Duke's health coaching sees ripple effect

Health coaching is all about helping people identify what is important to them and how they can go about it, says Julie Kosey, MS, CPCC, ACC, integrative health coaching manager at Duke Integrative Medicine in Durham, NC. Duke Integrative Medicine provides health coaching by highly trained health care personnel who work closely with their clients to help them follow their personal health plan.

The most critical piece of the process is whether the person is ready to make the changes, Kosey says. "So many people see their physician who may say that the most important thing they can do is quit smoking," she says. "They're not ready to do that, so they don't do anything."

For instance, when a health coach meets with a smoker, if that person says they want to start walking for exercise, the health coach helps them get started in the process. "There's often a ripple effect. They start walking and find they are short of breath and this encourages them to stop smoking," Kosey adds.

The participants may want to have the energy to play with their grandchildren, or to be around for their daughter's wedding, or to be able to climb a mountain. Whatever their goal, the health coach helps them reach it.

A lot of health coaching has a disease-management focus, such as encouraging patients to manage their blood sugar and report the results the next week, Kosey says. "What we are doing is to help the person understand what differences it would make in their life if they got their diabetes under control," she says. Integrative health coaching is not just about accountability, but it is about helping the person learn about themselves, Kosey says. "We help them engage in personal reflection in addition to, or instead of, a specific action," she says.

Individual coaching sessions typically are 30 to 40 minutes long. Group coaching sessions are an hour in length and may take place in person or over the telephone via conference calls.

The integrative health coaches have master's degrees in health promotion or behavioral change, such as health psychology, and are trained in how to help people change the way they relate to the world and how they behave. Duke Integrative Medicine provides training for the coaches on motivational interviewing, assessing readiness to change, and on mindfulness, along with clinical training that gives them the knowledge to work with members of the interdisciplinary team. The coaches are trained to recognize symptoms that indicate that people need to seek medical care.