I see patients at The NC Family Doctor who have some undesirable health habits like smoking.  I usually ask them when they plan to quit.  I usually get one of two answers: 1) I don’t want to quit.  I like smoking.  2.)  I wish I could.  I quit once for 6 weeks (or for some length of time) but I started again.

The first patient is answering I won’t.  Not an uncommon response for some people.  The second is answering I can’t.  Even more common.  Both have thought about it.  One has even taken action in the past but neither are ready now.

Think of a behavior like smoking, not exercising, eating too much or not enough.  Select one you have or have changed.

Now look at these 5 questions.

1. I do not intend to change this behavior in the near future.

2. I am thinking about changing this behavior in the near future

3. I am getting ready to change in the next 30 days.

4. I changed that behavior less than 6 months ago.

5. I changed that behavior more than 6 months ago.

A coach will use different approaches for different answers.  For the I won’t person, I would try to get them to tell me some of the benefits of changing the behavior.  I would not try to get them to change, just repeat aloud the benefit to someone else who quits.

For the person contemplating change in the next 30 days the approach would be more information and reinforcing their decision.  They need help getting ready and setting the goal to change.  They need to see that the benefits to change are better and bigger than the barriers to change.

For the person who has changed for more than 6 months, I would talk to them about possible triggers that might make them relapse into old behavior patterns.  How do they plan to handle triggers, or a relapse.  Do they have a 72 hour plan in case of relapse?

Ask yourself the above questions regarding a personal behavior.  If you are stumped as to what to do, get yourself a coach.

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A wellness coach can do many things to help you and few that are not beneficial to you. There are 12 areas or activities that instructors at the Cooper Institute teach their coaches to avoid. A coach is not a therapist, dietitian or teacher.

A coach should not:

1. Order, directly tell you, or command you in any activity. You should pick it and they should help you define your choice, make a plan and help you be accountable.

2. A coach should not warn you or threaten you. They should encourage you and help you see the big picture.

3. Wellness coaches should not give advice, suggestions or solutions to problems. You usually know what you need to do, but you need help in discussing aloud your desire, different options, formulation of a plan to achieve a desired outcome and a time table for that outcome.

4. A coach should not persuade or lecture you. It is your life to live. If you have issues that are unresolved you need a therapist. If you have goals to achieve you need a coach.

5. A wellness coach should not moralize, preach, fix or convert you. If you eat meat and the coach does not, the coach isn’t to persuade you to give up meat. They are to help you find a balanced diet that suits you and your goals.

6. A coach is not to blame, criticize, or judge.

7. A coach is to help you rise to a challenge. People need external reinforcement to get there. Your coach should not sabotage your effort through praise, agreement or approval of where you are if you want to change.

8. A coach should be your guide and not shame you, ridicule you or label you.

9. It isn’t the coach’s job to reassure you, sympathize with you in your struggle, or console you. The coach should help you set goals, make a plan and help you be accountable. If you are on track, the coach will tell you and that may sound like praise but it is feedback. You will know when you don’t meet a goal you set because you will be accountable and tell the coach not visa versa.

10. The coach will not probe or drill you. Got an issue, a counselor can probe. Your coach may have some training in this area also but if you want them to wear that hat it is a different visit and a different format and a different charge.

11. A coach will not humor you. They should do their best to guide you and help you think clearly and appropriately about your goal and your progress. If it isn’t happening, you will know and they will agree.

12. When you are being coached, the coach should give you complete and full attention. You will know by feedback if they aren’t and that is the time to get another one. Anyone can get distracted occasionally. I sometimes am processing what a patient said only to realize I missed their last statement, but I stop them, regroup and then get them to repeat and bring me up to speed with their train of thought.

You should realize a coach will not help you to harm yourself or anyone else or do anything illegal. They should make that known up front in writing and have you sign a document that you understand those principles and agree with them.

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What is the purpose of a Wellness Coach and should you have one?  That depends on if you are experiencing problems with your weight, exercise program, stress management or your nutrition.  I have already told you Wellness Coaches are not therapists, dietitians or teachers in their capacity as a coach.  They might be those things too, but not when they coach you.

How might you use the services of one of these professionals?  A huge percentage of Americans are over-weight or are obese.  They don’t exercise regularly, don’t eat properly and experience varying degrees of stress, some good and some bad.  They aren’t able to sustain the effort to change.  Those people could hire a coach, a Wellness Coach.

The Coach would have you sign some documents indicating that you understand what he/she can and can not do.  They would have you fill out some kind of assessment and then have a meeting with you.  That meeting could occur in person, via web cam or on the phone.  Different meetings would have different lengths, but the first meeting might last 45-90 minutes.  The second one 30-45 minutes and 10-30 minutes after that.  It really is up to the client after they are assessed and educated by their selected coach and how many areas they are working on simultaneously.

Coaching isn’t free, so check out your coaches published fee schedule.  You should agree on fees, the number and length of meetings and a payment schedule and how you will meet and contact each other on your first meeting.  That meeting might be free, it might cost a nominal fee, or if the coach is busy and in demand, might be the usual fee for that coaches time.

You can expect your Wellness Coach to listen, listen, listen and to ask questions.  The coach might give you information to read, view, or listen to.  They might use a number of techniques and skills to help you identify barriers to your progress,  Then help you identify how you can get past those barriers.  They will help you write up your own plan so you can begin to accomplish what you want to improve in one of the areas mentioned above.

Let me give you an example of how a coach helped me.  I have had issues of stress around doing things that are not part of my everyday routine, but things I want to do.  I want to visit my grandchildren more, but just can’t get packed, make the call and go visit.

She helped me with a plan where I schedule time on a calendar with my children to visit them at convenient times. For my daughter in NC, I plan to pack a suit case and leave it there with an air-mattress for me to sleep on.  This eliminated that barrier and lifted what had seemed quite heavy and made me avoid it which caused me to feel heavy with guilt.  Now I have a plan, and I will implement it and report back at a specified time on how it worked.  That is one issue in my life and though it may sound dumb, it held me back from some of the joy I could be having.

What kind of catalyst do you need?  A coach will help you identify your strengths and focus there.  He/she will help you with your self talk, with goal setting and progress tracking.  They will help to motivate you, guide you and challenge you.  Got and area you need to improve in, think about using a coaches services. 

I am getting this training because I wanted a more organized way to help my patients with healthy behaviors.  I wanted to be a better catalyst, more effective.  Just telling someone go do it isn’t the most effective method.  Many patients have prefaced their remarks with, “You aren’t going to like this, but…”  Now I  have ways to help patients and people who aren’t my patients make the changes they desire in the areas of weight/exercise, nutrition/eating habits, and stress management.  I have more to offer than just pills. 

What do you think?  Have you had a coaching experience you can share?  Do you like this idea?

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