By Liv Brown and Bee Pennington
As behaviour change experts, health and wellness coaches deeply understand that the secret of healthy living lies not in knowing, but in doing. It is about how ready and willing our clients are to explore their current habits, lean into change and pick themselves up and go again.
But the seeds of change can only start to bloom once a minimum level of readiness is achieved - usually clients who proactively seek out support from a health and wellness coach would at least be at the contemplation (“I may”) stage of change. Contemplators still need to find reasons for change that are strong. Even clients in preparation, action and maintenance phase need to keep their unique motivators in clear line of sight.
Lets run through some of the drivers of motivation that we see in our clinic at Melbourne Functional Medicine:
Chronic symptoms that are getting unbearable
Symptoms that are stopping them doing the things they love
Feeling guilty because their health is holding them back from being the employee, parent, son, daughter or friend they want to be
Knowing there's more to health than simply not being sick and wanting to do something about it
Feeling stuck because they don’t feel optimum but their labs from the GP are in the normal range
We are also seeing more and more clients who are wanting to harness the mountain of health data becoming available as barriers to access these advanced tests start to vanish.
“Health data is proving to be both a motivator to initiate change as well as sustain change.”
For example, Continuous Glucose Monitors are now for health optimisers, not just diabetics. Your DNA can be sequenced with a cheek swab via a mail order test kit, private labs are popping up offering our clients ways to test their microbiome, blood biomarkers and urine metabolites, and every second person has a ring, band or watch meticulously tracking their heart rate, heart rate variability, oxygen levels and sleep quality.
So. Much. Data.
Staying within scope
As health and wellness coaches, how do we harness this new world order to enhance coaching outcomes, yet stay within our scope of practice?
Firstly, it’s important to discuss the obvious; health coaches should never be interpreting any health data they are not additionally qualified for. In the case where a coach happens to have an additional qualification that warrants being able to read and interpret certain test reports, it is important to first seek approval from the client that they’re happy for you to interpret results and expressly let the client know the moment you’ll be changing hats and go from coach to advisor (expert).
Back to the words of HCANZA board members Sharon Curtain and Melanie White the role of a coach is “Implementation not information”.
In saying that, the motivating power of health information is something all coaches can harness.
How can health data be used to elevate motivation?
Health data can be used to intersect with the true essence (and the best part in our opinion!) of coaching - being a clients guide, rather than expert, thus empowering them toward self directed insight and change.
When considered against Prochaska’s Model of Change we can see how health data may have been the unexpected rude awakening during pre-contemplation, or how it can be used as strong motivation for a contemplator, a north star for a preparer, a metric of progress for a client in action and a fresh burst of new motivation for clients in maintenance or relapse stage.
There is a way for every qualified coach, within scope, to use health data by coming back to the role of coach precisely not to be the expert in the room, and thus shifting power to the client to direct their experience.
How can we enhance the client experience using health data?
To colour between the lines a little more, let's explore the types of health data available and some ideas on how health and wellness coaches can leverage it, within scope, with clients:
Working with objective health data
Objective health data encompasses testing that is usually run via a machine or lab. Measurement is scientifically validated and includes elements shown in the top half of the quadrant shown above.
What a coach cannot do
A coach should not interpret results
A coach should not provide advice regarding the results
A coach should not make any commentary about values or information on results reports
What a coach can do
Be very clear and upfront that the value in your role as coach is to support the client to extract the valuable and actionable insights from the results, rather than a clinical analysis of the results.
A coach can use motivational interviewing techniques, curiosity and thoughtful questions to determine the client’s outtake from their results with a view to actions:
Were there any specific lifestyle recommendations your doctor/specialist advised when taking you through these results?
What are the key takeouts for you from the results?
Is there anything, habits or lifestyle, that you have already changed as a result of the test?
Is there anything, habits or lifestyle, that you would like to change?
Of those changes, which one is the most important to you to act on first?
A coach can create a safe environment to tease out the emotional impact of the results on the client. This is often an overlooked factor in gaining test results back. Good questions a coach could ask are:
How was it for you receiving these results?
Why do you think that is?
How could we work together to turn these results into a positive reframe?
Caution - if a client has received results they have not had an appropriate health professional interpret, you may wish to appropriately suggest that your client explores this option first. Otherwise be extra careful to stick to your scope of practice!
How does working with objective data help with coaching outcomes?
There is a saying that “you can’t change what you don’t measure”. As a coach, we can harness this truth to explore readiness to change and motivation levels. Does having this data prove helpful or a hindrance to motivation? Why? How can we adjust to this new insight about our client?
Coaches can co-review a client's health vision and enhance it using any of the new insights the client has gathered. They may wish to add objective, measurable outcome based, long term goals to their vision.
Coaches can use the results, together with the emotional and motivational impact to explore new, healthful behavioural changes and wellness habits or edit the existing short term goals.
Now, after reading all the ways a coach can work alongside objective data, you may be wondering “Hmm, well that all sounds amazing but my clients have never brought up the topic of testing and data, but they do tell me they want ways to measure their success and progress.” Enter subjective health data from self measurement.
Working with subjective health data
Despite often being free of charge, gathering subjective data through awareness, observation and self reflection can be a very powerful tool.
Per the bottom half of the quadrant above, there are many ways to gather health-related subjective data:
Tracking of symptoms (relating to digestion, menstrual cycle, skin symptoms, sleep, etc)
Psychometrics (behaviour, tendencies and psychology-based inquiry)
Journaling mood, emotions, mental wellbeing, relationships, personal insights)
Tracking of inputs (nutrition, movement, sleep - this is often done with wearable devices)
The two types of subjective data are either self assessment (symptoms, behaviour) or professional assessment (behaviour, psychology).
As with objective data, we now have a swathe of investigative tools to help one understand their tendencies, behaviours and habits to better recognise how those things might be playing out in their lives. Some examples are:
Clifton Strengths
Positive Intelligence
PERMA
Character Strength and Values assessments
Once you have a trusting relationship with your client and you understand their roadblocks, these self assessment tools can illuminate for them where they might (accidentally) get in their own way.
How does working with subjective data help with coaching outcomes?
To demonstrate the power of subjective data in the coaching context, we’d love to share a real case with you.
A client who came to us was completely exhausted, experiencing a myriad of health expressions that all clearly point back to a chronic over-commitment to work, friendships and almost everyone (but her).
Once she explored the Positive Intelligence investigation, her report showed her ‘saboteurs’ as:
10/10 Pleaser
8.8/10 Hyper-Vigilant
8.8/10 Hyper-Achiever
Her report said “your mental fitness level is Surviving. In handling challenges and relationships, you use more negative mental modes (stress, anxiety, frustration, regret, guilt, etc.) than positive (curiosity, empathy, joyful creativity, calm clear-headed action, etc.)”.
As a coach, gaining access to this kind of insight was incredibly meaningful in several ways:
Personal responsibility. She took the test and was informed by this expert analysis (no blame or shame from the coach)
She was able to see how these traits played out in real life as well as how they intersected with her health concerns
The coach is then able to kindly and gently reference these as coaching opportunities (now that they had been acknowledged)
From a coaching perspective, the focus was to stay in staying in scope around behaviour change - not assessment, diagnosis or psychology
On the back of these insights, the client was able to readily find family patterns, generational beliefs and be in a safe space to explore if she would choose to willingly continue to play these out going forward.
Another way self collected data can help is to identify patterns. When a client tracks their own behaviours or symptoms, they gain invaluable insights. As long as their reporting is honest, as a coach you’ll be able to see the reality of their behaviours and be more informed for the right kind of inquiry to support their goals.
For example
A client has a goal of wanting to run a marathon. They have however, found it difficult to commit to regular training. They are often tired and use ‘pure motivation' as the way to push toward their goal. When they reflect on their habits and behaviours, nothing stands out as being counter productive.
They’ve tracked their nutrition, sleep, hydration and exercise for a month.
Now that you’ve seen their data, there is a clear pattern that emerged. On Monday they would go to bed around 9:30pm, and then as the week passed, their sleep time got later until Saturday, when they would typically be up until 1:30/2am.
As a coach, you now have some data that ties back to their goal.
You can explore what might be going on during the week that is impinging on better sleep patterns. You can also help them understand how good quality sleep ties in directly with their goal.
From a scope perspective, this kind of data is really wonderful because you get to reflect on behaviour, choices, habits - all of the things a coach is well-equipped to support someone with. As earlier mentioned, you would not be prescriptive with something like nutrition unless you had additional qualifications in nutrition. Habits and behaviour though, big green tick.
Any form of self reflection or self assessment is helpful in that the coach is not asserting any of their beliefs or assumptions. The client is self-identifying and in that, taking responsibility.
At Melbourne Functional Medicine, we often refer to Personal Health Literacy. This is the powerful combination of listening to your body (symptoms) and then adapting or taking action in response to this insight. Using data to help someone understand the symptoms they’re experiencing is fuel for future them. No longer will your client be blindly fumbling their way forward, frustrated by a lack of specific and targeted context, but they have data (subjective or objective) as well as the conversation that has bridged that with their lived experience.
The dark side of data - anxiety
As coaches, we may need to have our strong observational hat on when it comes to health data as sometimes, for some clients, health data anxiety is a real thing, acting like a paralysing hindrance to action or promoting learned helplessness.
When you believe health data is negatively impacting your client, gently open a conversation around it.
How did having this data make you feel?
Do you feel it is more or less motivating for you?
Is there a blessing in disguise that could come from this information?
Is the information from this test helpful? How so? How not so?
Thinking about going forward, is this data helpful to track and measure? If not, what could be more beneficial to you to measure?
Do you think having this device would be helpful or a hindrance. What data would be of interest to you? How might you use it?
What to do if your client wants testing and health data?
It can be helpful to be across credible offerings for health testing and data. Many of the subjective, online assessments were noted above, but here are a few other options to point your clients in the right direction:
Their GP
If they really want testing they cannot obtain via the GP, they can try iMedical or iScreen for privately billed pathology, but they’ll still need professional support with interpretation
Online providers that allow referral free, direct to consumer ordering, with most offering interpretation services. Examples are:
Their specialist practitioners
Clinics with specialist practitioners often offer the testing and interpretation within their services and programs rather than just a test and interpretation service alone, it is always worth allowing for initial consultation fees, test fees and follow up fees
What is the cost of accessing private pathology?
Standard pathology from iMedical or iScreen can start at $19 per marker. Most comprehensive blood panels would be at least $150 and advanced, functional panels such as metabolites, extensive hormones and food intolerance testing can range from $200-$750. DNA and biological age screening ranges from $350 to $800 and private health screening such as MRI and CT Angiography can be $2,500+.
These costs usually do not include professional interpretation.
We also believe that there is another cost of pathology and testing that is not monetary in value but emotional. Clients should be well considered about why they want to access testing, what they hope to find out, understand what is within and out of their control when it comes to actioning results and if a test result went either way, how emotionally fit they feel to navigate the results and being clear who they could lean on for support.
In closing, being able to leverage health data, whatever the form, can be incredibly powerful to use as a coaching tool. Health data can help you to elevate your clients experience, and most importantly their health outcomes using data for insight, motivation and change. The trick as a coach is to be prepared so you can stay in scope and focussed on providing value through the behavioural outcomes of the data, beyond just the data itself.
Article reproduced with permission from Liv and Bee
Liv and Bee are HCANZA members, supporting patients in their roles at Melbourne Functional Medicine. Bee was awarded 2023 Health & Wellness Coach of the Year in a Healthcare Setting and enjoys leading her team as well as being an active participant in the Melbourne coaching community. Liv is evolving her coaching to support more clients with advanced health optimisation and longevity goals.
Melbourne Functional Medicine offers testing and interpretation as a single service as well as bring part of their healthcare program for people with chronic disease, and their health optimisation services for people who are seeking peak performance and longevity.
If you’d like to get in touch or have have questions about how to help your clients access advanced lab testing we would be happy to chat - email liv@mfm.au or bee@mfm.au
To access our Advanced Lab Testing Menu click here.
