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5 Common Health Coaching Mistakes

by: Jennifer Wannen
Published: September 9, 2016
Updated: June 23, 2022


Although the science of health may be straightforward, the art of coaching is often not. We bring our expertise and our interest. Our clients, for their part, bring their willingness and their realities. We all bring our humanity. The resulting mix is considerably more complicated than the individual parts. Given the infinite variety of circumstances we meet with as coaches, it’s little wonder we can get sidetracked or confused by the complexity from time to time—especially in the early stages of our profession. Whether we find ourselves off our game with a particular client or struggling with the overall implementation of our coaching business, we can review core principles. Where are we clear on our roles, and where are we missing the mark?

1. Talking More than Listening

It’s easy, particularly in the early stages of coaching, to put too much stock in our health knowledge. We’ve spent considerable time, effort and resources building our expertise, and we know we have something important to offer those who come to us. Surely, they came to us to learn. And they have. But we must let them take the lead in order for this to happen.

A client-centered approach entails, of course, a focus on the clients—an emphasis on their stories, their challenges, their confusion, their celebrations, their process. The window we have to these is our clients’ sharing. The more room we leave for that, the more insight we’ll have into where they’re really at and what they need in this moment from us. When we get too directive, too prescriptive in our approach, we miss this, and they miss out on our best service.

But how can we realistically put this into practice without being a literal clock-watcher during sessions? We can shift the mindset we bring to our meetings for one. Instead of bringing an expert’s mind, we can come with a “beginner’s mind.” A concept from Zen Buddhism, beginner’s mind encompasses an openness to what we meet (in this case, the client) that is free of assumption and imposition. We approach the client with a fresh curiosity, trusting that what we most need to know we will learn in that moment. It’s not, of course, that we forget all we know about health and wellness. The difference is we don’t come to the session armed with it. We let it organically rise in free conversation with the client.

2. Asking Ineffective Questions

Yes/no questions (e.g. “Do you have a regular bedtime routine?”) might seem helpful because they’re easy for even the most stoic client. Likewise, leading or directive questions (e.g. “Could you work out over your lunch hour?”) have the appeal of moving a client quickly toward solutions we have in mind for them. Neither choice, however, will do much to move our clients forward in their own problem-solving. There’s a better option to support their process.

Perhaps the most critical tool of a client-centered approach is the open-ended question. “What kinds of preparation could help you have healthy food on hand for the workweek?” “When in your weekend is there time to fit in activity?” “What would the most relaxing pre-bed routine look like for you?” “What sensations do you notice most when you’re particularly stressed?” When we employ open-ended questions in our coaching relationships, we respect a client’s ownership of his/her process and encourage him/her to come to uniquely personal solutions. Most importantly, this kind of modeling will offer benefits far beyond the immediate concern and even beyond our coaching relationship.

3. Failing to Establish or Maintain the Client’s Accountability

Some of our clients come to us ready to work. They understand from the get-go that this will be their journey and their choice. Others come wanting results but not really ready to take ownership. Some of these folks will move into a sense of responsibility through our initial conversations and their early efforts. Others will struggle and let go of the process.

Accountability unnerves the people who aren’t ready for change and empowers those who are.

We come to coaching knowing that accountability is the crux of behavior change. But things may get fuzzy when we begin the actual process of working with clients who all have individual stories, ongoing pressures, personal crises, and other struggles. A client begins explaining his/her plight, and suddenly we can feel like we’re put in a spot to give him/her a pass or not.

Making accountability the centerpiece of our coaching isn’t about playing it tough. In fact, it’s about doing away with the pretense that anyone has authority other than the client him/herself. Accountability in a coaching relationship revolves around the choice to act—not the choice to desire but the choice to enact a desire each day.

Methods for accountability revolve around a design for change that you and your client collaborate to create and revise. While you offer the expertise to guide the trajectory, but the foundational commitment to everyday behavior is the client’s. Whatever the means of communicating, tracking and recording, the bottom line of any methodology will be the basic question, “What have you done today to live your health values?” In keeping with the mutually agreed upon program, what actions did you perform or not perform today? What choices today upheld your health priorities, and which didn’t? Clarity is the first step in commitment.

Accountability is a concept to discuss early and often in a coaching relationship. Most clients will grow into it over time, and talking about the concept in each session affirms the client’s role as director of his/her health. You, as coach, are trusted advisor.

4. Sliding into Unqualified Roles or Advice

Making significant changes in one’s health can be an emotional process. For deep, lasting transformation to take root, clients often need to spend time examining past beliefs and stories about themselves, their weight and their health that they’ve carried through years, if not decades. Suggesting your clients reflect on and even share about these old scripts can help them move beyond half-conscious blocks to their progress.

That said, at a certain point, we may find ourselves on the receiving end of shares that take us beyond our professional capacity. In the interest of our clients’ well-being and in keeping with our own professional integrity, we must refer our clients to other experts for assistance with these matters, whether they be past or present abuse, eating disorders, or mental illness. Likewise, if financial or legal situations come up in conversations (e.g. about current stressors, etc.), we should apply the same standard of professional conduct and avoid offering advice beyond the scope of our role as health coaches.

5. Abandoning Rules and Boundaries to Keep a Client (or Keep a Client Happy)

We all want to do what we reasonably can to satisfy our clients. We’re in the service business after all. Our jobs are about helping people, building rapport together and collaborating effectively. Sometimes, however, we need to remind ourselves what lengths we will go to in the service of our jobs and what limitations we need to set for them.

As a coach, you have the right to establish and maintain boundaries around your time, energy and services. For instance, you have the right to begin sessions at the pre-selected time and end them when they were scheduled to end regardless of what time a client may arrive. It is appropriate to not be reachable at all hours and to return calls or emails at your convenience. Likewise, you have the right to charge for contacts beyond scheduled sessions that entail more than logistical clarifications, particularly if a client is contacting you on a frequent basis outside of your regular meetings.

It’s important that we never lose sight of our coaching as a professional contract despite its personal dimension. Talking to other coaches can help us anticipate potential thorny situations and prepare for them by incorporating relevant explanation in our client agreement materials. Still, it’s important to acknowledge that we will in all likelihood at some point face novel challenges in which clarity around our professional and personal boundaries will serve us well.

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