Health Coaching: How Does It Work
Health coaching empowers and support people to play a more active role in managing their health and to be able to make healthy and sustainable lifestyle choices. Health coaching is a goal-oriented, client-centred partnership that is health-focused and occurs through a process of client enlightenment and empowerment (Olsen, 2013).
NHS’ Universal personalised care model which focuses on giving people the power and control to make their own health choices, defines Health Coaching as ‘helping people gain and use the knowledge, confidence and skills to become active participants in their care so that they can reach their self-identified goals’ (NHS, 2021) One size fits all approach cannot meet the complex and varied needs and expectations of individuals.
Increasing healthcare costs and growing evidence regarding the positive impact of healthy lifestyle behaviours in preventive health have increased interest in the need of health coaching.
How does it work
Health coaches are trained professionals in various aspects of health and body system, nutrition, physical activity, and lifestyle. They don’t diagnose medical conditions or write diet plans instead through the method of positive interviewing technique, they help and empower people to self-identify existing issues and encourage them to proactively participate in prevention of new and existing illnesses.
They work alongside people to coach and motivate them through multiple sessions, supporting them to identify their needs, set goals, and help them to implement their personalised health and care plan (NHS, 2021).
Health Coaches takes the elements of positive psychology and behaviour change models to support their clients.
Stages of Change model
The Transtheoretical model or stages of change model is a cyclic model developed by Prochaska and Diclemente in 1983 (TTM). The cyclic model suggests that people are at different levels of readiness and during the change process they go through a series of stages. There are five stages in the model and the client may start at any of these stages and may move between stages (Olsen, 2013).
Pre-contemplation- This is the stage when the client is in denial and doesn’t see any harm or risk in continuing with their health behaviour.
Contemplation- This is the point at which the client becomes aware of the benefits of making a change and starts weighting the pros and cons of making the change.
Preparation- At this stage, the client has decided to change their behaviour and they are getting ready to change. Finding information, making small changes, thinking of goals are some of the characteristics of this stage.
Action- This is the point when clients has started taking concrete steps for making change and continuing with their effort.
Maintenance- This is the continuation of the action stage where the change has become a part of life for the client, and they keep up with it.
Relapse- This is the stage when the client could fall off the cycle and move backward to another stage of the cycle. To stop this from happening it is essential to motivate and support the client throughout the maintenance stage.
Motivational Interviewing
Motivational Interviewing technique was originally developed for addiction counselling in 1980 and has evolved over the years. Currently defined as ‘a collaborative, person centred form of guiding to elicit and strengthen motivation for change’ (Butterworth, 2007). OARS model (Miller & Rollnick, 2013) is a basic approach used in motivational interviewing-
Open ended questions- asking questions that cannot be easily answered with a yes/no as open-ended questions invite deep and elaborate thinking
Affirmations are positive statements that help client recognise their strengths and see themselves in a positive light. They also help the client understand that change is possible even though previous efforts have been unsuccessful.
Reflections involve active listening and empathy as the coach gently guides the client towards resolving the ambivalence by focussing on the positives of making changes and negatives of maintaining the status quo.
Summaries highlight the important part of the discussion, help client stay focussed or move direction when needed.
Evidence suggest that the consequences of health coaching sessions result in improved health, health behaviour change and health goal attainment (Olsen, 2013). The tailored approach is effective in designing and implementing sustainable strategies to achieve overall health and wellbeing of an individual.
