Narratives of Integrative Health Coaching

Narratives of Integrative Health Coaching

Jennifer Lynne Bird (Florida Atlantic University, USA) and Eric T. Wanner (Palm Beach Sports Medicine & Orthopaedic Center, USA)
DOI: 10.4018/978-1-4666-9494-1.ch008
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Abstract

Integrative health coaching incorporates vision and values into the goal setting process in order for change to occur. While health coaches frequently work with healthy people who want to make changes in their lives such as finding time to exercise or getting more sleep, this narrative focuses on the role of a health coach when working with physical therapy patients at a hospital. Health coaching, a new addition to the field of health education, provides a missing link in the healing journeys of patients.
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Background Of Integrative Health Coaching

Integrative health coaches (IHCs), such as the ones trained at Duke University Integrative Medicine where Jennifer receives 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 can help patients illuminate the health stories they tell themselves. Health coaching can also build a bridge between helping patients decode complex medical terms and comprehending their treatment plan. Brown (2007) describes the feelings many patients have and shares, “it doesn’t matter if it’s physical pain or emotional pain. When we can’t find the right words to explain our painful experiences to others, we often feel alone and scared” (p. 155). When patients feel that their medical practitioners and health coaches earn the right to hear their stories, the sharing of narratives can become 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.

Steele (2009) encourages medical teams “to develop the tools and systems needed for effective and consistent patient education and expectation setting” (p. 99). Such tools, according to Jones, Brady, and Gaunt (2009), include “a diary showing type of surgery and progress” (p. 100) and “homework sheets that contain exercises and assignments for patients outside scheduled PT sessions” (p. 100). Health coaching provides patient education for patients. Health coaches also serve as another member of the support team for both patients and clinicians. As Helldorfer and Moss (2007) explain, “one important component in the way many medical facilities measure success is by the degree of patient satisfaction. How patients feel about the care they are receiving starts with first impressions. Taking the time to look a patient in the eye, say hello, and ask them how they feel is an ongoing challenge when we are busy” (p. 275). Health coaches follow up with patients about how they are feeling and provide a continual assessment for clinicians of how important each patient feels about the treatment plan and his or her confidence in achieving it. If the treatment plan a clinician provides is not important to a patient, the patient will be less likely to want to accomplish it. It therefore becomes the job of the health coach to determine what the patient values and how the patient can align the treatment plan with his or her values to achieve improved healing gains. If the patient is not confident he or she can accomplish the treatment plan, the patient will also be less likely to comply with it. Once patients become non-compliant it is not possible for them to get satisfactory results. It therefore becomes the job of the health coach to provide a vision of past success for the patient to build momentum in order to achieve future success.

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,

Key Terms in this Chapter

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.

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.

Integrative Medicine: A holistic approach to medicine that treats the whole person, not just the disease.

Integrative Health Coaching: Integrative health coaches help people make changes that support their vision and values of optimal health. Duke University Integrative Medicine is one of the leaders in the field of integrative health coaching.

Writing Voice: Voice in writing highlights a writer’s word choice and tone to compose a journal entry or other written composition that reflects the writer’s personality. Every writer has a unique writing voice, just like each person has a unique speaking voice.

Planning Process: Used in the fields of city planning, curricular change, and health coaching, this process encompasses the following steps: survey, analysis, plan, implementation, and feedback.

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).

HRQOL (Health Related Quality of Life) Survey: A general health survey in the public domain and able to be used by researchers without securing permission or paying copyright fees.

Journal Writing: The process of a person responding to prompts and writing about his or her thoughts and feelings. Even though journal writing is typically associated with writing classrooms, writing teachers including Julia Cameron and Natalie Goldberg advocate that journal writing can be done by anyone, anywhere, including patients in a hospital.

Writing as Healing: James Pennebaker is considered to be the pioneer in this field that discusses the health benefits of writing. Numerous studies have been conducted investigating the influence of writing on physical and emotional health.

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