Health Coaching Scope of Practice: A Discussion Paper

The health coach is a facilitator, a change agent, an accountability partner, and an empowering and inspirational source of information. As a non-clinical health care provider, a health coach, through skilful coaching conversations and a sound belief in a client’s capability and potential, plays a key role in supporting personal health transformations.

Health coaching is a non-clinical evidenced-based modality for the application of coaching skills, approaches and techniques to support lifestyle modification through behavioural change in a health and wellbeing context. Health coaching facilitates self-empowered health decision-making and supports people to improve their health outcomes (Wolever et al 2013)

UKIHCA’s definition published in 2021 describes health coaching as follows:

"Health and Wellness Coaching is a client-led, collaborative process that aims to promote self-management, self-empowerment and equip an individual to adapt positively to their internal and external environment to create a state of resilience through the pursuit of activities and a lifestyle that cultivates their whole-health continuum."

The health coach scope of practice can be appreciated for its simplicity, impact and the creative skill required to deliver services within in. At UKIHCA, we believe that it is the health coaching approach, as opposed to the health expert’s approach that makes the health coaching process so effective for the client, supportive for the clinical expert and multidisciplinary team and rewarding and satisfying for the health coach to deliver.

Thanks to our work and the work of other professional organisations such as the National Board for Health and Wellness Coaches, (NBHWC), Society of Behavioural Health Singapore (SBHS) Health Coaches Australia and New Zealand Association (HCANZA) and NHS England, we have reached a point in the development of professional health coaching where we are lucky to have a clear scope of practice, with themes that align across many countries, stakeholders, training providers and individuals.

That said, there is much work to be done to communicate with and educate the public, potential employers of health coaches and other healthcare professionals regarding the role of the professional health coach. There is also a call from health coaches, training providers and employers themselves for ongoing support regarding how scope of practice translates from theory and training into practice. This is particularly relevant in coaching conversations that focus on chronic health conditions and/or topics such as nutrition, mental health, physical exercise, workplace wellness, community health coaching and new and emerging areas of health promotion such as direct to consumer laboratory testing and wearable health devices.

As the industry continues to grow and evolve, the UKIHCA Professional Standards Team are reviewing of the scope of practice for health coaches and have drawn up a discussion paper.

This work forms an integral part of the continued development of the UKIHCA’s world class Standards for Education and Training for Professional Health Coaching and the guidance the UKIHCA gives to its members in relation to the application of health coaching in practice.

This discussion paper will be published alongside an accompanying set of resources and lays the foundation for us to provide clarity and more specific guidance in relation to navigating scope of practice for our members, education and training providers, the public, and for those working with, or employing health coaches across all sectors to support the advancement of professionalism in health coaching, furthering its recognition and understanding of its application.

This discussion paper and the accompanying UKIHCA Scope of Practice Guidance may be used as follows:

• a reference point for understanding the health coach scope of practice
• as guidance/support for those delivering training to health coaches
• as guidance/support for those delivering health coaching to clients
• a resource for those using health coaching skills within or alongside another scope of practice
• a resource for employers of health coaches.

UKIHCA - who we are

The UKIHCA is a robust self-regulating professional body, working at the forefront of establishing and maintaining appropriate standards for education and training of health coaches and upholding their scope of practice.

Health coaching is a non-regulated industry; clarity and alignment around key issues relating to standards for education and training and scope of practice is paramount to the continuing recognition of health coaching as a profession in its own right.

Since the UKIHCA published the (2020) Scope of Practice and Standards for Education and Training (2021), we have gathered information and learnings from a variety of sources, working with our members to navigate the delivery of the health coaching process, with training providers, and continually collecting feedback from industry stakeholders.

Why is scope of practice important to us?

Nowhere has it been more important to establish and adhere to a scope of practice than in a new and self-regulated profession seeking recognition, credibility and acceptance. Robust professional frameworks form the foundations for the growth of this transformational profession.

At UKIHCA, adhering to an agreed and aligned health coaching scope of practice is a fundamental requirement for membership. As a condition of membership, health coaches must be aware of and adhere to the scope of practice provided by their health coaching qualifications, as well as the UKIHCA scope of practice.

No apology is made here in saying, again, that establishing and adhering to a health coaching scope of practice is fundamental to establishing acceptance of the professional practice of this powerful discipline, and to offering clarity to other health care professionals and the general public.

Conclusion

Since UKIHCA’s inception in 2018, we have come a long way in our mission to raise awareness of and celebrate the health coaching scope of practice. A major part of our work with training providers in supporting them to meet the UKIHCA Standards for Education and Training for Professional Health Coaching has been to work together to ensure a scope of practice is not just published but threaded through the training itself as a foundational pillar of the practical delivery of health coaching.

Despite the significant progress that we, and other bodies have made in recent years, it is still the case that a cursory internet or social media search will yield a plethora of worrying and confusing messages from unqualified individuals on the role and scope of a ‘health coach’.

All of us who have invested in high quality, professional training and are pioneering the profession of health coaching and are committed to advancing this profession have a responsibility to understand and promote a clear and aligned health coaching scope of practice.

We hope this document and the associated UKIHCA Scope of Practice Guidance go some way to help and support you in that task and stimulate thought and discussion on this important topic.

It is important to note that the field of health coaching is a dynamic and evolving discipline and various stakeholders continue to contribute to the ongoing development of its scope of practice. Additionally, the integration of health coaching into healthcare settings and collaboration with other healthcare professionals will further impact on and shape the role and responsibilities of health coaches.

As the field evolves, there may be ongoing updates to the scope of practice and competencies for health coaching.

We invite you to explore our accompanying UKIHCA Scope of Practice Guidance for practical support on the application and implementation of the professional health coaching scope of practice.

"Coming together is the beginning; keeping together is progress; working together is success."

- Henry Ford

DOWNLOAD THE UKIHCA SCOPE OF PRACTICE DISCUSSION PAPER HERE