Health Coaching in Singapore. How to Find and What to Look for in a Coach.
Updated: Apr 29
For some the decision to partner with a health coach is made when, despite best efforts, their health is stuck in a rut and sustained change has been impossible. With our busy lives, pressure to deliver at work or at home, this is a common scenario.
But what do you do if you want to partner with a health coach? Are health coaches available in Singapore? The answer is Yes and in this article we provide some pointers for how you can find and work with one.
What is Health Coaching?
First of all, what is a health coach? The US National Board of Health and Wellness Coaches (NBHWC) defines the role of health coaching as:
“Health and wellness coaches engage individuals and groups in evidence-based, client-centered processes that facilitate and empower clients to develop and achieve self-determined, health and wellness goals.
Coaches assist clients to use their own insight, personal strengths, and resources to set goals, commit to action steps, and establish accountability in building an envisioned healthy lifestyle. In this way, coaches empower clients through encouragement, exploration, the mobilization of internal strengths, the identification and utilization of external resources, and through the support and development of self-management strategies for executing sustainable, healthy lifestyle changes.”
Health coaching is shown to be effective in clinical and non-clinical settings to address a broad range of whole person health conditions, from physical to mental and social wellbeing. Its focus is on creating healthy habits that last a lifetime. Habits that become lifestyle, to allow the client to live life to the fullest. For us at The Whole Health Practice, living a healthy life does not have to mean long-term restriction, the avoidance of the things that we love. Nor does it mean hardcore health regimens and living in denial. It means regaining health and finding balance through a lifestyle in keeping with one's vision and values.
A Global Community and our Little Red Dot
While health coaching is new compared to other fields in allied healthcare (healthcare providers distinct from doctors, nurses and dentists), it is now well established in key territories globally. The USA, UK, Australia and New Zealand all have formal bodies that provide a framework for the practice of health coaching, the certification and continuing education of their members. In the USA there is the NBHWC, in the UK the 'Health Coaching Association' and in Australia and New Zealand the 'Health Coaches Australia and New Zealand Association'.
In Singapore the government is adopting health coaching in its national Healthier SG plan and transformation of the healthcare system. At the time of writing the definition of health coaching and any potential framework or registry (as in the case for sports coaches) have yet to be formalised. Locally, the body most active in the promotion of health coaching is the Society of Behavioural Health Singapore, facilitating regular coaching focused workshops for its members and the public.
For our part at The Whole Health Practice (registered in Singapore), we decided to gain personal certification with the NBHWC.
Coaching and Chronic Illness
Health coaching effective at supporting its clients to make lifestyle change to improve or reverse chronic health conditions. From a clinical perspective coaching “results in clinically relevant improvements in multiple biomarker risk factors (including systolic and diastolic blood pressure, total cholesterol, LDL cholesterol, HDL cholesterol, triglycerides, fasting glucose, body weight, body mass index, waist circumference, and cardiorespiratory fitness) in diverse populations.” according to just one recent study.*
What does this mean for long-term health? Key medical conditions that are addressed by coaching, include:
· Cancer
· Cardiovascular Disease
· Chronic Obstructive Lung / Pulmonary Disease (COLD/ COPD)
· Dementia
· Diabetes, pre-diabetes
· Hypertension, high blood pressure
· Insomnia, sleep
· Medication Compliance
· Obesity & Weight Loss
· Peripheral Artery Disease
Match these conditions to the leading causes of death in Singapore** below and we see where health coaching can play a role in public health:
Cancer
Ischaemic heart diseases (typically the result of coronary artery disease)
Pneumonia
Cerebrovascular diseases (including stroke)
Hypertensive diseases (including hypertensive heart disease)
External causes of morbidity and mortality
Nephritis, nephrotic syndrome & nephrosis (kidney diseases)
Other heart diseases
Urinary tract infection
Diabetes Mellitus (type 2 diabetes)
It is not however the role of coaching to directly address the illness, but rather the cause.
* Gordon NF, Salmon RD, Wright BS, Faircloth GC, Reid KS, Gordon TL. Clinical Effectiveness of Lifestyle Health Coaching: Case Study of an Evidence-Based Program. Am J Lifestyle Med. 2016 Jul 7;11(2):153-166. doi: 10.1177/1559827615592351. PMID: 30202328; PMCID: PMC6125027.
** Source: https://www.healthhub.sg/a-z/health-statistics/4/principal-causes-of-death
Addressing the Root Causes of Ill Health
As coaching is a process its strength lies in being able to address modifiable behaviours to improve physical, mental and social wellbeing. The root causes of ill health. Coaching supports the adoption and implementation of key healthy behaviours that many people struggle with by themselves in the long-term. For example:
· the uptake of healthy diets and eating practices
· regular physical activity
· improved weight management
· risk avoidance (alcohol, smoking)
· medication adherence
· sleep improvement
· stress reduction
· work-life balance
· mental, emotional and spiritual health, self-confidence
· social connection
Note the holistic, whole person approach that the traditional medical care system has been unable to effectively address until recently.
Coaching & Integrative Health
Health coaches can work alongside medical doctors, as part of an integrative healthcare system, or independently. A health coach does not replace a primary health practitioner, doctor or therapist.
Coaching can, however, serve as a bridge between medical recommendations and the creation or management of healthy lifestyle behaviours. It addresses the root causes of ill health rather than, as the current the medical system operates, supplying patients with medications to treat the symptoms of lifestyle related chronic conditions.
The Coaching Process
Health coaching varies from practitioner to practitioner, dependent of their training, level of expertise or area of specialism. Different coaches offer different programmes; some coaches specialise in certain areas, others not. Coaching based programmes typically involve 8 to 12 sessions over 3 to 4 months, or longer. Clients ideally will have the skills and confidence to finish with their coaching by the end of the programme. Thereafter some clients may engage with their coaches on an ad hoc basis.
As health and healthy living is directly related to lifestyle and one's values and even definition of health differs between people, what works for one person may not work for another, even if their health goals are the same. The coaching process teases out these personal viewpoints before the client works further with the coach to plan their strategy to regain health.
Standard sessions normally last up to 45 minutes or an hour. Some coaches might offer ‘micro-sessions’ (30 minutes or so) to support their clients with specific issues.
Coaching is effective face-to face, by video and over the phone although preferably the coach and client should be able to see each other.
How to Engage a Health Coach, the Right Coach for You
Coaches come from a broad range of backgrounds and bring their own life experience and training to their practice. Some might come from clinical backgrounds, others not. While coaches should be objective and remain neutral in their engagement with the client it can sometimes be preferable that your outlook or worldview are in alignment.
To find a health coach, search online. To find a certified health coach, use a database from one of the national level certifying bodies, as can be found at the NBHWC website.
Before engaging the services of a health coach spend time with them to ask questions and gain a level of comfort. See if they have other qualifications that might be of value in your search for health.
When Coaching is not Effective
Coaching is only effective when the client is ready to make change, and - for many of reasons - not everyone is. Clients have to come to their own understanding of if and when they need support to take the right steps to improve their health. For many this might come after several attempts at making change by themselves, a progressive decline in their long-term health or a referral by their doctor.
Health coaching is a commitment. If you have signed-up with a health coach and the relationship is just not working, most should let you break your agreement - after a limited number of sessions - with minimal financial penalty. Be sure to discuss this before you sign-up for your programme.
Final Thoughts
Singapore has its own unique health challenges - the amazing food - the equatorial climate - the stresses of a modern, global city within the confines of a small physical area. However, a growing number of people are trying to find their path to health even if not always successfully. Of the many resources that are available, health coaching is an avenue that is increasingly being explored and there is a small and growing community of certified health coaches to support the city's residents.
Stay Healthy,
Alastair
Achieve your Health Goals
Your health, physical – mental – social - is complex and affected by multiple factors within and outside of your control. Our consults and programmes address the whole person, the root causes of ill health and maximising your health performance & vitality.
Take the first step. Book a Whole Health Consult to assess, identify and prioritise key factors (known and unknown) that affect your health. And receive personalised recommendations on how to address them.
Want to put recommendations into action? Learn more about our programmes for individuals or teams.
Published studies on health coaching:
Madigan CD, Graham HE, Sturgiss E, Kettle VE, Gokal K, Biddle G, Taylor GMJ, Daley AJ. Effectiveness of weight management interventions for adults delivered in primary care: systematic review and meta-analysis of randomised controlled trials. BMJ. 2022 May 30;377:e069719. doi: 10.1136/bmj-2021-069719. PMID: 35636762; PMCID: PMC9150078.
Kettle VE, Madigan CD, Coombe A, Graham H, Thomas JJC, Chalkley AE, Daley AJ. Effectiveness of physical activity interventions delivered or prompted by health professionals in primary care settings: systematic review and meta-analysis of randomised controlled trials. BMJ. 2022 Feb 23;376:e068465. doi: 10.1136/bmj-2021-068465. PMID: 35197242; PMCID: PMC8864760.
Hasan F, Tu YK, Yang CM, James Gordon C, Wu D, Lee HC, Yuliana LT, Herawati L, Chen TJ, Chiu HY. Comparative efficacy of digital cognitive behavioral therapy for insomnia: A systematic review and network meta-analysis. Sleep Med Rev. 2022 Feb;61:101567. doi: 10.1016/j.smrv.2021.101567. Epub 2021 Nov 10. PMID: 34902820.
Kwok ZC, Tao A, Chan HY. Effects of Health Coaching on Cardiometabolic Health in Middle-Aged Adults: A Systematic Review and Meta-analysis. Am J Health Promot. 2022 Nov 2:8901171221137332. doi: 10.1177/08901171221137332. Epub ahead of print. PMID: 36322092.
Ibrahim, O. M., El-Bassiouny, N. A., Dergham, E. A., Al Mazrouei, N., Al Meslamani, A. Z., Ebaed, S. B. M., Ibrahim, R. M., Sadeq, A., & Kassem, A. B. (2021). The effectiveness of pharmacist-based coaching in improving breast cancer-related health behaviors: A randomized controlled trial. Pharmacy practice, 19(4), 2563. https://doi.org/10.18549/PharmPract.2021.4.2563
Winkley K, Upsher R, Stahl D, Pollard D, Kasera A, Brennan A, Heller S, Ismail K. Psychological interventions to improve self-management of type 1 and type 2 diabetes: a systematic review. Health Technol Assess. 2020 Jun;24(28):1-232. doi: 10.3310/hta24280. PMID: 32568666; PMCID: PMC7336224.
Long H, Howells K, Peters S, Blakemore A. Does health coaching improve health-related quality of life and reduce hospital admissions in people with chronic obstructive pulmonary disease? A systematic review and meta-analysis. Br J Health Psychol. 2019 Sep;24(3):515-546. doi: 10.1111/bjhp.12366. Epub 2019 Apr 29. PMID: 31033121; PMCID: PMC6767143.
Barrett S, Begg S, O’Halloran P, Kingsley M. Integrated motivational interviewing and cognitive behaviour therapy for lifestyle mediators of overweight and obesity in community-dwelling adults: A systematic review and meta-analyses. BMC Public Health 2018;18(1):1160. doi: 10.1186/s12889-018-6062-9.
Barakat S, Boehmer K, Abdelrahim M, Ahn S, Al-Khateeb AA, Villalobos NÁ, Prokop L, Erwin PJ, Fleming K, Serrano V, Spencer-Bonilla G, Murad MH. Does Health Coaching Grow Capacity in Cancer Survivors? A Systematic Review. Popul Health Manag. 2018 Feb;21(1):63-81. doi: 10.1089/pop.2017.0040. Epub 2017 Jun 21. PMID: 28636526.
Kivelä K, Elo S, Kyngäs H, Kääriäinen M. The effects of health coaching on adult patients with chronic diseases: A systematic review. Patient Educ Couns 2014;97(2):147–57. doi: 10.1016/j.pec.2014.07.026.
LeBlanc EL, Patnode CD, Webber EM, Redmond N, Rushkin M, O’Connor EA. Behavioral and Pharmacotherapy Weight Loss Interventions to Prevent Obesity-Related Morbidity and Mortality in Adults: An Updated Systematic Review for the U.S. Preventive Services Task Force [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2018 Sep. Report No.: 18-05239-EF-1. PMID: 30354042.
Muñoz Obino KF, Aguiar Pereira C, Caron-Lienert RS. Coaching and barriers to weight loss: An integrative review. Diabetes Metab Syndr Obes 2017 10:1–11. doi: 10.2147/DMSO.S113874.
Patnode CD, Evans CV, Senger CA, Redmond N, Lin JS. Behavioral Counseling to Promote a Healthful Diet and Physical Activity for Cardiovascular Disease Prevention in Adults Without Known Cardiovascular Disease Risk Factors: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force. JAMA. 2017 Jul 11;318(2):175-193. doi: 10.1001/jama.2017.3303. PMID: 28697259.
Seyffert M, Lagisetty P, Landgraf J, Chopra V, Pfeiffer PN, Conte ML, Rogers MA. Internet-Delivered Cognitive Behavioral Therapy to Treat Insomnia: A Systematic Review and Meta-Analysis. PLoS One. 2016 Feb 11;11(2):e0149139. doi: 10.1371/journal.pone.0149139. PMID: 26867139; PMCID: PMC4750912.
Trauer JM, Qian MY, Doyle JS, Rajaratnam SM, Cunnington D. Cognitive Behavioral Therapy for Chronic Insomnia: A Systematic Review and Meta-analysis. Ann Intern Med. 2015 Aug 4;163(3):191-204. doi: 10.7326/M14-2841. PMID: 26054060.
Wu JQ, Appleman ER, Salazar RD, Ong JC. Cognitive Behavioral Therapy for Insomnia Comorbid With Psychiatric and Medical Conditions: A Meta-analysis. JAMA Intern Med. 2015 Sep;175(9):1461-72. doi: 10.1001/jamainternmed.2015.3006.
Shahnazari M, Ceresa C, Foley S, Fong A, Zidaru E, Moody S. Nutrition-focused wellness coaching promotes a reduction in body weight in overweight US veterans. J Acad Nutr Diet 2013;113(7):928–35. doi: 10.1016/j.jand.2013.04.001.