A health or wellness coach integrated into a personal healthcare team can be critical to catalyzing sustainable change. Many people understand they need to modify their self-care, yet fail to take the optimal steps to make such a transformation happen.

“What we’ve discovered is that people don’t routinely change behavior due to education alone or out of fear. They change through partnership,” explains Linda Smith, a physician’s assistant and director of professional and public programs at Duke Integrative Medicine, in Durham, North Carolina. Coaching partnerships supply a supportive bridge between provider recommendations and patient implementations, she says, “significantly increasing the client’s ability to make changes successfully.”

“Health coaching was absolutely essential to my health,” says Roberta Cutbill, a 72-year-old retired registered nurse in Greensboro, North Carolina, who considered her lifestyle relatively healthy when in her late 60s she experienced autoimmune and cardiac problems. “I have an excellent primary care doctor who, when these issues came up, told me that I needed to change my diet, thoughtfully downloaded a list of recommendations and sent me on my way. I still needed help with many things in order to make the changes,” recalls Cutbill, which is why she turned to a health coach at Duke Integrative Medicine.

Margaret Moore, founder and CEO of Wellcoaches Corporation and co-director of the Institute of Coaching at McLean Hospital, a Harvard Medical School affiliate, in Belmont, Massachusetts, identifies two primary forces that enable behavioral change: autonomous motivation (people want to do something for their own reasons, not because someone tells them to) and confidence (they believe they can do it). “The most powerful motivating forces of all are what you treasure most in life, your life purpose and contribution,” she remarks. Both Smith and Moore emphasize that the priorities in any health coaching relationship are client driven, based on the client’s chosen goals and personal intrinsic motivators.

Confidence in attaining ultimate success is built through positively framed experiments and experiences. “A health coach is trained to help clients break up their goals into manageable steps, focus on strengths, track progress and identify and overcome personal roadblocks,” explains Dr. Karen Lawson, an integrative physician and director of integrative health coaching at the University of Minnesota’s Center for Spirituality and Healing, in Minneapolis. A helpful approach sets goals that can be met and exceeded, not insurmountable ones.

“The key is always keeping a positive lens, helping clients see the progress they achieve,” continues Lawson. This involves speaking in terms of growth through trial and error, in which outcomes are explored without judgment and clients feel empowered to modify.

This is vital, explains Moore, because experiencing at least a three-to-one ratio of positive to negative emotions creates the conditions for the brain to learn, change and thrive, making people feel more capable of taking care of their health.

Mindful awareness is another essential tool; being self-aware and reflecting on what we are doing while it is happening. Unlike thinking, analyzing and planning, mindfulness involves observing while experiencing. During sessions, coaches use it to give their full attention in a non-judgmental way, modeling how clients can bring such compassion to themselves.

A mindful state calms mental noise and puts reflective distance between individuals and their beliefs, emotions and behaviors. It improves their ability to handle negative emotions and to make a conscious choice to respond with a different attitude or new behavior, according to Moore.

For Cutbill, maintaining a personal relationship with her coach over time has been the most significant factor in the improvement of her health. “The relationship was healing, because my coach regularly pointed out my progress with profound encouragement and validation. I wish all primary care doctors had health coaches on staff to help them and their patients attain the success they both are aiming for.”

Lauressa Nelson is an editor and contributing writer for Natural Awakenings. Connect at [email protected].