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Delivering The Behavioral Side Of Lifestyle Medicine Through Wellness Coaching

If we could give every individual the right amount of nourishment and exercise, not too little and not too much, we would have found the safest way to health.” –Hippocrates 420 B.C – 370 B.C.

Healthcare providers have been prescribing lifestyle improvement for thousands of years. The evidence has been built from the observations of Hippocrates all the way to the neuroscience of today. We know, from mountainous reams of data, that lifestyle affects the course of an illness or health challenge. The challenge for the healthcare provider of today is to see the “lifestyle prescription” translated into lasting lifestyle change. Many well-intentioned healthcare professionals have attempted to educate and admonish their patients into losing weight, ceasing the use of tobacco, managing their stress better, getting more sleep, being medically compliant/adherent, etc. Seeing actual success in behavioral change happening far too seldom, many have abandoned such efforts and just reach for the pharmaceutical prescription pad.

In recent years, however, there has been an exciting movement in the field of medicine that looks at how to use “lifestyle interventions” as first-line treatment.

“Recent clinical research provides a strong evidential basis for the preferential use of lifestyle interventions as first-line therapy. This research is moving lifestyle from prevention only to include treatment–from an intervention used to prevent disease to an intervention used to treat disease.” –The American College Of Lifestyle Medicine

The Lifestyle Medicine Movement has done much to establish an evidence base and it continues to examine research that distinguishes what appears to work for lifestyle improvement. Much of its attention has focused on nutrition, but more and more the field is realizing the importance of health and lifestyle behavior.

Wellness and health coaching has become the delivery mechanism for wellness programs, and its potential for the same vital role is being seen in Lifestyle Medicine. The reality is that the vast majority of clients that most wellness/health coaches see are already health-challenged in some way. They may already have a chronic lifestyle-related illness, or multiple risk factors that set them up for needing serious preventative help. Wellness/health coaches that work for disease management companies, insurance companies and many corporate wellness programs are already working with caseloads populated primarily by lifestyle medicine patients.

At past Lifestyle Medicine conferences, I’ve presented on “Wellness Coaching And Lifestyle Medicine: Covering The Whole Continuum”. and “Delivering The Behavioral Side Of Lifestyle Medicine: Wellness Coaching Skills & Concepts”. Together with other presenters on wellness coaching we have experienced a strong positive response from an audience made up primarily of physicians.

TP-WPOne of the key concepts of my talks that was especially well received was the idea of how the Treatment Plan needs to be integrated with the Wellness Plan.

Co-creating a Wellness Plan with our clients is one of the primary tasks for the wellness coach. Together we work with a structure that insures the client’s plan for lifestyle improvement will lead to success. A key part of that Wellness Plan will always be the “Lifestyle Prescription” that the client’s treatment team is recommending. What is key is that the Wellness Plan supports The Treatment Plan.

I will be talking further about this concept in my forthcoming book on the more advanced skills and methods of wellness coaching, but here is a sketch of the two plans and the way they overlap.

Treatment Plan

  • Diagnostically Derived
  • Treatment Provider Devised
  • Prescriptive
  • Responsibility on Provider to administer, responsibility on client to follow
  • Usually does not accommodate patient’s circumstances or abilities, may accommodate patient’s capacities.
  • Problem solving, solution finding oriented
  • Purposed for resolution of illness and disease, reduction of symptoms, healing
  • “Lifestyle Prescription” focuses on recommended behavioral changes leading to Lifestyle Medicine outcomes
  • Dependent greatly upon medical compliance/adherence

Wellness Plan

  • Derived through exploration and self-assessment combined with treatment recommendations.
  • Co-created by “client” and “coach”
  • Non-prescriptive – client centered
  • Responsibility on client to follow with coach’s accountability and support
  • Not only accommodates, but is derived from client’s circumstances, abilities and capacities.
  • Designed to eliminate barriers and develop additional support
  • Possibility, growth and self-actualization oriented.
  • Purposed for behavioral change and lifestyle improvement
  • Includes assisting client with medical compliance/adherence

Overlap Of Treatment And Wellness Plans

  • The Wellness Plan (WP) supports the Treatment Plan (TP)
  • TP identifies critical areas for recommended lifestyle improvement
  • Through “client-centered communication” WP aligns with the goals of the TP
  • Client engages, with coaching support, in lifestyle improvement behaviors that positively affect treatment outcomes
  • WP helps client with organization, accountability, etc., improving attendance for medical appointments and management of medications, self-testing/self-care
  • WP helps client make best us of medical appointments (self-advocacy)
  • WP helps client report more accurately to treatment team about changes in lifestyle behavior (providing more data for treatment decisions)

When clients are operating on a Wellness Plan that they have truly helped co-create with their own buy-in, the opportunity for weaving in Areas of Focus, Goals and Action Steps that support what their treatment team wants to see becomes obvious. Clients then have the structure and support they need to carry out the goals of the Lifestyle Prescription.

Physicians and other healthcare providers can already start making use of wellness and health coaching as a delivery mechanism for the behavioral change they would love to see. Many of their patients already have wellness coaching as an employee benefit. Their company’s wellness program may already provide it, or they may contract with a wellness coaching provider company. More and more employees have wellness/health coaching available through their insurance provider.

Wise medical organizations and practices are hiring wellness coaches to become part of their staff or are outsourcing to them. Healthcare providers are sometime “wearing two hats” and combining their treatment work with coaching. Others are becoming more “coach-like” in their interactions and are then handing the patient off to the wellness coach for the longer process of lifestyle improvement.

The Real Balance Wellness & Health Coach Certification curriculum (http://www.realbalance.com) has included how coaches fit into the Lifestyle Medicine approach for over a decade. Our students come to us as a resource for learning how they can help deliver the lifestyle improvement that their Lifestyle Medicine clients seek.

Wellness Coaching to support Lifestyle Medicine is not just an idea whose time has come, it has already arrived!

Originally published on Real Balance blog. Reprinted with permission.


Dr. Michael Arloski is the CEO and Founder of Real Balance Global Wellness Services, Inc. (www.realbalance.com). Real Balance has trained thousands of wellness coaches worldwide. Dr. Arloski is a board member of The National Wellness Institute, and a founding member of the executive team of The National Consortium For Credentialing Health and Wellness Coaches. He is author of the leading book in the field of wellness coaching: Wellness Coaching For Lasting Lifestyle Change, 2nd Ed.

Senior woman with help of physiotherapist

The Space Between Fitness and Medicine: Where “the Good You Do For Others” Brings the Reward you Deserve | Part 2

In our first part of this three-part discussion, in addressing the topic of financial reward, I asked you to ponder the value of restoration.  What, I prompted you to consider, is the value of helping someone who has moved along the dis-ease continuum, gradually leaving health in the proverbial rear-view-mirror back toward divine health?

It isn’t an easy question to answer.  We can tackle it by considering all of the dollars those who incur inflammatory issues, chronic challenges, and cellular degradation will have to invest in maintaining function and comfort.  We might also attempt to place a monetary value upon lost quality of life.  We might even consider the simple question, “what would someone pay to rediscover health” considering their fear and apprehension of the alternative, and from that extrapolate the value.

If you are willing to believe that personal trainers with advanced education and the development of a complementary skill set can have immeasurable impact upon “the unwell population,” one perspective becomes clear.

The trainer versed in restoring health commands a far greater value than the personal training mainstream.

That’s important.

STEPPING UP A LEVEL

As in any field, a specialist with enhanced value will serve his or her marketplace best by finding a direct line of contact with those in need of their specialty.

In the sentence above, “need” is the key word.

While it’s oft been said that personal trainers are a luxury or a privilege, with an appropriate adjustment in perspective, those who have slipped into the largest segment of our adult population, the unwell market, might consider any therapeutic resource, if wellness is a goal, a “need.”

Now that I’ve mentioned it a few times, I’ll provide a general description of the market I’m referring to as “unwell.” Then I’ll help you see the opportunity to step up, to meet this population in an arena where they “need” you.  I’, to command a value in line with a well-justified fee, and . . . here’s the biggie . . . to provide them the service they will truly benefit from.

WHO ARE THE UNWELL?

Let’s be really clear here.  I’m not suggesting the opportunity lies in training “sick people.”  I’m suggesting the largest, most opportune market share is made up of many American adults between the ages of 35 and 65.  They aren’t “sick” in a clinical sense.  They work.  They drive their kids to school.   They shop in the malls and grocery stores.  They eat in the neighborhood restaurants.  They pump gas in the same gas stations you do and they frequent Starbuck’s, Chipotle, and the local pizza place.

They don’t have need for hospitalization or chronic care . . . but they’ve slipped, moved along what I’m calling the dis-ease continuum.  They’ve begun a process of maladaptation, a movement away from healthful homeostasis, and while many haven’t yet been diagnosed (many have), their bodies have become imbalanced.  Whether it’s a hormonal imbalance, thyroid irregularity, blood sugar elevation, hypertensive condition, hypercholesterolemia, or chronic inflammation of one or several bodily systems, they have moved into a place where innate homeostasis is no longer their “norm.”

Not sick, at least not clinically, but not well.  What’s alarming is, I’m describing near 65% of the adult population over the age of 45.  Yes, the market is vast.

If the unwell were being cured of their ailments or remedied by the conventions of medicine, I wouldn’t see the “need” as being this opportune.  All I need to share is a single statement to help you see why there’s a desperate need for a new type of health practitioner, one who masters the exercise and eating intervention.  Here’s that statement.

In a society where chronic disease is most treated with pharmaceutical intervention, there isn’t a single medication that will cure any chronic disease.

Read that again.  While there exists a wild array of meds to manage conditions and change biomarkers, there isn’t one that will cure the plight of the unwell.

Conversely, there is an extensive body of evidence to demonstrate the power we have over shifts in blood sugar, blood pressure, and hormonal disruption when we strategically employ a variety of exercise modalities and guidance in the realm of supportive nutrition.

If the demand is great, the “need” remains unfulfilled, and the greatest potential lies in the skill set we, as fitness professionals, have access to . . . our value escalates above virtually any conventional yet impotent “cures.”

THE LEVEL 2 TRAINER AS A CORRECTIVE HEALTH SPECIALIST

If we consider a “Level 1” trainer someone who is qualified, credentialed, and able to provide safe and effective exercise prescription to a healthy population, let’s consider a “Level 2” someone who can effectively target this Unwell niche and deliver improvements in biomarkers, condition, and quality of life.

The Level 2 trainer can identify his or her “ideal client avatar.”  Moving forward I’ll refer to the Ideal Client Avatar as an “ICA.”

In establishing a presence and a track record with the Unwell, the enhanced personal trainer (enhanced with a higher level of education than the standard and an ability to implement positive change in the unwell) can justifiably command fees in line with other health practitioners, medical practitioners, and specialists.

In setting a fee structure, there should be a professional standard, a relationship-based fee that is consistent, one that exceeds “an industry standard.”  Remember, if you deliver above the standard, you deserve reward above the usual.

HOW DO YOU STEP UP AND CREATE AN AUDIENCE?

Marketing, for the Level 2 trainer targeting this niche is not as haphazard as “pass out cards, talk it up in the gym, and talk to everyone about what you do.”

In order to establish your position, you’ll want to have four.  Four strong successes.  Four living examples of the value you deliver, and finding those four requires a bit of front-end work.  Once you have your four you have a sound foundation upon which to build.  The question, therefore, that merits consideration is . . . how do you “break in.”  Where do your “four” come from.

I’ll make it step by step.

Note that everything that follows is based upon the assumption that you have received extraordinary training, that you’ve established a level of education complementary to your base credential, and that you’re positioned to initiate and maintain a practice with a revised focus on empowering clients to reverse the imbalances inherent in chronic disease.  This is a prerequisite of paramount importance and although I won’t invest any more time in addressing it here, don’t allow my failure to repeat and reiterate this point as an indication its any less than vital.

STEP ONE: Define your Ideal Client Avatar.  If you have a personal connection to a given condition or population (i.e. a relative with diabetes, a personal history with thyroid issues, etc.) and you have a passion for helping others who you feel are kindred spirits, that’s where you should best direct your marketing.  You can’t “market well” until you define your ICA.  This is a “must” in turning your ambition into financial security (and it’s the step most who seek to elevate their careers miss or ignore).  Your ICA may not be based on your personal experience, but rather on where you see the greatest opportunity or where you have the greatest inroads.  Devote time to getting clear on your ICA.  It’s the true key to successfully “Stepping up to Level 2.”

STEP TWO: Determine your fee structure, your promise, and your offer.  You don’t want to approach each prospective client with an open negotiation, nor do you want to exhibit uncertainty.  As any business owner, design your foundation.  What, precisely, are you promising each client?  How are you compensated for that?  What, precisely, is the person considering retaining you, supposed to do now, as a point of commitment.

STEP THREE: Choose a location, an affiliation, a network, and a social media platform where you can “meet” your ICA and spread the word.  This is far simpler than it sounds.  In outlining your ICA, simply as the question, “where do I find him (her)?”  This is marketing at its core.  Don’t think “medical.”  Think real life.  Where can you do a talk, a workshop, a presentation, knowing your ICA sits in the audience.  I realize this is the intimidating step . . . but it’s also the one that brings  you to human connection, and ultimately to commitment and money exchange.  Perhaps in the future I’ll share an entire article devoted to “finding your ICA in the real world.”   For now, accept that you have the answer to the question, you have the ability, and all it takes is a bit of courage and determination.

STEP FOUR: Create your Four.  Do your thing.  Work your magic.  Use your skill set.   Bring about change.  Documentable change.  Once you have your first four successes, you begin to build what I call an Arsenal of Evidence, and from that point on, the marketing challenge is replaced by magnetic appeal.

STEP FIVE: Build your business confidently, massively, professionally, and without limit.

This 3-part piece is intended, not to be a complete primer for business building, but to give you a sense of both the opportunity and your ability.

In creating a distinction between the progressive trainer willing to study, learn, and elevate, I’ve used the term “Level 2,” not to suggest any elite status, but to demonstrate a clear escalation in earning potential.  Before I conclude this second part of the piece, I’ll outline a few elements of what I’m calling The Level 2 Trainer.

FIVE DISTINCTIVE ELEMENTS OF THE LEVEL 2 TRAINER

  1. You are a specialist among a given population
  2. You command fees above the norm
  3. You have a consistent promise and offer
  4. You have a track record and consistently grow a marketing / referral base
  5. You understand and recognize the value in the potential you have as a guide to empower others to move away from chronic disease and back toward divine health

Is there a level above the Level 2 trainer?  Yes.  And the sky’s the limit.  Literally.  More to come in Part 3!

This is 3 part series. Read part 1 here, and part 3 here


Phil Kaplan has been a fitness leader and Personal Trainer for over 30 years having traveled the world sharing strategies for human betterment.  He has pioneered exercise and eating interventions documented as having consistent and massive impact in battling chronic disease.  His dual passion combines helping those who desire betterment and helping health professionals discover their potential.  Email him at phil@philkaplan.com

health-coaching-wordglobe

You Need a Coach

You Need a Coach.

This is a subject I am REALLY passionate about.

As most of my readers know, I’m writing to you from the perspective of a weight loss, nutrition, and fitness coach.​  

I own my own facility coaching others like you. 

And I have a coach. 

You need a coach.

You see, despite being a highly qualified coach myself across multiple areas, I hold a deep belief that everyone needs a coach in their life.

I have a business coach that I speak to 2 times a month, and it’s been a powerful investment I’ve made in myself.  I love the personal growth that comes from it.  There is tremendous value in being coached.  She tells me yes when I say no and vice versa. 

So what area of life should you look for a coach in?

Anywhere you are struggling, really.  Struggling with weight loss?  You need a coach. Struggling to make major decisions in life?  You need a coach.  Struggling to transition careers?  Hire a coach. Looking to improve athletic performance?  Hire a coach.

Think about it…there are not many people (if any) who reach high levels of success in life without a coach.  It’s too hard to go it alone, to know what to do, to see things in life objectively.

​The number one reason I hear from people for not hiring a coach is cost.

How many times have we tried to “do it on our own” and failed?​ Here’s the thing…we can’t afford not to.  We need accountability, support, guidance, advice, etc.

I’ve been there and fallen off the wagon.  I’ve given up and stopped believing in myself. 

But, the difference is that when you’ve got someone to bring you back to reality and pick you back up, life just gets easier and less lonely.  We all need an objective eye on our lives, someone who sees things entirely from an outside perspective.

So, if you have a goal that you want to achieve, stick to for the long run, and you believe investing in yourself is a top priority, hire a coach.  Go on that journey. Change your life, in whatever aspect you seek change.  

You’ll gain more than you ever expected.

Originally published on MoveWell Fitness. Reprinted with permission from Maurice Williams


Maurice D. Williams is a personal trainer and owner of Move Well Fitness in Bethesda, MD.

senior man having a massage in a spa center

What is an Allied Healthcare Professional?

Whether it’s exercise, nutrition, or massage therapy you are seeking, finding the right person to do the job can be incredibly challenging. The area known as allied healthcare professionals can be a challenging one to navigate.

The professions that require a state or national licensures, such as physicians, nurses, or physical therapists, help to provide checks and balances on who should and should not be providing a service to any individual. However, there are many professions within our healthcare community that are poorly understood and many times misrepresented by individuals with minimal certifications or credentials.

Allied healthcare professionals are thought to make up roughly 60% of the healthcare workforce by providing a range of diagnstic, technical, therapeutic and direct patient care and support services that are critical to the other health professionals they work with and the patients they serve. All categories of allied healthcare require either registration by law to practice or post secondary degree or higher education. Click here for more information about allied healthcare professions.

Is it time to re-assess who you trust with your healthcare needs?

It is essential to know the credentials and education of anyone you are trusting for information or advice whether it be an accountant, lawyer, dentist or teacher. Healthcare is no different, but there are many misunderstood healthcare professions.

Distinct from nursing, dentistry or medicine, allied healthcare professionals make up approximately 60% of the health workforce. Examples include athletic trainer, exercise physiologist, paramedic, and massage therapist. Many times, these professionals are those you are referred to by your physicians to help manage your healthcare needs daily, weekly, and monthly. National and state licensures ensure that certain healthcare professionals uphold the standards and scope of pratice that is pertinent to their level of education.

senior man having a massage in a spa centerMultiple allied professions remain to establish this key aspect of standardized care which simply means that certain professions are more susceptible to individuals claiming a level of expertise or knowledge that can be misleading or confusing to the general population. For example, as a Clinical Exercise Physiologist, I clearly understand the difference between my skillset and that of a personal trainer; however, to the general public, both professions provide guidance with exercise. Due to lack of established licensure exams, it is unclear to many people that some Exercise Physiologists (like myself) have a Master’s Degree, while others may have earned a weekend certification. It is incredibly important for you to understand the roll of any healthcare professional from which you seek treatment and advice as well as their experience and background in relation to your particular healthcare needs. Accessing information about these resources from a knowledgeable professional can help to ensure proper connection to an individual that is appropriately educated to effectively meet your needs.


Jaclyn Chadbourne, MA, CES has worked within the allied health profession as a Clinical Exercise Physiologist for 15 years.  She is currently the Director of Research and Development at Universal Medical Technology, and serves as Adjunct Faculty at University of New England DPT Program

helping climb

Motivation Plus Mobilization: Coaching For Success At Lifestyle Improvement

“I just don’t seem to have the motivation to really make changes.” This is a lament frequent to the ears of health and wellness coaches. Our clients are often puzzled by a lack of success in their efforts to start living a healthy lifestyle, or keep such efforts going. They blame it on either a lack of motivation to get started, or that their motivation fades as old habits reassert their rule.

Coaches help their clients examine and re-examine whatever sources of motivation they have mentioned. They help their clients revisit their desire to change and what drives it. They look at fear-based motivations such as not wanting to have an illness get worse, or not wanting to develop the maladies that have been prevalent in their family. They look at the love-based motivators like caring enough about ones self, wanting to be there for their grandchildren as they grow up, the intrinsic joy of dancing, swimming, tasting delicious and nutritious food, etc.

Perhaps the coach concludes, like their client, that these motivators just ‘aren’t enough’. The next step is to begin a usually fruitless search for additional motivators. Their client runs out of ideas and coaching descends into ‘what about this?’ suggestion after suggestion. What is really going on? What’s a more productive avenue to explore?

Your client may have enough motivation. They may in fact, have listed three, four or more reasons they want to change. They may possess a terrific combination of motivators. Motivation is like the fuel for a vehicle to run on. The problem might not be the fuel, but the lack of an actual vehicle! The vehicle is a methodology, a structure, and a process that facilitates change. To get where they need and want to go, the client needs both a vehicle to carry them and the fuel to put in it.

How do we mobilize motivation? By providing our client with methodology. I’ve always been amazed at how simple successful change can sometimes be when clients have a well-developed way of achieving it.

Coaches often hear their client’s frustration at wanting to improve their lifestyle, but not having much of a history of success at it. If we inquire if they have ever started their change efforts by first taking stock of their health and wellness in a really clear way, we find they rarely have. If we ask if they have ever begun by first developing a thorough plan as to how they will make their changes happen, we often find them admitting that they usually just get their will powered amped up and set some sort of goals. Rarely have they ever carried out their change efforts with the help of an ally who helped them with support and accountability. And, all too seldom have they ever keep track of their efforts at change and actually written it down.

A mentee of mine was recently coaching a middle-aged woman who complained of a lack of motivation holding her back. As we began listening to the recording, the coach helped the client describe at least four strong motivators that had propelled her into action. She realized that when her children were younger playing with them had provided her with more activity and energy. Now her energy was low and she wanted to reclaim that. She also talked about hoping for grandchildren and wanting to be a very active part of their lives. The client was concerned about her advancing age and not wanting to lose the health she had. She didn’t want to become a burden to anyone. She went on to list at least two more motivators.

As the client described her lack of success at change, her conclusion was that she was just lacking motivation. She described coming home from work tired and just fixing a quick (though not necessarily healthy) meal and watching television in the evening. “I just don’t have the motivation I need” the client lamented. She intended to be more active and intended to eat better. All she had for a plan were intentions.

Doing a great job of coaching, my mentee gently confronted his client and recited the substantial list of motivators that she did, in fact, have. He questioned whether it was a ‘lack of motivation’, or something else that was missing.

Clients try to figure out what is keeping them stuck. Unless it’s a matter of identifiable internal or external barriers, clients often say it’s a lack of motivation. They are looking for an explanation and, frankly, they often don’t know what else to call it.

Co-Creating The Coaching Alliance

An often ignored part of coaching is the work it takes to Co-Create The Coaching Alliance. In addition to getting acquainted with our client and hearing their story, an important part of our first session with a client is to convey to the client just how coaching works. Clients are used to meeting with consultants, not coaches. They expect to be able to provide the consultant with lots of great information and hear the expert recommendations. We spoke about this from the coach’s point of view in our blog post, Making and Maintaining The Shift To The Coaching MindsetThe client also needs to make a mindset shift to get oriented to this new way of working with someone.

Coaching is about co-creating agreements. We co-create with our client agreements about how we are going to work together. Some aspects of our working together are negotiable and can involve compromise. However, we are not going to compromise the nature of our coaching relationship. That is, we are not going to agree to just be our client’s educator, and let go of the role of coach.

Part of what an effective coach does is to explain, in a succinct fashion, exactly how coaching works, how it is structured and what the benefits of this structure are. The client-centered nature of coaching is conveyed with real reassurance that the client remains the one in the driver’s seat.

Part of the coach’s job is to facilitate the client’s use of the coaching structure. The coach does this by showing the client how advantageous it can be to operate with a solid plan, to track one’s progress at making changes, etc. The coach provides tools that make these processes easier. Mobile apps for tracking can be recommended and then, importantly, integrated into the coaching accountability.

Mobilizing Motivation

Motivation can be puzzling and elusive, but when it is present a methodology, a structure, is what the client needs in order to mobilize it. By providing our client with the vehicle, we help them get where they want to go.

Word Origin – Coach: In the 15th Century the Hungarian village of KOCS was the birthplace of the true carriage or “coach” as the word evolved in English.

In other words we might define both types of coaches as: A coach takes you from where you are at, to where you want to be!

Originally published on Real Balance blog. Reprinted with permission.


Dr. Michael Arloski is the CEO and Founder of Real Balance Global Wellness Services, Inc. (www.realbalance.com). Real Balance has trained thousands of wellness coaches worldwide. Dr. Arloski is a board member of The National Wellness Institute, and a founding member of the executive team of The National Consortium For Credentialing Health and Wellness Coaches. He is author of the leading book in the field of wellness coaching: Wellness Coaching For Lasting Lifestyle Change, 2nd Ed.

Mirabai New Year Article

Health Coaching: A New Way To Keep Those New Year’s Resolutions

So you go to your annual check-up and your doc says “whoops your blood pressure is up and you’re 15 pounds heavier than last year. I’ll give you some meds, but you’ll have to lose weight and get into shape, OK?

You say OK, you walk out and then what?

Join a gym, hire a personal trainer, go on a diet, take a walk? You might do one or several of these because, after all, it’s a new year and a new you.

Right? Right, and you try something. But how long is it till you throw up your hands and say, “ugh, I got started and now I’m off the track just like last year.”

What went wrong? Maybe nothing, except you might not have been psychologically ready to take those steps.

For any change there is a process. One of the models that are used is the transtheoretical model of behavior change (TTM) developed by James O. Prochaska , Ph.D

There are 5 stages:

Precontemplation – going along not aware of a need for, or not wanting a change.

Contemplation – recognizing a need to do something to improve your situation and considering making some sort of change.

Preparation – doing some research, making small changes, or at least thinking about what you’re going to do to help yourself.

Action – Actively making lifestyle changes,

Maintenance – Having made changes, keeping the healthy lifestyle going.

All too often we jump from contemplation to action without being ready for the change. It can feel like getting off a plane in Antarctica wearing shorts and a T-shirt. You wanted to be there but you weren’t ready for what that change would be like, and what you’d need to do to stay there comfortably.

But there is help, a new kind of help.

The health and fitness industry is rising to the challenge of our increased involvement with our own health care.

Many of us still think of fitness professionals as muscle heads with great bodies and not much else. Those types will always exist, but more educational opportunities including degrees and certifications are spawning a new breed of health & fitness professional, one that’s part of the health as well as the fitness industry.

Enter the Health & Wellness Coach

Not to be confused with a personal trainer, the Health & Wellness Coach is a consultant who helps you go, through, preparation, to action and on to maintenance. The coach helps you determine your health and wellness goals and needs. Once you have a path to your goals the coach continues to work with you to help you find the behavior modifications, activities, facilities and allied health professionals (MDs, Ph.Ds, Nurse Practitioners RDs, PTs, Personal Trainers, Exercise Instructors, etc.) to support your healthy lifestyle. You can do this on your own, but having someone with health industry knowledge who has your back, who is nonjudgmental, who just wants to help you focus and succeed can make all the difference.


Mirabai Holland MFA, EP-C, CHC is one of the foremost authorities is the health and fitness industry. Her customer top rated exercise videos for Age-Onset health issues like Osteoporosis, Arthritis, Heart Disease, Diabetes & more are available at www.mirabaiholland.com. Mirabai also offers one-on-on Health Coaching on Skype or Phone. Contact her at askmirabai@movingfree.com.

RB-health-and-wellness-coaching

Cancer, Lifestyle and Health Coaching

A cancer diagnosis is tremendously overwhelming and often takes away the feelings of control over one’s life. After diagnosis comes the whirlwind of information and new decisions that revolve around living with cancer. Health & Wellness Coaches work with clients in a variety of ways to help them navigate through the healthcare system and develop a self-created plan for treatment and lifestyle that supports the client in managing and re-gaining control over their lives.

Health Coaching Support for Alzheimer’s Patients and Caregivers

Alzheimer Concept.The emotional journey of facing a diagnosis such as Alzheimer’s disease or dementia can be overwhelming for both the patient and their families. Feelings of fear, stress, anxiety and loss can overpower all individuals involved and the ability to have questions answered is essential to easing these emotions.

Although there are a multitude of support groups available through local community organizations, access, availability, and comfort level of participating in a group setting can all be barriers to participation. A health coach can be a crucial lifeline to supporting the needs of both the family and the patient.  Health coaching services can be made available either 1:1 with the patient, loved one or as a family in which everyone is able to process many common issues facing Alzheimer’s patients.

This can include but are not limited to:

  • Understanding and adjusting to the diagnosis
  • Future care plans/options
  • Medical options and support resources
  • Managing symptoms and keeping loved one’s safe
  • Caregiver balance and managing one’s own health needs
  • Financial planning for support and medical management

A health coach does not necessarily need to be an expert in Alzheimer’s disease per se, but rather, have the ability to connect their client to professional, expert resources in their area. Their common goal is to navigate the needs and connect families to trusted experts that can create a network of safety and security throughout the progression of the disease. The supportive ear of a trained health coach can be enough to provide assurance that help is available and neither the patient nor the caregiver(s) are alone in this journey. Often the health coach is available to meet in convenient settings (including in-home or telephonically) as they realize that transportation can be a barrier to accessing resources.

In addition to care navigation, the health coach can connect the family to therapeutic resources such as exercise facilities, memory classes, and social support systems that can contribute to overall quality of life and management of symptoms. Their expert advice can help to remove burdensome details and guide the process in a meaningful, manageable way whereby the caregiver and patient are able to focus on enjoying their time together.


Jaclyn Chadbourne, MA is a Clinical Exercise Physiologist and Principal, Director of Research and Development – ‎Universal Medical Technology, LLC and United Medical Gym, Inc in South Portland, ME. With a passion for sustainable healthy living and desire to advocate for patient-centered care, Jaclyn works to help support community resources for all special populations and to implement and oversee clinical protocols. 

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Health & Wellness Coaching for Diabetes

Managing Diabetes can be very complex. How can the diabetes patient be successful at creating a solid lifestyle plan involving healthy nutrition, increased activity and effective medical management? A study published by American Diabetes Association, Clinical Diabetes, state’s “Controlling diabetes to reduce the incidence of its complications rests largely on individual patients and requires vigorous self-management of the disease. Unfortunately, without sustained support, few people achieve their goals or master the tasks that will allow them to live healthfully and reduce their risk of costly complications.”

Diabetes managementAccording to the New England Journal of Medicine, “Type 2 diabetes is increasingly common, primarily because of increases in the prevalence of a sedentary lifestyle and obesity. It was concluded that the reduction in the incidence of diabetes was directly associated with changes in lifestyle and that Type 2 diabetes can be prevented by changes in the lifestyles of high-risk subjects.”

Diabetes self-management can be very overwhelming for the diabetic patient often leading to a sense of failure but there is help. A Health & Wellness Plan created together with a coach has proven to increase success in achieving healthier lifestyle behaviors and a greater quality of life.

While diabetes management can be overwhelming the Clinical Diabetes study results “revealed broad agreement among participants that their coach helped them figure out what to do to better control diabetes, that their coach’s encouragement was important in controlling diabetes, and that coaching was an important part of the overall program.”

Studies performed by Duke University, published by the New England Journal of Medicine, and the American Journal of Lifestyle Medicine suggest that working with a Health Coach improves medical management, patient engagement, social support, physical activity, diet, decreases stress, and reduces A1C scores. In addition, patient perception indicated positive improvements in overall personal health status, as well as, accomplishment of their goals when working with a health coach.

The Affordable Care Act recognizes that focusing on wellness and prevention is key to improving the health of Americans. The National Prevention Strategy is moving us from a system of sick care to one based on wellness and prevention. Many of the programs and initiatives now being funded include coaching. An example is the YMCA Diabetes Prevention Program that now includes Health Coaches within their team. We are now also finding coaches within insurance companies, such as UnitedHealth Group, Optima Health and Aetna due to success in improving diabetes control for the patient.

health-coaching-wordglobeWhat Can Health & Wellness Coaches Do for You?

Coaches work with diabetes patients in a variety of ways. In one example of coaching in a healthcare setting Dr. Heather Bennett and her team (in an American Academy of Family Physicians publication) described Health Coaching for patients as encompassing five principal roles:

  1. Providing self-management support
  2. Bridging the gap between clinician and patient
  3. Helping patients navigate the health care system
  4. Offering emotional support and support resources
  5. Serving as a continuity figure.

In Bennett’s model the role of health educator and the role of health and wellness coach was combined.

Providing self-management support
Self-management support is essential for patients to extend their health care outside the clinic walls and into their real lives. Coaches assist patients in seven domains of self-management support: providing information, teaching disease-specific skills, promoting healthy behaviors, imparting problem-solving skills, assisting with the emotional impact of chronic illness, providing regular follow-up and encouraging people to be active participants in their care. Patients have better health outcomes when provided with disease-specific knowledge and skills.

Bridging the gap between clinician and patient
Throughout the care process, there are plenty of opportunities for disconnects between the clinician and the patient. Prescribing medications is one example. It is a two-part endeavor: 1) writing prescriptions and 2) making sure patients obtain, understand and actually take the medications as prescribed. Physicians perform part one but lack time to address the critical second part. Health coaches can bridge these gaps by following up with patients, asking about needs and obstacles, and addressing health literacy, cultural issues and social-class barriers. Health Coaches help patients navigate the health care system. Many patients, particularly the elderly, disabled and marginalized, need a navigator to help locate, negotiate and engage in services. Coaches can help coordinate care and advocate with patients when their voices are not heard.

Offering emotional support
Coping with illness is emotionally challenging. Well-intentioned but rushed clinicians may fail to address patients’ emotional needs. As trust and familiarity grow, coaches can offer emotional support and help patients cope with their illnesses. They also assist patients in seeking out additional emotional support that will help them achieve and maintain success.

Woman Doing Stretching Exercises In Gym With Trainer

Serving as a continuity figure
Coaches connect with patients not only for office visits but also between visits, creating familiarity and continuity. This is particularly helpful in practices where clinicians work part-time or see one another’s patient. Coaches travel with the patient as an ally and assist them with staying the course while implementing their wellness plan.

Health & Wellness Coaches Can Help

Coaches facilitate a patient-directed process of evaluation and assessment, exploration, tracking and accountability to and assist in co-creating a plan that is tailored to the patient Health & Wellness Coaches work with a patient individually or in small groups. They help create a whole-life integrated wellness plan toward managing diabetes and bringing about the lifestyle changes needed for a healthier life. Coaches serve as an ally to help those challenged with diabetes follow through with their health & wellness plan so they can achieve their goals toward their best life possible.


References

Affordable Care Act – Department of Health & Human Services: www.hhs.gov

Bennett et al, Health Coaching for Patients With Chronic Illness. Fam Pract Manag. 2010 Sep-Oct;17(5):24-29.

MacLean et al, Telephone Coaching to Improve Diabetes Self-Management for Rural Residents. Clinical Diabetes. January 2012 vol. 30 no. 1 13-16.

Melko et al, American Journal of Lifestyle Medicine, March/April 2010; vol. 4, 2: pp. 187-194.

National Prevention Strategy, Clinical and Community Preventive Services, National Prevention Council 2010. www.surgeongeneral.gov/initiatives/prevention/strategy/preventive-services.pdf

National Prevention Council Action Plan: Implementing the National Prevention Strategy
www.surgeongeneral.gov/initiatives/prevention/2012-npc-action-plan.pdf

National Prevention Council, National Prevention, Health promotion, and Public Health Council, 2013 Annual Status Report. June 25, 2012. http://www.cdc.gov/features/PreventionCouncil

Sacco et al, Effect of a brief, regular telephone intervention by paraprofessionals for type 2 diabetes. Journal of Behavorial Medicine. August 2009, Volume 32, Issue 4, 349-359.

Tuomilehto et al, Prevention of Type 2 Diabetes Mellitus by Changes in Lifestyle among Subjects with Impaired Glucose Tolerance .N Engl J Med 2001; 344:1343-1350.

Wolever et al, Integrative Health Coaching for Patients With Type 2 Diabetes A Randomized Clinical Trial. The Diabetes Educator July/August 2010 vol. 36 no. 4 629-639.