OUTCOMES ACROSS THE VALUE CHAIN is a peer-reviewed article published in July 2016 examining a corporate wellness intervention for over 150,000 employees.  Health coaching was offered only to those employees at greater risk meaning about 49,500 were eligible.  After learning about health coaching about half decided to give it a try and of these 78% (~19,800) completed the recommended four coaching sessions within one year. The program was highly successful with coached participants significantly (p < .05) improving: •    Systolic and diastolic blood pressure •    BMI •    LDL-cholesterol, triglycerides, and glucose •    Absenteeism and employment termination (involuntary or voluntary) •    Medical utilization (emergency room visits, hospital admission, and hospital lengths of stay) •    Medical costs Besides reporting these tremendous outcome improvements after coaching, the authors created a unique system of health engagement to classify participants.  They considered high engagement as regular health coaching, education, and goal achievement while low engagement involved a lesser experience with these practices.  In other words, high engagement meant fully buying into behavior change activities and succeeding at the process. At the study’s end, nearly 15,500 participants were classified as high engagers.  It should be no surprise that high engagers got the best results averaging 3.9% better (one-year change scores) improvement than controls across all 33 outcome variables measured. This study was very impressive not only because of participant number (nearly 20,000 making it the largest-ever study of coaching) and great outcomes, but also what we can learn from how coaching participants were selected and categorized.  Employees who had the most to gain, and who became fully engaged in the coaching and behavior change processes, were most successful in this wellness program.   Such an interpretation of these findings might inform both large employers and individuals (as well as health and wellness coaches) about who is ready to become invested in the coaching process. Whether you are working with a big company or a single client, here are some important take-away points from this landmark study that might help you: •    Largest peer-reviewed study of health and wellness coaching published to date •    Significant improvements in nearly all of 33 outcome variables (including medical costs and employee turnover) for high engagers over one year (see the citation for all variables1) •    Only high-risk employees were offered health coaching and not all of these were ready to make change (nearly 65% of those initially interested in coaching turned into high engagers) •    Those who fully engaged in the behavior change process produced the best results •    If an employee/client is not prepared to fully engage then coaching may not be as effective as it otherwise might be – consider first investing in those with the best likelihood of success •    Measurement of Readiness-to-Change (Transtheoretical Model) may be a key predictor of client success in the coaching process (but this hypothesis awaits confirmation from future research) Listen to a WEBINAR REGARDING THE RESEARCH. Outcomes Across the Value Chain for a Comprehensive Employee Health and Wellness Intervention A Cohort Study by Degrees of Health Engagement D. Adam Long, PhD, Roger W. Reed, BSN, and Ian Duncan, B Phil J Occup Environ Med. 2016 Jul;58(7):696-706 DOI: 10.1097/JOM.0000000000000765.

Join Margaret Moore and Eddie Phillips for their Harvard Health book launch event, SEPTEMBER 8, AT THE HARVARD COOP. Their  book, ORGANIZE YOUR EMOTIONS, OPTIMIZE YOUR LIFE, will be released on September 6 by publisher William Morrow. Read the INTRODUCTION AND FIRST CHAPTER NOW.

We learned from the Oscar-winning Pixar movie, Inside Out , that multiplicity of mind is natural and normal. In my 2013 paper: COACHING THE MULTIPLICITY OF MIND, A STRENGTHS-BASED APPROACH, I proposed a new model of the human psyche that is an adult version of Inside Out , positing that the human psyche has nine internal life forces, speaking as our inner “voices,” with distinct agendas including needs, values, and capacities. Our emotions then operate as a sensory system signaling whether the agendas of each life force are being served (generating positive emotions) or not served (generating negative emotions). I am on a mission to organize my inner dialogue and emotions and then help others do the same. I arrived at this model via my own deep personal work as a student of internal family systems practice, a therapeutic approach that teaches one how to discern among and tune into unique inner voices. I’ve confirmed the presence of nine common voices with hundreds of clients and shared the model in the co-authored Harvard Health book, ORGANIZE YOUR EMOTIONS, OPTIMIZE YOUR LIFE . Every morning, I do a roll call tuning into each of the nine voices and decoding the mixed emotional weather report served up before breakfast. I then start the day fresh with new insights, and more peace, calm, and equanimity. What I want to share with you today is a next iteration of this work, which is to suggest that there are healthy, counterbalancing, Yang (controlling) and Yin (letting go) states of each of the nine life forces. It’s important that coaches tap into the optimal state of each “subpersonality” during coaching sessions. This is what I mean by this blog’s title: A Coach’s Mind: Inside Out . Let’s take a spin and see how this might work. 1. Let’s start with the voice of Autonomy. This life force is the captain of the proverbial human ship. It is concerned most about marching to our own drummers, being authentic and free to make the choices which best serve our values and interests, and control our destiny. As Sammy Davis Jr. sang beautifully, “I gotta be me.” Autonomy is the master of self-interest first, prone to rebelling when others, particularly those who do not “get us” or share our values, tell us what to do. Decades of research led by psychologists Ed Deci and Rich Ryan has identified autonomy as the primary, organismic drive of humans. Coach’s Mind: A Yin state of Autonomy. Put self-interests aside and support another’s autonomy. A Yang state of Autonomy : Be in control, be right, have things go our way. 2. Let’s tune into the Relational voice who exists to serve others and puts others first, showing genuine empathy and concern. The Relational helps others thrive and perform at their best. Having high social and emotional intelligence, the Relational is a team-player and knows how to build win-win relationships, collaborations, and partnerships. Being loyal and trustworthy are high priorities. Coach’s Mind: A Yang state of Relational: to serve others, put others first, tune completely into others’ interests and states. A Yin state of Relational: Let go of putting others first, pleasing or avoiding conflict with others. 3. The next voice is the Standard Setter, is responsible for internal standards of performance and achievement, setting ambitious goals and meeting them. It is concerned with self-worth. It also tracks external standards to make sure we are valued, get respect and validation, and we are treated fairly .  It can be a hard taskmaster, a tough (inner) critic. It makes us persist through ups and downs to accomplish big things. It cares about what others think, concerned with social comparison, and wears whatever mask is needed to get social validation and approval. Coach’s Mind: A Yin state of the Standard Setter. Let go of personal achieving or winning. Let go of judging and criticizing ourselves and others. Tune into humility. A Yang state of the Standard Setter: Set ambitious goals, compete, perform, persevere, and win. Criticize and judge performance, ours and others. 4. Now onto the voice of Confidence, dedicated to being strong, competent and confident. It is the lion on the team, showing off its knowledge and skill. Hope and optimism spring from confidence in oneself and others relative to the challenges ahead. Confidence (or lack of), which can result from a too-high performance standard be next up, the Standard Setter, can lead us to procrastinate and suffer from self-doubt. Coach’s Mind: A Yin state of Confidence. Let go of demonstrating competence and power. Support building of competence and confidence of others. A Yang State of Confidence: Show competence, prove knowledge and skills. Show how strong and powerful we are. 5. Enter the voice of the Adventurer, the fearless explorer, tuning into opportunities, realities, and surprises in the internal and external world with an open and curious mind. Enjoying novelty, the Adventurer is deeply inquisitive, welcoming and embracing change and risk. It’s ever-ready supply of curious energy is a big source of resilience when things don’t go well, helping us recover and adapt quickly. Coach’s Mind: A Yang state of the Adventurer, open-minded and curious, in wide open receive mode and not active send mode. Exploring, taking risks, pursuing change. A Yin state of the Adventurer: Let go of curiosity, novelty, risk taking, and pursuit of change. 6. Let’s check in with the Creative voice which loves to play, to generate, to create and invent. It functions well in chaos and enjoys spontaneity, finding brilliant ideas just in time. The Creative life force delivers out-of-the-box approaches and innovations, with a good dose of creative humor, to help address enormous challenges. Coach’s Mind: The Yang state of the Creative . Foster emergent and collaborative spontaneity, nonlinear thinking, and creativity. The Yin state of the Creative: Switch off or turn down creative impulses. 7. The Executive Manager is the voice of your inner organizer, planner, analyst and strategist. Juggling many balls in parallel, the Executive Manager can stay clear and calm in the face of an overwhelming volume of demands. It can synthesize massive amounts of data into an integrated solution. Getting to the bottom line, it can distil a situation into its bullet points, bringing order to chaos over and over and over. Coach’s Mind: A Yang state of the Executive Manager. Help others discover more clarity and order. A Yin state of the Executive Manager: Switch off or turn down need for clarity and order. 8. Second to last is the voice of the Body Regulator, focused on safety, stability, and balance, including physical and mental health. The Body Regulator is down-to-earth and grounded. It values sustainability, for self, others, and our planet. A Coach’s Mind: A Yin state of the Body Regulator. Let go of stability and homeostasis. Embrace imbalance. A Yang state of the Body Regulator: Stability, homeostasis, and balance. 9. Last is the voice of the Meaning Maker, which stands back and tunes into meaning and purpose, zooming in to consider the import of a small moment or zooming out to find patterns and make sense of large moments. It channels the greater good, the transcendent or spiritual dimension, asking “what is the larger lesson of this situation?” The Meaning Maker is the wise mentor, mature sage, and inner coach, offering gratitude and awe, nudging us to consider all perspectives. Then it offers the wisdom hiding behind agitation, just what is needed for this moment. A Coach’s Mind: A Yang state of Meaning Maker: seek higher purpose, a transcendent perspective, awe and gratitude. A Yin state of Meaning Maker: Switch off or turn down making of meaning and seeking or purpose. As you will have noted, I am suggesting that the Coach’s Mind draws on the “Yang” states of the Relational, Adventurer, Creative, Executive Manager, and Meaning-Maker, and the “Yin” states of Autonomy, Standard Setter, Confidence, and Body Regulator. Originally published by the Institute of Coaching: HTTP://WWW.INSTITUTEOFCOACHING.ORG/BLOGS/COACHS-MIND-INSIDE-OUT

Our UNDERSTANDING of the human mind, including where it came from, it’s true NATURE, and how it works and evolves, is primitive. In the absence of scientific understanding, the lexicons for MINDFULNESS and MEDITATION are rich with evocative metaphors. We search for perfect images or words to describe or evoke various experiences and BRAIN STATES that free us even for a few moments from the messiness of being human. Now pop stars are calling us in cool ways to calm and clear our minds: “IT’S ALL ABOUT THE BREATH,” “FEEL THIS MOMENT.” In MINDFULNESS PRACTICES we sit in the here and now and gently watch the passing inside weather. Thought clouds or windy surges of emotions rush in and pass by. Unhooking from the inner weather leads to experiencing the moment fully. You may also get occasional glimpses of a stillness of being, resonating with the sky behind the clouds. Quantum biologists call this resting energy state, recently shown to be widely prevalent in biological molecules, “QUANTUM CRITICALITY.” Daoists call it “Dao,” a pervasive stillness of the individual and collective consciousness. While I cherish tuning into the moment and even an empty state of mind, I have always felt a nagging dissatisfaction with letting thoughts and emotions go. I am curious about the nature of the thought clouds, windy emotions, and the ever-changing emotional weather report. Judy Collins captures my sentiments in her song BOTH SIDES NOW: I’ve looked at clouds from both sides now From up and down and still somehow It’s cloud’s illusions I recall I really don’t know clouds at all A yearning to understand the inner clouds and windy emotions led me on a journey four years ago to “turn the lights on” in my inner world, starting with study of INTERNAL FAMILY SYSTEMS (IFS) practice developed by Dick Schwartz. In the IFS model, which is focused on healing, the mindful mind, or “self,” witnesses and orchestrates an internal family of “parts” or subpersonalities that are the source of thoughts, emotions, and behaviors, healthy and unhealthy. As a biologist (17-year CAREER in biotechnology), immersed in the awe-inspiring order of mother nature, I was certain that there is a strengths-based scaffolding for the internal family. Gradually I unpacked and organized my inner world. I found nine independent life forces or characters, now depicted as MY PERSONAL EMOJIS. To convey this experience, I published a hypothesis paper: COACHING THE MULTIPLICITY OF MIND: A STRENGTHS-BASED APPROACH, followed by a new Harvard HEALTH book, ORGANIZE YOUR EMOTIONS, OPTIMIZE YOUR LIFE, co-authored with Harvard physician Eddie Phillips, and writer John Hanc. For four years I have done a daily roll call as my early morning mindfulness practice, which decodes my emotional weather report and brings some clarity and calm. I have taught the practice to hundreds of COACHING clients, helping them tune into a “radio frequency” of each life force. Now I use the metaphor of a solar system; I experience the psyche as having a sun at the “core” and eight planets, each in its own unique orbit. My mind seems like the energy field of a solar system. When I want to quiet my mind I ask my “planets” to go out to orbit, like sending kids out to play, so I can have a quiet moment. In my flights of imagination, I wonder whether the solar system is the source of elements and energy forms and states that self-organized on earth into life forms, and four billion years later, populate our minds. Now we are back to a metaphor and a question: Is there a solar system in the mind’s sky?

Originally printed in Family Circle, October 2016 If you’re arguing with your partner… Take a step back and consider what needs your mate may believe are not being met. It’s likely one of you is feeling a little controlled or neglected. Talk things out with compassion to address what requires more attention. When you have a large project looming at work… Figure out what must get done today and successfully tackle it so you build momentum to keep going Pause for mental breaks to reboot your focus, and think about what the task means to you so you’ll feel re-energized. If you’re overwhelmed with family tasks… Seek outside help and be honest with your kids, explaining that while you would do anything for them, you need some time for self-care They’ll understand and you’ll teach them about balance and personal preservation.

The story goes: a prominent thinker, perhaps William James or Bertrand Russell, delivered a lecture on the nature of the solar system. In response, an elderly woman proposed an alternate theory, that the world is flat, sitting on a turtle, and it is turtles all the way down. Her wacky notion has a kernel of wisdom for leaders in healthcare today. The emerging profession of coaching in healthcare is well on its way to identifying the “turtles,” the mechanisms of coaching that ignite and foster personal engagement in healthy living (1, 2, 3, 4), giving us the resources to perform at our best. What we wrote in a 2006 white paper: THE OBESITY EPIDEMIC, A CONFIDENCE CRISIS CALLING FOR PROFESSIONAL COACHES, is standing the test of time. Health and wellness coaches (5), and the deployment of coaching techniques by health providers, are contributing to population health by: accepting and meeting us where we are today asking us to take charge, take hold of the steering wheel of our lives helping us define a higher purpose for well-being helping us uncover our natural impulse to be well guiding us in doing the mindful thinking and doing work that builds confidence helping us tap into our innate fighting spirit addressing mental and physical health together helping us draw a personal blueprint for well-being helping us set realistic goals; small victories lay the foundation for self-efficacy harnessing our strengths to overcome our obstacles helping us view challenges as opportunities to learn and grow helping us build a support team inspiring and challenging us to go beyond what we would do alone. Population health is our destiny. It’s time to lead. Let’s go first. While we have no map yet to guide us toward successful healthcare reform, perhaps better described as transformation, there is no doubt as to our destination. Population health is our destiny. To lead in healthcare then is to coach ourselves and all we serve, including providers and patients, to cultivate personal health and well-being. Going first means that the first population to get healthy is the population of healthcare workers who take great care of those whose health is compromised. At a recent HARVARD MEDICAL SCHOOL CONFERENCE FOR WOMEN HEALTHCARE LEADERS, I presented on coaching in healthcare, proposing that population health depends on a coaching culture in healthcare (6) from top to bottom: A culture where one’s own self-determination is well served by investing in the self-determination of others. A culture that transforms burnout into full engagement in well-being. A culture that is accepting and empathetic while inspiring autonomy and heartfelt purpose. A culture that draws out the intrinsic motivation of leaders, providers, and patients, and pours the energy into building confidence and habits of well-being. A culture of well-being that unleashes the adventurous and creative forces that will power us toward the transformation of healthcare. Our best path to the triple aim (7) is not just reform, fixing what’s not working. Let’s unleash a triple aim of human biology. Connect. Grow. Thrive. At its simplest, the recipe for a coaching culture is based on eliciting that which makes humans thrive, which then unleashes our most innovative, adventurous, and purposeful minds. Start with a genuine “I have your back” (8) connection, then add the ingredients that help people grow and engage in the habits that generate more thriving (9). Leaders, providers, and patients will begin to thrive in more moments, more hours, days, and maybe the rest of our lives. Then we are on the way to transforming healthcare. Harvard physician JULIE SILVER, who organized the conference for women healthcare leaders, started #QUOTEHER, and called on us to be more visible by contributing our own quotes. Here are three “Coach Meg” quotes, my call to action for coaching in healthcare. In healthcare, it’s coaching all the way down. Population health is our destiny. It is time to lead. Let’s go first. Engage biology’s triple aim. Connect. Grow. Thrive. References & Resources 1. Moore, Boothroyd. 2006. THE OBESITY EPIDEMIC: A CONFIDENCE CRISIS CALLING FOR PROFESSIONAL COACHES. White paper published by Wellcoaches Corporation. 2. Wolever et al. 2013. A SYSTEMATIC REVIEW OF THE LITERATURE ON HEALTH AND WELLNESS COACHING. Global Advances in Health and Medicine. 3. INSTITUTE OF COACHING, McLean Hospital, a Harvard Medical School affiliate 4. Moore, Jackson, Tschannen-Moran. 2015. COACHING PSYCHOLOGY MANUAL. Endorsed by the American College of Sports Medicine and published by Wolters Kluwer. 5. PRESS RELEASE announcing partnership of National Consortium for Credentialing Health & Wellness Coaches and National Board of Medical Examiners to deliver national standards and national certification of health and wellness coaches and support deployment of professional coaches and coaching competencies across the spectrum: clinical, organizational, and community settings. 6. Wolever, Moore, Jordan. 2016. CHAPTER 29. COACHING IN HEALTHCARE. The Sage Handbook of Coaching. 7. Institute of Healthcare Improvement. 2016. TRIPLE AIM OF HEALTHCARE – affordable, quality care, optimal health for all 8. Amy Edmondson, PhD, Harvard Business School. TEAMING AND PSYCHOLOGICAL SAFETY. 9. Moore, Phillips, Hanc. 2016. ORGANIZE YOUR EMOTIONS, OPTIMIZE YOUR LIFE. A HARVARD HEALTH BOOK published by William Morrow.

Every four years, families sit down together after a presidential election. They set aside their political differences to appreciate each other and feel gratitude for the gifts of family, and the wonders of being alive. Political divisions are as old as democratic societies that make room for diverse and opposing views. At least now we are far more civil than long ago when people dueled, staking their lives over opposing positions. Nevertheless, this season can be challenging, not just for families, but also for circles of friends, and work colleagues and teams. Civility and politeness in politics and being respectful and considerate to others’ views has been a casualty of our 2016 election cycle. As The Wall Street Journal’s Elizabeth Bernstein notes on HOW TO AVOID A FAMILY BLOWUP AT THANKSGIVING, “the election has left Americans polarized and resentful. Emotions are high. Empathy is low.” The Harvard Gazette just published an article: NEW NATIONAL MOTTO: YOU’RE WRONG, I’M RIGHT. Of course, we didn’t arrive at this deep level of polarization overnight. But now that it’s out in plain view, we need new ways to navigate our differences. I want to offer a perspective based upon the notion that the human mind is a collection of independent and distinct parts, each with its own agenda, beautifully depicted in the Pixar movie, Inside Out. My STRENGTHS-BASED MODEL OF THE MULTIPLICITY OF MIND is made up of an inner family: the Mindful Self and nine life forces. It’s explored in the new Harvard Health book, ORGANIZE YOUR EMOTIONS, OPTIMIZE YOUR LIFE. The Mindful Self steps back and detaches from our strongest and loudest voices, and draws out other voices to provide more balance in the inner dialogue. Then we can tune into a variety of life forces to diversify perspectives and bring more wisdom and even gratitude, especially when parts of you don’t feel grateful. Here’s what this might look like as we approach work, social, and family events over the holiday season and deal with inner and outer conflicts. Autonomy (authenticity, values, self-determination): The political values of someone close (family, friend or colleague) conflict with values I hold dear, and maybe even conflict with my self-actualization. Standard Setter (setting standards and judging): I agree with Autonomy. These opposing values are simply not acceptable and not good for us. I will not lower my standards. Adventurer (new experience and learning): It might be helpful to have an open mind here. I wonder whether we could set aside self-concerns and judgment and get curious about what is driving these opposite values – life experience, priorities, deep wiring? Maybe there is something new to appreciate, to learn. Relational (puts others first and wants social harmony): I’m remembering an old adage of parenting – you can be right, or you can have the relationship, but sometimes you can’t have both. How about we empathize with the opposing view, even if we disagree, and choose the relationship? We could shift focus to what we appreciate, and our common values, not only on where we differ. Creative (out-of-the box thinking): Let’s find some humor. What if we pivot to having fun together like we used to, telling jokes, playing games, even being able to appreciate the satire inherent to the situation? Meaning Maker (zoom out to meaning and purpose): Let’s look at the higher meaning. A first step in a major disagreement with someone close is to seek to understand, appreciate, and respect the other side, channeling one’s higher self. Perhaps the real learning is to upgrade our acceptance of others and what we can’t change. Expand our limits of compassion. We could then be grateful for the gifts of this experience. We may even be a role model for those whose values clash with ours. Body Regulator (concerned with health and balance): Let’s chill and enjoy each other. And don’t forget to get in a workout, savor every bite, and hold back on overeating along with strong emotions. In the best case, family, friends, and colleagues with opposing values and views come together to find common ground, acknowledging the good in both perspectives. We then go on to improve our relationships. That’s the beautiful upside of polarization: we are grateful for opposing views. They can lead us together to a better place.

As the coaching industry expands, the choices of schools, programs and philosophies has grown exponentially. However, becoming a coach is about much more than studying a set of skills and then applying them scientifically to another person. Becoming a coach is as much about personal transformation as it is professional growth. To become a coach, one must BE coach-like in all aspects of one’s life. And, for this transformation to occur, it is important that you connect with a coaching community with shared values, philosophies and visions. This 10-part blog series is designed to support you in navigating that choice. Wellcoaches faculty are experienced and masterful coaches. Like you, your teachers at Wellcoaches are lifelong learners, continually striving to grow and improve. That is why eight of our faculty members have the highest certifications from the INTERNATIONAL COACH FEDERATION. Ongoing professional development is a joy for us – and we love to share our leading-edge learning with you! Your teachers bring diverse backgrounds, just like you in a field that is diverse in its nature.  They are scientists, psychologists, nurses, physicians, physiologists, dieticians, executive coaches, healthcare experts, authors – and most of all, dedicated to living an authentically healthy lifestyle.  You will find both role models and inspirations among them. Our faculty members are practicing coaches, with active coaching practices –  with real success stories…and real challenges.  We love to share the stories of our clients’ victories and our own learning processes to support new coaches in navigating their own discovery about the kinds of coaches they are becoming. Our live classes provide the opportunity for rich storytelling and discussion about the work. Although we present forward-thinking, leading-edge content, this is not an experimental program. You will benefit from our many years of coach training experience.  Since 2002, we have trained the largest pool of professional coaches in the world – over 10,000.  Many of our students come from health care systems, large employers, and coaching and wellness vendors. We have a well over a decade of experience learning from our students, who are applying the concept of coaching in the real world.  You can be certain that you will be presented with new ideas and skills in a way that enables you to apply them with confidence. Inquires for reflection: What kind of experience do you believe is important for faculty to have? What are indicators of coaching “expertise”? What is the learning environment you hope an masterful teacher would create for the students?

SEE STUDY IN BMC MUSCULOSKELETAL DISORDERS https://bmcmusculoskeletdisord.biomedcentral.com/articles/10.1186/s12891-016-1316-0 Client Testimonials “I am more comfortable with having fibromyalgia and being able to get through it; I know I am going to be okay; I started going to the gym twice/week; I still have a lot of fatigue but the pain has subsided” “I’ve always been a goal setter and do things no matter how much I hurt; my coach and I have worked on taking time for myself and sleeping more; getting more restful sleep; I am seeing a difference in pain levels –decreased soreness to the touch and less trouble with my legs” “I would have had a different life if I’d had this 10 years ago” Results at a glance In collaboration with Kevin Hackshaw, MD, four Wellcoaches-certified coaches (Susan O’Donnell, Pat Roix, Lisa Creekmur and Christine VanHoozer) worked with 9 patients with fibromyalgia (FM) for 12-months leading to: an increase in self-compassion and self-kindness; pain scores decreased 32% and FM impact scores improved 35%; and an 86% decrease in health care utilization during and 6 months post-intervention. What is Fibromyalgia? Fibromyalgia is a member of a class of disorders called “medically unexplained symptoms” which present significant diagnostic and therapeutic challenges in healthcare (1). The economic impact of FM is enormous; current estimates suggest that as many as 25% of FM patients in the US receive some form of disability or injury compensation (2, 3). Various reports suggest that overall healthcare costs of FM are more than double that for people without FM (4, 5). Two factors that determine FM patients’ health and quality of life are a positive diagnosis and effective treatment (6). What is Health & Wellness Coaching (HWC)? The purpose of this study was to test the hypothesis that a Health and Wellness Coaching-based (HWC) intervention for FM would result in sustained improvements in health, quality of life, and reductions in healthcare-related costs as documented by subjective global improvement and health care utilization. The HWC approach employs health professionals who have completed the Wellcoaches professional health and wellness coach training and certification (125 live hours training over 18 months). The training curriculum integrates evidence-based theories in behavior change, self-determination, self efficacy and self regulation, motivational interviewing, positive psychology, and communication techniques into a standardized patient-centered protocol. HWC helps patients identify a personal vision of thriving, mentally and physically.  Coaches assist patients in developing autonomous motivation, new skills, improved self-efficacy, and sustainable changes in mindset and behavior that deliver more thriving through improved health and well-being. The 12 Month HWC Protocol The HWC protocol combined 60-minute, phone-based group coaching sessions (for 12 months) with 45-minute, private phone-based coaching sessions (up to 20 sessions over 12 months). Web-based educational webinars were provided, prior to each group coaching session, drawing upon the latest neuroscience discoveries to encourage patients to work on “rewiring their brains”, thinking and feeling patterns, and personal wellness habits. Group coaching sessions addressed webinar topics including taming emotional frenzy, deep focus and flow, mindfulness, self-compassion, and leveraging one’s strengths. Individual coaching sessions were customized while encouraging patients to discuss their learning and application of the content in the webinars and the group coaching sessions. Following the HWC intervention, patients expressed an appreciation for feeling increased calm, more in control of health issues, greater self-compassion, and decreased stress leading to healthier choices. References 1 Yunus MB. Editorial Review: An Update on Central Sensitivity Syndromes and the Issues of Nosology and Psychobiology. Curr Rheumatol Rev. 2015;11(2):70-85. 2 Smith HS, Harris R, Clauw D. Fibromyalgia: an afferent processing disorder leading to a complex pain generalized syndrome. Pain Physician. 2011 Mar-Apr;14(2):E217-45. 3 Wolfe F. The fibromyalgia syndrome: a consensus report on fibromyalgia and disability. J Rheumatol. 1996 Mar;23(3):534-9. 4 White LA, Birnbaum HG, Kaltenboeck A, Tang J, Mallett D, Robinson RL. Employees with fibromyalgia: medical comorbidity, healthcare costs, and work loss. Journal of Occupational and Environmental Medicine. 2008 Jan;50(1):13-24. 5 Thompson JM, Luedtke CA, Oh TH, Shah ND, Long KH, King S, et al. Direct medical costs in patients with fibromyalgia: Cost of illness and impact of a brief multidisciplinary treatment program. American Journal of Physical Medicine and Rehabilitation. 2011 Jan;90(1):40-6. 6 Clauw DJ. Fibromyalgia: a clinical review. Journal of the American Medical Association. 2014 Apr 16;311(15):1547-55.

Every health professional can probably point to a certain circumstance or life event that helped guide them to that role. For me, my journey began about 6 years ago. I was struggling with a mix of health issues (skin, hormonal, emotional) and decided to pursue holistic care. I consulted a nutritionist for just under a year with few results to speak of. Next, I started meeting regularly with a naturopathic doctor and continued for about 9 months. The answers I longed for weren’t rushing to the surface, but the support I felt from this doctor was night-and-day difference from the first nutritionist. I could tell that the naturopath genuinely cared about my health challenges as well as my frustrations in not seeing answers despite intense effort. Over a year later, I chose to work with another naturopathic doctor and started to see a few signs of progress in my physical health. About this same time, I enrolled in Huntington College of Health Sciences and started studying nutrition. Along the way, I had the opportunity to work with wellness programming for two 3-month periods at my local hospital. It was during one of these internships that I first discovered Wellcoaches and heard a bit more about the health coaching model. Something clicked. A candle started to flicker. My passion for coaching was kindled. Upon graduation from college, I decided to pursue health coach certification. Initially, I planned to enroll in a program that offered no person-to-person interaction, but it was reasonably priced and only a few months long. However, after consulting a few trusted individuals in the healthcare field—one of them had been through Wellcoaches herself—I switched course and signed up to be a part of the January 2016 Core Coach Training cohort. Even before the training started, I had such positive expectations of what the experience would be like. I was not disappointed. During the first teleclass on January 19, I decided to speak up despite the butterflies I felt in my stomach and my uncertainty about what I could offer in a class of so many professionals with years of experience in their fields. However, once I moved past the initial fear, it started to get easier to volunteer in demonstrations with the instructors or express my recent “aha” moments in coaching. The nerves weren’t gone by any means, but I was talking in every class and feeling more confident every time I pressed the “1”. My learning partner assignment was also an incredibly rich part of my journey at Wellcoaches. Kelsey and I connected via email after the first teleclass and scheduled a time to Skype later in the week. From that first interaction, we bonded; we grew as coaches; we were honest about our challenges; and we encouraged each other to keep pressing “onward and upward” as Coach Meg says. January turned into February, and February into March, and each week I felt more confident in my coaching skills and was excited to learn more and have more dynamic interactions. (I’ll come back to describe this term in more detail shortly.) By April, the assignments turned to creating your own wellness vision with the assistance of another coach-in-training. The dominant theme that surfaced for me could be summarized in one word…thriving. To this end, I came up with a list of activities that I believed cultivated that thriving feeling. And one of those was…dynamic interactions. From my journal, “What Makes Me Feel Like I Am Thriving?”: “dynamic interactions with individuals that challenge me to be my best self (e.g., coaching with classmates/practice clients).” From my first encounter with Wellcoaches (during the internship) to the actual Core Coach Training to my Skype sessions with Kelsey, I knew health coaching was something special for me. Through the development of my wellness vision I was able to see why: the dynamic interactions of coaching were intricately connected to my best self’s ideal of thriving. Coach. Connect. Thrive. Hannah Ewing is a Certified Wellcoach with a passion for everything coaching-related. She facilitates the Facebook group WELLNESS COACHES UNITED, where she connects with coaches all over the United States and even internationally. She is also the owner of HANNAH’S HEALTH COACHING, LLC, and spends much of her time building this business.

FareWell Pilot Results In a February 16, 2017 release, Dr. Mark Berman (Head of Health at FareWell Company) shared the results of pilot testing a new digital platform providing a means for weight loss, using Wellcoaches trained coaches.  FareWell is a physician-led program to help people improve health by making lasting changes to diet and lifestyle; the program and mobile app provides clients with coach calls, weekly meal plans, how-to videos, and 24/7 messaging support.  The company’s goal is to pioneer novel digital therapeutics targeting lifestyle-related cardiometabolic diseases like diabetes, heart disease, obesity and certain cancers (HTTPS://FAREWELL.IO/).  The nutritional features and exercise recommendations of the program are derived from evidenced-based findings and incorporate key principles established by FareWell’s advisory board that includes Dr. David Eisenberg, Dr. David Katz, Margaret Moore, and Mark Erickson. In their pilot study, Dr. Berman and associates recruited 94 female volunteers with a willingness to prepare meals at home and eat mostly whole, plant-based foods.  The study was a non-randomized, pre-post design offering 16 weeks free access to the Farewell program.  It included meal planning tools, smart shopping lists, recipes, a daily self-monitoring feature, variable weekly goals, and a short weekly curriculum delivered by email.  Each participant received a free digital scale with weigh-ins accessible to both participant and health coach.  Coaching calls, scheduled every two weeks at the participant’s convenience, provided participants behavioral support and a degree of personalization. The average participant age was 51 years and BMI was 32.8 (class 1 obesity).  “Starters” were defined as those with two or more coaching calls and at least one digital engagement (e.g. logging a daily target) in four weeks, and, “completers” defined as those who had at least 2 digital engagements in week 16 of the program.  Given this definition, nearly 75% of participants completed the program. Findings from the FareWell study emphasized those with the greatest engagement had the best results.  Those in the top third of participation lost 7.1% of body weight while the average for all completers was 5.1% loss over the 16-week program.  More than 70% of those in the top third achieved greater than 5% loss of body weight; a goal associated with improve health outcomes.  Excellent participation in physical activity (average = 4 times/week) was also achieved by program completers. The results from the FareWell pilot study are reminiscent of the large-scale (> 25,000 participants) coaching study published last summer.  In that article, Long et al. reported coached participants with higher engagement showed better overall health outcomes than participants with lesser engagement in their coaching program (also Wellcoaches-based).   A common theme in the FareWell results, and the Long et al. study, is those who stick with their health coach have a better chance for successful behavior change and positive health outcomes, particularly weight loss. The FareWell study provides an excellent and specific clinical demonstration of successfully incorporating the Wellcoaches model into a behavioral intervention plan for obese women.  FareWell presents a digital platform and new alternative for those seeking healthy behavior changes with weight loss as a first goal.  It is exciting to see Wellcoaches-trained coaches be a critical feature in the success achieved by those participating in the FareWell program. Sources Berman, M.  (2017). Learning and outcomes from our first digital therapeutic pilot. HTTPS://FAREWELL-ASSETS.S3.AMAZONAWS.COM /PILOT_RESULTS_EXTENDED_REFERENCED_VERSION.PDF Long, D., Reed, R. & Duncan, I. (2016).  Outcomes Across the Value Chain for a Comprehensive Employee Health and Wellness Intervention: A Cohort Study by Degrees of Health Engagement Journal of Occupational & Environmental Medicine:  JULY 2016 – VOLUME 58 – ISSUE 7 – P 696–706 doi: 10.1097/JOM.0000000000000765

In the United States, primary care has historically treated patients using a “sick care” model, a system which waits for patients to become ill before they are treated.   However, the advent of the Affordable Care Act, gave rise to patient centered medical homes, which are designed to support a primary prevention model, a system which seeks to prevent the onset of disease.  In an effort to prevent the development of type two diabetes, many patient centered medical homes have instituted proactive HbA1c screening for patients at high risk for developing type two diabetes. Unfortunately, even with preemptive testing, most patients with prediabetes do not receive proven interventions that prevent or slow the development of diabetes.  On occasion, patients will receive counseling from their primary care physician regarding the benefits of weight loss, physical activity and diet, but due to a lack of resources patient centered medical homes are not capable of delivering time intensive, evidence based interventions, such as the Diabetes Prevention Program.  Massachusetts General Hospital’s Ambulatory Practice of the Future (APF), a patient centered medical home, is no different, as it does not have the means to provide a comprehensive educational and behavioral lifestyle intervention, which call for frequent dietary counseling and supervised exercise sessions.  However, the APF does have the resources to provide health coaching. As a Wellcoaches certified health coach, working at the APF, I set out to explore the preliminary outcomes associated with behavioral health coaching for adults with prediabetes.  Through a retrospective chart review I found that patients with prediabetes who received an average of seven health coaching sessions, over a five month period: – Lowered their HbA1c from 5.85% to 5.64%, over a two years. – Sustained an average weight loss of 12 pounds, over a two years. – Experienced a continued improvement in HbA1c and body weight after the active health coaching period concluded, suggesting the potential for a sustained effect of the intervention. – Most commonly set goals associated with: Cardiovascular exercise (82%), Strength training (71%), Food Preparation (59%) Due to the study’s limitations a direct correlation between the use of a health coaching model and a reduction in HbA1c cannot be drawn.  However, this retrospective study generated a need to further evaluate the effectiveness of a health coaching intervention, when delivered to patients with prediabetes, as it may provide a feasible and effective behavioral intervention that can be delivered within a patient centered medical home.  To read the full article, recently published in the American Journal of Lifestyle Medicine , please follow this link: PRIMARY CARE-BASED HEALTH COACHING FOR THE MANAGEMENT OF PREDIABETES