Research Paper By Maria Ermioni Papastefanou
(Health and Wellness Coach, GREECE)
This article aims to discuss:
a. the meaning of health and wellness and health and wellness coaching
b. stress and coaching
c. a body-mind coaching model to achieve health/wellness related goals
d. the applications of health and wellness coaching
We are living in an era where modern medicine has started looking closer into the Body-Mind connection. It is now known that our intellectual and emotional state affect our physical state and our physical state affects how we think and feel. (Dr N. Kostopoulos, MD, “Ayurvedic Approach to Psychosomatic conditions”).
People dealing with health-related issues start to realize that they cannot rely on their cure only on medical care. In order to improve their health people need to change; change their lifestyle habits, their harmful thoughts, their negative feelings. Although change may be decided instantly it is an ongoing process of transformation. This is the time when coaching can be an empowering life choice and accountability system to personal effectiveness in meeting health related goals and intentions.
B. Coaching For Health And Wellness
I. Definition Of Health And Wellness
According to World Health Organization, health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.
Wikipedia defines wellness as a healthy balance of the mind, body and spirit that results in an overall feeling of well-being. The term has been defined by the Wisconsin-based National Wellness Institute as an active process of becoming aware of and making choices toward a more successful existence. Wellness is a view of health that emphasizes the state of the entire being and its ongoing development. The phrase can be seen as an analogue to the medical term “homeostasis“. Wellness can also be described as “the constant, conscious pursuit of living life to its fullest potential.” (Wikipedia)
The above clearly showcases that our choices and behaviors affect our health and we have the power and responsibility to change them. This principle is exhibited more clearly in the below pie chart, as provided by the American Holistic Health Association:
Factors Defining The Level of Health And Well-being
Understanding that over fifty per cent of the quality of our health depends on our choices can be an empowering realization of what we can do to attain the optimum degree of health and set health-related goals.
II. Definition and Benefits of Health and Wellness Coaching
Since the early 1990’s, coaching has been gaining recognition as a profession that facilitates performance (Downey, 1990). International Coach Federation defines coaching as partnering with clients in a thought-provoking and creative process that inspires them to maximize their personal and professional potential. The business world has been applying coaching extensively in the workplace to improve performance and produce results. Applying this knowledge and approach on the health sector, improved performance and results on individuals facing health issues can be expected. Health coaching focuses on facilitating the promotion of healthy behaviors and to help individuals achieve their health-related goals and enhance their well-being (S.Palmer, International Journal of health promotion and education). A minor difference can be discerned among health and wellness coaching. Whilst health coaching deals mainly with specific health issues (e.g. hypertension), wellness coaching is about attaining wellness goals, such as engaging in physical exercise, loosing weight, managing stress, cessation of smoking.
Through health and wellness coaching one can develop ownership and responsibility, self awareness, improve skills and behaviors, increase self-efficacy, identify solutions to specific health-related issues, take action and generate the desired results.
III. Stress Management
A basic component of self-care and well-being is the effective management of stress. As 60-90% of healthcare visits are related to mind-body stress induced conditions (Harvard Medical School), it is worth examining stress further and discuss structures to manage it effectively.
a. What Is Stress?
Stress is defined as the perception of a physical or psychological threat and the perception that the individual’s responses are inadequate to cope with that threat. Threats include major life events, trauma, and abuse, environmental signals, or physical and emotional stress.
When the brain perceives the threat, it triggers a cascade of events the result of which is called the stress response or fight or flight response. Some of the physical results are a heightened arousal state, alertness, and focused attention. The stress response is integral to the life of every living organism, evolved as an adaptive mechanism to preserve stability or homeostasis. (“Body Mind Medicine”, Harvard Medical School). Therefore, some stress can be beneficial at times (eustress), producing a boost that provides the drive and energy to help people get through demanding and challenging situations. However, an extreme amount of stress (distress) and the prolonged time of adapting to change can lead to pathological consequences, related to hyperarousal, gastrointestinal, hormonal, musculosketelal, inflammatory, cardiovascular and respiratory disorders. Other common symptoms of stress are headaches, sleeping disorders, lack of energy and concentration, irritability, depression, nervousness and inability to take decisions. When discussing stress and stress management we refer to distress.
b. Types Of Stress And Coaching
Identifying the various types of stress, can help to choose the most suitable coaching approach or refer patients/clients to a health care expert for treatment.
The American Psychological Association has defined three types of stress: acute, episodic acute and chronic.
Acute stress is the most common form of stress and it comes from demands and pressures of the recent past and anticipated demands and pressures of the near future. Episodic acute stress comes from ceaseless worry and pessimism. Chronic stress comes when a person never sees a way out of a miserable situation. It’s the stress of unrelenting demands and pressures for seemingly interminable periods of time.
Dr Karl Albrecht, (author of the book “Stress and the Manager”, 1979), identified another four types of stress, frequently encountered in the modern environment of organizations:
- Time related stress (fear of failure to achieve something important),
- anticipatory stress ( it concerns the future and it can be focused on a specific event, or be vague and undefined), situational stress (it is experienced when there is a scary situation that we have no control over),
- encounter stress (it revolves around people and it is about worrying when interacting with a certain person or group of people. It can also occur in the case where a lot of personal interactions with people that are in distress).
Through coaching all the above types of stress can be addressed; one can learn to balance urgent and important tasks, making sure that there is enough time spent on the important priorities that are the ones related to life’s meaningful objectives. Positive visualization techniques help to imagine the situation going right. Mindfulness and meditation are other techniques that help develop focus and the ability to concentrate on what’s happening right now, rather than on an imagined future. Preparing and making contingency plans can give a greater control of the situation. Increasing self-awareness by recognizing the “automatic” physical and emotional signals that the body sends out when it is under pressure is essential that one understands both the physical and emotional symptoms of stress, so that one can manage them appropriately. Self care (taking short breaks to recharge), learning to communicate effectively, recognizing emotions and needs of self and others, and exercising empathy, are all valuable skills for coping with stress.
Stressful times are inevitable but living in stress is optional.
Stress management coaching, self care and the adoption of a healthy lifestyle in the way that is described in the following section, are essential approaches to cope with stress.
IV. A Body-Mind Coaching Model for Health and Wellness
Based on the principles of coaching, body-mind medicine and holistic health, an approach to coping with health and wellness issues is outlined in this model, using the following six steps.
The first step is to create awareness and recognize the signs that the Self sends through various channels (physical, mental, emotional) when one of the self aspects is out of balance. When there is an imbalance at the physical level, attention needs to be paid on the signals that the body sends to recognize what makes it feel good and what hurts. At the emotional level, one observes emotions to know which people or activities cause positive or negative feelings. At the mental level, one examines the thoughts that make one tighten up or relax. Coaching can help become aware of behaviors that lead to such imbalance and focus on what needs to be changed. Active listening, powerful questioning and feedback without judgment can promote awareness.
Implementation of a Healthy Life-Style
According to the American Holistic Health Association and Harvard Medical School, a healthy life- style concerns all aspects of self and it means taking care of it at all levels.
- balanced diet according to the needs of the individual
- physical exercise
- recuperative sleep
- being able to recognize and handle emotions
- share feelings
- play/have fun
- create warm, loving relationships
- develop positive thinking and positive attitudes
- examine limiting beliefs and replace them with empowering ones
- communicate effectively
- spend quiet time with self to connect with inner self and wisdom/nature/Higher Power
- exercise mindfulness
- unleash creativity
- exercise gratitude
During a coaching session, the areas that need focus and development can be identified and create structures to strengthen them.
Through value elicitation a coach can assist in the identification of the reasons one wants to change. Values are what we move toward or away from and they provide a motivation for our actions. Values are those things/or notions, that we are willing to expend resources for, or to obtain resources to have and they govern all human behavior. Values are mainly unconscious and they drive a person’s true purpose in life. (Tad James & Wyatt Woodsmall, Timeline Therapy and the Basis of Personality). Once the values and purpose are identified, decisions can be made accordingly so that the individual is aligned with who she/he is. A coach can support, encourage, hold them accountable and acknowledge the individual for the new decisions that lead to the desired life-style changes. Once the individuals find their reasons for wanting to change, they can get excited about what will happen if they do change their habits and behaviors to achieve wellness.
4. Goal Setting
An important step in the process is the setting of S.M.A.R.T. goals that will be based on the identified values. S stands for specific, M for measurable and meaningful, A for achievable and as if now (act as if), R for realistic and responsible (ecological), and T for timed and toward the desired outcome. Health-related goals are always tailor -made as wellness varies according to the life-style and conditions of each individual.
5. Taking Action
Once the goal is determined, the next step is to decide what changes need to be made to achieve them, (for instance practicing a beneficial activity more often, replacing an unhealthy habit with a healthy one). Any goal, no matter how big or difficult it may seem, can be broken down to smaller goals and milestones. Creating and maintaining well-being is an ongoing process and doesn’t happen overnight. It is all about taking the first step and celebrating small achievements to create momentum and reinforce the willingness to move forward.
Measuring performance daily or weekly, allows to be aware of where one stands in regards to one’s desired outcome. During the evaluation status of goals can be reviewed, barriers will be addressed and strategies revised if necessary. Identifying and acknowledging what worked is another useful part of the process as it encourages the commitment by seeing the results of a behavior that has been changed consciously.
V. Applications Of Health and Wellness Coaching
People at all stages of health can benefit from health and wellness coaching – from those who want help maintaining health and a state of well-being, to those who are at risk of developing, or already have chronic conditions.
Patients in hospitals and clinics, medical practice groups, patients of health-care practitioners, can learn that they are active participants in treatment and they learn to develop new behaviors required to achieve their health-related goals.
Wellness coaching benefits corporations/organizations because healthier, happier employees are more loyal and more productive. When individuals are most willing to make a change, they increase their success rates.
Universities could benefit from wellness coaching programs to ensure that the professional leaders that are being prepared to work in any field, learn how to be in charge of their health and well-being in order to be effective in their professional life.
It is everybody’s birthright to be healthy and happy. A state of well-being constitutes the solid foundation of a meaningful, happy and successful life. When one starts examining its wellness status at all levels (physical, mental, emotional, spiritual), one can identify the areas of one’s life that need to change or improve in order to feel fulfilled.On such a healthy foundation other goals can be built upon and flourish.