Tier One coaching is especially valuable if the coaching client is elderly, traumatized: or afraid of “medicine”, The coach can be of significant help to her client if the client comes from another culture/society and is unfamiliar with health care practices in the “new” culture/society, If one’s client is without family or social support (living in isolation) the health-based coach can fill in as a caring and assisting support service.
A colleague of mine provides this type of coaching for several elder clients who are without family or consistent community support. My colleague has often made herself available to her clients when then have fallen, suffered a minor stroke, or went to the hospital with a life-threatening fever (occurrences that are all too common among the elderly). She provides “hands-on” assistance, helping her client check in at the physician’s office or hospital. She also sits in on meetings of her clients with the physician. One of her clients recently held her hand and told her (with considerable emotion) that he believes he would not be alive right now without her caring support. While many elderly men and women need full-time health care assistance, others only need to know that a Tier One health-based coach is available when needed.
Tier Two: Amelioration
In keeping with the Cliff metaphor, the Tier Two Health-based Coach encourages her client (who has been “saved” by the net) to seek and maintain health care practices that are of value in their recovery and in their avoidance of further complications. Frequently, with Tier Two coaching, the coaching client has had a “wake up” call – having suffered a stroke, having been given a startling medical diagnosis regarding diabetes or a pre-cancerous condition, or having just recovered from a broken limb.
“What do I do to avoid further injury or illness?” The health-based coach can help her client answer this question in three ways: (1) identify appropriate ways to pose this question to their health-care provider, (2) suggest articles, books and reports that the client might read for their “self-help”, and (3) ask client challenging and generative questions regarding their own health habits (what led them to fall from the cliff) and potential sources of personal as well as family and community sources of support for (and resistance to) their new health habits. This third mode of coaching assistance (asking generative questions) is often of greatest value–and most often missing in a client’s life.
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Rey Carr
January 9, 2019 at 8:12 pm
I like the modernizing of prevention and its application to health coaching. When I was working as a school psychologist in a community mental health center in San Francisco in the early 1960s, this prevention approach was our mandate and mantra. Originally developed by Gerald Caplan (1917-2008), a child and community psychiatrist who wrote the prevention “bible”: Principles of Preventive Psychiatry. He founded the idea of mental health consultation and I was fortunate to be in one of his workshops on how to implement the three-tier model of prevention, simply known as primary prevention, secondary prevention and tertiary prevention (which correspond to your model). I was able with Dr. Caplan’s guidance to complete a research study in 1976 on the power of the “preventive consultation” model: “The effects of preventive consultation with elementary school principals on changing teacher staff meeting behaviours. “Canadian Counsellor, 10(4), 157-166.
Rey Carr
March 25, 2020 at 6:09 pm
In my recent research I found out that the International Association of Health Coaches has 80,000 members; and the National Society of Health Coaches has 5,600 members. This significant increase in membership parallels the points that Bill is making in this article.
One other point that I’d like to add. There could be another level of prevention: the training of health coaches to provide services at the other levels.