Dr. Michael Arloski, Author at MedFitNetwork

Pre-diabetes – A Wellness Opportunity To Help

Dr. Michael Arloski/23 October 2023/ All MFN blog, Conditions/

There is an opportunity for wellness and wellness coaching to impact the lives of millions of people in a life-saving way. 79 million Americans are estimated to have a condition called pre-diabetes. Usually symptom free, without intervention they will develop full-fledged Type II diabetes within ten years and possibly endure physical damage to their heart and circulatory system along the way. Yet, according to the American Diabetes Association, if a person is successful at lifestyle improvement they can completely avoid the onset of diabetes 70% of the time.

Motivation Plus Mobilization: Coaching For Success At Lifestyle Improvement

Dr. Michael Arloski/2 August 2023/ All MFN blog/

“I just don’t seem to have the motivation to really make changes.” This is a lament frequent to the ears of health and wellness coaches. Our clients are often puzzled by a lack of success in their efforts to start living a healthy lifestyle, or keep such efforts going. They blame it on either a lack of motivation to get started, or that their motivation fades as old habits reassert their rule.

Coaches help their clients examine and re-examine whatever sources of motivation they have mentioned. They help their clients revisit their desire to change and what drives it. They look at fear-based motivations such as not wanting to have an illness get worse, or not wanting to develop the maladies that have been prevalent in their family. They look at the love-based motivators like caring enough about ones self, wanting to be there for their grandchildren as they grow up, the intrinsic joy of dancing, swimming, tasting delicious and nutritious food, etc.

Perhaps the coach concludes, like their client, that these motivators just ‘aren’t enough’. The next step is to begin a usually fruitless search for additional motivators. Their client runs out of ideas and coaching descends into ‘what about this?’ suggestion after suggestion. What is really going on? What’s a more productive avenue to explore?

Your client may have enough motivation. They may in fact, have listed three, four or more reasons they want to change. They may possess a terrific combination of motivators. Motivation is like the fuel for a vehicle to run on. The problem might not be the fuel, but the lack of an actual vehicle! The vehicle is a methodology, a structure, and a process that facilitates change. To get where they need and want to go, the client needs both a vehicle to carry them and the fuel to put in it.

How do we mobilize motivation? By providing our client with methodology. I’ve always been amazed at how simple successful change can sometimes be when clients have a well-developed way of achieving it.

Coaches often hear their client’s frustration at wanting to improve their lifestyle, but not having much of a history of success at it. If we inquire if they have ever started their change efforts by first taking stock of their health and wellness in a really clear way, we find they rarely have. If we ask if they have ever begun by first developing a thorough plan as to how they will make their changes happen, we often find them admitting that they usually just get their will powered amped up and set some sort of goals. Rarely have they ever carried out their change efforts with the help of an ally who helped them with support and accountability. And, all too seldom have they ever keep track of their efforts at change and actually written it down.

A mentee of mine was recently coaching a middle-aged woman who complained of a lack of motivation holding her back. As we began listening to the recording, the coach helped the client describe at least four strong motivators that had propelled her into action. She realized that when her children were younger playing with them had provided her with more activity and energy. Now her energy was low and she wanted to reclaim that. She also talked about hoping for grandchildren and wanting to be a very active part of their lives. The client was concerned about her advancing age and not wanting to lose the health she had. She didn’t want to become a burden to anyone. She went on to list at least two more motivators.

As the client described her lack of success at change, her conclusion was that she was just lacking motivation. She described coming home from work tired and just fixing a quick (though not necessarily healthy) meal and watching television in the evening. “I just don’t have the motivation I need” the client lamented. She intended to be more active and intended to eat better. All she had for a plan were intentions.

Doing a great job of coaching, my mentee gently confronted his client and recited the substantial list of motivators that she did, in fact, have. He questioned whether it was a ‘lack of motivation’, or something else that was missing.

Clients try to figure out what is keeping them stuck. Unless it’s a matter of identifiable internal or external barriers, clients often say it’s a lack of motivation. They are looking for an explanation and, frankly, they often don’t know what else to call it.

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Co-Creating The Coaching Alliance

An often ignored part of coaching is the work it takes to Co-Create The Coaching Alliance. In addition to getting acquainted with our client and hearing their story, an important part of our first session with a client is to convey to the client just how coaching works. Clients are used to meeting with consultants, not coaches. They expect to be able to provide the consultant with lots of great information and hear the expert recommendations. We spoke about this from the coach’s point of view in our blog post, “Making and Maintaining The Shift To The Coaching Mindset”. The client also needs to make a mindset shift to get oriented to this new way of working with someone.

Coaching is about co-creating agreements. We co-create with our client agreements about how we are going to work together. Some aspects of our working together are negotiable and can involve compromise. However, we are not going to compromise the nature of our coaching relationship. That is, we are not going to agree to just be our client’s educator, and let go of the role of coach.

Part of what an effective coach does is to explain, in a succinct fashion, exactly how coaching works, how it is structured and what the benefits of this structure are. The client-centered nature of coaching is conveyed with real reassurance that the client remains the one in the driver’s seat.

Part of the coach’s job is to facilitate the client’s use of the coaching structure. The coach does this by showing the client how advantageous it can be to operate with a solid plan, to track one’s progress at making changes, etc. The coach provides tools that make these processes easier. Mobile apps for tracking can be recommended and then, importantly, integrated into the coaching accountability.

Mobilizing Motivation

Motivation can be puzzling and elusive, but when it is present a methodology, a structure, is what the client needs in order to mobilize it. By providing our client with the vehicle, we help them get where they want to go.

Word Origin – Coach: In the 15th Century the Hungarian village of KOCS was the birthplace of the true carriage or “coach” as the word evolved in English.

In other words we might define both types of coaches as: A coach takes you from where you are at, to where you want to be!

Originally published on Real Balance blog. Reprinted with permission.

Dr. Michael Arloski is the CEO and Founder of Real Balance Global Wellness Services, Inc. (www.realbalance.com). Real Balance has trained thousands of wellness coaches worldwide. Dr. Arloski is a board member of The National Wellness Institute, and a founding member of the executive team of The National Consortium For Credentialing Health and Wellness Coaches. He is author of the leading book in the field of wellness coaching: Wellness Coaching For Lasting Lifestyle Change, 2nd Ed.

Friendly therapist supporting red-haired woman

The What, the How and the Why of Lifestyle Improvement

Dr. Michael Arloski/30 May 2022/ All MFN blog/

Health and wellness folks are sometimes confused about the role each professional might play in helping individuals to live their best life possible. Our clients are seeking to be healthier by losing weight, managing stress, stopping smoking, becoming less isolated, and often, managing a health challenge of some kind. To do so they need excellent wellness information, great treatment (if that is called for) and a way to make lifestyle changes that will ensure lasting success. So, who is responsible for what?

Fitness trainers, rehabilitation therapists, physical therapists, dietitians, various treatment professionals and health educators can help their clients/patients to know what lifestyle behavioral changes will move them towards improved health and wellbeing. What we often hear from these medical and wellness pros is frustration with a lack of success on their client’s part in making the recommended changes and making them last. The reality is, most people simply don’t know that much about how to change the ingrained habits of a lifetime.

The physical therapist works with their client in their session and sends them home with exercises that must be done every day. The dietitian creates a fantastic meal plan that their client must put into practice. The fitness professional creates a tailor-made workout plan, but their client needs to exercise on their own, not just in front of their trainer.

Health educators, treatment professionals, etc. provide the
WHAT
Health and Wellness Coaches provide the
HOW
Our Clients find their
WHY

Everyone’s challenge is the how. It takes more than willpower and motivation. What is often lacking is an actual well-thought-out plan that the client has co-created with the help of someone who can provide support, accountability and a well-developed behavioral change methodology. Translating the lifestyle prescription into action and fitting it into an already busy life is often where, despite good intentions, our clients struggle. This is where having a trusted ally in the cause of one’s wellness pays off.

As the field of health and wellness coaching grows, the challenge coaches sometimes face is clarity about their own role. Sometimes the confusion is all about the what and the how. For coaches to be proficient at “writing” the lifestyle prescription they need additional qualifications. It becomes a question of Scope of Practice.

To guide coaches, the National Board for Health and Wellness Coaches (NBHWC) has developed a Scope of Practice Statement. Here is the part most relevant to our question:

“While health and wellness coaches per se do not diagnose conditions, prescribe treatments, or provide psychological therapeutic interventions, they may provide expert guidance in areas in which they hold active, nationally recognized credentials, and may offer resources from nationally recognized authorities such as those referenced in NBHWC’s Content Outline with Resources.” (NBHWC)

If coaches can “wear two hats” professionally they can combine the what and the how. Otherwise, the key is to coordinate with other wellness professionals or work with the lifestyle prescription that their client already has.

Beyond the what and the how is the why. The “why” of behavior is all about motivation – initiating and sustaining behavioral change efforts by drawing upon the energy and desire to do so. The key here once again is the question of who is responsible for supplying this. People may initiate behavior based upon external motivation – the urging and cheering on of others, the fear of negative outcomes. In order to sustain that motivation, it has to come from within. The challenge here for all wellness professionals is to help our clients to discover their own unique sources of motivation. Seasoned wellness professionals realize they can’t convince or persuade anyone to be well. However, when we help our clients discover their own important sources of what motivates them, they discover their why. Motivation is fuel. Now with the aid of a coach our clients can find the vehicle to put in. They know what they need to change. Now they have a way to know how to change and grow, and they know themselves, why.

Webinar with Dr. Arloski

Join Dr. Arloski for The Behavioral Side of Health: Bringing Coaching Skills Into Your Wellness Work.

All wellness professionals want their clients to succeed at becoming as healthy and well as possible. For them to do so requires the expertise your bring from your profession as a fitness trainer, dietician, therapist, etc., and a way for your clients to follow through on your recommendations and live a wellness lifestyle. That’s where the skills of coaching come in.

Michael Arloski, Ph.D., PCC, NBC-HWC is CEO and Founder of Real Balance Global Wellness Services, Inc. Dr. Arloski is a pioneering architect of the field of health and wellness coaching. He and his company have trained thousands of coaches around the world.

Coming Soon! Foundations of Wellness and Lifestyle Coaching

Dr. Michael Arloski/2 December 2021/ All MFN blog/

Having a foundation in coaching skills equips fitness professionals and wellness professionals to help their clients succeed at lifestyle improvement.

MedFit Classroom’s upcoming course will provide you with a thorough overview that enables you to be much more coach-like in your work with clients.

In this new course, authored by Dr. Michael Arloski, you’ll…

Learn how to help your clients go well beyond just goal setting and make use of behavioral change methodologies that create real progress.
Gain the skills needed to help clients mobilize their motivation to make positive lifestyle changes and accomplish goals they never thought possible.
Become proficient in having The Wellness Coaching Conversation, a conversation that demonstrates understanding while eliciting and empowering the client to choose an active role in their own health.
Through the use of select coaching skills training videos and demonstrations you’ll learn about the use of Active Listening Skills and Powerful Questions to help your clients assess their own wellness and develop a Wellness Plan for growth and change.
Gain accountability and support skills that ensure progress towards lasting lifestyle improvement.
Explore the use wellness and health coaching models and how they can be implemented in your setting.

This course is ideal for the fitness or wellness professional looking to either integrate the skills and methods of coaching into their own professional work, or to serve as an introduction to the path of learning how to become a health and wellness coach.

Dr. Arloski is a pioneering architect of the field of health and wellness coaching. He and his company, Real Balance Global Wellness, have trained thousands of health and wellness coaches worldwide. His book, Wellness Coaching for Lasing Lifestyle Change is a foundational book of the field, and his new book Masterful Health and Wellness Coaching: Deepening Your Craft takes the field to a new depth.

Join MedFit Classroom’s course waitlist to receive a notification when this new course goes live, and receive a special discount!

The Health And Wellness Coach’s Value Proposition

Dr. Michael Arloski/29 September 2021/ All MFN blog/

Every potential coaching client is looking to have the question ‘What’s in it for me?’ answered. Every coach needs to be able to succinctly answer that question by conveying what they will provide for their client.

Potential coaching clients are rarely familiar with what a coach, especially a health & wellness coach, can do for them. They are used to dealing with educators and consultants, medical and otherwise, not coaches. Usually clients expect to be directed, educated, and led in the best direction for them. All too often they hear a wellness coach tell them something like:

“I’m not going to tell you what to do. I’m not going to tell you what to eat or how to exercise. You’re the one in charge. You’re the one behind the steering wheel. You’ll be making your own wellness plan, and I’ll help you follow it.”

Why should this person become your client when it appears that they, themselves, are going to be doing all the work? Our client-centered approach to coaching does not mean we are not providing value, however we have to communicate the value of what we offer, and do it very clearly. What will the client gain from coaching?

This is true for the self-employed coach as well as the coach working for a wellness program, a disease management company, an insurance carrier, or any other organization that provides wellness and health coaching. It is about engagement. When coaches are confronted with the “incentivized” client, who is reluctantly complying with coaching in order to get their prize (or much-needed insurance discount), conveying the Health And Wellness Coach’s Value Proposition is more vital than ever.

Here is my way of presenting The Health And Wellness Coach’s Value Proposition. Please adapt to your own words and use it!

The Health And Wellness Coach’s Value Proposition*

“Thank you for your interest in improving your lifestyle and your life. You may be new to coaching, and especially wellness coaching, so let me share with you the value that it brings.

Wellness/health coaching is all about you living the best life possible for you. To do that most people find there needs to be some improvements in their way of living, their lifestyle. Making those improvements, those changes is challenging when you have to do it all by yourself. Perhaps you’ve already had some experience with that.

When I work with someone in coaching I’m here to serve you. You are the one in charge of your life and our work together. It’s your hands on the steering wheel. I’m not going to tell you what to do and give you a pre-maid wellness plan. But, together we can co-create a plan to help you succeed at making the lifestyle improvements that you want to make.

As your coach I will be working with you to get very clear about where you are at with your health and well being right now. We’ll help you take stock of that by exploring together, using some coaching tools that will help give you a more complete picture, and by going over the lifestyle improvement recommendations you’ve gotten from treatment professionals. Then we’ll work together to help you form a clear picture of the kind of life you want to live, your healthiest life possible for you. We’ll compare where you’re at and where you want to be and together form a solid plan to help you get there.

Once we have that plan we’ll work together as allies to help you be accountable to yourself and follow through on the steps you need to be taking on a regular basis to help you achieve the goals you have in your plan. I’ll be with you throughout the journey. I’ll be there to help you strategize over, under, around and through the barriers that come up. I’ll help you with challenges that make it tough for you to live the healthy life you want and together we’ll help you keep on track. Together we’ll help you find and develop the sources of support that will make your changes last. We’ll evaluate our progress and adjust the course along the way as we need to. My goal is to assist you in becoming self-sufficient in your wellness, to be able to live a healthy life in a completely sustainable way.

I bring the value of a professional that knows about succeeding at lifestyle improvement. I bring the value of an ally.”

*Created by Michael Arloski, Ph.D., PCC, CWP. Please adapt to your own words and use it! If used intact you must include authorship credit and contact information (Real Balance Global Wellness Services, Inc, https://www.realbalance.com).

Originally published on Real Balance blog. Reprinted with permission.

Senior man in a gym talking to personal trainer

Connecting With Others in 2021 – Be More Coach-Like

Dr. Michael Arloski/19 January 2021/ All MFN blog/

Even before the advent of the Global Covid-19 Pandemic interpersonal connection in our modern world had already become quite challenging. We saw 2020 become a year of greater isolation. At the same time, we also discovered the value of connection.

Social Distancing – Not Social Isolation: Coaching for Connectedness

Dr. Michael Arloski/25 March 2020/ All MFN blog/

We all still need each other. Even in the age of COVID-19, our health continues to depend upon healthy supportive relationships. Our coach training company, Real Balance 1 has always stressed what we call Coaching for Connectedness. We‘ve seen lifestyle improvement occur and last more often when people receive support for the changes they are making to live healthier lives. When a coaching client sets up an action step we ask “Who/what else can help support you in this?”. Research on what makes health behavior last points primarily to two factors: a shift in self-concept and community support. (2) It’s also a well-established fact that people who are more socially isolated have significantly higher rates of all major chronic illnesses. (3)

Our challenge in the midst of a pandemic situation is how we distance from each other while remaining connected to each other. Yes, follow the CDC guidelines for social distancing. We can still greet each other with elbow bumps, and then go for a walk, a bike ride, a cruise in kayaks, etc., and continue to avoid the proximity that puts us at any risk. We can connect via phone and receive the nourishment of live, interactive conversation that texting and e-mail don’t quite match. We can climb on board a web-based platform such as Zoom and Skype where we are face-to-face for our conversation. We also have all sorts of apps such as Facetime, WeChat, and many more that allow us to have face-to-face interaction for live conversations.

As coaches we can continue to work remotely with our clients, as the majority of coaching is already done. As we do, explore the feelings that the changes brought about by social distancing are bringing out in your clients. Empathize. Explore. When people talk about their fears, the intensity of those fears almost always lessens. As people become less afraid, their thinking improves. They aren’t so quick to jump into dismissive all-or-none thinking. They are then able to engage in strategic thinking with their coach to find unique solutions to staying healthy.

The fitness center is shut down. How can you shift to working out at home? Use stretch bands. Modify a spare room into a place to do Yoga, floor exercises, etc. Spring brings better weather allowing more cardio outdoors.
Do more outdoor exercise/activity with other people – just keep your proper distance.
Encourage clients to find new ways to electronically visit their friends, grandchildren, and others. Play online games together.
Check in with your clients to make sure they have CDC information/WHO information about how to stay safe during the COVID-19 pandemic. (5,6)

Take heart at how people are showing concern for each other during this time. Younger people who are at somewhat less risk are engaging in social distancing, handwashing, etc. not only for themselves, but for the older and more vulnerable people who could be affected by the contact they are having. People in neighborhood chatlines are volunteering to go pick up groceries and prescriptions for older or more sickly neighbors. Hopefully what will come out of all of this is a greater sense of how we are all in this together. Distancing does not mean isolating. The truism of wellness pioneer Jack Travis is still valid: Connection is the Currency of Wellness.

Be well and stay well!

Michael Arloski, Ph.D., PCC, NBW-HWC – A psychologist with over twenty-five years of clinical work, and more than 23 years as a professional wellness coach, Dr. Arloski is one of the key developers of the field of health & wellness coaching. He is the author of Wellness Coaching For Lasting Lifestyle Change, 2nd Ed., and Masterful Health & Wellness Coaching: Deepening Your Craft. His company, Real Balance Global Wellness Services, Inc., has trained over 9,000 health & wellness coaches worldwide www.realbalance.com.

References

This article was published on Dr. Arloski’s blog. Reprinted with permission.

Delivering The Behavioral Side Of Lifestyle Medicine Through Wellness Coaching

Dr. Michael Arloski/18 May 2018/ All MFN blog/

If we could give every individual the right amount of nourishment and exercise, not too little and not too much, we would have found the safest way to health.” –Hippocrates 420 B.C – 370 B.C.

Healthcare providers have been prescribing lifestyle improvement for thousands of years. The evidence has been built from the observations of Hippocrates all the way to the neuroscience of today. We know, from mountainous reams of data, that lifestyle affects the course of an illness or health challenge. The challenge for the healthcare provider of today is to see the “lifestyle prescription” translated into lasting lifestyle change. Many well-intentioned healthcare professionals have attempted to educate and admonish their patients into losing weight, ceasing the use of tobacco, managing their stress better, getting more sleep, being medically compliant/adherent, etc. Seeing actual success in behavioral change happening far too seldom, many have abandoned such efforts and just reach for the pharmaceutical prescription pad.

In recent years, however, there has been an exciting movement in the field of medicine that looks at how to use “lifestyle interventions” as first-line treatment.

“Recent clinical research provides a strong evidential basis for the preferential use of lifestyle interventions as first-line therapy. This research is moving lifestyle from prevention only to include treatment–from an intervention used to prevent disease to an intervention used to treat disease.” –The American College Of Lifestyle Medicine

The Lifestyle Medicine Movement has done much to establish an evidence base and it continues to examine research that distinguishes what appears to work for lifestyle improvement. Much of its attention has focused on nutrition, but more and more the field is realizing the importance of health and lifestyle behavior.

Wellness and health coaching has become the delivery mechanism for wellness programs, and its potential for the same vital role is being seen in Lifestyle Medicine. The reality is that the vast majority of clients that most wellness/health coaches see are already health-challenged in some way. They may already have a chronic lifestyle-related illness, or multiple risk factors that set them up for needing serious preventative help. Wellness/health coaches that work for disease management companies, insurance companies and many corporate wellness programs are already working with caseloads populated primarily by lifestyle medicine patients.

At past Lifestyle Medicine conferences, I’ve presented on “Wellness Coaching And Lifestyle Medicine: Covering The Whole Continuum”. and “Delivering The Behavioral Side Of Lifestyle Medicine: Wellness Coaching Skills & Concepts”. Together with other presenters on wellness coaching we have experienced a strong positive response from an audience made up primarily of physicians.

One of the key concepts of my talks that was especially well received was the idea of how the Treatment Plan needs to be integrated with the Wellness Plan.

Co-creating a Wellness Plan with our clients is one of the primary tasks for the wellness coach. Together we work with a structure that insures the client’s plan for lifestyle improvement will lead to success. A key part of that Wellness Plan will always be the “Lifestyle Prescription” that the client’s treatment team is recommending. What is key is that the Wellness Plan supports The Treatment Plan.

I will be talking further about this concept in my forthcoming book on the more advanced skills and methods of wellness coaching, but here is a sketch of the two plans and the way they overlap.

Treatment Plan

Diagnostically Derived
Treatment Provider Devised
Prescriptive
Responsibility on Provider to administer, responsibility on client to follow
Usually does not accommodate patient’s circumstances or abilities, may accommodate patient’s capacities.
Problem solving, solution finding oriented
Purposed for resolution of illness and disease, reduction of symptoms, healing
“Lifestyle Prescription” focuses on recommended behavioral changes leading to Lifestyle Medicine outcomes
Dependent greatly upon medical compliance/adherence

Wellness Plan

Derived through exploration and self-assessment combined with treatment recommendations.
Co-created by “client” and “coach”
Non-prescriptive – client centered
Responsibility on client to follow with coach’s accountability and support
Not only accommodates, but is derived from client’s circumstances, abilities and capacities.
Designed to eliminate barriers and develop additional support
Possibility, growth and self-actualization oriented.
Purposed for behavioral change and lifestyle improvement
Includes assisting client with medical compliance/adherence

Overlap Of Treatment And Wellness Plans

The Wellness Plan (WP) supports the Treatment Plan (TP)
TP identifies critical areas for recommended lifestyle improvement
Through “client-centered communication” WP aligns with the goals of the TP
Client engages, with coaching support, in lifestyle improvement behaviors that positively affect treatment outcomes
WP helps client with organization, accountability, etc., improving attendance for medical appointments and management of medications, self-testing/self-care
WP helps client make best us of medical appointments (self-advocacy)
WP helps client report more accurately to treatment team about changes in lifestyle behavior (providing more data for treatment decisions)

When clients are operating on a Wellness Plan that they have truly helped co-create with their own buy-in, the opportunity for weaving in Areas of Focus, Goals and Action Steps that support what their treatment team wants to see becomes obvious. Clients then have the structure and support they need to carry out the goals of the Lifestyle Prescription.

Physicians and other healthcare providers can already start making use of wellness and health coaching as a delivery mechanism for the behavioral change they would love to see. Many of their patients already have wellness coaching as an employee benefit. Their company’s wellness program may already provide it, or they may contract with a wellness coaching provider company. More and more employees have wellness/health coaching available through their insurance provider.

Wise medical organizations and practices are hiring wellness coaches to become part of their staff or are outsourcing to them. Healthcare providers are sometime “wearing two hats” and combining their treatment work with coaching. Others are becoming more “coach-like” in their interactions and are then handing the patient off to the wellness coach for the longer process of lifestyle improvement.

The Real Balance Wellness & Health Coach Certification curriculum (http://www.realbalance.com) has included how coaches fit into the Lifestyle Medicine approach for over a decade. Our students come to us as a resource for learning how they can help deliver the lifestyle improvement that their Lifestyle Medicine clients seek.

Wellness Coaching to support Lifestyle Medicine is not just an idea whose time has come, it has already arrived!

Originally published on Real Balance blog. Reprinted with permission.

A New Code of Ethics For Health And Wellness Coaches: Healthy Boundaries, Part One

Dr. Michael Arloski/22 August 2017/ All MFN blog/

The old New England expression that “good fences make good neighbors” applies to the world of professions as well as it does to rows of piled rocks in the old fields and forests of places like Vermont and Maine. The concept of professional boundaries seems to expand the more you look into it. In this and a following post we will look at role definition, ethics and scope of practice, boundary crossings and violations, self-disclosure, and other issues from the unique perspective of the health and wellness coach.

Since its inception just over twenty years ago the ICF (International Coaching Federation) has developed a Code of Ethics which it revises on a regular basis. The ICF also maintains an Ethics Community of Practice where you can bring ethics questions and learn from presentations.

Law & Ethics in Coaching: How To Solve And Avoid Difficult Problems In Your Practice (2006) by Patrick Williams and Sharon K. Anderson houses considerably valuable information from the chief authors and other contributors.

With the development and growth of the field of health and wellness coaching, the question of ethics and scope of practice emerged with the realization that such coaches often face unique situations, sometimes interacting with the medical world, that require a fresh look. While the ICF Code of Ethics is to be embraced by all coaches, the need for something more became evident.

As an Executive Team member of The National Consortium for Credentialing Health and Wellness Coaches, I was honored to chair a committee last summer of extraordinary coaches who are part of our NCCHWC Council of Advisors.

Through our efforts “in August 2016, the NCCHWC created the Code of Ethics and Health & Wellness Coach Scope of Practice to serve as a reference for health & wellness coaches and faculty. The NCCHWC expects all credentialed health and wellness coaches (coaches, coach faculty and mentors, and students) to adhere to the elements and Principles and ethical conduct: to be competent and integrate NCCHWC Health and Wellness Coach Competencies effectively in their work.”

Please download the NCCHWC Code of Ethics and Health & Wellness Coach Scope of Practice here: NCCHWC Code of Ethics; NCCHWC Health & Wellness Coach Scope of Practice. You can also find copies of both documents in the Wellness Resources section of the Real Balance website.

Codes of ethics such as these serve as the primary guides to help form professional boundaries that we can adhere to. In Section Three of the NCCHWC Code of Ethics we find most of the references to boundaries. The most obvious boundary here is #23 – to avoid any sexual or romantic relationship with current clients, sponsor(s), students, mentees or supervisees. But, we also see in other items in this section, that much of the issue of boundaries also refers to creating clear agreements with our clients about the nature of coaching, how it works, confidentiality, financial agreements, etc. The client-centered nature of coaching is emphasized along with complete transparency, spelling out the rights, roles and responsibilities for all involved.

The issue of boundaries is more directly addressed in item #22. Hold responsibility for being aware of and setting clear, appropriate and culturally sensitive boundaries that govern interactions, physical or otherwise, I may have with my clients or sponsor(s). Here we are looking at how we create a safe environment for our client where they feel respected, comfortable and safe. While most individuals are at least somewhat sensitive to this in most social interactions, the coach must be especially sensitive about it because of the trusting nature of the coaching relationship. While not on the same level as clinical relationships, coaching clients must feel free to express themselves at a trusting level. The health and wellness coaching client who is attempting to gain insight about how they hold themselves back from being successful at weight loss, for example, needs to feel that they can reveal information about relevant feelings and experiences without feeling vulnerable. This shows up mostly in two areas, the appropriateness of touch, and self-disclosure.

While not inherently wrong, behaviors such as giving/receiving a hug from/with a client after a triumphant moment in coaching, may be misconstrued in its intention. For one client it may, according to some authors, “engender healthier relationships”, while for another it may feel like a boundary crossing, which other authors would argue, might “pave the way to a boundary violation.” Coaches learn early on in their training to ask permission. Seeking permission first and respecting our client’s wishes can avoid such boundary crossings/violations. We avoid the pitfalls of assumptions and honor our client’s personal and cultural boundaries in this way.

Self-disclosure also has different boundaries in different cultures and with different individuals. We looked closely at this topic in a previous blog post “Self-Disclosure in Coaching – When Sharing Helps and Hinders“. We can remember from that post that coaches who do not self-disclose at all are not trusted, while those who disclose “too much” are thought to be incompetent. Our own self-disclosure, should never put undue pressure on our client to also self-disclose. Differences in culture, social class, family upbringing, etc. all can set very different boundaries around the issue of appropriate self-disclosure.

Originally published on Real Balance blog. Reprinted with permission.