Coaching: A Complex Field

Coaching is delivered in many forms and is a complex field. The terminology used can occasionally lead to confusion around what area the coach actually works in. That can be confusing for people who are considering embarking on training and a career in the field. What kind of coaching do they want to do? Who do they want to coach? When our students begin their program at Wellness Coaching Australia, we do our best to demystify, yet clarify the work of a health and wellness coach. Yet we are often asked about other types of coaching labels that are popping up in various circles. With the growth of the coaching industry has come a decrease in clear pathways for people wishing to work in the field. Let’s take a look at some of the issues.

We used to differentiate between a health and a wellness coach but in recent years, the NBHWC has led the way by using the term “health and wellness coach” in their Board Certification and credentialling process. However, as you will read, the titles can be used separately and it is often determined by the environment and market the coach is working with. Yet there are more terms to consider.

Some titles used for coaching are quite broad and not really self-explanatory. A paper by Perlman and Abu Dabrh (2020) highlights the potential confusion and lack of clarity , even amongst healthcare and other related coaching. They put forward a description of the various types of coaching that are on offer and how they differ, (Incidentally, whether you refer to ‘wellness’ or ‘wellbeing’ is not particularly important, yet there is a move to favour the latter term – we wonder why when confusion already abounds and Health and Wellness Coach (HWC) is finally being used consistently.

Let’s take a look at some of the distinctions according to Perlman and Abu Dabrh.

Wellness coaches – have a stronger emphasis on positive psychology and a focus on all aspects of wellbeing. However, Wellness coaches can also work as Health Coaches and as already stated many people and organisations refer to the two as one role – Health and Wellness Coach. Back to the paper and the authors’ proposed distinctions:

Health Coaches – involve strategies that focus on physical health-related goals, with assessment, management and prevention forming part of their work. Their background is usually a health professional qualification and they work in specialised areas such as obesity, diabetes or smoking cessation.

Life Coaches – the authors believe that these coaches fall within the spectrum of HWC as their aim is to explore and envision how clients can improve their wellbeing with emphasis on relationships, financial, and career oriented goals. This opens the door for ICF to step into the health space?

Holistic Health Coaches – use an integrative approach with focus on mind/body using diet and lifestyle changes to improve health in general.

Leadership/Executive Coaches – a specialised type of health and wellness coaching that emphasises challenges faced by people in leadership roles and coaching towards results in that role – although their work can also focus on clients’ wellbeing! (This is the first time I have read of executive coaches working in the field of health and wellness.)

Capacity Coaching – a specialised or modified type of HWC when coaching patients with chronic conditions or multi mobility the capacity referring to the patients ability to handle healthcare and daily life.

Integrative Health Coaching – A hybrid form of HWC generally provided within healthcare settings and bridging the gap between medical recommendations and patient’s goals of wellbeing – supporting the implementation of recommendations into the clients life.

Does that make it clear? I doubt it.
It doesn’t take a scholar to recognise that overlaps and confusion between the roles are bound to exist.

Perhaps the accrediting body can help clear this up?

  • The NBHWC (National Board for Health and Wellness Coaches) in the US are building a strong following of qualified coaches within their community and seem to be leading the way in the HWC field making progress for rebates and integration of HWC within healthcare setting.
  • The ICF (International Coaching Federation) has been around the longest time and although in the past has represented primarily life and executive coaches, is now laying claim to health coaching too. Should HWC be looking towards the ICF for greater recognition and credibility?
  • The CCE – Center for Credentialing and Education seems to offer accreditation for most of the categories of coaching.

Can international borders help us understand the industry?
Not really. The NBHWC appeals to many countries who have not created standards of their own, simply because of the amount of work they have done in the field of HWC and the partnership with the Medical Board of Examiners. However, the UK (UKHCA) have decided that the volume of training that is required by the NBHWC is too low and is now expecting training providers to show proof of offering over 600 hours of training with 120 being live – somewhat prohibitive for many.

Australia and NZ have their own association (HCANZA) yet they too have different ideas as to what a health and wellness coach should know. Europe leans towards the EMCC. European counselling and mentoring Accreditation.

The ICF seem to have the greatest international recognition but do they really have a focus on working with people with health issues? Wellbeing sure, but do approved courses have to include specialised knowledge that HWC need to possess to keep clients safe?

Perhaps choosing a niche is the answer?
We’ve seen an increase in niche coaching with coaches choosing and to work in the areas of cancer, diabetes, weight loss, giving up alcohol, retirement and relationships to name a few. Is this going to create an even greater need for clarity around who does what, the training they require and which accrediting body they decide to follow?

Where does this leave the coach in term so knowing what training and accreditation is best?
I believe our roles now overlap more than they did some years ago. Recent years and events have resulted in a complexity of issues being brought to coaching – any type of coaching – and the outcomes desired are widespread and not just related to one area of life.

The need for collaboration
There is no one answer to this issue. Coaching is delivered in many forms and is a complex field. However, as a training provider in the HWC field, we think it is important that the accrediting and international bodies come together and start a conversation around their work. Research is scattered and diverse and hard to rely on when the background of coaches, the name of the coaching, the population being coached and the outcome they desire vary so greatly.

For example, who would be better qualified to coach a physician who is suffering from burnout? An executive coach, a health and wellness coach, a life coach? And who can claim the space of self-actualisation and living life to the full? What about the people working in higher education or even PhD students? Who should they turn to?

Because of the current situation and changing trends, we are seeing ICF graduates doing gap training to qualify them as HW Coaches, and our HW coaches are wondering whether they should subscribe to the expensive and rigorous accreditation standards of ICF. Then the trainers are similarly challenged. What qualifications and credentials do they need? We know that all coaching adheres to certain key principles. We all speak the same language around the need for partnering with our clients, using evidence-based models supporting, while leaving responsibility in the hands of the client

I can’t help thinking that the only people who are benefiting are the accrediting bodies with the coaches, the training providers and the end user wading through a confused mass of information and fees.

I would like to think that, in future, the coaching organisations and bodies need to be talking about the various levels of accreditation, requirements to meet their criteria and hope that we can come together to recognise coaching as a means of support that crosses many areas of life and help people enter and stay in the field without having to pay excessive fees and meet multiple standards to remain current, relevant and recognised.

Fiona Cosgrove; Mast Ex Sci; Mast Counselling, NBC-HWC
Founder and Managing Director
Wellness Coaching Australia