Health Coaching In Primary Care

For those embarking on a journey in health coaching, an enlightening perspective arises from Dr. Marcia Reynolds’ seminal work, "Coach the Person, Not the Problem." Reynolds elucidates a philosophy of coaching the being, rather than just the doing, focusing on the individual's essence instead of solely addressing superficial issues. This approach, grounded in peer-reviewed research, might be the missing piece of the puzzle for aspiring and current health coaches seeking to deepen their impact and improve client outcomes. In this article, we delve into the idea of coaching the person, not the problem or what is sometimes called “coaching the being, not the doing.” and the need for health coaching to embrace this concept.

The Philosophy of Coaching the Being
 

Marcia Reynolds propounds a shift from problem-centric coaching to a more holistic approach, where the coach engages with the client or patient's core being. This approach cultivates a space where individuals can reflect on their thoughts, behaviors, and emotions, fostering self-awareness and facilitating transformative changes. This isn’t about ‘fixing’ problems; it’s about harnessing the potential within, unlocking new possibilities and choices.

So what does this really mean?

When health coaches are trained there is often great emphasis on the skills of strategizing, planning, and creating SMART goals with the patient or client. While this is not surprising, given health coaching is heavily influenced by healthcare practices and healthcare’s inevitable focus on “care plans” (as it should be). I believe, however, health coaching is different. When the focus is creating “SMART goals”, it can lead coaches to coach around the problem and not the person or coach the doing not the being. Moreover, “SMART” goals and goal setting may not be the most effective strategy for our clients and patients.

An Example

A client of mine was frustrated with himself because he kept procrastinating on a task. He is a prolific baseball card collector and salesperson. As he sells very high profile baseball cards worth quite a bit of money, he often gets offers he would not ever consider. When he gets these offers, he often procrastinates on responding and so it relentlessly remains on his to-do list and never gets crossed off. If I were to coach the doing or coach the problem, I would focus on trying to solve the problem of procrastination. And perhaps that problem would get solved by setting reminders or having an accountability partner to get the task done, but, more likely the problem would be temporarily solved but procrastination would win out eventually, again.

If I were to coach the person or coach the being the conversation would look very different. And it did. As I coached the person and not the problem, we discovered the real reason why he was procrastinating and it wasn’t because he is just simply bad with time management. He discovered that when he declines a low offer he feels worried people are going to see him as not flexible, tough, and “all about the money” and not about the love of baseball. He also indicated that he was worried he would get called out on reddit for not being reasonable in his selling price. Yet, he knows what the cards are worth and is very confident in his pricing strategy and knows what he needs to make on each card to make it worth the effort of trying to sell them.

We discovered that this worry as being seen as unreasonable led to feelings of shame. The shame led to just simply not responding to offers. He indicated that the low offers “made him second guess himself”. He said he would wonder whether he was as smart as he thought he was about baseball cards and the prices to sell them at. We would have never gotten to this point if I would have focused on coaching the problem: procrastination.

While this is an anecdote, the science generally backs up the effectiveness of coaching the person, not the problem. Don’t get me wrong. There are definitely times and specific situations where coaching the problem can be very useful and effective, but if we rely on this as the main strategy as health coaches, we may have missed the whole point. Coaching is the act of addressing thoughts, feelings and behaviors (within scope of practice), this often shows up as limiting beliefs, assumptions, and helping clients or patients to shift their perspective and question these beliefs and assumptions. That is the true essence and is more effective.

Why Coaching the Being is More Effective

1. Fosters Self-Awareness.
   Research indicates that coaching the being promotes heightened self-awareness, allowing individuals to delve into their intrinsic motivations, beliefs, and values. This exploration fosters a deeper understanding, enabling sustainable behavior change and enhancing wellbeing.
2. Empowers the Individual.
   Instead of prescribing solutions, coaching the being empowers individuals to discover their solutions. This empowerment elevates confidence and enhances self-efficacy, essential elements in sustaining health-related behavioral modifications.
3. Cultivates Resilience.
   By addressing the individual's essence, this approach fortifies resilience, allowing clients to navigate challenges with more ease and adapt to adversities, a crucial component in maintaining long-term health and wellbeing.

Making it Engaging and Transformative

The holistic approach to coaching the being requires a symphony of empathy, active listening, presence, and insightful questioning. It’s about making each coaching session a dynamic dance of discovery, where every step, every move is a path to unraveling the threads of one’s being. It’s not just a professional interaction; it’s a human connection, a journey of mutual growth and understanding. And this journey is peppered with joy, revelations, and sometimes, challenges, making it a truly enriching experience for both coach and client or patient.

Benefits for Aspiring Health Coaches

For aspiring health coaches, embracing this approach is a pathway to becoming architects of transformation. It provides a framework to facilitate profound, lasting change, ensuring that the impact of coaching extends beyond superficial layers, reaching the core of the individual. By fostering an environment of exploration and empowerment, aspiring coaches can truly be the catalysts of holistic wellbeing, positioning themselves as experts in the realm of the health coaching process and behavior change.

Conclusion

As we delve deeper into the essence of coaching the being, we find that it’s not just about solving problems; it’s about uncovering potentials. It’s about fostering an environment where each interaction is a step towards self-discovery and holistic wellbeing. Health coaching will move into healthcare and my fear is that we will continue to perpetuate coaching the problem and not the person, coaching the doing and not the being and as a result our impact will be limited. Health coaching has a chance to change “care plans" and “to do” lists into “to be” lists. My hope is that health coaching embraces this journey, let’s dance the dance of transformation, and let’s be the harbingers of a holistic, enriched, and fulfilled existence.