The Rise of a New Profession… the Health Coach?

Over the last couple of years, with more emphasis being placed on healthy living and the rise of the internet, I have seen an explosion of a new profession. This has been the rise of the “health coach”. Persons who either virtually or face-to-face provide coaching in small groups or one on one in different areas of a persons’ life.

This label can apply to a lot of things! It can mean teaching a relatively healthy person how to manage stress from work or it can mean counselling a person with borderline diabetes how to manage their blood sugar to avoid taking medications. Because of this broad range, it gave me pause. Calling yourself a health coach can mean a lot of things.

Being a new field, there is always this grey area as people try to figure out who they are and what they do within their profession (physiotherapist’s I believe have gone through a lot of these transition zones throughout their history as well).

So being the research nerd that I am, I went digging. I wanted to see what the literature has to say about health coaching (if there has been any done) and get some clarity on the definition of health coaching.

To my surprise, there was a systematic review that had been published in 2013 (which ended up being more of a synthesis so I would probably label it as a scoping review, but I digress). In this article, authors tried to look at the full spectrum of the literature to try to get an idea about what it MEANS to be a health coach.

There is actually an International Consortium for Health and Wellness Coaching (ICHWC), that has begun tackling some of the questions. They give this definition for a health coach:

“Health and wellness coaches are professionals from diverse backgrounds and education who work with individuals and groups in a client-centered process to facilitate and empower the client to achieve self-determined goals related to health and wellness. Successful coaching takes place when coaches apply clearly defined knowledge and skills so that clients mobilize internal strengths and external resources for sustainable change.”

The results of the review were pretty consistent about a couple of points related to this definition.

1. The education in coaching varied.

Some persons just did on-site training for their role, others went through formal programs to teach how to work with individuals on behaviour change and habit formation.

2. There was agreement that health coaches should have MEDICAL training

The majority (>90%) of studies defined coaches as medical professionals who had had additional training. The background ranged from medical doctors, to nurses, to physiotherapists and other allied health professionals. These were persons with a regulated healthcare body that were providing additional services.

3. There is no standard of care or regulations.

The amount of time people spent with their clients, the format, the subject matter was all different.

For me, this raises a lot of questions and some concerns that I make sure that I keep an eye on.

As a healthcare provider, I am registered. What that means is that you can look up my record on my College website. That not only protects me but it protects my clients. You can look me up to see if I have had any offenses, disciplinary actions or complaints against me by any of my clients. You can also check that I am still rostered to provide physiotherapy care.

As a physiotherapist, I am also regulated. I have a scope of practice and a governing body that can take action if I do something that goes against that scope of practice or is unethical.

I cherish these two things (as much as an audit is not very fun!). But in my eyes, it maintains the integrity of my profession.

This is the concern that has come into fitness and health recently. Why there has been a call for some sort of regulation of fitness and health providers.

Health coaches have the capacity for tremendous amounts of good. There is so much information out there about health, we often times need all the help we can get!

But we cannot forget that there is also a pretty substantial capacity to do harm. Counselling persons that are on medications for heart related issues (which unfortunately more and more of us are as we get into our 50s for example, without the proper education can create issues with a persons’ health. Even counselling around healthy natural remedies to certain things when persons are on different meds can interact in a dangerous way.

A defined scope of practice is needed and actually exists but is rather vague.

It states, “Health and wellness coaches work with individuals and groups in a client-centered process to facilitate and empower the client to develop and achieve self-determined goals related to health and wellness.” And what I like the most is, “As partners and facilitators, health and wellness coaches support their clients in achieving health goals and behavioral change based on their clients’ own goals and consistent with treatment plans as prescribed by individual clients’ professional health care providers.”

In my mind, what health coaches bring is accountability and strategies to implement the healthy lifestyle changes we want to make! That to me is awesome! So, I’m not bringing them down in the slightest!

However, make sure you’re asking questions. Things like asking about their education, background and experience can make sure you’re finding the right fit for you. There are accredited programs through the ICHWC. Make sure that the person you are working with has worked with people that have some of your issues/concerns/goals. It is okay to interview the coach that you are looking to see. Ask about their methods and how they coach. It’s important! That to me is not just about the coach, but as a physiotherapist, I would be totally okay with my clients asking me questions about my methods/ reasons/ experiences etc.

What are you experiences? Have you heard of a health coach before or worked with one?

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Christina Prevett

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