Health Coaches: What Are They and What Do They Do?
What is a health coach? Why are they so important in the modern healthcare landscape? I’m not sure that I could have answered these questions several years ago when I was burned out from work, feeling lousy, and trying to change my health habits.
Health Coach: Definition and Description
- Coaches help people discover the “why” behind their desired health change
- They empower people as the experts on their own bodies, minds, and circumstances
- They help people identify challenges and blind spots that are preventing change
- They provide support and accountability
- They use their broad knowledge of health and wellness to help people navigate a variety of health concerns
Pillars of Health Coaching
- Motivational Interviewing (MI): includes values/strengths
- Positive Psychology (PP) and/or Appreciative Inquiry (AI): includes values/strengths
- Stages of Change (SOC)/Transtheoretical Model (TTM)
Core Competencies of Health Coaching
- Open questions
- Reflective listening
- Sharing info
Health coaches are experts on human behavior, motivation, and health. They are “change agents” who help their clients set and achieve health goals and build new habits. How do they do this?
No other health profession has this unique skill set. That is why health coaching fills a critical gap in our healthcare system and why health coaches are increasingly in demand.
Health coaches are “change agents.” Check out this article to find out how they use their knowledge of human behavior, motivation, and health to help clients set and achieve their goals. #healthylifestyle #iamachangeagent #kresserinsitute
Health coaching has grown to a $6 billion market with the potential to make a big difference in the quality of people’s lives and their interactions with the healthcare system. (1) Health coaches have a vast array of employment opportunities, from solo practice to collaborative care with practitioners and full-time employment in hospitals and integrative medicine clinics.
Even within the conventional healthcare system, health coaches have an important role. They can be a critical interpreter and patient advocate for people dealing with a medical system that has less and less time to listen or explain how to implement treatment plans.
And health coaches don’t just work with the least healthy members of the population. They can support people with any number of health challenges and goals, from restarting an exercise regimen or getting into peak physical shape to reducing stress, managing diabetes, implementing autoimmune protocols, or losing weight.
With so many opportunities for coaching to make a difference, it’s no wonder that the demand for health coaches is growing.
The Art and Practice of Health Coaching
Why do people often succeed when working with a health coach when they’ve struggled to make changes on their own? Part of this success comes from basic steps like helping clients set goals and create action plans, but much of the success also comes from:
- A coach’s presence
- How coaches listen and what they listen for
- The types of questions that coaches ask
- The collaborative relationship that coaches develop with clients
Sometimes coaches just stir the pot or plant a seed with a simple question or reflection, leading clients to pause and consider their health in a way they never have before. Coaches also use their intuition, tap into their compassion and empathy, and develop a rapport with clients in ways that make the coaching process an artform.
Health coaching is a partnership between coaches and clients that guides clients toward the changes that they want to make. Coaches and clients develop a relationship built on trust and respect that allows them to explore clients’ values, reasons for change, and what’s possible.
Health coaching is a multifaceted practice that requires both training and practice to master.
What Do Health Coaches Do?
You can think of health coaching as sitting at the intersection of health information and behavior change. Health coaches have a working knowledge of diet, lifestyle, and nutrition. They understand how these contributors to health affect the body, which helps them understand and empathize with clients’ health challenges.
Coaches also have the tools and skills to help clients build new habits and make lasting changes. This is what makes health coaches unique in the healthcare industry—they are not just a source of information but a catalyst for transformation.
A Client-Centered Approach
Health coaches use a client-centered approach to working with people. Coaches are not experts on what their clients should do. Instead, they act as partners and facilitators, supporting their clients in taking action, creating plans, and achieving goals based on the clients’ ideas, interests, and experiences. (2) This chart lists the differences between the “expert” approach and the “coach” approach.
|Expert Authority||Coach Approach|
|Educator||Facilitator of change|
|Defines agenda||Elicits client’s agenda|
|Feels responsible for client’s health||Client is responsible for health|
|Solves problems||Fosters possibilities|
|Focuses on what’s wrong||Focuses on what’s right|
|Has the answers||Co-discovers the answers|
|Interrupts if off topic||Learns from client’s story|
|Works harder than the client||Client works as hard as coach|
|Wrestles with client||Dances with client|
Instead of the coach being the expert in the coaching relationship, the client takes the role of expert. Clients know their bodies, their lives, and what’s worked well (or not worked well) for them in the past.
With a client-centered approach to coaching, the client sets the focus of a session and owns the insights, the actions steps, the work, and the success. This creates a very powerful environment for them to make significant and sustainable changes in their health.
Some Tools of the Trade
Coaches can use powerful questions, reflections, affirmations, and even well-timed silence to explore clients’ reasons for change and spark a deeper investigation into the topic at hand. They direct the flow of the conversation by asking certain questions at certain times and guide the session through certain phases like agenda setting, exploration, planning, and closing. In other words, coaches own the facilitation of a coaching session.
Coaching tools and techniques fall into a number of broad categories:
- Motivational interviewing, which helps people to discover their own motivation and strategies for change
- Positive psychology, which teaches people to build on what’s working, rather than fixing what’s broken
- Understanding the stages of change, which allows health coaches to offer the appropriate type of support at each stage of change
- Habit formation and reversal, which supports people to create new, healthy habits and reverse unhealthy ones
- Accountability and goal setting, which helps people to stay on track and achieve their goals
The Coaching Mindset
As a coach, how you relate to your clients has a big impact on the success of the coaching relationship. Coaches are trained to listen, to observe, and to customize their approach to individual client needs based on what they hear and see. (3) Coaches attune themselves to nonverbal communication, changes in client energy and emotion, and what’s not being said by the client.
It is also so important that coaches display unconditional positive regard for their clients, regardless of clients’ success or progress. Clients who have been on a roll may struggle one week. Clients who have been upbeat talking about one topic may suddenly become reserved or quiet when the topic shifts. No two clients are the same and no two client sessions are the same. Coaches must maintain a belief in their clients’ capacity for change and honor clients as experts in their own lives, while ensuring that all interactions are respectful and nonjudgmental. (4)
Imagine yourself as a client and knowing that the coach you’re working with thinks that you have the power to achieve a goal that you didn’t think was possible … doesn’t that sound motivating?
Health Coach vs. Nutritionist: The Difference and What Can Health Coaches Say
Restrictions and regulations on what coaches can say about nutrition, exercise, and lifestyle vary by state within the United States as well as internationally. (5) According to the National Board for Health & Wellness Coaching (NBHWC), health coaches may provide expert guidance in areas in which they hold active, nationally recognized credentials and may offer resources from nationally recognized authorities. (6)
Coaches are likely to find that sharing information as an expert doesn’t serve clients as well as using coaching techniques to help clients research and discover what works best. Clients who come to conclusions on their own will have far more success than ones who are given information and told what to do with it.
On a related topic, see this article about whether health coaches should interpret lab tests.
Looking for more information on establishing your health coaching career? Download this free eBook for an in-depth look at the health coaching industry and the job opportunities that are out there.
What is a health coach? Why are they so important in the modern healthcare landscape? I’m not sure that I could have answered these questions several years ago when I was burned out from work, feeling lousy, and trying to change my health habits.
Benefit from Working with a Health Coach
Working with a health coach can have a variety of benefits for clients. Some clients may take actions that they never considered possible or overcome sticking points that they thought were insurmountable. Others may see a shift in mindset that helps them take an important next step. Still others may discover how to make lasting lifestyle changes after years of cycles of success and failure.
Benefits for People with Chronic Diseases
Research shows that health coaching has positive effects on clients dealing with heart disease, hypertension, obesity, and diabetes, among other chronic diseases. (7) Clients with these chronic diseases get help understanding their diagnosis and treatment plan, get support with the difficult emotions that can result from a chronic illness, and have a partner to hold them accountable as they take steps to manage or reverse the disease.
Clients may see benefits that go beyond their initial focus area. They often gain confidence as they take action and make changes, which can spread to other areas of their lives. These benefits can include better relationships, work–life balance, or general improvements in life satisfaction.
Specific habits may also translate well from one area of health to another. You may notice that clients who have breakthroughs starting an exercise routine also implement a regular bed time or develop consistent meditation practice.
Even after a coaching relationship ends, your work with a client can continue to provide benefits for them. Clients who learn how to build habits can continue creating a healthy life for themselves for the rest of their lives. As the proverb goes, you can give someone a fish and feed them for a day, or you can teach them to fish and feed them for a lifetime.
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What Does it Take to Become a Great Coach?
I’ve talked about what health coaches do, but how do they do it well? One of the most important roles a health coach can play is as a guide for clients.
Coaches aren’t there to lecture, direct, or prescribe. They are there to empower clients to make healthier choices for themselves. This requires abandoning any personal agendas, dealing with one’s own emotional triggers related to client topics, and learning to listen from a neutral, nonjudgmental place. What else makes a great coach?
As with any discipline, you only get better at it with practice, and coaching is no exception. This starts with coach training, with programs that provide lots of opportunities for practice setting their graduates up for success. Coaches also benefit from practicing coaching with peers, getting their own coach to guide them, and talking with other coaches about the process of coaching. Beginner coaches should remember that it takes time to get good at coaching, and they should try not to compare their “beginning” to another coach’s “middle.”
Coaching is a rigorous practice. It requires empathy, personal insight and reflection, unconditional positive regard for clients, and a nonjudgmental approach. Clients may not do the work that they commit to, and some clients may expect you to tell them what to do. Managing your expectations and emotions, keeping sessions focused, and maintaining focus and openness demand a lot of a coach. Great coaches practice self-care to ensure that coaching is a successful, fulfilling, and sustainable endeavor for them.
Some self-care tips:
- Take time for personal reflection through journaling and meditation
- Practice what you preach around diet, exercise, and lifestyle
- Maintain a manageable client load
- Schedule your clients with enough time between sessions to write notes and reset yourself
Credentialed health coaches adhere to a professional set of standards and ethics that are in the best interests of their clients and that elevate the profession. Coaches must not only understand the foundational competencies of health coaching but also learn about what coaches can and can’t do. This “scope of practice” includes not diagnosing conditions, prescribing treatments, or providing psychological therapeutic interventions. (8)
Coaches should also be able to recognize red flags and know when to refer clients to other health professionals. Being able to recognize mental and physical health concerns that should be referred out to a health professional qualified to deal with these issues is not just a nice thing to do for clients. It is part of the code of professional conduct for health coaches.
Becoming a Certified Health Coach
We need health coaches now more than ever. How can you take your passion for health and helping people and turn it into a career? By enrolling in a health coach training program and becoming a certified health coach, you can combine that passion with the training required to make a real difference in clients’ lives. Prospective coaches who are ready to take that next step should consider a few things when looking at health coach training programs.
What makes a good health coach training program? Here are some things to look for.
An Education in Functional Health and Nutrition
Coaches with an education in Functional Health and nutrition understand the root causes of disease and how changes to diet and lifestyle affect these systems. This allows them to understand client health concerns and provide clients with appropriate resources when requested.
Learning how to coach is important, but you’ll also need to know how to market yourself, network, and potentially even run your own business.
Expert Instructors and Experienced Mentor Coaches
Look for faculty members who have experience and are leaders in their field. These faculty set the foundation of your coaching education and are an important part of successful development as a coach.
How much practice does the program offer? Is this practice with peers, experienced mentor coaches, real clients, or all of the above? I think that significantly more time should be spent on practice than book learning … it’s the best way to hone your skills as a coach. Programs that incorporate lots of practice train coaches who are immediately ready to coach effectively.
Approved by the National Board for Health & Wellness Coaching
Coaches who graduate from an NBHWC Approved Health and Wellness Coach Training & Education Program don’t just learn the foundational competencies that are essential to health coaching—they’re also eligible to sit for Health & Wellness Coach Certifying Exam. Passing this exam and receiving the National Board Certified Health & Wellness Coach (NBC-HWC) credential provides further evidence of a coach’s expertise and competence. (9)
Health Coaching as a Career
Health coaches are currently in demand. Major organizations like the CDC, the National Board of Medical Examiners, the Mayo Clinic, and the Cleveland Clinic are speaking out in favor of and employing health coaches. Health coaching is now a $6 billion market, and job growth for health coaches and other community health workers is expected to expand by 11 percent by 2028. (10, 11)
Health coaches fill a gap in the healthcare system that is underserved, and often unserved, by other healthcare professionals. Our healthcare system employs lots of experts, diagnosticians, and professionals who can develop individualized treatment plans. The problem is that we have few healthcare professionals who can help people understand these diagnoses and treatment plans or help them make the necessary changes to get better. Health coaches fill this gap.
Health coaching is different from other health and helping professions. They are not like sports coaches or life coaches, they are not therapists, and they are not nutritionists or physicians. All of these other professions play an important role in people’s health and well-being, but none of them are “agents of change” for health improvement the way that health coaches are.
Health coaching has many paths to career and business success. Coaches can work with a variety of clients in a number of professional settings. There are so many people across the world who can benefit from working with a coach and numerous ways for coaches to build a career. There is no shortage of health coaching opportunities.
How Is Health Coaching Different from Related Professions?
Health coaches are not advisors, mentors, friends, counselors, or diagnosticians—they’re health behavior change specialists. They support people in discovering their own strategies and motivations for change, overcoming obstacles, and implementing protocols that have either been prescribed by a clinician or nutritionist/dietitian or that the client has chosen to implement on their own. Here are some of the professions that are similar to health coaching and how health coaches are different.
Health Coaching vs. Sports Coaching
All coaches are similar in that they don’t “get in the game.” Clients do the work just like athletes compete on the field of play. But unlike sports coaches, health coaches don’t focus on training or directing behaviors. They ask questions and guide conversations to provide clients with insight into their own behavior.
Health Coaching vs. Life Coaching
Both types of coaches use the same client-centered general skill set, but health coaches have a working background in health. They are specifically suited to understand the health challenges of their clients. Health coaches are also able to spot health-related red flags and refer a client to a physician or mental health professional in ways that life coaches aren’t trained for.
Health Coaching vs. Therapy
Coaching is its own unique process designed to support health behavior change and habit formation. It is not therapy lite. Coaches don’t diagnose or treat mental health issues. They guide their clients in a forward-looking way rather than focusing on the past. Compared to clients in therapy, clients in coaching have reported that it’s more “goal directed and action based.” Coaching clients have also reported using “more humor, being more actively engaged, and having greater flexibility within the coaching relationship.” (12)
Health Coaches vs. Nutritionists, Dietitians, Personal Trainers, and Doctors
Nutritionists, dietitians, personal trainers, and doctors are specifically trained to diagnose, treat, or prescribe individualized treatment plans for their patients and clients based on their training. Health coaches do not typically have this training, but they don’t need it to be successful in supporting behavior change, which is their primary purpose and role.
Where Do Health Coaches Work?
Health coaches are employed in countries all around the world. They practice in rural areas and metropolitan ones. And they work with their clients in person or virtually, by phone or video chat.
Their practices can also take many forms. As a health coach, you can:
- Run your own private coaching business
- Work as part of a clinic or hospital
- Work full time in a corporate setting
- Create your own hybrid health coaching career path
Running Your Own Private Coaching Business
Many coaches with an entrepreneurial spirit start their own coaching business. This route offers considerable flexibility, but it comes with lots of responsibility. As a private practice coach, you aren’t locked into working one on one with clients. You can also work with groups and develop workshops or online content. A private practice also allows you to choose a niche that you are passionate about and work only with patients in that area of focus.
Working as Part of a Clinic, in a Corporate Setting, or with a Remote Coaching Company
Coaches who are looking for the stability of full-time employment may want to consider working in a clinic, a corporate wellness program, or with a remote coaching company.
Coaches in clinics often work quite closely with clinicians. These coaches help patients understand treatment plans developed by the clinician and make the necessary changes to follow through with these plans. In this practice model, clinicians get to focus on diagnostics and treatment, while coaches focus on support and behavior change. Health coaching also tends to improve the level of trust between patients and clinicians, leading to better relationships between them. (13)
Corporate wellness is another option for health coaches. It’s a growing field that is projected to grow to a $15 billion market by 2024. (14) Close to 46 percent of businesses offer wellness programs, many of which employ health coaches. (15) In large companies, wellness programs can reach tens of thousands of employees, providing coaches with an opportunity for impact on a large scale.
Remote coaching companies offer the flexibility of working from home with the stability of a salaried coaching job. These jobs are often specific to one niche, product, or coaching service, such as weight loss or back pain. Coaches usually interact with clients through an app and provide guidance via chat or email.
Creating Your Own Hybrid Health Coaching Model
Coaches aren’t locked into one way of practicing. They can work one on one with clients and also work closely with a clinician. Or some coaches may start out working in a hospital while they hone their craft and then go out on their own in private practice.
Who Do Health Coaches Work With?
People at all stages of their health and wellness journeys can benefit from working with a health coach. Coaches work with the sick and the healthy. They work with people who just want to feel well again and others who want to optimize their health and take it to the next level. Coaches also work with clients experiencing a variety of health challenges, from stress to autoimmune disease, cancer, heart disease, diabetes, obesity, and more.
Clients at all levels of readiness for change can benefit from coaching, too. These include clients who:
- Don’t know what to do to improve their health or are unsure if they even want to change
- Know what to do but not how to do it
- Know how to change but aren’t confident that they can succeed
- Are already taking action and want lasting change
- Want to take back their health and be empowered to make healthy choices in their lives
Coaching is not covered by insurance and can be expensive for clients. With so many people who can benefit from working with a health coach, this is a frustrating reality. Some coaches may consider reduced-priced or group-based options for those who need coaching but who can’t afford it, in addition to offering full-priced coaching for those who can.
Can You Make Health Coaching a Career?
The short answer is yes. A coaching career starts with a passion for helping people and a willingness to listen and support them. Knowing the type of coach you want to be, who you want to work with, and how you want to practice are important to creating your coaching career vision.
Income can vary depending on your location, your area of focus, the type of job or practice you want, and your experience. Doing a search for coaching jobs or looking at coaching rates for coaches near where you live can give you a good idea of your earning power as a coach.
Successful health coaches come from diverse backgrounds. You do not need a healthcare background to become a coach or succeed as one. Some coaches come from vastly different careers and are just as successful as those from healthcare backgrounds.
I’ve covered so much about what a health coach is, but so much more can be said. Stay tuned for more articles on what health coaches do, how they work, and hear from other health coaches in interviews and guest articles.
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