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 From Wellness Management, Spring/Summer 2008, the newsletter of The National Wellness Institute
Michael Arloski, Ph.D., PCC
Globally, according to the World Health Organization, non-communicable or "lifestyle" diseases account for nearly 60 percent of deaths. By 2020, this is projected to rise to 73 percent. The lifestyle behavior factor in such diseases is critical. It has become increasingly evident that sedentary lifestyles, poor diet (as a result of industrialized food manufacture, distribution and sales as is the case for convenience and fast foods), greater social isolation, and increasing stress, contribute to both the onset and the course of chronic diseases such as diabetes, heart disease, asthma, cancer, hypertension, and many others.
The Center for Disease Control and Prevention estimates that chronic illness consumes 82% of U.S. healthcare resources (CDC, 2004). A New England Journal of Medicine article estimates that people with chronic conditions receive only 56.1% the recommended care for their health challenges. The cost of medical non-compliance (which is entirely behavioral) is in the billions. (McGlynn, Asch, et. al., 2003). In summary, the cost of chronic disease combined with the cost of medical non-compliance for these diseases is staggering. What is to be done?
Health educators, nurses, corporate wellness programmers and others involved in the wellness field over the past thirty years have long pointed to the consummate sensibility of prevention. Entire programs were built around the reduction of health risks and the prevention of illness. Now we see undeniable evidence that helping people change behaviors and reduce health risks, is an essential part of any wise treatment program for most, if not all chronic medical conditions (American College of Lifestyle Medicine).
As professionals in the wellness field, we now face the two-fold
challenge of promoting prevention while also being part of the
treatment solution. The people we serve span the entire continuum from
those with severe health challenges to all who aspire for peak
performance, and living joyful, meaningful and satisfying lives. In
short, as we zero in on the behavioral nature of health, it is
increasingly apparent that wellness professionals, are uniquely
qualified to help. So what is the best way to help people change?
We have learned what does not work. The old models of prescribe and
treat and educate and implore have caused a real lack of faith in
behavioral medicine because they simply dont result in behavioral
change often enough or in ways that last. Just telling people what to
do, even very authoritatively, or giving them great information and
begging them to change, wont get the job done.
As James Prochaska said, Change is a process, not an event.
(Prochaska, et. al., 1994). Essentially, those seeking to effect
lifestyle change, do not need a lecture and a curfew to get them home
safely, they need guidance and support through the entire process of
change. This suggests a need for a paradigm shift in the way we do
things. Fortunately, such a shift has already been quietly taking place
for the past several years.
We have recently seen the development of health and wellness coaching
strategies for addressing the lifestyle behaviors that impact
healthcare costs and public health. Making widespread use of health and
wellness coaches, disease management companies have become a growing
part of the healthcare industry that seeks to implement some of these
new strategies. Employee Assistance Programs (EAPs) are beginning to
include health and wellness coaching in their services. Self-insured
companies are exploring these same strategies to improve the health of
their populations and thus contain rising healthcare costs.
Increasingly, wellness professionals in hospitals and corporate
wellness programs are being asked to work with clients one-on-one,
using a coach approach to increase the probability of real success.Health coaches can
vary substantially in their methods and in their training backgrounds.
They range from highly qualified masters degree-level counselors, ICF
certified coaches, and registered nurses, all the way to less educated
phone bank employees. Their contacts with clients range from 30-50
minute unlimited coaching sessions to quarterly ten-minute check-in
appointments that mostly focus on encouraging good medical compliance.
Some coaches work with health risk assessment feedback and some are
there merely to provide information about wellness program and
insurance program benefits.
Clients with a health challenge have historically received a lifestyle
prescription from a healthcare provider. They are often told to be
less sedentary, manage stress better, get more sleep, improve their
nutrition, etc. But these prescriptions often go unfilled. The truth
is that if the client is directed to a well-trained wellness coach, the
prescription for lifestyle change has a much better change of being
successfully filled.
The wellness coach can guide the client through processes to 1) assess
their current level of wellness; 2) envision and determine areas of
focus to work on; 3) factor in key elements such as readiness for
change; 4) identify measurable outcomes; 5) determine a course of
commitment and connect with motivation; 6) determine challenges in the
way of success; 7) develop strategies to overcome those challenges; 8)
identify and recruit sources of support for the journey; and 9) secure
accountability methods to ensure success. The value that wellness
coaching contributes to the field of lifestyle medicine should be
increasingly apparent as we implement such models and study them
further.
An important rule of thumb to follow when seeking wellness coach
training is to focus specifically on lifestyle behavioral change
instead of generalist training. Programs that integrate the best of
the art and science of health promotion with the skills and
methodologies of life coaching provide a strong foundation for the
developing wellness coach. A number of good coach training programs
will be featured at the National Wellness Conference this summer.
Michael Arloski, Ph.D., PCC, is the author of Wellness Coaching For
Lasting Lifestyle Change. He is CEO of Real Balance Global Wellness
Services (www.realbalance.com <http://www.realbalance.com> ), and
this summer will be presenting a two-day pre-conference certificate
training program, Wellness Mapping 360 Wellness Coach Training, at The
National Wellness Conference, July 12-13, 2008.
American College of Lifestyle Medicine. Lifestyle Interventions In The
Treatment Of Selected Diseases Summary By Disease.
http://www.lifestylemedicine.org/resources/LMabstracts.pdf
Arloski, M. (2007) Wellness Coaching For Lasting Lifestyle Change. Duluth, MN: Whole Persons Associates.
Prochaska, J., Norcross, J, & Diclemente, C. (1994) Changing For
Good. New York, NY: Harper Collins/Quill. 1994 Harper Collins, 2002
Quill reprint.
Center for Disease Control; The George Washington University, National
Health Policy Forum Medicares Chronic Care Improvement Pilot Program:
What is its Potential? NHPF Brief No. 797 May 10, 2004.
McGlynn, Asch et al. The Quality of Health Care Delivered to Adults in the US , NEJM 2003; 348:2635-48
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