The Wild West of Wellness Coaching

Joan McGuire

The profession is a growing part of health care, but many practitioners are uncertified. 

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If you were feeling under the weather a few hundred years ago, your doctor might have given you a healthy dose of mercury. If you suffered from a mental health condition, you might very well have been hooked up to a generator for some electroshock therapy. Exciting as those procedures might sound, if you were hoping for a cure, you would be disappointed.

The archaic practices didn’t go extinct overnight. They were gradually phased out as the fields of immunology and psychiatry became standardized and evidence-based. Groups of medical professionals compared notes, figured out what worked and why, and formed organizations which could certify people who knew what they were doing.

Now the medical profession has a new member tapping on the door to the clubhouse: the health and wellness coach. Perhaps due to the rise in chronic health conditions, or perhaps due to a renewed media focus on mindfulness, health and wellness coaching is quietly gaining popularity. There are double the amount of board-certified training programs today than there were five years ago. And as wellness coaching registers more and more on physicians radars, private and public health insurers will have to decide where they stand.

According to the National Board for Health & Wellness Coaching, “Health and wellness coaches partner with clients seeking self-directed, lasting changes, aligned with their values, which promote health and wellness and, thereby, enhance well-being.”

If that sounds vague, consider an example:

Say physician diagnosed you as being pre-diabetic they might refer you to a dietician, who could tell you to eat more leafy greens and exercise. They might also refer you to a wellness coach, who would help you make and keep up with the healthy behavior changes you wanted to make in your life.

Or say you had a chronic condition. A doctor may tell you to exercise and take medication regularly, but living with recurring health problems can take a toll, and a wellness coach could work with a client to ensure they develop the habits which allow them to lead their healthiest life.

Basically, figuring out you should get eight hours of sleep and eat leafy greens is one thing, but creating habits around them takes time. A health and wellness coach isn’t a fitness guru or a weight loss expert, they are behavior change professionals who help clients achieve their goals through regular meetings and conversation techniques.

For Allie Quady, a board-certified health and wellness coach in Portland, she finds that there is still a lot of misconceptions about what she does. Often clients come seeking quick fixes for their habits, which is not what her training is about.

“People want me to tell them what to eat and how to solve all their problems, but most of them already know how to eat healthy. My training is to redirect attention and create space for a solution so they can go away with a plan that works for them.”

Oregon State University already employs staff members with health and wellness coach training. As colleges and businesses begin to see the positive mental and physical effects of evidence-based, change-making techniques, there’s a good chance more institutions could follow their lead.

As it stands now, however, health and wellness professionals face two distinct challenges. First, their services are not yet covered by most insurance providers. Second, the profession still suffers from a large amount of misinformation.

“The problem is there are people out there calling themselves health and wellness coaches who have no actual training or certification,” says Leigh-Ann Websterexecutive director of the National Board for Health & Wellness Coaching. “A lot of times there will be people who are personal trainers calling themselves coaches, and people can get confused.”

Webster’s organization is dedicated to certifying health and wellness coaches, ensuring practitioners use evidence-based techniques, and clients have a seal of approval to look for. In order to be certified by the board, a coach needs to take a test, a bit like the bar for lawyers or the board exam for nursing. The exam covers current evidence-based practices, meaning that a board-certified coach understands the proper techniques.

“We didn’t pull these standards out of a hat.” says Webster “We bring together the thought leaders in the industry. That’s how you’re able to develop standards.”

In addition to murky public perception, for health and wellness coaches to truly thrive, health insurance will have to play a role. Coaching is not, generally speaking, covered by health insurance. Despite peer-reviewed studies showing the lasting impact of coaching on overall health, insurers have yet to jump. Webster believes that the profession won’t truly be able to join the healthcare pantheon until “people stop having to pay for wellness coaching out of their own pocket.”

What will it take for insurers to get onboard? “It takes studies, which there are, but you also need funding new studies, and you need funding to generate the data for those studies,” says Webster.

Until then, health and wellness coaches need to maintain business savvy not usually required in the medical profession. Without health insurance to cover their services they can’t rely on doctor referrals. This means a practicing coach needs to know how to market themselves, as well as cater to a client base able to afford their services. They must also fight off the stigma that they are weight-loss trainers.

For now, anyone seeking a certified wellness coach can visit the national directory. It also pays to be on guard, as many who claim to be wellness coaches are skilled in the art of persuasion.

“It’s been like the wild west for a while now,” says Quady. “Be careful of anyone who’s promising you the world. Change takes time.”

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