“To experience peace does not mean that your life is always blissful. It means that you are capable of tapping into a blissful state of mind amidst the normal chaos of a hectic life.” ―Jill Bolte Taylor Note: This was previously published as an IOC Research Dose Introduction In today’s turbulent world, dealing with constant and ever-changing stressors is the norm. Although these are typically not large-scale stressors like death of a spouse or child, or a major trauma, chronic stressors cumulatively over time harm physical and mental health and well-being. Ongoing stress impairs the immune system, cognitive functioning, engagement at work, and makes us more prone to burnout. It has been difficult to study the cumulative effects of everyday stressors and how to prevent them without a tool for measuring them. The new Personal Sustainability Index (PSI) described and validated in a 2021 article by Boyatzis et al in Consulting Psychology Journal: Practice and Research titled “Thrive and Survive: Assessing Personal Sustainability” can provide that measurement. The authors note: “there are four types of experiences that activate and exaggerate stress: (a) the degree to which an activity is important to a person; (b) the degree of uncertainty the person is experiencing; (c) the degree to which others are watching or evaluating; and (d) the anticipation of any of these experiences.” The PSI tracks not only the frequency and variety of everyday stress events but also “renewal” events, such as walking in nature, playing with a child, or meditating, that help to counteract stress events. The article’s authors explain that reducing stress only helps us to survive, while increasing renewal instead helps us to thrive, and that the PSI is a critical tool for helping us get there. The Stress Response Boyatzis et al provide practical definitions of both stress and renewal. Stress activates the sympathetic nervous system (SNS), while renewal activates the parasympathetic nervous system (PNS). The SNS is a network of nerves important in the “fight-or-flight” response and is more active when a person is stressed or in danger. The body secretes adrenaline in response to danger, which increases heart rate, breathing capacity and the availability of energy stores. If the threat continues, the body releases cortisol, the primary stress hormone, to increase sugars in the bloodstream and keep the body primed for action. The PNS, associated with hormones like oxytocin and vasopressin, is the brake that shuts down the stress response. The fight-or-flight response was very effective at helping early humans evade predators. Once the sudden threat passed, the PNS shut the stress response down. However, in today’s hectic world, where low-level stress awaits at every busy corner or failed internet connection, the stress response remains switched on, with serious consequences for physical and mental health. For example, such chronic stress can increase the likelihood of heart disease, heart attack and stroke, cause sleep problems or weight gain and lead to anxiety and depression. Because we are so accustomed to these low-level stressors, such chronic stress can fly under the radar. Boyatzis et al describe the problem: “Adapting to life can enable us to adjust to dangerous or dysfunctional levels of stress. The ordinariness of many episodes may deceive us into tolerating stress and not acknowledging or even noticing the strain from the cumulative impact.” The Importance of Renewal The authors summarize the current theories on the need for a balance of stress events and renewal events: “…the degree of renewal (parasympathetic nervous system) needed is determined by the degree of stress (sympathetic nervous system) activated in the person during the recent past. The renewal experiences, if sufficient in arousal, can help to return the body to its prestress levels. The result is that the person has resources and energy in relationships, work, and life to feel more engaged, excited, and satisfied.” Many of the previous measures of stress have heavily weighted major life events like death of a loved one (e.g., Social Adjustment Rating Scale) or focused on posttraumatic stress (e.g., Impact of Events Scale). Other scales were meant to measure recovery from stress, such as unwinding after work (Recovery Experience Questionnaire), or coping with it, as for example by venting of emotions or seeking emotional support (Multidimensional Coping Inventory). Unlike these scales, the PSI focuses on the cumulative impact of everyday stressors and measures the events that not just reduce stress but that activate the PNS to shut it down. It inventories 16 renewal and 17 stressful everyday events, which were gleaned from the psychological and medical literature on chronic stress. In the words of Boyatzis et al, “Renewal is not assessed as low stress but as actual experiences that invoke the PNS.” By measuring not just everyday stressors but also renewal events, the PSI provides an important tool for better understanding and managing chronic stress. What the researchers found Using structural equation modeling to analyze the survey results, investigators found that depressed or anxious people may be less likely to engage in a variety of renewal activities. Subjective well-being, work engagement and career satisfaction were all significant positive consequences. Variety was a stronger determinant of these relationships than frequency, though frequency often but not always moderated variety’s effects. Boyatzis et al summarize the findings as follows: “To use the analogy of dosage from the pharmaceutical industry, a person would feel and function better if they had more episodes of renewal each week than stress, as well as a greater variety of types of renewal experiences each week.” Conclusion The PSI is an innovative tool for measuring everyday stress and renewal events. It helps us appreciate how low-grade stressors contribute to chronic stress and how renewal events can build resources and resilience. The PSI can be an informative tool for measuring how well a client is managing stress. It could also support the optimizing of stress management and improving the coaching experience. Takeaways for Coaches Using the PSI directly or being inspired by its principles, coaches can: Develop a list of renewal events (e.g., coaching, volunteering, showing compassion, exercise, nature, yoga, breathing, reflection, meditation, prayer, play, laughter, enjoyable meal) building on those inventoried in the PSI. Brainstorm on renewal activities with clients to counter their stress. Suggest that clients do a renewal activity just before or at the beginning of a coaching session to help them engage more in the growth process. Incorporate renewal activities into the coaching session to help clients integrate the skills learned. Encourage clients to track and manage their everyday stress and renewal activities. Help clients understand the importance of renewal activities not only for themselves but also for others at their organization. Citation: Boyatzis, R. E., Goleman, D., Dhar, U., & Osiri, J. K. (2021). Thrive and survive: Assessing personal sustainability. Consulting Psychology Journal: Practice and Research, 73(1), 27.

In July 2023, Medicare shared their laudable mission informing proposed changes for 2024: “If finalized, the proposals in this rule ensure the people we serve experience coordinated care focused on treating the whole person, considering each person’s unique story and individualized needs — physical health, behavioral health, oral health, social determinants of health, and are inclusive of caregivers, which are all so important to providing the care that people with Medicare deserve.” What Moves is Medicare proposing? 1. Coding and payment for social determinants of health risk assessments. 2. Separate coding and payment for community health integration services (supporting SDOH), including person-centered planning, health system coordination, promoting patient self-advocacy, and facilitating access to community-based resources to address unmet social needs. 3. Improve access to behavioral health in Medicare by allowing marriage and family therapists and mental health counselors, including addiction counselors, to enroll in Medicare and bill for their services for the first time. Increase payment for crisis care, substance use disorder treatment, and psychotherapy. 4. Payment for Principal Illness Navigation services to help patients navigate cancer treatment and treatment for other serious illnesses. These services are also designed to include care involving other peer support specialists, such as peer recovery coaches for individuals with substance use disorder. 5. Pay for certain caregiver training services in specified circumstances, so that practitioners are appropriately paid for engaging with caregivers to support people in carrying out their treatment plans. 6. Relevant to coaches – add health and well-being coaching services using the Category III coaching CPT codes, to the Medicare Telehealth Services List on a temporary basis for CY 2024. While temporary, Medicare’s proposal to open the door to 2024 payment for health and well-being coaching services is a pivotal and promising move for our field, particularly in the context of better addressing health equity and SDOH. It’s time, time for more and more people to grow and thrive with our help as the best health and well-being coaches! The Excited Wellcoaches Team

Last month the American Journal of Lifestyle Medicine published an article entitled “Health and Wellness Coaching and Sustained Gains: A Systematic Review" (Ahmann et al., 2023). Three of the six authors of this paper were Wellcoaches trained! The study’s purpose was to determine what is known about long-lasting effects for coaching clients after completing a health and wellness coaching program. To make this determination, the authors reviewed 231 HWC data-based research studies housed in the Compendium of Health and Wellness Coaching (Sforzo et al., 2020). They ultimately selected 28 articles of sufficient quality to examine the sustainability of a coaching effect post-intervention. Physiological, psychological, behavioral, and health risk outcomes were measured in these studies. It was essential that clients received NO additional coaching before the follow-up measurements, which usually occurred 3-12 months after the initial coaching period. The authors rated the results of each of the 28 retained studies as gains not sustained, gains partially sustained, gains fully sustained, or gains improved at follow-up compared to post-intervention. The average length of coaching intervention for the 28 studies was 6.4 months with about 8 coaching sessions over this time. The time for follow-up measures averaged nearly seven months after the completion of the coaching intervention. So, in essence, the question being addressed in this paper was, are beneficial coaching changes still evident more than six months after the cessation of a six-month coaching program. The authors found that coaching effects were sustained in 25 of the 28 studies examined (nearly 90%). This finding is supported by a large JAMA-published cluster RCT that found blood pressure changes after coaching were sustainable for up to four years (Nguyen-Huynh et al., 2020)! Sustainability of treatment benefits is a robust achievement for health and wellness coaching. Consider that, short of surgery, the effects of most other health interventions are not maintained long after halting treatment. For example, medications must be taken regularly, or the effect quickly fades away – cholesterol will go up if the patient stops taking daily doses of a statin. Take rehab programs (e.g., cardiac rehab or PT for orthopedic reasons) that typically last 2-4 months. After these programs, patients will show a loss of gains made after 2-4 weeks of detraining, with all benefits likely lost within 3-6 months if treatment is fully halted. And we are all acutely aware of what happens when a client falls off a successful diet plan and returns to old eating habits – they will certainly regain most, if not all, of whatever weight was lost. Long-lasting Effects of Coaching – I’ll have mine in BRICK, please! The present study demonstrated that a coaching program, supporting and encouraging behavior change, can have long-lasting benefits. In fact, in nine studies examined outcomes of interest (e.g., physiological and psychological) actually improved months after ceasing the coaching process. This likely indicates that healthy behaviors habits, newly formed during the coaching process, yielded enhanced benefits months after the last coaching session. Health and well-being coaching appears to be a unique form of health intervention that keeps on giving well after the process stops. In the 3 studies where outcomes were not sustained, it was likely to be physiological outcomes (e.g., BMI, A1C, or BP) that reverted to baseline. Improved psychological (e.g., stress or anxiety) or behavioral outcomes (e.g., exercise or eating habits) were more stable than physiological outcomes, typically being maintained for months of follow-up after coaching ended. These physiological parameters matter greatly in healthcare, and we do not want our clients to revert to baseline on these outcomes. Practically applied, this finding might lead coaches to discuss with their client how to best follow-up after completing the initial coaching intervention. As with all coaching, this would be a client-centered discussion and would consider that maintaining beneficial physiological changes might take careful attention and may require a maintenance strategy. That strategy might include using new resources or on occasional coaching booster at a lesser frequency than initially prescribed. As part of their coaching competencies, the National Board of Health and Wellness Coaches clearly and formally encourages coaches to assist clients in finding a sustainable pathway forward. The authors of this rapid systematic review strongly conclude that they provide “…evidence for the efficacy of sustaining gains beyond the active coaching period.” They continue, “…the unique value and important contribution HWC can make for varied health conditions….” It is hard not to agree with their conclusions! A well-delivered program of health and wellness coaching not only helps a client during the process but also for a substantial period after the intervention is stopped. With careful attention to follow-up management, our patients and clients can expect gains made during a coaching program to stick with them for an indefinite length of time. Not too many health or medical interventions can make that claim. Viva health and well-being coaching …. and the clients who benefit! References Ahmann E, Saviet M, Conboy L, Smith K, Iachini B, DeMartin R. Health and Wellness Coaching and Sustained Gains: A Rapid Systematic Review. American Journal of Lifestyle Medicine. 2023;0(0). Sforzo GA, Kaye MP, Harenberg S, et al. Compendium of Health and Wellness Coaching: 2019 Addendum. American Journal of Lifestyle Medicine. 2020;14(2):155-168. doi:10.1177/1559827619850489 Nguyen-Huynh MN, Young JD, Ovbiagele B, Alexander JG, Alexeeff S, Lee C, Blick N, Caan BJ, Go AS, Sidney S. Effect of Lifestyle Coaching or Enhanced Pharmacotherapy on Blood Pressure Control Among Black Adults With Persistent Uncontrolled Hypertension: A Cluster Randomized Clinical Trial. JAMA Netw Open. 2022 May 2;5(5):e2212397. doi: 10.1001/jamanetworkopen.2022.12397

Introduction Given the high population prevalence of mental health issues, more and more coaching professionals are being called to support people who want to improve psychological well-being and are encountering a shortage of mental health professionals. This article briefly chronicles the 25-year history of the distinctions, overlap, and collaboration of mental/behavioral health professionals and coaching professionals, enabling an evolving collaboration, a beautiful duet going forward. Phase 1: Distinctions in scope of practice Over the past 25 years, clear distinctions between the scope of practice of mental/behavioral health professionals and coaching professionals have formed the basis of their work with different, although overlapping, populations. In the US, mental/behavioral health professionals invest in years of education, including Master's and PhD degrees, followed by rigorous state licensing and insurance credentialing requirements, in order to be skilled and qualified in helping people restore or improve their mental health. They routinely roll up their sleeves to deal with tough challenges that impair daily functioning, including past trauma, depression, anxiety, addictions, grief, and relational disturbances. Behavioral health professionals work with addiction, substance abuse, eating and mood disorders etc. This work is intense. It can be fraught with risk, especially when people are harming themselves or at risk of harming themselves, or their situations are straining their significant relationships. This sacred work, hidden from view, helps people heal and stabilize their mental and emotional health. It is a calling that is not for the faint of heart. On the other hand, coaching professionals in leadership, business, and health and well-being are trained to work with people who have stable mental health and want to improve themselves, their work, and their lives. Coaching helps people expand their internal and external resources to self-actualize and reach their greatest potential. Coaches are not trained nor qualified to help people better manage and overcome trauma, depression, anxiety, addiction, or loss/grief. They refer out to mental health professionals when they encounter such mental health challenges. Occasionally a client works with both a mental health professional on their mental health issues as well as a coach on their path forward to positive growth in parallel. Phase 2: Overlaps in interventions This simple distinction - mental health professionals working with people suffering with mental health challenges, and coaches working with people to realize their full potential, began to get blurry over the past decade or more. Both professions began to get training in interventions that can be applied in both contexts. For example, cognitive behavioral therapy was repurposed as cognitive behavioral coaching; similarly, solution-focused therapy as solution-focused coaching. The immunity to change model was developed for coaches, and is based on a cognitive behavioral framework. Acceptance and commitment practices are used in therapy and coaching, as are motivational interviewing, readiness to change, mindfulness, and self-compassion practices. Internal family systems practices are now taught to coaches who have embraced working with the multiplicity of mind. Going the other way, positive psychology interventions are now used by mental health professionals. Psychologists are trained in behavioral strategies and interventions now also used by coaches to support lifestyle change as a treatment for chronic psychological disorders. All in all, the new and emerging interventions have enriched the work and increased the flexibility of therapists and coaches. There is indeed a symbiotic relationship here. While coaches and therapists still work with distinct populations – the overlap is becoming more fluid and common. Phase 3: New Collaboration Emerging developments are launching a third phase of opportunities – a collaboration phase: The epidemic of mental health conditions in recent years has led to a serious shortage of mental health professionals. Coaching interventions are showing promise in improving psychological well-being, including autonomous motivation, efficacy, and forward growth, including those with burnout and recent suicide ideation. The evidence for lifestyle medicine (exercise, plant-forward nutrition, emotional resilience, healthy sleep, and social connections) to address the harm to the mental health of metabolic issues, has opened the door for coaches in health and well-being to work with this population. Addressing all of the recent trends, large health insurance companies Cigna and United Healthcare have begun to support “behavioral health” coaches and coaching for employees with mental health conditions. What then is important to the flourishing of this new collaboration? First and foremost, the responsibility for clinical evaluation, diagnosis, creating, and implementing treatment plans for mental health conditions rests with mental health/behavioral health professionals. Ideally, a client or patient who is willing, ready, and able to engage in lifestyle medicine is offered the option of a coaching program by mental health professionals or physicians, which would then be supervised by the referring professional. Having basic training in mental health literacy, coaches are able to collaborate effectively with mental health professionals. That said, coaches focus on the coaching process that moves people toward positive well-being goals, not focused directly on the mental health diagnosis and treatment plan. Supervising mental health professionals would lead regular check-ins to monitor and support progress and other resources that might be needed. Similarly, mental health professionals are beginning to get trained in coaching methodologies and some are offering a hybrid model that involves the resolution of past traumas and the movement towards goals and aspirations going forward. The opportunity for lifestyle medicine coaching to improve mental health is a new frontier. In a time of great population need, shortage of mental health professionals, and evidence for lifestyle medicine in improving mental health, a new collaboration of mental health and coaching professionals will help more people than ever to both restore mental health and move onto a path toward well-being. Margaret Moore, MBA, NBC-HWC Simon Matthews, MHlthSc, NBC-HWC Randy Kamen, EdD, Licensed Psychologist

As coaches and exercise professionals, you are in the unique position to accompany our clients through the ups and downs of their lives. What a gift it is to be with them in the moments of success– that first 5k, a successful week of workouts, the discovery of a new physical activity. It’s fun to be included in the celebration and to cheer them on. But lasting relationships include the whole of a person’s experiences – the losses, challenges, fears, and anxieties. To truly support our clients in achieving their goals (big and small), we need to have the skills to be present to a range of feelings. It’s easy to smile along with clients when they are happy; we are well-versed in affirmative statements and high-fives. The not-so-happy feelings, however, can feel intimidating – even scary. We can be tempted to avoid (change the subject), change the channel (try to talk them into feeling better), or hyper-focus (fix it/them). Here are some strategies that will prepare you for creating a connecting space with your clients without letting those “negative” feelings swallow you both whole. 1. Don’t mix up your story with theirs. When someone is suffering, it’s human nature to be reminded of the similar ways we’ve experienced the same feelings. We might recall when we went through the same circumstances. Take a breath and shift your focus to their story and their circumstances. Your story isn’t the antidote to their pain. 2. Make a guess. Most people don’t want or need to, be “rescued” from their feelings, they want to be heard. Sometimes, all it takes for the intensity of a feeling to be reduced if for it to be named. Take a guess about what your client is feeling and ask them about it. “Are you feeling disappointed?” or “It sounds like you are feeling anxious” gives them an invitation to say what they are experiencing. Most importantly, don’t rush past this. Discomfort is okay and part of working with humans. 3. Ask what they need. Your client knows best about what is helpful, and unhelpful, to them. Allow time in the conversation to explore strategies. Resist the temptation to take over and be the hero. Your client has ideas and experiences to draw from; encourage their ideas and their capability to find a resolution if there is one. 4. Let it go out the door. As a caring professional this can be the most difficult step – letting go of the need to take responsibility or fix it. When your time with your client is over, allow yourself to release any of your own intense emotions. Step away, take a breath, find whatever you need to reconnect with your work, and be fully present for your next client. Steps 2 and 3 above can be useful for you too!

Let me start this piece with a confession. I am addicted to watching Penn and Teller. There. I said it. If you haven’t seen one of their TV shows or their live shows (I’ve seen both), you’re seriously missing out on one of the greatest experiences of wonderment of the modern age. Their magic is incomparable and having been a performing duo for nearly 50 years, they have a capacity to entertain and amaze like no other. Entertainment and witty banter aside, the thing I love most is their capacity to completely fool me. I simply do not know how they do what they do. I watch. I watch again. I replay in slo-mo. I see nothing. And nothing gives me greater joy than not knowing. It’s that experience of not knowing that I really relish. If I knew how all their tricks were done, I think it would be a little tedious to watch quite frankly. Not knowing has an enchanting quality to it. It’s the place from which questions can be asked. It’s the place from which discoveries can be made. It’s the place from which new ideas can be considered, without having to commit to any of them. It’s the place from which anything might be, because nothing is yet known. Not knowing is also the position from which I’ve endeavoured to carry out my professional work as both a psychologist and coach for 30 years. This means I must ask; and I must be prepared to hear anything in response. Furthermore, I’ve learnt that the best questions to ask are those that are difficult to answer – those questions which first elicit a response of: “I don’t know – I’ve never thought about that…” In the practice of coaching, inquiry and questions are one of the basic ingredients we use – a little like flour to a baker, if you will. Powerful questions can ignite self-reflection, insight, awe, motivation, realization, and a host of other responses. But how do you get to the point of being able to ask questions that can do this? In the 1990s I was fortunate to study with and be taught and supervised by some very talented family therapists. That experience really has been a great foundation for my career since then. I’ve never let go of the power of questions to ignite imagination. Recently, I took one of the ideas I was exposed to in the 90s and re-imagined it. The result is an article just published in the American Journal of Lifestyle Medicine, entitled (it’s a mouthful!): The Question Cube Re-imagined – A 5-Dimensional Model for Cultivating Coaches’ Capacity for Curious Inquiry in Health Behaviour Change. I describe there a model for understanding and deconstructing the elements of a question. A common understanding of questions in coaching (and therapy!) really revolves around just one dimension – how open the question is; and even this dimension is often oversimplified into “open” and “closed” questions. In fact, the openness of a question really moves on a continuum from where a question may elicit a lengthy narrative response (open) all the way through to a single word response (closed - for example, yes or no). In the space between, there are wonderfully useful question formats such as rating or scaling questions (On a scale from zero to 10, how excited are you?) or ranking questions (Which of these appeals to you most? Which next?) and even forced choice questions (Which of those two emotions do you feel most strongly at the moment - anger or relief?). The next dimension relates to the focus of the question. We all likely have an intuitive appreciation of this dimension, but don’t necessarily realise the powerful way in which we can use it to shape the meaning and intent of a question. Questions may focus on what someone is doing (action), what they're feeling (emotion), as well as the quality of a particular relationship that they have, beliefs that they hold and meaning that they ascribe to their own actions, or the actions of others. For example, there are a number of ways in which I could inquire about a single event - a friend giving you a gift. I could ask: What was the gift? What feelings did you experience when you opened it? How important is this person in your life? What does the giving of this particular gift signify to you? What does this action say about your friendship? The third face of the question cube relates to the subject of the question. I could ask you a question about your own beliefs and values. I could also ask you about your perspective on another person’s beliefs or values and I could even ask you what views you imagine that other person might have about you. It's that last perspective that I find particularly useful because it invites the client to step out of their own frame of reference and consider a different perspective. It's much like crossing the road to look at your own front garden. When you sit inside your house, you can see your front garden, but you only have your own perspective of it. If you cross the road, you now get to see your front garden as people on that side of the road get to see it. If you've ever tried this in real life (go on - give it a go now) you will almost certainly notice different things in your front garden that were previously obscured from the view you have within your own house. The fourth dimension is fun - it's the dimension of time. Again, we probably know and use this intuitively, however it's really valuable to recognise that we can frame questions focused on the present, the past and the future. The usefulness of this is immediately obvious - it gives our clients (and us) a means of observing changes across time. If you ask me what I believe my best quality is, and you also ask me what I considered my best quality was two years ago, I'm now invited to engage in self-reflection on what those differences might be, and more importantly - what they might mean. The final dimension is that of reality and possibility. The things we do, the things we have, the people we are, are all real. They might be in the past, present or future. For example, I was born in Australia; I love watching Penn and Teller; I will be warmer later today when I light the fire. But we also inhabit a world of possibility - a world in which we are free to imagine actions we might take and parts of ourselves that have not yet been called into being. For me, this is one of the most exciting parts of coaching: to be able to explore all the possibilities that conceptually exist; all the things that might be. And of course we can frame questions focused not only on “What is?” but also “What might be?”. So the re-imagined Question Cube allows us to understand questions as ranging from “fully open” to “fully closed” as well as consider to whom the question is addressed, about whom, the subject matter, the timeframe and whether or not the question explores something that is or something that might be. As with anything in life, once you’ve deconstructed something and really understand how it works, you can reconstruct it in almost any way you like. I’ve written this in the hope that it might inspire you to engage in powerful inquiry; and if you are a teacher of coaching, counselling or therapy skills, my hope is that you’ll find this framework a straightforward and powerful means of teaching the compelling impact of well-crafted questions. Questions are like keys to rooms you’ve never been in. If you approach with an open mind, a recognition that you don’t know what’s behind, you may just open the door to one of the most extraordinary adventures you could have. What might be the best question you could ever ask? Matthews, S. M. (2023). The Question Cube Re-imagined–A 5-Dimensional Model for Cultivating Coaches’ Capacity for Curious Inquiry in Health Behaviour Change. American Journal of Lifestyle Medicine, 15598276231172910.

Priorities, priorities, priorities! Mark Twain said that to change your life, you need to change your priorities. As an executive coach whose job it is to focus on change, personal, team-focused, and organization-wide priorities come up in every coaching conversation. Priorities are how we match our ambitions with our capacity. Priorities shape organizational effectiveness, departmental focus, and individual contributions. And priorities aren’t limited to industrial focus, they are also essential to spiritual life. In spiritual practices we refer to this as discernment, the ability to judge well and select among options. Discernment is at the heart of spiritual discipline, moral living, and raising consciousness; it’s about making choices. And priorities are just that, clear choices grounded in awareness. Priorities signal to everyone what to pay attention to, where to deploy their Units of Attention. Here’s what I mean by that. Every day we wake up with an inventory of Units of Attention, and wherever we deploy a Unit of Attention is where we spend our energy and our time. If I give Units of Attention to making breakfast, my energy and time go to menu, cooking, eating, and clean up. If I spend Units of Attention on morning news, my energy and time go to thinking about weather and stock market and war. You get the picture. When you deploy a Unit of Attention, you spend energy and time on that Unit – whether a person, idea, process, or object. And that spent Unit of Attention is non-refundable and non-transferable. This is really, really important. You cannot reclaim or reverse the time and energy you spend by deploying those Units of Attention. This is key. Priorities tell us where to place our precious Units of Attention. In the words of Stephen Covey, “The key is not to prioritize what’s on your schedule, but to schedule your priorities.” And to schedule your priorities requires both wisdom and power. Wisdom to discern what’s aligned with your values and enriching to your life. And power to set boundaries and advocate for yourself. Wisdom and power establish your priorities. Priorities harness attention. This also works at group level. Team and organizational priorities direct how everyone applies their time and energy. And when we collectively attend to the same priorities, our collective efforts turn to amplification – power drawn from, “the whole that is greater than the sum of the parts.” Well-articulated priorities have the power to heal one of the most crippling organizational maladies – silos. When departments don’t focus on organization wide priorities, they spend their Units of Attention – time and energy – on their own ideas, and miss the power of amplification. Establishing priorities gets people and functions to collaborate, and effective collaboration is the key to amplifying power. Here, for your consideration, are six elements for your priority process. 1. Align on a clear picture Get alignment on what the key business challenges are and how to solve them, this begins alignment on priorities or what defines success. Get everyone on the same page and define your guiding light, your “north star.” (For coaches, it’s helping clients create a wellness vision that serves as their north star. You and the client are aligned in the direction to move) * 2. Signal collective propulsion Because department heads tend to prioritize their departments, they can be a little myopic of the bigger picture. Help functional leaders understand the big-picture goal and how they are going to help achieve it, so they can be connected to what’s most important. (As a coach, set aside your ideas about the next best step. Listen to your client. Defer to their genius. They know the way.) * 3. Set the pace and sequence Priorities combine pace and sequence, and near-term and long-term balance. Step onto the balcony and review priorities with the lenses of: running the business better today, building capability for tomorrow’s business, and growth bets for the future. (Your client likely has big dreams and goals, but it all takes time. Know your client's direction, then help them break that down into the now. Help orient them to how the goals they have for today, this week, feed toward the vision.) * 4. Communicate to resonate If people can’t relate their jobs to what you’re saying the company needs, and what they can do to help, they will automatically disconnect. So make priorities accessible and understandable in the context of daily work activities. (Clients need to have resonance for what they are working toward.; those goals and activities need to relate to their values and their lives.) * 5. Set in-process milestones We don’t just track priorities at the end, but along the way, too. Set “in-process” milestones for people to see if they are “on track” or “off track” that’s how they can make corrective action. (Weekly or bi-monthly coaching sessions help clients keep their focus while attending to the other day-to-day demands of life.) * 6. Celebrate wins, then rapidly move on It is essential to create momentum, and even a movement, by celebrating early successes and leveraging this success to other areas. And then challenge the status quo by running rapid experiments and capturing the learnings of successes or failure. Oh, and celebrate these, too. (No success is too small for acknowledgment. Take the win, however small or big!) * Dan Millman, author of Way of the Peaceful Warrior, once said, “I learned that we can do anything, but we can’t do everything… at least not at the same time. So, think of your priorities not just in terms of what activities you do, but when you do them. Timing is everything.” Do this not just for your sake, but because as a leader you are a steward of your people. Without priorities, people pull in different directions, give their Units of Attention (their precious energy and time) to different tasks, and weaken the overall effectiveness of the collective. By making your priorities explicit you are guiding attention, effort, and direction; you enable your people to pull together and generate positive power toward achieving meaningful results. Reprinted with permission *Information in parentheses are Wellcoaches additions.

Geoff Montgomery, NBC-HWC Health Coach WellSpark Choosing Wellcoaches is the best decision I made when I decided to pursue a new career as a Health and Wellbeing Coach. The methodology they teach is easily recognized in the Health Coaching profession and brings instant credibility when looking for a job in the industry. Wellcoaches experienced staff are extremely professional and offer continued support throughout the curriculum, helping ensure success and a feeling of community. Additionally, I have been able to take advantage of the continuing education and monthly offerings to stay up-to-date and continue my education. The Wellcoaches program helped me prepare for the National Board exam, and was instrumental in my getting hired by Well Spark as a Health Coach. I would highly recommend the Wellcoaches program to anyone looking to pursue a career in Health Coaching.

In an interview on Java with Jimmy, Coach Meg and Dr. Claude Alabre at Massachusetts General Hospital meet with host Jimmy Hills to discuss New Year’s resolutions. Here’s what we talked about. Juice last year to the last drop Left to our own devices with New Year’s resolutions, they can work out but they often don’t. But not for the reasons we imagine. We tend to blame a lack of motivation, laziness or being too busy as the reasons we miss the mark. There’s more to unpack. Coach Meg explained that because the new year switches over so quickly, we don’t take the time to really process the year before. We start running hard toward new goals as soon as the new year begins. Changing yourself is not easy, in the best of times. In order to move toward new change and growth, we need to cultivate a foundation of strengths. People can’t get better if they don’t have sufficient “psychological capital,” the resources needed to support the self-improvement process. We need to take time to ground ourselves in our resources and strengths. From that place, we are better prepared to move forward and step into the ups and downs of self-change. How to do that? Harvest the good that emerged last year. “Juice” the good experiences to the last drop: what did I do well, what are the biggest wins, how did I get better, what did I learn, how did I grow? Only then, is it a good time to start to consider – what are my next opportunities to get better? Create a lane in your life for the inside game Improving ourselves starts with an inside game. Lasting change requires a lot of reflection and internal discoveries about ourselves. When our energies are focused on meeting the demands of the external world, including expectations about New Year’s resolutions, we lose connection to the inner game. It’s important to create space in our lives to pause, reflect and allow ourselves to harvest in order to grow. If we are running in the lane of getting stuff done and performing well ALL of the time, there is no space to pull back and reflect and gather - gather lessons, gather gratitude, and breathe in what’s good in our lives and work. Give ourselves grace and gratitude as Jimmy says. Working with a partner or coach can help us to reflect and gather all of our psychological capital. Once we open up the lane of reflection on our strengths and we invest in our psychological bank accounts, we can turn to reflecting on what powers us through improving ourselves – the combination of deep, heartfelt motivation AND a solid amount of confidence in being successful. Go deeper than you would typically do to find out what goal is really important, what change really matters to you, and why it’s important, why it’s a top priority to get better. Then dig some more to cultivate confidence in your ability to change by considering your challenges and getting creative in finding ways to get around them. Ignore social pressures in order to pause Forget about the social pressures in the ritual of New Year’s resolutions. As humans, pausing and reflecting first is vital. Of course, we also need to strive - productive striving is really important. However, striving isn’t just for the start of a new year. If we make time for pausing and harvesting the wins from last year, striving can begin later. Whether you give yourself an extra push to strive in January, June, or September it doesn’t really matter. You don’t always have to be striving, even if it’s the start of a new year. What also works against our efforts to pause and harvest is the incessant thinking that takes over our minds. In the book Coach Meg co-authored with Paul Hammerness, “Organize Your Mind, Organize Your Life,” (now Train Your Brain) we explore the topic of frenzy. It’s one word with a lot behind it. The culture we live in creates frenzy by telling us: if we are not achieving something, we have no value. It’s important to keep in perspective that this force surrounds us. It’s like being in an intense weather system. It can take real effort to move against it and understand that we don’t need to be achieving or producing every moment of every day, including at the start of a new year. For starters, let’s give ourselves some group compassion for how we are all living in this pressure cooker of achievement, and appreciate that the extreme pressure runs counter to pausing - stopping to reflect and gather, or simply doing nothing, catching our breath and resting. See stress as a direction for growth The second thing in the big umbrella term of frenzy - is stress. By its simplest definition, stress is the sign that the demands of the moment are greater than our perceived abilities. Stress puts us into the state of being afraid we can’t keep up. In pandemic times, we all have a lot of stress and negative emotions circulating inside and outside. And the suffering is our path to new growth and more strength. We can be with, and work with, our stress and other difficult emotions and feel compassion for them, bringing warmth and curiosity. Then we can ask ourselves “what is the meaning of this experience?” After that, we can move toward learning and growth. A bigger way to think about this is the scientific model of post-traumatic growth. Trauma is a situation where the general future and our individual futures are disrupted. COVID has been and still is a trauma. We are all traumatized because our future continues to be disrupted. We need to let go of the idea of bouncing back, returning to old norms, and instead learn to suffer well, lean in, and turn the trauma into growth. If we have survived, the pandemic is ultimately a force for good in our lives, if we use the experiences well. Nature has growth in its basic design. We lose track of our basic nature – the urge to grow, become wiser, stronger, and more competent. A mindset to consider then is to view the whole process of living through a pandemic as a way to grow and expand ourselves. The goal to strive for isn’t reducing stress, it’s to expand ourselves; becoming bigger, stronger, and better people. Get in touch with how you are growing and who you are becoming. The deeper the sense of who you are and who you want to be and why that matters, the more likely you'll be successful in your efforts. What goals really matter Java with Jimmy is focused on helping people get healthier. Despite all of the urging, most people don’t view good health in itself as a high priority goal - the bigger goal is living a good life. What matters then is connecting your health to what you really want in life. Go a few layers deeper on what you would lose if you didn’t have your health. That’s what you need to think of every time you make a choice: apple or cookie, exercise or stay in bed, e-cigarette or yoga stretches. In those moments where we choose either our dearest life goals or, feeling better for a quick moment - pause to ask: who do I want to become? How do I want to get better? And how does this choice serve that? If we are not clear on our highest yearnings, we go for what feels better in the moment, rather than investing in the future we want, the future that’s precious to us. New Year New What? "Juice" the good from the last year Invest in your psychological bank account by pausing and reflecting on the good Feel compassion for the disruption of the pandemic on yourself and everyone else Welcome your stress and suffering as a signpost to grow Focus on the goals that really matter to you Strive well – know why self-improvement is precious to you. Then recall what is most precious when you make choices, remembering your goal for getting better. Onward to getting better, better days, and a better future. Coach Meg

While we could write a book about the 14-year journey from 2009-2022, I want to share the quick highlights to remember the countless hours and years invested by Wellcoaches that led us to the eve of applying for full approval of CPT codes for health and well-being coaching services, planned in early 2023. The original founders in 2009 were from Wellcoaches (me, Coach Meg), University of Minnesota (Karen Lawson), Duke, then Vanderbilt (Ruth Wolever), ACSM (Dick Cotton), Wisdom of the Whole (Linda Bark), CIIS (Meg Jordan), Real Global Wellness (Michael Arloski), Duke Integrative Health (Linda Smith), and Vanderbilt (Roy Elam). Our biggest accomplishment was the journey of the founding team from being competitors to making deep friendships and a collaborative agenda. We all transcended, moving past self-interest and our own organizations and even personal and financial interest to say, “This is for the betterment of the coaching industry and the world.” That energy, that collaboration of serving a larger cause, is the life force behind NBHWC. Here's a quick gallop through our journey together: 1. Co-chaired by me and Karen Lawson, we gathered 70 stakeholders for a fall 2010 summit in Wellesley, MA, titled: Summit on Standards & Credentialing of Professional Coaches in Healthcare & Wellness. We used an appreciative inquiry process to align on a shared agenda to make a big impact on healthcare – developing the new profession of Coaching in healthcare and wellness. One of our many accomplishments? New lyrics for the song – I’d Like to Teach the World to Sing: The Change that’s Sure to Last We used to teach the world to do, Exactly what we said. It didn’t bring them health or joy, And gave us jobs we dread. But now we’ve learned just how to coach, Results are coming fast. This brings them health and gives us joy. The change that’s sure to last. View the Executive Summary of the Summit here. 2. By 2013, the expanded team agreed on one job definition: Health and Wellness Coaches are professionals from diverse backgrounds and education who work with individuals and groups in a client-centered process to facilitate and empower the client to achieve self-determined goals related to health and wellness. Successful coaching takes place when coaches apply clearly defined knowledge and skills so that clients mobilize internal strengths and external resources for sustainable change. Our collaborative and hard-won breakthrough meeting weekly over our first two years was to build one set of standards – for one coach - the health and wellness coach (not different standards for different coaches, e.g. health coach, integrative health coach, or wellness coach). We formed a nonprofit legal entity and board of directors, and we raised $100k in donations. 3. 2014 was a big year. With Dick Cotton’s leadership, ACSM donated the services of a psychometrician to lead a job task analysis process, gathering 15 coaches with varied backgrounds for three days of discussion in Indianapolis to define the job tasks (tasks, knowledge, and skills), further validated by 1,000 practicing coaches. Armed with the job task analysis, and following the best practices DACUM process, we gathered 19 coaching leaders to collaborate in Minneapolis for three summer days on moving toward a consensus on the minimum training and education standards for the health and wellness coach. We invited advisors from ICF and other organizations to assist. The consensus and detailed minimum program standards evolved over the next six months to 60 hours of coaching skills training, 15 hours of healthy lifestyle knowledge, 3 mentor coaching sessions, and a pass/fail practical skills assessment, to be eligible for the national certification examination. We also agreed on a transition phase, ultimately from 2016-2021, with a lower standard - at least 30 hours of coaching skills training and a pass/fail practical skills assessment. We published the standards for public comment by May 2015. 4. In early 2015, Wellcoaches coach Leigh-Ann Webster joined the team as the first paid staff member, serving as the NBHWC operations manager. Now Leigh-Ann is the NBHWC Executive Director – a spectacular rise of a brilliant leader who has built an incredible team of rising leaders. We set out to find a partner to build a certification examination and reached out to several organizations. With great foresight, David Eisenberg introduced Don Melnick, then president of NBME, to me in spring 2015, which evolved into a 2016 MOU, and then a complex, multi-year negotiation, multi-million dollar investment, and formation of NBHWC as a non-profit NBME affiliate, starting up in January 2019. In parallel, we created a certification competency blueprint (team of 6, with Ruth Wolever and me doing much of the heavy-lifting), and creation of the first 600 certification examination items (team of 20+ coaching leaders). 5. Fast forward to 2022, NBHWC is now a financially healthy and growing organization, in its sixth year in delivering the national board certification examination for health and wellness coaches. NBHWC has approved 100+ programs to train health and wellness coaches eligible for the examination and certified 7,000 coaches, including nearly 1,000 Wellcoaches coaches who have accomplished a 93.1% pass rate. 6. Since 2019, my focus has been building the Healthcare Commission that is forging the path to billing and reimbursement of coaching services in healthcare, generating the economic foundation for the role of the coach. In 2019, with the VA’s leadership, we earned approval of Category III codes for health and well-being coaching services. In 2021, we established a taxonomy code for the health and wellness coach to work in healthcare, as well as guidance for coach use of various CPT codes. Erika Jackson, Chief Coaching Officer @ Wellcoaches is a member of the Program Approval Commission, assisting in the ongoing evolution of national standards. Through my 14 years of volunteer leadership and contributions, frequently two or more days of my workweek, I have helped lay down the foundation for our beloved profession – the vigorous teamwork and multiple intense retreats that led over five years to the standards and job task analysis, the rigorous weeks and months invested to meet the NBME certification standards and build a high-quality examination, a demanding three years of negotiations with the NBME legal team, starting up a five-year collaboration with the CDC on group coaching, the creation and execution of a robust business plan and high-functioning NBHWC board, and now the many hours and days preparing for the AMA CPT Panel meetings. My deepest gratitude goes out to the many friendships and rich collaborations with the top leaders across our field that continue to grow as we now have an NBHWC team that is more than 70 – 7 staff, 13 board members, and 30 volunteer leaders on four commissions, as well as a large team of 20+ that continues to evolve the certification examination. We really can move mountains together! Onward & upward! Margaret Moore, aka Coach Meg Founder/CEO, Wellcoaches Corporation Co-Founder, Board member, NBHWC

The Sept/Oct issue of the American College of Sport Medicine’s Health and Fitness Journal was a special themed issue with articles focusing on wellness throughout the lifespan – or, as we are asked to do, refocus on “healthspan” instead of lifespan. This issue contains our article (David Diggin was my co-author) entitled “Enhancing Wellness During Young Adulthood.” In this paper we provided a roadmap for improving wellness to fitness professionals working with young adults (roughly 18-45 years). A big part of the article placed emphasis on understanding barriers to wellness, such as lack of time, resources, and/or support. The interconnectedness of these barriers was discussed so that the fitness professional might understand the complexity of obstacles faced. As an example, imagine time is short at work and friends ask you to catch a “fast food” lunch during your designated walk/exercise break. Ouch – conflict - social pressures and times pressures now challenge good intentions for exercise and a healthy diet. These are struggles young adults face quite frequently -some manage the challenge, but many do not - complicated stuff! Several strategies to motivate young adults (e.g., gamification, persuasive technologies) toward wellness goals were offered in the article as help with overcoming barriers. Gamification is what it sounds like, making a game (e.g., accumulating points) out of achieving wellness goals. A good example of persuasive technologies is using a fitness app/cell phone to aid in exercise efforts. The suggestion to understand and encourage the formation of habits was also made in the paper – with a habit being a healthy behavior done while requiring a minimal effort or little cognitive resource. A common example is brushing our teeth before going to bed at night. Trying 5-10 minutes of meditation before going into a challenging meeting or preparing nutritious lunches for the week on Sunday afternoon, are other healthy habits one might consider adopting. Goal setting with clients was also discussed. Before concluding the paper, there was a recommendation for fitness professionals to remember the experts. When a client can’t seem to overcome obstacles - is just stuck and ready to throw in the towel; this is not the time to give up …. it is the time for fitness professionals to refer to a health and wellness coach (HWC). The article advocates for the effectiveness of the coaching process and suggests clients can be moved from wellness contemplators to action with professional help. To optimize clients’ chances for success, a fitness professional must recognize when it is time to call for a HWC's help. Fitness professionals should have contact info for one or two good wellness coaches. As coaches we should remember this advice cuts both ways! HWCs are advised to include fitness professionals in their professional network – they are important collaborators clients moving clients toward their wellness goals. The article concludes by emphasizing how important young adulthood is for developing healthy habits (e.g., an active lifestyle) that will influence well-being later in life. The fitness professional is urged to work with the young adult in overcoming wellness obstacles while being reminded a HWC coach is there if they need help with a tough client. If you want to access the original article here is the link – sorry but the publisher is only making the abstract available for free. CITATION Sforzo, Gary A. Ph.D., Diggin, David Ph.D. ENHANCING WELLNESS DURING YOUNG ADULTHOOD, ACSM's Health & Fitness Journal: 9/10 2020 - Volume 24 - Issue 5 - p 32-37 doi: 10.1249/FIT.0000000000000605

I imagine I'm not alone in my fantasy of being a drummer... ...living in the flow of sensing rhythm, creating rhythm, tapping into rhythm, or simply being the rhythm. Alas, like many of us, I don't have a natural aptitude for drumsticks. I look for rhythm, finding my groove, mostly in my work. What's a groove? Merriam-Webster describes a groove as a situation suited to one's abilities and interests, an enjoyable experience or rhythm, a sense of harmony with one's world. Most people who find their groove, find it through work. Gallup authors reported in the book Five Elements of Well-being that career well-being (liking what you do at work) matters the most. In positive psychology, Martin Seligman's PERMA model could be described in terms of grooving - we engage and expand our strengths in activities that bring higher meaning and enable achievement, thereby generating the positive emotions we get from grooving. Self-determination theory is another model of grooving - we have autonomy-supporting relationships, the social nutriments that enable our adventurous pursuit of interesting activities that make us feel ever-more competent through mastering new challenges. Let's give thanks to grooving job crafting scientists, translating positive psychology and self-determination theory into everyday work. They have shown through 100+ studies that we groove when we get to shape our work so that: it's meaningful uses our strengths grows our competence generates nourishing relationships brings interesting opportunities, and supports our non-work well-being - mind, body, and life. Labor Day 2022 If there was ever a moment to find our groove, to reinvent the experience of work, it's now. Those at Gallup who groove in gathering and analyzing data have been telling us for a long while about the crisis of low work engagement (no rhythm, no groove - emotionally detached). The 2022 Gallup global workplace data shows that only 33% of workers in the US and Canada are engaged (the highest scores globally), dropping to 14% in Europe (the lowest scores). The Washington Post noted: More than two years of a pandemic have jolted the meaning of work and the way employees think about it. The consequences are just unfolding... Millennials and Gen Zers are shifting ambitions from wanting to reach the top to having a meaningful effect on their communities, nation and the world. Our jobs are not loving us back, notes a cited Elle article on women's new take on ambition. This summer, McKinsey published an article on COVID 19 as a catalyst to cancel burnout cultures - workplaces that ask from workers more than they get back, throwing them out of their grooves. “People aren’t just quitting their jobs, they’re rejecting the idea that burnout is the price they have to pay for success,” said Arianna Huffington... Whatever accelerating work trend resonates most: the engagement crisis, the great resignation, quiet quitting, or the burnout epidemic, it all boils down to work ill-being, which drives our well-being downhill. More than that, work ill-being is a colossal, if not tragic, waste of human potential. How might we groove at work on a large scale? Zooming out, we can see a shift coming in capitalism - a shift in the longstanding, implicit deal between capital and workers. Recent Harvard Business School Dean Nitin Nohria wrote about it in HBR magazine this summer: Today workers up and down the socioeconomic ladder are reexamining their commitment to employers and the fairness of the existing bargain between capital and labor. Our deep questioning of capitalism is no surprise. If our work lives are a main driver of overall well-being, and work is failing to deliver what humans want dearly, than it is time for a new deal. How about we ask "capitalism" (leaders, bosses, investors) for a new deal: growing wealth and growing well-being together. Instead of consuming well-being for work, we all make well-being a product of work. We need to ask for more than corporate wellness - including physical well-being (eating, exercise, sleep, etc), and mental/emotional well-being (mindfulness, self-compassion, resilience, balance, recharge, etc), along with fair financial compensation. We need to properly integrate our groove - crafting personally meaningful work, that uses our strengths, grows our competence, generates nourishing relationships, and brings interesting opportunities. The future of work is good - more wealth and well-being, grooving together. Coach Meg. www.coachmeg.com Find a coach. Find your groove: www.wellcoachesnetwork.com