About Health Coaching
Overview
There is a growing recognition that simply educating patients is not effective in bringing about long-term behaviour change. This creates frustration for patients, health practitioners and health organisations.
Health coaching is an evidence-based model for health behavior change. It provides structured guidance for health professionals to help patients to adhere to medical and health recommendations and to make health enhancing lifestyle changes. Health coaching is typically conducted in the context of health behavior change for disease prevention and/or chronic condition self-management within public and private health services.
Health coaching integrates a diverse range of health behavior change techniques in a manner that makes efficient use of time in health consultations. It keeps the consultation focus on what patients can actively do to improve their health and promotes patient responsibility for their own health management.
Health coaching is typically conducted as part of usual professional practice for health professionals. Health coaching health professionals combine their usual assessment, recommendations and patient education with health behavior change assistance so that patients are better able to adhere to health recommendations.
Health coaching is suitable for use by interdisciplinary teams of health professionals within chronic disease prevention, early intervention, rehabilitation and other chronic condition self-management programs. The model can also be used within other contexts such as disability services, aged care, general practice and the provision of private practice allied health services.
Health coaching can be used as a stand-alone health behavior change intervention. There is a growing tendency for chronic disease management programs within health organisations to include dedicated health coaching or case management /coordination sessions delivered by health coaching trained Key Workers, Case Managers or Health Coaches. Consultations are generally face-to-face or telephone based (e.g., The Good Life Club, Kelly, Menzies & Taylor, 2003).
Health Coaching interventions help health professionals to motivate patients toward readiness to change, assist them to change unhelpful thinking patterns, promote behaviour change and empower patients to achieve self-regulation and self-management of lifestyle risk factors and treatment regimes associated with chronic illnesses.
The Nature of the Health Coaching Model
The HCA health coaching model was designed to meet WHO (2003) recommendations for addressing adherence to long term (health) therapies. Health coaching acknowledges the difficulties inherent in making lifestyle changes for all human beings.
The health coaching model is based on a readiness to change framework. The health coaching processes explicitly identify and target individual barriers to changing behaviours at a particular point in time, for a particular person, given his or her unique life circumstances. These barriers are behavioural, emotional, situational and cognitive in nature. They include habitual behaviours, emotional reactions to behaviour change attempts, physical and social environmental factors, beliefs, attitudes, expectiations and everyday thinking patterns that undermine health enhancing behaviour change intentions) . The model guides health professionals regarding which behavior change intervention/s to match to the patient’s state of readiness, importance and confidence in making particular changes. Readiness is viewed as being in a constant state of flux, depending upon the patient's perceptions of barriers and facilitators for change.
The communication style and techniques used in health coaching interventions incorporate elements of motivational interviewing and solution-focused coaching. These are combined with crucial cognitive change techniques to enhance the effectiveness of motivational interviewing and solution-focused interventions.
Using the HCA Model in Practice
Many organisations in Australia are combining health coaching techniques with other chronic disease prevention and self-management (CCPSM) models such as the Flinders and Stanford models. These models are complementary and the use of multiple models can enhance intervention effectiveness.
There are a number of options available for integrating the HCA Model and intervention framework into clinical practice. These are:
- Use the entire framework as a stand alone intervention for health behaviour change for CCPSM;
- Use the framework in conjunction with other models of CCPSM such as the Stanford group education model (Lorig et al, 1999), or the Flinders model for CCSM (Battersby at al, 2003).
- Use of single components of the model within short consultations (e.g., use of a cognitive change intervention technique to address cognitive barriers to carrying out an action plan, or use of MI techniques to encourage a client to seek assistance regarding a psychosocial problem acting as a barrier to self-management).
The HCA training, structural framework and tools provide health practitioners with micro skills that may augment the effectiveness of other CCPSM interventions. Feedback from organisations that use a combination of models suggests that this is the case.
Client Experience of Receiving Health Coaching
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