1. Coaching relationship: respect, trust, concern, safety
2. Coaching spirit: seeking solutions, building on strengths, identifying opportunities, and aiming for a healthier, more satisfying future
3. Principles of active listening
4. Principles of strategic questioning
5. Communication strategies o Nonverbal o Verbal
6. Behavioral
7. Environmental
8. Financial
9. Medical and dental
10. Nutritional
11. Occupational
12. Physical
13. Psychological
14. Social
15. Spiritual
16. Outcomes
17. Review of skill development
18. New insights and take-aways

NOTE: Competence in the areas that require the coach to discuss, describe, list, and summarize information must be demonstrated at the 5th to 8th grade levels, similar to the simplicity of explanation in the patient education information and tutorials available through the National Library of Medicine and National Diabetes Information Clearing House.

1. Display and perform duties with professionalism in action and speech
2. Maintain privacy and confidentiality
3. Respect the integrity of the established Wellness Coaching model as taught and practiced
4. Work within the defined scope of practice in terms of strategies, techniques, and resources used in the coaching encounter
5. Recognize when referral to other professionals or services is needed
6. Use verbal and nonverbal communication skills to foster a collaborative atmosphere
7. Adapt personal style and approach to suit individual characteristics of the client, such as disability, gender, culture, ethnicity, age, sexual preference, and health status
8. Identify appropriate settings in which coaching can take place
9. Establish a coaching agreement with the client that makes clear the responsibilities of coach and client and delineates the scope of coaching services
10. Follow prescribed process for introducing new resources into the established Wellness Coaching model
11. Demonstrate commitment to ongoing skills development and performance improvement
12. Describe the multiple models and varied definitions of wellness
13. Discuss the attributes of each wellness domain within the varied models
14. Characterize levels of wellness in objective terms based on the degree to which each wellness attribute is present and/or achieved
15. Describe how attributes of wellness may vary depending on client factors, such as gender, age, and cultural, social, and environmental factors
16. Provide real-world examples of wellness in each domain
17. List common challenges and barriers to achieving wellness in each domain
18. Describe common approaches to achieving wellness in each domain
19. Define the 5 stages of change in the transtheoretical model of change
20. Provide examples of how a person may think or behave in each of the stages of change
21. List the tasks and goals associated with each stage
22. Recognize client’s readiness to change
23. Describe coaching interventions that may be undertaken at each stage to help client move to action and maintenance
24. Use decisional balance scale to help clients weigh the pros and cons, and costs and benefits of change
25. Summarize the models of supportive coaching practice and the evolution of positive psychology theory
26. Contrast problem-based versus solution-based models
27. Describe the principles of approaches that focus on supporting the client’s strengths as a way to reach a preferred future
28. Employ coaching techniques that help clients recognize their strengths, values, interests, and activities that increase their sense of fulfillment and purpose
29. Use strategic questioning to help clients craft a rich conceptualization of a preferred future
30. Recognize the differences among directing, guiding, and following
31. Provide low-key feedback
32. Roll with resistance
33. Avoid arguments
34. Use a supportive, nonjudgmental, warm, collaborative approach
35. Convey empathy through words, body language, tone of voice, pacing
36. Demonstrate genuine concern and awareness of client’s experience
37. Follow the client’s lead in the discussion without imposing an agenda or structure
38. Use client’s reactions as a guide for choosing strategies and techniques
39. Use open-ended questions that elicit client’s perceptions of problems, motivation, change efforts, plans
40. Begin with interrogatives (“What,” “How”) or lead with a request (“Tell me,” “Describe”)
41. Use questions that encourage greater client exploration and recognition of problem areas and motivation for change
42. Make questions simple and direct, reducing the chance for confusion
43. Time comments or questions so client has adequate time to reflect and respond
44. Verbally reinforce client’s strengths, abilities, efforts to change behavior
45. Enhance client confidence by praising small steps taken in the direction of change
46. Express appreciation of client’s personal qualities that may facilitate successful change efforts
47. Verbally reinforce client’s strengths, abilities, efforts to change behavior b. Enhance client confidence by praising small steps taken in the direction of change c. Express appreciation of client’s personal qualities that may facilitate successful change efforts
48. Use affirmations to promote effective change rather than just offering general, “feel good” compliments
49. Accurately identify essential meaning of what client has said in a way that client easily understands
50. Repeat client’s actual words
51. Rephrase by slightly rewording client’s words to clarify what the client means
52. Paraphrase by slightly amplifying client’s thoughts or feelings, using analogies, making inferences
53. Make reflective summary statements
54. Offer reflections that increase the time client spends talking
55. Reflect on client statements in a way that increases client introspection, conversation, and motivation for change
56. Recognize resistance (arguing, interrupting, denying, ignoring) and counter it with reflection, reframing, coming alongside
57. Convey in words (verbal) and action (nonverbal) that coaching is collaborative, not driven by the coach
58. Emphasize the importance of the client’s own decisions, confidence, and perceptions
59. Demonstrate respect of client autonomy and personal choice
60. Roll with resistance by emphasizing personal choice and autonomy
61. Elicit client discussion of change using evocative questions or comments designed to promote greater awareness or concern of the problem, recognition of the advantage of change, increased interest/optimism to change, elaboration on topics related to change
62. Help client develop a way to assess current perception of importance of change, confidence, readiness, commitment using rating scales
63. Explore how motivation might be strengthened
64. Create or heighten the internal conflicts client has relative to their current state
65. Increase client’s awareness of current life situation compared with desired state
66. Explore how current state may be inconsistent with client’s goals, values, or self-preceptions
67. Present discrepancies as legitimate conflicts or mixed experiences
68. Address the negative and positive effects of client’s current state in a nonjudgmental way
69. Explore potential costs and benefits of change
70. Conduct decisional balance activities to reveal the cost-benefits or pros and cons of change
71. Develop and support ambivalence as a normal part of the change process
72. Reflect back to client the mixed thoughts and feelings underpinning the ambivalence
73. Accept resistance as a part of the process
74. Capitalize on change talk (DARN-C; desire, ability, reasons, need, commitment)
75. Define the kinds of talk that lead to change using the DARN-C rubric
76. Help client recognize the disadvantages of the status quo
77. Help client explore the advantages of change
78. Foster a sense of optimism about change
79. Use strategic questioning to guide client in discussion about intention to change
80. Respond to statements about change and intentions to change with reinforcing statements
81. Present key points of the conversation in a concise statement and use it strategically to reinforce discrepancy and amplify change talk
82. Move discussion forward to another important topic or into change discussion
83. Assess readiness using measures such as the Readiness Ruler
84. Facilitate discussion of client self-identified goals
85. Work collaboratively with client to develop a change plan
86. Help client establish SMART goals
87. Help client identify initial potential barriers
88. Help client identify options to overcome initial barriers
89. Guide client in discussion of supportive resources available to them, such as family and friends
90. Explore potential roadblocks on the path of change and ways to address them
91. Use open-ended questions and reflections along the way to reinforce collaboration and strengthen commitment to change
92. Recognize appropriate situations in which to give information
93. Describe the uses of informing
94. Explain how to determine the right pacing, how much information to give, and how to direct with care
95. Ask permission to offer information
96. Employ collaborative strategies for informing: chunk, check, chunk; elicit, provide, elicit
97. Facilitate discussion of problem areas for which client is requesting coaching
98. Invite deeper exploration of problems by successively building on what client has already reported
99. Avoid directing conversation to problems identified by others, not the client
100. Provide feedback only when solicited by the client or after explicitly requesting client’s permission to offer it
101. Avoid using a judgmental or sarcastic tone
102. Refrain from using verbal and nonverbal language that inhibits client trust and comfort
103. Refrain from imposing a structure or agenda or using tactics that seek to control the client
104. Avoid providing unsolicited advice, feedback, or directions
105. Refrain from giving specific, concrete suggestions for what the client should do, but recognize exceptions when such suggestions may be appropriate
106. Do not instruct client on how to be successful with their plan for change
107. Avoid emphasizing one solution or goal as the only legitimate way to achieve the client’s goals
108. Refrain from imposing a particular behavior as a necessary standard for judging progress toward goal or improvement
109. Avoid directly confronting client about their failure to recognize problems related to their current state
110. Refrain from directly confronting client about not taking steps to change identified problem areas
111. Avoid emphasizing the concept of the powerlessness the client has over the problem or the inevitability of the problem
112. Refrain from expressing the view that the client’s life is out of control or unmanageable in the current state
113. Avoid asserting clear conclusions or decisions about what would be best for the client
114. Avoid asserting clear conclusions or decisions about what would be best for the client
115. Do not tell client “what works” best or the likelihood of a less optimal outcome if the client chooses one solution over another
116. Refrain from using the coach’s own experiences, knowledge, and expertise to highlight the points made to the client
117. Avoid asking questions that could be answered with a simple “yes” or “no”
118. Avoid asking questions that call for very specific answers, details, or information about client’s past behavior or circumstances contributing to their current problems
119. Refrain from hurrying client or steering or leading with questioning
120. Avoid hurrying client or requiring answers to multiple questions in close succession
121. Describe the principles of Tiny Habits in clear and easy-to-understand ways using the Fogg Behavior Model (behavior = motivation, ability, and triggers)
122. Identify client motivation according to core motivators (pleasure/pain, hope/fear, social acceptance/rejection)
123. Help client identify personal abilities and triggers
124. Help client identify personal target behaviors to be developed
125. Apply principles of simplicity to help client refine target behaviors
126. Ensure that ability and triggers are appropriate to achieve behavior-change goal
127. Reinforce client success
128. Help client monitor progress, evaluate outcomes, and problem solve
129. Emphasize use of Tiny Habits as an experiment and learning opportunity
130. Guide client in exploring ways to apply Tiny Habits skill development in new contexts or for new purposes
131. Employ sample scripts and scenarios to inform and refine practice
132. Make abundant use of algorithms, tips, and checklists to enhance effectiveness in planning, execution, and assessment
133. Use graphics and other non-text–based visuals to clarify, amplify, and enhance communication with client
134. Use email and text messaging to communicate with clients at all stages of change process as requested by client
135. Use email and text messaging as required by the coaching program for planning, performance assessment, monitoring, reporting, program development, and research
136. Offer client a variety of informational handouts and tools to foster self-assessment, planning, monitoring, performance, evaluation
137. Recognize client efforts to use tools in support of change process
138. Reflect the client’s experience back to client
139. Affirm client efforts and success
140. Describe the use of interactive journaling and the power of expressive writing in the change process
141. Explain the power of color and graphics to help enhance the change process
142. Offer the client opportunities to experiment with the use of interactive journaling
143. Collaborate with the client to use interactive journaling as a tool for change through all stages of change
144. Demonstrate to the client various online and mobile technology tools that the client can use independently of the coach to aid the change process
145. Help client access chosen digital technologies and tools
146. Recognize client’s efforts to use digital technologies and tools
147. Affirm client’s efforts and successes
148. Meet established ethical and professional standards
149. Establish an appropriate coaching agreement with all clients
150. Establish intimacy and trust as the foundation of an effective coaching relationship
151. Establish a coaching presence and style that is open, flexible, and confident, characterized by appropriate risk taking, use of humor, experimentation, and shifts of perspective
152. Employ active listening to focus full attention on the client and client’s agenda by supporting client’s full self-expression
153. Use powerful questioning to elicit discovery, insight, commitment, and/or action
154. Employ direct communication, characterized by language that has the greatest potential of impact
155. Integrate and accurately evaluate multiple sources of information to optimize client awareness
156. Assist client in designing actions that lead to client achievement of stated goals and fulfill purpose of coaching
157. Develop a coaching plan with results that correlate with SMART goals and can be adjusted over time to accommodate new learning or new situations
158. Manage progress and accountability so that the client’s autonomy is fully supported and the client is always the locus of control
159. Define the theoretical underpinnings of different coaching practices in use today
160. Examine the scientific literature related to the utility, feasibility, and effectiveness of coaching modalities used in practice in the field today
161. Evaluate the benefits and risks of current coaching practices as applied to different populations
162. Describe case scenarios illustrating the benefits and risks of coaching practices in use today
163. Describe initiatives to promote wellness using wellness coaching that expand coaching practice beyond conventional models and settings
164. Serve as a role model and advocate for wellness in formal and informal settings in public and private sectors
165. Discuss the use of alternative coaching interventions that complement traditional and evidence-based practice

NOTE: Competence in the cognitive areas (Competency items 1–7), which require the coach to discuss, describe, list, and summarize information, must be demonstrated at the 5th to 8th grade levels, similar to the simplicity of explanation in the patient education information and tutorials available through the National Library of Medicine and National Diabetes Information Clearing House.

1. Describe the attributes of health
2. Discuss the roles played by diet, exercise, and stress management on overall health
3. Explain how values, attitudes, thoughts, and beliefs drive healthy or risky behaviors
4. Describe the personal skills that foster health
5. List personal habits that foster health
6. Describe the current state of American public health
7. Discuss the national goals for health set forth in Healthy People 2020
8. List barriers and challenges that prevent people from achieving optimum health
9. Identify characteristics of people who are successful at achieving health goals
10. Evaluate solutions that have been suggested to improve America’s health
11. Describe how cultural values and perspectives shape health beliefs and habits
12. List examples of cultural values that may inhibit or foster healthy habits among people of different cultures
13. Recognize common cultural assumptions and biases that may come into play when working with people from diverse cultures
14. Use verbal and nonverbal modes of expression in ways that respect cultural differences
15. Display comfort and competence in cross-cultural exchanges
16. List resources for learning about different cultures
17. Recognize factors that contribute to the validity and credibility of biomedical resources
18. Describe common study designs and their strengths, weaknesses, and utility
19. Use credible biomedical data to support work with clients
20. Critically appraise advice and recommendations offered by popular media
21. List sources of reliable, credible health data and information
22. Describe the role good nutrition plays in physical and mental health
23. Summarize the roles played by macronutrients (carbohydrates, fat, protein) and micronutrients (vitamins, mineral, phytochemicals) and fluids
24. Define the components of a healthy diet
25. Describe the current US national diet recommendations
26. Discuss the rationale and utility of MyPlate
27. Describe alternate models for healthy eating and meal planning, including the Harvard School of Public Health's Healthy Eating Plate
28. List components of a healthy diet
29. List the most common diet challenges for different populations based on age, environment, culture, socioeconomics
30. Discuss common tips and techniques to foster healthy nutrition in individuals and families
31. Summarize evidence-based recommendations for weight loss in overweight and obese individuals
32. List sources of reliable, credible information on nutrition and healthy eating
33. Describe the role fitness and exercise play in physical and mental health
34. Define the components of physical fitness
35. Describe the current US national exercise recommendations
36. List basic exercises and activities to improve cardiorespiratory fitness, muscular strength, endurance, and flexibility; and body composition
37. List the most common fitness and exercise challenges for different populations based on age, locale, culture, socioeconomics
38. Discuss common tips and techniques to foster physical fitness in individuals and families
39. Summarize evidence-based recommendations for exercise in diverse populations
40. List sources of reliable, credible information on physical fitness and exercise
41. Define stress and describe its effect on the body
42. Discuss common causes of stress at home, on the job, and in the community
43. Describe the physical, mental, and behavioral symptoms of stress
44. Summarize the importance and benefits of managing stress
45. List defenses and rationalizations people use to normalize stress
46. Describe effective personal stress management strategies, including cognitive, physical, behavioral, and environmental strategies
47. Describe effective stress management strategies that may be used in interpersonal relationships
48. List the application of stress management practices at home, on the job, and in the community
49. List sources of reliable, credible information on stress management
50. Establish a helping relationship with client characterized by genuine interest, concern, respect, empathy
51. Promote the individual’s knowledge acquisition, skill development, and change of attitude that may contribute to a positive change in the individual’s health and fitness
52. Help client set SMART goals using the Tiny Habits model of simplicity
53. Facilitate client’s recognition of health and fitness improvement and emphasize the value of celebrating success
54. Assist the client in engaging family members and others in their sphere of influence (e.g., coworkers) in activities that increase health and fitness
55. Offer Interactive Journaling as an aid to developing greater skills that support specific aspects of health and fitness
56. Use client journaling and other modes of expression as a springboard for discussion related to health and fitness

NOTE: Competence in the cognitive areas (Competency items 1–5), which require the coach to discuss, describe, list, and summarize information, must be demonstrated at the 5th to 8th grade levels, similar to the simplicity of explanation in the patient education information and tutorials available through the National Library of Medicine and National Diabetes Information Clearing House.

1. Describe the attributes of family wellness
2. Describe the challenges that families confront through the continuum of life
3. List credible resources available to families for education and support
4. Describe the developmental tasks and milestones in early childhood (birth through eight years)
5. Discuss the developmental tasks and milestones of middle childhood (ages eight to twelve)
6. Discuss the developmental tasks and milestones of adolescents
7. Describe the developmental tasks and milestones that contribute to successful emergence into adulthood
8. Describe ways to help clients manage the expectations of marriage
9. Foster development of positive, effective communication skills
10. Discuss healthy strategies partners can use to manage conflict
11. List effective problem-solving strategies
12. Promote empathy and help clients develop appropriate expectations of their children
13. Describe the role parenting skills play in family wellness and help parents consider how to develop and/or enhance their skills in the following areas: a. Positive communication b. Effective praise c. Responsible behavior and discipline d. Modeling values e. Family decision making f. Establishing a safe and nurturing environment for children g. Effective problem solving, stress management, anger management, and coping h. Balancing family, work, and personal interests i. Incorporating healthy behaviors into the family j. Preventing problems before they start
14. Describe issues families must address as family members age, including medical, physical, and emotional challenges, end-of-life issues, living arrangements, and cost of care
15. Discuss the unique challenges faced by members of the “sandwich generation” who are raising their own children while caring for aging parents
16. Help families anticipate the challenges of caring for elderly family members with advance planning
17. Provide compassionate support for families struggling with the challenges of aging family members and end-of-life issues
18. Establish a helping relationship with client characterized by genuine interest, concern, respect, empathy
19. Affirm client’s autonomy and control and expertise about their family
20. Support client’s exploration of issues related to their family that they want to consider changing
21. Promote client’s knowledge acquisition, skill development, and change of attitude that contribute to positive changes in the family
22. Facilitate client’s recognition of change and emphasize the value of celebration of success
23. Assist the client in engaging family members in activities that increase wellness
24. Offer Interactive Journaling as an aid to developing greater skills that support wellness within the family
25. Use client journaling and other modes of expression as a springboard for discussion and client assessment and self-reflection related to family issues and change

NOTE: Competence in the cognitive areas (Competency items 1–3), which require the coach to discuss, describe, list, and summarize information, must be demonstrated at the 5th to 8th grade levels, similar to the simplicity of explanation in the patient education information and tutorials available through the National Library of Medicine and National Diabetes Information Clearing House.

1. Describe the variety of models and theories of addiction and other problems related to substance use
2. List the social, economic, political, and cultural contexts in which addiction and substance abuse exist
3. List risk and resiliency factors that affect susceptibility to substance use problems
4. Discuss the general behavioral, psychological, physical health, and social effects of substance use on the person who uses and on significant others
5. Recognize the potential for medical and mental health conditions to coexist with substance use and addiction
6. Recognize that an estimated 22 million Americans struggle with a drug or alcohol problem, and that almost 95 percent of people with substance use problems are considered unaware of their problem
7. Describe warning signs, symptoms, and the course of substance use disorders
8. Describe the general properties of each drug and alcohol classification, including alcohol, depressants, cocaine and other stimulants, opioids, hallucinogens, cannabinoids, and other drugs, such as inhalants, steroids, OTC drugs, and designer drugs
9. Describe the physiological effects of each drug class
10. Describe the psychological effects of each drug class
11. Discuss the withdrawal syndrome and drug interactions
12. Describe the philosophies, policies, and outcomes of the most generally accepted and scientifically supported models of treatment, recovery, relapse prevention, and continuing care
13. Describe the principles and components of treatment
14. Discuss the role of family, social networks, and community in the treatment and recovery process
15. Establish a helping relationship with client characterized by genuine interest, concern, respect, empathy
16. Affirm client’s autonomy and control
17. Support client’s exploration of personal goals and options
18. Foster client’s active engagement in the treatment and recovery process
19. Promote client knowledge, skills, and attitudes that contribute to a positive change in substance use behaviors
20. Encourage and reinforce client actions that promote achievement of established goals
21. Foster client self-reflection to recognize and avoid behaviors inconsistent with progress toward goals
22. Demonstrate willingness to involve client’s significant others as appropriate
23. Introduce other areas of wellness for the client’s consideration, with the intention of fostering the development of behaviors that support recovery
24. Facilitate client’s recognition of change and emphasize the value of celebration of success
25. Assist significant others in adopting strategies and behaviors that support recovery and healthy relationships
26. Offer Interactive Journaling as an aid to recovery
27. Use client journaling and other modes of expression as a springboard for discussion and client assessment and self-reflection

NOTE: Competence in the cognitive areas (Competency items 1–7), which require the coach to discuss, describe, list, and summarize information, must be demonstrated at the 5th to 8th grade levels, similar to the simplicity of explanation in the patient education information and tutorials available through the National Library of Medicine and National Diabetes Information Clearing House.

1. Recognize factors that contribute to validity and credibility of biomedical resources
2. Summarize key points of current biomedical data reported in popular media
3. Use credible biomedical data to support work with clients
4. Critically appraise reports and recommendations provided by popular media
5. Identify sources of reliable, credible data and information
6. Recognize prevalence of diabetes
7. List the risk factors for diabetes
8. Identify characteristics of high-risk populations
9. Recognize the severity of the problem of diabetes prevalence
10. Discuss the medical, social, physical, psychological, and economic burden of illness on the individual, family. and community
11. Describe normal glucose metabolism
12. Describe the multiple pathophysiologic processes (at least 8 factors) that contribute to the development of diabetes
13. Differentiate between the 3 common types of diabetes mellitus (type 1, type 2, gestational) and prediabetes
14. List common risk factors for the development of diabetes-related complications
15. Describe the micro- and macrovascular complications of diabetes
16. List signs and symptoms of long-term complications of uncontrolled diabetes
17. Describe the building blocks of a treatment plan
18. Discuss the roles played by each member of the diabetes care team within the current medical model of care
19. Describe the emerging model of an expanded care team and the role played by Wellness Coaches
20. Describe the critical role of diet and exercise in the treatment of diabetes
21. Discuss fundamental aspects of healthy food choices, portion control, and meal planning
22. Explain basics of carbohydrate counting
23. Make sense of nutrition labels
24. Provide insights into marketing practices associated with unhealthy foods
25. Describe the role of exercise in treatment and the effect of exercise on the disease process
26. Discuss the loss of beta cell function and why diet and exercise usually are not adequate in regulating blood sugar
27. Describe how different medications target different disease processes and sites
28. List the drug classes of common medications, how they are administered, their safety profiles, and common side effects
29. Discuss why no single medication can target all processes and why multiple agents are used
30. Describe how combinations of multiple agents, including various insulin regimens, help regulate blood sugar
31. Describe the fundamental components of self-management
32. List challenges and barriers to good self-management
33. Recognize the personal characteristics of a person with diabetes that contribute to success or failure with self-management
34. Acknowledge that attitudes about health and health management vary across individuals and cultures
35. Establish a helping relationship with client characterized by genuine interest, concern, respect, empathy
36. Promote the individual’s awareness about the benefits of good self-management and the opportunities available for improvement
37. Access a wide variety of tools, techniques, and resources to help support client in the development of good diabetes self-management practices
38. Offer Interactive Journaling as an aid to developing greater skills that support specific aspects of diabetes management
39. Use client journaling and other modes of expression as a springboard for discussion and client assessment and self-reflection related to diabetes management
40. Personal Factors that Contribute to Success a. Help client identify effective self-management practices they already employ b. Help client identify self-care practices that may need change c. Help client identify personal resources and strengths d. Promote readiness to take action by supporting good planning e. Support client in identifying challenges, difficulties, and barriers to success
41. Goal Setting a. Provide examples of immediate-, short-term, and longer-term goals the client may want to consider b. Help client identify areas needing change c. Help client identify SMART goals d. Promote successful action by supporting good planning
42. Action Planning a. Help client prioritize issues and decide the order in which to tackle them based on the significance of the problem, the resources available to the client to address them, and the significance of barriers b. Include the use of the Tiny Habits model in crafting specific behaviors to initiate c. Help client identify resources, tools, and a support matrix to assist in achieving specific goals d. Help client develop a plan that adheres to the SMART model e. Assist client in action planning by including key components of self-management in discussions. These components include medication, diet, exercise, monitoring, making adjustments to maintain good blood sugar control, and addressing psychosocial issues f. Help client recognize the importance of good foot, eye, and skin care g. Help client experiment with various techniques and tools to establish a reliable system for good self-management
43. Assessing Outcomes a. Use easy tools to help client manage the plan and assess outcomes b. Invite client to reflect on progress and outcomes
44. Affirming Commitment and Resolve a. Review goals with client to identify progress, barriers, ambivalence b. Help client refocus and reinforce commitment to goals and methods
45. Celebrating Success a. Help client identify meaningful ways to reward themselves for achieving goals b. Monitor client recognition of achievements, large and small, and “micro” successes c. Help reenergize client to work toward intermediate and long-range goals
46. Making Mid-course Corrections and Adjustments a. Guide client in assessing progress over time b. Suggest a variety of tools to use for monitoring, logging, and assessment to help patient maintain gains c. Remind client to monitor, assess, and reassess d. Support client in making necessary changes to established care regimen, including adjustments to medication, diet, activity level, support structure, and other factors affecting their condition e. Help client monitor their condition and stay on top of care, particularly related to blood sugar control and complications f. Assist client in anticipating and managing challenges to their self-care routine, such as weekends and holidays, travel, illness, and work
47. Recovering from Setbacks a. Help client put setbacks in context to help them avoid catastrophizing b. Explore with the client the process by which setbacks occurred c. Help client identify factors under their control which they can affect d. Help client assess goals and to reaffirm SMART goals e. Provide support for client’s action planning to reduce the risk of setbacks and avoid repeating the setback f. Help client brainstorm a variety of solutions to overcome setbacks and avoid them in the future

NOTE: Competence in the cognitive areas (Competency items 1–4), which require the coach to discuss, describe, list, and summarize information, must be demonstrated at the 5th to 8th grade levels, similar to the simplicity of explanation in the patient education information and tutorials available through the National Library of Medicine and National Diabetes Information Clearing House.

1. Define occupational wellness
2. List the components of occupational wellness
3. Describe the factors that contribute to occupational wellness
4. Discuss current theories about the role of work in an individual’s life throughout the lifespan
5. List available resources to help individuals assess their skills, strengths, interests, values
6. Discuss ways to help individuals engage in self-reflection and self-assessment related to key components of occupational wellness: a. Alignment with interests and values b. Work-life balance c. Interaction with others d. Sense of purpose and achievement e. Recognition f. Growth and development g. Appropriate level of responsibility, control, and autonomy h. Healthy, safe, supportive environment
7. Help client identify specific strengths that they possess that can be applied in the workplace
8. List the personal attributes that contribute to occupational wellness (ie, work quality and productivity, self-management, communication [speaking and listening], healthy boundaries, initiative, teamwork)
9. Describe how these attributes come into play on the job
10. Discuss ways to increase the effectiveness of these attributes
11. Describe strategies for maximizing effective collaboration and cooperation, and minimizing interpersonal conflict at the workplace
12. Explain the rationale, benefits, and risks of job crafting
13. Describe the principle of job crafting as a way to redesign work to foster greater job satisfaction, engagement, resilience, and thriving in the workplace
14. Summarize the key research on job crafting in terms of its practical implications
15. Provide examples of job crafting motivation, techniques, and outcomes
16. Describe how job crafting can be used as a coping technique for adversity and challenges in the workplace
17. Establish a helping relationship with client characterized by genuine interest, concern, respect, empathy
18. Promote the individual’s awareness about the benefits of occupational wellness and the opportunities available for improvement
19. Help client identify areas of occupational wellness that they want to change and improve
20. Help client establish SMART goals for increasing skills that foster occupational wellness
21. Provide opportunities for client to explore alternatives and solutions to interpersonal conflicts in the workplace
22. Facilitate client’s recognition of improvements in occupational wellness and emphasize the value of celebrating success
23. Offer Interactive Journaling as an aid to developing greater skills that support specific aspects of occupational wellness
24. Use client journaling and other modes of expression as a springboard for discussion and client assessment and self-reflection related to occupational wellness

Introduction to and definition of peer counseling, mentoring, coaching Privacy and confidentiality Responsibilities and limitations/boundaries Principles of professional conduct in action and speech Challenges and successes Scope of practice o Issues to address o Strategies and techniques that may be employed in the coaching encounter o Published and web-based resources that may be used to support coaching efforts o Process for introducing new resources into the established coaching program Establishing a coaching agreement Making referrals to other professionals: why, when, how, to whom Fostering a collaborative atmosphere: verbal and nonverbal skills Coaching setting: workplace, health clinics, recreation centers, retail locations (eg, pharmacy, grocery store), community and senior centers, houses of worship, gyms, private offices Coaching structure: Individual, family, or group coaching; single session or regularly scheduled meetings

Multiple Models, Varied Definitions o Emotional o Environmental o Financial o Intellectual o Mental o Multicultural o Occupational o Physical o Social o Spiritual Total Force Fitness: “a state in which the individual, family and organization can sustain optimal well-being and performance under all conditions” o Social (support and cohesion) o Psychological (coping, awareness, beliefs, decision making, engagement) o Behavioral (hygiene, substance abuse, risk mitigation, peer support) o Spiritual (perspectives, core values, identity, ethical foundation, embracing diversity) o Physical (strength, endurance, power, flexibility, mobility) o Environmental (temperature, altitude, noise, air quality) o Medical and dental (immunizations, screening, prevention) o Nutritional (food quality, nutritional requirements, food choices)

Framework for change: focusing on solutions, strengths, and a preferred future Solution-oriented strategies o Starting with the end in mind o Crafting a vision of a preferred future o Identifying precursors and resources o Defining progress Components of positive psychology o Happiness o Optimism o Values o Strengths o Accomplishments Stages of readiness: Transtheoretical Model of Change Health belief model o Perceived susceptibility, severity, benefits, costs o Motivation o Enabling or modifying factors Motivational interviewing o Spirit and practice o Expressing empathy o Developing discrepancy o Rolling with resistance, avoiding argumentation o Supporting self-efficacy Tiny Habits (Fogg model) o Behavior = motivation + ability + triggers o Principle: place hot triggers in the path of motivated people o Behaviors on a continuum: one time, over a span of time, ongoing o Behavior types: new, familiar, increase intensity or duration, decrease intensity or duration, stop Interactive Journaling o Rationale and outcomes data o Application in diverse populations and settings o Exploring risks, needs and goals o Identifying strengths and resources o Managing change one step at a time o Use of The Change Companies Interactive Journaling® library of evidence-based products

Recognizing stages of change Interventions to achieve goals of each stage Use of decisional balance scale to assist client evaluate pros and cons/costs and benefits of change Coaching to enhance maintenance

OARS+E: Client-centered counseling skills o Open-ended questions o Affirmations o Reflective listening o Summaries o Eliciting change talk OARS practice o Types of reflections: simple, amplified, double-sided o Levels of reflection: repeat, rephrase, paraphrase Exploring ambivalence Rolling with resistance o Defining resistance: arguing, interrupting, denying, ignoring o Defining rolling with resistance o How to roll: reflect, shift focus, reframe, agree with a twist, emphasize personal choice & control, coming alongside Readiness o Readiness as related to stages of change o Assessing and measuring readiness Change: DARN-C o Significance of DARN-C: desire, ability, reasons, needs, commitment o Using a ruler o Assessing importance and confidence o Pros and cons o What next? o Using hypotheticals Informing o Uses of informing o Pacing, amount of information, directing with care o Asking permission o Strategies: chunk, check, chunk; elicit, provide, elicit Developing a change plan o Role of information and advice o Menu of options o Use of SMART rubric to formulate goals

Defining Tiny Habits/target behaviors o Cycle behaviors o Cue behaviors Recognizing core motivators o Pain/pleasure o Hope/fear o Social acceptance/rejection Identifying ability Designing behaviors to make them simple o Time o Money o Physical effort o Mental effort o Social deviance o Departure from routine Identifying and choosing powerful triggers o Sparks (for low motivation) o Facilitators (for low ability) o Signal (cueing) Recognizing and celebrating success Evaluating outcomes

International Coaching Federation core competencies o Ethics, standards, agreement o Coaching relationship and style o Effective communication: listening and questioning o Optimizing outcomes: goal setting, planning, responsibility, accountability, achievement Expanded coaching practice: innovation and tradition o Theoretical underpinnings of coaching practices in use today o Evidence of utility, feasibility, and effectiveness of current coaching modalities o Benefits and risks of current coaching practices as applied to different populations o Expanded coaching practice beyond traditional models and settings o Wellness advocacy o Alternative and complementary coaching interventions

Coaching support tools o Sample scripts and scenarios o Tips, algorithms, checklists o Emails and text messaging (for coaching and client support) o Collaboratory resources o Links to approved websites Client handouts and tools o Interactive journaling o Personal assessment o Decision support o Monitoring & tracking o Logs

Assessing motivational interview sessions o Assessing adherence o Assessing competence Assessing outcomes and performance one session at a time o Gathering and using feedback to inform coaching decision making o Assessing the client’s perception of how they are doing o Assessing the client’s perception of the coaching session Review of key concepts Coaching skill development Problem solving Required and optional participation in the Collaboratory Standards and procedures for client data collection and submission Standards and procedures for program collection and submission

The attributes of health The role of diet, exercise, and stress management on overall health The effect of values, attitudes, thoughts, and beliefs on behavior Personal skills and habits that foster health

Current state of American public health: epidemiology National goals: Health People 2020 Factors contributing to the current public health problems Personal skills and habits of health people Policies and practices recommended to address current problems

The role of cultural values in shaping health beliefs and habits Cultural values in diverse American populations that foster or inhibit healthy habits The effect of cultural assumptions and biases in coaching relationships Working with sensitivity and respect with people from diverse cultures Resources for learning about different cultures

Overview of research principles in health and fitness How to read and interpret biomedical data How to use data to support your work Sources of reliable and credible data

The role of nutrition on mind, body, spirit Nutrition defined: The role of macro-and micro-nutrients Components of a healthy diet and eating habits Current nutritional recommendations and the use of MyPlate Challenges to healthy eating in diverse populations What the scientific data say about how to lose and sustain weight loss Sources of reliable and credible information on diet

The effect of exercise and fitness on mind, body, spirit Fitness defined: What constitutes “in good shape?” How much and how hard: Current US recommendations for exercise and physical activity Basic exercises and activities to improve cardiovascular health; muscular strength, endurance, flexibility; and body composition Tips and techniques that foster physical fitness in individuals and groups Challenges to healthy eating in diverse populations What the scientific data say about how to lose and sustain weight loss Sources of reliable and credible information on physical fitness and exercise

The definition and causes of stress at home, on the job, and in the community The short-and long-term effects of stress on the body, mind, spirit The importance and benefits of managing stress Common coping mechanisms for stress: defenses and rationalizations Effective stress management techniques and strategies o Cognitive o Physical o Behavioral o Environmental How techniques and strategies may be applied at home, on the job, and in the community Managing stress in interpersonal relationships Sources of reliable and credible information on stress management

Scope of coaching practice in the area of health and fitness o The role of the coach o Issues to address o Responsibilities and limitations/boundaries Core skills applied to health promotion o Strategies to enhance positivity, optimism, focus on solutions and a preferred future o Stages of change process o Motivational interviewing o Interactive journaling o Tiny Habits Assessment o Adherence and competence using established coaching models o Feedback-informed coaching using results of outcomes and session ratings o Problem solving to increase coaching effectiveness based on results of assessment

The attributes of family wellness Challenges to families through the continuum of life Resources for families for education and support

Appropriate expectations of marriage What science suggests about how healthy marriages function Principles and skill development of effective communication in marriage Problem solving and conflict management

The developmental tasks from birth through adolescence Stages of adulthood from early adulthood through midlife Aging and end-of-life Issues

Parents as leaders and models of behaviors, thoughts, and values Components of healthy family dynamics Factors that contribute to safe, nurturing environments for children Challenges and solutions to competing demands of family and work Managing the stresses of family life o Effective problem solving o Stress management o Anger management o Coping strategies Enhancing positive feelings: formal and informal practices

The medical, physical, emotional, economic, and social challenges of aging Caring for an elderly family member while maintaining healthy family functioning Options for living arrangements and care Compassionate end-of-life care

Scope of coaching practice in the area of family wellness o The role of the coach o Issues to address o Responsibilities and limitations/boundaries Core skills applied to the family coaching setting o Strategies to enhance positivity, optimism, focus on solutions and a preferred future o Stages of change process o Motivational interviewing o Interactive journaling o Tiny Habits Assessment o Adherence and competence using established coaching models o Feedback-informed coaching using results of outcomes and session ratings o Problem solving to increase coaching effectiveness based on results of assessment

Definition of addiction and substance use disorders Models and theories of addiction The context for addiction and substance use disorders Risk and resiliency factors Coexistence of medical, mental, and substance use disorders Substance use, abuse, and addiction in the US How to identify the warning signs, symptoms, and course of substance use disorders The effects of substance use disorders on the individual The effects of substance use disorders on families and community

Classification of psychoactive agents Physiological effects Psychological effects Withdrawal syndrome and drug interactions

Review of history of treatment: from myths to evidence-based practice Philosophical underpinnings and policies of common models of treatment Components of care: treatment, recovery, relapse prevention, continuing care The role of the family, social networks, and community in treatment and recovery

Scope of coaching practice in the area of addiction and substance use disorders o The role of the coach o Issues to address o Responsibilities and limitations/boundaries Professional issues: rights of individuals being coached o Confidentiality o Informed consent o Reporting: child/spousal abuse, duty to warn Core skills applied to the addiction setting o Strategies to enhance positivity, optimism, focus on solutions and a preferred future o Stages of change process o Motivational interviewing o Interactive journaling o Tiny Habits Assessment o Adherence and competence using established coaching models o Feedback-informed coaching using results of outcomes and session ratings o Problem solving to increase coaching effectiveness based on results of assessment

Sources of biomedical data How to read and interpret biomedical data How to use data to support coaching practice

Definition of diabetes and description of the 3 common types Prevalence Risk factors Burden of illness

Normal glucose metabolism The role of beta cells and the impact of beta cell dysfunction The “ominous octet” that contributes to the development of diabetes (beta cell dysfunction, insulin resistance in muscles and liver, overproduction of free fatty acids, alpha cell overactivity, incretin hormone dysregulation, increased glucose reabsorption, neurotransmitter dysfunction) Signs and symptoms of long-term complications of uncontrolled diabetes

Building blocks of treatment o Pharmacologic treatment o Non-pharmacologic treatment o Self-management Team care in the current model o Physicians o Nurses o Diabetes educators o Other medical staff Emerging models of care o The expanded team model o The role of Wellness Coaches

Diet o How diet affects diabetes; how diabetes affects diet o Basic nutritional guidelines o How to read nutritional labels o Food choices o Environmental factors that challenge healthy eating o Meal planning o Carbohydrate counting o Diet challenges: weekends, holidays, travel Exercise o How exercise affects diabetes; how diabetes affects exercise o Recommended exercise options o Setting up an exercise routine o Risks associated with exercise and vigorous activity o Exercise safety

Why diet and exercise often are inadequate to treat diabetes Complexity of the processes contributing to diabetes and the involvement of multiple organs Rationale for multidrug therapy Goals of treatment o Improve insulin sensitivity o Preserve beta cell function o Protect blood vessels and organs o Control appetite Non-insulin therapies Insulin therapy o Short-acting insulin to control blood sugar in response to food that’s eaten o Long-acting insulin to control production of glucose by the liver

Adherence to prescribed medication regimens Healthy eating Maintaining an active lifestyle that includes regular exercise Blood glucose self-monitoring Effective problem solving Healthy coping Reducing risks of diabetes-related complications

Scope of coaching practice in the area of diabetes support o The role of the coach o Issues to address o Responsibilities and limitations/boundaries Professional issues: rights of individuals being coached o Confidentiality o Informed consent Core skills applied to the diabetes setting o Strategies to enhance positivity, optimism, focus on solutions and a preferred future o Stages of change process o Motivational interviewing o Interactive journaling o Tiny Habits o Risks associated with exercise and vigorous activity o Exercise safety Assessment o Adherence and competence using established coaching models o Feedback-informed coaching using results of outcomes and session ratings o Problem solving to increase coaching effectiveness based on results of assessment

Definition of occupational wellness Components of occupational wellness Factors that contribute to occupational wellness The meaning and role of work through the life span

The need for ongoing reflection and assessment: foundations of lifelong learning Assessing personal strengths, skills, interests, and values Qualitative and quantitative methods for assessing and measuring occupational wellness How to promote self-reflection and self-assessment related to occupational wellness Helping clients apply their unique strengths in the workplace

Defining and enhancing personal attributes that increase occupational wellness o Work quality and productivity o Self-management o Communication skills (verbal and nonverbal, speaking and listening) o Setting and maintaining healthy boundaries (integrity and professionalism) o Initiative o Teamwork

New concepts about the meaning of work and how to thrive on the job Principles of job crafting Techniques for job crafting to increase job satisfaction, engagement, resilience, and thriving o Altering the number, type, or nature of tasks o Changing interactions with others o Reframing and changing thoughts or beliefs about job Job crafting as a way to cope with job challenges and stress

Scope of coaching practice in the area of occupational wellness o The role of the coach o Issues to address o Responsibilities and limitations/boundaries Professional issues: rights of individuals being coached o Confidentiality o Informed consent Core skills applied to the work setting o Strategies to enhance positivity, optimism, focus on solutions and a preferred future o Stages of change process o Motivational interviewing o Interactive journaling o Tiny Habits o Exercise safety Assessment o Adherence and competence using established coaching models o Feedback-informed coaching using results of outcomes and session ratings o Problem solving to increase coaching effectiveness based on results of assessment