When a coaching client tells you they have a complex health condition, do you feel confident coaching them?
Or do you start to get a case of imposter syndrome, wondering if your client should seek out another coach?
Here is a reminder for you: Health coaches are specialists in behavior change. That means you represent the often missing puzzle piece in your client’s journey to wellness. You work closely with each of your clients to understand them, support them, and offer a collaborative space to work toward their health goals. This is true for people with and without complex health conditions.
If you have a client with a complex health condition, there are several things you can do to feel more prepared, modify your coaching process to meet your client’s needs, and, ultimately, be a source of support to your client.
This article provides you with a five-step process to support your coaching client with a complex health condition.
What Is a Complex Health Condition?
The US Institute of Medicine has proposed a set of criteria for serious complex health conditions. These include, but are not limited to, those that:
- Are life-threatening (cancer, health disease, and stroke)
- Cause serious disability, without necessarily being life-threatening (spinal cord injuries, congenital malformations, stroke)
- Cause significant pain or discomfort that cause serious interruptions to life activities (allergies, migraines, arthritis)
- Require major commitments of time and effort from caregivers for a substantial period of time (mobility disorders, blindness, Alzheimer’s disease, and dementia, depression, Down’s syndrome)
- Require frequent monitoring (diabetes, asthma, schizophrenia)
- Predict or are associated with severe consequences (hypertension associated with heart disease, depression associated with suicide)
- Are associated with negative consequences to someone else (HIV/AIDS, tuberculosis, high-risk pregnancy)
- Require management to narrow physiological parameters (kidney failure, type 1 diabetes)
- Require coordination of multiple specialties (breast cancer, multiple sclerosis, cerebral palsy)
- Affect multiple organ systems (cancer, diabetes, HIV/AIDS)
- Treatment requires a risk of complication (cancer, complex surgeries)
- Require adjustment in a non-medical environment (mobility disorders, blindness, frailty, Alzheimer’s disease)
To quote the US Medical Institute, “It is important to recognize that these conditions may be serious and complex for some patients at some points during the course of their disease or disability. The conditions will not necessarily be serious and complex for all patients at all times.”
Complex health conditions often require support from a health professional or team of professionals specialized in that condition. While it is helpful to obtain a diagnosis, many complex health conditions are undiagnosed despite testing and seeking out specialists.
The Role of the Health Coach in Supporting Clients with Complex Health Conditions
Most healthcare delivery systems face severe challenges when accommodating the unique and complicated needs of people with complex health conditions. Often, several disjointed organizations are involved in the diagnosis, treatment, and management of complex health conditions, including private clinics, public hospitals, and insurance companies, all of which are directly affected by public health policies. As a result, the quality of care that people with complex health conditions receive is often inadequate.
A growing body of research shows that the health coach has an increasingly important role in improving patient outcomes.
Health coaches help to:
- Improve client relationships with their doctor by having a positive impact on patient anxiety and improving their adherence to treatment plans.
- Increase client engagement in healthcare through using communication strategies that help patients step into an active learning role to manage their health.
- Improve health outcomes in people with chronic and complex diseases.
- Improve the health outcomes of minoritized populations and low-income individuals.
These strengths can be applied to your personal coaching practice.
5 Steps to Coaching a Client with a Complex Health Condition
Learn about the Condition
When your client has voluntarily disclosed they have a serious health condition, it is vital you take the time to learn more from both your client’s perspective and a theoretical perspective.
Ask your client if they are willing to share their experience with their complex medical condition. If they are comfortable, you can ask them:
- What it feels like
- How it affects them internally (mental and emotional wellness)
- How it affects them externally (physical, financial, occupational, cultural, social wellness)
- How their experience with medical professionals has been (if they are seeing anyone)
- If their insurance covers treatment, testing, and management
- Where you can learn more
- If there is anything they would like you to know about it
Additionally, it is important to do your own research on the condition. Review your textbooks, read recent research, and look for reputable sources of information online. Many research and advocacy organizations contain patient and medical professional information pages. Focus on signs, symptoms, progression, and treatment as well as on how it might affect diet, physical activity, communication, energy levels, and others.
Ask What They Need From You
“How can I support you?”
That simple question lets clients know that you value them and their experience. You are letting them know that you are not going to assume how you can help them or offer unwanted advice. If they are unsure, you can talk to them about the role of a health coach and give examples of ways you can support them, always ensuring to stay within your scope of practice.
Even when you ask, you may expect a different answer.
They may say:
- Nothing, just be aware of it.
- If I think of something, I’ll let you know.
- Support me in adapting my lifestyle to that condition.
- Come up with a nutrition or exercise plan that is respectful of my condition.
- Help me understand what my doctor is saying.
- Support me in adhering to my treatment plan.
- Help me understand how my condition is affecting my body.
And others. If your client says they don’t want you to do anything specific to their health condition, for the time being, respect that decision. This is where you pause.
If your client does want you to take a more active role in their health management, you can continue to the next step.
Ask If They Are Seeing a Specialist
If they are seeing a specialist, it is likely there are laboratory studies, a diagnosis (or multiple diagnoses), and a treatment and management plan. You can ask to see them or to have your client explain them to you. Ask about their experience with the specialist and what they feel is missing.
Asking these questions will help give you a better idea of the context. Your role isn’t to question the healthcare team but rather to better understand your client’s circumstances to advocate for them.
Ask Permission to Reach Out to Their Healthcare Team
If your client says it’s okay for you to reach out to their healthcare team, it is a great opportunity to:
- Work in coordination with your client’s healthcare team
- Help understand your client’s obstacles from a clinical perspective
- Help fill in gaps of information and support health professionals who often do not have the time for lengthy appointments
- Advocate for your client’s needs
Build an Informed Coaching Plan
Note that the complex health condition may not be the focus of your sessions at any point in time. However, being aware of your client’s strengths and obstacles is important to collaboratively build a sustainable health plan with specific, attainable, and realistic goals.
Be clear about what a coach is and what a coach isn’t. Unless you have a medical or nutritional license that allows you to do so, a coach doesn’t diagnose or treat health conditions. They do, however, support clients in adopting healthy lifestyle choices.
You can learn more about the dos and don’ts of health and wellness coaching here.
More on Complex Health Conditions
AFPA has a wealth of information on complex health conditions written for coaches on the blog.
You can search for the health condition in the AFPA blog search box, or you can skim some of the featured articles we’ve linked below.