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Integrative Health Coaching
Personal, Practical Support

by Leila Finn

Wouldn’t it be great to have a member of your health-care team who listened to you, asked you what you want and need, and then helped you to get there? Someone who didn’t tell you what to do, but rather helped you figure out how to do it? That person is now entering the health-care arena: the integrative health coach.

Integrative health coaching was developed at Duke University’s Integrative Medicine Center to fill an important gap in the health-care system. Typically in today’s health-care system, a problem is diagnosed and a course of treatment is prescribed, but little is offered to help individuals succeed in the goals that are essential to both their treatment and their overall health. Integrative health coaches help bridge the gap that often exists between a doctor’s assessment and a patient’s desired outcomes. They can help you clarify your goals, highlighting your strengths and weaknesses, to help you develop a plan to achieve them. In a system geared toward treating disease, integrative health coaches strive to support the whole person.

The coach’s role
Take, for example, Susan. Susan has recently been diagnosed with Type 2 diabetes, and her doctor tells her to lose weight and eat less carbohydrate. She tells him that she is driving more for her new job and relying more on take-out meals. She has less time at home and is feeling really stressed. The doctor is sympathetic and understands that Susan is busy, so he refers her to a dietitian and an integrative health coach and asks her to come back in three months.

Susan’s doctor tells her what she needs to do: eat less carbohydrate and lose weight. Her dietitian may tell her what to eat or even how to make smart choices when eating out. But her integrative health coach helps Susan figure out how to make the changes she needs to make and helps her address the other concerns she expressed to her doctor, namely stress and her desire for more time at home. The health coach looks at the whole picture, asking questions that help Susan create a plan that meets her needs.

Integrative health coaching aims to bring about lifestyle changes by providing the support necessary to adopt healthier behaviors for the long term. In one study of health coaching and Type 2 diabetes, coaching was found to help reduce stress, increase exercise, and significantly reduce HbA1c levels (indicating improved blood glucose control). Duke’s health coaching model also emphasizes mindful awareness, or the practice of paying attention to the present moment. To change, a person needs to be aware of his values, needs, and what gets in the way of change. Meditation is often used to increase mindful awareness, and it can additionally help improve focus, strengthen the immune system, and reduce pain, stress, and even blood pressure level.

Managing goals
Let’s go back to Susan. Susan meets with her coach and identifies several areas she wants to address to meet her health goals. She wants to add some regular exercise, eat out less, and reduce stress in her life. With her coach, she breaks these down into SMART goals: goals that are specific, measurable, action-oriented, realistic, and time-based. For example, a specific goal for Susan is to eat out less. This goal is measurable; she can keep track of how many times she eats out each week. It is action-oriented because to accomplish this goal, Susan will pack a lunch three days a week, on the days she has to travel for work. This is realistic; Susan feels confident she can pack her lunch on these days. And Susan’s goal is time-based; she will start next week.

Often, goals are things a person doesn’t really want to do: “I can make healthy choices at the cafeteria, but I don’t really like the food there.” “My doctor says I should do strength training to increase my insulin sensitivity, but I don’t like the gym and I don’t know what to do with weights.” In these situations, a health coach can help you overcome your initial hesitance to act by showing that there are many ways to achieve your goals.

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