Top Ten Books for Health & Wellness Coaching

Winter is a great time for coaches to rest up, reflect and recharge their energy. It’s a great time to also work on your ongoing professional development and what better way this time of year than to cozy up with a good book!

Many of you are taking your professional development as a health & wellness coach seriously and are preparing to take the certification exam of the National Board for Health & Wellness Coaching (https://nbhwc.org). It is definitely an exam to be taken seriously! Concerted preparation is needed to pass, even for seasoned health & wellness professionals.

Many people find that being part of an Exam Study Group with other coaches can be extremely valuable. Some great resources are the Exam Study Groups offered by Real Balance Global Wellness (Starting Jan. 9, 2023. (https://realbalance.com/study-group-for-the-national-exam-july-2022). These groups are open to anyone preparing for the exam, not just Real Balance alumni. We have been offering these groups for years and they are led by two of our Real Balance faculty: Annalise Evenson and Michelle Lesperance.

Here are the Top Ten Books that Annalise, Michelle and myself would recommend that you include in your exam preparation as well as for your own professional development as a coach.

BOOK IT!

NUMBER ONE: Masterful Health & Wellness Coaching: Deepening Your Craft. Michael Arloski.
(https://wholeperson.com/store/masterful-health-and-wellness-coaching.html)

I’m unabashedly recommending my own book first for one very practical reason – one of the central purposes in writing this book was to put all of the major behavioral change theories for health & wellness coaches preparing for the national exam in one place and show how they apply to coaching.

Appreciative Inquiry – Chapter Four
Positive Psychology – Chapter Four
Self-Determination Theory – Chapter Six
Social Cognitive Theory – Chapter Six
Transtheoretical Model of Behavior Change – Chapter Eight
Motivational Interviewing – Chapter Nine

It is also worth noting that all the content regarding The Transtheoretical Model of Behavior Change in Chapter Eight was edited for me by Drs. James and Janice Prochaska. In Chapter Nine, all the content regarding Motivational Interviewing was edited by Dr. Adam Aréchiga, a professor of Psychology at Loma Linda University who has taught M.I. courses for years.

Masterful Health & Wellness Coaching will also teach you about: coaching skills at a high level; how to coach clients with health challenges; how to be directive yet remain within the client-centered heart of coaching. It also explores how to use self-disclosure effectively; how to avoid collusion, and many more topics that are relevant to the national exam.

NUMBER TWO: Changing to Thrive by James and Janice Prochaska. (https://jprochaska.com/books/changing-to-thrive-book/)

A thorough understanding of the Transtheoretical Model of Behavior Change is foundational for anyone practicing health & wellness coaching. In Changing to Thrive, the Prochaskas draw upon their countless research studies to show the coach how to work with clients at every one of the six stages of change. Especially helpful is the material on how to work with the person in Pre-Contemplation and help them simply move to Contemplation. While the original work on the Stages of Change model was done primarily in clinical settings, in this book the Prochaskas use examples related to challenges that health and wellness coaching clients frequently face. It is critical that coaches learn how to co-create with their clients, action steps that are ‘stage appropriate’. The book also provides coaches with 12 Principals of Progress that can help guide our clients through the stages of change to healthy lifestyle improvement.

NUMBER THREE: Wellness Coaching for Lasting Lifestyle Change, 2ND Ed. Michael Arloski
(https://wholeperson.com/store/wellness-coaching-for-lasting-lifestyle-change.shtml)

Top of the list before Masterful was published, this was the first major book specifically on health & wellness coaching and set much of the foundation for the field. Used as a primary text by many health & wellness coach training programs/schools, this Amazon review by Jennifer Rogers describes its value well. “I am currently utilizing my coaching skills as I start up a health coaching program in a teaching hospital’s primary care setting. I used Dr. Arloski’s original book as my coaching Bible. As I read through his second edition I am just as impressed. He makes wellness attainable to all of us by his deep understanding of behavioral health. The references to other founders in the wellness field and mentions of helpful resources truly makes this book an invaluable resource. He has done all the hard work for us coaches and passed it on to us in this book. Every time I read a new chapter and apply it in the coaching session, myself and the client benefit. This book is a go to guide for all coaches and for anyone who wants to make sustainable lifestyle changes.”

NUMBER FOUR: Motivational Interviewing: Helping People Change, Third Edition. Miller, W. R., & Rollnick, S. (https://www.amazon.com/Motivational-Interviewing-Helping-People-Applications/dp/1609182278/ref=sr_1_1?gclid=Cj0KCQiAtbqdBhDvARIsAGYnXBN6cm3WP-VDrrXLL_mRnCB2ScAkiJP1KpaVEoluwBJxerEHV0zpqaQaAqNKEALw_wcB&hvadid=241591702995&hvdev=c&hvlocphy=1014517&hvnetw=g&hvqmt=e&hvrand=13138936209095786326&hvtargid=kwd-43267252088&hydadcr=15557_10342300&keywords=motivational+interviewing+3rd+edition&qid=1672421889&sr=8-1)

Motivational Interviewing or “MI” is another foundational resource for health & wellness coaches. This 3rd Edition presents the methodology of MI in a thorough but very understandable manner. As Adam Aréchiga put it, MI and coaching do a lot of the same things, they just call it by different names. While Miller and Rollnick come right out in this text and say the names of all of these skills and methods don’t matter, the wise exam taker would be prudent in learning these terms, especially for all the various types of reflections. I also found many hidden gems in this book that can truly enhance the skills of any coach.

NUMBER FIVE: Coaching Psychology Manual. Moore, M., Jackson, E., & Tschannen-Moran, B.
(https://www.amazon.com/Coaching-Psychology-Lippincott-Williams-Wilkins/dp/0781772621)

Another foundational book of the field, Coaching Psychology Manual is an easy read that is very comprehensive. A great blend of theory, tools and practical application. A must for exam preparation.

NUMBER SIX: Co-Active Coaching: The Proven Framework for Transformative Conversations at Work and in Life, 4th Ed.. Kimsey-House, H., Kimsey-House, K., Sandahl, P., Whitworth,L., Phillips, A. (https://www.amazon.com/Co-Active-Coaching-audiobook/dp/B07LGF815Q/ref=sr_1_1?crid=1ARJZ1WP9DA0Y&keywords=co-active+coaching+4th+edition&qid=1672423077&s=books&sprefix=Co-Active+Coaching%2Cstripbooks%2C212&sr=1-1)

One of, if not the best, books ever on coaching foundational principals and coaching skills. The authors were among the initial pioneers of the life coaching field and the founders of Coaches Training Institute. Deepen your understanding of the skills used across all types of coaching.

NUMBER SEVEN: Becoming a Professional Life Coach: Lessons from the Institute of Life Coach Training. Williams, Patrick and Menendez, Diane. (https://wwnorton.com/books/9780393708363)

Tied with Co-Active Coaching for just about the best book on coaching skills, presence, etc. Becoming a Professional Life Coach provides you with a rich understanding of coaching mindset and methods. Numerous scenarios and dialogues give the coach a real feel for how to implement these principals. Joy and creativity in coaching come through in this book urging coaches to stretch and grow.  3rd edition just out.

NUMBER EIGHT: Your Journey To A Healthier Life: Paths of Wellness Guided Journal, Vol. 1, 2nd Ed. Michael Arloski (https://wholeperson.com/store/your-journey-to-a-healthier-life.shtml)

This journal lays out the whole Wellness Mapping 360 Methodology for lifestyle improvement for clients to use either with a coach, or if they are quite self-directed, on their own. As such it becomes a very useful workbook for the coach to understand coaching methodology and understand how lifestyle behavioral change can happen effectively. Numerous tools included.

NUMBER NINE: How to Be a Health Coach: An Integrative Wellness Approach Third Edition. Meg Jordan. (https://www.amazon.com/How-Be-Health-Coach-Integrative/dp/B09XJGVDHQ/ref=sr_1_1?crid=16JWJUA2ODES3&keywords=how+to+be+a+health+coach+meg+jordan&qid=1672681245&s=books&sprefix=Meg+Jordan%2Cstripbooks%2C151&sr=1-1)

A great resource from one of the great wellness pioneers, and my comrade in being a founding member of the NBHWC, Meg Jordan. To quote from the book’s own review “The new 3rd edition of this highly valued and popular textbook offers updated behavior change models, theories and essential healthy lifestyle information with the biometric data coaches need to know. Also included: comprehensive, actionable lessons for the key competencies needed for the NBHWC exam; new guidelines for group coaching, a vastly improved index; coaching templates for doing intake sessions, initial meetings, ongoing sessions, motivational interviewing, and for closing the coaching relationship; client agreement forms; and several types of Wellness Wheels for use with clients.”

NUMBER TEN: Professional Coaching Competencies: The Complete Guide. Goldvarg, D., Mathews, P., and Perel, N. (https://www.amazon.com/Professional-Coaching-Competencies-Complete-Guide/dp/1532376820)

A comprehensive, hands-on guide to understanding and applying the International Coaching Federation (https://coachingfederation.org/) professional coaching competencies to your coaching. Michelle found this book very helpful when she studied for the ICF Exam.

Honorable Mentions

There are so many honorable mentions that they deserve a blog post of their own, some to include that Annalise and Michelle recommended would be:

Nurse Coaching: Integrative Approaches for Health and Wellbeing by Dossey, Luck and Schaub.
Atomic Habits by James Clear
One Small Step Can Change Your Life, The Kaizen Way by Robert Maurer.
Thrive by Martin Seligman
Taming Your Gremlin by Rick Carson
Fierce Self-Compassion by Kristen Neff
Tiny Habits by B J Fogg
Coaching Questions: A Coach’s Guide to Powerful Asking Skills by Tony Stoltzfus
Change Your questions Change Your Life by Marilee Adams

Some other wellness favorites:

The Blue Zones, Dan Buettner
The Wellness Workbook, Jack Travis & Regina Ryan
The Open Heart Companion, Maggie Lichtenberg
The Craving Mind, Judson Brewer
Raw Coping Power, Joel Bennet
The Way We’re Working Isn’t Working, Tony Schwartz
The Spectrum: A Scientifically Proven Program to Feel Better, Live Longer, Lose Weight, and Gain Health by Dean Ornish

On Buying Books

To save considerable money buying these books, look to book brokers that draw from hundreds of independent used bookstores. I often buy from https://www.abebooks.com

So there you have it! Kick off the New Year with cozy cup of your favorite wellness beverage and a good book!

Michael Arloski, Ph.D., PCC, NBC-HWC is CEO and Founder of Real Balance Global Wellness – a world leader in health and wellness coach training (https://realbalance.com/). Doctor 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.

Compassionate Detachment

January 2022! Welcome to a New Year and all of its potential. Ready to put the stresses and the tragedies of 2021 in the rearview mirror it’s a time to set intentions for a better year ahead. Hopefully you had some respite over the winter holidays and are ready to charge ahead in a positive way. Yet, the carryover, perhaps hangover, from that last year is very real for many people including ourselves and the clients we serve.

As we listen compassionately to stories of loss, grief, and challenges of all kinds, we need to find a way to be there for our clients and yet care for ourselves as well. Compassion fatigue is a common experience when we are exposed to too many stories of strife and trouble. How can we refill our own cup when it seems at times like this, others are draining it? I address this issue in Chapter Five of my new book. I offer this to you in my own spirit of compassion.

From Chapter Five – Masterful Health & Wellness Coaching: Deepening Your Craft, by Michael Arloski

Compassionate Detachment

We practice compassionate detachment for the benefit of our client and for our own benefit as well.

Compassionate detachment is respecting our client’s power enough to not rescue them while extending loving compassion to them in the present moment. Simultaneously compassionate detachment is also respecting ourselves enough to not take the client’s challenges on as our own and realizing that to do so serves good purpose for no one.

Compassionate detachment is an honoring of our client’s abilities, resourcefulness, and creativity. We remain as an ally at their side helping them to find their own path, their own solutions. We may provide structure, an opportunity to process thoughts and feelings, a methodology of change, and tools to help with planning and accountability, but we don’t rescue. As tempting as it is to offer our suggestions, to correct what seem to be their errant ways, to steer them toward a program that we know works, we don’t. We avoid throwing them a rope and allow them to grow as a swimmer. Sure, we are there to back them up if they go under or are heading toward a waterfall. We are ethically bound to do what we can to monitor their safe passage, but we allow them to take every step, to swim every stroke to the best of their ability.

To be compassionate with a client we have to clear our own consciousness and bring forth our nonjudgmental, open and accepting self. We have to honor their experience.

“Only in an open, nonjudgmental space can we acknowledge what we are feeling. Only in an open space where we’re not all caught up in our own version of reality can we see and hear and feel who others really are, which allows us to be with them and communicate with them properly.”
Pema Chodron, When Things Fall Apart

Compassionate detachment is also about giving ourselves permission to protect ourselves. Being in proximity to the pain of others is risky work. There are theories about the high rates of suicide among physicians and dentists based on this phenomenon. Compassionate detachment is also about being detached from outcome. We want the very best for our clients and will give our best toward that goal, but we give up ownership of where and how our client chooses to travel in the process of pursuing a better life. Their outcome is theirs, not ours.

Compassionate detachment is not about distancing ourselves from our client. It is not about becoming numb mentally, emotionally, or physically. It is not about treating our clients impersonally.

Compassionate detachment is being centered enough in ourselves, at peace enough in our own hearts, to be profoundly present with our clients in their pain, and in their joy, as well.

Masterful Health & Wellness Coaching: Deepening Your Craft, by Michael Arloski, Ph.D., PCC, NBC-HWC
https://www.amazon.com/Masterful-Health-Wellness-Coaching-Deepening/dp/1570253617/ref=sr_1_3?crid=1MJ0IKCHU30MJ&keywords=arloski+wellness+coaching&qid=1641835655&sprefix=Arloski+%2Caps%2C200&sr=8-3

Michael Arloski, Ph.D., PCC, NBC-HWC is CEO and Founder of Real Balance Global Wellness Services, Inc. (www.realbalance.com). 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. Dr. Arloski’s newest book is Masterful Health & Wellness Coaching: Deepening Your Craft

Keys to Coaching Clients Who Overidentify With Their Illness

We like to say that a coach listens to a person’s story and helps them to realize that they are not their story.

For the health-challenged client, their illness, conditions, or health experience is a huge part of their story. “I am a diabetic.” While this is true, how strongly does the person now see themselves through this lens? What effect could it have on someone’s confidence that they can regain their health? How hopeless do they feel if they have framed their health challenge like a prison sentence instead of a challenge to be overcome? How different it might be if the same person could say “I’m a person challenged by diabetes.”

Erik Erikson, the renowned developmental psychologist who coined the term ‘identity crisis’, viewed identity “as the degree to which an individual integrates different self-assets into a coherent sense of self, and such a coherent sense of self translates itself into daily life and guides choices and values.” (Oris, 2018) When we think about a sense of self-guiding choices and values and apply this to making lifestyle choices, illness identity could play a huge role.

What happens to that coherent sense of self when a person is diagnosed with a life-threatening illness? What happens when that person may not only label themselves according to their health challenge, but is labeled by treatment professionals and even friends and family?

“Although most patients succeed in adjusting to their illness, some patients experience difficulties, which can negatively affect their physical and psychosocial functioning.” (Morea, 2008) Much of that difficulty comes when a client has over-identified with their health challenge.
As health & wellness coaches we know that attitudes and beliefs drive behavior. Each of our clients will react to their health challenge in their own unique way, but it may be very helpful for the coach to understand how these reactions or responses may be seen in terms of different dimensions or states of identification with the person’s illness.

Let’s look at keys to understanding and coaching strategy around client identification with their illness.

Key Number One: Understand the degree to which chronic illness dominates the client’s identity and daily life.

In 2016 an international team of scientists sought to understand this concept more deeply. Their work with adolescents dealing with Type One diabetes led this team to develop the Illness Identity Questionnaire and identify four illness identity dimensions or states: engulfment, (Oris, 2018) rejection, acceptance, and enrichment. (L.Oris, 2016)

Think of the term engulfment. Your client may be completely engulfed by their illness. “Individuals completely define themselves in terms of their illness, which invades all domains of life, at the expense of other important self-assets (Morea, 2008).” They may be experiencing continual physical reminders of their condition as symptoms of their illness manifest. If your client feels in the grip of such an illness, how hopeful are they? How disempowered do they feel that they can do anything about it? They may experience great fear that they will never get better. They may just not know what the future holds, but their illness has taken over their lives. It is quite likely that such a client may be in the Precontemplation Stage of Behavior Change when it comes to lifestyle improvement efforts.

Key Number Two: Meet your ‘engulfed’ client where they are at with compassionate understanding.

A client experiencing their illness this way may feel overwhelmed and helpless. The illness is so figural in their life that they seem to process their entire life through the filter of their health challenge. We want to convey sincere empathy but be prepared to have it either well or poorly received. Our client may feel like nobody else could understand what they are going through. Use your process coaching skills to help your client to work through some of the emotional load they are carrying. Slow down on setting up ‘what to do about it’ strategies. Your client is far from the Action Stage.

If your client has been stuck in this stage for months after their diagnosis or health event, consider what else might be going on. They could be experiencing some secondary gain. That is, they may be receiving some kind of reinforcing experience for staying stuck where they are. Family and others could be treating them with such extra kindness that it makes their overidentification rewarding. Be careful how you approach this subject as clients may feel accused and judged if you are too forthright about this. You might instead approach their situation from the angle of nurturing hope.

Part of what can increase hope is learning more about their illness and their prognosis and potentially what they can do about it. Inquire what they know about their health challenge. Share with them the information that patients who know more about their illness and treatments have better outcomes. Let them know that lifestyle improvement may not cure their illness, but it can significantly affect the course of that illness.

Key Number Three: Understand the Rejection Dimension of Illness Identification

While some clients embrace an identification with their illness others do their best to reject it as much as possible. “…rejection refers to the degree to which the chronic illness is rejected as part of one’s identity and is viewed as a threat or as being unacceptable to the self.” (L.Oris, 2016) This client avoids thinking or talking about their illness and they tend to neglect it, which results in poor treatment adherence. Their approach is one of denial and/or minimization. They attempt to go on with life and business as usual to the point where their biometric markers (e.g. blood sugar levels, blood pressure, etc.) worsen.

Attempting to persuade such a person to follow their doctor’s orders and begin improving their lifestyle will almost certainly go nowhere. If you are given the opportunity to coach such a person, instead take a holistic explorer approach. Have them tell you the story of life before their illness and what led up to their diagnosis. Ask them what the experience of hearing that diagnosis was like. Meet them with empathic understanding. Inquire about what it feels like they have lost. Often the experience of a loss of health is central to such a response to a life-threatening illness. (See my blog post “Astonishing Non-compliance – Understanding Grief and Readiness for Change in the Health Challenged Client” https://wp.me/pUi2y-n2)

This client may be the farthest away of all from the Action Stage and firmly entrenched in Precontemplation. Refer to Changing To Thrive, by Janice and James Prochaska (https://jprochaska.com/books/changing-to-thrive-book/) for extensive guidance on how to coach someone through the stage of Precontemplation.

Key Number Four: Coach the accepting client at a higher level of readiness to change

The acceptance dimension of illness identity shows a client who is not overwhelmed by their chronic illness, does not deny it, but rather accepts that this is their reality. “Chronic illness plays a peripheral role in one’s identity, besides other personal, relational, and social self-assets, and does not pervade all life domains.” (Morea, 2008) Such a client will be trying to lead as normal a life as possible without being in denial about their illness. They, to one degree or another, are finding ways to adapt to their illness.

Explore with this client their current level of knowledge about their illness and treatment. Inquire about the lifestyle prescription that their treatment team has recommended and how successful they have been at achieving those recommended lifestyle changes. Explore their motivation that fuels their desire to deal more successfully with their illness. Help them create a fully integrated Wellness Plan for how to move forward and affect the course of their illness in a positive way.

Key Number Five: Partner with the possibility of transformation

The fourth illness identity dimension, enrichment, provides the coach with a unique situation. Here the client has developed to where they frame their illness as an opportunity for growth and transformation. They see positive changes in themselves having taken place as a result of these negative developments in their health. “Such positive changes manifest themselves in different ways, including an increased appreciation for life, changed life priorities, increased personal strength, and more positive interpersonal relationships.” (Tedeschi, 2004) Coaching with a client who has reached this state of identity with their illness would be a delight. Here the focus might be more upon maintaining good self-care and treatment adherence, and possibly upon continued improvement in health. Such a client might be motivated to work on disease reversal through lifestyle improvement such as we see with programs like that of Dean Ornish. (https://www.ornish.com)


Content for the blog has come from Dr. Arloski’s forthcoming book Masterful Health & Wellness Coaching: Deepening Your Craft, published by Whole Person Associates, Inc., and is fully copyrighted.

Stay informed about the book’s publication at https://wholeperson.com/store/masterful-health-and-wellness-coaching.html

REFERENCES:

L.Oris, J. S. (2016). Illness Identity in Adolescents and Emerging Adults With Type 1 Diabetes: Introducing the Illness Identity Questionnaire. Diabetes Care, 757-763.
Morea, J. M. (2008). Conceptualizing and measuring illness self‐concept: 571 a comparison with self‐esteem and optimism in predicting fibromyalgia adjustment. Research in Nursing and Health, 563-575.
Oris, L. L. (2018). Illness Identity in Adults with a Chronic Illness. Journal of Clinical Psychology Medical Settings, 429-440.
Tedeschi, R. G. (2004). Posttraumatic growth: conceptual foundations and empirical 604 evidence. Psychological Inquiry, 1-18.

Michael Arloski, Ph.D., PCC, NBC-HWC is CEO and Founder of Real Balance Global Wellness (https://realbalance.com) a premier health & wellness coach training organization that has trained thousands of coaches around the world.

 

Positivity and Perspective Needed in These Times

What we see depends upon our perspective.

It is easy to feel under bombardment today with news of COVID-19, economic chaos, and all of the fallout that reaches into our communities, our families and our lives. There can be a sense of negative overwhelm that can seem inescapable. This is true for us as well as for our wellness coaching clients. We all know that dwelling on the negative is not good for our mental or physical health, yet how can we deny reality?

Positivity is not about denying the challenges we face, the losses we suffer and the pain we feel. It is not about self-deception. It is, however about the ratio of our negative thoughts to our more positive thoughts. Researcher Barbara Fredrickson pioneered what is known as the Positivity Ratio (https://www.positivityratio.com). She contends that we do need to accept that negative emotions are quite real. She also admits that our more positive emotions are often rather fleeting. Rather than focus on how they come and go, she urges us to notice their quantity. The key is to balance the negative thoughts and feelings with the positive ones. While her positivity ratio of three positive thoughts to one negative thought has come under critique, there can be no doubt that seeking some kind of more positive balance can contribute to our wellbeing.

As you go about your day more mindfully:

• Begin your day with a morning ritual that includes calm awareness of your surroundings; a practice of gratitude; a kind and gentle transition as you wake up.
• Focus on positive information as you check in with the rest of the world. Don’t ignore the news but consider whether you want to begin your day with all of the heart-breaking stories that lead.
• As your day unfolds remain in a state of gentle self-vigilance about your thought patterns. Seek that balance of positive to negative. Catch yourself when you find sarcasm and cynicism emerging.
• As you deal with negative events seek to put them into perspective. Recall how you have been resilient enough to make it through difficult times in the past. Realize that all things will pass.

Coaching has developed the skill of re-framing to help our clients to see things from new perspectives. Re-framing is, again, not self-deception. It is not about denial. It is about seeking out the upside, the potential for viewing and experiencing an event through the lens of new and other possibilities. We have all experienced blessings in disguise. Unfortunately, the disguises are sometimes quite painful at first. Then we see how they may have worked out for our best.

Before we re-frame it is critical to acknowledge what is real. For ourselves and when we coach with a client, First Acknowledge, Validate and Empathize (https://wp.me/pUi2y-bZ). Allow feelings to be felt, honored, and validated. It’s okay to feel the way you feel. Then, you can move on to seeking a way to re-frame. Pushing to re-frame too quickly is often perceived as dismissing one’s feelings. “Come on. Cheer up!” No one wants to hear that when we are in the midst of pain. Once feelings have been honored, then you can help the person (or yourself) to gain a new perspective and move forward with their (our) lives.

On the Real Balance Global Wellness homepage you will find the video of the Real Balance April Free Monthly Webinar: “Wellness Coaching In The Time Of Covid -19: Self-care and Helping Others” with special guests Drs. James & Janice Prochaska and Dr. Pat Williams (https://realbalance.com).  Be sure to watch this excellent hour-long video.  CEU’s are available upon completing watching it.  For further questions re: this inquire to deborah@realbalance.com.  

 

Wellness in a Time of Crisis: Serving Others/Caring for Ourselves

 

Maintaining strong immune systems and helping people to manage their current illnesses is part of the vital work that health & wellness coaches are doing every day. COVID-19 is causing much higher mortality rates among people with chronic health challenges – the very population that health & wellness coaches and wellness professionals serve. The world needs the work you do now more than ever.

There are two issues at play during this pandemic crisis: how can we best serve our clients/members, etc.; and how can we remain healthy and well enough to be of service and maintain our own wellness?

Serving Your Clients/Members/Patients

As wellness professionals face the new realities and restrictions of the pandemic and our responses to it unique challenges confront us.

• Remaining in contact with your clients/members/patients while both you and they are working remotely.
• Adjusting to remote contact when you’ve always worked in-person with those you serve.
• Helping people who work on the frontlines of the medical world’s response to the pandemic.
• Dealing with clients, members, or patients who are reporting more stress, depression and anxiety.
• Helping people who feel frightened and helpless in the face of this crisis.
• Helping people get the services they need, including your own, when those services are overwhelmed.

At the end of this piece I’ve listed some great resources to help with some of these challenges.

What Do You Need Now?

Many of us who are in the human-helping business tend to step up and be there for others with little hesitation.  The other side of this is our own tendency to not attend enough to our own needs during this time. What kinds of demands are you facing in your workplace?  Some wellness and coaching services are under greater demand and stress. Independent coaches, fitness trainers, etc., may be facing a reduced number of clients. What are you up against?

What are you doing for your own wellness and self-care now?
As each of us reach out to our clients and others to be an ally we also need to nourish ourselves.  In time of crisis, when it seems that we don’t have time for our own care, it is actually time for extreme self-care.  Stress has a terrible toll on the immune system and that is exactly what we all need to work on maintaining right now.

We are also not invulnerable to the same fears, anxieties and stresses that our clients and members are facing.  Perhaps you are working at home trying to juggle your work obligations with having a house full of family members trapped by social distancing guidelines.

Secondary Trauma

Be compassionate with yourself.  As you work with others during this crisis the emotional toll it takes upon you may be not just exhausting, it may be traumatic.  Secondary traumatization takes place when we are exposed to the trauma that others are going through.  It can have many of the same symptoms and effects upon us as direct exposure to trauma.  Here is an excellent resource for learning more about this. Emergency Responders: Tips for taking care of yourself.  (https://emergency.cdc.gov/coping/responders.asp)

Seeking Connection

People that go through any kind of wellness training always develop a wonderful appreciation for their fellow classmates.  We see this when we all attend professional conferences and feel the support of like-minded colleagues.  Attempts to keep in touch are usually hard to maintain as everyone returns to their busy lives.  Now, with the cancelation of live conferences and such, we are left without that usual opportunity for rejuvenation and support.  You may be feeling alone, but you are not.

We know that the way through crisis, the way to build resilience is through CONNECTION, through reaching out and support.  As you saw in my previous blog post, (Social Distancing – Not Social Isolation: Coaching for Connectedness in the age of COVID-19 https://wp.me/pUi2y-p5 ) social distancing is not the same as social isolation.  Reach out to friends, but also reach out to your wellness colleagues.  They are going through many of the same experiences as you and can be primary sources of support.

Let me invite you to connect in many ways. One way is to GET A SUPPORTIVE CONVERSATION GOING by engaging in conversation about your concerns, fears, hopes and stresses that you are experiencing right now with COVID-19 happening worldwide. 

Connect on Facebook with the REAL BALANCE STUDENTS, ALUMNI & FRIENDS GROUP – https://www.facebook.com/groups/1581133502099770/  This group is open to all wellness-related professionals.

Connect on Linkedin with the Real Balance Wellness Coach Training Institute Group:https://www.linkedin.com/groups/3808651/   This group is also open to all wellness-related professionals.

Let’s make these forums one place where we can do that. Please contribute to these conversations. Building COMMUNITY takes participation.

Another opportunity will be April 24th. Our April Free Monthly Webinar will be: Wellness Coaching in the Time of Covid 19: Self-care and Helping Others with very special guests James and Janice Prochaska and Pat Williams. 

 

RESOURCES for helping others and helping ourselves during this crisis:

• Managing anxiety during the COVID-19 outbreak. https://socialwork.wayne.edu/coronavirus/anxiety

• Tips for Coaches and Therapists during times of crisis with Dr. Patrick Williams (https://youtu.be/VoiufoD_HNA)
• HOW COVID-19 IS IMPACTING THE WORKPLACE: Resources for employees and employers during this time. (https://www.welcoa.org/covid/)
• Living With Mental Illness During COVID-19 Outbreak– Preparing For Your Wellness (https://mhanational.org/living-mental-illness-during-covid-19-outbreak-preparing-your-wellness)
• Food safety, nutrition, and wellness during COVID-19. (https://www.hsph.harvard.edu/nutritionsource/2020/03/25/food-safety-nutrition-and-wellness-during-covid-19/)
• Mental Health and Coping During COVID-19 | CDC. (https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/managing-stress-anxiety.html)

Also, please feel free to contact us by email (deborah@realbalance.com) or phone (1-866-568-4702) to let us know how we may be of support at this time.

Be well and stay well!

Coach Michael

 

2010-2020 A Decade of Growth for Wellness Coaching

After years of building a foundation, health and wellness coaching has flourished in the last decade. At the beginning of this last decade the International Coach Federation was only fifteen years old and the National Board for Health and Wellness Coaching hadn’t even been thought of yet. My book, Wellness Coaching for Lasting Lifestyle Change, had been on the market for only three years, and The Coaching Psychology Manual, for only one. Thousands of people were already trained and working as health and wellness coaches, but the numbers were nowhere near where they are today. Wellness coaching was being used by employee wellness programs, disease management and insurance companies but had not made its way into the clinical world much at all. There was considerable success where wellness coaching was being applied, but the research to back it up was lagging. As the decade moved along towards 2020, everything shifted. Health and wellness coaching has truly arrived!

In the last ten years we have seen the profession of health and wellness coaching grow both in its application and as a true profession with standards and credentialing. Early in 2010 the National Consortium for Credentialing Health & Wellness Coaches was formed to develop and establish those standards and a system of credentialing. After an untold number of hours of work by dedicated coaching professionals this evolved into the National Board for Health & Wellness Coaching that we have today. Now, in addition to certification that coaches can receive by the organization that trained them, they can apply to become certified through the NBHWC by qualifying for and passing an examination administered by the National Board of Medical Examiners. Prospective coaches can now choose to be trained by qualified organizations that have earned approval by the National Board, ensuring great quality for their educational experience.

Importantly the critical research evidence backing up the incredible effectiveness of health and wellness coaching has mushroomed. We now have hundreds and hundreds of solid peer-reviewed journal articles making the case for health and wellness coaching.

My observations over the past decade is that the growth of health and wellness coaching has particularly accelerated in three areas: universities, the international arena and clinical/lifestyle medicine. Let’s look at the role Real Balance Global Wellness has played in each.

Loma Linda University

Early in the decade only a handful of schools were offering programs that included health and wellness coaching. These were mostly schools of Integrative Health or related areas. Leaders such as The California Institute of Integral Studies, Duke University, and the University of Minnesota were such innovators. As more and more schools discovered that health and wellness coaching offered their students a practical skill set and a needed certification in the field, actual training in health and wellness coaching became highly desirable. Real Balance began to partner with schools of Public Health, Nursing, and a variety of programs to not only deliver direct training, but to train college and university faculty to become Real Balance Trainers and be able to deliver our curriculum and certification. Our program nurtures such schools along until they are ready to apply to the National Board to become an approved program in their own right.

China!

As lifestyle diseases have replaced infectious disease as the number one cause of premature death, the value of health and wellness coaching is being increasingly recognized around the world. Interest is growing fast in Europe, Asia and Latin America. Real Balance truly became Real Balance GLOBAL Wellness in this last decade. We developed training programs in Ireland/UK, Brazil, Australia, and China. We delivered keynotes and programs in the Azores Islands of Portugal, and the Philippines. Students from around the globe continue to become trained as health and wellness coaches through our live webinar classes.

The third area of growth for health and wellness coaching that has ballooned especially in the last few years of our past decade is primary care/lifestyle medicine. The recognition that a large component of our health is behavioral has led to the greater openness to the role of health and wellness coaching in direct medical services. Health and wellness coaches are helping patients to be more successful at medical compliance/adherence, and at accomplishing the directives of the lifestyle prescription recommended by their treatment team. The tremendous growth and increasing acceptance of the principles of lifestyle medicine has helped health and wellness coaches to be seen as a very practical solution for the behavioral changes sought by physicians and other healthcare practitioners. The recent granting of a Level Three CPT Code for health and wellness coaching is a huge step forward. Though direct reimbursement is a ways off, the new code helps legitimize health and wellness coaching in the eyes of the medical world and opens doors.

Health and wellness coaching enters this new decade with an earned respect. We have the evidence of our effectiveness, solid professional credentialing and standards, international awareness, and a recognition that we can play a key role in improving health and wellbeing all around the world. Be a part of helping us take it forward!

Michael & Deborah Arloski

Emotions, Feelings and Healthy Choices: Coaching for Greater Wellness

One of the first things we learn about in the fields of Wellness & Health Promotion and Health & Wellness Coaching, is that our lifestyle choices are a primary determinant of our health and wellbeing. It seems straightforward that making the right or healthy choice is a rational process based upon having the best information. We often then address how challenging it is for a person to put that choice into practice by looking at their social support, environmental conditions, etc. Much of the focus for wellness coaching becomes helping our client to create a wellness plan based upon those healthy choices and implementing with support and accountability. Let’s stop and take a closer look at those decisions.

Anyone in the healthcare or wellness fields is keenly aware that clients don’t always opt for the best, or healthiest choice. They also often observe clients changing these choices for no apparent reason. One day our client is convinced to start working towards a largely plant-based diet, and on another day, they show little if any desire to do so. We can explore ambivalence, of course, but what is really going on in our client’s decision-making process?

Applying what we know about the role that emotions play in decision-making can be extremely useful to the wellness coach. Learning how to coach our client in this emotional realm is often critical to their success. (See my previous post: “The Great Utility of Coaching In The Emotional Realm”, https://wp.me/pUi2y-lA)

Emotions and Making Lifestyle Choices

Making lifestyle choices are like any other decision-making process – they are more complex than it seems at first. Understanding how our emotional bias fits into this process may help coaches to be less perplexed by some of the self-defeating lifestyle choices we see that our clients have made and continue to make.

Emotions are a heavily researched area of psychology and it is easy to get lost in its vast literature. In an especially succinct article, Executive Coach Svetlana Whitener synthesizes the work of several key researchers and conveys a useful paradigm to coaches to learn from. (“How Your Emotions Influence Your Decisions”, https://www.forbes.com/sites/forbescoachescouncil/2018/05/09/how-your-emotions-influence-your-decisions/#5eece5313fda)

Emotions emerge as a response to external stimuli, or the recollection of it, or the imagining of it. “That stimulus generates an unfelt emotion in the brain, which causes the body to produce responsive hormones. These hormones enter the bloodstream and create feelings, sometimes negative and sometimes positive… So, to review, it’s stimuli, then emotions, then hormones and, finally, feelings. In other words, your emotions impact your decision-making process by creating certain feelings.” (Whitener, 2018)

 

How we interpret or frame those feelings and how we respond to them results in our choices executed in our behavior.

In this model it is not the emotions that we are aware of, it is the resultant feelings that we feel. When our clients contemplate making lifestyle changes, they often experience a variety of feelings. They may experience positive anticipation or dread. The memory of past failures may bring up the emotion of fear resulting in feelings of embarrassment, regret, shame or guilt. Likewise, a history of more pleasant experiences may lead to positive anticipation. What Stage of Change the client is in may be heavily influenced by the feelings they are experiencing.

Expand Your Emotional Vocabulary

Psychologist Paul Ekman’s research on emotions opened a huge doorway to understanding how people express themselves. A key from his work that can help the coach is to look at how (as in our model above) emotions generate feelings and how those feelings differentiate. Researcher Tiffany Watt Smith has listed 154 different worldwide emotions and feelings. (1). Studying Ekman’s Wheel of Emotions can help a coach to expand their own knowledge and use of emotional terminology. As you coach with your client you can explore more possibilities to help your client clarify exactly what they are feeling.

 

Ekman’s Wheel of Emotions

 

 

 

 

How The Coach Can Help: Coaching With Emotions and Feelings

1. Coaching Presence – Your coaching presence sends an ongoing message that either gives permission to explore feelings or denies it.
2. Notice – Be keenly observant of the emergence of feelings on the part of your client. Be continually scanning not just their words, but how they say them. Hear the changes in tone of voice, volume, rapidity, etc. Notice all of the nonverbal information you can gather.
3. Contact – Help you client to connect with their feelings. Use the Active Listening Skill of Reflection of Feelings. Share observations of patterns you see. “I’m noticing that each time you talk about taking time for self-care you begin speaking about your partner.”
4. Name it – Help you client to name their feelings. As we saw above emotions can generate a wide variety of feelings. Expand your own emotional vocabulary and help your client to drill down to what they are truly experiencing. “Well, it’s not really anger, it’s more like resentment.”
5. F.A.V.E. – First Acknowledge the client’s experience and what they have been through. Then Validate their feelings. It’s okay for them to feel the way they feel about it. (Regardless of how rational or appropriate their feelings may seem.). You absolutely must not judge their feelings. Most importantly Empathize. Show real empathy and compassion and put it into words.
6. Process – Help your client to explore and process their feelings. Allow them to expand and talk about them. Once the initial release has taken place, they will usually start to analyze what is going on for them, looking to make sense (and meaning) out of their feelings.
7. Insight – Is your client able now to gain some insight from what they have learned in this process?
8. Application/Integration – Are they able now to take their insights and turn them into action? Now you can coach your client on ways they can modify their behavior or create experiments in their lives to improve their lifestyle.

Note – If you find that you are answering the questions in items 7 & 8 with the negative, your client may benefit more from counseling instead of (or in addition to) coaching. That is, if they just continue to process feelings, and process feelings without it leading to insight, or if they are unable to put their insights into action, and instead return to processing feelings (and emoting), then begin to explore the alternative of counseling. See my blog on this topic – Coaching a Client Through To A Mental Health Referral Using The Stages of Change (https://wp.me/pUi2y-lp).

A wellness coach may think that it is their job to get their client to make the right lifestyle choices. When coaching deteriorates into convincing or persuading, we are stepping away from the coaching process. We can certainly warn our clients about misinformation they may have about fad diets, or unproven remedies, etc. However, effective coaches honor their client’s autonomy. The reality is that after a coaching session, our clients will go on living their lives doing what they choose to do despite our urging. Trust the coaching process. Help your client to factor in their emotions in a more conscious way so that the lifestyle choices they make are working for them instead of against them.

References
(1) Tiffany Watt Smith. “The Book of Human Emotions: An Encyclopedia of Feeling from Anger to Wanderlust” (PDF). Anarchiveforemotions.com. Retrieved 2017-05-28.
(2) Ekman, Paul (1999), “Basic Emotions”, in Dalgleish, T; Power, M (eds.), Handbook of Cognition and Emotion (PDF), Sussex, UK: John Wiley & Sons.

Dr. Michael Arloski

Michael Arloski, Ph.D., PCC, NBC-HWC, is a psychologist, professional coach, author, trainer/educator and CEO and Founder of Real Balance Global Wellness. Follow his blog at https://realbalancewellness.wordpress.com, and his presence on Facebook (https://www.facebook.com/michael.d.773), Twitter https://twitter.com/DrMArloski) and LinkedIn (https://www.linkedin.com/in/realbalance/).

The Utility of Self Determination Theory and Motivation in Wellness Coaching – Part Two: Autonomy, Competence & Relatedness

 

Activities like camping with a friend in the backcountry can meet our three innate psychological needs.

As health and wellness coaches work with their clients to help them live their healthiest lives possible, an understanding of the basics of Self-Determination Theory of Edward Deci and Richard Ryan (http://selfdeterminationtheory.org), is very useful. In the Part One blog posting on this subject we looked at how this theory addresses human motivation. (https://wp.me/pUi2y-nT). Here we will look at how coaches can benefit from understanding the significance of the theory’s identified three innate psychological needs that we all have.

 

The Three Innate Psychological Needs

At the heart of Self-Determination Theory (SDT) is the underlying assumption that there is an inherent human need for fulfillment and self-actualization through personal growth, development and mastery (competence), for connectedness (relatedness) and for the experience of behavior as self-determined and congruent with one’s sense of self (autonomy). These three needs are considered universal and essential for well-being. Whatever supports the positive experience of competence, relatedness and autonomy promotes choice, willingness and volition, interest, full engagement, enjoyment and perceived value — the inherent qualities of intrinsic motivation. It also leads to higher quality performance, persistence, and creativity.

The degree to which these needs are either supported or compromised and thwarted has a significant impact on both the individual and the individual’s “social context” (the physical and social setting in which people live and work and the institutions with which they interact). If all three needs are satisfied “people will develop and function effectively and experience wellness” and if not, “…people will more likely evidence ill-being and non-optimal functioning.” (http://selfdeterminationtheory.org/theory/)

“We believe that all human beings have a set of basic psychological needs. The needs that we feel are important are the need for competence. That is to say to feel confident and effective in relation to whatever it is you’re doing. Second, to feel relatedness, that is to say to feel cared for by others, to care for others, to feel like you belong in various groups that are important to you. And the third need is autonomy… Human need is something that must get satisfied for optimal wellness and optimal performance. If they don’t get the need satisfied, then there will be negative psychological consequences that follow.” (https://www.youtube.com/watch?v=m6fm1gt5YAM)

 

Coaching In Support of Autonomy

People have a need to feel they are operating their lives out of their own choice. Supporting the client’s need for autonomy is considered one of the primary tasks of a coach. The client-centered nature of coaching supports client autonomy throughout the coaching process. Coaching operates on mutual agreements between client and coach. Agendas are co-created with the client always in the lead. In wellness and health coaching this is especially true as client-generated goals have more inherent “buy-in”, that is, more motivational connection. The coaching cornerstone stance that the client is “naturally creative, resourceful and whole” (NCRW)( https://coactive.com/why-cti/buy-the-book) fosters autonomy as the coach works to evoke the inner wisdom of the client. Rather than operating from an expert point of view, the coach provides support for the client’s own decision making, even though they assist in the process.

Coaching In Support Of Competence

This NCRW stance also supports the other key human need according to SDT, of seeking to achieve competence. Again, in line with the tenets of humanistic psychology and the more recent developments in positive psychology, clients are treated as though they are indeed capable and possessing great potential. The strengths-based, positive psychology nature of coaching emphasizes acknowledging and building upon the client’s attributes and qualities they already possess. A key here is acknowledgement. Client’s often minimize or fail to recognize their strengths and achievements. If their self-efficacy is already low, having been brought down by previous failure experiences, they may tend to overlook what they are accomplishing, or to downplay it. The active listening skill of acknowledgement needs to be used by coach whenever it can be genuinely utilized. As client and coach work on self-determined goals and break it down into doable action steps, leading the client to enjoy more and more successful experiences. As they do so, they begin to feel more competent in the area of improving their lifestyle, which naturally builds their feelings of self-efficacy.

Coaching In Support of Relatedness

The heart of coaching is the coaching relationship itself. Creating that alliance supplies the client with a trusted resource for support that can be relied upon unconditionally. As the coach exhibits the qualities that make up great coaching presence (supplying the facilitative conditions of coaching) (https://wp.me/pUi2y-6i) the client feels accepted, acknowledged and cared for. Often our clients are lacking relationships in their lives where they experience adequate empathic understanding and are free from judgment.

“It is important to note that whilst a coachee may have close relationships outside coaching, s/he may not consistently feel heard, understood, valued and/or genuinely supported within those relationships. If not, they are unlikely to feel strongly and positively connected to others and in an attempt to satisfy this basic need, may attempt to connect by acting in accordance with the preferences of others, rather than one’s own.” (https://ro.uow.edu.au/cgi/viewcontent.cgi?referer=https://www.google.com/&httpsredir=1&article=1106&context=gsbpapers)

For the client, it is not only refreshing to relate to someone who provides unconditional positive regard and validates their experience and feelings, it may actually free the client up to explore their lives with new openness and independence. Perhaps they have been holding themselves back from making some of the lifestyle changes they need to make because of the fear of losing connection, to some degree, with others. Perhaps with the support of the coach, the client may be willing to take such risks to live in a healthier way.

The Real Balance approach to coaching has long recognized the importance and power of coaching for connectedness. We realize that coaching is a very brief moment in someone’s life and that lasting lifestyle improvement often hinges upon finding the support of others for the changes clients need to make. As we help our clients choose action steps in their Wellness Plan, we continually ask, Who else can support you in doing this? Building in strategies to seek out and gain support for wellness goals and the action steps needed to achieve them is often critical to success.

Of course, not all of our clients enjoy lives rich in connectedness at home, work and in their communities. As we co-create the Wellness Plan with our clients, we may want to include developing more connectedness as an Area of Focus to be consciously worked on. Part of that process may be exploring ways in which the client holds themselves back from reaching out and making more interpersonal connections in their lives. As clients feel empowered by the autonomous nature of choice in the coaching process, they may be more willing to increase their connectedness.

As coaches reflect upon their work, not only with a single client, but will all of the people they coach, they can benefit from asking themselves if their coaching process addresses and supports the fulfillment of these three innate psychological needs. The self-vigilant coach may want to listen to session recordings and ask themselves “Am I coaching in a way that really supports my client’s autonomy, or am I being too prescriptive or too directive? Am I using acknowledgement enough to help my client realize how their sense of competency is increasing? Am I remembering to ‘coach for connectedness’ and help my client expand their circles of support?”

Deci and Ryan see the fulfillment of these needs as paving the way towards optimal functioning — essentially making the wellness way of life much easier.

Dr. Michael Arloski

For the very best in wellness and health coach training look to REAL BALANCE GLOBAL WELLNESS SERVICES, INC.  Over 8,000 wellness & health coaches trained worldwide.  http://www.realbalance.com 

 

For more about effective coaching refer to Wellness Coaching For Lasting Lifestyle Change, 2nd Ed., by Michael Arloski, Ph.D., PCC, CWP, NBC-HWC.   https://wholeperson.com/store/wellness-coaching-for-lasting-lifestyle-change.shtml

and to Your Journey to a Healthier Life (Paths of Wellness Guided Journals) by the same author.  https://wholeperson.com/store/your-journey-to-a-healthier-life.shtml 

The Utility of Self Determination Theory and Motivation in Wellness Coaching – Part One: Motivation

“Don’t ask how you can motivate others. Ask how you can create the conditions within which others will motivate themselves.”
Edward L. Deci

The motivation of the coaching client for change is usually seen as the foremost factor in the coaching process, yet many coaches lack adequate knowledge of this concept. Some coaches believe that is it somehow their responsibility to motivate their client. This can come across as an attempt to convince or persuade the client to become engaged in a lifestyle improvement process, urged on by a cheerleading coach. As coaches become more experienced, they usually discover that effective coaching is about helping the client to get in touch with what motivates them from the inside and build on that. One theory that can help coaches grasp the nature of human motivation and then implement it well is Self-Determination Theory.

The life work of psychologists Edward Deci and Richard Ryan (http://selfdeterminationtheory.org) has yielded a theory of human motivation that not only fully supports the coach approach but also adds valuable tools of understanding. In complete alignment with the tenets of humanistic psychology (https://www.amazon.com/Toward-Psychology-Being-Abraham-Maslow/dp/0471293091) , Self-Determination Theory (SDT) views human beings as constantly striving towards actualizing their potential, seeking out ways to foster their growth and development. It is also very much in alignment with the Client-Centered (or Person-Centered) Approach of Carl Rogers (https://www.amazon.com/Becoming-Person-Therapists-View-Psychotherapy/dp/039575531X/ref=pd_lpo_sbs_14_t_0?_encoding=UTF8&psc=1&refRID=3WAH0XRWWQF0SM32MPZJ). Finally, it is easy to see how the way coaches trained in the ICF Core Competencies and the coaching foundations that are laid out in sources such as Co-Active Coaching (https://www.amazon.com/Co-Active-Coaching-Fourth-transformative-conversations/dp/1473674980/ref=sr_1_1?s=books&ie=UTF8&qid=1549473972&sr=1-1&keywords=co-active+coaching) work with clients are entirely congruent with SDT.

A core contribution of SDT is the way it demonstrates how it is the type of motivation, not the quantity of motivation that is key to success with behavioral change. According to Self-Determination Theory there are two types of motivation, controlled motivation and autonomous motivation. SDT presents a ‘motivational spectrum’ with amotivation, or total indifference at one end and intrinsic motivation, doing something for its own intrinsic satisfaction at the opposite end. In between these two extremes lies extrinsic motivation with its own motivational spectrum from the most externalized (controlled) to the most internalized (becoming autonomous) types of motivation.

MOTIVATIONAL SPECTRUM
A client is viewed as potentially having different types of motivation related to different behaviors, similar to what we have seen in the Transtheoretical Model of Change, (http://jprochaska.com/books/changing-to-thrive-book/) Your client may be in the “Action Stage” when it comes to improving their nutrition, but in the “Contemplation Stage” regarding beginning an exercise program. Likewise, in the SDT model, your client may feel Controlled Motivation from and Extrinsic source (e.g. pressure from physician and spouse) to begin exercising, and yet possess Autonomous Intrinsic Motivation to improve their nutrition because of a life-long fascination with and enjoyment of healthy eating.

Coaches certainly encounter clients who are indifferent to making changes in some areas of their lives. This would be referred to as Amotivation, or simply lacking motivation. SDT looks at the process of motivation as part of the behavior change process, rather than a pre-requisite for coaching. The client does not have to be “ready” for coaching, rather, it is within the coach’s function to help the client get in touch with the motivation they need for change and resolve ambivalence Again, it our job to meet our client where they are at.

Controlled Motivation

All too frequently the wellness coach encounters clients who are feeling the pressure of Controlled Motivation. This is the “carrot and stick” approach to motivation. It means doing something in order to get a reward or to avoid punishment. It is characterized by feeling seduced (towards a reward) or coerced (to avoid negative consequence). Either way there is a perception of being pressured, obligated or even forced. A perfect example is the coaching client coming to fulfill a requirement for a wellness program incentive plan. The client feels forced into coaching to receive the reward of a 10-20% discount on their health insurance premium (and to avoid the implied penalty of missing this discount). Deci has emphasized that this approach has negative consequences for both performance and well-being. Deci and Ryan also noticed that individuals coming from controlled motivation tend to take the shortest path to the end result. They often complete the wellness program requirement and immediately quit the program.

Autonomous Motivation

Autonomous motivation has two aspects. The first is interest and enjoyment. If these two are present, so is motivation because I don’t have to be convinced to do what I love doing. The second type has to do with deeply held values and beliefs. Behaviors that are in sync with values and beliefs are coherent with one’s sense of self. According to Deci, the research demonstrates that when behavior comes from autonomous motivation people are more creative and better at problem solving. When confronted with challenges or obstacles they are more able to think ‘outside the box’. Overall, performance is better especially around hands-on learning and people feel better about themselves. All in all, “autonomous motivation is associated with both physical and psychological health.”

Autonomous behavior is about choice. Deci, in an effective video interview (https://youtu.be/m6fm1gt5YAM) , points out that it is not the same as independence. A person can be experiencing autonomous motivation (operating out of their own volition) when they choose to seek out a walking group to participate in. Autonomous motivation can drive both individualistic and collectivistic behaviors.

SDT also acknowledges that there is often a process experienced by people whereby their motivation may progress from Controlled External Motivation to eventually become a choice that they fully embrace — Autonomous Intrinsic Motivation. What may begin as

 

Spatial representation of different forms of extrinsic regulation. From Spence & Oades PDF (2011)

a requirement of a program (see a wellness coach to get an incentive) — External Controlled Motivation — may move to compliance with a program (continue to see the coach out of an ‘introjected’ sense that they ‘should’ do so). However, if the coach is effective at creating a true coaching alliance with their client and helps them to see the benefits that they may have to gain by continuing coaching, the motivation shifts through a sense of “identification”, to that of Autonomous Motivation — the client is truly choosing to be involved in coaching. Finally, as the client experiences the benefits of coaching and enjoys the coaching, they have fully ‘integrated’ the process and are experiencing Autonomous Intrinsic Motivation to engage genuinely in coaching.

In effective coaching we always refer to co-creating with our client ‘self-determined goals’. The message to the client is that they are the ones in the driver’s seat, choosing their own Wellness Plan with our assistance. As we coach our clients through the journey of change we can draw upon SDT to remind us to stay client-centered, to continuously move towards building client autonomy and towards motivation that is more intrinsic in nature. It’s just good coaching!

In Part Two on the topic of Self-Determination Theory, we’ll look at how we can incorporate the Three Innate Psychological Needs of SDT — the needs for autonomy, competence and relatedness into more masterful coaching.

 

For the very best in wellness and health coach training look to REAL BALANCE GLOBAL WELLNESS SERVICES, INC.  Over 8,000 wellness & health coaches trained worldwide.  http://www.realbalance.com 

 

For more about effective coaching refer to Wellness Coaching For Lasting Lifestyle Change, 2nd Ed., by Michael Arloski, Ph.D., PCC, CWP, NBC-HWC.   https://wholeperson.com/store/wellness-coaching-for-lasting-lifestyle-change.shtml

and to Your Journey to a Healthier Life (Paths of Wellness Guided Journals) by the same author.  https://wholeperson.com/store/your-journey-to-a-healthier-life.shtml 

The Psychophysiology of Stress – What The Wellness Coach Needs To Know

Easier Said Then Done

Stress gets blamed for most everything, and much of time deserves the accusation (60 percent to 90 percent of health-care professional visits are stress-related – https://www.apa.org/monitor/2008/10/relaxation.aspx ). Wellness and health coaching clients inevitably recognize that excess stress in their lives is affecting their quality of life, performance at work, and their very health in negative ways. Finding a way to deal more effectively with stress becomes part of most client’s Wellness Plan.

Wellness coaches all too often approach stress by working with their clients to strategically attack the sources of stress in their client’s lives. While there may be some specific gains made by that approach, all too often the result is temporary and band-aid-like, as yet another source of stress emerges. Solution-seeking as a stress management strategy is like flirting with infinity.

For over twenty-five years I worked as a psychologist and devoted much of my focus to helping people with stress-related disorders. I was an early adopter of the use of biofeedback and relaxation training methods. Combining those modalities with psychotherapy, my work was able to be of great value to clients suffering from muscle-tension and migraine headaches, a wide variety of gastrointestinal disorders, insomnia, Raynaud’s Disease, and many more issues. I delivered hundreds of stress management workshops and became so involved in the field that I eventually became President of The Ohio Society For Behavioral Health and Biofeedback.

Both my clinical work and my years of coaching showed me that ‘managing stress’ requires the clinician or coach to understand the mechanisms of stress, its psychophysiology. I use the term psycho-physiology here because, perhaps nowhere else is there such a demonstration of how our thoughts and emotions have direct effect on our body. This is the center of the mind-body connection. Just thinking about taxes, a strained love relationship, a scary health condition, etc., can immediately result in an increase in blood pressure, the secretion of stomach acid, the constriction of blood vessels in our extremities, the release of cortisol into our bloodstream, and more. Understanding the psychophysiology of stress is vital to being able to develop coaching approaches that will allow our clients to recognize stress, recover from it, and develop the resiliency that they need to live their best possible lives.

The Psychophysiology of Stress

The human body operates on an amazing system grounded in the principal of homeostasis. This self-correcting process allows us to bring ourselves back into balance whenever it is required. When we overheat, we sweat and cool down. When our blood becomes too thick, mechanisms bring more water from our cells and thin our blood down to its proper viscosity. When we are under stress this homeostatic principal seeks to bring us back into balance. Let’s take a look at how our nervous system operates this.

 

From this graphic, focus upon the Autonomic Nervous System. You will see that it is composed of two parts, the Sympathetic and Parasympathetic Nervous Systems. When we are under threat, or stress, the Sympathetic Nervous System (SNS) kicks in and arouses us to either fight, flee or freeze. This is the classic Fight or Flight Response.

When we are under real threat, like a stranger jumping out of van and confronting us as we approach our car in an isolated parking lot, this response may be vital to our survival. Suddenly our heart rate goes up, our adrenal glands release adrenalin and noradrenalin, cortisol and other stress hormones enter our bloodstream, our eyes dilate (allowing us to see better in low light), blood leaves our extremities and pools to our body core (minimizing bleeding in case our arms or legs are cut, and protecting our vital organs), our digestion shuts down (we need our energy elsewhere), the bronchi dilate increasing our ability to take in oxygen, and more glucose is made available to the blood to provide a supply of instant energy for both cognitive and physical purposes. So, you can see that this remarkable response does a fantastic job of equipping us to deal with muggers, Saber-toothed Tigers (back in our days in the cave), and other acute threats.

Unfortunately, in our modern-day world, we often trigger SNS arousal to a greater or lesser degree, by what might be called ‘false alarm states’.

 

As any wellness coach can recognize, these false alarm states are often the drivers of the very issues that bring our clients to coaching. Stress has a tremendous effect upon these and many more health challenges. When we are in a chronic state of SNS arousal we will see more headaches, insomnia, difficulty managing chronic pain, more tendency towards unhealthy coping mechanisms (including addictive behaviors), and difficulty managing anxiety, anger and our emotions. It’s easy to see how a client with weight issues might have improved eating and exercise/movement but is still struggling losing weight as they continue to live a high-stress life. Thus, while we are wired to handle acute stress in a potentially adaptive way, chronic stress is our nemesis.

The Relaxation Response

Back to the all-ruling principal of homeostasis. The nervous system’s answer to Sympathetic Nervous System arousal is to counter-balance it with Parasympathetic Nervous System (PNS) arousal. To counteract all of this activation for action we need a way to slow down the heart rate, reduce the blood pressure, calm the breathing, bring blood back into the extremities, quiet down the release of stress hormones, get the digestive system back online, and essentially bring us back to our baseline level of tension/arousal, or even dip below it. In contrast to ‘fight or fight’, this response is sometimes referred to as ‘rest and digest’.

For thousands of years people have found ways to bring about this PNS arousal. Methods of meditation, breathing, movement, prayer, chanting, etc. all have the potential to bring about this state of profound relaxation. Harvard cardiologist, Herbert Benson, coined the term ‘Relaxation Response’, and his groundbreaking 1975 book by that title created a whole new way to approach dealing with stress. His research since then has continued to demonstrate the profound utility of bringing out this quieting response through mind-body practices. Benson managed to demystify meditation and to distinguish it from religious practices. In more recent times, Jon Kabat Zinn has done the same with Mindfulness Based Stress Reduction techniques. Bringing out the Relaxation Response allows us to recover from stress. I will be delving into how to coach clients to do this in my next blog posting.

 

Actions of The Relaxation Response

 

Stress And Distress

Coaches often encounter a client who will claim to “thrive on stress”.
We actually do require a certain level of stress to bring out our best performance. Think of how some of the greatest performances in music and sports have occurred in the most high-stress moments. We look to experience ‘optimal stress’, or what is called Eustress.

There is, of course, a point where the stress becomes excessive and this is where we see this positive stress become Distress. This is where one’s stress related disorder may kick in. The headache comes on, the difficulty sleeping begins, the gastrointestinal problems start, the skin reacts, etc. Practicing some kind of method that brings out our Relaxation Response on a regular basis may, however, bring our baseline level of stress down enough for us to remain in eustress longer and perhaps not cause us to cross over into distress. Thus, the wellness coach may work with a client to help them find a way to integrate some kind of regular practice that brings out the Relaxation Response. Performing such practice could be an activity the client keeps track of and sets up accountability agreements about with the coach.

Caution Coaching With The Relaxation Response

As a wellness coach working with a client who has chosen to practice some form of relaxation training or meditative practice, you need to inquire about your client’s health concerns and all forms of medical treatment that they may be under. The chief concern is that as a client develops more competency with bringing out their Relaxation Response, it may alter their psychophysiology in a positive way, but in a way that must be accounted for with potential medical adjustments. Specifically, if your client is, for example, taking medication for hypertension, such practices may reduce their need to this medication and the dosage may need to be adjusted. Have your client inform their treatment team of their practices that may affect their medication needs. The Wellness Plan always supports the Treatment Plan. Make sure your efforts are coordinated with your client’s treatment team.

In two subsequent blogs I will be addressing how we can coach around the need to recover from stress, and how we can build greater resiliency to stress.

Resources

https://www.apa.org/monitor/2008/10/relaxation.aspx

https://www.ncbi.nlm.nih.gov/pubmed/11822639

https://www.britannica.com/science/fight-or-flight-response/media/206576/207822

Benson, Herbert and Klipper, Miriam. The Relaxation Response. William Morrow Paperbacks; Updated & Expanded ed. edition (February 8, 2000)

Real Balance Free Monthly Webinars: “Stress! Recovery & Resilience: How The Wellness Coach Can Help”.  http://www.realbalance.com/wellness-resources

For the very best in wellness and health coach training look to REAL BALANCE GLOBAL WELLNESS SERVICES, INC.  Over 10,000 wellness & health coaches trained worldwide.  http://www.realbalance.com 

 

 

For more about effective coaching refer to Wellness Coaching For Lasting Lifestyle Change, 2nd Ed., by Michael Arloski, Ph.D., PCC, CWP, NBC-HWC.   https://wholeperson.com/store/wellness-coaching-for-lasting-lifestyle-change.shtml

and to Your Journey to a Healthier Life (Paths of Wellness Guided Journals) by the same author.  https://wholeperson.com/store/your-journey-to-a-healthier-life.shtml