On May 19 ,2017 the American Journal of Lifestyle Medicine published our article entitled “Compendium of health and wellness coaching literature.”   The paper is available to all as an open-access publication and can be found at: http://journals.sagepub.com/doi/full/10.1177/1559827617708562 The Compendium is a thorough collection of peer-reviewed literature on the topic of health and wellness coaching (HWC).  The paper describes how the Compendium was built while also providing an overview of results presented in the HWC literature. The authors (G.A. Sforzo, M.P. Kaye, I. Torodova, S. Harenberg, K. Costello, L. Kuo, A. Faber, B. Frates, and M. Moore) applied an operational definition of HWC that emerged from a 2013 SYSTEMATIC REVIEW and then collected 219 articles representing a detailed compendium of most everything written about HWC in the scientific literature since 2000. The HWC Compendium is organized into two parts with Part A containing 150 data-based research papers and Part B containing 69 commentary/position/review papers.  The Compendium is current through June of 2016 and each part (A and B) is sub-divided into categories for cancer, cholesterol, diabetes, heart disease, hypertension, obesity, and wellness. The columns of Part A spreadsheet provide the reader with many details about each article, including a brief critique and results. The number of HWC papers on obesity and diabetes management are greater than 30 and about half are randomized and controlled trials (RCT) – the type of research often cited as the most powerful and convincing.  The Wellness category also contains over 30 articles but within it resides several topics too small to be given a separate category.  In Wellness you can find HWC papers on fibromyalgia, multiple sclerosis, and glaucoma, as well as numerous papers on risk-factor reduction (e.g., smoking cessation).  The point is, no matter what kind of HWC research information you seek, the Compendium is organized to help you find what you need. There is a lot to learn from perusing and exploring the Compendium. The Results Summary provided in each patient/client category generally support the positive benefits of HWC.  The findings are particularly well-detailed in patients who have diabetes and obesity. Although less extensive, the potential quality of life benefits from HWC for cancer patients is also impressive.  While the authors do provide some cautionary critique and call for more research, the consensus theme speaks of advantages gained through HWC intervention. A major purpose of the Compendium is to assist health and wellness coaches (especially Wellcoaches) as well as researchers of HWC.  The information in the Compendium can be used to understand how different client/patient presentations are treated with HWC and to potentially get ideas on how to work with a client you are seeing.  For someone interested in doing HWC research the Compendium will be an invaluable resource for searching literature and helping to identify gaps in the HWC research.  In other words, the Compendium is a new tool available to help the HWC profession. The Compendium project was fully endorsed and supported by Wellcoaches.  Margaret (Moore) provided invaluable impetus for this work and it would not have happened without her encouragement and guidance.  Wellcoaches aims to be a driving force behind projects such as the Compendium, helping to advance not only the Wellcoaches family but the coaching profession in general.

In August 2017, the American Journal of Lifestyle Medicine published our article entitled “INTEGRATING HEALTH COACHING WITH A MEDICAL FITNESS PROGRAM TO TREAT CHRONIC HEALTH CONDITIONS.”   Brad Roy, Ph.D. is the lead author of this work and it is co-authored by other members of his Kalispell staff (Pam Roberts, M.D., Cathy Lisowski, M.S.), Miranda P. Kaye,Ph.D., as well as Wellcoaches Research Advisor (Sforzo). Journey-to-Wellness (J2W) Program is offered by a multidisciplinary team at The Summit Medical Fitness Center in Kalispell, Montana.  The team includes nutritionists, exercise physiologists, physicians, nurses, and wellness coaches serving hundreds of patients who are managing lifestyle-related medical disorders (e.g., diabetes).  During the period studied in the published article, J2W treated 1,306 patients and each averaged between four and five coaching sessions in a three-month period.  Their patients averaged about 53 years of age and were all referred to J2W by a primary care physician.  Patients suffered with a wide range of disorders including heart disease, obesity, chronic pain, and cancer to name a few.  The researchers measured many outcomes (see below) before and after the three-month intervention. Findings from the J2W program were extremely encouraging.  With just three months of J2W participation, those with chronic pain, obesity, cardiac problems, and even cancer improved on four or more outcome variables.  Reports of better health status and quality of life were evident across all 12 diagnostic categories studied. Patients with obesity and chronic pain may have benefited the most from J2W with improvements in 13 of 14 outcome measures. Those patients who may have the most to gain from a reduction in fat deposition (diabetic, pre-diabetic, obese, hypertensive) experienced strong changes in all body composition-related variables. It is clear J2W was a highly effective wellness endeavor in a short period of time.  Medical fitness programs can be successful but J2W exceeded expectations.  Is it possible wellness coaching was the added ingredient to spur on the highly positive results. In an effort to isolate the effects of coaching in J2W participants, the researchers compared outcomes achieved by those patients with more or less coaching.  Those completing more than four sessions reported greater improvements in quality of life, and health status, than those exposed to less than four coaching sessions in three months.  Furthermore, nutrition behaviors and weight management also tended to be better for participants with more than four sessions. Many other outcomes were not clearly affected by greater amounts of coaching.  Ultimately, the researchers essentially concluded it is difficult to separate out the independent effects of coaching in J2W – it is a fully integrated medical fitness program.  The value of coaching was agreed to be even beyond the positive statistical findings and not easily quantifiable. The highly successful Journey-to-Wellness Program has health and wellness coaching as a key and fully integrated component for patient intervention.   It is both exciting and affirming to see Wellcoaches-trained coaching professionals working daily with a diversity of patient presentations at the Summit Medical Fitness Center.  You can read all about this work in the most recent edition of the American Journal of Lifestyle Medicine. Source Roy, B., Roberts P., Lisowski C., Kaye, M.P., & Sforzo, G.A.  “Integrating Health Coaching with a Medical Fitness Program to Treat Chronic Health Conditions.”  American Journal of Lifestyle Medicine.

In September, 345 Wellcoaches coaches walked into computer testing sites nationwide and completed the national board certification examination for health and wellness coaches (NBC-HWC). All had studied diligently, pouring in their best efforts. Some weathered hurricanes or their aftermath to be there. Most completed a Wellcoaches exam preparation course steeped in our love of coaching competencies and their many nuances. Many were nervous (having not taking exams for a long while), including Wellcoaches faculty and team members. Four or so hours later they emerged. The examination, eight years in the making, was challenging and covered the bases. There was a collective sense that we had together made a beautiful leap forward, setting a robust standard for health and wellness coaches. Then for a month or so, everyone awaited their results. Examination results arrived in October as Wellcoaches coaches were gathered together at the Institute of Coaching conference in Boston and the American College of Lifestyle Medicine conference in Tucson. Together we celebrated a big milestone. We also felt compassion for those who didn’t pass and were deeply disappointed. All of our Wellcoaches faculty and mentors and nearly all of the Wellcoaches coaches passed. Strong together, faculty, mentors, operations team, and Wellcoaches-certified coaches, we delivered an A+ performance – a 97% pass rate. What wonderful evidence for our GOLD STANDARD and the high value and impact of our Wellcoaches training and certification programs. If you are a Wellcoaches coach and didn’t pass the exam, we want to assure you that you are close. Please contact us – we are here to support you in passing the examination in the future. While a stellar accomplishment, this is just a beginning. Please join the Wellcoaches coaches who led the way for the next examinations in 2018. Together, and in collaboration with the whole field, we are lifting our field of health and wellness coaches onto high ground – wonderful outcomes and job opportunities by helping thousands transform their health, well-being and lives. Congratulations and much love to the Wellcoaches family and community. GREAT JOB!! Wellcoaches leads with DUAL CERTIFICATION With the arrival of the national board certification, for which we worked tirelessly to build for eight years, you lead our field with the dual certification – certified wellcoach® and NBC-HWC. Here’s why Wellcoaches coaches are leaders and why the Wellcoaches credential will continue to be the most sought after by employers and medical organizations including our partners, the American College of Sports Medicine and the American College of Lifestyle Medicine: – Stellar A+ performance of Wellcoaches coaches in the national board certification examination – Wellcoaches requirement for education in health-sciences, a higher certification standard than the national board certification. – EVIDENCE BASE of large scale application of Wellcoaches protocol, as published in our peer-reviewed Coaching Psychology Manual – Continuous innovation of coaching processes, theories and constructs by masterful faculty – including the soon-to-launch WELLCOACHES HABITS, and LIFESTYLE MEDICINE COACH in collaboration with ACLM – Coach membership program to enjoy world class continuing education, professional development and tools including the web coaching platform. Last, we make the dual certification easy: – Certified Wellcoaches, who are also Members during their entire certification period, renew their Wellcoaches certification for free. – Your Wellcoaches membership delivers the 36 continuing education hours required for your national board certification every three years. – Your Wellcoaches certification dates will be synchronized with your national board certification dates. Onward and upward! Coach Meg

Executive or leadership coaching is now an EVERY-DAY ACTIVITY in the life of many leaders, helping them grow and develop beyond what they can do without an expert facilitator of change. The now-common experience of coaching impact on leaders is igniting interest in learning coaching skills, pioneered in the book LEADER AS COACH twenty years ago by Hicks and Peterson, and more recently popularized by the new book THE COACHING HABIT (Bungay Stanier). Wider dissemination of coaching skills and development of a COACHING CULTURE is emerging in recent years. A COACHING CULTURE is particularly relevant to the healthcare industry where workforce health and population health depends on everyone making sustainable change – fully engaged in self-care and healthy lifestyles. Healthcare leaders are called to navigate, even better create, disruptive change which often needs to start with SELF-DISRUPTION. None too late in our age of accelerations when external change is changing, and faster than humans can change. It’s TIME FOR EVERYONE, NOT JUST LEADERS, TO GROW FASTER to avoid burnout and keep up, even get ahead of external forces of change. That means living and thriving ON THE GROWTH EDGE, like what happens in a good coaching session. Harvard psychologists Bob Kegan, Lisa Lahey and colleagues recently published a book titled “AN EVERYONE CULTURE” on becoming a deliberately developmental organization. One of the book’s lessons is that a coaching culture is one where there is an investment in balancing … performing at a high level to produce strong results, and growing to develop the capacity for even better results in the future It’s hard to welcome growing as equal to performing. Growing takes time to cultivate. It is sometimes awkward and clumsy as people experiment with new mindsets and behavior. As a nonlinear process, growing is unpredictable – even the best coaches can’t predict the timing of transformational insights or shifts and the conditions that might generate small and large shifts. My work life has placed me at the interface of coaching (as a coach and trainer) and leading (three organizations and a larger field). Distinct from my pre-coaching career in biotechnology, I’m now using coaching skills as a leader. But first I went through many clumsy, awkward phases, shifting from: the expert/boss who is directing and advocating to a cultivator of others’ self-determination the driver’s seat to the passenger seat attached to the expert/boss identity to serving others first being in charge to pulling back to observe and reflect seeing what’s wrong to appreciating what’s strong critiquing and judging to accepting (I mean really accepting) Like other leaders who have become coaches, I’ve grown to a higher level of consciousness, resonating with the emerging movement of CONSCIOUS LEADERSHIP OR CAPITALISM: 1. Quickly embracing missteps and turmoil as opportunities to grow, instead of getting down on what everyone did including me to produce the turmoil 2. Getting excited about messy chaos as a signpost to pursue change, instead of wishing for more control or certainty 3. Loosening the grip on any wishes, goals or agenda to allow the unpredictable, nonlinear growth process to unfold 4. Being calm and detached when assumptions and syntheses are overthrown by events and I don’t know what to do 5. Entering a state of wisdom and grace when the inner and outside worlds are not wise or graceful This has all led me to teach a refresh of the longstanding model of TRANSFORMATIONAL LEADERSHIP (Bernard Bass) to include self-transforming leadership as well as coaching and self-coaching competencies. A quick map of the coach approach to the four “I’s” of transformational leadership looks like this: Idealized influence – modeling self-transformation Inspirational motivation – inspiring others to be visionaries Individual consideration – coaching everyone to grow Intellectual stimulation – open, accepting, risk-taking, creative, evolving mind Coaching is the new leadership. Sometimes you lead. Sometimes you coach. What are the growth edges? Know how to do both and when to do what. Learn about COMMON GROWTH EDGES: LEADER TO COACH More on habits of transformational leaders: WWW.WELLCOACHESHABITS.COM WATCH TRANSFORMATIONAL LEADERSHIP WEBINAR (Password: Leadership)

New AHA Scientific Statement: Advancing Physical Activity with a Clear Call for Coaching Skills On April 4, 2018 the American Heart Association (AHA) released a new scientific statement entitled “Routine Assessment and Promotion of Physical Activity in Healthcare Settings” published in Circulation 1.  This paper is available to all as an open-access publication and can be found at: HTTP://CIRC.AHAJOURNALS.ORG/CONTENT/EARLY/2018/04/03/CIR.0000000000000559 This AHA scientific statement provides concrete evidence on the risks of a sedentary lifestyle while presenting an argument for assessing a patient’s physical activity status at every  office visit.  The logic is that we routinely gauge other risk factors (e.g., obesity, smoking, blood pressure, glucose, cholesterol) but we do not typically make a standardized measure and record of sedentary lifestyle or physical activity (PA) level; the message from the AHA is we need to have a “PA vital sign.”  There is substantial discussion of PA questionnaires, and leveraging the popularity of wearable activity monitors, as tools for measuring PA levels.  After making a strong case for regularly assessing PA, the authors (Felipe Lobelo, Deborah Rohm Young, Robert Sallis et al.) emphasis shifts to how healthcare professionals can help patients improve PA.   They note effectiveness, albeit limited, of various strategies and concluded a multilevel approach is necessary to improve our collective PA need.  The AHA authors added, brief physician counseling combined with a referral system promoted improvements in patients’ PA and were also cost effective, i.e., results support a favorable return-on-investment (ROI). The article then begins to recognize potential barriers to widespread integration of PA assessment in clinical settings.  Poor training, scarce resources, and omni-present financial matters are identified and thoroughly addressed.  It is at this point when the paper first considers the patient’s perspective, suggesting the primary-care provider should briefly counsel (1-2 min) on PA while, if possible, employing shared-decision making, motivational interviewing, and other proven behavioral strategies. This notion is immediately countered by a possible lack of time, and/or knowledge, for using these interventions.   The recommendation then turns to physician referral………but to whom?  There is mention of a patient navigator or exercise professional taking over as the lead in PA promotion, but also a clear recognition of the need for special skills to deliver behavior-change counseling.    The AHA statement recognizes some individuals are not ready to immediately begin exercising – some are “in precontemplation” exploring the possibilities of increases PA while some others are in “contemplation.”  This reference by the AHA to coaching skills, and the Transtheoretical Model’s stages of change, provides a clear opening for Health and Wellness Coaches to step through!  Nurses, physical therapists, and exercise professionals are mentioned in the AHA statement, but most of these professionals are not fully prepared with coaching strategies to help patients aiming for behavior change ……….but a health coach is exactly what the doctor can (and should) order! It is evident from this AHA scientific statement there is a perceived void in the medical system.  There is a need for physicians to be able to refer their patients to someone who can professionally and effectively help with behavior change.  Ample evidence for health and wellness coaches as effective behavior change agents for all types of patient populations exists in the evidence-based literature (see the Compendium of Health and Wellness Coaching Literature2).  It should (and must) be made clear that Health and Wellness Coaches are most prepared and able to fill this perceived void while promoting positive behavior change and advancing patient care.  There really is not a void – it just needs to be more apparent that we (health and wellness coaches) are here and ready to do the job.  This AHA scientific statement on physical activity represents a major force in the health-care industry making a bold and potentially monumental set of recommendations.  If you can, take the time to read the AHA Scientific Statement, and, pay particular attention to opportunities for professional health and wellness coaches to play a big part in being as a solution to major obstacles identified in the proposed plan. References 1. Lobelo F, Rohm Young D, Sallis R, et al. Routine Assessment and Promotion of Physical Activity in Healthcare Settings.  doi.org/10.1161/CIR.0000000000000559 2. Sforzo GA, Kaye MP, Torodova, I, et al. (2017). Compendium of health and wellness coaching. Am J Lifestyle Med. Published On-line First. doi: 10.1177/1559827617708562.

Lifestyle and Life Expectancy: Five Factors to Minimize Health Risks An international team of scientists just released an original research article, “Impact of Healthy Lifestyle Factors on Life Expectancies in the US Population” published April 30, 2018 in Circulation 1. The abstract for this important paper is available at: HTTP://CIRC.AHAJOURNALS.ORG/CONTENT/EARLY/2018/04/25/ CIRCULATIONAHA.117.032047 This international team from the US, UK, Netherlands, and China identified five low-risk, lifestyle related factors: never smoking, BMI < 25, mod-vigorous activity > 30 min/day, moderate alcohol intake, and high-quality diet. To examine these factors, along with rates of mortality, they used data from over 120,000 participants who originally took part in the NHANES and Health Professionals Follow-up studies. In these studies, they documented over 42,000 deaths in 34 years following participants. Examining non-adherence to the five low-risk factors they noticed significant relationships with cancer, cardiovascular, and all-cause mortality. They calculated that at age 50, participants who adopted all of the low-risk behaviors tended to live about 18 years longer (93.1 years for women; 87.6 years for men) than those who adopted zero low-risk lifestyle related factors. For reference, these lifespans are comparable to the average American life expectancy of 78.8 years (in 2014). The authors added, combinations of any low-risk factors (but less than all) also yielded prolonged life expectancy regardless of which lifestyle behaviors were examined. They did not differentiate between the strength of individual factors but instead considered each of the five low-risk behaviors essentially equal in their discussion. They determined that more than half of cancer-related, and three-quarters of cardiovascular-related, premature deaths are attributed to poor adherence to a low-risk lifestyle. Despite several limitations, this is very high-powered study with a clear and not-so-surprising conclusion: Life expectancy can be extended, particularly in the USA, by adopting improved health-related lifestyle behaviors. While providing a very strong case for promoting a low-risk lifestyle (high-quality diet, exercise, avoid smoking, moderate alcohol consumption, and maintain healthy BMI), this impactful article does not address interventions to encourage patients to adopt, or improve, their practice of healthy lifestyle behaviors. Not addressing such an important issue almost leaves the impression behavior change is as simple as the standard physician advice: “just stop smoking, eat right, and exercise more.” Decades of such advice, however, has proven essentially fruitless and we recognize healthy behavior change is difficult but possible. In fact, organizations exist primarily to emphasize the importance of a healthy lifestyle (e.g., AMERICAN COLLEGE OF LIFESTYLE MEDICINE-ACLM) and making related behavior changes (e.g., WELLCOACHES). Health and Wellness Coaches in particular, know healthy, sustainable behavior change can decrease burdens associated with protracted chronic lifestyle-related diseases but it is hard work. In this context, it is especially relevant to mention the ACLM and Wellcoaches recently launched (May, 2018) a partnership offering a Lifestyle Medicine Coaching credential to certified health and wellness coaches. The online course is open to all, however, only previously certified coaches can earn the advanced professional credential. When a major medical journal (Circulation 1) and two world-class organizations (ACLM, Wellcoaches) recognize the same important issue at nearly the same moment in time (the same month!) then the topic must be a highly relevant and timely matter. Adopting healthy lifestyle behaviors is the key to drastically reducing the individual and societal suffering associated with chronic lifestyle-related diseases. Health and wellness coaches have much to offer in this regard and now have lots of scientific and professional training support on their side. References Li Y, Pan A, Wang DD, Liu X, Dhana K, Franco OH, Kaptoge S, Di Angelantonio E, Stampfer M, Willett WC, Hu FB. Impact of Healthy Lifestyle Factors on Life Expectancies in the US Population. HTTPS://DOI.ORG/10.1161/CIRCULATIONAHA.117.032047.

This month at the INSTITUTE OF COACHING we featured a LITERATURE META-ANALYSIS and a SCIENTIFIC WEBINAR by Siegfried Greif on the theory and application of “implementation intentions.” Before we discuss the theory and the meta-analysis, let’s consider the nature of “intention.” The wisdom of the inadequacy of intentions goes back a long way – the proverb – THE ROAD TO HELL IS PAVED WITH GOOD INTENTIONS– dates back to France in 1150. Philosophers have turned the study of intention into a broad conversation of a complex construct. Stanford Encyclopedia of Philosophy’s entry on INTENTION, updated in 2018, explains that intention comes in three guises: Intention for future – I intend to write this article to add to my writing contributions on coaching and change Intention with which I act (the why) – My intention for this article is to help myself and others be more discerning and impactful when discussing “intention” Intentional action – I am intentionally writing this article (in a conscious manner) to get readers thinking Now let’s move to November 2018, when a META-ANALYSIS OF RANDOMIZED CLINICAL STUDIES OF “IMPLEMENTATION INTENTIONS” arrived using physical activity as the target behavior. Here’s a quick tour of the paper. Good intentions abound in physical activity Even though regular exercise is a BREAKTHROUGH LIFESTYLE MEDICINE, improving control of diabetes, brain function, emotional well-being and self-efficacy, while reducing risk of heart disease and cancer, in the Americas 43% of the population is not active. (The WORLD HEALTH ORGANIZATION describes being physically active as engaging in 150 minutes per week of moderate physical activity or 75 minutes per week of intense physical activity). As a result, theoretical approaches to increase physical activity are of great interest to health practitioners and researchers. Intention is not enough Icek Ajzen’s THEORY OF PLANNED BEHAVIOR proposed that intention, or motivation, is a main predictor of behavior. However, even strong intentions aren’t reliable: one study of people with FIBROMYALGIA AND STRONG INTENTIONS to exercise showed that only 32% moved from intention to action. As we know from our own lives, even with strong intentions, the desired behavior may not reliably happen. This is the “intention-behavior gap.” Implementation intentions This gap led researchers to separate the elaboration of intention to engage in a behavior from executing or implementing of the intention. A new theory was created: theory of implementation intentions. Implementation focuses on the when, how, and where of a behavior, aka action planning. To reinforce the action planning, the theory expanded to include coping planning, where one imagines potential obstacles and ways to overcome them. Thereby, implementation intentions are the intentions to implement an action plan and a coping plan for a behavior that you intend to do in the future. The study conclusions The featured study is a systematic review of studies which tested the effectiveness of interventions that supported implementation intentions. The authors found 507 relevant studies and identified 11 for a meta-analysis. The authors concluded that interventions asking participants to develop implementation intentions were significantly more successful in increasing physical activity, compared to a control group. Most effective were interventions that helped participants develop action plans, strategies for coping with obstacles, along with reinforcing their implementation intentions (e.g. by phone or text) and adjusting the plans during the interventions. Translation for coaches Implementation intention activities are supported in coaching. Coaching techniques designed to help others change behavior include action plans, coping plans, and ongoing reinforcement and adjusting of both – coaches are applying the science of implementation intentions. We can go even further, now addressing four meanings of intention: 1.     I intend in the future to write an article on intention 2.     My intention for this article is to help myself and others be more conscious in using intentions 3.     I intentionally write this article to make a multifaceted construct easier to understand 4.     I intend to complete this article today, a rainy Sunday morning, while turning off email and avoiding distraction Here’s to the many facets of good intentions! Let’s pave our paths forward with all of them.

POSITIVE PSYCHOLOGY AND COACHING PSYCHOLOGY ARE GROWING UP TOGETHER. Let’s flash back 20 years to the birth of Wellcoaches and the launch of the health and wellness coaching industry. That was also the time when a new science of happiness, virtue, and optimal functioning —named positive psychology — was called for by Martin Seligman and colleagues. Since then an evidence base for both fields, positive psychology and coaching psychology, has grown quickly and matured. Now supported by the evidence: – coaches use techniques grounded in positive psychology concepts – coaches integrate positive psychology interventions into coaching programs – a coaching specialty called positive psychology coaching is growing Let’s have a look at a broad study of the peer-reviewed literature linked to the positive psychology movement (Donaldsen et al, 2015). A systematic review selected 750 articles published in English between 1999-2013 (no review yet for 2014-2019) that were empirical tests of positive psychology theories, principles, and interventions.This review did not include a review of the scientific quality of the articles. That said, this growing body of evidence indicates positive psychology is based on a foundation of respected scientific methods and positive outcomes. What are the interesting takeaways? While well-being is defined and measured in various ways, the authors note that this literature suggests that it includes hedonic and eudaimonic components. The hedonic component is the affective experience of positive emotions and absence of negative emotions, along with the cognitive aspect of evaluating life satisfaction. The eudaimonic component is the search and attainment of meaning, self-actualization and personal growth. The authors present five main conclusions: 1. Well-being is the dominant topic - The most researched topic in positive psychology to date is well-being, accounting for almost 40% more publications than all the other key topics combined. 2. Predictors of well-being - The research shows that gratitude, mindfulness, hope, and spirituality, and more generally, identification and use of character strengths predict well-being. 3. Well-being & performance - In the organizational context, several studies suggest that psychological capital is positively related to employee performance. 4. Predictors of post-traumatic growth - Post-traumatic growth is predicted by emotional expression and positive coping strategies, including positive attitude, hope, optimism, and spirituality. 5. Positive psychology interventions work - There is a growing evidence base for the effectiveness of positive psychology interventions. More than 160 intervention studies were identified; the major categories included coaching, mindfulness, strengths development, positive affect enhancement, and gratitude practice. Empirical evidence was found to link these interventions to increases in well-being, resilience, hardiness, engagement, hope, and goal attainment, among other outcomes. Let’s zoom into the impact of coaching as a positive psychology intervention. Thirteen coaching studies (in the positive psychology field) were selected. They were informed by the “solution-based cognitive model” that includes self-monitoring, cognitive restructuring, and behavior modification to enhance goal achievement. The authors conclude that coaching interventions report significant improvements in goal attainment, depression, anxiety, stress, and quality of life. Wellcoaches integrated coaching techniques based on positive psychology concepts, as well as positive psychology interventions, into our curriculum nearly 15 years ago and found the impact to be transformational for clients. As a bonus, our students have reported an increase their  own well-being, especially eudaimonic, in the learning process. Here’s to growing up together! Resources: DONALDSON ET AL (2015). HAPPINESS, EXCELLENCE, AND OPTIMAL HUMAN FUNCTIONING REVISITED: EXAMINING THE PEER REVIEWED LITERATURE LINKED TO POSITIVE PSYCHOLOGY, JOURNAL OF POSITIVE PSYCHOLOGY 10:3, 185-195

When I was ten years old, I was given a 3 inch reflecting telescope. That’s the kind in which a concave mirror focuses light, bounces it into a series of mirrors and ultimately into the eye piece. I could see the moon as if I was holding it in my hand. Now a telescope is being constructed on Mauna Kea in Hawaii which will have a 30 meter mirror! Why spend huge amounts of money, intelligence and passion to build a bigger mirror? Just this: to see beyond what our everyday eyes can see. Isn’t that a big part of what we do as coaches? We help our clients see what they have not seen about their environments, their goals, their lives, their possibilities. A challenge in building giant telescopes is that earth’s gravitational pull distorts the huge mirrors enough to create inaccurate images. Care must be taken to continually adjust the mirrors and to avoid the slightest dirt – even as small as a skin cell – which will damage the reflection. Reflective practice helps avoid distortions in coaching. 1. A coach became frustrated with his client’s progress toward agreed upon objectives. The coach’s intense values about completing objectives had prevented him from recognizing that his client’s world had changed dramatically during the engagement. Distortion: substituting his values for his client’s. 2. Another coach felt she and the client were swirling around, yet the client was very happy with the monthly conversations. Nothing changed. Distortion: the coach and client had similar difficulty prioritizing. 3. Another coach was working with a young executive. The executive received difficult feedback from her CEO and the coaching relationship deteriorated. Through supervision, the coach realized he was unconsciously caring for the executive as if he was her father. Distortion: loss of clear boundaries between parts of his life. 4. A health and wellness coach was frustrated with a client’s weight loss progress. In reflection, the coach discovered that her own life-long relationship with food was masking her compassion for the client, whose story about food was profoundly different. Distortion: assuming our histories and values flowing form them are the same. Reflective Practice in supervision is a discipline of opening ourselves to fresh information about what we see, feel, think, want and do. It calls us to see ourselves and our clients as accurately as possible before, during and after the coaching conversation. In short, reflective practice is a process of polishing and correcting our mirrors. Why is this important beyond initial coach training? In coach training, we learn important theories and competencies; we learn how to coach. According to Schon (1987) and McGonagill (2000) this process provides us with “espoused theories” as distinct from “theories in action”. The latter are the theories, and by extension behaviors, which we attempt to apply in moments of coaching. Schon and others observed that professional workers (in various fields) described their work one way and actually did it another way. Reflective practice helps bring espoused and in-action knowledge closer together over time, and it is never complete because our mirrors, like those on Mauna Kea, are constantly shifting. How can we develop a reflective practice? One approach is to work with a person trained in guiding reflective practice. In the world of coaching, this person is being referred to as a Coaching Supervisor who has substantial understanding of both coaching competencies and additional experience with coaching psychology, dynamics of relationships, human systems dynamics and various tools for deep reflection.  A result of this work is development of an internal supervisor – a part of us that observes our coaching in real time and helps keep the mirrors clean and aligned. We can also begin reflective practice by attending regularly to a process. Find a mirror, physical or in your mind. Take a moment and gaze into your reflection. 1. What do you feel good about in your coaching? 2. What is unsettling in your coaching right now? A client session that didn’t go as planned? A client relationship that is suddenly not as comfortable as it was? Clients you find you actually don’t like? 3. What distortions might be creeping into your mirrors? Fatigue? Fast pace? Surety rather than curiosity? 4. What boundaries are in need of attention? Might you be performing roles that are not yours to perform? Are you moving away from your client when there’s conflict in the air? Are you trying to make your client happy? 5. What other questions are you sitting with and where could you go for answers? References: 1. Donald Schon, (1987) Educating the Reflective Practitioner. Jossey-Bass 2. Grady McGonagill (2000) The Coach as Reflective Practitioner, Notes from a Journey without End. In Executive Coaching: Practices and Perspectives. eds Catherine Fitzgerald and Jennifer Garvey. Davies Black Publishing.

by SIMON MATTHEWS, DipIBLM FASLM M Hlth Sc Newcastle MAPS, Cert IV Fitness Reflections on the Journey from one discipline to another… So before you read any further, I think it’s only fair to tell you that this process of moving from Therapist to Coach is in train for me – I don’t want you to read all the way through looking for a happy ending and finding yourself frustrated at the absence of one, though it is a happy story so far… I’d been practicing as a Psychologist in Australia for over 20 years when the opportunity arose for me to undertake Coach training. I’d initially trained in Systemic Family Therapy, then Solution Focussed Brief Therapy (SFBT), Motivational Interviewing (MI) and along the way I’d dipped my toe in other approaches that held some interest for me such as Acceptance and Commitment Therapy and even the clinical use of metaphor in therapy. Over the years, as I’d become more ensconced in the ‘bread and butter” of psychological treatment – depression and anxiety, I began reading more about the benefits of activity and exercise for mood and mental health. Long story short, I became a Fitness Trainer and began incorporating this into my psychological treatment. Roll forward a little further and I became convinced about the importance of nutrition also, studied that formally and also incorporated nutritional guidance into my psychological treatment. Then one day I woke up and realized I’d toppled into Lifestyle Medicine. Over time I incorporated work with pre-and post-surgery bariatric patients, adding this to my portfolio of clients with depression, anxiety, life crises and marital breakdowns, all the while using my secret blend of SFBT, MI, Fitness and Nutrition. But to be honest, I’d started to become a little jaded…I didn’t look forward to client sessions like I used to, I’d started to entertain ideas that an increasing number of my clients were unmotivated for change, and I’d started to see myself as less efficacious as a treatment provider than previously had. If I’m really honest, I’d say that some of the humanity that I used to bring had started to fade and I was approaching my work more instrumentally and less humanly than I was comfortable with. The opportunity to undertake coach training arose and, encouraged by some peers I respected, I decided to enroll with Wellcoaches. I travelled halfway around the world (yes, literally) to complete my training and here’s my takeaway: It was the most transformative personal and professional experience I’ve had in 25 years. Let me explain a little more… I expected to come away with an increased range of professional skills and, based on the pre-reading I’d done, some nuanced capacity to apply skills I’d been using for two decades. What I didn’t expect was to come away with a clarity of vision for my own professional life, a re-vitalised well of energy for supporting others during processes of change and transition, a re-connection with my own joy, passion and purpose and a strongly enhanced sense of my own self-efficacy and self-esteem. Of course my Coach Trainer played a significant role in this, as did many of my fellow coaching students. Since completing my initial training I’ve had limited time to practice skills due to more travel and conferences but when I returned to Australia I made a decision to apply the health and wellness coaching protocol in all my sessions with bariatric clients both to consolidate the skills for me and also to give me a discrete set of clients for whom I could assess the impact. Here’s what I can say so far: – Every one of my clients had tears in their eyes when they stated aloud their health and wellness vision – not a word of a lie – every one! I haven’t seen passion and feeling in my clients in this way for years. There is something bold, brave, expansive and almost magical about the capacity to articulate such a vision – Every one of my clients has walked out of those sessions saying something along the lines of “Wow – that wasn’t what I expected” or “Wow – I got so much more out of that than I thought I would” – I get to the end of a session feeling energized and enthused, not drained and desperate for a Double Espresso – I feel like I am doing the right amount of work in relation to my client – rather than feeling like I’m working so hard to help them make a tiny bit of progress. – Most important of all for me – I feel like I am present again – able to simply “be with” another human being and not feel compelled to “do for” them. In 30 years of human services work and 20 years as a Psychologist, nothing has challenged me as much; nothing has energized me as much and nothing has reconnected me with my own enthusiasm and passion for work like coaching training has. Your mileage may vary…but if you’re a Psychologist or Therapist who’s considering the transition then follow the advice of Johann Wolfgang von Goethe: “Whatever you can do, or dream you can, begin it.” And I would add “Now”.

Watch HOW COACHING WORKS: A SHORT MOVIE A decade ago, we released a movie titled “How Coaching Works” as a way to explain coaching using an animated cartoon. This blog series aims to share the psychological underpinnings of the cartoon. This second blog in the series  is a simplified script for the coach and client dialogue. Scene One: MEET Coach:  Hello. Thanks for meeting today. Let’s begin by having you tell me more about what you hope for most for your life. Who would you be if you were at your best? Client: I would engage in activities that energize me, strive for optimal health, and live life with gratitude and a sense of purpose every day. I’ve been thinking about this for while, but when I start it doesn’t last, it doesn’t get done. And, when I think about all of the things that get in my way, I’m overwhelmed. Coach: WOW, that’s an appealing vision. I hear your deep yearning to get there. Let’s talk about how we can work together. I’ll help you construct a roadmap to your future. You’ll bring a wealth of insight about what works for you and what doesn’t. With the help of my toolbox, you’ll get it done.  Let’s explore more about your life today….cont’d. Scene Two: VISION Coach: Tell me more about that vision. What is important to you about it? Client: Taking control of my life. I’ve let my priorities get out of order. Coach: What’s important about now? Client: Life is going quickly and I realize that I don’t want it to pass me by.  I used to have big dreams…and then work and family responsibilities got in the way. Coach: What will be possible when you achieve it? Client: I’ll feel proud of myself and have more confidence. I think that’s what I miss most about my younger self – feeling like I can do anything. Coach: When you are at your best, you are confident and optimistic that you can achieve anything you set your mind to. Let’s expand your vision to address what strengths you’ll apply to get there, your major challenges, and some of the strategies you might use to rise above your challenges….cont’d. Scene Three:  THE PLAN Coach: Let’s start working on how you will get to the vision you yearn for. What is the first thing you’d like to be doing in three months that would get you closer? Client: That’s a good question.  The first thing I’d like to be doing in three months is spending time with my spouse most evenings. Coach: What do you mean by spending time? Client: We used to play games together; that was always fun. Or, taking walks – I see couples doing that and always think “How lovely.” Coach: What would be the benefits of spending more fun time with your spouse? Client: I always feel less stressed when I take time to relax. And, my spouse is my best friend; I always feel better about myself when we have time to be together. We talk about new things to pursue together. Coach: So, if you were to set a goal around this for the next three months, how would you write it? Let’s make it very specific and detailed. How much time would be enough to energize, relax, and inspire you? Client: By the end of three months, I would like to spend two evenings and one half-day on the weekend together. Coach: Would you be willing to change the language to say “I will spend two evenings and one half-day weekend day with my spouse”? Client: Yes, that sounds great! Coach: Let’s work on the rest of your plan. What’s the second goal you’d like to pursue in the next three months…cont’d. Scene Four: THE JOURNEY Coach: Now let’s work on the first step you will take toward your three month goals and your vision. What is a small step that you can take next week? Client: I’m not really sure. I’m so busy with work in the evenings and weekends and it’s been hard to take time out for myself, let alone to spend time with my spouse. Coach: You’re feeling overwhelmed right now because on one hand, it’s important to you to spend time with your spouse and, on the other hand, you are committed to doing a good job at work. Client: Yes, exactly. But, I know in the end, my spouse and my health are precious and I feel badly that they are not higher on my priority list. Coach: Tell me about a time when you are your spouse were taking time for each other. What was happening when you felt really connected? Client: Let me think about that…when we first got together, we used to take walks in the park near our home every night. After dinner, we would go for a 15 or 20 minute walk, just to digest our food and talk about our days. Coach: What did you enjoy about that? Client: Talking, being best friends…It also felt great to get outside at least once a day. Coach: You loved being connected to your spouse and you benefited from the exercise and fresh air. Client: Yes, we never made any plans those evenings until 7pm so we could be sure to walk. Coach: What could you learn from that and use today? Client: It seems that what was most important was that it was kind of an unspoken non-negotiable agreement that we’d walk every day. Coach: So, which part of that worked – the agreement or the walking every day? Client: It was the agreement we had together. And, just taking a short time; 15 minutes seems possible. Coach: What do you want to commit to this week? Client: I will take a 30-minute walk on Friday, after work, with my spouse. (Fast forward – The client attempts the goal but has a set back and “falls off of the ladder”) One week later… Coach: Tell me what went well with your goal of taking a 30-minute walk on Friday, after work, with your spouse. Client: It didn’t go as well as I’d hoped. Coach: Which part did go as well as you hoped? Client:  Although we didn’t actually take a walk, we did have some time, during a car ride, to start talking about what we’d like to do together. Coach: Sounds like just talking about the idea was a great way to connect. Client: Yes, it was. Coach: What did happen on Friday? Client: We ended up being invited to go to a friend’s house; it was a last minute invite from some friends we hadn’t seen in a while. The downside was that, even though we were both there, we were off talking to other people at opposite ends of the house. Coach: What did you learn from trying out this goal? Client: That Friday nights probably aren’t the best night to plan for our alone time together.  It does tend to be the night we are most likely to do something with other people. Coach: Okay, so it’s time to step back and rethink the goal; take a smaller step perhaps. Client: I think it would be more likely to happen if we planned for a weeknight instead of a weekend night. Coach: What night would be best next week? Client: Tuesday is the least busy. Coach: If you have chosen the best day, what else will it take to be successful with this? Client: I need to turn off my cell phone during dinner so I don’t get caught up in a phone call – my family tends to call during the evenings – instead of going on the walk. Coach: What is your goal this week? Client: I will take a walk with my spouse on Tuesday evening, after dinner, and will turn off my cell phone so we don’t get interrupted. Coach: How important is it to you that this happens? Client: Very. My spouse and I really are looking forward to it. Coach: On a scale of 1-10, how confident are you that this will happen? Client: A 10! Coach: Great work thinking this one through! I’m really looking forward to hearing about your success. Scene Four: Success Coach: Welcome back! I’ve been really excited to hear about your week. What was the best part of it? Client: Working on one goal got me thinking about the other areas of my life that I could make some improvements. Coach: Tell me more. Client: On Sunday, after having a big dinner, I was getting ready to cut out a big slice of my favorite kind of cheesecake when I remembered our conversation. Remember, when I said that my goal is do more activities that give me energy? Well, I was already full from dinner and it dawned on me that adding cheesecake on top of it was going to put me into a food coma. Coach: You were really paying attention to the signals your body was sending. What did you decide? Client: I didn’t eat the cake!  I told myself that “I had really enjoyed a great-tasting dinner and that I would appreciate it more if I stopped eating now.” Coach: How do you feel about that choice? Client: Surprised! I haven’t had that kind of willpower for years. Coach: It’s pretty exciting when you take control.  How did you use that willpower when you worked on your goal of walking on Tuesday, after dinner, without the cell phone? Client: We had such an incredible walk. The weather was perfect that evening, just the right temperature for a walk. We got to talk about our day and even do some planning for the next day. Coach: What did you most enjoy about working on this goal? Client: Giving myself 15 minutes to relax, away from the TV, and with my spouse. We laughed a lot. Coach: Sounds like you felt more energized and entertained than you usually are when you watch TV instead. Client: Yes, I usually use the TV to wind down, but it never really helps me relax. Coach: What did you learn about yourself this week? Client: That I really am ready to make some changes in my life. I can do it! Coach: I’m certain that you can – and you already are. What’s next?

Does coaching improve health? This is an important question for 160+ million people in the US, and multiples of that number globally, who have a health risk or chronic condition that can be improved by health-giving habits of mind and body. It’s also an important question for doctors and healthcare providers, leaders, employers, healthcare systems, health plans, governments, and of course coaches, who are dedicated to improving individual and population health. It’s an even more important question today because health is declining in the US and globally, mostly caused by unhealthy habits. More than 95% of adults don’t engage IN ALL OF THE TOP SEVEN HEALTH HABITS, 60% OF ADULTS HAVE AT LEAST ONE CHRONIC DISEASE, ONE THIRD OF ADULTS AND 19% OF CHILDREN ARE OBESE, and 50% OF ADULTS HAVE DIABETES OR PRE-DIABETES, which can be described as a food-borne disease. From the Aspen Health Strategy Group earlier this year: THE COST OF UNHEALTHY LIFESTYLES IN THE US WILL ADD UP TO $42 TRILLION BETWEEN 2016 AND 2030 IN HEALTHCARE COSTS AND LOST PRODUCTIVITY TO EMPLOYERS. Wellcoaches research advisor Gary Sforzo is leading a team that just published an UPDATE TO THE 2017 COMPENDIUM ON THE HEALTH & WELLNESS COACHING LITERATURE in May 2019. Two new meta-analyses of coaching outcomes were published in 2018 and the number of randomized clinical trials increased from 72 to 108 in two years since the 2017 compendium. The author team ambitiously delivered a complete review of HWC research, first from 2000-2016, and now an update from 2016-2018.  Selected papers met criteria that define coaching which emerged from a 2013 SYSTEMATIC REVIEW: 1. coaches trained in behavior change, motivational techniques 2. patient-centered (guided by patient values) 3. patient determined goals 4. self-discovery 5. accountability 6. ongoing relationship Key Characteristics You can see in Exhibit A that obesity, diabetes, and wellness are the main areas of research focus.  In Exhibit B, we learn that approximately half of selected studies are randomized controlled studies, 108 in total (well exceeding the 15 RANDOMIZED CONTROLLED STUDIES IN THE EXECUTIVE COACHING LITERATURE as of 2016). There is also one welcomed meta-analysis on the positive HWC effects on A1C IN DIABETES PUBLISHED IN 2018, and another meta-analysis on SEVERAL APPROACHES TO HYPERTENSION INCLUDING COACHING. Limitations of HWC outcomes research The main limitation is that many studies combine HWC with other education or wellness interventions (in fact, mirroring real world practice), thereby obscuring the pure effect of a coaching intervention on a particular outcome. In recent years, there are more studies isolating the effects of coaching. Yes, coaching improves health While not unanimous, the bulk of the research reports a favorable impact of HWC on obesity, diabetes, hypertension, cholesterol, heart disease, and general wellness.  The study of cancer patients, more limited, shows positive findings. The consistent and beneficial impacts of HWC on weight loss, A1C, blood pressure, cholesterol, stress, anxiety, self-efficacy, exercise participation, and nutritional habits nicely support the use of HWC to prevent or treat chronic conditions. More to come The HWC literature is on pace to double every four years or so. This will include better-designed studies and studies using coaches who meet newly established standards, passing the NATIONAL BOARD CERTIFICATION FOR HEALTH AND WELLNESS COACHES backed by the NATIONAL BOARD OF MEDICAL EXAMINERS. Studies will likely explore the optimal coaching dose, how to improve sustainability and cost effectiveness as well as emerging coaching trends, such as combining coaching with digital tools and group coaching models. Takeaways for Coaches 1. If you are a coach and your health needs an upgrade, walk the walk and engage a health and wellness coach. 2. Recommend to your doctor that s/he refers patients to NBC-HWC – national board certified health and wellness coaches. 3. If you coach leaders and their employees’ health needs an upgrade, suggest they hire health and wellness coaches to help them improve employee health, engagement and productivity. Let’s toast our most precious asset, health, and the hundreds of researchers showing that coaching improves health! Sforzo, Kaye, Harenberg, Costello, Cobus-Kuo, Rauff, Edman, Frates, Moore.  (2019). COMPENDIUM OF HEALTH AND WELLNESS COACHING: 2019 ADDENDUM.  American Journal of Lifestyle Medicine.