Wellness Coaching
Certifications: A New
Career Frontier for
Personal Trainers in
Health Care
Cherie Pettitt, EdD, HFS, CSCS, PAPHS, CWC
Department of Human Performance, Minnesota State University, Mankato, Minnesota
ABSTRACT
BECOMING A CERTIFIED WELLNESS COACH OFFERS AN EXCITING NEW WAY FOR PERSONAL
TRAINERS TO EXPAND THEIR
SCOPE OF SERVICES, ESPECIALLY IN HEALTH CARE. A CERTIFIED WELLNESS COACH
REQUIRES GAINING ADDITIONAL
KNOWLEDGE AND SKILLS THAT
MAY BE LIMITED IN EXERCISE
SCIENCE AND PERSONAL TRAINING CURRICULA. THIS ARTICLE
SUMMARIZES WHAT A WELLNESS
COACH IS, HOW WELLNESS
COACHING IS DIFFERENT FROM
PERSONAL TRAINING, AND CURRICULA-RELATED ISSUES. MOREOVER, THIS ARTICLE DESCRIBES
AVAILABLE WELLNESS COACHING CERTIFICATIONS AND HOW
THESE CERTIFICATIONS
ENHANCE THE NATIONAL
STRENGTH AND CONDITIONING
ASSOCIATION’S CERTIFIED SPECIAL POPULATION SPECIALIST
CERTIFICATION AS THESE PROFESSIONALS PARTNER WITH
HEALTH CARE PROVIDERS IN THE
CONTEXT OF HEALTH CARE
REFORM.
INTRODUCTION
ellness coach is a relatively
new formal profession in the
disciplines of psychology,
health care, fitness, and wellness
(9,12,34). Wellness coaching does not
refer to athletic coaching, performance
coaching, or executive/life coaching or
simply encouraging participants to perform better. Rather, the National Consortium for Credentialing of Health and
Wellness Coaches (NCCHWC) defined
wellness coaches as “professionals from
diverse backgrounds and education
who work with individuals and
groups in a client-centered process
to facilitate and empower the client
to achieve self-determined goals
related to health and wellness (20).”
W
Wellness coaching has emerged as a service offered by clinics, health insurance
companies, wellness companies, and fitness centers. The expansion has created
new opportunities for certified personal
trainers and those with degrees in exercise science or related degree programs.
Driving forces for careers in wellness
coaching may be from client demand;
formation of wellness coaching organizations; health care reform; and a result
of television, personalities, and celebrity
personal trainers (24). Nevertheless, it is
reasonable to assume that wellness
Copyright Ó National Strength and Conditioning Association
coaching and personal training are complimentary and offer personal trainers
another avenue to expand their scope
of services, partner with health care providers, and increase their client’s success.
Given the complexities of ameliorating
sedentary lifestyles, now more than
ever, personal trainers need to draw
on the psychology of behavior change
and coaching psychology theory.
Unfortunately, the information from
these disciplines is limited in exercise
science baccalaureate degree programs,
although it is increasing (7,8,25). This
article will summarize what a wellness
coach is, how wellness coaching is different from personal training, and how
personal trainers can develop their wellness coaching skills to develop a potential career path in health care.
WHAT WELLNESS COACHING IS
Coaching is “the art of creating an environment, through conversation and
a way of being, that facilitates the process by which a person can move
toward desired goals in a fulfilling
KEY WORDS:
wellness coaching; personal training;
coaching psychology; behavior
change; health care; CSPS
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Wellness Coaching Certification: New Frontier in Health Care
manner (11).” In other words, coaches
act as hiking guides: they conavigate
the journey up the mountain with the
client but cannot hike up the mountain
for them. With a focus on building selfefficacy, the goal of coaching is to
encourage personal responsibility and
deep thinking to help clients reach their
goals (19). Clients are provided a nonjudgmental supportive but challenging
environment to explore self-discovery
while working toward their self-defined
goals (19).
Wellness coaches help cofacilitate the
behavior change process. For example,
a client may seek a wellness coach to
help them reduce their stress and resolve
their ambivalence about improving their
overall health. A wellness coach may
meet with their client face-to-face, telephonically, or using other technologies
over the course of weeks or months depending on a variety of factors. Early
sessions may involve setting a wellness
vision or specific wellness-related goals
(19). Subsequent wellness coaching sessions may involve using techniques such
as motivational interviewing to elicit
“change talk” (one’s own reasons and
arguments for change) (17).
Wellness coaching is grounded in coaching psychology theory and integrates
over 15 evidence-based theories from
a variety of academic fields (18). Examples of theories a wellness coach might
use include appreciative inquiry (4),
motivational interviewing (16,17), and
transtheoretical model of change (27).
Although coaching psychology draws
on many psychological theories, it is
important to understand the difference
between coaches and psychologists.
works with people who are already
doing some things well in their lives
and who wish to do better or to
develop in other dimensions (18).”
PHILOSOPHICAL DIFFERENCES
OF PERSONAL TRAINING AND
WELLNESS COACHING
Individuals seek personal trainers for
advice on exercise techniques and
developing comprehensive physical
training programs. Successful personal
trainers may draw on their academic
preparation and experiences to help clients improve fitness parameters (e.g.,
strength, endurance) by providing specific instruction and education to their
clients. Telling someone exactly what
they need to do to improve their health
can be successful when clients are
highly motivated. Conversely, if a client
has significant barriers or is ambivalent,
they will struggle often to improve their
health in a meaningful way.
Wellness coaching is not didactic in
nature and coaches are trained to collaborate with their client rather than
telling them exactly what to do (3).
Wellness coaches seldom analyze
problems and set the goals for the client. Wellness coaches believe that clients have the answers that will work
best for them and the power to change
within themselves (3,19). A wellness
coach’s job is to increase a client’s
self-efficacy and help a client resolve
any ambivalence to change (19).
Some core philosophical differences
shown in the Table may impose challenges for the personal trainer–client relationship. If the personal trainer is serving
64
PERSONAL TRAINING
PREPARATION AND ACADEMIC
COURSEWORK
The requirements to challenge the
NSCA Certified Personal Trainer certification examination (22) include the
following: (a) being at least 18 years of
age, (b) having a high school diploma or
equivalent, and (c) CPR and AED certified. If one does not have an exercise
science–related degree, the NSCA recommends reviewing the NSCA-CPT
Exam Content Description booklet (2)
and the NSCA’s Essentials of Personal
Training textbook (6). To challenge the
NSCA Certified Special Population
Specialists (CSPS) certification exam
(23), one must meet all the following
criteria: (a) CPR and AED certified,
(b) baccalaureate degree in exercise science or related field, and (c) 250 hours
of related practical experience.
Wellness coaching a sedentary individual to adopt a physically active lifestyle
requires a different set of competencies.
Moreover, most exercise science curricula lack comprehensive coverage of
behavior change theories and coaching
Table
WHAT COACHING IS NOT
Psychologists, therapists, and psychiatrists treat diagnosable disorders based
on the Diagnostic and Statistical Manual of Mental Disorders (1). Wellness
coaches are not trained to diagnose,
treat, or coach individuals that suffer
from mental health disorders. Rather,
they should be trained to recognize the
signs and symptoms of mental health
disorders and how to refer to appropriate resources. Simply put, “coaching
as the client’s wellness coach and personal trainer, the skill-set may be different
depending on their focus for that day (e.
g., teaching an exercise versus discussing
behavior change strategies). While a challenge, being a successful wellness coach
and a personal trainer is attainable; however, additional training beyond a certification and/or baccalaureate degree in
exercise science or related discipline is
needed (e.g., behavior change theory,
motivational interviewing, and practical
wellness coaching skills) (7).
Comparisons between the personal training approach and the wellness
coach approach
Personal trainer
Wellness coach
Presents as the expert
Presents as a facilitator
Primarily instructs/didactic in nature
Primarily listens
Corrects problems
Builds on strengths/self-efficacy
Provides a solution
Assists with overcoming ambivalence
VOLUME 35 | NUMBER 5 | OCTOBER 2013
Data obtained from Frates et al. (10).
psychology theory (7). For example, the
NSCA’s Essentials of Personal Training
textbook (6) does not cover information
related to behavior change theory or
coaching psychology theory. Skills
related to psychology are focused on
athletic performance. As such, personal
trainers must seek additional training
that is evidence based to offer the additional service of wellness coaching.
Organizations such as the NSCA may
consider additional emphasis on wellness coaching competencies as the role
of the personal trainer evolves. The
CSPS certification appears to be headed
in that specific direction with the
emphasis on partnering with health care
providers and patients with chronic diseases. That is, the CSPS certification
does cover some content on “applying
motivational/coaching techniques” (23).
WELLNESS COACHING
COMPETENCIES
The International Coaching Federation identifies 11 core coaching competencies and accredits “health and
wellness” coaching programs (14).
Unfortunately, none of these coaching programs appear to be specific
to exercise-related behavior changes.
Recently, the NCCHWC, a group of
75 organizations and individuals,
formed to create a vision to “transform the health care system in America by the integration of professional
health and wellness coaches; addressing health issues with a whole-person
orientation, focusing on prevention
and wellness, and facilitating personal
engagement and empowerment for all
ages, levels of socioeconomic status,
and cultures” (21). The primary goal
of NCCHWC is to develop competencies for the profession and integrate health and wellness coaches
into health care. Academic institutions offer certifications, minors, and
graduate degrees grounded in coaching psychology theory including the
University of Minnesota (30), Duke
University (5), University of Louisville (29), University of Delaware
(28), and University of Sydney, Australia (31).
AFFORDABLE CARE ACT AND THE
FUTURE OF HEALTH CARE
On March 23, 2010, the United State’s
Patient Protection and Affordable Care
Act (PPACA) became law (26). The law
includes language about prevention and
the importance of enhancing prevention services and included a 15 million
dollar Prevention and Public Health
Fund. Specifically, on September 23,
2010, preventive care became free and
includes counseling on such topics as
losing weight, eating healthfully, and
depression (26). In addition, new language was added that includes an
Annual Wellness Visit and Personalized
Prevention Plan for all Medicare participants. It is unclear who would provide
the preventive counseling services, but it
may include a fitness professional as
part of the health care team or a referral
to a fitness professional.
On January 1, 2015, physicians in the
United States will receive reimbursement for their services based on value
not volume (26). In other words,
physicians will receive more reimbursement, based on a patient’s
increased level of health. This change
in the United State’s health care system strengthens the case for fitness
professionals and wellness coaches
to be reimbursed for their primary
prevention services as part of the allied
health care team. The PPACA will
greatly enhance the opportunities for
NSCA CSPS professionals, especially
if they attain wellness coaching competencies, to improve primary and
secondary prevention efforts.
WELLNESS COACHING
CERTIFICATIONS AND HEALTH
CARE
As certified personal trainers begin to
expand their services in wellness coaching, there will be an increasing demand
for coaching psychology and behavior
change competencies embedded in academic programs and certification curricula. In addition, industry may demand
the skills of wellness coaching to meet
the health care challenges related to
chronic disease. Wellness coaching skills
in combination with the expertise of
personal trainers will best position the
profession to meet the needs of their
clients. Ensuring evidence-based wellness coach training for personal trainers
is the essential next step.
The wellness coaching industry continues to evolve and the NCCHWC
continues to make progress. In the
meantime, personal trainers have some
certification options available to them.
Three examples of wellness or health
coaching certifications include Wellcoaches, the Health Science Institute,
and Mayo Clinic.
In partnership with the American College of Sports Medicine, Wellcoaches
(32) offers a 18-week evidence-based
certification program grounded in
coaching psychology and behavior
change theory. The certification exam
consists of a practical skills assessment,
written exam, submission of practice client data, submission of your client’s personal wellness vision, and 3-month goals
and a certification fee. Prerequisites
include a baccalaureate degree in
a health-related field or a nonhealth–
related baccalaureate degree plus
a health-related certification such as
the NSCA-CPT or CSCS certifications
(33). Some exercise science programs are
partnering with Wellcoaches (e.g., University of Louisville (29)) to introduce
wellness coaching competencies into
their curriculum.
The Health Science Institute (13) offers
a Chronic Care Professional certification
that includes a 40-hour curriculum
focused on chronic disease, health care,
prevention, and health coaching. The
certification exam consists of 100 multiple choice questions. Prerequisites
include anyone working currently in
health care or a health-related field.
Unfortunately, the examination does
not include a practical portion; therefore, those challenging the examination are not required to demonstrate
competencies in wellness coaching.
Mayo Clinic offers a wellness coach
certification program through the
Mayo School of Health Sciences (15).
On completion of the course, the participant is eligible for 3 credits of graduate coursework. It is an 11-week
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Wellness Coaching Certification: New Frontier in Health Care
online program with a 2.5-day workshop onsite at Mayo Clinic in Rochester, Minnesota. Prerequisites include
baccalaureate degree or an associate
degree in a health care–related field
with current license to practice. The
2.5-day workshop includes an assessment of practical coaching skills.
It is not clear to what extent the personal training industry, academia, and
health care will embrace wellness
coaching as a discipline; however,
these 3 industries, through the power
of collaboration, have the potential to
impact chronic disease by helping
those with diabetes, obesity, and other
health-related conditions. In addition,
these new professionals have an
opportunity to engage the health care
community in primary prevention.
Certifications and curricula within
the discipline of kinesiology should
include training and application of
evidence-based behavior change and
coaching psychology to meet the
needs of clients and the challenges
individuals face in their effort to
reduce sedentary lifestyles. Moreover,
it is likely that health care providers
will seek to refer their patients to professionals that have certifications that
emphasize competencies related to
behavior change. Likewise, certified
wellness coaches may consider attaining a baccalaureate degree in exercise
science. The synergy between these 2
disciplines has the potential to better
meet the needs of clients and may
increase career opportunities in health
care as the Affordable Care Act continues to unfold.
CONCLUSIONS
Personal trainers may consider adding
wellness coaching as a service to better
meet their client’s needs and enhance
health-related outcomes. There are
philosophical differences between the
didactic model of personal training and
the cofacilitation model of wellness
coaching. Thus, certified personal
trainers or new CSPS professionals
may consider attaining additional education or certifications in wellness
coaching. By becoming competent in
66
wellness coaching, personal trainers
may have additional opportunities to
provide preventive counseling services
as part of an allied health care team to
help patients become healthier as written in the PPACA. Fitness professional
organizations, academic programs, and
health care will play an important role
in enhancing personal training education and competencies because they
relate to behavior change and coaching
psychology theory to impact chronic
disease and primary prevention efforts.
Conflicts of Interest and Source of Funding:
The author reports no conflicts of interest
and no source of funding.
Cherie Pettitt
is an assistant
professor in the
Department of
Human
Performance at
Minnesota State
University,
Mankato.
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