The Bigger Mindset Shift: Waking Up To Lasting Lifestyle Improvement

Wake up to a whole new way forward!

Wake up to a whole new way forward!

Just back from a whirlwind of professional travel, I’m struck by a pervasive awakening that our health is largely behavioral, and if we truly want to improve health worldwide, we must seek methods that support success at lasting lifestyle improvement. At the Lifestyle Medicine 2015 Conference, where I presented, we saw that the medical profession is embracing wellness & health coaching as never before. In Europe we witnessed increasing interest in how to integrate wellness coaching into health systems and medical training. In the large disease management company where I just delivered a week of training, there is truly a mindset shift from a consultant style of helping relationship using simple goal-setting to an integrative model based on the Real Balance Wellness Mapping 360°™ Methodology

Real Balance Wellness & Health Coach Certification Training is continually fostering “making the mindset shift” – going from “prescribe & treat” or “educate and implore” to the coaching mindset of “advocate and inspire”. We repeatedly emphasize the importance of shifting from the Consultant role to that of a true Coach. The recognition that assisting people in succeeding in behavioral change is a very different process than sharing medical, educative or other expertise, is starting to take hold stronger than ever.

Making The Mindset Shift is our way of saying Wake Up and realize that co-creating wellness is the way forward.nature-landscape-path-walkway-mist-mountain-grass-sunrise-river-clouds-water-1920x1200

A co-creative way of working with people honors their inner wisdom, acknowledges the contextual factors that facilitate or inhibit lifestyle improvement while honoring and celebrating differences. Co-creation allows a person to be the expert in their own life, and yet does not send them out to climb the mountain alone. It is our commitment to accompany them on the journey providing support, guidance, tools, and our expertise in changing lifestyle behavior.

It is easy to feel overwhelmed by the increasing “lifestyle disease” health statistics documented by the World Health Organization. As we see budgets (whether of families, states, provinces, companies or countries) plundered by chronic illness expenses we are also, finally pulling ourselves out of the floodwaters, reaching for higher ground, gaining perspective, and seeing that more of the same will just continue to drown us. There is a coalition of Wellness & Health Coaching, Wellness & Health Promotion, Lifestyle Medicine and other like-minded people with enough vision to see that lifestyle improvement, individually and collectively, will be what allows us to keep our heads above water, start to swim and return to the healthy place that seems like dry land. Please join us!

“Let’s get together and feel all right.”
One Love
By Bob Marley

Michael & Deborah Arloski in London

Michael & Deborah Arloski in London

Posted in coaching, health coaching, Lifestyle Medicine, wellness, wellness coaching | Tagged , , , , , , , , , , ,

Delivering The Behavioral Side Of Lifestyle Medicine Through Wellness Coaching

Wellness Coaching: Bringing Light To Lifestyle Medicine

Wellness Coaching: Bringing Light To Lifestyle Medicine

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

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

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

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

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

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

Lifestyle Medicine 2015

Lifestyle Medicine 2015

At Lifestyle Medicine 2014 (the annual conference of the American College of Lifestyle Medicine I presented on “Wellness Coaching And Lifestyle Medicine: Covering The Whole Continuum”. This year I presented “Delivering The Behavioral Side Of Lifestyle Medicine: Wellness Coaching Skills & Concepts” at Lifestyle Medicine 2015 in Nashville. Together with other presenters on wellness coaching we have experienced a strong positive response from an audience made up primarily of physicians.


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

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

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

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

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

Overlap Of Treatment And Wellness Plans

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

so_healthcoaching_1When clients are operating on a Wellness Plan that they have truly helped co-create with their own buy-in, the opportunity for weaving in Areas of Focus, Goals and Action Steps that support what their treatment team wants to see becomes obvious. Clients then have the structure and support they need to carry out the goals of the Lifestyle Prescription.

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

© Copyright 2011 CorbisCorporationWise medical organizations and practices are hiring wellness coaches to become part of their staff or are outsourcing to them. Healthcare providers are sometime “wearing two hats” and combining their treatment work with coaching. Others are becoming more “coach-like” in their interactions and are then handing the patient off to the wellness coach for the longer process of lifestyle improvement.

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

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

Michael Arloski, Ph.D., PCC., CWPMedium5


Posted in coaching, health coaching, Lifestyle Medicine, wellness, wellness coaching | Tagged , , , , , , , , , , , ,

Seven Expressions Of Courageous Coaching


Courageous coaching! What would “courageous coaching” look like for you? There are many ways to approach the subject of courage in coaching. As a trainer of wellness & health coaches here are some of the ways I would like to see courage show up for the coaches we educate.

1. The Courage To Stand For NCRW- Naturally Creative, Resourceful And Whole

In the foundational coaching book Co-Active Coaching ( , the authors say “We start with this assertion: people are, by their very nature, creative resourceful and whole.” They finish their paragraph with “In the Co-Active model it more than a belief – it is a stand we take.” I love the courage in that statement. When coaches are functioning at their best, serving their clients to the fullest, they are taking that stand. It is like a line drawn in the sand that coaches will defend against all who would ridicule, diagnose, or demean their clients or disenfranchise them of their human dignity. The power of this stand feels not only like the compassionate expression of unconditional positive regard, but like the solid feeling of someone who stand with you. Standing alone facing those who would treat you as broken, inadequate, and incapable, it is like the feeling of an ally stepping up from behind you and you feel their shoulder touching yours as you face your challenge together. The coach’s courage brings out your own.

The courage of the coach is called forth here as they work in systems that would still adhere to old diagnostic models that label people. The wellness field sometimes deals with its challenge of leveraging large numbers by labeling people as “high-risk”, “obese” (according to completely unreliable BMI charts), or by the tag of their health challenge (diabetic, etc.). Here our courage comes forth as we welcome that client and treat them, despite what others say, or even what the discouraged clients believes about themselves, as naturally creative, resourceful and whole. We may be the first person in a human-helper role who has treated them this way.

“If you treat an individual as he is, he will remain how he is. But if you treat him as if he were what he ought to be and could be, he will become what he ought to be and could be.”
― Johann Wolfgang von Goethe

“You’ve got to REACH, a little bit higher!”

2. Courage To See The Potential In All And To Confront And Challenge

As we take this courageous stand to hold our clients to be naturally creative, resourceful and whole, there are times when we may believe this about our clients more than they believe it about themselves. Our clients come to us with lessened self-efficacy from repeated failure experiences and sometimes lack of support and even discouragement heaped upon them by others who did not see them as capable of much in their lives. From our perspective we may see possibilities and capabilities in our clients not evident to them. Here we can courageously confront and challenge our client to do more. As we demonstrate our belief and faith in our client’s abilities and capacities, they may rise to the challenge and succeed to a degree that surprises them.

Challenging clients to take a next step, to walk three times next week instead of two, to have that crucial conversation with their boss all hinges on the strength and depth of the coaching relationship. I challenge clients very little early on in coaching. As our alliance grows and they know that I am truly their ally, holding that their agenda is the only agenda, then a challenge is welcomed instead of mistrusted.

Coaches may also have to confront the unspoken conflicts that can arise in coaching. One of the bravest things that coaches do is to invite exploration of how can the coaching be improved. Right in the middle of the coaching process coaches will ask how they can work better with their clients. When coaches tune in to the tone of voice, to the increasing resistance, to the “agreements” made to new action steps that are mouthed in lukewarm fashion of compliance instead of embraced with motivation, the wise coach is alerted that the basic coaching relationship needs attention. The courageous coach then talks about “the elephant in the living room” and clears the air.

It may take real courage to make a referral. It’s easier, at first, to just ignore or minimize how our client is struggling. We may fear that our client will be offended, or that they will no longer like or trust us. We may try to fake our competency in areas where we are insufficiently prepared. Such coaches make numerous suggestions for solutions, whether the issues are nutritional questions or more psychological in nature. We have to be courageous enough to say “I don’t know.” We have to hold the client’s safety and wellbeing far above our own fears.

3. Courage To Do Process Coaching4806502-hands-reaching-out-for-each-other

Research tells us that 60% of all decisions are made emotionally, not logically. Emotion permeates the experience of working on changing our behavior. When we strive to change our belief systems (like the person who has always believed they must please others all the time and finally realizes that managing their own stress means saying “no” at times) there is always an emotional component. In wellness & health coaching we almost always encounter the emotional side of life as our clients deal with attempting work no body image, success and failure experiences, etc. Thinking that coaching is just a process of logically formulating plans, setting “goals for the week” and holding people accountable to those goals is not only naive, it is actually condescending, dismissive and disrespectful. So, coaches must be skilled in the art of process coaching, helping people process emotion so they can connect it to motivation and action.

Beyond the skills required for process coaching, is the courage to enter the world of emotions with one’s client. Certainly the confidence that comes from learning and practicing such skills enables the emergence of the courage we need. However, there is more than just confidence involved here. Can the coach face his or her own fears around dealing with emotion? Is the coach grounded enough in their own emotional balance to stay centered as they walk down the path of emotion with their client? Can the coach distinguish between the emotion of the client and their own feelings? Can the coach realize how safe they, themselves, truly are as their client deals with feelings?

We might call it emotional maturity coming from life experience. When one has learned from processing their own feelings, gained insights and applied those insights to their lives, fears around emotion lessen. Overcoming family of origin programming around such fears can be very challenging. If we can just learn that feelings are our allies, not our enemies, we can open up to the growth process that allows us to gain such maturity.

dcaa3213091a04451cbf0aaff27a3f5d4. Courage To Dance In The Moment

When my wife and I go dancing (as we love to do), I often listen to the music for a few bars and decide if it’s a number that suites our style before I propose getting out on the floor. In coaching it’s more like being out on the floor already and going with whatever music is played! As our clients conduct the band, the music can shift at any time. The client who seemed to simply be working on smoking cessation is suddenly talking about the profound sense of loss that has come from avoiding their old smoking companions during breaks. Dance with it!

It takes courage to go “out on the dance floor” when you don’t know what will happen next. Be centered in the confidence you have in your skills, but also draw upon the positive qualities you know you have. Coaching presence and your ability to be non-judgmental, empathic and compassionate will allow you to face, with your client, challenges of all sorts.

Trusting the coaching process is advice I am constantly giving coaches in training. Yet, part of coaching is knowing that the “coaching process” is something much bigger than a “protocol”, a rigid coaching format or worst of all a script. We can’t always anticipate the next move by our dancing client. Part of the true coaching process that we trust is letting go of what we thought was going to be our work today and going in the direction that emerges. Yes, structure is our friend, and our client’s friend as well, however structure has to accommodate flexibility. A client may have a day when resolving a conflict with the coach on direction and how to work together, or a time when a personal crisis takes over. On such occasions, feel free to toss the old agenda of reporting in on action steps out the window and deal with what is right in front of us.

5. Courage To Stand For Transformation

When a client reports that coaching has helped them change their life, that they are a “new person”, that what happened in the coaching process far exceeded their expectations, then we know that we have co-created, with our client, transformative coaching. As our clients work to improve their lifestyle, what is key to remember is that our clients will need to be living that new and healthier way for the entire rest of their lives. Yes, it’s good to reduce blood pressure points, A1C scores and percent body fat numbers. Yet, if all we are measuring is how many times Joe or Martha walked each week for the last few months, have we really helped our client as much as we could have?

Part of what coaches in the world of corporate coaching face is standing for transformation, not just single variable increases that can be conveniently measured and paid for. Coaching the whole person takes time. Yet, if we don’t want to see that client coming back through the revolving door of coaching, or perhaps of the treatment end of the healthcare system (with yet another chronic illness) then working courageously with our clients to help them make sustainable lifestyle improvement just makes good sense. When more than just some change in a measurable behavior takes place, when the person’s self-esteem, self-efficacy and connectedness with additional and lasting support systems can rise, then we know that lasting lifestyle change can thrive. Work to help your clients transform their lives.

6. Courage To Do Your Own “Work”self-reflection_1024x768

The oft-used phrase “knowing when and how to get yourself out of the way” has great import for coaching. When there are issues in our lives that are so unresolved, so demanding of our awareness, that we are distracted by them, influenced by them and/or almost pulled to them unconsciously they will interfere with effective coaching. Such issues are likely to push us into projecting our own feelings on to others. The coach who is carrying around unresolved anger sees more anger in their client’s expression of emotion. We believe that others “need” to work on the same “stuff” that we are wrestling with. The danger continues with such coaches ascribing feelings or beliefs to clients that they really don’t possess. The probability of collusion increases dramatically. We give the struggling client a quick free-pass on their accountability because of our own feelings about their challenge. The border between effective process coaching and the world of psychotherapy/counseling becomes much more ambiguous for such coaches.

In all of my years as a psychologist practicing psychotherapy and working with colleagues in universities, clinics, and private practices, I observed that the truly effective therapists were the ones who were continually working on their own personal growth. They were open to looking at their own shortcomings and how to improve. Socially they were open and easy to get to know. The ineffective therapists were much more defended and resistant to self-examination, much less seeking out of personal growth. They maintained a “clinical presence” with their “patients” and were more socially distant. The lesson for coaches is equally clear.

It takes courage to look at ourselves. Who knows what lies hidden if we crack open Pandora’s Box? A coach who is afraid of not being able to handle the contents is most likely going to coach with the fear of being surprised by what a client might say. Instead of clearly distinguishing then if we can proceed with coaching, or encourage a referral to a mental health professional, such a coach may instead retreat from dealing with feelings altogether and rigidly stick to talking about goals and action steps.

Do we need to finish up all of our unfinished business emotionally before we can coach effectively? Of course not. We all have moved forward effectively in life with some weight left in our backpacks. If, however, we’re carrying an iron anvil in that pack, it definitely will weight us down and get in the way of our coaching work. So, take on the personal challenge if need be, to seek out the ways for you to do the intrapersonal work that you need to do and be a better coach!

“The unexamined life is not worth living.”

personalgrowth7. Courage To Grow

When clients realize that wellness is ultimately about personal growth as a whole human being, transformation takes place. Motivation for lifestyle improvement then becomes easy. When a coach realizes that that personal growth is not something to fear, but something to embrace, their professional growth mirrors that unleashing of potential. Growth means change. Change means loss. Scary stuff. Sometimes it is most tempting to hang on to the status quo, even if it is stifling, unfulfilling and stagnating. The personal growth journey is always a twisting path and there is seldom much of a view of what’s around the next bend. So yes, it takes courage to be open to growth and perhaps even more to seek it out.

Growth is about joy, but also about being uncomfortable. Our growing edge is sometimes tender, sometimes a place where pain has taken place. Our inner-critic is always on hand to discourage us, to shake our confidence, to have us consider all of the ways we can fail, or that we are even worthy of the benefits that it might bring.

Yet, when we risk and succeed, when we calculate our leap and then we take it the rewards are great. Personal development and professional development overlap and we thrive. Personal growth opportunities take on many shapes. We grow mostly from being open to experience life and what comes to us. At other times, we know that stretching ourselves might require seeking growth out. Signing up for a new opportunity to socialize or engage in adventure, to travel outside the walls of the “all-inclusive”, or simply to allow ourselves to experiment with that which has been the hardest for us to do, can all yield surprising growth. It might be giving ourselves permission to risk being vulnerable and let an intimate relationship grow. It might be backpacking through Europe solo. The “what” depends upon where your own growing edge is located.

Courageous coaching can show up in many ways as we have seen. Courageous coaching pays off in greater integrity, confidence, personal growth and ultimately in better service for our clients.

In the astonishing book, Facing The Lion, Being The Lion: Finding Inner Courage Where It Lives ( , poet and cancer survivor, Mark Nepo urges us to face things in life. “…facing ourselves, each other, and the unknown. It is something we cannot do without, for facing things is what courage, at its most fundamental level, is all about. Without this, we replay and pass our suffering on to others repeatedly.”

For those who grow, there comes a time to Face The Lion, and by doing so, Become The Lion.

For those who grow, there comes a time to Face The Lion, and by doing so, Become The Lion.

Later this month I will be hosting a Real Balance Free Monthly Webinar ( with Real Balance Faculty member Joshua Steinfeldt as my guest. His topic will be “What Are Coaches Afraid Of? An Exploration Of Courage And Coaching Mastery”. A recent grad of the Masters Degree Program in Positive Psychology at the University of Pennsylvania where Martin Seligman and others in the Positive Psychology Movement teach, Joshua will be presenting the fascinating work he did on his Masters Thesis.

Posted in coaching, health coaching, wellness, wellness coaching | Tagged , , , , , , , , , , , ,

Downshifting To The Speed Of Life: Coaching Slowness


“Summertime and the livin’ is easy.” How long has it been since the words of that old song rang true? In response to the accelerated pace of life a conscious movement has emerged to help us slow down and reclaim our quality of life again.

In my last post I shared about Time Affluence ( and how we can experience a greater sense of time by changing our way of perceiving it. Today I’ll share about another way to address our sense of “time poverty” by learning how to deliberately slow down our pace of life: the “slow movement”.

What started in Italy with “slow food” as a reaction to omnipresent “fast food”slow-food-logo-1-550x392 ( ) has morphed into a broader “slow living” movement including slow travel, slow schools, slow cities, slow design, slow relationships and more. Its main tenet is that for a more fulfilling and deeply satisfying life we need to allow the appropriate amount of time to experience the activities we engage in.

Savoring may save us. Consciousness may return control to our lives. As author Carl Honore (In Praise of Slowness) ( puts it, our cultural obsession with speed erodes our health, productivity and quality of life. “We are living the fast life, instead of the good life.”

Operating on “automatic pilot” may seem like an important strategy to cope with feeling overwhelmed. However it usually results in staying stuck in habits that don’t serve us as well as the conscious choices we might make instead, if only we…slowed down and thought about it. As Mae West tells us “Anything worth doing is worth doing slowly.”


So, how do we make the shift? How do we de-stress ourselves, further change our perception of time and pump up our quality of life? How do we begin to embrace and benefit from “slow living”?

Value the intrinsic over the extrinsic. Focus on the internal rewards found in experience, not production; the taste of fresh tomatoes, the smile of a child. The irony here is that we know that intrinsic motivation drives greater and more creative productivity.

Re-wire your brain. Changing life-long habits means developing new neural pathways in our brains and staying off the old well-worn habit pathways. Catch yourself in your old speedy habits and jump back on the new path over and over again.

Plan to be spontaneous. Plan ahead to have free time. Make plans to “be” not just get things done. Make reservations at campgrounds so you will get out and do it. Arrange with friends to have a slow dinner evening savoring food and fun.

Lose your mind and come to your senses. Focusing on our sensory experience of taste, sound, touch, and smell can help us slow down. Breath deep, eyes closed, and take a moment to smell the roses.

16702647-mmmainCreate conspiracies. The only way to break out of unhealthy cultural norms is to conspire with friends, family and co-workers to create healthier, slower ones. Together cultivate the Italian phrase “Il dolce far niente” the sweetness of doing nothing!


Small head cropped1

The Coach’s Takeaway

Our coaching clients often come to us either feeling that they are overwhelmed and have to slow down their pace of life, or, perhaps when they have had a “wake up call”, like the onset of a serious health challenge, that has caused them to reassess life’s priorities. They want to “slow down”, but, “marinated in a culture of speed” (as Honore puts it), they don’t know how.

You may have clients who are do not want to slow down. Staying busy, staying distracted, they don’t have to look at deeper issues that may be more troubling to encounter. Coach them around exploring what they fear might happen if they were to slow down. Explore “what if” examples: “What would happen if you made an agreement with your family to eat dinner together with no television or other devices turn on?” “What would it be like to take a long, hot bath instead of a quick shower?” Some clients may have such fears that they need counseling rather than coaching and the “pressure” to slow down may be too much. Referral can be discussed, but you can also back up and coach in other areas until they are ready to look at how they might experiment with slowing down.

Some fears might not be so psychological. Your client may fear that if they slow down they won’t be able to compete in the workplace or marketplace. They may fear that they won’t appear as a attractive as the hard-charging, “work-hard/play hard” person they want to portray. If you client is open to it, this may be where you can turn them on to some of the resources of the “slow movement”, such as Honore’s book, or:;; and They may learn that they can allay many of their fears by seeing how the benefits of slowing down include just what they are trying to achieve by rushing and working too hard: greater creativity, productivity and quality of life.

Slowing down may have a link with self-permission. Many of the healthy changes in behavior often revolve around greater self-care. Great wellness plans go nowhere if the client is unwilling to give themselves permission to implement them. Explore this concept of self-permission and how the person is holding themselves back.

For most clients though, the desire for a slower, more fulfilling life is there.

  • Create experiments using the Downshifting idea above.
  • Get creative with your client and co-create new action steps that they can take week by week to try out new ways to slow down in whatever area seems both important to them and most likely of succeeding.
  • They may even want to commit to looking at several dimensions of their wellness (perhaps as represented in a simple tool like the Wheel of Life) and creating experiments in each area.
  • Commit to cooking more meals at home.
  • Visit a farmers market.
  • Declare a “technological Sabbath” for a day.
  • Commit to learning and practicing “centering” activities such as Tai Chi, Yoga, relaxation training, or some form of mindfulness practice.
  • Commit to reading a novel instead of work-related books.
  • Read Thoreau’s essay “On Walking” and learn to saunter! (


Posted in coaching, health coaching, Slow Living, Uncategorized, wellness, wellness coaching | Tagged , , , , , , , , , , , , ,

Time Affluence: What New Findings Mean For The Wellness Coach

Man in lounge chair on beach

No matter how intensely we human beings think about time, the Earth rotates on its axis in the same twenty-four hour cycle. Yet time is all about our perception of it, and far too frequently we view it as a scarce commodity. Time scarcity thinking is just as detrimental to our health and wellbeing as financial scarcity thinking, maybe even worse. Yet, in our stressful world it is so easy to feel like that planetary rotation has indeed accelerated. Feeling behind in our work, overwhelmed by our responsibilities and our to-do list, it often feels that we are indeed in a “time famine”. The perception of a time famine (as researchers have actually begun to call it) drives stress and dissatisfaction with life. We attempt to adapt by overscheduling ourselves, downloading productivity apps, making endless lists, and rushing from one thing to another, usually without scheduling enough time for the transit in between. No matter how hard we work, or how hard we work at “managing” time, we simply cannot conjure more minutes in the day.

The clients of the wellness coach, like many of us, experiment in ways that negatively impact health. We cut down on the hours of sleep, sometimes following the advice of so-called motivational speakers and celebrities who have “made it”. The harsh reality message of science, however shows us that getting less than our eight hours of shut-eye increases our risk of all the major chronic illnesses. ( We cut down on time with family and friends leading to a real deficit in getting many of our emotional needs met and straining the most important relationships in our lives. We cut down on the time we spend cooking healthy meals, exercising, etc. The experiments buy us some minutes here and there, but in addition to what we lose in quality of life, we often don’t feel any more satisfied with the abundance of time in our lives.

Omnipresent Urgency

My blog post “Stress Coaching Part I: A False Sense Of Urgency” ( spoke of how we can individually or collectively (like in the workplace or family) drive anxiety and even panic through creating a sense of urgency that is not in line with the reality of the situation. A frantic sense of urgency driven by anxiety and fear, sets us all up for unhealthy levels of stress and severely diminished quality of life. That post looked at how we create such perceptions and at ways to distinguish between true urgency and false urgency, and between urgency and emergency. We also explored how to concretely coach around this issue.

Get Organized!

Coaches often serve their clients very well by helping them to improve their experience of time by assisting them with organization. I’ve often been surprised by how often my stressed-out client operates a complicated life with no written calendar and no simple “to do” list! “Time management” strategies can help, but usually only go so far. What else is really at play here?

Time Poverty

Feeling like we are not in control of our time, especially in the workplace is actually a huge health risk. A UK study of over 10,000 employees found that those who were in situations where they were at the command of others as to when to work and when to take breaks were three times more likely to call in sick, and had a mortality rate three times higher than others the same age.

“Take Back Your Time” activists argue that the more control we feel over our moment-by-moment schedule, the greater our sense of time spaciousness, or time affluence. Tim Kasser, the researcher credited with coining this term, recently published the results of four empirical studies documenting its positive impacts. It not only relieves stress; it also improves physical health and leads to greater civic involvement, more positive ecological behavior, and increased well-being, including job and family satisfaction—all at rates significantly higher than increasing material affluence.” ( Workplaces may have to face their responsibility here for driving such health risks and the individual coming to coaching may have such an environment to cope with.

Time Affluence

What if we both personally, and as a family, a workplace, or of friendship circle, went from time famine to “time affluence”? What if we coached for a shift in perspective and consciousness, not just more and more “management” experiments?

Leisure timeCan you remember times when you had all the time you needed, even surplus time? It may have been during the summer in childhood. It may have been the prime motivator for traveling to another country where there is greater time affluence. The appeal of vacation destinations like Italy, Mexico or Ireland often rests largely in their more laid-back pace of life. Our challenge is not scheduling more vacations; it’s changing our thinking about time and creating norms that embrace a more conscious pace of life. Feeling time affluent can be incredibly empowering and lead, according to researchers, to greater health and personal happiness. “Time affluence, it appears, has real benefits in our lives. If time famine can create a state of rolling personal crisis, studies have shown that feeling “time affluent” can be powerfully uplifting, more so than material wealth, improving not only personal happiness, but even physical health and civic involvement.” ( However, becoming time affluent is not the same as financial affluence. “Time-poor people report being more stressed and less satisfied with their lives, and even money doesn’t appear to help. Figures from Gallup suggest that wealth has an inverse relationship with time famine. “The more cash-rich working Americans are,” a 2011 Gallup report on time concluded, “the more time-poor they feel.” (

Coaching For Time Affluence

So, what are some quick ways to coach a shift in our perception of time and slow our lives down to an optimally healthy speed?

First, change our language about time. What would happen if you took the thought “I don’t have time to…” and changed it to “This is not a priority for me.” It might be tough to admit to yourself, but then again, it might cause you to reevaluate the way you think of your time and that particular item. How would it feel to say “My wellbeing is not a priority.”? Sure there are times when the situation demands that your own wellbeing might need to be temporarily set aside, but how chronic is this pattern? Are you saying “I don’t have time for me!” far too often?

A second idea is to begin to live your life with greater mindfulness about your daily experience. Tune in to what you are doing in the present moment and see if it is something you want to savor. Sunsets, bird song in the morning, the graceful movement of a child, the taste of fresh lemonade can slow us down to the speed of now and the relaxation and balance that comes with it. This is where “mindful eating” and such approaches can fit in nicely.

Giving It Away (Giving to/doing for others)

Counterintuitive as it may sound, but researchers have found, much to even their surprise, that when people help others, donate their time, they actually feel like they have more of it! Feeling useful and effective in such acts seems to create the feeling of an expansion of the time we have. People who gave more freely of their time for others actually engaged in more self-care activities as well.(

Full Of Awe Not Awful

When people experience awe, time seems to also expand. Even tiny doses such as visualizing an inspiring scene in nature, watching a video of such, writing about a personal experience of awe or happiness, etc. can bring a momentary boost of in life satisfaction, and increase the perception of time availability. So, as coaches work with clients around relaxation practices we might want to include such guided visualization. The work we do with helping the client to create their “Well Life Vision” may serve not only as a destination for our wellness plan, but also as a source of time expansion as we settle in to visualizing that ideal way of living and see ourselves there experiencing it!

In further posts we’ll take a further look at the “Slow Movement” and additional ways to become more time affluent.

Posted in coaching, health coaching, wellness, wellness coaching | Tagged , , , , , , , , , , , , , , , , ,

Ten Steps To Structuring Great Wellness Coaching Sessions

HopscotchWellness coaching clients show up for appointments desiring to make progress in improving their lifestyles and thereby improving their lives. For as much as they want the session to be productive, it is easy for the client and the coach to drift together from topic to topic and finish up realizing that little has been accomplished. Sometimes a client comes to the session eager to talk about a particular subject, perhaps an emotion-laden one. Quickly the session’s minutes evaporate while little else is covered, including, perhaps, exactly what the client had originally hoped to work on. The Wellness Plan that the coach and client had developed gets pushed aside and soon the session is over. If this happens repetitively client dissatisfaction soars and soon coaching comes to a premature end.

Getting Started

Beginning coaches often feel awkward initiating the coaching conversation.  Clients come through our door or arrive on the call sometimes unsure how to get started as well.  A lesson from anthropology will tell us that social greeting behavior is expected, normal, and helps everyone relax.  The old saying that “Bullshit is good fertilizer.  Sometimes good things grow from it.” is really saying that it’s not only okay to exchange what we might call pleasantries, talk about the weather, etc., it grounds us in a more comfortable and familiar interaction from which to proceed.

“Structure Is Your Friend!”

While every coach is free to develop their own coaching style, and is probably a better coach because of that, consciously following a basic coaching structure will help insure that sessions are as productive as desired. Clients engage with coaches in order to accomplish what they have not been getting done in their lives. Much of the help that coaches provide is in helping clients to become better organized, to plan, to commit and to be accountable to themselves, thereby producing the results they want to see.

Being client-centered does not mean passively following the client in conversation wherever they may lead. It means facilitating the client’s own process, keeping them in the driver’s seat, but traveling down the road to where the client wants to go. The metaphor of the coach and client walking down a trail in the woods at midnight is a good one. It is the coach’s job to hold the flashlight and illuminate the way. It is the client’s job to choose the path.

Co-Creating The Agenda- Every Timeagendaicon

Coaches help their clients to get clear about what they want to accomplish in coaching. They consciously co-create the coaching alliance. They hold the client’s agenda to be the agenda, but that does not mean starting a session with the often-disastrous invitation “So! What do you want to talk about today?” Make your coaching sessions more productive and satisfying by using the following steps as part of your coaching session structure.

tenStepsTen Steps To Structuring Great Wellness Coaching Sessions

1. Preparation. Begin working on the session before it even happens. Have your client use a Coaching Session Prep Form to list their “wins”, address their commitments to action steps, and share what is important to process. Do your own homework on this client by reviewing notes, and getting mentally and physically prepared for the session.
2. Consciously Co-Create The Agenda for the session. Create an agreement about what will be worked on in this particular session. This should be relevant to the client’s overall Wellness Plan, or to the development of that plan. Following a map insures that we will get where we want to go.
3. Acknowledge and… When a client comes bursting through the door, so to speak, with an important issue to discuss handle it like this: A. Acknowledge their experience. B. Reflect their feelings about it. C. Emphasize the importance of being sure to talk about this issue today and ask what else the client wants to be sure to include in today’s agenda.
4. Dealing with crisis. Realize that when a client comes to the session in the midst of an immediate crisis that the empathic understanding and support of the coach may be all that “gets done” today, and that is totally okay. Create an agreement to just focus on helping them to express themselves about this issue and, perhaps do some immediate problem solving, such as helping them find additional resources to deal with the crisis (this could include referral to medical resources, mental health resources, or other possibilities).
5. Wins! Most sessions will progress from Co-Creating The Agenda, to checking in on what has gone well for the client since the last session. You may want to go over the Prep Form together. Looking at “wins” first is a positive psychology approach that coaching is famous for. It works! This moves along to checking in on progress and challenges regarding the action steps that the client had committed to working on during the last session.
6. Drawing out learning and processing. Explore the client’s experience with those action steps, with internal and external barriers that have come up. Coach for realization, insight and deeper understanding of self and environment. Connect with motivation. Coach for possibilities.
7. Next steps. Leave about one-third of the session available for “Where do we go from here?” Drawing upon what was gained in the session co-create next steps for the client to take in applying what they are learning. Look at previous commitments to Action Steps and either RECOMMIT (to the same Action Steps), RESET (adjust the Action Steps to a different level or threshold), or SHIFT (shift to new Action Steps). You may also want to co-create with the client an “inquiry” for them to work on in the coming week – something for them to think about, journal and/or converse about that is relevant to what came up in the session.
8. Review and agree. Summarize the essence of the session. Review exactly what the client’s understanding of the way forward is and agree upon specific Action Steps that the client is committing to. Reinforce the motivational connection between the Action Steps and how these actions will help the client achieve what they want in their Wellness Plan.
9. Wrap it up and close. Leave the client with inspiration, acknowledgement and clarity about the next meeting time.
10. Notes & Self-Care time. Finish up your notes, including notes about information you need to find (such as knowledge about a medication your client is taking) and any action steps that you have committed to doing. Then, take a little time for your own self-care, on a mental, emotional and/or physical level.27-730x487

Students in our Advanced Wellness Coaching Competencies classes ( and our Mentor Coaching program have consistently remarked how implementing the co-creation of an agenda for the session (Step #2), has completely changed and improved how they coach with their clients. Step #3 has often helped them to stick to this structure while meeting the client where they needed to be met.

Structure often serves to paradoxically increase our freedom. Instead of wandering or even floundering on our coaching path, we find we cover more ground discover more along the way by having a map to follow.

Posted in coaching, health coaching, wellness, wellness coaching | Tagged , , , , , , ,

Wellness Coaching And Chronic Lung Disease

DandelionbreathIt surprises many people to discover that the third leading cause of death in the United States, behind heart disease and cancer, is chronic lower respiratory diseases. These conditions take twice as many lives annually as does diabetes. Yet, unless COPD (Chronic Obstructive Pulmonary Disease), or another such disease is part of your life or family, the seriousness of this public health challenge seems to seldom get our attention.

It’s estimated that over 15 million people in the U.S. suffer from COPD. The two main diseases that are associated with COPD are emphysema and chronic bronchitis. Approximately 22 million people in the U.S. are affected by asthma. Pneumoconiosis, also known as Black Lung Disease, is an occupational lung disease caused by inhaling coal dust. This affects more people in coal producing areas such as Appalachia and Northern Wyoming. All of these respiratory diseases have much in common, but for this article our focus will be on COPD and the ways in which lifestyle improvement can be relevant.

The most common cause of COPD is cigarette smoking and can also be related to ongoing exposure to indoor, outdoor and occupational air pollution. The preventative implications are obvious and wellness, health and safety programs can play a significant role. Like other chronic illnesses once thought to present a health challenge that we were helpless to do much about, COPD has a behavioral component that can affect the course of the illness and improve quality of life. The lifestyle medicine approach is illuminating ways in which the COPD patient can affect their condition for better or worse. Wellness and health coaching is emerging as a delivery mechanism to support COPD patients in succeeding with the lifestyle improvements that their treatment team wants to see.

271813-exhaleThe Behavioral Side Of COPD

COPD normally develops slowly and is the cumulative effect of decades of exposure. Any damage that is done to the lung tissue is irreversible. There is no cure for COPD and so treatment goals aim to slow the progression of the disease and to reduce symptoms. Once properly diagnosed the most immediate behavioral interventions are environmental: (reduction in exposure to workplace or living environment pollutants, e.g. a person working in an industrial pottery who is daily exposed to clay dust); strategic: an effort to immediately cease smoking; and medically behavioral: compliance/adherence to medical treatment (e.g. bronchodilator treatments, regular medical appointments).

The overall wellness of the client is important on a number of fronts. As treatment continues, lifestyle changes, physical exercise, and regular practicing of breathing exercises may also help to improve a person’s ability to remain active, prevent exacerbations and improve one’s overall health. A good nutritious diet is very important in order to avoid infections and to keep their lungs as healthy as possible. Maintaining a healthy weight is an important factor for a person that has lung disease. If a person is overweight it can make it difficult to move around and make it even harder to breathe. Being underweight though is actually a worse prognosis than being overweight. As lung disease progresses a person will become more short of breath and fatigued. Even eating can become a lot of work and a person might find it very difficult to get all the nutrients and calories that they need.

Improving a person’s overall strength and exercise tolerance is also a goal. The patient photo3063should speak first with their physician to determine what exercise or activities would be safe for them to do. Even though activity can make a person feel more short of breath it is vital to strengthen their muscles so that they will be able to continue to do the things they enjoy and be able to care for themselves. An individual will greatly benefit from participating consistently in a local pulmonary rehabilitation program.

Raising self-efficacy is vital to the COPD patient. Clients/patients benefit greatly from learning as much as possible about their disease and how to manage their symptoms, work properly with their medications and make the best use of supplemental oxygen. In fact, in a study of Mindfulness training and COPD (Mindfulness: A New Approach To Reduce COPD Hospitalizations Discovery’s Edge, Mayo Clinic’s Online Research Magazine, Volume 8, Issue 1 researchers found that the patient’s perception of their disease was the greatest predictor of frequency of hospitalizations. (70% of the medical costs associated with a COPD patient come from hospitalizations).


The majority of people that experience COPD also
have other chronic conditions too. Researchers aren’t sure
why, but for some reason COPD patients seem to have more
comorbid conditions than patients with other types of diseases.
In a recent study of over 1,500 people with COPD, researchers found
patients averaged having four other types of comorbid conditions whereas those that didn’t have COPD averaged less than two other
problems. This study confirmed that comorbidities are very
common in people with COPD. Some of these conditions
included heart disease, high cholesterol, high blood pressure,
diabetes, osteoporosis, arthritis, depression and cancer. These
comorbid conditions increase the likelihood of a COPD patient
being hospitalized and can also result in death (WebMD.
(2014a). COPD comorbid conditions: Heart disease, osteoporosis,
and more. Retrieved from

Older-Adults-Support-TeamCoaching And Coping

When we review the behavioral changes that facing the challenge of COPD requires we begin to realize what a huge potential role successful lifestyle improvement has. Wellness and health coaches have been finding effective ways to assist COPD patients in their quest for a healthier life with their illness. In a cooperative study with Duke and Ohio State Universities (Coping Techniques Help Patients With COPD Improve Mentally, Physically “147 COPD patients participated in coping skills training. Psychologists provided regularly scheduled phone sessions, offering patients and their caregivers general information about COPD, step-by-step instructions in relaxation techniques such as deep breathing, tensing and releasing muscles, and ways to manage their reactions to stressful events.
Another group of 151 patients also received regular phone consultations, but only on topics such as medication and nutrition. They did not receive specific coping techniques. Participants who received training in coping skills reported improvements in their overall mental health, and lessened depression, anxiety, fatigue and shortness of breath when compared to the other group, according to the study’s findings.
Although there were no improvements in COPD-related hospitalizations or deaths, the study suggests that the low-cost approach could enhance quality of life, reduce distress and somatic symptoms, and improve physical functioning for patients, according to the researchers.” While not coaching per se, this combination of instruction and a very coach-like relationship with the psychologists who provided the phone sessions, proved the value of lifestyle improvement in increasing quality of life for COPD patients.

At the Mayo Clinic, researcher Roberto Benzo, M.D. is using Mindfulness Training (as mentioned and referenced earlier in this article) and a coach approach to not only increase client self-efficacy (and the key factor of their perception of their illness), but has shown outstanding results in reducing the number of days his subjects have needed to stay in the hospital when they are hospitalized, and reduced the overall number of needed hospitalizations.

“Patients in Dr. Benzo’s clinical trials undergo an active eight-week rehabilitation program. A wellness coach uses motivational interviewing, a style of communication, to identify an appropriate exercise and develop an individualized plan. Participants are also trained to become aware of their body sensations and motions as they exercise. Active coaching is followed by monthly calls to keep them motivated.
“Daily practice is the core of the rehabilitation,” Dr. Benzo says. “This means carving out a special time to be present with what is going on with their body and coming to terms with their life as it is.” ( As is found in most work with chronic illnesses, a combination of education and coaching was successful.

Dr. David Hinton Thom at the University of California, San Francisco is currently conducting a two-million dollar grant-funded study to bring the coach approach to patients in underserved communities who are challenged by COPD. “The most comprehensive disease self-management programs, i.e., “pulmonary rehabilitation,” are generally not available to patients who are seen at community clinics. While self-management educational programs are more generally available, they are not often accessed by patients and do not provide personalized, sustained support. Health coaching by trained medical assistants or health workers has emerged as an effective model to provide individualized, patient-centered information, decision and self-management support, and coordination of care to improve outcomes for patients with chronic conditions. Health coaching provides patient support and reinforcement for self-management skills and activities, strategic approaches to effect behavior change, and a platform to improve comprehensiveness and quality of care. For the management of COPD, health coaches, for example, could assist patients with getting vaccinations, prescriptions, engaging in a graded exercise program, responding to exacerbations of their COPD, learning correct inhaler technique, and coordinating care between the patient’s primary and specialty providers.” (Health Coaching to Reduce Disparities for Patients with Chronic Obstructive Pulmonary Disease Here we see how the role of a coach can become incredibly practical and strategic, assisting patients/clients with their medical self-care and self-advocacy.

177859857Ways Coaches Can Assist With Lifestyle Modification For COPD:

• Smoking cessation
• Securing and attending a Pulmonary Rehab Program
• Securing education about proper breathing techniques from doctor, respiratory therapist or nurse to help reduce shortness of breath, and then tracking and accountability through coaching to ensure consistent practice
• Securing education about different cough techniques and breathing positions that are more effective.
• Explore various stress management tools and relaxation techniques, learning and practicing with coaching accountability.
• Tracking the intake of water (at least 8 glasses/day), to help hydrate secretions to be able to clear them from the airway.
• Tracking, follow through and accountability re: exercising regularly to improve overall strength and cardiovascular reserve. Client should speak first with their health care provider for specific instructions.
• Assisting client with nutritional/eating goals such as:
o Eat smaller meals more frequently to diminish shortness of breath.
o Eat healthy foods and maintain a normal weight.
• Securing support for their lifestyle improvement through family, friends, workplace, and others. Coaching for connectedness.
• Securing more support through group wellness coaching and finding a greater sense of community amongst others challenged with the same illness.

The Power Of An Ally In Lifestyle Improvement

Beyond all of the concrete behavioral steps involved in lifestyle improvement nothing exceeds the importance of having a solid coaching alliance between patient, now client, and coach. Having an ally through the behavioral change process is a boost to the motivation of the client and can help them to feel that a better life is possible.

Coaches also need to be aware that clients could experience more irrational feelings and “Gremlin talk” when short of breath and oxygen level are low. Decreased oxygen levels can cause people to feel fatigued and confused, which can have a direct effect on self-efficacy. When this is suspected, once again, a referral back to the client’s treatment team is in order.

Coaches can help their clients to process the grief they feel around their loss of health. This could be directly related to diminished feelings of self-efficacy and increased helplessness. (See “Astonishing Non-compliance” in Wellness Coaching For Lasting Lifestyle Change, 2nd Ed. by the author.)

Facing the challenge of COPD while seeking one’s best life possible means integrating a well-coordinated treatment plan with a wellness plan focused on lasting lifestyle change. Taking the journey to one’s best health may best be done with an ally walking side-by-side with us all the way.

Posted in coaching, health coaching, wellness, wellness coaching | Tagged , , , , , , , , , , , , , , ,