Re: 2 new messages in 2 topics - digest

[Rachel Lukasavige]

Hi,

I work for a health insurance company in addition to starting up my own business as a health coach.  The way I see it is that if employers are offering incentives for employees to participate in health coaching, then the individual is not in it for the right reason.  Successful behavior change comes from your own desire to make your life better, not because your employer pays you to.

Regardless of whether the health coach is giving advice (which I agree is not what they should be doing) or giving guidance I don't think people are going to change their behaviors unless they have signed up for it for their own benefit.  I think that health coaching in the insurance industry was once thought of as more disease management, where you have a health coach call you to help you manage the disease you have, or may be at risk for.  Companies are finally understanding that they can be used for so much more - to help with behavior change. 

I hear more and more about companies offering health coaching to employees through their insurance company.  I'd be curious to hear about others' take on this and whether that has or has not affected your health coaching practice.

Rachel

 

Health Coach
www.healthierwayoflife.com

---

From: health-coaching group <nor...@googlegroups.com>
To: health-coaching digest subscribers <health-...@googlegroups.com>
Sent: Wednesday, November 12, 2008 5:35:32 AM
Subject: 2 new messages in 2 topics - digest


Health Coaching
http://groups.google.com/group/health-coaching?hl=en

health-...@googlegroups.com

Today's topics:

* Current Concerns - 1 messages, 1 author
http://groups.google.com/group/health-coaching/browse_thread/thread/71883e5430c2cc4c?hl=en
* Health coaching trends and training - 1 messages, 1 author
http://groups.google.com/group/health-coaching/browse_thread/thread/f3af191701963c47?hl=en

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TOPIC: Current Concerns
http://groups.google.com/group/health-coaching/browse_thread/thread/71883e5430c2cc4c?hl=en
==============================================================================

== 1 of 1 ==
Date: Mon, Jun 2 2008 3:17 am
From: "Janette Gale" 


Hi Bill and others,

I am not quite sure what the models are in use in the US. Here in Australia
Health Coaching is taught to health professionals to use as part of their
professional practice as usual, rather than having a dedicated health coach.
This involves weaving professional advice in with health behaviour change
assistance so that even when asking for advice from doctors, nurses,
dietitians, exercise physiologists etc., the professional recommendations
are provided to patients/clients in a way that decreases resistance and
empowers patients/clients to make health changes in a way that suits their
own circumstances.

We have developed a highly structured, time efficient method to guide health
professionals when assisting clients to engage in health behaviour change.
Many organisations are using it in our government-funded health system.

I would be interested to discuss health coaching practice models with anyone
who is interested in sharing their own information. There is a lot of talk
about health coaching in the marketplace, but health coaching seems to be
often equated with telephone service delivery rather than with health
behaviour change methods.

Janette Gale
Health Psychologist
Health Coaching Australia
www.healthcoachingaustralia.com.au 
Phone: 61 2 4465 2185
Fax: 61 2 4465 2831
Mobile: 0402 065 673

-----Original Message-----
From: health-...@googlegroups.com
[mailto:health-...@googlegroups.com] On Behalf Of Bill
Sent: Friday, 30 May 2008 12:31 AM
To: Health Coaching
Subject: Current Concerns


Hi All:

A couple of recent statements about health/wellness coaching caught my
eye and I felt they were worth sharing with this community.  Both have
added to my increasing concerns regarding the heavy promotion and
explosive proliferation of health and wellness coaching.

In the article " Wellness Incentives Need Oversight" by Gloria
Gonzales, published May 26, 2008 in Business Insurance (http://
www.BusinessInsurance.com), Elona DeGooyer, Senior Consultant Health
and Wellness for Humana, Inc. is quoted as saying: "Humana, Inc. gave
incentives to employees to sign up for health coaches, but it found
that some employees ignored their coach's advice."

In the article "Wellness Programs on the Rise" by Kristen Frasch,
published May 14, 2008 in Human Resource Executive Online, (http://
www.hreonline.com),  Tom Lerche, Health Practice Leader for Aon
Consulting is quoted as saying: "Employers and health insurers alike
are now getting it, that healthcare is neither health nor care without
wellness coaching."

My comments about the two quotes:
1.    What a shock to find out that employees didn't follow a health
coach's advice! Just because a coach says it doesn't mean that people
are going to respond any better than when they get advice from their
healthcare provider or someone else.  True health and wellness
coaching works because it is not about giving advice! A true coach is
about guiding and facilitating, not giving advice!
2.    When it comes to employer health related costs and employee health,
coaching is only one tool or strategy to be considered.  Coaching is
not a silver bullet!

What do the rest of you think?

Bill McPeck

William McPeck
Certified Worksite Wellness Program Consultant
Work-Life Certified Professional
Certified Health Promotion Director
Director, Employee Health and Safety
Maine State Government
207-287-6780 (voice)
207-287-6796 (fax)
william....@maine.gov











==============================================================================
TOPIC: Health coaching trends and training
http://groups.google.com/group/health-coaching/browse_thread/thread/f3af191701963c47?hl=en
==============================================================================

== 1 of 1 ==
Date: Tues, Nov 11 2008 12:34 pm
From: Melanie Matthews 


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Regards,


Melanie Matthews
The Healthcare Intelligence Network




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[Bill]

Hi Rachel:

In an ideal worls, you would be correct. In the real world,
incentives have been determined to be a critical component of wellness
programs.

Think about yourself. The last time you bought a big ticket item, I
bet you took advantage of a sale, manufacturer's incentive or rebate
of some type. External motivation plays a big role in what we do.

External motivation gets the person to the table or in the game. Then
it is up to the coach to engage that individual in such a fashion that
their intrinsic motivation gets identified and engaged for the long
haul.

I would agree with you that most of the health/wellness coaching I am
seeing is being provided through the insurance carrier .

Bill McPeck

William McPeck, MSW

[Ruth Fikes]

This is excellent dialogue. I work for a behavioral health management
company and our belief is that coaching is only as good as the coach and the
training. The traditional insurance coaching model here in the US has used
RNs as coaches within the disease management model. While I believe there
are some excellent RN coaches, their basic training is in a medical model,
which tends to focus on "prescriptive medicine." I've also come across
licensed behavioral health clinicians who are excellent coaches, however,
they have difficulty with the boundary between coaching and therapy. There
are also a variety of non-clinical coaches (e.g., personal trainers,
executive coaches). My only concern about non-clinical coaches is their
ability to screen and refer for true behavioral health and substance abuse
disorders.

I believe that as we integrate health coaching into healthcare services, the
profession will need to be defined and certification developed. This is the
process that Addiction Counselors (CADAC), Case Managers (CMC, CCM), and
Geriatric Care Managers (NAPGCM) have all gone through. It will be
important that organizations with an investment in professional excellence
help define the trainings, standards, and ethics.

As for incentives, I believe any program which gets people connected with
information is worthwhile. They may not be ready for change at that moment,
but planting seeds may lead to future change. I've also seen that in my own
company, incentives help overall employee morale.

Ruth Fikes, MFT
Comprehensive Behavioral Health Management

-----Original Message-----
From: health-...@googlegroups.com
[mailto:health-...@googlegroups.com]On Behalf Of Bill
Sent: Wednesday, November 12, 2008 7:23 AM
To: Health Coaching

[Janette Gale Optusnet]

Hi Folks,

In Australia we have a public health system and insurance companies can't
use traditional incentives to get members into programs (due to
legislation). So we have had to find other strategies to engage
patients/clients in health behaviour change.

The public health system including community health services, Hospital
Admission Risk Programs, community nursing and allied health services,
cardiac rehabilitation, diabetes services etc. are starting to implement
health coaching in their business as usual. We are working with our state
governments and health organisations to embed health coaching into practice
at every level of the health system here.

Our approach is that we encourage the use of these techniques by Every
health practitioner throughout the country, in every patient consultation.
In essence, whenever a health professional wants a patient to actively do
something to improve their health (medication, attend appointments, change
lifestyle behaviours etc.) health coaching techniques can be used to attain
better outcomes by engaging the patient in health behaviour change. This
acknowledges that there is natural resistance to being told what to do to
manage disease and risk factors - even though we would benefit from it.

Health insurance companies here are also using dedicated health coaches (all
of whom are usually health professionals). One of the most important ideas
to get across to the health coaches (many of whom come from acute care
settings) is that they need to 'sell' the idea of health behaviour change to
the member right from the first qualifying telephone call. If the member
doesn't think that there are any personal benefits for them, they won't
engage. It is a different mindset for health professionals coming from a
traditionally didactic paradigm.

We find the major barrier to change is the way that people think about
behaviour change. They think that they have to make huge, absolute changes
to their lifestyle, don't believe they can do this (because they may have
tried and failed in the past) and hence give up before they start. If health
coaches (and health professionals generally) don't have cognitive change
facilitation skills, they can't work with much of the population. Even when
people want to change, they find it difficult due to their undermining
self-talk. Unfortunately, this skill often gets overlooked in health coach
training.

Janette Gale
Health Psychologist
Director, Health Coaching Australia
612 4465 2185 / 0402 065 673
www.healthcoachingaustralia.com.au