Health and wellness coaching

Domain VI · Brief, integrative, trauma, hypnosis & coaching · Ruth Wolever · 2013 · United States

What it is

Health and wellness coaching (HWC) is a professional field and a semi-structured model, not a single psychotherapy. Wolever et al. (2013) defined it from 284 studies as a patient-centred process grounded in behaviour-change theory. It combines client-determined goals, self-discovery and active…

Format

• Format. One-to-one or group. In person, phone or video. Formats include long-term, brief ("laser"), virtual and incentivised. A VHCP programme typically runs 3–6 months, often fixed by the payer.
• NBHWC. Coaches do not diagnose or interpret medical data, prescribe or de-prescribe medication, recommend supplements, give nutrition consultation or meal plans, prescribe exercise, or advise as an expert. They do not provide psychological therapeutic interventions. NBHWC defines those as methods…

Who practises it, and how they are trained or regulated

• ICF. Coaching focuses on visioning, success, the present and future, and generally serves well-functioning people. Therapy addresses psychopathology, healing and the past. The ICF compares the coach to an athletic trainer and the therapist to a sports-medicine doctor. The ICF Code (effective 1 April 2025) requires coaches to stay alert to signs that coaching no longer serves the client and to explore "a different…
• EMCC and AC (Global Code of Ethics). The code states that coaching is not counselling, psychotherapy or medical intervention, and members must respect those boundaries. Members refer clients to suitably qualified practitioners where appropriate. They encourage ending the engagement if "a different form of professional help" would serve the client better. They state confidentiality limits (illegality, danger to self…
• Version followed: the US National Board for Health & Wellness Coaching (NBHWC) standard, meaning the HWC Scope of Practice and the HWC Certifying Examination Content Outline 2026–2030. Session-by-session procedure follows the Vanderbilt Health Coaching Program (VHCP) model as published by Wolever & Weinand (2025), which the authors describe as aligned with NBHWC structure. The operational definition comes from…

Evidence status, as the guide reports it

• NBHWC. Coaches do not diagnose or interpret medical data, prescribe or de-prescribe medication, recommend supplements, give nutrition consultation or meal plans, prescribe exercise, or advise as an expert. They do not provide psychological therapeutic interventions. NBHWC defines those as methods…

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Does it involve any substance, plant preparation, remedy or supplement? Has your doctor or prescriber been told, especially about any medication you take?
• Does it involve intense or unusual breathing? Have you been told about the medical conditions for which that is not advised?
• Does it involve fasting, a special diet or 'detox'? Have you discussed this with your doctor?
• Is it a group, retreat or community? How do they respond if someone wants to leave or raises a concern?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• shame after lapses. Respond with self-compassion work (§4.18).
• steps the client sets to please you. Ask whose idea the step is.
• low importance. Explore other domains rather than pushing this one.
• pre-formed plans for the client. Drop them before the session starts.
• outcome-only goals. Ask: "What would you be doing differently that would get you there?"

Problems the guide addresses

• Signs a coachee needs referral to clinical care
• Stuck clients (repeated non-completion of steps)
• Resistance, sustain talk and discord
• Overwhelm
• Non-adherence and lapses
• Ruptures
• Modality-specific difficulties

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.