As health coaches our success is in the joy of seeing our clients navigate their own health behaviour change confidently.

We see ourselves as helping clients to explore their values and clarify their intentions. We work alongside them, holding steady the process and craft of health coaching, while they drive the agenda forward towards their health aspirations.

Goals are well described by Austin & Vancouver (1996, cited in Greif et al, 2022) as ‘Internal representations of desired states or outcomes’. How do we become the container to help our clients articulate their desired state and outcome?

Within the PREKURE coaching process & together with our client we co-create:

  1. The overarching goal(s) within the health coaching agreement
  2. The focus session outcome in each health coaching session

Within the methodologies of coaching, there are more than twenty different goal constructs some of which are outcome, distal & proximal goals, approach and avoidance goals, performance and learning goals, higher and lower order goals, and concrete results which the client aims to achieve. John Whitmore’s well favoured transactional GROW model is one such example of an actionable performance & goal schema. These distinctions allow us to understand the different approaches and methodologies that drive the goal directed activity of coaching.

In health behaviour change:

  • We understand that the barriers to change are both internal and externally driven.
  • We focus on exploring the true inner person.
  • We know that emotion drives behaviour and that inner beliefs and values along with external constructs wield overpowering influence.
  • We dig deep to explore and support new awareness and identify our clients true focus and desired outcome.

Behaviour change is more likely to be maintained when the overarching health goals are self-determined by the client Patrick & Williams, 2012. This relates to self-determination theory, which essentially states that it is the quality, rather than the quantity of motivation that counts when it comes to behaviour change. Those who autonomously engage in behaviours that are important to them are more likely to sustain those behaviours in the long-term. Through the transformational health coach approach we support our clients’ new self-discovery and ultimate self-efficacy utilising coaching skills and the delivery of health science information.

1. The Coaching Agreement

In health coaching we celebrate each coach’s unique style and ability to coach whatever shows up. We adhere to a set of competencies and a coaching mindset that not only puts the client at the centre of their own journey, it also upholds our health coaching ethics and scope of practice. Within the bounds of each new relationship, our clients ‘big goal(s)’ are explored.

A strategic coaching agreement is co-created that focuses on:

  • The client’s overarching goal(s) that are meaningful to them

  • The steps that are achievable for that client
  • The time in which the contract is set
  • The measures of success for the entire engagement

Our clients’ individual approach to their own health aspirations rather than fears are part of this equation in formulating these goals. We record and utilise the measurements and metrics that fit with them. These become part of the magnet that pulls them towards their why.

‘Well crafted goals embody our clients’ compelling vision’

We seek to explore & clarify these ‘big client goals’ over the pre-engagement & discovery sessions. Experienced health coaches know; that for each client the journey will be unique and different, it is the health coaches role to support their clients agenda. Whilst holding both the process and their commitment to change steady. We utilise our many health coaching skills to create new awareness. When required or as part of our individual health coaching process & style we use health coaching exercises and tools to aid new discovery, for example: wheel of life. Our curious questions are directed in service of our clients goals and the measurement of their desired outcome(s):

  • What are your goals for our coaching engagement?
  • Where do you want to be in three months?
  • What feels achievable within the timeframe?
  • How will we know/ acknowledge when these goals shift?
  • What does success look like?
  • How would you like to measure this success?
  • What are the measurements you would like to use?

These big goal(s) are then recorded and used as a compass with which to navigate and re-visit client progress along the coach-client journey. For example:

In three months time I will be achieving an exercise routine that will be at least 1 hour, 3 x per week. I am currently at a 4/10 in confidence with this and would like to be at a 7/10.

Or/ &

Within three months my HbA1c will have reduced below 41 mmol/mol and my waist circumference will have decreased by 2 inches.

Or/ &

Within three months I will have more energy: My current energy levels are at 3/10. I would like to be at 7/ 10.

Among others, Smart Goals are used by many health coaches to support the clarity and measurability of these ‘big goals’. Coordinating achievable goals skillfully builds client confidence, a clear and feasible plan and a pathway to success.


2. The Focus Session Outcome

At the beginning of each health coaching session it is important to establish a focus. The focus is a clear topic that you will put the spotlight on during the session. This focus is always born from the client’s agenda. The first 5 -20 minutes of the conversation (as an example in an hour coaching session) is spent exploring and expanding the clients mind for the importance, meaning and understanding of this focus.

Take the focus the client chooses and filter it down to gain client awareness on meaning by asking questions such as:

  • ‘When you say gain more energy, what do you mean by this?’.
  • ‘When you say explore ways of getting more movement into your day, what do you mean by explore?’.
  • ‘What needs to be resolved in order to achieve this outcome?’.

The coach then partners with the client to establish an outcome (compelling vision) for each coaching conversation to ensure:

  1. Clarity for both parties on the intended end result of the conversation.
  2. Clear and meaningful outcomes to guide the conversation and prevent wander.
  3. The result of the conversation can be measured against the intended outcome. Allows check-ins throughout the conversation.

Determining the outcome of the coaching session can be established by asking your client the curious questions such as the following:

  • What would you like to achieve from this session?
  • What do you want to take away from today’s conversation?
  • What outcome do you wish to have by the end of today’s conversation?
  • How do you want today’s coaching session to serve you?
  • How will you know that we’ve achieved your goal with today’s session?
  • What would you like to accomplish in our session today?
  • How will you know whether the coaching has been of use to you?

In service of the clients agenda, there can sometimes be a requirement to shift towards a new focus within the session. This is part of the ‘moment by moment’ skill, in the dance of coaching the client, where they are at right now. Our deep exploration and the clients forthcoming new awareness, may bring about the necessity for this ‘re-focus’. Essentially, our client shifts their focus (topic) during a session towards a deeper more meaningful outcome.

‘When you change the way you look at things, the things you look at change’ — Wayne Dyer

With this, our health coaching mindset to embody our clients as creative and whole, will negate the exploration of this shift towards a new desired state or outcome. Our check-in here; on a possible new session focus outcome is paramount in order to stay in step with our client. For example:

  • I noticed that you are now talking about (xyz). How does this relate to what you said you wanted to talk about today?
  • This seems like a different topic. Is that how you see it? How would you like to move forward from here?

Use the PREKURE Health Coaching Mantra below:

Start of Session:

  • Welcome
  • Ethical guidelines/ confidentiality
  • Length of session
  • Is there anything you would like to do before we start?
  • Focus session outcome

End of Session:

  • Next step
    • What (will you do?)
    • When (will you do it?)
  • Support (what support do you need?)
  • How would you like to be accountable?
  • Wrap up x 2:
    • What do you take from this session?
    • What else?

Tip: A short and concise formulated focus session outcome creates clarity for the partnership between client and coach on what to work on together for the session. Ask your client to rephrase or bottomline what the outcome of the session is in a short sentence. For example ‘to look at my nutrition journal and make positive steps forward’ or ‘to find motivation for exercise’.

A health coach’s ability to co-create:

  1. Succinct and measurable goals within the health coaching agreement,
  2. A clear focus session outcome for each health coaching session,

is an intricate part and competency in the art of coaching. Walking forward together with clear commitments and a compelling vision is an important milestone in the coach-client relationship towards ultimate success.



References as well as embedded in text:

Greif, S., Mӧller, H., Scholl, W., Passmore, J., Müller, F. (2022). International Handbook of Evidence-Based Coaching: Theory, Research & Practice. Springer, Switzerland.