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Changing for Good!

A Health Coach Fosters Results

by Lauressa Nelson

HW_0114_HealthCoachA health or wellness coach integrated into a personal healthcare team can be critical to catalyzing sustainable change. Many people understand they need to modify their self-care, yet fail to take the optimal steps to make such a transformation happen.

“What we’ve discovered is that people don’t routinely change behavior due to education alone or out of fear. They change through partnership,” explains Linda Smith, a physician’s assistant and director of professional and public programs at Duke Integrative Medicine, in Durham, North Carolina. Coaching partnerships supply a supportive bridge between provider recommendations and patient implementations, she says, “significantly increasing the client’s ability to make changes successfully.”

“Health coaching was absolutely essential to my health,” says Roberta Cutbill, a 72-year-old retired registered nurse in Greensboro, North Carolina, who considered her lifestyle relatively healthy when in her late 60s she experienced autoimmune and cardiac problems. “I have an excellent primary care doctor who, when these issues came up, told me that I needed to change my diet, thoughtfully downloaded a list of recommended foods and sent me on my way. I still needed help with many things in order to make the changes,” recalls Cutbill, which is why she turned to a health coach at Duke Integrative Medicine.

Margaret Moore, founder and CEO of Wellcoaches Corporation and co-director of the Institute of Coaching at McLean Hospital, a Harvard Medical School affiliate, in Belmont, Massachusetts, points to two primary forces that enable behavioral change: autonomous motivation (people want to do something for their own reasons, not because someone tells them to) and confidence (they believe they can do it). “The most powerful motivating forces of all are what you treasure most in life, your life purpose and contribution,” she remarks. Both Smith and Moore emphasize that the priorities of behavioral change in any health coaching relationship are client-driven, based on the client’s chosen goals and personal intrinsic motivators.

Confidence in attaining ultimate success is steadily built through positively framed experiments and experiences. “A health coach is trained to help clients break up their goals into manageable steps, focus on strengths, track progress and identify and overcome personal roadblocks,” explains Dr. Karen Lawson, an integrative physician and director of integrative health coaching at the University of Minnesota’s Center for Spirituality and Healing, in Minneapolis. A helpful approach sets goals that can be met and exceeded, not insurmountable ones.

“If I set too many goals, my health coach would ask me, ‘What are the top three for this week?’” Cutbill recalls. “She taught me to break things into parts and specify attainable steps. Now I do that on my own.”

“The other key is always keeping a positive lens, helping clients see the progress they achieve,” continues Lawson. This involves speaking in terms of growth through trial and error, in which outcomes are explored without judgment and clients feel empowered to learn and modify.

The health coach’s collaborative, patient-centered process enables clients to change their beliefs and sustain wellness-supporting behaviors to a degree not otherwise possible.

This is vital, explains Moore, because experiencing at least a three-to-one ratio of positive to negative emotions creates the conditions for the brain to learn and change and for a person to thrive and be resilient enough to handle the winding road of transformation. She observes, “Improving the mental game makes people more capable of taking care of their health.”

Mindful awareness is another essential tool; being self-aware and reflecting on what we are doing while it is happening. Unlike thinking, analyzing and planning, mindful awareness involves observing while experiencing. During sessions, coaches use it to empty their own minds in order to give their full attention in a kind, non-judgmental way, modeling how clients can bring such attention and compassion to themselves.

A mindful state calms mental noise and puts reflective distance between individuals and their beliefs, emotions and behaviors. Mindfulness allows for a creative and curious attitude that improves the ability to handle negative emotions and to make a conscious choice to respond with a different attitude or new behavior, according to Moore.

For Cutbill, maintaining a personal relationship with her coach over time has been the most significant factor in the improvement of her health. “Every week, we spoke by phone. The relationship was healing, because my coach regularly pointed out my progress with profound encouragement and validation. Pill prescriptions don’t teach the lifestyle skills needed to manage or recover from chronic medical conditions. I wish every primary care doctor had a health coach on staff to help them and their patients attain the successful outcomes they both are aiming for.”

Lauressa Nelson is an editor and contributing writer for Natural Awakenings. Connect at


Hallmarks of a Good Health Coach

by Margaret Moore

In the past 10 years, approximately 10,000 health professionals have become coaches through dedicated training schools and university programs focused on life, corporate or health and wellness coaching. The selection of the right partner to help in the quest for lifelong wellness entails assessing the following qualifications.

Credentials and training: A reputable health and wellness coach training program typically requires six months to two years of education, skills training and practice with clients, followed by a certification process that tests for knowledge and core competencies.

Employment background: Additional desirable credentials in the medical, physical or mental health fields will likely include exercise physiology, physical therapy, psychotherapy, nutrition counseling, nursing or medicine.

Structured relationship: A coach should be able to explain how coaching works and why successful results are more likely with a coach. Coaching sessions are typically conducted by phone and last between 30 and 60 minutes. Many coaches provide online support between sessions, using web-based tools such as progress trackers. Some charge per session, usually weekly or monthly; others charge a package fee for a series of sessions. Coaching services are not commonly covered by insurance yet.

Personal character: Effective health coaches are good listeners, interested in clients’ unique stories. They foster self-acceptance and self-respect, pointing out personal strengths, values and desires. Coaches engage, energize and challenge clients through a positive, non-judgmental focus, while at the same time asking courageous questions. As skilled partners, they help clients become clear about personal motivations and an overall vision for life, so that they can help design a detailed, attainable plan that successfully moves them toward fulfilling their goals.

Margaret Moore is CEO of Wellcoaches Corporation and has a master’s degree in business administration. Email or visit or

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