Abstract
This narrative focuses on a health coach collaborating with a physical therapist and working with the emotional needs of physical therapy patients, but anyone looking to improve health can use the strategies presented. Integrative health coaching incorporates vision and values into a person's goal-setting process. Health coaches provide resources such as journal writing to assist the healing journeys of patients as well as strategies for healthy people who want to make wellness behavior changes.
TopBackground Of Integrative Health Coaching
Integrative health coaches (IHCs), such as the ones trained at Duke University Integrative Medicine where Jen received her training, focus on an eclectic approach to healing. The Wheel of Health from Duke Integrative Medicine (2010) encourages patients to reflect on multiple dimensions of health including movement, exercise and rest; nutrition; personal and professional development, physical environment; relationships and communication; spirituality; mind-body connection; and mindful awareness (p. 5). This makes health become a comprehensive plan that focuses on the person, not just the disease.
Health coaching and conversations about the responses to both written and numerical subjective questions help patients illuminate the health stories they tell themselves. Health coaching builds a bridge between helping patients decode complex medical terms and comprehending their treatment plan. When patients feel that their medical practitioners and health coaches earn the right to hear their stories, the sharing of narratives leads to healing conversations. Health coaches are not psychologists; if a patient wants to share a painful story about the past, the health coach will make a referral to a psychologist. Instead, health coaches help patients maintain forward momentum for achieving their goals by providing encouragement, suggestions for completing a prescribed treatment plan, translation of potentially confusing medical terms, and a supportive person to listen.
Since health coaching is a new field in medicine, there is not a large amount of previous studies to share. Simmons and Wolever (2011) report, “broadly defined, health coaching is a method of working with patients that utilizes thoughtful inquiry, accountability, goal clarification, goal setting, identification of obstacles, use of support systems, and connection to intrinsic motivation, vision, and values to improve health through positive behavior change” (p. 1). Simmons and Wolever summarize the existing research and elaborate,
Despite the infancy of the research, several studies have demonstrated that coaching does improve health outcomes. The strongest findings have been in cardiovascular health, where coaching has been shown to improve total cholesterol, body mass index, stress, exercise, diet, and smoking cessation. Studies of cancer patients have demonstrated decreased pain severity and increased pain control. Studies of coaching for patients with diabetes and related kidney disease have shown increases in health promoting behaviors like physical activity and diet, as well as decreases in fasting blood glucose, hemoglobin A1C, hospital admission rates, and amputations. A coaching intervention also improved outcomes in obese patients (BMIs >30), including decreased waist circumferences and increased functional health status. (p. 1).
Heath coaches inspire patients to become educated about a diagnosis and treatment plan as well as collaborate with the medical experts who want to help with the healing process.
Key Terms in this Chapter
Integrative Medicine: A holistic approach to medicine that treats the whole person, not just the disease.
Self-Compassion: The act of demonstrating the same kindness for oneself that one would demonstrate for other people.
Community Development: The process of creating a place where people feel welcomed and supported, whether it is a neighborhood, a classroom, or a network of colleagues who provide support for an individual.
Integrative Health Coaching: Integrative health coaches help people make changes that support their vision and values of optimal health.
Physical Therapy Outcome Measures: Tests used by physical therapists to measure the progress a patient makes when a body part is injured, such as such as the DASH (Disabilities of the Arm Shoulder Hand), LEFS (Lower Extremity Functional Scale), NDI (Neck Disability Index), and Modified Oswestry (for back pain).
Behavior Changes: Behavior changes occur when people put forth a conscious effort to make lifestyle changes to improve health. While health coaches can encourage behavior changes, ultimately the choice of which behavior changes to implement belongs to each individual.
Narrative Medicine: The field of medicine, used by programs such as the one Rita Charon founded at Columbia University, which encourages medical practitioners to use theories from the fields of literature and composition to enhance comprehension of the stories patients share.