The August 2022 Online first edition of the American Journal of Lifestyle Medicine (AJLM) published our new paper about health and well-being coaching research. This issue contains our article (Sebastian Harenberg and Joel Edman are my co-authors) entitled “A Rubric to Assess the Design and Intervention Quality of Randomized Controlled Trials in Health and Wellness Coaching.” While the title is a mouthful, read on. We developed a rubric (a checklist of questions) to examine the quality of a research study from two perspectives: how well the study was designed and how well the coaching intervention was planned and implemented. In all, the rubric we created contains 28 items. Of these, 15 address study design criteria and 13 examine coaching intervention criteria. The questions related to study design assess items such as participant recruitment, participant allocation to group, exclusion criteria, sample size, control group management, outcome measures, and statistical analyses. The rubric questions are scored 0-1 or 0-2, and the greater the total score the better the assessment of study design quality. For studies of health and well-being coaching, it is also essential to examine the structure and implementation of the coaching intervention. The rubric questions addressing the quality of coaching intervention ask about items such as coach training, certification, and experience. Questions on the coaching intervention include coaching session frequency, duration, and program length (in months). Finally, the rubric also calls for a description of the coaching process, coach quality checks during the research project, and client adherence. Using the rubric, a given research paper might potentially score high on study design and low on coaching intervention, or vice versa. The best research papers score high on both dimensions. Check out the full-length article, which is cited below and is available open access from AJLM Sage publishing website. https://journals.sagepub.com/doi/full/10.1177/15598276221117089 Once the rubric items were selected, they were reviewed by research design and coaching experts. The items were also crossed-scored on 29 articles by the study authors to establish reliability. In other words, all three authors read 29 health and well-being coaching research papers and scored those articles using the rubric. An intraclass correlation of .85 (ICC = .85; CI95% - .68-.93) indicated very good levels of agreement between the three of us (study authors: Harenberg, Sforzo, Edman). These processes of gathering expert opinion and checking reliability provide a measure of validity for the new rubric. We have encouraged other authors to use the rubric in their work and further validate it as a useful tool for assessing health and well-being coaching research. In this paper, we applied the rubric to randomized controlled trials (RCTs) studying patients with Type 2 diabetes (T2D; n = 11 articles) or RCTs studying patients with obesity (n = 18 articles). The total rubric score for the T2D studies turned out to be slightly greater than found for the obesity studies – mainly because the scores for coaching intervention design were higher in the T2D research examined. This serves as a caution for readers of those obesity studies and as a reminder to future researchers of health and well-being coaching when applied in an obese patient population. It is important to carefully design and implement the coaching intervention. Only with a well-designed, described, and implemented coaching protocol can we optimize and best understand the effects of coaching. Those papers with carefully designed and presented coaching methodologies contain the research propelling the field forward and informing us how to apply the best coaching strategies in practice. We believe the most valuable contribution of the new rubric and this publication lies in application for future research. Rather than thinking of the rubric as an evaluation tool, it is best thought of as a roadmap for designing future health and well-being coaching research. When planning a project, researchers can look at the rubric and check off criteria to maximize rubric score and design the best possible study. We know from our Compendium work (2,3) the quantity of health and well-being coaching research is rapidly expanding. It is important to the development of health and well-being coaching profession that the quality of coaching research is continuously improved going forward. This article and the related explanation may seem like way too much information for the average health and well-being coach – why would they need to know how to assess research? Maybe they don’t! However, the typical coach benefits from understanding the status of the existing research and having an appreciation that this base of knowledge is being examined for quality. With such knowledge, a practicing coach can confidently apply state of the art methods and techniques with their clients. We expect application of the rubric will improve the future of health and well-being coaching research and thereby improve the standards of coaching. CITATIONS Harenberg S, Sforzo GA, Edman J. A Rubric to Assess the Design and Intervention Quality of Randomized Controlled Trials in Health and Wellness Coaching. American Journal of Lifestyle Medicine. August 2022. doi:10.1177/15598276221117089 Sforzo GA, Kaye MP, Todorova I, et al. Compendium of the Health and Wellness Coaching Literature. American Journal of Lifestyle Medicine. 2018;12(6):436-447. doi:10.1177/1559827617708562 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

Editor’s Note: This article was originally written as a research dose for the Institute of Coaching. Become a member of the Institute of Coaching to access thousands of resources on coaching science. To get a 40% discount, select Wellcoaches when asked. Positive emotions generate precious resources - they improve thinking, behavior, mood, and physiology, in turn improving self-efficacy, optimism, work engagement, creativity, stress coping and resilience, health, teamwork, relationships, customer satisfaction, and leadership. Positive emotions can be directly improved in organizations using practical techniques, leading to enduring resources and upgrading work enjoyment and performance for all. Introduction In April 2021, we lost a giant in the science of well-being – Ed Diener. This article features one of Ed Diener’s last publications (in collaboration with Stuti Thapa and Louis Tay) – a mega review on positive emotions at work (2020) addressing some important questions for coaching: How are positive emotions defined at work? How can we regulate our positive emotions? How do positive emotions exert their effects? What resources do positive emotions expand in the workplace? What are other interesting findings on positive emotions? 1. How are positive emotions defined at work? The first perspective – discrete positive emotions Scientists have explored and defined “discrete” positive emotions or constructs including gratitude, awe, pride, interest, optimism, and humor. The authors note that this perspective leads to studies of the effects of discrete emotions, for example: “different positive emotions have differential effects on job attitudes where pride is linked to psychological empowerment, interest is linked to work satisfaction, and gratitude is linked to satisfaction with supervisors and colleagues.” One study showed that work-related gratitude positively predicts job satisfaction and negatively predicts emotional exhaustion and depersonalization. Another study showed that awe led to the perception that time is more plentiful, reduced impatience, increased willingness to volunteer time, and much-improved goal progress. The second perspective – positive valence or feeling good The common thread of discrete positive emotions is their underlying dimension of feeling good – they have a positive valence or mood, which brings us to the second perspective. Positive valence (a general sense of feeling good rather than a specific type of good feeling like inspired, enthusiastic or proud) has been shown to be associated with positive individual and organizational outcomes, including better performance and job attitudes. The third perspective – positive adaptive function The authors describe a third perspective - positive adaptive function: “Emotions are regarded as positive insofar as they lead to positive personal and organizational outcomes; positivity is… the outcomes it produces… No emotion is universally “good” or “bad” but its value is context-dependent. For example, anger may be considered to be negative, but it can have prosocial functions if elicited by perceptions of injustice and unfairness and then induces remedial behavior to address the wrongdoing… A recent meta-analysis showed that shame can be positive, as it leads to prosociality and self-improvement when reparative actions can be taken. Although inducing gratitude can lead to prosocial behavior, it can have burdening and negative effects on the helpers.” 2. How can we regulate our positive emotions? First, regulatory approaches that highlight, harness, and sustain positive emotions include cognitive practices such as savoring, positive rumination, journaling, and sharing one’s blessings or gratitude with others. A second approach is behavioral strategies that can improve the quality and quantity of positive emotions including: being present and paying attention to the positive in current moments expressing positive emotions in communications celebrating positive events to amplify positive emotions summoning a specific positive emotion, such as optimism, gratitude, or a positive reinterpretation A third type of emotion regulation promotes emotional integrity—where the inner experience and outer expression of emotions are authentic and aligned. Emotional authenticity is both valued and less draining. An example is the concept of deep acting, as opposed to surface acting, where deep acting is the practice of modifying the inner emotion required of a job, whereas surface acting is merely modifying external emotional expressions. Deep acting is preferable, having shown more positive outcomes than surface acting. A fourth approach in emotion regulation is the multi-faceted construct of emotional intelligence, the ability to understand and distinguish one’s own and others’ emotions and use that knowledge to guide thoughts and behavior. Interestingly, there is a bi-directional street between positive emotions and regulation strategies for positive emotions – more of one generates more of the other, creating an upward spiral. Emotion regulation strategies have been shown effective for both undoing negative emotions and up-regulating positive emotions. A study of six emotion regulation strategies (reflection, reappraisal, rumination, distraction, expressive suppression, and social sharing) found that rumination and expressive suppression decreased positive emotions, whereas reflection increased positive emotions. Positive humor has been shown to down-regulate negative emotion and up-regulate positive emotion. 3. How do positive emotions exert their effects? The authors synthesize the literature into four channels that generate positive outcomes: cognition, affect, behaviors, and physiology. Emotion to cognition to outcome Maintaining (or savoring) and enhancing positive emotions through cognitive processes can promote positive outcomes such as more open-mindedness and more strategic thinking and creativity, which is the basis of positivity spirals (i.e., positive emotions beget more positive emotions— both degree and types of positive emotions) and undoing effects (i.e., positive emotions reduce the effects of negative emotions). In the work context, a study showed that high positivity reduced the impact of negative emotions in reducing job satisfaction. Emotion to behavior to outcome The authors explain: “positive emotions lead individuals to engage in novel and larger behavioral repertoires that lead to new opportunities and building of new skills. Positive emotions are related to positive promotion-focused individual behaviors that are important for worker health and productivity such as healthier eating, exercise, better sleep and stress management, and social behaviors like collaboration and cooperation.” Emotion to emotion to outcome “In addition to the direct experience of positive emotions, emotion expressions act as social information and can spread to others, creating positive emotion contagion. For example, genuine smiles (or Duchenne smiles) promote perceptions of employee friendliness and customer satisfaction; positive emotion expressions are associated with more positive social outcomes such as greater potential for business relationships and cooperation.” Emotion to physiology to outcome Substantial research supports the role of positive emotions in generating positive health outcomes such as greater longevity, lower intensity of illness, higher immune resistance, reduced inflammation, and better physiological recovery. Three physiological systems—cardiovascular functioning (lower heart rate and blood pressure), endocrine functioning, and immune functioning—are improved by positive emotions. 4. What resources do positive emotions expand in the workplace? Positive emotions expand resources, building physical, intellectual, social, and psychological resources that support positive outcomes or buffer against the damage of stressful situations. These resources include longer-term, habitual patterns of cognitions, behaviors, emotional responses, and physiology. The authors explain: “the broaden-and-build theory proffers the view that positive resources are an outcome of cumulative effect of positive emotions over time and are explicitly described as enduring.” These ten enduring resources are listed below and summarized in the Appendix: Positive belief in self, including self-efficacy Creativity Work engagement Stress coping and resilience Health Teamwork Relationships Customer satisfaction Leadership Performance 5. What are other interesting findings on positive emotions? Fluctuations in positive emotion, regardless of the mean levels or intensity of positivity, is maladaptive. A high level of reactivity to negative events (quick drops in positivity) may be maladaptive to well-being. There are daily cycles for positive emotions but not negative emotions, and weekly cycles for both, where people have higher positive affect during the weekend and then “blue Mondays” where people have steep downward slopes in positive emotions. Seasons can influence emotion states – some experience less positive mood in winter than summer. Positive outcomes don’t always emerge from positive emotions, as they can sometimes lead to shallow, cognitive processing. Negative moods can be sadder-but-wiser, leading to deeper cognitive processing. Maximal happiness is not ideal. While those who experience the highest levels of happiness have better close relationships and engage in more volunteer work, those who experience slightly lower levels of happiness have greater success in terms of income, higher rates of employment, and greater political participation. There are cultural differences - happiness is associated with personal achievement in Western societies in contrast to interpersonal connectedness in Eastern societies. In Eastern societies, positive low arousal emotions (e.g., calm) rather than positive high arousal emotions (e.g., excited) appear to be more related to positive outcomes. For example, European Americans preferred excited (versus calm) applicants, whereas the converse was true for Hong Kong Chinese. Individuals’ emotional experiences have a much more profound influence on the judgment of life satisfaction in individualist cultures than in collectivist cultures. It's important to note, that a focus on improving positive emotions in organizations is optimally combined with a focus on navigating negative emotions, including mindfulness, self-compassion, emotional agility, and post-traumatic growth. In February 2022, Wellcoaches shifted its credential title to reflect the value of well-being. While the terms wellness and well-being were used interchangeably, this has now changed. In recent years, the burst of scientific exploration of the domain of well-being has been profound. Well-being has now overtaken wellness as a larger, broader, and deeper construct of human flourishing and thriving. This change is energizing and expansive for the Wellcoaches community as we integrate the fullness of the well-being domain (physical, psychological, life, work) into health and well-being coaching. Takeaways for coaches Organizations can benefit by developing a workplace that cultivates positive emotions. Organizations can consciously manage and shape a positive emotional culture (e.g., a culture of joy/fun/love versus a culture of fear/anger) that can enhance organizational performance downstream. In coaching, you can: Intentionally cultivate authentic positive emotions as resources for change and well-being for your clients during coaching sessions, using appreciative inquiry techniques for example. Consider using the positivity ratio to help your clients get a quick read on their levels of positive emotions and negative emotions. Help your clients understand the various approaches to regulating positive emotions and negative emotions. Help your clients understand the organizational impact of elevating positive emotions – self-belief, engagement, creativity, teamwork, relationships, health, customer satisfaction, leadership, and performance. Citation: Diener, E., Thapa, S., & Tay, L. (2020). Positive emotions at work. Annual Review of Organizational Psychology and Organizational Behavior, 7, 451-477. Appendix Resources improved by positive emotions in organizations Positive belief in self The authors summarize: “positive emotion enhances positive belief in self that arm individuals against negative consequences of negative experiences. Self-efficacy is one such positive belief that has clear connections to work motivation and performance. There is substantial evidence that positive emotions promote self-efficacy. There is also evidence that people in a good mood set more ambitious goals and have higher expectations. Therefore, people who feel good see the world in a more optimistic light and have more positive beliefs about succeeding, which in turn promotes higher performance downstream. Studies also suggest that positive emotions are related to increases in ego-resilience over time.” Creativity Say the authors: “In the creativity literature, positive emotion (conceptualized often as mood) is one of the most reliable predictors of the creativity process. Multiple meta-analyses of the influence of positive mood on creativity have found positive moods to be a predictor of the creativity process (e.g., flexibility and fluency, the number of unique ideas produced) when compared to control conditions. For example, one study showed that physicians in a positive mood were more flexible and made more accurate diagnoses when solving a case of a patient with liver disease.” Work engagement Work engagement is a positive work-related state of mind, characterized by vigor (high energy and motivation to invest effort at work), dedication (strong involvement in work and experiencing pride and enthusiasm about work), and absorption in work (flow at work). Positive emotions have been shown to be a driver of work engagement, and their lack leading to disengagement. Coping Positive emotions and emotion regulation approaches can help people be resilient and cope with the inherent stress of work, supporting solving problems, planning, and positive reinterpretation rather than some of the less effective emotion-focused strategies such as avoidance, denial, disengagement, and turning to alcohol and drugs. One study showed that those with high levels of emotional intelligence use emotion-focused coping such as venting, denial, and disengagement, for both letting go of negative emotions and prolonging positive emotions (e.g., joy). Health “Multiple meta-analyses have found positive moods to be associated with better health and greater longevity… Research suggests that positive affect was associated with lower blood fat and blood pressure and a healthier body mass index…People with low levels of positive feelings were at a higher risk for heart disease….Experimental studies have found that inducing positive feelings led to faster cardiovascular recovery.” Teamwork “Positive emotions can contribute to collaborative behavior as well as choices and trust. Negotiation studies have found that positive emotions boost cooperative and collaborative behavior instead of withdrawal or competitive behavior. Individuals induced with positive moods are more willing to make concessions. Moreover, displaying positive emotions during negotiations can lead to increased interest in future business relationships and the likelihood of closing a deal as well as greater concession from the other party. In group managerial settings, induced positive affect promoted positive emotion contagion; in turn, it improved cooperation, decreased group conflict, and increased perceived task performance.” Relationships “There is firm evidence for the relation between positive emotions and good relationships; additionally, some studies also show that positive emotions may causally lead to better relationships...Experimental studies find that positive mood induction leads to interpersonal communication and self-disclosure, improved social skill assessments, and lasting social relationships.” Customer satisfaction “There is also a body of work showing a causal relation between positive emotions of employees to positive customer experience. Studies have identified emotion contagion as one of the explanations for how positive mood of workers can lead to better customer satisfaction….One study found that positive behaviors of shoe salespeople, such as greeting, smiling, and eye contact, correlated with customers’ in-store positive mood and subsequently the time they spent in the store and their willingness to shop there again. In general, there is evidence that positive emotions can promote greater sales performance through higher customer satisfaction.” Leadership “Positive emotions are recognized as a crucial aspect of charismatic, transformational, and authentic leadership…Theoretical and empirical work on authentic leadership posits positive emotion as a distinguishing feature between authentic and nonauthentic leadership…Authentic leaders affect employee creativity through the mediating role of employees’ positive affect and hope.” Performance “Research has shown that individuals disposed to positive affectivity perform better in ratings on decisional and interpersonal tasks. Furthermore, positive interpersonal affect has been shown to be associated with better performance ratings…One study found that collective positive emotions led to team resilience, which in turn leads to increased team performance as measured using supervisor ratings.”

In 2006 I began a journey to discover the purpose God had created me for. While watching what I thought to be an action movie in early 2007, I was introduced to the issue of human trafficking and was wrecked to the core. Not only did I know I had to do something, I also knew I had found “my thing” and truly felt in my spirit that one day I would be working for an anti-trafficking organization. Over the years, I took several mission trips overseas to serve at safe houses and during those trips discovered my passion for working with survivors as they endeavor to recover, restore and heal from the physical and emotional trauma they endured. Yet, I never felt called to study mental health. In 2019, my employer enrolled me in the Wellcoaches Coach Training as part of my Wellness Coordinator role. During the 4-day onsite initial training we went through the process of crafting our Wellness Vision. I was slightly surprised to see working in human trafficking show up in that vision. While I was still passionate about the issue, I had encountered many roadblocks in my efforts to serve in the space domestically. But there was no denying its need to be a part of my wellness vision. In early 2020, while attending an event, I heard a speaker who from a local anti-trafficking organization, Harbour Hope International, whose main mission is to provide mentoring relationships to survivors of human trafficking on their journey towards self-sustainability. I again felt the strong conviction that this was the place I was to pour out my passion. I went through their volunteer training and began serving as a mentor for a survivor. As my mentor partner and I helped our mentee establish goals for her life, I realized I had finally found the place for all of my Wellcoaches training to be applied in a way I was extremely passionate about. As the issue of trafficking continues to grow, so does our need for mentors to come alongside those survivors who are lucky enough to leave “the life”. In July of 2021 I was offered a position with Harbour Hope as their Mentor Program Coordinator, leading our mentor teams that are serving survivors on a daily basis. The skills I acquired during my Wellcoaches training perfectly prepared me for this position, equipping me to help guide others to discover how to be the best version of themselves, unlocking the great potential that already lies within but simply needs to be uncovered. When survivors of trafficking make the brave step to leave the life for good, they come with a lot of baggage but little self-efficacy in their ability to do anything but the life they came from. Witnessing the transformation of the heart, mindset and behaviors of these individuals, facilitated by the Wellcoaches approach to coaching, is truly life-changing – for me as a coach and the survivors we serve. It moves these courageous individuals from a life of literally just surviving to an expectant future of thriving. As my mentor team grows to accommodate the need, the evidence-based and practical protocols learned in my Wellcoaches certification allow me to help my mentors discover what sets their soul on fire and how they can step confidently & fully into that vision. While I appreciate every aspect of the comprehensive Wellcoaches training, creating my wellness vision and then watching it become my reality, has been the most motivating byproduct of the experience. Knowing we get to do the same for others is a blessing I feel honored to be a part of.

Today, more than 14,000 coaches in 50 countries have been trained in the Wellcoaches protocol, which was first designed and tested in 2000-2002 for the launch of the first Wellcoaches coach training program in September 2002. The protocol continued to expand, deepen, and evolve through the teamwork of ten Wellcoaches faculty, leading to its publication in the Wellcoaches Coaching Psychology Manual by Wolters Kluwer in 2009 (2nd edition in 2016). Research Since 2009, research teams in the US and Europe have designed, implemented, and published 22 outcomes-oriented studies of the Wellcoaches protocol, delivered by Wellcoaches trained and certified coaches, in peer-reviewed scientific journals. The evidence base consisting of 22 data-based studies of the Wellcoaches protocol, from 2009 to 2020, involved 623 coaches serving 34,0646 clients and delivering 129,225 coaching sessions. All 22 studies produced beneficial results with statistically significant outcomes. These 22 studies (summarized in the Table) are diverse in patient/client application, settings, demographics, and locations: Applications - patients or clients with obesity, pre-diabetes and diabetes, cancer, fibromyalgia, cardiovascular risk factors, smoking cessation, in need of lifestyle medicine or enhanced wellness behaviors. Settings - implemented in primary care practices, hospitals, community clinics, medical fitness programs, and employee wellness centers. Demographics – young, middle-age, and older adults, military, health-care workers, minority and low income, rural and urban settings Locations – throughout the US (15 states) and abroad. Weight Management There are five published studies of the Wellcoaches protocol addressing weight management. Weight loss was achieved in all four studies where it was a goal. The fifth study focused on disordered eating syndromes and showed diminished incidence of binge-eating in the 225 patients studied. Diabetes There are four research papers describing the impact of Wellcoaches protocol in patients with diabetes and/or pre-diabetes. Three of these studies tested A1C and all found a beneficial reduction in this primary diabetes outcome measure. The fourth study did not evaluate A1C; it found improved autonomy and self-efficacy, implying better diabetic self-care, after experiencing the coaching intervention. Risk Factors & Wellness There are nine research papers studying the Wellcoaches protocol for improvements in wellness, lifestyle medicine, and cardiovascular disease risk factors. These studies are unanimous in finding health benefits such as reduced blood pressure, lower BMI, improved fitness, lower anxiety, smoking cessation, and improved physical functioning. There are also reports of enhanced exercise habits and improved nutritional behaviors. Fibromyalgia and Cancer The beneficial results in studies of cancer and fibromyalgia include reduced anxiety and pain, reduced use of health care services, and improved quality of life. Physician Burnout Wellcoaches coaches adapted the Wellcoaches protocol to mitigate the effects of burnout for primary care physicans. After six coaching sessions, reduced burnout, improved job satisfaction and psychological capital were reported. Conclusions 1. The Wellcoaches protocol is the most thoroughly tested coaching protocol. 2. The evidence base for the Wellcoaches protocol includes 22 studies published in scientific journals between 2009 and 2020. 3. All 22 studies showed beneficial and statistically significant outcomes. 4. These studies involved 623 Wellcoaches-trained coaches serving 34,064 clients and delivering 139,225 coaching sessions. 5. The 22 studies addressed diverse: a. challenges including obesity, diabetes, cardiovascular risk factors, smoking cessation, lifestyle medicine/wellness behaviors, cancer, fibromyalgia, and physician burnout. b. demographics: age, low income, minority, military, healthcare workers, rural and urban populations, US and Europe. c. settings including primary care, community clinics, medical fitness facilities, hospitals, and employee wellness. Overview of published Wellcoaches Protocol studies Citations 1. Ahn S, Lee J, Bartlett-Prescott J, Carson L, Post L, Ward KD. Evaluation of a Behavioral Intervention with Multiple Components Among Low-Income and Uninsured Adults With Obesity and Diabetes. Am J Health Promotion 2018;32(2):409-422. doi:10.1177/0890117117696250 2. Berman MA, Guthrie NL, Edwards KL, Appelbaum KJ, Njike VY, Eisenberg DM, Katz DL. Change in Glycemic Control With Use of a Digital Therapeutic in Adults With Type 2 Diabetes: Cohort Study. JMIR Diabetes 2018; 3(1):e4. doi: 10.2196/diabetes.9591. PMID: 30291074; PMCID: PMC6238888 3. Djuric Z, Segar M, Orizondo C, Mann J, Faison M, Peddireddy N, Paletta M, Locke A. Delivery of Health Coaching by Medical Assistants in Primary Care. J Am Board Fam Med. 2017 May-Jun;30(3):362-370. doi: 10.3122/jabfm.2017.03.160321. PMID: 28484068; PMCID: PMC5634140 4. Edman JS, Galantino ML, Hutchinson J, Greeson JM. Health coaching for healthcare employees with chronic disease: A pilot study. Work 2019;63(1):49-56. doi: 10.3233/WOR-192907. PMID: 31127744. 5. Eisenberg DM, Righter AC, Matthews B, Zhang W, Willett WC, Massa J. Feasibility Pilot Study of a Teaching Kitchen and Self-Care Curriculum in a Workplace Setting. Am J Lifestyle Med. 2017;13(3):319-330. doi: 10.1177/1559827617709757. 6. Galantino ML, Schmid P, Milos A, Leonard S, Botis S, Dagan C, Albert W, Teixeira J, Mao J. Longitudinal Benefits of Wellness Coaching Interventions for Cancer Survivors. The International Journal of Interdisciplinary Social Sciences: Annual Review 2009: 4 (10): 41-58. doi:10.18848/1833-1882/CGP/v04i10/53020 7. Guthrie NL, Berman MA, Edwards KL, Appelbaum KJ, Dey S, Carpenter J, Eisenberg DM, Katz DL. Achieving Rapid Blood Pressure Control With Digital Therapeutics: Retrospective Cohort and Machine Learning Study. JMIR Cardio. 2019; 12;3(1):e13030. doi: 10.2196/13030. PMID: 31758792; PMCID: PMC6834235. 8. Hackshaw KV, Plans-Pujolras M, Rodriguez-Saona LE, Moore MA, Jackson EK, Sforzo GA, Buffington CA. A pilot study of health and wellness coaching for fibromyalgia. BMC Musculoskelet Disord. 2016 Nov 8;17(1):457. doi: 10.1186/s12891-016-1316-0. PMID: 27821160; PMCID: PMC5100173. 9. Hildebrandt T, Michaeledes A, Mayhew M, Greif R, Sysko R, Toro-Ramos T, DeBar L. Randomized Controlled Trial Comparing Health Coach-Delivered Smartphone-Guided Self-Help With Standard Care for Adults With Binge Eating. Am J Psychiatry 2020 Feb 1;177(2):134-142. doi:10.1176/appi.ajp.2019.19020184. 10. Long DA, Reed RW, Duncan I. Outcomes Across the Value Chain for a Comprehensive Employee Health and Wellness Intervention: A Cohort Study by Degrees of Health Engagement. J Occup Environ Med. 2016 Jul;58(7):696-706. doi: 10.1097/JOM.0000000000000765. PMID: 27294443. 11. McGloin H. Exploring the potential of telephone health and wellness coaching intervention for supporting behaviour change in adults with diabetes. Journal of Diabetes Nursing 2015:19:394-400. 12. McGonagle AK, Schwab L, Yahanda N, Duskey H, Gertz N, Prior L, Roy M, Kriegel G.. Coaching for primary care physician well-being: A randomized trial and follow-up analysis. Journal of Occupational Health Psychology 2020: 25(5), 297–314. https://doi.org/10.1037/ocp0000180 13. Mielenz TJ, Tracy M, Jia H, et al. Creation of the Person-Centered Wellness Home in Older Adults. Innov Aging. 2020;4(1): 1-13. igaa005. doi:10.1093/geroni/igaa005 14. Mettler EA, Preston HR, Jenkins SM, Lackore KA, Werneburg BL, Larson BG, Bradley KL, Warren BA, Olsen KD, Hagen PT, Vickers KS, Clark MM. Motivational improvements for health behavior change from wellness coaching. Am J Health Behav. 2014 Jan;38(1):83-91. doi: 10.5993/AJHB.38.1.9. PMID: 24034683. 15. Rivera LO, Ford JD, Hartzell MM, Hoover TA. An Evaluation of Army Wellness Center Clients' Health-Related Outcomes. Am J Health Promot. 2018 Sep;32(7):1526-1536. doi: 10.1177/0890117117753184. Epub 2018 Feb 5. PMID: 29402124. 16. Roy BA, Roberts PA, Lisowski C, Kaye MP, Sforzo GA. Integrating Health Coaching With a Medical Fitness Program to Treat Chronic Health Conditions. Am J Lifestyle Med. 2017;14(3):326-334 doi:10.1177/1559827617728025 17. Schwartz J. Wellness Coaching for Obesity: A Case Report . Global Adv Health Med. 2013;2(4)68-70. DOI: 10.7453/gahmj.2013.029 18. Sforzo GA, Kaye MP, Simunovich S, Micale FG. The effects of health coaching when added to a wellness program. Journal of Workplace Behavioral Health, 31:4, 242-257, doi: 10.1080/15555240.2016.1228463 19. Sforzo GA, Kaye M, Ayers GD, Talbert B, Hill M. Effective Tobacco Cessation via Health Coaching: An Institutional Case Report. Glob Adv Health Med. 2014 Sep;3(5):37-44. doi: 10.7453/gahmj.2014.029. PMID: 25568823; PMCID: PMC4268607. 20. Sherman RP, Petersen R, Guarino AJ, Crocker JB. Primary Care–Based Health Coaching Intervention for Weight Loss in Overweight/Obese Adults: A 2-Year Experience. Am J Lifestyle Med. 2019;13(4):405-413. doi.org/10.1177/1559827617715218 21. Sherman RP, Ganguli I. Primary Care-Based Health Coaching for the Management of Prediabetes. Am J Lifestyle Med. 2017; Apr 11;12(2):175-178. doi: 10.1177/1559827617702074. PMID: 30202390; PMCID: PMC6124994. 22. Tucker LA, Cook AJ, Nokes NR, Adams TB. Telephone-based diet and exercise coaching and a weight-loss supplement result in weight and fat loss in 120 men and women. Am J Health Promot. 2008;23(2):121-9. doi: 10.4278/ajhp.07051646.

In February 2022, the American Journal of Lifestyle Medicine published our article entitled “Dosing of Health and Wellness Coaching for Obesity and Type 2 Diabetes: Research Synthesis to Derive Recommendations.” The primary purpose of our study was to determine an effective initial amount (or dose) of health and wellness coaching to recommend to patients with obesity and/or type 2 diabetes (T2D). To make this determination, we closely examined the health and wellness (HWC) coaching literature using the previously published Compendium papers. After identifying 88 peer-reviewed articles (51 obesity; 37 T2D), we synthesized the amount of HWC effectively applied in this literature. We defined and quantified HWC programming using five variables: 1. session duration 2. session number 3. session frequency 4. program length 5. total HWC dose The general dosing recommendations we derived for HWC are shown here: This programming information can serve as a guideline for coaches when a patent asks, “How long will this take?” Now, the coach can provide an evidence-based answer to that important question. Another important function of these HWC dose recommendations is to provide physicians a starting place when referring patients to coaching treatment or intervention. All treatments have initial dosing recommendations (e.g., 8 sessions of physical therapy, 16 weeks of cardiac rehabilitation, or 10 mg of a statin). Such prescriptions allow for patient planning while also enabling appropriate billing practices to be understood and arranged. Underlying all initial prescriptions, is the fact that every prescription is adaptable to accommodate patient needs. Everything from a medication to an exercise prescription, can be adjusted to fit an individual patient. Flexibility is most certainly true for these HWC dosing recommendations. HWC is a patient-centric process, and these guidelines are in no way meant to change or violate this critical concept. All programming variables (from single session duration to program length and total HWC load) are ultimately determined by a patient and coach working together to determine how to best serve a patient. The recommendations provided in this study provide a reasonable and initial coaching dose that would be effective in most circumstances. If you are practicing coach, use these guidelines to best suit your needs and the needs of your patients. These recommendations were derived from studies involving obese and diabetic patients. It is reasonable to extend these findings to other patient groups, awaiting more data. HWC is a fast-evolving profession with need for science-based guidelines that support best practice guidelines. The recommendations in this article are appropriate for initial HWC programming guidelines. Dosing guidelines are sign of a maturing health profession. Check out the full paper to learn more about our investigation. References 1. Sforzo GA, Kaye MP, Faber A, Moore M. Dosing of Health and Wellness Coaching for Obesity and Type 2 Diabetes: Research Synthesis to Derive Recommendations. American Journal of Lifestyle Medicine. 2022. On-line First. doi:10.1177/15598276211073078 2. Sforzo GA, Kaye MP, Todorova I, et al. Compendium of the Health and Wellness Coaching Literature. American Journal of Lifestyle Medicine. 2018;12(6):436-447. doi:10.1177/1559827617708562 3. 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

Today we explore how to work with a client who is an avid runner and competes in many road races and marathons on the weekends. She has sustained a stress fracture and cannot run for 8 to 12 weeks. She is very concerned about maintaining her fitness, being ready for an upcoming marathon, and managing her weight and her stress levels. She has not done any other type of training in a long time and seems very reluctant or fearful of doing anything else. Anyone who depends upon regular exercise to stay sane in today’s crazy world could be terrified about losing the incredible benefits of exercise when stopped in their tracks due to an injury or surgery that requires a long recovery period. What are some tools and techniques that allow our clients and ourselves to recover well and return stronger than ever? Be a curious explorer: A great antidote to feeling frustrated and disappointed during a long recovery is to cultivate a curious and open mind that is looking for new adventures. Questions to consider: How can I look at my situation in new ways? What can I do differently? What do my mind and body need right now? How can I recover quickly and well? What is there to learn? This is a time for new questions, and a time when there are more questions than answers. Soften the need to be in control: The sense of freedom and being in control is heightened by mastery of an intensive exercise routine. It’s incredibly hard to watch others running when you are grounded for a long while. Perhaps the recovery experience is a way to learn to better accept what we can’t control, reminding ourselves of the serenity prayer, which I phrase as: accept the things I cannot change, be courageous about the things I can change, and get wise about knowing the difference. Make the experience meaningful: A valuable tool to rising to the challenge is to have faith that there will be silver linings,  although not immediately apparent. Humans learn and grow stronger through setbacks. Whatever led to an injury such as a stress fracture is the body’s way of telling us that something isn’t quite right. While the full value of a setback may not appear until long after recovery, an open and curious mind that is looking for new meanings will be a great asset along the way. For example,   a good physical rest may lead to healing of all sorts of physical stresses and strains from head to toe that a nonstop exercise routine prevents. Or it will be just the catalyst needed to experiment with changes in a stable exercise routine. Even better, the time freed can be used to create and enjoy new experiences. Learn new approaches to regulating emotions: If you use running or exercising to tame emotional frenzy, stress levels may  get more challenging during recovery. The time saved during recovery can be invested in developing new mental skills for handling negative emotions. Mindfulness techniques allow us to unhook from a burst of negative thoughts that come with a post-injury phase (Yikes! My cardio fitness is dropping like a stone. My muscles are going soft. My marathon time will be shot. I will gain weight…). This is also a good time to invest the time saved in not running to harness and harvest positive emotions: What professional and personal tasks make you feel good and how can you do more of them? What blessings can you count? Seek compassion and love: The biological method for soothing the scared emotions of a newborn is the tender soothing by the parents, which releases a neurochemical called oxytocin (also known as the hormone of love). This same soothing phenomenon works just as well in adults, except we can soothe ourselves with big-hearted self-kindness. A recovery period is an excellent time to exercise your self-compassion. And, connect with other people who have done well in recovering from long injuries and benefit from their empathy and compassion during this tough phase. Enhance body intelligence: It’s time to improve the depth of listening to what your body needs each moment and over the next days and weeks. What adjustments to eating habits are needed  to handle lower calorie needs? What exercises feel good and safe right now? Perhaps this is an opportunity to slow down your eating pace, savoring fully by chewing every bite at least 30 times. Or maybe there is an opportunity to trim some emptyish calories to keep weight stable. Get creative: One of the best interventions for mental and physical suffering is to engage in creative tasks. You could experiment with cooking new recipes, write poems or blogs, play the piano, or submit funny lines to The New Yorker for its weekly cartoons. Recalibrate self-esteem: If your self-worth is closely connected to the state if your physique and fitness level, maybe this is a  time to have your inner judge go on vacation, detaching your self-respect from your physical fitness. You could then set a good standard for simply dealing well with the physical setback, focusing on healing, increasing equanimity, and learning new life lessons. Build confidence: One of the main variables that predicts life satisfaction is resilience, the ability to bounce back from adversity. Take stock of all your personal strengths that have made you resilient in the past and look for creative ways to use you strengths in new ways during the recovery phase. This is a great opportunity to build resilience muscles. Reset goals: An injury is an opportunity to hit the reset button and to rethink fitness and life goals, at least in the short term. A great goal is to simply aim to recover beautifully, to not rush the biological processes, and to allow the body’s talents for healing to run well, so that you can run well when this phase is behind you. Originally published in ACSM Certified News Coaching Column

As we wrote in the Institute of Coaching report – Leading with Humanity - the pandemic era has awakened our humanity as leaders. More of us are tuning into the ultimate purpose of organizations - to serve humans - our aspirations, needs, values, strengths – the sum of everything that influences human well-being. Everything leaders and organizations do have the ultimate, higher intention of making human lives better. We are moving away, albeit slowly, from bureaucracies where humans serve institutions and moving toward “humanocracies” where institutions serve humans and humanity. How work drives human well-being is right in front of our eyes now – connection, trust, relationships, purpose, engagement, collaboration, productivity, and creativity – these are drivers of BOTH human well-being AND great performance at work. Our eyes confirm the work of researchers. Leading well, aka being led well, has been shown to generate psychological and physical well-being – improving engagement and reducing stress and burnout. The research shows that the reverse is true too – life well-being enables our best performance at work. What’s a map then for leaders to foster human well-being, in ways that also enable great work? In my co-authored Harvard Health book, Organize Your Emotions, Optimize Your Life, we explored nine universal personality elements that code for our individual needs, values, interests, and strengths. Each of us has our own formula for well-being based on our unique personality mix. These personality elements also manifest in 8 types of corporate cultures, as explored in an HBR article on corporate culture. We’ve since mapped the nine elements to a variety of personality models, including: Jung's cognitive functions, the basis of the Myers-Briggs assessment Enneagram model of personality drives Let’s consider how these core elements of well-being offer leaders a whole, human-centered model for leading well. Autonomy (Jung’s introverted feeler, Enneagram Reformer) A primary human need is autonomy (self-determination theory) – to live our lives in alignment with our core values, interests, needs, and strengths. High levels of autonomy are needed to lead well – to model personal responsibility, stand up for what is good and right, to be authentic, and to be courageous and values-driven. Empowering others to do the same promotes their autonomy and well-being. Relational (Jung’s extraverted feeler, Enneagram Helper) Another primary need is relationships where we attune to and serve others’ needs, strengths, and values, and receive the same in return. Social intelligence and compassion have been shown to be vital in leadership and teamwork. They generate well-being in followers as we/they feel connected, seen, heard, appreciated, respected, and supported, especially in tough situations. Confidence (Self-Determination Theory, Enneagram Challenger) Confidence is both task-specific and broad. It’s a big driver of well-being – one of the three core psychological needs unpacked in Self-Determination Theory. We dearly want to be competent, using our strengths to master work and life’s challenges. Leaders continually help people learn, grow, and expand their competence and confidence, which spills over to engagement - using our skills and knowledge well at work. Continual growing and learning is a hallmark of a human-centered leader - for self and others. Regulator (Jung’s introverted sensor, Enneagram Loyalist) We all need a sense of stability, balance, safety, and security, built upon a work (and life) environment that is carefully constructed to have integrity and to be stable. Good leaders know how to balance and stabilize themselves (e.g. good emotion regulation, good fitness, and health). They encourage everyone to be physically and psychologically fit and healthy, and to steer around reactivity and burnout. They also create a psychologically safe culture and a sound organizational structure (e.g. people, processes, finances). Adventurer (Jung’s extraverted sensor, Enneagram Enthusiast) Once adults (like children) feel stable, they are ready to explore, take risks, learn new things, create new adventures, find the lessons in adversity, enjoy life’s pleasures, and change what’s ripe for reinvention. Leaders model the adventurous spirit, agile and enthusiastic, shaking up the status quo, and keeping up or, even better, getting ahead of external change. Thinker (Jung’s introverted thinker, Enneagram Investigator) People want to understand how things work, what causes what, to solve complex problems, and to make and implement great decisions. Leaders model critical, objective thinking and analysis, finding the truth camouflaged in the noise and messiness of human minds and activity. Leaders’ thinking processes are on display in their communications, helping others think and understand clearly their analysis and best steps forward. Standard Setter (Jung’s extraverted thinker, Enneagram Achiever) Humans need to strive toward a purpose and goals, to have a reason to bounce out of bed and make ourselves and our world a little better every day. Leaders model the purposeful goal-directed process – defining what excellence looks like, designing goals and being accountable to get there, getting things done, and tracking and reporting continual progress. Creative (Jung’s extraverted intuitive, Enneagram Individualist) While most of us aren’t songwriters or artists, we all want to be creative and develop new opportunities, new ways of doing things, and new or improved products and services. Co-creative collaboration is particularly nourishing – when we come together and invent things none of us could do alone. Leaders help themselves and others be more creative, igniting and inspiring others to go nonlinear, to outgrow today’s ways of thinking, feeling, and doing. Strategist (Jung’s introverted intuitive, Enneagram Peacemaker) The ability to step back and zoom out to see the whole picture, create harmony, make meaning of complex situations, find the wisdom in the moment, synthesize all of the data into a strategy – this is the higher purpose of leadership. Leaders are in their roles because they handle more complexity, spot gaps, see further ahead, and find and convey meaning, wisdom, gratitude, and good strategy. As a human-centered checklist on the well-being of the people and organization you lead, consider how well you are supporting these nine personality elements individually and collectively - autonomy, relationships, competence, regulation and stability, adventure and change, critical thinking and decisions, ambition and direction-setting, creativity, and strategic thinking. While our personality structures vary widely in the sorting of our mental processes, drives, and strengths, we share all of the underlying elements. This is our common humanity, which makes for a good starting point in mapping human well-being to leadership. Onward and upward, Coach Meg www.coachmeg.com www.wellcoaches.com www.instituteofcoaching.org www.nbhwc.org Resources: Institute of Coaching report: Leading with Humanity - the future of leadership and coaching McKinsey & Company - Cultivating compassionate leadership during COVID-19 Humanocracy - Creating organizations as great as the people in them Research Handbook on Work & Well-being Organize Your Emotions, Optimize Your Life, Harvard Health book published by William Morrow The Leader's Guide to Corporate Culture, Harvard Business Review Carl Jung's Psychological Types Enneagram personality types Self-determination theory Social intelligence Compassion matters in leadership Josh Bersin - The secret to well-being at work is leadership

Wellcoaches created the animated movie “How Coaching Works” to explain health and well-being coaching when it was in its infancy. Now with almost 2 million views, the video remains a helpful illustration of the beauty of the coach/client relationship. This blog series aims to share the psychological underpinnings of the cartoon. The first blog provides insight into the approaches used by the coach which are based on the principles and processes of coaching psychology. This blog series aims to share the psychological underpinnings of the cartoon. The first blog provides insight into the approaches used by the coach which are based on the principles and processes of coaching psychology. Scene One: MEET In this scene you find the coach in the office with a client. You may expect that it’s the coach’s role to tell my client what to do. Instead, the coach asks them to create a picture of their vision, symbolized by the mountains off in the distance. The client is eager to move toward that vision, and has even started doing some of the thinking necessary to get there, but feels overwhelmed by the things that stand between reality and the dream. The knotted path represents the many possible paths toward the vision. It’s up to the client, with the coach’s support, to figure out which path is the best one. The coach and client first agree on how they are going to work together. They shake hands, symbolizing the important boundary-setting conversation and agreement that starts a coaching relationship. For this relationship to be growth-promoting, the coach radiates warmth, empathy, confidence, zest, humor, and courage. Scene Two: VISION In the next scene, the coach encourages the client to get very clear about what it is that they want, and why. The coach elicits motivation by getting the client to explore why change is important now. They explore what it is exactly that the client wants to create – noting that all of life is invented – and that together they will experiment with how to get from Point A to Point B. Did you know that it’s all invented? According to the Constructionist Principle, we construct our reality - what we perceive, what we believe, what things mean, and what we value. In other words, it’s all made up! And, it’s from this frame of reference that the best coaches work with their clients. They playfully support the client in making up the rules to the client’s “game of life” and in experimenting with the ways to play it. An inspiration for coaches comes from the work of Ben and Rosamund Zander in their book The Art of Possibility. Check it out and learn to say “How fascinating!” about all of life’s knots in the road. Scene Three: THE PLAN Notice that when the client works on their plan, the coach digs into the toolbox and hands over a tool – a BIG pencil. The client is uncertain that they can handle the pencil, but the coach’s certainty is greater than the client’s doubt. From the domain of Hope Psychology, we know clients have the willpower, and now just need to develop the waypower. And, waypower isn’t best developed by having someone tell you what to do, or doing it for you; it’s best developed by experimenting with the change oneself. The client gets specific with what they want to have happen –the specific changes that will take place in their life to get to the mountains in the vision. The more specific, the better. The box that the client draws represents the importance of focus and clarity in setting one’s goals. They are exploring the question of what the client is going to take responsibility for creating, and doing, to reach the beckoning goal. Scene Four: THE JOURNEY As the coach presents the next tool, a trampoline, the client is beginning to feel more confident in their ability to take that first leap. The trampoline represents the power of setting goals that are appealing, specific, and measurable, and of thinking through all that it will take to be successful, including the ever-important supporting relationships. The coach invites the client to recall other times when they have been successful in achieving other life or work goals, as well as their strengths and talents. It’s an opportunity to learn from past successes and to apply one’s strengths, rather than focusing on what’s hard. More building blocks are constructed – the stepping stones to reaching success. The vision of the client’s best self becomes clearer and closer. But as the client continues to experiment, they fall off of the ladder – missing a challenging step. This, of course, happens in real life – we lapse and fall back into our old habits. The coach brings a safety net, a non-judgmental space in which they can explore what happened and what they learned from it. How fascinating! This leads to his insight and decision to create smaller steps, drawn onto the ladder. How important it is to move to action at the right time, with the right goal in mind. There is little benefit to clients of working on goals that are beyond their capability. When clients set goals that are well matched to their readiness to move forward, with enough stretch to be engaging but not too much to produce anxiety, they become aligned with their “best self.” The client rises above the challenge, achieves the plan, and jumps up, having grown into the image of their best self. They are excited as they experience what it feels like to be there – and that will propel more successes going forward. Scene Four: SUCCESS The Coach and Client end with a celebration – the client has found the best path, outgrown perceived roadblocks, and become the vision of their best self. Together the heartily acknowledge the accomplishment. The final scene is a cliff hanger, so to speak. Its message of “To Be Continued” speaks to the fact that change is a journey, a process to revisit continually. We know that as the client continues down the road toward the vision, there will be another knot, or a ditch, or a seemingly impenetrable object. Yet, through the coaching partnership that cultivates hope and the acknowledgement of strengths and abilities, the client will continue on the path and further develop their best self.

“In this century, human knowledge is extremely expanded and developed. But this is mainly knowledge of the external world. In the field of what we may call "inner science", dealing with the inner things, there are many things, I think, that you do not know. You spend a large amount of the best human brain-power looking outside - too much. and it seems you do not spend adequate effort to look within, to think inwardly. . . . Perhaps now that the Western sciences have reached down into the atom and out into the cosmos finally to realize the extreme vulnerability of all life and value, it is becoming credible, even obvious, that the Inner Science is of supreme importance. Certainly, physics designed the bombs, biology, the germ warfare, chemistry the nerve gas, and so on, but it will be the unhealthy emotions of individuals that will trigger these horrors. These emotions can only be controlled, reshaped, and rechanneled, by technologies developed from successful Inner Science.” ~ The Dalai Lama, speaking at Harvard in 1984 ( courtesy of www.wisdomatwork.com)

One of the enduringly fascinating questions in coaching is why it actually works. To consider this question, a valuable body of research is that of common factors theory. Believe it or not, we’ve been talking about why therapy and coaching work for over 80 years. The common factors research suggests that elements such as client resources, strengths, supports and practitioner attitudes – warmth, empathy, compassion and many others account for about 70% of the beneficial changes a client experiences. These ideas area discussed widely in what remains one of the best books on the subject – The Heart and Soul of Change. Still, the question remains – why do these elements make such a difference? In coach training, we teach the 3 core skills – “doing skills”, if you will, or “micro-skills” – deep listening, open inquiry and reflection. These are embedded in the words of Epictetus, the Greek Stoic philosopher, who lived from about 50 CE to 135 CE. He was born into slavery in what is now Turkey, living many of those enslaved years in Rome, before gaining his freedom as an adult. He moved to Greece and established a school of philosophy. Among many other profound reflections on the nature of being human, Epictetus observed this: “We have two ears and one mouth - we should therefore use them in that proportion.” Applied to coaching, such a view centralises the skill of listening, as the most important of the three core skills. Listening demonstrates a deep commitment to being present for another person. It also provides the foundation on which the other two core skills – open inquiry and reflection – are built. Without listening, any inquiries would be “unanchored”, and reflections would be impossible. Open inquiry embodies the attitude of curiosity in coaching. Curiosity is key to remaining “non-judgmental”. Curious open inquiry communicates to the client a desire to know and learn about them. It is “co-created” by client and coach, in that a client’s response to one inquiry then has a shaping response on the following inquiry. At its best, curious open inquiry conveys to a person that their story, however it emerges, has value. Reflection is the skill which “closes the loop” of communication – it tells the sender of a message that it has been received and understood as intended. This approach is already used in many industries all over the world including aviation, marine, rescue, first response and more. The importance of understanding a message as intended is embedded in those industries. Yet in interpersonal communication, we sometimes make the assumption that because something has been said, it has been understood. Reflection helps the speaker to be confident that they have conveyed the message they wish to convey. When these three skills – deep listening, open inquiry, reflection - are used together, they do the work of establishing channels of communication. But they do much more than this – they provide a “meta-communication” to the client which builds a bridge between two unalike beings and forges a bond which says: I am with you I want to learn about you I see you I hear you I understand you

Ellen Albertson is launching her newest book this month entitled: "Rock Your Midlife: 7 Steps to Transform Yourself and Make Your Next Chapter Your Best Chapter.” Albertson, a Wellcoaches professional coach training graduate, has been working with women in midlife her whole career. Today, at nearly 60, her aim is to revolutionize aging and live well to at least 100. She calls this period in life, a second adulthood, a rich time to take everything we’ve learned and ask, “what do I want to create?” One of her aspirations is that “when our daughters get to be midlife there’s no crisis left.” Anybody can pick up this book and get something from it, she said, adding it is based on reams of science and research much like Wellcoaches curriculum. A major section of the book is focused on “destination vibration.” What that means in practical application is to become the person you want to be, today. And you start by thinking about a time in your life that you were really happy. For Albertson, she visualizes herself dancing. She recreates the energy and joy she feels while dancing. Albertson’s career has morphed and transformed as much as she has over the years. Moving from a dietician and personal trainer into coaching and practicing self-compassion. “I would not be who I am without Margaret Moore. Wellcoaches changed my trajectory.” She recalls Wellcoaches Professional Coach Training having a distinct impact on her work. Through the training, she has even more tools in her toolbox. The work of Bob Kegan, Barbara Frederickson, Martin Seligman, all this work that was introduced in Wellcoaches training also shows up in her book. “It was so worth it and it was so much fun. It’s going to have a profound impact on your coaching skills. No hesitation one of the absolute best training I have ever done. If not THE best,” Albertson said. “PCT transformed my life. Getting all of this coaching and a profound opportunity for enlightening yourself." She said Margaret Moore guided her toward Fielding Graduate University where she earned her Ph.D. and learned about self-compassion. Albertson shared that while earlier in life she had a negative body image and experienced depression, she has now through the integration of Kristin Neff’s work on Self-compassion (who also was on her dissertation committee) created a better relationship with herself. She feels more empowered. The seven steps in her book are all part of her personal experience too. She has moved through them and said she is now called to make the world a better place.

Good morning! “I’m so tired and overloaded,” he exclaims. "How come?" I ask. "I don’t know why I keep saying yes to things,” he replies. "I’ve agreed to two new projects, to changing my plans, to a couple of truly messy meetings, and to a new committee role. It’s too much!” Indeed, we have an epidemic of ‘yes.’ In theory, saying ‘no’ should be straightforward. But every day I talk to leaders that say ‘yes’ when they really want to say ‘no.’ We realized that ‘no’ is bad when mom and dad fussed at us for saying “I don’t want to go to bed/brush my teeth/ share with my sister.” We’ve been cajoled, bribed, or downright forced to say ‘yes’ instead of ‘no.’ So we learned to say ‘yes’ in order to please people, avoid conflict, not be criticized, get kudos and praise, prove our worth, demonstrate our commitments, and even show our love. Oy! Turns out that saying ‘no’ is an act of maturity and personal power, and leadership skill of its own. Of course, there are times when saying ‘yes’ is the exact right answer; times to agree, accede, compromise, and even capitulate. And even if you’re asked to do something that’ll cost you (family time, energy, money, falling behind on your duties), it can still be a ‘yes' if you’re staying true to your values, and the cost is worth it. But if your ‘yes’ is an automatic reflex that has no boundaries, then you pay with your health, get burnt out, frustrated, disengaged, and even resentful. A default and automatic ‘yes’ isn’t a choice, it’s a habit. Your ability to say ‘no’ is correlated with making choices. Choices are correlated with having agency. Agency is correlated with personal power and saying ‘yes’ when you mean ‘no’ leaks away your power. As a “healing” process, I invite you to be a conscious being at choice, and experiment with intentional ‘no.’ Turns out that when you feel your power and choose to say ‘no,’ you can then say ‘yes’ with genuine commitment and sincerity. Next time someone invites you to a meeting, asks for a favor, or wants you to take on a project, in your mind, say ‘no.’ Don’t answer aloud yet. Listen to your heart and your gut, and notice what they are saying. Does saying ‘no’ make you more relaxed or more tense? Why say ‘yes?’ Is it to soothe or appease, to get approval or people please? Or is ‘yes’ your genuine choice? Mentally start with ‘no’ and then make a choice, but don’t just agree on autopilot. Then if you want to say 'no' out loud, here are a few starters that you can adapt to your personal style. “I can’t do this now, but I’d love to revisit this next week” “I want to do a great job, and given everything on my plate, I can’t take this on and do a job I’m proud of. What do you think I should deprioritize?” “I can’t do this, but Brenden over in Marketing might be interested.” "I’m going to say no for now, but if conditions change, I promise I’ll get back to you.” “I can’t do what you’re asking for, but I can do this instead.” And, "No, I'm not going to do that." As you bring on the ‘no,’ some folks will feel (and some will tell you) that you’re being selfish and “not a team player.” Not true. You’re becoming a conscious being at choice. I promise that with practice, saying ‘no’ makes you more effective, less overwhelmed, and more powerful.