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Wellness Coaching: strategies for optimizing QOL

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Nicole Radich

on 16 August 2013

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Transcript of Wellness Coaching: strategies for optimizing QOL

Phase 1
Phase 2
Longitudinal Benefits of Wellness Coaching Intervention for Cancer Survivors
Objectives for our Time Together:
Wellness Coaching: Strategies for Optimizing Quality of Life
Wellness Coaching
Mary Lou Galantino, PT, PhD, MSCE
Richard Stockton College of NJ
University of Pennsylvania

Define wellness and all it encompasses
Discuss key wellness concepts
Define wellness coaching
Investigate the benefits of wellness coaching
Learn how to implement a lifestyle change via the Circle of Life assessment tool
Appreciate the evidence for the integration of wellness coaching in exercise, nutrition and overall quality of life.
Key Concepts
(Travis & Ryan, 2004)
Wellness is…
A choice- decision made to work toward optimal health.
A way of life- designed to achieve the highest potential for well-being.
A process- development of awareness there is no end point, health and happiness are a possibility of each moment-the here and now.
A balanced channel of energy- energy is received from the environment, transformed within you, and returned to affect the world around you.
The integration of body, mind, and spirit- appreciation that everything that you do, think, feel, and believe has an impact on your state of health.
The loving acceptance of your whole self.
Wellness Key Concepts
As stated in the book, The Wellness Workbook, 3rd Ed: How to Achieve Enduring Health and Vitality by Dr. John W. Travis and Regina Sara Ryan
Achieving a balanced state of wellbeing is an ongoing process
Key concepts:
Illness-wellness Continuum
Iceberg Model
Wellness Energy System
(Travis & Ryan, 2004)
Illness-wellness Continuum
Wellness is a process, never a static state.
(Travis & Ryan, 2004)
Illness and Health- (your current state of health) are only the tip of the iceberg.
To understand the cause, you must look below the surface as well (90%).
 Iceberg Model
(Travis & Ryan, 2004)
We are all energy transformers, connected with the whole universe. All our life processes, including illness, depend on how we manage energy.
Full Wellness Energy System
Evidence: Coaching improves health outcomes
Cancer survivors
Chronic pain
Heart disease
Physical activity
Weight loss
J Aging and Health (2005)
504 subjects (65+ yrs) with 1 or > chronic dx
Total 11 contact hours: IE, Action Plan, 6 month reassess
Team: nurse health coach, MSW, geriatrician
After 12 months, the intervention group participated in aerobic activity and stretching for more minutes each week than controls (p<.01)
Physical Activity - RCT
Holland et al.
Galantino ML, Schmid P, Teixeira J, Botis S, Dagan C, Leonard SM, Milos AA
Purpose of the study
To determine the feasibility and benefits of wellness coaching in improving health, fitness, well-being, and overall quality of life; both the immediate 3 month changes, and one year sustainability for cancer survivors
Hospital Anxiety and Depression Scale – change in depression subscale (p=.039)
Exercise Stage Assessment (p=.005)
Total QOL – Cancer Survivor – (p=.009)
Significant Results
Wellness coaching is a promising intervention for cancer survivors.
Results for heterogeneous cancer population:
Significant reduction in depression scores, improvement in QOL, and exercise readiness
Positive trends were noted in all variables
Longitudinal data indicated sustainability of positive changes for the WC intervention
Initial session:
90 minutes
A wellness vision
Three month behavioral plan with first week’s SMART goals
Five follow up sessions:
30-40 minutes
Completed over three months
Review of goals, what went well, challenges, strategies, refocus to vision/3 month goals, coaching tools as needed
Coaching Sessions
Health benefits
Tai Chi
Wellness Coaching: The Evidence
15 Change Footholds for Higher Well-being
The following frequency of responses were identified:
Primary benefits of coaching to live a healthier lifestyle:
Goal setting, awareness of food choices, & exercise
Health, fitness, and well-being improvements in last 3 months:
Exercise and increasing healthy food choices
Small changes made and confident in maintaining:
Exercise & eating healthier
Most helpful in working with coach:
Motivation & feedback
All participants recommend program to other survivors
Cancer Survivors: Open-Ended Results of wellness coaching
“Moving, getting up and being active. I have moved away from a sedentary lifestyle that I was feeling trapped in after my cancer. I make healthier choices in my eating. I quit smoking. I feel like I established a new pattern of health behavior.”

“Just having someone to talk to that understands what I’m going through. Having someone to lean on and give me advice on what to do if I’m in trouble.”
Personal Responses
Integrative Therapies in PT Coaching:
Use of Yoga and Tai Chi
Evidence of Yoga for Joint Pain
Yoga was well tolerated with no adverse effects and improved flexibility, balance and ADL
60% of women with FR under 20cm were at a high risk for falls, but after 8 weeks only 20% were at risk
Tree - Vrikshasana
NSAIDS offer pain relief but associated with GI, CV and renal side effects (Berman, 2007)
Women prefer not to take medications continuously for managing AI symptoms (Mao, 2008)
Tai Chi – potential non-pharmacological treatment approach
Evidence of Tai Chi for Aromatase Inhibitor Arthralgias in Breast Cancer Survivors
Frequent responses from open-ended questions regarding the perceived benefit of coaching included:
Positive ability to manage stressors
Improve physical activity
Enhanced ability to relate with others.
Actual reported changes and improvements included:
Less stress, more exercise
Healthier eating and weight loss.
Can we really take time at work?
Circle of Life
How to implement change into your life
What is a “Wellness Coach”?
The National Consortium for Credentialing of Health & Wellness Coaches defines provides a definition of the job description of a Wellness Coach :
“Health and Wellness Coaches are professionals from diverse backgrounds and education who work with individuals and groups in a client-centered process to facilitate and empower the client to achieve self-determined goals related to health and wellness. Successful coaching takes place when coaches apply clearly defined knowledge and skills so that clients mobilize internal strengths and external resources for sustainable change.” (National Consortium for Credentialing of Health & Wellness Coaches, 2013)
Integrative Wellness Coaching
Access 12 areas of your life
Every aspect of the your life can have a positive impact or a negative impact on every other aspect of your life
What aspect of your life is giving you positive energy in your life right now?
What aspect of your life is draining your energy in your life right now?

Create your individualized health plan: The Circle of Life
(Circle of Life Programs , 2007-2011)
The Circle of Life Phases
Phase 1 - Assessment and Self-Inquiry
Phase 2 - Readiness for Change
Phase 3 - Design Change with Intentions, Goals, Challenges, Affirmations, Actions and Accountability
Phase 4 - Plan Actions
Phase 5 - Take Action and Access Resources
Phase 6 - Re-evaluation, Course Correction and Accountability
Strengths and Victories: I have followed my oncologist’s advice. I joined the YMCA to begin to exercise.
Intention: To live a long and healthy life to support my children
Goal: My goal is to lose 40 lbs, lower my cholesterol and blood pressure to normal in 4-6 months. I will have less pain in my joints
Challenges: Deep cultural conditioning: “Women take care of everyone but themselves” Too busy for exercise. I have 6 kids. I work 6 days a week. I don’t like exercise. It is hard to be regular about exercise.
Affirmation: I exercise so I can live longer. Exercise is so important I do it everyday. I love to exercise knowing it saves my life for my children
Action Steps – establish day, time, environment (put on music and dance, include better food choices, no eating after 7:30p.m.)
Mind/Body Optimizing Practices: Drink 32 oz of water or herbal tea (non- caffeinated); say affirmations 5x/day; manage stress through breathing practices
Accountability: Workplace wellness; partner to “check in”
Primary Focus – Exercise
Complete Blueprint for Change
The Circle of Life Health and Wellness Coaching was used to establish SMART goals:
Initiate an exercise program
Reduce painful joints
After 12 weeks, Kate had met her two original goals which were to have less pain and exercise more. Through the process of clarifying her intention and taking reasonable, consistent steps she found that she was able to create positive life outcomes.
Circle of Life Coaching – Group Focus
(McLean, 2008)
Where would you love to go?
What pathways might possibly take you there?
What waypoints might you enjoy along the way?
What processes or support can carry you there swiftly and safely?
What preparations will equip you for a successful journey?
Who (and what) can you bring along to guide you on the way?
What is the greater purpose behind your life journey?
The Big Picture
Questions for the Journey
(McLean, 2008)
…acknowledge as a victory?
…take to a new level?
…focus your attention on?
…experience more power in?
…improve or strengthen?
…connect with more resources?
…shine the light of awareness on?
…give supportive or positive attention to?
…release struggle / allow for more grace
and ease?
…clarify direction in?
…tune into?
…channel energy into?
…clear blockages?
Is there any aspect/part of your life you want to…..

…release or let go of?
…bring to a higher level of consciousness?
…acknowledge a victory in?
…clear a pathway to?
…uncover the truth about yourself?
…harness your passion or your energy?
…open the floodgates in?
…move the Chi?
…fire up or ignite?
…get more in the flow of?
…feel more grounded or centered?
…accept or make peace with?
Circle of Life –Try it yourself
I choose to feel good right now.
I choose to be Peaceful here and now.
I choose to trust in the process of life.
I choose to have fun and make life a playful experience.
I give myself time to recoup and regroup, digest and integrate by not overcrowding my
Financial Abundance comes to me easily, lovingly, and generously as I easily, loving, and
generously give of my unique talents.
I am lighthearted and playfully productive.
I take time to feel and express Gratitude daily.
I choose to use positive uplifting self talk..
I commit to seeing my beauty and Divine essence every time I look in the mirror.
I operate from Love.
I am always Divinely guided to take the right path and the right course of action or nonaction.
I trust that the Benevolent Forces of the Universe will make a way where there is no
I now find fulfillment to my deepest longings in God through stillness and Meditation.
I enjoy my life
I exercise regularly, and I love it.
My intuition now guides me clearly and I follow it.
I eat healthful food that nourishes my body.
I now easily see and choose the higher path in all my decisions.
In my heart I can now see the good that flows through you and me.
I now clear my mind and readily shift all that's needed for my progress.
I now take excellent care of myself.
I am in the process of positive changes.
Step by step I am on the upward path to my goal of .
I love and accept myself completely, just as I am.
Affirmations For Well-being
I am relaxed, calm, and centered.
I now prioritize for my wellbeing..
I am in the process of healing.
My relationship with---------- is healing.
My body is created to express health and wholeness. I hold this picture in mind.
I am created to be healthy. I claim health and peace for myself now.
This day I choose to spend in perfect peace.
I give myself permission to be health, happy, prosperous, and at peace.
I let God's light shine through me in everything I think, feel, say and do.
I communicate clearly and compassionately.
I now set aside a time to enjoy.(fill in the blank)
I now enjoy the process of life.
I am happily married to my own inner peace.
All my needs are always abundantly provided for in a positive, Divinely synchronized way.
I choose to enjoy performing my daily Love missions (tasks, responsibilities).
I have the ability to and I am now taking action steps.
I relax, and trust and let Spirit show me Divine rights next steps.
I let the Light flow through me increasing my vibration and the vibration of all I
I choose to work from a higher place.
I am a radiating center of divine love.
I bathe in the unconditional love of my Creator, and it radiates from me at all times.
I love and approve of myself.
I can let go of worry of what I cannot control.
I forgive myself and others for errors in the past.
When I can let go of old pain, resentment and fear, I lighten my heart and free up my
I understand that time for re-injuring myself by revisiting old wounds is over.
Now is the time to open my heart to peace, love and freedom of forgiveness.
The time to be motivated by the need to prove myself is over, now is the time for
celebration & joy of self expression.
I can see myself being more patient with myself
I am learning to listen to my body and sense what it needs.
PT’s as life coaches
Being Present
Cancer Survivors
Delaware Cancer Consortium for QOL
Margaret Moore – Wellcoaches Leader
DPT students at Richard Stockton College of New Jersey
Oncology Section of the APTA
Research Committee of Oncology Section of APTA
Where to find a Wellness Coach-NJ
Sonia Decker, MA
Roselle Park, NJ
Specialty: Working with people who want to find their soul's purpose and create the life of their dreams; Addiction Recovery, Body/Mind/Spiritual Work.
Sherry Hurwitz, MA CTRS/L
Trenton, NJ
Specialty: Nationally Certified Recreation Therapist, Certified Circle of Life Health and Wellness Coach, Tai Chi Easy Practice Leader, Reiki Master
Sophie Weiner 
Wayside, NJ 
Specialty: Teen Coaching. Relationship, Motherhood, Parent/Children Issue
Ideal Choice of a Health and Wellness coach-The PT
PTs understand the body, how it functions, and how to maximize its performance
PTs have the background in physiology, exercise, and nutrition they need to help progress former patients toward lives that are healthier physically and emotionally
PTs know their patients and spend the most time with clients, allowing for the opportunity to foster lasting change
PTs are well connected within the health care community
wellness coaching perfectly complements the goals of physical therapy by encouraging sustainable, positive lifestyle change
PT in Motion
(Ries, 2012)
"A good PT [physical therapist] listens before he or she talks, and a good coach does that, too," Cooper is saying. "PTs understand the body, how it functions, and how to maximize its performance. A good health and wellness coach understands those things. PTs know that, to make progress in the clinic, patient buy-in is essential. A good coach realizes, 'I can lecture you all day, but it's not going to make an ounce of difference if you don't feel invested—if you don't feel you're doing this for yourself, not anyone else……...[PTs]have the basis in physiology, exercise, and nutrition they need to help progress former patients toward lives that are healthier physically and emotionally.“ - Brad Cooper, PT, MSPT, ATC, MBA.

"We spend more time with our patients and clients than do most health care providers, which affords us a tremendous opportunity to foster sustainable behavior change. And we're so well connected within the health care community. If we're working with someone who's obese, for example, we know the dietitians and endocrinologists to whom that individual might be referred……I've seen wellness coaching evolve over the past 30 years, and it perfectly complements the goals of physical therapy by encouraging sustainable, positive lifestyle change."-Andrew Wood, PT, MS, CBES, CPWC
The PT as health coach
PT in Motion
(Ries, 2012)
The PT as health coach
Take Shape for Life
Ric Baird, PT, DPT, ATC
3-pronged approach
frequent consultation with a certified coach for nutrition and exercise guidance
regimen of nutritious, apportioned meals
use of a playbook -Habits of Health.
US Corporate Wellness
Brad Cooper , PT, MSPT, ATC, MBA
Partners with organizations to help its employees improve their health and well-being
by using a team of wellness coaches the company trains its coaches to provide one-on-one guidance by telephone and via an array of online resources
Goal: help individuals get healthier, save their employers money
Patti Durkin
Bay Head, NJ 
Specialty: Health and Wellness Coaching, Women's Groups.
Lu Pierro, MEd, EdS
Flemington, NJ
http://www.lupierro.wordpress.com blog
Specialty: Mind/Body/Spirit, Women at the Crossroads, College Bound kids, people who wish to actualize their true potential. 

Regina Rosenthal, PT, MA 
Holmdel, NJ 
Specialty: Health and Wellness Coaching, Establishing Self-Care Practices to Maximize Wellbeing. Teens, Adults, Individuals and Groups.
Nicole Radich, SPT
Mind/Body Optimizing Practices:
3 deep breaths – “Center In” every hour
10 min-full body tune up – 1x/day
15 min massage/week
Accountability: Workplace wellness: Center for Rejuvenation
Integrative Therapies – Center for Rejuvenation
Full transcript