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 With Standards in the Works, Is it Time to Claim, and Certify, the Health Coach Within?  
 
The following is one in an ongoing series of columns entitled Integrator Blog by . View all columns in series
Summary: The concept of coaching patients toward healthy behavior is deeply embedded in many integrative disciplines and practices. The healthcoach.com website, for instance, was claimed at the dawn of the worldwide web by a naturopathic doctor. The use of a health coach as a distinctive practice, however, evolved separately and more recently in the employee health and manage care industries. Now federal health reform legislation has highlighted the potential in health coaching. Nursing and integrative medicine leaders associated with Harvard University, University of Minnesota and the The Institute for Integrative Health have begun a defining process toward setting national standards and certification. The official kick-off is a Health and Wellness Coaching Invitational Summit this month. Representatives of the chiropractic and naturopathic disciplines have been invited. In reductive political terms, health coaching is broadly shared turf. All integrative practice fields that claim to be health creating have skin in this game of figuring out what is, certifiably, a health coach.


Extra! Extra! Invitational Health and Wellness Coaching Summit in September 2010 to propose plan of action for national certification.

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Harvard's Institute of Coaching a key backer
This summit, sponsored by
Harvard University's Coaching in Medicine and Leadership program and the University of Minnesota Center for Spirituality and Healing, is exceedingly timely. Integrative medicine leaders had a lead role in shaping this working meeting. Any self-respecting integrative practitioner worth their value set would be served to pay attention to its evolution. The organizers view the Summit as a kick-off of a months-long process toward setting the national standard.

The proximal instigator would appear to be that the role of health and wellness coaching was elevated as a health-promoting and cost-saving practice during the nation's 2009-2010 health reform discussions. Health coaching is specifically mentioned, for instance, in the language establishing the National Prevention, Health Promotion and Public Health Council. Coaching was positioned as part of the solution. Helping people get healthy. Ending our reactivity. Worker bees of health transformation. And likely reimbursed for it, these new professionals.

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U Minnesota Center for Spirituality and Healing coach program
But what is a "health coach" exactly? And who can be one? And what do you have to do to become one? These are the kinds of questions with which the participants in the process that begins with this summit will be grappling.

Will coaching standards reflect integrative practice?

Many integrative practitioners may be thinking: Shoot, I do that. I am always counseling my patients, coaching my patients, toward health. Will the way they certify this coaching reflect the way I work with my patients? Will these coaches use or recommend the kinds of tools I use? Will I be able to get reimbursed for my coaching one day?

Or, alternatively: Might these new practitioners be good parts of my practice? If so, how much flexibility will I have with how they approach patients?

The idea of
health coaching goes to the heart of what attracted me to these integrative practice fields 27 years ago. A friend urged me to take my journalism and community organizing work sideways. Would I consider a job with a holistic healthcare field of naturopathic medicine? I knew little. I read what I could find and listened to learn more. The hook sunk when I repeatedly heard these practitioners express a philosophic commitment to helping patients lessen dependencies and give them tools and inner skills to reclaim their health.  

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Percival: ND was early developer of health coach concept
Nearly a decade later, in 1991,
Mark Percival, DC, ND indelibly inscribed health coaching in my mind as a way to describe this commitment to patient empowerment. Percival had and continues to have great passion for a program he developed and registered as Health Coach(R). When the web emerged a few short years later, he scooped up www.healthcoach.com as his program's internet platform.

Percival's program reflected my own bias that coaching a person to health is the heart of quality, transformational, integrative practice. The power is in the inside job of developing a relationship with the patient and working with him or her toward healthy choices.

The coach within

Over time I learned that the "coach within" is a guiding center for many integrative practitioners, whether chiropractic doctors, naturopathic physicians, acupuncturists, homeopaths, integrative medical doctors or massage therapists and yoga therapists, and certainly midwives.

Sure, there are
chiropractors who may do little more than provide an adjustment and acupuncturists some needling and naturopathic or integrative medical doctors for whom treatment is substantially in dispensing standardized botanical extracts and fractionated nutrients. 

Most, even of these procedure-oriented practitioners, will claim
that they also counsel or coach patients in life-style change. For others, enabling patients to make healthy changes is so deeply embedded in their daily interactions that it is less a modality than a way of being. In either form, health coaching, or something like it, is part of the integrative practitioner's stock in trade. Practices are built on positive outcomes. Patients are attracted to these qualities.

Emergence of a distinct profession

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Institute financially backs program
More recently, this internal concept for integrative practitioners has taken shape as a separate entity, externalized as a distinct type of professional. The website of a sponsor of the upcoming summit, The Institute for Integrative Health, led by University of Maryland integrative medicine director Brian Berman, MD, describes the history leading to the Summit this way:
"Over the last decade, professionals called 'health' or 'wellness coaches' have been providing a wide range of services, both independently and under the auspices of third-party payers and employee benefits companies. Among these professionals, there is great variability in the depth and content of training and skill, as well as in the services provided. Some have conventional health professional education, while others come from a general coaching background with minimal healthcare knowledge.

"In response to the need for and the variability of these services, leaders in integrative medicine began to collaborate with leaders in the field of health and wellness coaching, to define this new type of healthcare professional, focused on lifestyle change.
The result is the Integrative Health and Wellness Coaching Invitational Summit ... "
Should you pay attention?

The question for the various integrative practice fields is: Should we pay attention to the evolution of what we see as core value of our practices into a separate, certified, standardized field? 

At least two professional organizations have their own, related initiatives. The American Holistic Nurses Association (AHNA) engaged an effort to create integrative coaching certification for nurses. The American Chiropractic Association has a new initiative to deliver wellness certification with a coaching component.

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Lawson: Holistic/integrative medical leader a co-chair
Leaders of the AHNA initiative were part of the Summit's development. While planners did not originally include any practitioners from the distinctly licensed so-called "CAM" fields, they extended invites when such inclusion was suggested. A chiropractic leader with the ACA program will attend as will a naturopathic physician educator recommended by the chair of the Association of Accredited Naturopathic Medical Colleges.

Long-time integrative and holistic medicine leader
Karen Lawson, MD, co-chair of the summit and director of the health coaching track at the University of Minnesota Center for Spirituality and Health, is clear that this invitational gathering is the beginning of a process. There will be more steps and more times for input. A summary document will be produced for submission to Alternative Therapies in Health and Medicine. I was invited to attend and will be writing up a report in the Integrator.

Of course, the
ultimate summary document will be the national certification standard toward which the group is driving. This development should make the integrative practice fields sit up, take notice, reflect, and give input. Credit the sponsors for getting the process rolling.


Send your comments to johnweeks@theintegratorblog.com
for inclusion in a future Your Comments Forum.
      
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 About The Author
Resumes are useful in employment decisions. I provide this background so that you may understand what informs the work which you may employ in your own. I have been involved as an organizer-writer in the emerging fields......moreJohn Weeks
 
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