Unlocking the Power of Group Health Coaching

For every one of us, the importance of engagement in our own health journey has become paramount in a world where preventable suffering, health disability and healthcare costs are skyrocketing. 

Much of our current healthcare attention is focused on the biological, genetic, biochemistry, immune, physical and dietary issues of why people get diseases. We must not forget to focus on the psychosocial. People are wired for protection and connection. It is well understood that one of the key determinants of health is social connection, WHO. Something highlighted on a profound level in the 2019 COVID pandemic. 

Connection to others is a fundamental piece of what it means to be human. It provides meaning, purpose in life, and creates a safety net of support that individuals turn to in times of adversity. 

An advocate and leader in the move towards community medicine, James Maskell, surmises that a community is a group of people who share a story. He proposes that the power of group or community health medicine and the role it plays in the prevention and healing of chronic disease, chronic mental health issues, access to affordable care, loneliness, social isolation, and emotional health are some of the biggest challenges to the healthcare system right now.  He upholds the biggest driver of all-cause mortality is loneliness and social stress. 

Group health coaching in lifestyle medicine and science is in its infancy, particularly in Australia and New Zealand. RCT’s are very much needed on group health coaching as opposed to 1:1 health coaching, support groups, education groups, team coaching and just waiting for support, to determine its degree of effectiveness. Being able to highlight data on our anecdotal evidence of group health coaching’s key attributes and quantify training standards is of prime importance for the future. 

The health coach mindset (health coach approach) that our clients are whole real and creative, and they have their own answers is the starting point when forming a group. In group health coaching we must continue to meet our clients where they are at right now,  see them all as a whole person, not a problem and provide a safe coaching container that works towards confidentiality, courage, connection, shared meaning, accountability and ultimately self-efficacy. 

Some lessons can be taken from the ICF team coach approach definitions and competencies, whilst taking care to recognise that health coaching is a separate philosophy, ICF, 2021.  The ICF definition of team coaching: ‘The team coach partners with the group in a co-creative and reflective process on group dynamics and relationships in a way that inspires them to maximize their abilities and potential in order to reach shared purpose and common goals’.

In particular the team coach:

•  Adopts more directive team development modalities only when needed to help the team achieve their goals.

As applied to health coaching: Each group member must be heard and play an integral role in group discussions. The health coach must remain objective in all interactions with group members, sponsors, and relevant stakeholders. The health coach should not be perceived as taking sides, should remain open to what is emerging in the sessions, and should be completely honest in all dealings with the group. Discussions with individual group members will need to remain confidential to the health coach and group member unless the group member allows disclosure of information to others and as per the group coaching agreement.

•  Maintains the distinction between team coaching, team building, team training, team consulting, team mentoring, team facilitation, and other team development modalities. 

Again as seen through the lens of a health coach, they may partner with other experts when the demands of a specific team coaching engagement warrant or when specific knowledge and skill levels are required. Group health coaches may need to refer clients to many types of professionals and also receive assistance from a co-coach, a supervisor, or other team development professionals.

The competencies of a group health coach thereafter adopt those of the health coach approach (see PREKURE health coaching competencies below):

• Working towards building the foundation of privacy and confidentiality within the group. 
• Co-creating a group coaching agreement, building rapport and a group-driven agenda that includes:  Big goals (with metrics if it is a purpose-driven group) and focus session outcomes that fit with the group agenda. Setting group rules, expectations and space for all to participate equally, encouraging innovation and diversity of thought. 
• Maintaining presence, space and managing self towards consistent curiosity without judgment. 
• Using the tools and skills of the health coach approach to facilitate growth.
• Introducing science, challenge, inquiry and information with permission that fits with the group’s goals and agenda. 
• Working within SOP towards what is positive and possible. 
• Understanding the change model (TTM) and that all participants will be at different stages of change and emotion. 
• Utilise a health coach process (The PREKURE mantra) to support effective time management, and a safe and growth/strength-driven health coach container. 
• See PREKURE Health coaching competencies;

• Foundation 

1. Demonstrates ethical practice
2. Embodies a coaching mindset

• Co-Creating the Relationship

1. Establishes and maintains agreements
2. Cultivates trust and safety
3. Maintains presence

• Communicating Effectively

1. Listens actively
2. Evokes awareness

• Serves the clients desired outcome

1. Asks permission
2. Delivers lifestyle medicine education on the clients agenda

• Cultivating Learning and Growth 

1. Facilitates Client Growth

Lastly, It is through my own anecdotal group health coaching practice that I have observed the patterns and key elements in group health coaching to be: 

• Fun, engagement, humour and story-telling
• Scaffolding and sharing of emotions and knowledge
• Recognising that you are not the only one
• Shared values, beliefs and understanding
• Belonging, connection and having a tribe
• Learning to be vulnerable and trust
• Championing others and strength spotting
• Gaining confidence and mental fitness skills (being comfortable in the uncomfortable)
• Uncovering ancestral and historical knowledge
• Deeper self-awareness A-HA moments
• Reframing of priorities and dropping of comparison 
• Celebrating wins, motivation and momentum

We have spent many years in our medical system uncovering and fixing what is wrong with people. We are now upon the emergence of wrap-around health models, that include the modality of group health coaching in lifestyle medicine. Now is the time to connect back to the power in our communities, and uncover their strengths, their stories, their wisdom and ancestral knowledge to make positive health changes. I believe the power of group health coaching is just such a vehicle to that change. 

References:

• As within text links 
• https://www.jamesmaskell.com/
• https://www.healcommunity.com/value-based-care