors?”
In the fitness industry, we have made ongoing efforts to address the deep divide between intentions and actions. In striving to be motivational forces for change, we’ve worked passionately to create fun, accessible, inclusive programs. Yet, there may be a more effective approach: health and wellness coaching. Health coaching is rapidly emerging as a game-changing intervention that addresses the important behavioral component of health and fitness, positioning people to become the powerful drivers of change in their own lives.
You can practice health coaching in locations ranging from clinical settings to the community at large. It is a career path worth investigating if you want to expand your reach and strengthen your impact. Learn what health coaching is, how it’s poised to grow as a profession and how to envision a career path that embraces this effective approach to empowering people.
What Is Health Coaching?
The International Consortium for Health & Wellness Coaching has taken the lead in defining the role and scope of health coaching in an effort to create a strong, credible foundation for this emerging field. According to the ICHWC, “Health and wellness coaches partner with clients seeking self-directed, lasting changes, aligned with their values, which promote health and wellness, and thereby, enhance well-being” (ICHWC 2019). Health coaching involves a way of communicating with people—based on the art and science of behavior change—that helps them achieve their self-determined goals.
Leigh-Ann Webster, NBC-HWC (National Board Certified Health & Wellness Coach), executive director of the ICHWC, says the client-centered, client-driven nature of health coaching is the transformative piece of the process that makes it so effective. Instead of coming from an “expert” perspective, health coaches embrace a “guiding” style, effectively partnering with clients in the change journey. Goal setting, action planning and accountability are addressed in a collaborative partnership with the client in the driver’s seat. The client envisions both the destination as well as the steps he or she is willing to take, in the moment, to get there, with personal values fueling the journey.
A Perfect Fit for Fitness Pros
Although heath coaching and personal training are distinctly different disciplines, there is a natural alignment between the two professions, including a valuable opportunity for interdisciplinary collaboration, explains Jessica Matthews, DBH, MS, NBC-HWC, assistant professor and program director of the Master of Kinesiology in Integrative Wellness Program at Point Loma Nazarene University in San Diego and senior adviser for the American Council on Exercise. While many individuals will make a definitive transition into the role of certified health coach to reach and serve clients in a different way, other fitness professionals will provide great benefit by embracing a “coach” approach in their current line of work. “Adopting a ÔÇÿcoach’ approach by learning and applying the transformational science and skills of behavior change elevates the work we do as fitness professionals and, in turn, enables us to best support and empower our clients in the process of enacting and sustaining lifestyle change,” says Matthews.
It is a natural fit for passionate fitness professionals to cultivate the powerful “being” skills of health coaching, such as demonstrating warmth, empathy, authenticity and unconditional positive regard for their clients. These qualities, known as “coaching presence,” have been shown to promote and support lasting change (Moore, Jackson & Tschannen-Moran 2016).
Either path will require a substantive shift in perspective—stepping back from our “expert” persona is not always easy. However, Erin Nitschke, EdD, a personal trainer in Sheridan, Wyoming, who added a health coaching certification to her credentials, shares why it is worth the effort: “Becoming an ACE-certified health coach has allowed me to understand my clients on a deeper cognitive and behavioral level. As a result, facilitating behavior change as a personal trainer is a more intuitive process that has resulted in more fruitful outcomes.”
Directive vs. Coach Approach: Spot the Difference
Shifting from a traditional “directive” approach to a “coach” approach has proved to be effective in helping people adopt and sustain health-related behaviors.
TRADITIONAL DIRECTIVE APPROACH
- uses directive style
- is expert-led
- gives advice
- motivates clients
- conducts fitness assessments
- is goal-oriented
- educates clients
- focuses on data-driven rewards
- uses guiding style
- is client-driven
- asks permission before offering information
- strengthens each client’s own motivation
- facilitates guided inquiries
- is process-oriented
- empowers clients
See also: Health Coaching vs. Life Coaching
Educating Health Coaches
Though health coaching is becoming more mainstream in both the healthcare and wellness industries, it is still in the formative stages. Developing national standards, best practices and educational benchmarks will strengthen its professional standing and protect the public by identifying reasonable standards and expectations regarding training, certification and performance in the health coaching field (Jordan et al. 2015).
Here are some of the most prominent training and certification programs available to fitness and wellness professionals:
- The ICHWC has partnered with the National Board of Medical Examiners to develop a “gold standard” for health and wellness coaching. In 2017, they launched a well-respected national board certification, paving the way for seamless integration of health coaches into the healthcare setting. Currently, 1,882 NBC-HWC professionals across the country have met the rigorous standards of training and practice to earn this prestigious designation.
- ACE recently updated its Health Coach certification study program, which prepares individuals for a successful career as a health coach. At present, the ACE credential is the only health coach certification accredited by the National Commission for Certifying Agencies. Obtaining this certification will position you to work as a qualified professional on the healthcare continuum alongside other NCCA-certified allied health professionals, such as registered dietitians, occupational therapists and nurse practitioners.
- In July 2018, the American College of Sports Medicine and Wellcoaches® expanded their existing partnership to deliver two cobranded programs for fitness and wellness pros pursuing an interest in health coaching: a health and wellness coach training and education program and a behavior change coaching skills program.
(See “Resources,” below, to find out more about all these educational opportunities.)
The demand for qualified health coaches is increasing as people become more aware that lifestyle medicine can not only address chronic health conditions but also increase longevity, enhance well-being and improve quality of life as we age. Coaching opportunities are multiplying in both healthcare settings and corporate wellness programs. Many individuals want to address their health in a holistic fashion, and the new, less-intimidating approach to employee wellness involves engaging health coaches as a way to lower insurance-related costs while increasing productivity and employee satisfaction.
Lee Jordan, MS, an ACE-certified health coach and behavior change specialist in Jacksonville Beach, Florida, says, “Offering health coaching that focuses on sustainable change and enhanced well-being through the use of evidence-based tools opened the door [for me to provide] health coaching for a company of over 800 employees.”
A Bright Future
Matthews signals unlimited opportunities for health coaches with this bold prediction: “Ultimately, it is health coaches who will be integral members of the healthcare teams of the future.” Particularly, as health care moves toward more value-based care, demonstration of effective interventions that produce improved patient health outcomes will fuel the need for qualified health coaches. As mounting evidence supports the efficacy of health coaching, patients are also expressing greater satisfaction in their healthcare experience as a result of the coaching process (Thom et al. 2014).
Matthews envisions a day when certified health coaches are working as transformational team members on every fitness staff. “Employing qualified health coaches will enable clubs to expand the services offered to effectively reach more people at various stages of behavior change, including those who may not be drawn to the ÔÇÿtraditional’ health club environment.”
Frank Ardito, MS, EdD, NBC-HWC, professor of health and wellness promotion at College of Lake County in Grayslake, Illinois, is emphatic that the power of coaching should be available to everyone. Technology is helping to make that happen. Innovative healthcare and wellness technology companies are creating digital behavior change programs that skilled health coaches are delivering by phone, with promising results. With this breakthrough, we will be able to reach more and more people where they are (literally), with a scalable, cost-effective intervention. If we’re going to improve the global state of health, that is important, given the scope and magnitude of the task.
There was a time when putting a person on the moon seemed like mission impossible, and then we achieved that ambitious dream. The vision of a world free of preventable disease and a global population that is healthy and thriving has always felt light years away, too. But the growth of health coaching and the throng of passionate professionals ready to take on the transformational coaching role means that the Wellness Moonshot, launched 2 years ago, just got closer to becoming a reality.
American College of Sports Medicine. ACSM recently partnered with Wellcoaches® to provide two new training programs related to health coaching. Visit acsm.org.
American Council on Exercise. ACE’s Health Coach certification is the only one accredited by the National Commission for Certifying Agencies. The new ACE textbook (see “Books”) is a comprehensive resource for health coaches. Learn more at ACEfitness.org.
Dr. Sears Wellness Institute. This organization offers a health coach certification program that is approved by the International Consortium for Health & Wellness Coaching. Go to drsearswellnessinstitute.org to find out more.
International Consortium for Health & Wellness Coaching. In 2017, the ICHWC partnered with the Board of Medical Examiners to launch the first National Board Certified Health & Wellness Coach certification. Learn more (and see a list of approved training
programs) at ichwc.org.
Wellcoaches. Wellcoaches has been a leader in the coaching field since 2002. Several of the company’s coaching programs are approved as continuing education by ICHWC, and Wellcoaches’ founder, Margaret Moore, played a major role in developing the NBC-HWC certification. Wellcoaches is currently partnering with ACSM to provide health coach training. See wellcoaches.com.
American Council on Exercise. 2019. The Professional’s Guide to Health and Wellness Coaching.
Arloski, M. 2014. Wellness Coaching for Lasting Lifestyle Change. Duluth, MN: Whole Person Associates Inc.
Moore, M., Jackson, E., & Tschannen-Moran, B. 2016. Coaching Psychology Manual (2nd ed.) Lippincott Williams & Wilkins.
GWI (Global Wellness Institute). 2017. Global Wellness Institute launches Wellness Moonshot: Destination—A world free of preventable disease. Accessed Mar. 4 2018: globalwellnessinstitute.org/wellness-moonshot/global-wellness-institute-launches-wellness-moonshot-destination/.
International Consortium for Health & Wellness Coaching (ICHWC). 2019. Welcome. Accessed Mar. 4, 2019: ichwc.org.
Jordan, M., et al. 2015. National training and education standards for health and wellness coaching: The path to national certification. Global Advances in Health and Medicine, 4 (3), 46–56.
Moore, M., Jackson, E., & Tschannen-Moran, B. 2016. Coaching Psychology Manual (2nd ed.). Philadelphia: Wolters Kluwer.
Thom, D. H., et al. 2014. Does health coaching change patientsÔÇÖ trust in their primary care provider? Patient Education and Counseling, 96 (1), 135–38.
WHO (World Health Organization). 2018. World Health Statistics 2018. Accessed Mar. 4, 2019: apps.who.int/iris/bitstream/handle/10665/272596/9789241565585-eng.pdf?ua=1.
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