Over the last few years, there has been increasing recognition of the value of coaching in a variety of settings from business to health and wellness. 

Coaches can work with a range of individuals managing complexity. Their role is to offer clients safe, professional, and independent support.  This provides them an opportunity to explore thoughts, feelings, attitudes and beliefs regarding their professional and personal roles, relationships, and wellbeing. This is common for both Executives and those impacted by cancer.

Executive Coaching

Executive coaching has been described as a form of leadership training and development. It is characterised by support that is tailored to the individual to create relevant, actionable and timely outcomes (de Haan, Duckworth, Birch, & Jones, 2013).  

Thus, coaches work flexibly with clients to create a process of reflection, action, and further reflection.  In my experience of being both client and coach, this process engenders a sense of empowerment.  As Thomas & Velthouse (1990) described, an effective coaching intervention will result in the client developing a sense of meaning, competence, self-determination and impact.    

Working with skilled independent practitioners appears to have the biggest impact on those who work in complex roles and where there are outcomes on their wellbeing (Jones, Rebecca, Woods, Stephen, & Zhou, 2018). Although coaches do not work with mental health issues, they do provide a talking intervention within a “helping relationship” (de Haan et al., 2013).  Supporting clients to build resources, change perspectives, and manage their working relationships in different ways can help them become more engaged and negotiate the psychological demands of their roles.  In this way, working with emotions/affect, personal resources, or the wellbeing of clients may certainly benefit from an outside perspective.  An independent practitioner, such as a coach, enables safety for the client to explore a more honest appraisal of their own situation.  This honesty can also provide a strong platform for personal growth or development.

Coaching for Acute & Chronic Medical Conditions

Having worked for over 20 years in various roles to support health and wellbeing, including research scientist, innovation leader and complementary therapist,  I have been very interested in exploring the global role of coaching to support people with acute and chronic medical conditions.  

In the USA, the National Consortium for Credentialing Health and Wellness Coaches (HWC) has been making significant progress in standardising training for Health and Wellness Coaching (HWC). HWC is a collaborative, client-based approach to elicit sustainable behavioural lifestyle changes. Such standardization addresses outstanding questions regarding the nature of approaches, definitions and professional nature of practitioners (Cosgrove & Corrie, 2020).  A compendium of evidence-based literature relating to HWC has also been developed (Sforzo et al., 2017, 2019).

In the UK, a volunteer coaching service developed by the Fountain Centre, in partnership with the National Health Service, to aid cancer patients and their families effectively provided emotional support, built confidence and managed relationships (Parsons et al., 2019).  This is consistent with evidence-based study findings where positive outcomes were associated with psychological benefits with less than half reporting specific behavioural changes (Cosgrove & Corrie, 2020). 

Individuals living with and beyond a cancer diagnosis and treatment face significant changes in physical, psychological, and social aspects of their lives (Stanton, Rowland, & Ganz, 2015).  This may result in a life of high complexity and uncertainty for a number of individuals.  

The Fountain Centre’s coaching program for cancer patients sought to support patients in building resources and developing the confidence to deal with change (The Parliamentary Review, 2019).  The program revealed an effective coaching intervention creates a safe and reflective conversation to support the development of a sense of meaning and skills to achieve new or old goals (competence). It builds motivation (self-determination) and recognises achievements (impact), all which are valued by both service users and providers.    

As a practitioner, the parallels in “making sense” and adapting and learning ways to cope in complex and multi-dimensional social interactions were highly evident between Executives and those impacted by cancer.  As a scientist, it seemed relevant that these elements are also highly predictive of health. 

Salutogenesis

First described by Antonovsky (1979, 1987a, 1987b, 1996), a sense of coherence (SOC) describes our ability to adapt and cope to remain healthy.  It has three essential elements relating to beliefs about meaning, where we fit into the world (comprehension), and our abilities to utilise resources (manageability) (Antonovsky, 1996).  Essentially, it represents a balance between availability of resources and demands placed upon us, which are key elements of work engagement that protects against burnout and enables performance (Bakker & Demerouti, 2017).  In the workplace, providing a resourceful environment builds SOC and leads to worker engagement (Vogt, Hakanen, Jenny, & Bauer, 2016).  

Antonovsky developed the broader theoretical framework surrounding the construct of SOC which he termed saluto (health) genesis (promotion).  This is a cross-cultural construct that fits well with the psychological transitions related to post-traumatic growth (Almedom, 2005).  Salutogenesis provides a highly validated framework that links the experience of coaching executives and cancer patients around their personal learning and growth (development) and ability to “make sense” of their situation.  Making sense (SOC-comprehensibility), coupled with clarity on meaning (SOC-meaningfulness) and learning to utilise available resources (SOC-manageability), no doubt creates a sense of empowerment and self-leadership (Manz, 1992).  

Salutogenesis and Coaching

Not all coaches will be able or want to work across this intersection of salutogenesis.  The coaches’ ability to self-regulate their emotions, be present, mindful and empathetic will be key to establishing an effective therapeutic working relationship (Jackson & Parsons, 2016).  Additional reflective tools to ensure safe and effective boundaries will inform coach practice (Corrie & Parsons, in press) for working with mental wellbeing.  Indeed, salutogenic approaches have been used to support coaching interventions to support wellbeing in other areas (Stelter & Andersen, 2018).

Health is so much more than the absence of disease or returning to function.  It encompasses many, if not all aspects of our lives.  Coaches have an opportunity to play a significant role, alongside other professionals to enable health.  This is true not only in workplace settings, but also in providing those undergoing significant challenges with diagnosis and/or treatment of life changing medical diagnoses.  

Coaching in health and wellness provides an exciting area of academic research and practice development.  Salutogenesis provides a validated framework that coaches can utilise to enable empowerment in health.  

Blog Based on Empowerment in Health and Wellness edited by Andrew A Parsons, Sue Jackson and Jackie Arnold.

References:

Almedom, A.M. (2005). Resilience, hardiness, sense of coherence, and posttraumatic growth: all paths leading to “light at the end of the tunnel”? Journal of Loss and Trauma, 10(3), 253-265. 

Antonovsky, A. (1979). Health, stress, and coping. San Francisco: Jossey-Bass.

Antonovsky, A. (1987a). Health promoting factors at work: the sense of coherence. In R. Kalimo, M. El-Batawi, & C.L. Cooper (Eds.), Psychosocial factors at work and their relation to health (pp. 153-167): World Health Organization Geneva, Switzerland.

Antonovsky, A. (1987b). Unraveling the mystery of health: How people manage stress and stay well. San Francisco: Jossey-Bass.

Antonovsky, A. (1996). The salutogenic model as a theory to guide health promotion. Health promotion international, 11(1), 11-18. 

Bakker, A.B., & Demerouti, E. (2017). Job demands–resources theory: taking stock and looking forward. Journal of Occupational Health Psychology, 22(3), 273. 

Corrie, S., & Parsons, A. A. (2021). The contribution of coaching to mental health care. An emerging specialism for complex times. In M Watts & I Florance (Eds.), Emerging conversations in coaching and coaching psychology. Hove, East Sussex: Routledge.

Cosgrove, F., & Corrie, S. (2020). Promoting wellbeing through the emerging specialism of health and wellness coaching. The Coaching Psychologist, 16, 35-44. 

de Haan, E., Duckworth, A., Birch, D., & Jones, C. (2013). Executive coaching outcome research: The contribution of common factors such as relationship, personality match, and self-efficacy. Consulting Psychology Journal: Practice and Research, 65(1), 40. 

Jackson, S., & Parsons, A. A. (2016). Developing principles for therapeutic coaching: A UK perspective. Philosophy of Coaching: An International Journal, 1(1), 80-98. 

Jones, R., J., Woods S.A. & Zhou, Y. (2018). Boundary conditions of workplace coaching outcomes. Journal of Managerial Psychology, 33(7/8), 475-496. doi:10.1108/JMP-11-2017-0390

Manz, C.C. (1992). Self-leadership... the heart of empowerment. The Journal for Quality and Participation, 15(4), 80-89. 

Parsons, A. A., White, A., Pike, A., & Kehinde, A. (2019). Coaching in support of cancer patients and their families. Paper presented at the 25th Annual International Mentoring, Coaching and Supervision Conference, Dublin, Ireland. 

Sforzo, G.A., Kaye, M.P., Todorova, I., Harenberg, S., Costello, K., Cobus-Kuo, L., . . . Moore, M. (2017). Compendium of the health and wellness coaching literature. American Journal of Lifestyle Medicine, 12(6), 436-447. doi:https://doi.org/10.117/1559827619850489

Sforzo, G.A., Kaye, M.P., Harenberg, S., Costello, K., Cobus-Kuo, L., Rauff, E., . . . Moore, M. (2019). Compendium of Health and Wellness Coaching: 2019 Addendum. American Journal of Lifestyle Medicine, 14(2), 155-168. doi:https://doi.org/10.1177/1559827619850489

Stanton, A.L., Rowland, J.H., & Ganz, P.A. (2015). Life after diagnosis and treatment of cancer in adulthood: Contributions from psychosocial oncology research. American Psychologist, 70(2), 159. 

Stelter, R., & Andersen, V. (2018). Coaching for health and lifestyle change: Theory and guidelines for interacting and reflecting with women about their challenges and aspirations. International Coaching Psychology Review, 13(1), 61-71. 

The Parliamentary Review. (2019). Reciprocal Minds Limited. Education Services, 27-29. https://www.theparliamentaryreview.co.uk/organisations/reciprocal-minds-ltd

Thomas, K.W., & Velthouse, B.A. (1990). Cognitive elements of empowerment: An “interpretive” model of intrinsic task motivation. Academy of Management Review, 15(4), 666-681. 

Vogt, K., Hakanen, J.J., Jenny, G.J. & Bauer, G.F. (2016). Sense of coherence and the motivational process of the job-demands–resources model. Journal of Occupational Health Psychology, 21(2), 194.