HowToBecomeAHealthCoach byDrSandraScheinbaum

FUNCTIONAL
MEDICINE
POSITIVE PSYCHOLOGY MIND-BODY
NUTRITION
How to Become a Health Coach:
The Career That

Can Bring You Joy
by Dr. Sandra Scheinbaum
Foreword by Cheng Ruan, MD
© 2022 Functional Medicine Coaching Academy, Inc. All rights reserved. www.functionalmedicinecoaching.org
How to Become a Health Coach: The Career That Can Bring You Joy 2 2
Dr. Sandra Scheinbaum
TABLE OF CONTENTS
Foreword
Introduction
SECTION I: THE HEALTH COACHING PROCESS

1. What exactly is health coaching?
2. Why is health coaching such a powerful process?
3. What is the health coach scope of practice?
4. What is Functional Medicine health coaching?
SECTION II: ENTERING THE HEALTH COACHING

PROFESSION
5. Who becomes a health coach?
6. Who do health coaches serve and where do they work?
7. What about legal compliance and ethical
considerations?
8. What should I look for when choosing a training
program?
SECTION III: THE RAPID GROWTH AND RECOGNITION OF

HEALTH COACHING
9. Is health coaching a legitimate healthcare profession?
10. What’s on the horizon for health coaching?
Foreword
The landscape of medicine has changed label blood pressure medicines
drastically over the last few years. The time is that prolong life. Amazingly, that
ripe for a new era of engagement and list is shorter than you think.
behavior change specialists to assume a Shouldn’t they all prolong life? We then
position of dominance with the medical were asked to label medications that
community. Health coaching is no longer had the best effect on lab values, but
optional. It is necessary to drive down the were not shown to prolong life. That list
economic, emotional, and spiritual burden of contained a majority of chronic care
chronic disease. medications that are still prescribed today.
What’s the point of improving numbers if
Just 70 years ago, physicians who delivered they do not necessarily prolong life or
healthcare to people in need were assumed improve the quality of life? This is the biggest
to possess seemingly magical powers. They contradiction in medicine today.
were viewed as healers who carried and
created potions for uncertain situations. The Most doctors recognize, whether they admit
contents of the doctor’s bag were sacred. The to it or not, that the biggest contributor to
relationships that doctors formed with their improved quality of life and increased
patients were considered a sacred bond of longevity in those with chronic disease is
trust, respect, and compassion. commitment to lifestyle change. The delivery
of care based upon behavior change can
The modern healthcare system emphasizes prevent the tragedies attributed to chronic
the delivery of care through medical illness and improve the overall cost of health
procedures and medications. While care by reducing hospitalizations and
technological breakthroughs in acute care emergency room visits.
interventions led to life-saving advancements
in urgent and emergency care, management Physicians are not trained as behavior change
of chronic conditions falls short, and is being experts. Helping people adopt new habits
left behind. involves the establishment of a trusting
relationship. Building trust takes time,
In today’s world, patients are increasingly requires compassion, and the employment of
plagued with doubt and question the delivery emotional intelligence by both parties
of healthcare. I find that doctors are having a involved.
hard time adjusting to this new ecosystem,
and are experiencing burn-out at an alarming Modern medicine needs a field dedicated to
rate. What I find most encouraging is that the behavior change process. This is where
more and more individuals desire to take health coaching comes in. The field of health
charge of their health. coaching can and will bridge the dangerous
gap between patient expectations and the
In medical school, I vividly remember a modern healthcare delivery system. The role
section on my exam where we were asked to of health coaches is not only viable, but
crucial to the current medical ecosystem. Encouraged by data showing significant

What’s great about health coaching is that the patient improvement, we then initiated a group
health coaches position themselves as guides health coaching program. By harnessing the
and let the patient be their own heroes. power of groups, we witnessed even better
results when group participants were
Health coaching sheds light on valuable data, compared to those who only participated in
such as the social determinants of health. one-on-one health coaching.
Medical professionals need to consider
possible socioeconomic impediments to We decided that health coaching is the true
creating health and longevity, including the core of our practice. The doctors and other
neighborhood where patients live. Another allied health professionals support the core
role for health coaches involves recognizing health coaching structure, not the other way
any previous psychosocial traumas that may be around. This mindset allowed us to create an
what’s driving their poor physical health. When even stronger backbone for our medical
patients engage with health coaches, they have ecosystem by allowing doctors, nurse
the support and advocacy that they do not practitioners, physician assistants, and
typically have access to via the assembly-line dietitians to practice at the top of their
styled fee-for-service type of medical care. licenses. Health coaching alleviates the
Coaches meet people where they are, with unnecessary pressures that we experience as
compassion and accountability. As a result, practitioners.
patients experience connection without fear.
My vision entails making Functional and
When I first met Dr. Sandra Scheinbaum in Integrative Medicine more accessible and
2017 in California at the Annual International affordable by bringing these root cause-based
Conference of the Institute for Functional approaches into an insurance-based billing
Medicine, I had the impression that not only is model. By choosing this path, I encountered
she passionate and knowledgeable, but she numerous obstacles to making this approach
also knows how to execute her vision about viable within a reimbursement structure set up
what the delivery of healthcare should look for acute care medicine. Despite setbacks, I
like. This was someone I could truly identify made sure I failed forward. Sandra and I kept
with! A few months later, I started a prototype in touch and she helped me become a
practice in Houston, Texas, now known as passionate advocate for health coaching.
Texas Center for Lifestyle Medicine.
Health coaching experienced dramatic growth
When I started Texas Center for Lifestyle over the last few years. In April of 2021, health
Medicine in 2017, I did not fully comprehend coaches were granted their own taxonomy,
how health coaches could accelerate the referred to as a national provider identification
healing process of my patients. But when I number (NPI). This signifies an incredibly
looked at our data for multiple disease states, I important advancement for the field because a
found that those who received health coaching taxonomy code designates a provider’s
had much better scores on measures of classification when providing health services.
depression, anxiety, physical symptoms, and Having a taxonomy means that health
hospitalization rates than those who chose not coaching is recognized as a legitimate
to work with a health coach. profession within the medical system.
Possessing an NPI signifies that they are System in New York, the University of
medical providers. Arizona, the University of San Diego,
Spectrum Health, Mayo Clinic, and Duke
Despite the significant advancement that University are just some of the larger well-
having a taxonomy represents, there are still established systems that employ health
hurdles to overcome. Many health insurance coaches in different, yet powerful ways. Due
companies still have to “wrap their head to the creativity I witness when talking to
around it.” Here at Texas Center for Lifestyle representatives from these groups, I feel
Medicine, when we submitted claims to optimistic about the future of medicine.
insurance companies for health coaching
services, they had to do their own internal Health coaches have been the missing link no
digging before allocating reimbursement. one knew we needed. The era of health
Luckily we were able to show enough proof coaches has begun and will not stop anytime
and documentation of services rendered that soon.
our claims were successfully processed in
most cases. This set a precedent that is now I’m grateful for the opportunity to reveal my
honored with other clinics and medical thoughts to a new generation of people who
systems that utilize health coaches. wish to deliver both quality healthcare and
personal empowerment, so that we can all
I have been working with many major centers lead healthier, happier lives.
around the United States that already utilize
health coaches to advance healthcare. Health – Cheng Ruan, MD
systems such as Massachusetts General C.E.O. Texas Center for Lifestyle Medicine
Hospital in Boston, Maimonides Hospital texascenterforlifestylemedicine.org
Introduction
• Which career offers one of the greatest health coach?” Six
opportunities to help people transform Branches of Learning™
their lives? emerged as the answer.
• Which career has the biggest potential In order to become an

to foster personal growth and bring effective health coach, a firm
you joy? grounding in Functional Medicine, positive
psychology, functional nutrition/psychology
• Which career is considered one of the
of eating, mind-body techniques, and of
fastest growing professions? course, the art and science of coaching is
needed. These knowledge areas are critical
If you answered HEALTH COACHING, you’re
to be a competent health and wellness coach.
correct!
Additionally, we want each coach to know
I hope that reading this book inspires you to how to land a job and attract clients in order
become a health and wellness coach. to actually use the health coach training
received, so we included a sixth Branch:
In 2014, the Functional Medicine Coaching Career Navigation.
Academy (FMCASM) was established to close
the gap between the available training I firmly believe that receiving an education in
opportunities in health coaching and the need Functional Medicine principles, along with
to teach prospective health coaches the five other important Branches thoroughly
Functional Medicine model of wellness. prepares coaches to help people create
Along with co-founder, Elyse Wagner, and our healthier lives. Whether you’re new to the
collaboration partner, The Institute for profession or already coaching and wanting
Functional Medicine® (IFM), we created the advanced training, if you integrate the Six
solution: an online school that trains health Branches of Learning, you will be an effective
coaches based on the Functional Medicine and successful health and wellness coach.
philosophy.
6
As we planned the curriculum, I thought about The 6 Branches of
what elements were essential for an aspiring Learning at FMCA™
coach to learn. I drew upon my past
1. Functional Medicine principles
professional experiences, such as having
spent close to 40 years as a licensed clinical 2. Functional nutrition principles
psychologist, and many years before that as a
3. Positive psychology
college instructor who prepared students to
become special education teachers. 4. Mind-body medicine
The central question we wanted to answer 5. The art and science of coaching
was “what knowledge areas do we need to 6. Health coaching career
teach so that our students can shine as a
Does pursuing a career that consists of support-

ing people on their wellness journey and help-
ing them reach their goals resonate with you?
If you answered yes to the above question, then consider becoming a health and wellness coach.
The fact that you’re reading this book means that you’re already picturing yourself as a trained
health coach. And there’s no better time to enter this rewarding profession.
To help you gain insights about the health

coaching profession, I asked health and
wellness coaches three questions:
1. Why did you choose to become a health coach?
2. What brings you the most joy as a health coach?
3. Would you recommend that others pursue a career as

a health coach?
These reflections are sprinkled throughout the book.
Coach Reflections
Why Did You Choose to Become a Health Coach?
“When I discovered health coaching, I “To come alongside and support those
saw a way to help people make the kinds navigating a health journey. To let them
of lasting changes that will have a positive know they’re not alone, and there’s always
impact on the rest of their lives and the hope!”
lives of their families.” Kerry Chamberlain
Jennifer Newton
“I wanted to help people overcome

“I have always been passionate about
illness and optimize their health. I believe
health and wellness. I wanted to take my
that there is a root cause to every illness
knowledge to the next level and learn how
and because of that people can heal
to coach people to transform their health.”
themselves.”
Colette Chandler
Melissa Champine

One of the most rapidly
growing careers
LinkedIn identified the fastest-growing job
areas in 2020, ranking them based on a
combination of growth in demand and
number of jobs available. Health care
supporting staff titles, including health
coaches, ranked third overall. The increase in
concerns about health precipitated by the
global pandemic will continue to propel
growth in this field. A 2021 U.S. Bureau of
Labor Statistics report ranked physician January, 2016 had 97 students. The March,
assistants as one of the fastest-growing 2021 certification class consisted of 410
healthcare occupations. It should be noted enrollees. These purpose-driven individuals
that health and wellness coaches could be come from around the world and from all
classified as medical assistants on labor walks of life.
surveys.
I’m excited for our coaches and future
These numbers are consistent with the coaches to “lead the charge” in this rewarding
exponential growth in the Functional and much-needed healthcare profession. The
Medicine health coaching model that we demand for health and wellness coaches is
pioneered at FMCA. Our first official class in soaring and will continue to do so!
Why are health coaches in demand?

The answer lies in the growing epidemic of the United States. A 2011 study by the World
chronic diseases, such as obesity and type 2 Economic Forum projected that by the year
diabetes, that overwhelm the current 2030, the cost of chronic illness treatment
healthcare system. worldwide will exceed $47 trillion.
It’s been estimated that almost half of all Now we face an even larger problem: the
American adults suffer from at least one lingering after-effects of COVID-19. At the
chronic illness. These conditions are time of this publication, all of the long-term
commonly referred to as lifestyle-related ramifications are still unknown, but the costs
conditions. How we live our lives, including to an already overburdened healthcare
what and how we eat, if we exercise, how we system will be considerable. Millions are
manage stress, and the quality of our sleep, suffering, both physically and psychologically,
are major contributing factors. either as a direct or indirect consequence of
the worldwide pandemic.
The Center for Disease Control estimates that
managing chronic illnesses accounts for As you can see, health coaches are needed
some 78 percent of the health expenditures in now more than ever.
Who’s hiring health coaches?

To address the rapid rise and increasing
prevalence of lifestyle-driven chronic
illnesses, health coaches are sought after by a
variety of organizations. Here’s some of the
major ones:
• Medical practices, including those that • Companies developing artificial

are creating innovative virtual models intelligence-based health tracking
devices who realize the importance of
• Major corporations and small human communication to affect
businesses interested in the well-being behavior change.
of their employees
• Wellness centers and spas dedicated
• Insurance companies interested in to offering a comprehensive approach
lowering healthcare costs by keeping to self-care.
people healthier and preventing the
onset and subsequent complications of • Individuals who want to become the
chronic disease CEO of their personal health.
What Makes Health Coaching So Extraordinary?

Health coaches help people manage and ask the right questions. We need someone to
even reverse chronic conditions, lose weight cheer us on and help us create a plan to
and keep it off, increase movement and achieve our goals. That’s the special role of
activity, and generally improve their physical the health coach.
and mental health. Employers appreciate how
health coaching brings down patient coverage As the behavior change specialist, the health
costs and reduces health insurance claims. coach plays an important role on the medical
collaborative care team. A growing body of
We all want good health. It’s getting there evidence demonstrates that helping people
that’s challenging. initiate and sustain lifestyle changes
improves their overall health and well-being.
What do you think derails someone from
achieving their best health? Lack of The popularity of health coaching continues
preparation? Lack of willpower? Lack of to grow because the model works. Health
resources? The number one obstacle people coaches build trusting relationships, identify
face on their journey toward better health is what the client values and desires, and know
lack of support. how to help that client transform their unique
goals into actions that create lasting change
Everyone wants to get healthy, but we all and true health, wellness, and vitality.
need someone to hold us accountable and
The World Needs Health Coaches Now!

It’s become clearer than ever that the world
NEEDS health coaches!
As we enter the third year of the pandemic,

we’re seeing an overburdened healthcare
system struggling to meet the needs of
millions of people suffering from debilitating
chronic conditions, including the still
unknown long-term impact of COVID-19 and
the variants that are continuing to emerge.
Our emotional wellness is at stake as the
incidence of anxiety and depression is on the
rise amongst individuals of all ages and
across the globe. On a positive note, many
people are showing increased interest in their
health and want to partner with a health
coach to take proactive steps to maintain or
restore wellness.
Coach Reflections
“Becoming a health coach fulfilled both
my personal and professional passion. I
feel that it is my greatest opportunity and
“Health Coaching gives me an
gift to the world to help others feel
opportunity to share my passions and gifts
empowered to make meaningful differences in
with others. I wanted to be part of the
their lives.”
solution to the healthcare crisis for
Stephanie Staples
individuals. I realized I could make a
significant difference in other people’s lives
as a coach.”
“It married all of my lifelong interests in
Linda Schillinger
health, nutrition, psychology, people’s
stories, and wanting to help people live
more healthy and fulfilling lives.”
Shelby Garay
Join the movement that’s

transforming healthcare
At the Functional Medicine Coaching
Academy™️, we train physicians, nurses,
dentists, psychologists, social workers,
dietitians, chiropractors, acupuncturists, and
massage therapists, to name just a few • Imagine that becoming a health coach
professions. Yoga instructors, personal leads to your own personal growth and
trainers, and allied healthcare professionals transformation, both physically and
are becoming health coaches. Many emotionally.
practitioners are enrolling in coaching
I’m on a mission to share the power of health
programs so that they can add coaching to
coaching with the world. It’s my intention that
their existing skill sets. I also want to
this guide serves as a gateway to your next
emphasize that many of our graduates had
step on the path to becoming a health coach.
ZERO training in a healthcare field before
I created it to answer commonly asked
deciding to earn a certificate in health and
questions.
wellness coaching. They come from a variety
of background and educational levels, and • What exactly is health coaching?
range in age from 16-86.
• Why is health coaching such a powerful
I hope that you’ll be inspired to join the process?
movement that’s increasingly playing a major
role in the transformation of healthcare from • What is the health coach scope of
acute care management to prevention and practice?
reversal of lifestyle-related conditions.
• What is Functional Medicine health
• If you’re someone with a calling to coaching?
serve others, health coaching is an
ideal career choice. • Who becomes a health coach?
• If you want to be a key member of a • Who do health coaches serve and

medical collaborative care team, health where do they work?
coaching can be a rewarding
• What about legal compliance and
experience.
ethical considerations?
• Imagine awakening every morning
• What should I look for when choosing
thrilled to work in a field aligned with
a training program?
your mission and purpose.
• Is health coaching a legitimate
• Imagine acting as the catalyst for
healthcare profession?
growth and transformation.
• What’s on the horizon for health
coaching?
SECTION I:
THE HEALTH
COACHING PROCESS
Chapter 1
What Exactly is Health Coaching?
“Health & wellness coaches partner with clients seeking to enhance their
well-being through self-directed, lasting changes, aligned with their values.
In the course of their work, health & wellness coaches display an
unconditional positive regard for their clients and a belief in their capacity
for change, honoring the fact that each client is an expert on their own life,
while ensuring that all interactions are respectful and non-judgmental.”
National Board for Health & Wellness Coaching (NBHWC)
Health coaching evolved from life coaching

I received my doctorate in clinical psychology may have come from a clinical psychology or
at Fielding Graduate University. My mentor, counseling background, but when working
the late Dr. Fredric Hudson, was one of the with clients at these mid-career retreats, they
visionaries behind the creation of the employed the coaching process rather than
profession referred to as life coaching. In engaging in psychotherapy.
1984, I had the privilege of spending many
hours with Dr. Hudson as we planned The Dr. Hudson believed that coaches “inspire
Mid-Career Development Institute, a program passion and purpose in others.” They take
rooted in humanistic psychotherapy. Rather people from where they are to where they
than serving those with diagnosed mental want to be.
health conditions, the Institute met the needs
Health coaching evolved from life coaching.
of those wanting to find renewed meaning
Michael Arloski, Ph.D., one of the early
and purpose in their lives, both personally
pioneers in the field, defines health coaching
and professionally.
as the application of the principles of life
Participants came together for retreats, which coaching to the goals of lifestyle
were led by “coaches.” These professionals improvement for higher levels of wellness.
The Coaching Structure

Health coaches meet with clients individually vital component of the coaching process
or in groups. Sessions take place in person, involves helping people discover their own
over the phone, or online. power to change.
During the initial consultation, the client tells Due to the client-centered nature of coaching,
their story to the coach, shares their vision for the coach doesn’t set the goals, but helps the
what they would like their life to look like, client establish them through an inquiry
and together they determine the best number process that consists of open-ended
and type of sessions for a successful questioning. The coach facilitates a decision-
outcome. making process that begins with determining
where the client wants to start their unique
During coaching sessions, the coach and journey towards better health. While
client collaborate to turn aspirations into brainstorming ideas, the client arrives at their
achievable goals. Specific goals might be own conclusions.
formulated around nutrition, hydration,
exercise, relaxation, sleep, stress, or Because the client determines the agenda
interpersonal relationships. A health coach and sets the goals, they experience a strong
educates and supports clients as they make sense of empowerment. I cannot emphasize
diet and lifestyle changes. But the process enough the importance of allowing the client
isn’t just teaching them to eat this and not to “be in the driver’s seat.”
that, or get more sleep and reduce stress. A
The Coaching Process

“Trust the process” has been my mantra ever
since I trained in humanistic psychotherapy
back in the 1970’s. Many new coaches
mistakenly believe that it’s all about the
content. They often believe that they need to
plan ahead before going into a session. This
can’t be further from the truth. It’s not about
the content, i.e., the words that are spoken or
The incredible power of coaching lies in the
the themes discussed. It’s about the process:
process. First and foremost, it’s how people
the emotional connection that’s established,
become inspired to change. It’s also the
the permission to be oneself, the experience
reason why coaching wins as one of the most
of being fully heard and held in unconditional
rewarding professions.
positive regard.
Four key features result

in client engagement and commitment:
1 Establishing Rapport
Being in rapport means the ability to enter
3 Becoming an Ally
and Guide
into another person’s model of the world, Client-centered coaching translates to taking
and communicating that you truly understand the client’s side as a way of facilitating the
that world in a congruent way. The perception best possible outcome, no matter what
of being understood must be established, as happens, no matter what the client does or
it’s critical for engaging someone’s trust. It doesn’t do. The coach who acts as a genuine
also functions as the launching pad for ally chooses to see each of their client’s
actively leveraging the power of the coaching choices as purposeful. In instances where the
relationship. coach doesn’t understand particular choices
that the client made or is choosing to make,
Building rapport consists of creating the
they employ open-ended inquiry to look for
safety that allows the other person to be
strengths and elicit a positive outcome. The
completely themselves, and feel comfortable
client knows that the coach is a staunch
enough to risk change.
supporter and will remain by their side, no
Building rapport enriches not only the client, matter what choices they decide to make or
but the coach as well. not make. As a result, they typically remain
2
open to opportunities to try new tactics,
Open-Ended Inquiry particularly when their choices haven’t
yielded the results they want.
Closed-ended inquiry usually has single word,
or “correct” answers. These are questions that The coach acts as the guide and navigator.
don’t require the client to provide insight into When embarking on a journey, in this case, a
their experience in order to answer. They tend journey to health, a guide can mean the
to deal in the realm of facts more than difference between success and failure to
thoughts and feelings. Questions that can be reach the destination. Clinicians who act as
answered by a simple “yes” or “no” may close the experts by providing advice and
off the conversation. recommendations are often at a loss as to
why people don’t follow what they were told
“Do you understand the doctor’s to do. Having an ally and a guide can make
recommendation?” is an example of a closed- all the difference.
ended question. In contrast, “tell me your
thoughts about the doctor’s recommendation” Like humanistic psychotherapy, first and
represents open-ended inquiry. foremost, the health coaching model is
client-centered and non-directive. It involves
One of my favorite open-ended questions is a combination of self-discovery and self-
“what do you want your health for?” This line monitoring, in addition to education, goal-
of inquiry leads to discovery of meaning and setting and accountability.
purpose and enhances motivation.
Health coaches guide clients on their journey The coach accepts the individual as they are.
towards better health and well-being. They By doing so, and refraining from judgment,
help people find the intrinsic motivation to the client perceives the coach as being “on
create sustainable change. their side.”
4 Creating a Meaningful
For clients suffering from chronic illnesses,
the health coach often acts as their advocate
and navigator through the web of medical
Connection
care. The health coach makes the difference A sense of belonging and positive
between “getting doctor’s orders” and connections to others significantly contribute
actually following through. to both mental and physical well-being.
Research in positive psychology, (a
The client-centered nature of coaching cornerstone of the coach training at FMCA
transforms the coach as well as the client. that we’ll discuss in a later chapter) supports
Stepping into the role of advocate and guide the power of meaningful relationships.
yields profound satisfaction.
In a client-centered relationship, the coach is
Being an ally involves maintaining both the teacher and the student, the leader
unconditional positive regard for the client. A and the follower. Both coach and client
defining principle of humanistic benefit from the meaningful connection that
psychotherapy, it’s the act of seeing another their relationship provides.
person as perfect and whole at the present
time, regardless of their behavioral choices.
Coach Reflections
Listen to health coaches describe the experience of deep connection and the immense joy they
experience from establishing meaningful relationships with clients.
“My greatest joy is actually

“Becoming a health coach fulfilled both
‘connecting’ one-on-one with clients and
“I am a very curious person and love
asking questions that open their minds to
learning and hearing about someone’s
how best to care for themselves and how
story, where they come from and where
to set and pursue goals for healing.”
they hope to go. I feel a sense of pride in
Lura Kay Robison
knowing I can help support someone on
their journey to a healthier, happier and
fuller life. I love seeing people grow into “What I love most about being a health
their optimal, most healthy version of coach is the honor of taking the journey
themselves.” Andrea White with the client. It is so gratifying and
empowering to see them learn about
themselves and get revitalized by their
“I love the first meeting with a person
plans and commitments to improve their
and hearing their story. Then, seeing them
health. Many clients have had a hard road
figure out what healthy habits they want
and felt less than optimistic and seeing
to add in, and how they’re excited over it
the transformation through small but
and proud of their accomplishments
significant victories is a gift for them but
- that’s the best.” Beth O’Leary
also to me; they light up with possibility
and hope. It’s the best feeling to see
someone succeed and transform.”
Tita Arroyo
Pause to Reflect
• Imagine how strong and powerful a relationship becomes when the other person knows
that you’re holding them in unconditional positive regard.
• Imagine having an ally and being the recipient of unconditional positive regard.
• Consider times in your life when you had a trusted guide.
CHAPTER 2:
Why is Health Coaching Such A
Powerful Process?
I consider the coach to be the most powerful person on a medical collaborative care team. Why?
Because they’re the behavior change specialist. They support people through the process of
finding their motivation and the resources needed to create lasting health, and reduce or
eliminate the particular conditions they may be suffering from.
Here’s seven of the crucial ways that coaches support clients:

1. Takes the time to truly listen
2. Provides education and clears up confusion
3. Facilitates problem-solving and resolve ambivalence
4. Helps set realistic goals and celebrates tiny wins
5. Provides crucial emotional support
6. Promotes self-management
7. The coaching process is equally powerful for the coach
1 Takes the time to truly listen

• “I went to my doctor and they only
spent seven minutes with me.”
How many times have you heard people voice
these types of comments after seeing their
doctor? Now consider the significant impact
• “I tried to tell my doctor what was wrong,
of being heard, the positive effect of being
but didn’t feel like they heard me.”
with someone who is truly listening. First and
• “They weren’t interested in what I had foremost, coaches are listeners. By doing so
to say.” in a nonjudgmental manner, they become
allies. Coaches are frequently described as
• “My doctor was looking at the
“personal cheerleaders.” That’s what makes
computer screen while I was talking.”
coaching such a powerful process.
• “I felt rushed during the appointment.”
2 Provides education and not confused, and are fully-committed to

following the plan that their healthcare
clears up confusion provider laid out.
3
• “I didn’t get a chance to ask my doctor
all my questions.” Facilitates problem-solving
and resolves ambivalence
• “I have unanswered questions because
I was too embarrassed to ask my Another important reason why the coaching
doctor.” process is so powerful has to do with helping
people make choices. Let’s face it: lifestyle
• “I don’t understand why my doctor change is hard. People hear lots of conflicting
wants me to do this.” advice from experts, particularly regarding
diet and exercise. Coaches are not experts;
• “I’m not sure why I need all these they do not take a stance and tell their clients
medications that they prescribed.” what they should be doing. Instead, they
guide people so that they arrive at their own
• “I walked out of my appointment
conclusions. Coaches accomplish this by
feeling confused.
listening and asking questions so that clients
Health coaches are trained to listen. I believe realize the pros and cons of each decision.
that’s their most important role because it The process may involve asking clients to
validates the client’s experience and leads to remember how they felt in the past when they
a sense of empowerment. A second role is made a particular choice. Alternatively, clients
that of educator. The examples above show are asked to imagine their future self and
that people are often confused when they see determine whether the direction they choose
their doctor or leave with questions still at the present time supports or hurts their
unanswered. There may not have been an ideal future self. In this way, clients resolve
opportune time to ask the question, perhaps ambivalence about committing to making
they felt rushed, or maybe they were reticent healthier lifestyle changes that may be
to ask due to shame, embarrassment, or simply difficult to initiate and sustain.
4
not thinking the question was important
enough to waste the doctor’s time on. Helps set realistic goals
and celebrate tiny wins
Health coaches convey the message that
there’s no such thing as a dumb question. One of the most effective ways that coaches
They let clients know that having a coach inspire people to commit to change is to
means they have an ally and an advocate. break down goals into realistic, achievable
Clients come to appreciate that their coach steps. Big goals morph into smaller
has the time to answer questions, or find the increments that are of the client’s choosing.
answers to any they can’t answer. The client is in control of setting their goals at
all times. They decide how and when they
Health coaches make sure that clients want to start and how they want to be held
understand their practitioner’s plan of care. accountable by the coach.
How do they do this? They listen and ask the
right questions to make sure that clients are There’s something inherent in coaching
behavior change that makes the process We’re seeing a rapid growth in behavioral
particularly magical. That has to do with health coaching. What’s encouraging about
celebrating tiny wins. The renowned behavior this initiative has to do with the removal of
change expert, B.J. Fogg, author of Tiny labels and the stigma of psychiatric disorders.
Habits, coined an emotion called “shine” that As a clinical psychologist, I saw the emotional
captures the essence of how you feel when toll that so many experienced as a direct
you accomplish something that you set out to result of being diagnosed with a psychiatric
do. The coach helps their client understand disorder. A health coach who engages in
that the most powerful step is the first one behavioral health coaching does not focus on
and when the client accomplishes that initial what’s wrong or broken, but helps normalize
step, no matter how small it may be, the symptoms and offer individuals a road map
accomplishment is acknowledged and for change that includes awareness of how
celebrated together. Imagine an athlete poor diet, lack of exercise, insufficient sleep,
crossing the finish line and spontaneously and stress contribute to emotional distress,
throwing up their arms, jumping in the air and anxiety, and mood shifts.
6
saying “yes!” That’s shine! It’s a powerful
feeling that’s experienced by both the client, Promotes
as well as the coach who was at their side. self-management
5 Provides crucial
emotional support
The ultimate goal of coaching is to guide
people towards self-actualization. Coaches
help clients realize that change is up to them.
Coaches are not therapists; they don’t offer They can take charge and become the CEO’s
psychotherapy. They do provide essential of their health. During coaching sessions,
emotional support that involves helping clients always take the driver’s seat,
clients build resilience, typically through determining the direction of the conversation,
acknowledging and expressing their as well as how, when and if they’re ready to
signature strengths. Coaches show up for change. The special nature of the coaching
their clients with compassion and offer hope process has to do with client empowerment.
7
that problems can be resolved.
The coaching process
The reason coaches provide emotional
support connects to their role as a
is equally powerful for
nonjudgmental listener and an ally. Just being the coach
heard is therapeutic. Having an alliance with
Witnessing the behavior change journey
another human being alleviates loneliness. It
unfold is incredibly satisfying for the coach
shows the client that they are not “crazy” for
and makes their work meaningful. Over and
having particular thoughts and feelings and
over again, I hear coaches describe the joy
are not alone in their suffering. The coach
they experience when helping people change
guides the client to experience hope and
and celebrating wins together.
imagine that they can create a better,
healthier future for themselves.
Coach Reflections
“I have gratitude for the ability to hold “I love the magic that happens when
a safe space for my clients to be heard clients are introduced to their unique
and cared for. I always meet my clients divine blueprint. Supporting them on their
where they’re at and support them at their journey to achieve their full potential is so
own pace to work on their health goals. rewarding to me. When clients experience
When I see my clients reclaim their health shifts in momentum, renewed confidence
and freedom it’s a very precious and and a more integrated life, I am so
special honor.” grateful.”
Carla Alpert Deborah Schapiro
“My favorite phrase to hear from a “I am overjoyed when I see the

client is: ‘It’s just not worth it!’ That tells transformation that occurs in the lives of
me they picked something to work on, individuals who enter one of our health
they stuck with it long enough to feel the and wellness plans filled with uncertainty
positive effects, they’ve gone back to the and doubt to emerge 3-6 months later
old habit and have felt worse. Now, they filled with confidence in their ability to
consciously decide which habit serves develop a living personalized health and
them best and they usually opt for that wellness plan that leads to a sustainable
habit over the long term, and it’s ‘sticky.’” life transformation. In addition, these
Monica Tarr clients are a joy to serve because they are
able to express their goals and take
responsibility for doing the necessary
work needed to reach their goals.”
Erien W. Fryer
Pause to Reflect
• Imagine entering into a deep relationship with a client that will be as transformative for
you as it is for the client.
• Picture yourself being uplifted because you became someone’s ally and witnessed their
journey to health?
CHAPTER 3:
What’s the Health Coach Scope of Practice?
All of the services that health coaches can legally and ethically provide are commonly referred to
as their scope of practice.
The “secret sauce” lies What’s outside the

inside the scope of practice! scope of practice?
The health coach scope of practice Health coaches aren’t licensed providers and
encompasses all of the ways that they don’t provide the types of services rendered
support, guide and educate clients towards by medical doctors, mental health or nutrition
better health. Consider all that’s within the professionals. Rather, as the behavior change
health coach scope of practice as the “secret specialist, they play an important role on
sauce.” collaborative care teams alongside clinicians
and allied healthcare professionals.
The following areas are considered to be outside the

coaching scope of practice:

Diagnosing medical or psychiatric conditions
Developing treatment plans
Providing psychotherapy
Ordering and interpreting lab testing
Recommending medications and supplements
Recommending specialized diets
The coach does not make recommendations; instead, they listen, ask questions, and educate.
They support clients by helping them mobilize their internal strengths and external resources.
They provide guidance by clarifying the physician’s diagnosis and plan, and referring to
resources from national-recognized authorities and evidence-based research.
Read how health coaches describe the power of the

coach’s scope of practice.
Coach Reflections
“Nothing is more satisfying than sitting “Nothing feels better than when a
back and listening to a stressed out, client no longer needs my help! Hearing
overworked, chronically fatigued woman that they’ve learned how to listen to their
have her own moment of enchantment body, embraced how the choices they
and brilliance where there is the make changes their body chemistry for
realization that she, like Dorothy from the the better, and mastered lifestyle
Wizard of Oz, has had the power all along modifications to the point where they’re
to be able to become the glorious now thriving on their own is a twofold
goddess she was meant to be! When a gift–it confirms I’ve been effective as a
client comes to the turning point of radical coach, and means another member of our
self-honesty and then turns it into a local community understands the power
comprehensive health revolution that of working mindfully with our bodies
changes her whole life, there is nothing instead of just medicating away
better than the privilege of seeing that symptoms.”
alchemy unfold!” Kimberly Kaye
Tiffany Zwingli
“I wanted to be able to empower

“I get excited when I see my clients others to realize their full health potential;
excited about their own progress, when to help people learn more about
they have made some significant, difficult themselves and how the choices they
changes and have seen life-changing make around food, sleep, stress, or their
results. Even more so, I get excited when I environment, have a direct impact on the
see them taking more and more quality of their life.”
responsibility for their own self-care.” Crystal Sgro
Jane Webster
The coach as educator

Coaches provide crucial information so that
clients can make their own decisions, and
that’s more powerful than giving direct
advice. This process is way more effective
than telling people what to do. If you’re
thinking, “this sounds restrictive” or “I want to
be able to tell my clients what to eat or how
to exercise,” you’re not alone. Many
prospective coaches think that’s the power of
coaching and may even be drawn to the
profession for this reason.
Receiving advice from experts often fails.

People may possess the knowledge needed Coaches can be great resources for health-
to lose weight or engage in an exercise related information. At FMCA™️, we
program. Although they’ve been told by a encourage our graduates to stay up-to-date
healthcare provider, read advice in a book or on the latest research and recommendations.
magazine, heard suggestions on a podcast or They definitely play a strong role as health
news report, unlike the famous Nike quote, and wellness educators. However, their
“just do it,” they “don’t just do it.” They require unique position as the behavior change
support and accountability, not merely specialist sets coaches apart from the advice-
education. giving experts .
The coach as behavior change agent

Health coaches provide education, but the In fact, acting as a behavior change agent
process involves so much more than that. It creates profound satisfaction for the coach
empowers the client to make lasting changes and is one of the primary reasons that so
for better health and well-being. many decide to become health and wellness
coaches.
Implementing and sustaining diet and
lifestyle changes can be hard. Working with a Here’s what health coaches had to say about
coach closes the gap between intention and the joy of guiding clients towards healthy
behavior. lifestyle changes.
Coach Reflections
“I am happy to see my clients thrive as “I became a health coach because I

a result of the new habits they have been have a true calling to help others heal. I
able to implement. We all know how hard studied psychology for 6 years in college
it is to change habits and being able to and not one class focused solely on
support people to change their lives and comprehensive strategies for behavior
thrive is an awesome experience.” change (usually just research around goal
Juliana Nikolova setting as a motivator), and typically just
analysis and assessment of behavior.
Health coaching is the answer to true
behavior change, healing and wellness.”
“I love seeing people discover the
Keri Sitrick
resources, strength and motivation within
themselves to achieve their goals. Seeing
hope renewed and transformation happen
“Coaching provides me with the
before your eyes is truly rewarding and I
opportunity to align my values and
feel privileged to be able to walk
strengths as I support others to do the
alongside people on their journeys.”
same. I am energized by working with
Claudette Jordan
individuals who are seeking greater
integrity, a clearer sense of purpose and
transformational change. Coaching is a
powerful and effective way to help clients
bridge the gap between where they are
and where they want to be.”
Deborah Schapiro,
Pause to Reflect
• Were there times when you were given advice by an expert, but found it hard to
implement?
• Have you seen family members receive recommendations but struggle with adherence?
• What would it be like to have a coach who provided education and support, but always
acknowledged that you were in the driver’s seat?
• Imagine the power of setting your own goals and having an ally to help you achieve them.
CHAPTER 4:
What is Functional Medicine
Health Coaching?
In 2015, the Functional Medicine Coaching Academy™️pioneered
a new type of health coaching: the merger of Functional Medicine,
functional nutrition, positive psychology, and mind-body medicine
principles with the art and science of coaching. Let’s first define
the Functional Medicine and positive psychology approaches to
physical and mental health.
The Functional Medicine Approach

Dr. David Perlmutter, a world-renowned questions: Who is this person? Why are they
Functional Medicine neurologist, describes experiencing these symptoms? How can they
Functional Medicine as the opposite of thrive again? When piecing together the
“dysfunctional medicine.” Based on systems puzzle that each new client presents, the
biology, the Functional Medicine approach process of mapping symptomatology to the
identifies the root causes of disease, such as experiential timeline of a client’s life provides
underlying inflammation, and acknowledges clues for the direction of their healing.
the important contribution of lifestyle factors
to the development of clinical imbalances. The treatment plan created by doctors
Rather than “one size fits all,” Functional trained in a Functional Medicine approach
Medicine is personalized medicine. typically considers nutrition, hydration,
exercise, stress, toxic load, sleep and social
A Functional Medicine approach prioritizes relationships. That’s where the health coach
listening to the client’s story to gain insight comes in, as these are the areas they address
into the physical and social environment that with clients.
caused their genes to express themselves
through patterns of chronic illness. By actively Many people are drawn to health coaching
listening to their patient’s story, Functional because they overcame a health challenge
Medicine practitioners discover the antece- themselves. As a result, they have a strong
dents, triggers, and mediators that underlie desire to help others heal. This phenomenon
discreet symptoms and specific illnesses. is particularly pronounced when we consider
the number of prospective health coaches
Functional Medicine involves a conscious drawn to Functional Medicine health coaching.
synthesizing process that answers the
Coach Reflections
“It began with my own health journey. I “After facing a health crisis and being
sought answers to my health issues and introduced to Functional Medicine, which
discovered a holistic approach to health. set me on a healing journey, I wanted to
As I applied Functional Medicine make it my purpose to educate and
principles, I saw great results. I was so empower others in achieving their health
inspired that I wanted to learn more and goals.“
help others thrive.” Kathy Borthwick
Yvette Aungamuthu
“I was inspired by my own incredible

“After battling undesirable symptoms experience with Functional Medicine and
for 10 years I discovered the Functional lifestyle change. I wanted to share that
Medicine approach, and it was my cure. I inspiration with others. I am passionate
knew of too many friends and family about the ability of Functional Medicine
members who were also suffering from and all aspects of healthy lifestyle to
symptoms and I wanted to be able to prevent and heal. I wanted to have a
help. Health coaching seemed like a great positive impact on the health and wellness
place to start!” of others by educating, supporting and
Alexandria Larsen empowering them with the tools of
Functional Medicine and positive lifestyle
changes.”
Marisa Pizzuto Jurassic
The Positive Psychology Approach

Positive psychology nurtures what’s best Coaches trained in positive psychology help
within people to help them thrive. The focus is clients discover their signature character
on what’s right, not what’s wrong with them. strengths and use them as “psychological
capital” to change behaviors, find both
The application of character strengths physical and mental well-being, build
constitutes a key element of positive resiliency, and lead more meaningful lives.
psychology. Considered the foundation for Guiding the client to discover new
well-being, character strengths are the traits perspectives and possibilities initiates a
that allow us to thrive. They’re what’s best process of growth and transformation.
about human nature and everyone has the
capacity to express these essential traits. The coach listens for opportunities to reframe
Some are of the heart, such as love and the client’s story in light of their unique
kindness, while others are of the mind, such strengths and helps them discover the
as judgment and perspective. redemptive aspect to their personal narrative.
They help the client find new meaning in their kinds of relationships they want to cultivate.
life stories and become the best version of Clients choose their preferred way of being
themselves. This version is the one closest to by using their character strengths.
their dreams, values, commitments, and the
Functional Medicine Health Coaching

At FMCA™️, we created a coaching model that
mental, emotional, and
merges the positive psychology approach
spiritual components that
with Functional Medicine principles because
drive their motivation to
we believe that this combination is uniquely
heal. The process begins by
suited to helping individuals preserve or
listening to the client’s story.
restore their physical and psychological
The importance of understanding their unique
well-being. Both Functional Medicine and
experiences cannot be overemphasized.
positive psychology provide a road map for
thriving. Integrating these principles creates The Functional Medicine approach consists of
profound transformations and many health more than hearing the client’s story and the
coaches tell us that their own lives, as well as sequence of events in their life. It’s about
the lives of their loved ones, are positively understanding the client’s interpretation of
impacted as a result of studying these these events.
disciplines and applying them personally.
The Functional Medicine physician and coach
A Functional Medicine health coach educates work together to provide a road map for the
and supports the client as they make client’s healing journey. While practitioners
important diet and lifestyle changes. create a timeline of significant life events,
Although the coach may know what areas including medical history, the Functional
need to be addressed, the client chooses Medicine health coach ensures that clients
what to work on and where to begin. The fully understand how modifiable lifestyle
process entails acknowledging and using factors created and perpetuate the current
character strengths to build resilience and health challenge. The coach and client work
enhance motivation to change. together to identify ways to change the story
by changing the environment and changing
Making changes in modifiable lifestyle factors
the client’s vision of what’s possible.
can be challenging. Education is not enough.
Scare tactics fail. Coaches support clients as I believe that the most important job of a
they make the difficult behavior changes health coach involves creating a partnership
required to prevent or reverse chronic disease. with clients to discover what will drive their
That’s why an increasing number of Functional motivation to heal. Both from personal and
Medicine practitioners are adding Functional clinical experience, I’ve seen that people
Medicine health coaches to their team. change when their minds and hearts change,
and when their beliefs about what’s possible
The most important role of a Functional
changes. They often experience a crucial
Medicine health coach consists of creating a
“ah-ha” moment of discovery.
partnership with clients to discover the

What brings coaches the most joy?
We asked our graduates to describe what brings them the most joy and
satisfaction. Many referred to a discovery process and a journey towards
enlightenment that they share with another human being. Over and over
again, they spoke about that “aha” moment that occurs as a result of the
coaching process
Coach Reflections “Facilitating the process for my clients

to discover and trust their own Super
Powers (aka Character Strengths!), and
“My reward is the transformation that I
witness their beautiful transformation
am able to bring out in my client’s lives,
once they implement simple, micro-
the fact they finally have hope and faith in
moments and 5-minute techniques into
themselves and feel empowered to take
their day, one day at a time!”
charge of their own health, plus the
Benedict Sivarajasingham
changes that my clients make in terms of
mindset, lifestyle and their diet so that
they can not only create but sustain health “Far and away, I get the most joy and
for the long run.” satisfaction from coaching when one of
Anindita Guha Maulik Rungta my clients has an ‘aha’ moment — that
point when they connect the dots and see
things in a whole new way.
“It brings me joy and satisfaction to
educate and empower clients to make Sometimes it’s the recognition of how
positive lifestyle changes and experience their behaviors and habits are directly
real healing and wellness. It is very impacting their well-being. Sometimes it’s
satisfying to witness clients experience connecting with what matters most to
their own learning, growth and change by them. Sometimes it’s seeing themselves
using food as medicine and evidence in a new and more positive way. Just
based tools of Functional Medicine. I am watching it happen is gratifying enough,
grateful for the gift of empowering others and when the client thanks me for helping
to have enhanced wellness and joy as it them achieve that insight, it is such a
allows me to feel that my life has great wonderful feeling, it reminds me why I do
purpose.” what I do. It brings me joy when a client
Marisa Pizzuto Jutras says thank you for the littlest
improvement. I love to see the growth of
scientific information to share with
clients.”
Pause to Reflect Jennifer Newton
• Imagine the satisfaction that you feel
when you guide someone towards a life-changing realization.
• Imagine helping people experience an “aha” moment
SECTION II:
ENTERING THE HEALTH

COACHING PROFESSION
CHAPTER 5:
Who Becomes a Health Coach?
People from all walks of life, of all ages, gender and nationalities enter the rapidly growing
field of health coaching. Although their background may differ, they share some defining
characteristics. From my experience, I can say with certainty that prospective health
coaches possess a deep desire to help others. Many also overcame their own medical
challenges, or helped a loved one get well, and now they want to guide others on a path to
health. The process of health coaching gives them meaning and purpose, often for the first
time in their lives.
Individuals with a deep desire to help others

Health coaching offers the opportunity to find meaning and purpose because guiding clients on
their wellness journey provides immense satisfaction. It feels good to “do good” in the world.
Individuals who overcame health challenges

The driving force for becoming a health coach could be deeply personal. Choosing health
coaching as a profession may have stemmed from the experience of being diagnosed with a
chronic illness. Finding the medical establishment lacking sufficient answers, they set out to
discover ways to overcome their health issues.
Perhaps someone experienced a health crisis, saw one practitioner after another because the
answers provided to them were lacking or nonexistent, and found themselves alone in their
suffering. Rather than give up, they kept searching for solutions and eventually journeyed back to
health. As a direct consequence of their illness and personal suffering, people frequently decide
to transform their lives, including finding a new career path. I would say that the majority of our
FMCA graduates share a version of this story when asked why they chose to become a health
coach.
Individuals who saw a loved one suffer

Another common theme that draws people to health coaching is witnessing the suffering, and
often the untimely passing, of a family member or close friend. They make the decision to
become a health coach so that others won’t experience the same fate.
Coach Reflections
“I chose to become a health coach “I went through a lot of stress in my life
because all people deserve to feel well and this had started impacting my health.
and thrive. We are surrounded by Through lifestyle changes, I was able to
outdated beliefs and information about make remarkable improvements and
food and health and often disconnect our handle my stress much better. This made
lifestyle choices to our health status. I feel me realize that there is a lot within our
it’s part of my mission and life’s work to control and I felt empowered! I really
help awaken people’s awareness to the wanted to share this experience with
simple and powerful ways that they can others who might be in similar situations.”
heal themselves and prevent chronic Sudha Gopal
illness so that they can have more energy
to enjoy their lives, families, work and
activities.”
“When doctors and psychiatrists
Erica Zygelman
continued their failed and frustrating
message that pharmaceutical and
cognitive behavior therapy were my
“I struggled with an eating disorder daughter’s only lifetime treatments for
throughout my teen years, then again in debilitating fear, irritability, chronic worry,
my 20s. After doing a lot of work on repeating thoughts, fatigue, joint pain and
myself to reverse the damage done to my more, crushing her ability to live out her
body over those years, I decided I was dreams and passions, enough-is-enough
ready to be a part of the solution rather pivoted my career. I did the only thing a
than the problem and help others find mom can do—I got busy and searched for
their way to optimal wellness.” a way to take care of my girl. Health
Rebecca Arsena coaching gave me the tools to help her,
and now others, live easier, healthier and
happier.”
Debbie VanderWeyden
Health coaches have

diverse educational and
career backgrounds
Health coaching is open to all who have a mission to serve
others. Some are attracted to the profession after having
worked in healthcare or the wellness industry. Others have
no previous background in healthcare. Many are coming out
of retirement to become a health coach.
There are no age limits or educational prerequisites to train

as a health coach* (*note that if you seek national board-
certification through the National Board for Health
&Wellness Coaching an associates degree or higher is required).
Previous training in a
healthcare ﬁeld
Many choose coaching after working in Despite having trained in a wide range of
healthcare fields, including nursing, medicine, healthcare professions, what stands out is
pharmacy, physical or occupational therapy, how these healthcare professionals found the
and nutrition. Others have prior experience in practice of health coaching to be a refreshing
the wellness and food industry, such as change. By using the coach approach rather
fitness trainers, yoga teachers, Pilates than acting as the medical expert, they not
instructors, and chefs. only provide better care, but experience
renewed meaning in their work.
Coach Reflections
“After experiencing major shifts in my “I became a Functional Medicine health
health with Functional Medicine and coach to be a greater advocate to my
health coaching, I wanted to learn as dental hygiene patients by connecting
much as I could. I had been a practicing whole body health. Health coaches are a
occupational therapist and it has been valuable asset in the medical and dental
incredible to take off my expert hat (OT) fields. It’s a career I can continue to grow in.
and use a more ‘client-centered’ Antoinette Alaimo
approach. It’s been great to see clients SO
empowered instead of being directed.”
Jill Booth-Clibborn “I am a Reiki Master Teacher
specializing in brain health and I help
people of all ages to shift their energy and
“As a psychologist I have always been mindset. Healing starts from within and
passionate about helping people focus on being aware of making conscious
holistic wellness rather than only treating decisions that are going to improve our
‘illness.’ Walking my own journey in the wellbeing. Being a health coach helps me
patient’s shoes having an autoimmune to be my client’s ally to achieve overall
condition and hormonal imbalances but well being in every area of their lives.”
not receiving any assistance from Marilyn Ocasio Forward
traditional medicine, I bumped into
Functional Medicine on my quest to help
myself heal, learned all I could and “With nearly 18 years of testing new
applied it to myself. My life was medications in development with clinical
transformed! Being a spiritual person, I trial volunteers, I discovered that health
came across a quote that read, ‘You have could not be found in a pill. Rather, health
been given this mountain to show others resides within each of us and can be
that it can be moved’ and immediately felt cultivated through a trusting,
energized and full of purpose to help my compassionate relationship. Embarking
patients and others find hope, healing and on training to become a health coach
optimal health.” allowed me to put my patient
Claudette Jordan engagement skills to use in new ways,
generating sustainable outcomes aligned
with clients’ deepest needs and desires,
on their terms.”
Allison Kelly
No prior training in a healthcare field

In Resonant Leadership, Richard Boyatzis describes three elements as key to
positive interactions: mindfulness, hope and compassion. Those who become
health coaches describe a passion for helping others and a desire to serve.
Put this together with mindfully listening, conveying hope, and showing
compassion and you have the prerequisites for becoming a health coach.
Coaches come from all walks of life that are outside of healthcare,
including corporate, education, entrepreneurship, legal, marketing,
engineering, technology, and stay at home parenting.
Some of the best health coaches have no prior training or experience in

health and wellness fields. They’re starting fresh, without any previous training
that may have led them to assume the role of the healthcare expert. When you’ve worked for
many years as a practitioner, you may be used to acting as the expert. You come up with the
diagnosis and the treatment plan. Then you tell your patients what they should and should not
do. That’s not the coach approach. Coaching is a participatory process where the client ultimately
makes the decisions. When you understand this fundamental coaching principle, then you’re on
your way to becoming a health coach, no matter what your previous training may have been.
Coach Reflections
“The vast majority of people need help “I was retired and looking for
navigating and understanding the something meaningful to do. When I
overwhelming world of health & wellness. discovered the Functional Medicine
Chronic disease rates are skyrocketing Coaching Academy, I realized that I could
and I want to help people be more use the loving, nonjudgmental attitude
proactive with their health before it’s too that I enjoyed in my previous work, while
late. Specifically with longevity and brain adding a fresh component of helping
health. I was at a crossroads in my people specifically to move toward
professional career—I was making money optimal health.”
and had the title, but I was deeply Kirin Loomis
unhappy, unhealthy and stressed.”
Kim Hochman
“I am a Reiki Master Teacher
specializing in brain health and I help
“I have been passionate about holistic people of all ages to shift their energy and
health and nutrition for 30 years, but my mindset. Healing starts from within and
education took me down a different being aware of making conscious
career path. After years of career decisions that are going to improve our
dissatisfaction, I decided that enough was wellbeing. Being a health coach helps me
enough. I didn’t think it would be worth to be my client’s ally to achieve overall
putting the time and money into a well being in every area of their lives.”
nutrition degree, so I hired a career coach Marilyn Ocasio Forward
and we discovered that health coaching
was a great option. After much research, I
found FMCA and couldn’t be happier to
work in a career that serves my purpose
and passions!” Lis Wiesenthal
Pause to Reflect
• Can you relate to wanting to make a real difference in the world by pursuing a career
that’s tied to meaning and purpose through serving others?
• Have you also overcome a health challenge or witnessed loved ones battle debilitating
conditions, and now want to help others suffering from the same or similar issues?
COMMONLY ASKED QUESTIONS:

Do coaches need formal
training in nutrition?
When doctors contact FMCA to find a health
coach for their practices, they frequently
confuse health coaching with nutrition
counseling. The two disciplines are quite
distinct and each of these professionals
belongs on the collaborative care team.
Effective health coaching requires a skill set

that’s different from the requirements to students learn about how to coach exercise
become a nutrition professional. and movement, sleep and relaxation,
relationships, and stress transformation, in
The curriculum of robust certification addition to nutrition and the psychology of
programs for health and wellness coaches eating.
differs from the educational content that
nutritionists and dietitians receive. Training in Rather than acting as experts in nutrition,
the client-centered approach to behavior coaches refer to the expertise of nutrition
change requires specialized education that professionals and other medical experts.
incorporates both a deep dive into the study However, many health coaches do have prior
of coaching principles along with adequate training in nutrition and are licensed
time in their course of study for experiential nutritionists or registered dietitians. But this
learning and practice coaching. training is by no means a prerequisite to
becoming a successful health coach. In fact,
As a result of highly-specialized training, many who come from previous healthcare
health coaches function as experts in fields where they were accustomed to acting
behavior change. They help facilitate change as the expert who “told the patient what to
across all of the modifiable lifestyle factors, eat” struggle with the client-centered approach.
not just nutrition. Therefore, at FMCA,
Can doctors and other providers become

health coaches?
You don’t need to choose between being a practitioner and a coach. Increasing numbers of
healthcare practitioners, including physicians, pursue training in health and wellness coaching.
Become a health coach by using any of these three models:
1 Integrate the coach approach It’s easy to slip into the expert role. To further
establish boundaries, always refer to those
within your existing practice. you coach as “clients” and those you treat in
your medical practice as “patients.” Rather
By incorporating coaching strategies, such as
than referring to you as “Dr...” suggest to
open-ended questioning, you’ll enhance the
coaching clients that they address you by
therapeutic alliance. Not only will your
your first name.
patients benefit, there’s a high likelihood that
you’ll experience more satisfaction in your
When considering whether or not to “switch
work and re-discover why you chose to enter
hats,” it’s important to bear in mind that in
the medical field. the event of a lawsuit or professional
2
regulation complaint, you will be held to your
Keep your existing prac- highest license, which would be your medical
tice and add a dedicated license if you’re a physician. Take the time to
coaching business. put protective measures in place before

starting to coach. The best risk management
In this model, you’re switching hats. Maintain strategies are the creation of a clear coaching
your professional license and continue to see agreement with new clients, strict boundaries
patients. Simultaneously, establish a coaching between your medical practice and your
business as a certified health coach. The key coaching practice, and adherence to the
to creating dual roles is being crystal clear on coach scope of practice when you wear the
precisely what constitutes each position. coach hat.
3 Close your existing

Draw up a client agreement that clearly spells
out the nature of a coaching relationship.
Specify that you’re a licensed practitioner, but
practice and become a
that they’re contracting with you for your full-time health coach.
services as a health coach. You will not be
An increasing number of healthcare
diagnosing or treating any medical condition.
professionals describe feeling burned-out
Make sure that both you and the client sign
and exhausted. Many see themselves as data
the agreement.
entry clerks and slaves to the electronic medical
Maintain strict boundaries. This may mean record system. Some may be frustrated by
having separate coaching clients and not their particular licensing restrictions. Others
coaching existing patients. If the need arises, are nearing retirement and want to continue
refer those clients to medical colleagues. In to serve the needs of others.
other words, you’re not switching hats for any
Health coaching offers a path to pursuing a
given individual.
career that’s aligned with your meaning and
To avoid confusion, refrain from acting like a purpose.
medical practitioner when you’re coaching.
Pause to Reflect:
• Which of the pathways to becoming a health coach described above matches your current
career status?
• Can you imagine incorporating the coach approach into your existing job?
CHAPTER 6:
WHO DO HEALTH COACHES SERVE AND WHERE
DO THEY WORK?
Who do health coaches serve?
You have a calling to serve others, which constitutes a huge first step to becoming a health
coach. An additional step involves envisioning who you want to serve when you finish your
training,
Before considering the many ways that coaches work, let’s discuss the importance of
specializing. This is often referred to as finding a niche. Many of our graduates with an
entrepreneurial spirit launch their own businesses, often desiring to focus on a particular niche.
It’s common to serve those who you resonate with or who suffer from conditions that you’ve
experienced personally. Many coaches choose to serve individuals who have a similar cultural
heritage or profession, specialize in female or male health, or narrow in on a particular age
group, Some work with children and their families; others with people in midlife transition or the
elderly.
Here’s just a few examples of the diverse populations that health coaches serve:
Individuals experiencing the following symptoms or conditions:

• Chronic stress • Neurodevelopmental disorders
• Burnout and exhaustion • Eczema
• Hormonal imbalances • Mild cognitive decline
• Celiac disease • Alzheimer’s disease
• Infertility • Type 2 diabetes
• Polycystic Ovarian Syndrome (PCOS) • Weight loss
• Female hair loss • Chronic pain
• Mold and tick-borne illnesses • “Long-haul” Covid
Coach Reflections
“I want to help other people, especially “I struggled with my self-image even
the most vulnerable, such as immigrant though I didn’t have a weight problem.
Latina women who need to feel loved, When I realized the role that our mind and
whole and empowered.” our nutrition played in our well-being, I
Laura Gonzalez knew I had to share. My goal was and is to
help women gain control of their lives by
restoring that mind/body connection so
“I’ve seen first-hand the individual they can look, feel, and be the best
suffering caused by dementia and version of themselves.”
Alzheimer’s disease to the ones who have Nicole Batiste
the disease. I’ve also experienced the
potential devastation the disease brings
“I became a Health Coach to help
to a family. After learning that this disease
women who are struggling with health
can be largely prevented or reversed (if
and wellness, to show them they are
caught early), I wanted to become a health
strong and it’s ok to take time for
coach to help make that possible for many
themselves.”
thousands of people.”
Lynda Kaye Prior
Monica Tarr
What are the Various Ways to Work

as a Health Coach?
Let’s discuss three primary ways to work as a health coach.
1. Establish your own business

• Do you have an entrepreneurial spirit?
• Are you a visionary who dreams of creating your own business?
• Do you long to be your own boss and set your own work schedule?
• Do you love to connect with others and form collaborations?
• Are you willing to persevere despite setbacks?
• Are you ok with a certain degree of financial uncertainty?
Looking back at my various careers before When I earned my doctorate in clinical

founding FMCA, I now realize that I’ve always psychology, I chose to transition my private
had an entrepreneurial nature. During the tutoring practice to one that specialized in
time that I spent as a special education health psychology. Once again, I accepted the
teacher in the 1970’s, I loved helping my reality of starting small. Through consistent
students thrive, but didn’t enjoy working networking and creating trusted relationships
within a bureaucratic school system. So after with physicians, I gradually built a successful
5 years, I left to establish a private practice as practice. Early on, I recognized the
a learning disabilities tutor. Starting with one importance of establishing a niche. I helped
client, I soon had a roster of about ten people with anxiety and stress-related
students, all based upon word of mouth. I physical conditions by teaching them
loved the experience of designing my biofeedback-assisted relaxation techniques
practice and deciding who my ideal client combined with cognitive-behavior therapy.
would be, as well as the freedom of arranging
my own schedule.
2. Work for a medical practice as an independent

contractor or employee
Here’s some questions to consider when looking for a job
with a medical practice:
• First and foremost, what are the provider’s values, mission, and vision? While values and
mission pertain to the present-day, the vision is future-oriented. Do you align with these
important parameters?
• Is the provider trained in Functional Medicine or an integrative approach?
• What population does the practice serve?
• Is the practice part of a hospital or government-run healthcare system?
• Is the practice insurance or cash-based?
• Will you be expected to see patients in-person or remotely?
• Will you be given the opportunity to facilitate groups?
Work as an Independent Contractor

Although during my previous careers I
primarily focused on building a private
practice, I also entered into many contractual
relationships. For example, as a learning
disabilities diagnostician, I worked as an
independent contractor for local school
districts to provide psycho-educational
testing. In these instances, I was paid a flat
rate for each battery of tests that I administered.
Similarly, as a clinical psychologist with
expertise in personality testing, I contracted
with psychiatrists to administer test batteries
to their patients. My compensation was
For example, you might contract with a
usually 50% of the fees collected.
practice to run a group program, such as a
Let’s suppose that after initial conversations meditation group or a group for patients with
with a medical practice, they express interest type 2 diabetes. As an independent
in bringing you on as an independent contractor, you could offer your services to a
contractor. Now what? number of practices.
The first step involves getting an agreement If the practices you work for are in the United
in writing. The practice may already have a States, they need to make sure that the terms
template for hiring contract workers and wish of service meet the Internal Revenue Service
to follow their standard operating requirements for classification as an
procedures. If not, work with your own independent contractor rather than a salaried
attorney to create an independent contractor employee.
agreement. In this contract, state that you’re
engaging with the medical practice to deliver Get hired as a full or
services to their patients. This may consist of part-time employee
the following:
I’m often asked about the average salary for
• Information about the coaching a health coach. Pay scales vary widely and
services you’re offering, such as a take into account experience, the types of
package of sessions, typically eight to responsibilities that you’ll be given, the
ten, that would be paid for in advance geographic area where the clinic is located,
by the clients. and the specific population that they serve.
• Details about how the services would
be delivered, such as in-person or
remotely, either 1:1 or in a group format.
• Specifics regarding how you will invoice

the practice and how they will pay you.
How can coaches be a Add value through

source of income for “secondary skills”
practices? In addition to helping clients thrive, you can
Many practitioners mistakenly believe that benefit the practice by bringing in
adding a health coach to their team amounts “secondary” skills. These may include
to a financial drain on the practice. In fact, building a social media presence, developing
coaches can be an added source of revenue. online courses, creating blogs or offering
community presentations.
As discussed above, one popular option
consists of paying you a percentage of the By demonstrating a great track record, you’ll
revenue collected by the practice for your become a highly-valued member of the
specific service. You get paid when the collaborative care team. I’ve seen many
business gets paid. health coaches create successful programs
within the office that help both the doctor and
I advise health coaches to demonstrate in a allied staff decrease stress and prevent
variety of ways that they’re fully-committed burn-out.
to growing the practices of the doctors who
hire them. Exceed expectations, such as Show your value to the practice’s patients,
bringing in new clients, and documenting the team, and to the financial bottom line. By
positive changes in the clients that you work doing so, everyone thrives.
with.
3. Get hired by a company to coach their employees

or customers
Employee wellness initiatives
The opportunities for employment by perpetuators of these conditions, the need for
corporations, both large and small, and acute care interventions and medications
representing a variety of industries, are often decreases. As a result, healthcare costs
rapidly increasing. It seems like not a day go down, which is a desirable outcome for
goes by when I don’t see a press release payers.
announcing that a major company hired
health coaches to promote employee What company would turn down the
wellness. opportunity to have a healthy workforce?
Would they say no if you told their executives
Insurance companies are increasingly that signs of fatigue or burnout amongst
adding health coaching as a benefit to their employees would lessen, incidence of calling-
enrollees. This makes sense because when in sick would decrease, and healthcare costs
someone with a chronic medical condition would go down? Would they turn down an
partners with a health coach to address the opportunity to have a more engaged,
lifestyle factors that may be the triggers or energetic workforce and better job
satisfaction? Would they want to deny their lowering healthcare costs. Show companies
employees the possibility of thriving and just how valuable your services are. Hiring a
increasing their physical and mental well- health coach for employee wellness is not
being? As a health coach, you could make only a way to increase the well-being of a
these arguments. company’s workforce, it’s good for the
bottom line. Employee wellness run by a
Tell prospective employers that you have a health coach yields a favorable return on
model that has been demonstrated to investment.
improve physical and emotional health while
Artificial intelligence-based (AI) platforms come

with a health coach!
We’ve entered the era of the “quantified self” increasingly possible to have access to
and the movement is growing. More and bio-markers, but the reason that people are
more people own wearables, such as smart unhealthy is not typically due to lack of
watches, fitness tracking devices, or sleep information. It’s because initiating and
monitors. They work out on AI-driven exercise sustaining lifestyle changes are hard. The
equipment and receive personalized results growing number of companies who offer
from lab testing that they can order and AI-based platforms realize this fact. As a
perform at home. Having access to result, they’re starting to include access to a
information from wearable devices or health coach with their consumer product or
receiving personalized recommendations membership program. Expect this model of AI
based on AI can be very beneficial and help plus health coaching to explode in the future.
people take charge of their health. It’s
Wherever they work,

health coaches
love what they do
No matter where health coaches find
themselves working, it’s the connection with
clients and the coaching process itself that
brings joy to the coach.
Coach Reflections
“Being in flow with my clients in their “I find joy and a true sense of purpose
process of self discovery, hearing the by serving others and partnering with
small wins my clients are making them on their health journey. I admire the
gradually, and when clients come back to courage of my clients to share their stories
me and tell me I saved their life (even with me and to embrace their inner wisdom
though it was all them), it makes all the to make positive changes in their life.”
hard work worth it.” Stephanie Staples
Zara Faisal
“The thing that brings me the most joy

“My best days are the days I am in health coaching is listening to my
coaching. Hearing a client say, ‘I never clients discover what works best for them.
thought of that!’ and watching them We are all unique individuals and have so
succeed in fulfilling their health goals is much to bring to the table of good health.
most rewarding!” Their transformations and lasting changes
Kathy Borthwick are what makes it truly rewarding.”
Sandy Zielinski
Pause to Reflect
• As you contemplate becoming a health coach, what would your ideal career look like?
• Who would you like to serve?
• Where would you like to work?
• Does the idea of launching your own coaching business excite you?
• Can you picture yourself working for a doctor?
• Are you excited by the thought of being an employee of an organization that’s developing
new models of care?
• Would you like to work for a company that’s helping people track their health data?
CHAPTER 7:
What about Legal Compliance and Ethical
Considerations?
?
At the present time, health and wellness
coaches are not licensed as providers by any
state government. Although anyone can hang
up a shingle and call themselves a health
coach, the industry has evolved considerably
and standards have been put in place to
protect the public This is largely due to the
tireless work of the National Board of Health
and Wellness Coaching (NBHWC), which you
will learn about in Chapter 9.
An important requirement for becoming a

competent and will-respected health coach
involves understanding and adhering to I also highly recommend that you take the
guidelines set forth by NBHWC regarding necessary steps for risk management when
scope of practice and code of conduct. entering the health coaching profession.
The following are some of the questions that we frequently

get asked about.
Must coaches maintain HIPAA compliance?
Because health coaches are not licensed You owe it to your clients to keep anything
practitioners and therefore not “covered they share with you, whether orally or in
entities” under the Health Insurance writing, completely private. If clients want
Portability and Accountability Act (HIPAA), you to share their confidential information
they are not LEGALLY bound by HIPAA with someone else, they must grant formal
regulations. However, HIPAA compliance written permission, commonly referred to as
needs to be maintained for ethical reasons. a “release of information.”
Do coaches need liability insurance?

Although there’s no legal mandate to carry If you’re working for a medical practice,
professional liability insurance, it’s prudent to whether as an employee or an independent
do so. Many places of employment require contractor, that organization would most
health coaches to have their own liability likely list you on their malpractice policy, just
insurance and provide evidence that it’s as they would any other allied staff member.
up-to-date.
Can coaches work remotely and

across state lines?
Health coaches increasingly work remotely
and virtual sessions, whether one-on-one or
in a group format, are becoming the norm.
The worldwide pandemic accelerated the
trend away from live encounters. Thanks to
online platforms like Zoom (which offers a
HIPAA compliant version) it’s possible to
create powerful engagement.
Health coaches are currently not licensed as

medical practitioners by any state governing
body. Therefore, they can work across state
lines. This holds true whether they’re working
in a medical practice, running corporate
wellness programs, or operating their own
health coaching business.
Pause to Reflect
• Imagine entering the health coaching profession full-equipped to set up your business.
• If legal and ethical issues seem daunting right now, can you rest assured that experts
provide education and guidance?
CHAPTER 8:
What Should I Look For When Choosing A
Training Program?
As health and wellness coaching catches on, identifying themselves as health coaches in
more people want to train to become the United States. Compare that to just over
coaches. As an increasing number of people one million professionally active physicians in
call themselves health coaches, will the job the US. Consider joining the ranks and
market be overrun by trained coaches? Will encouraging others to enter this rewarding
there be too much competition for jobs? profession. The world needs more coaches.
The belief that the health coaching profession In order to become a health coach, you need
is already saturated, or will be in the proper training. One of the first questions
immediate future, cannot be farther from the prospective coaches typically ask is “where
truth. The more health coaches we have, the should I get my training?” Here’s some
more credible the profession becomes. As of important considerations to address prior to
2021, there are approximately 109,000 people enrolling.
Questions to consider: 9. Are the graduates of the school pursuing the

type of coaching career that resonates with you?
1. First and foremost, does the program match
your values? 10. Is the program fully-approved by NBHWC
so that you will be eligible to sit for the board
2. What’s the program’s mission? exam and become a Nationally Board-
Certified Health and Wellness Coach?
3. How long have they been in business?
11. Do they provide training in how to set up a
4. Do they provide experiential learning coaching business and work on medical
where you practice what you’ve been taught, collaborative care teams?
rather than just passively taking in the
information. 12. Do they offer opportunities to connect
with those who are hiring?
5. Are there facilitators who provide feedback
to you? 13. Do they offer support after graduation?
6. How long is the training program?* 14. Do they teach you how to work outside the
scope of practice of a health coach?**
7. Who comprises their faculty roster? Are
they subject-matter experts? 15. Does the school’s sales team aggressively
market to you or are their admissions
8. Are the program developers accessible to counselors genuinely interested in helping
students and graduates? you make a thoughtful decision based on
your unique needs?
* Be wary of schools promising to train coaches in a few months. Learning and practicing the coach approach takes
time. Don’t sacrifice a quality education for the promise of a fast-track approach. Cutting corners can leave you
ill-prepared to be an effective coach and less likely to get the job of your dreams.
** This could be a red flag. Doctors may not wish to hire a health coach who is operating outside of their scope of
practice by engaging in practices considered reserved for those who hold a medical license. I hear from many
practitioners that they will not hire or refer to coaches who are ordering and interpreting labs. Nutritionists and
registered dietitians have filed complaints against health coaches who perform nutritional assessments and
recommend specific dietary approaches. The rationale provided by the coach in question has often been that they
were trained to do so at the coaching school they attended. As I’ve stated earlier, the power of coaching lies in the
coach approach, i.e., the scope of practice, not acting as the medical or nutrition expert.
Benefits of a Functional Medicine

coaching education
Just as more and more medical professionals are seeking education in Functional Medicine and
functional nutrition, an increasing number of prospective health coaches desire training with a
Functional Medicine orientation. The benefits are not restricted to growing your career.
Learning Functional Medicine and functional nutrition principles will lead to powerful personal
transformation. Additionally, when you study these powerful approaches to healing, you can be
of service to your loved ones as well.
Pause to Reflect
• What would an ideal training program look like for you?
• How important is engagement with other students?
• How important is interacting with faculty and receiving mentoring and support?
• Would you benefit from continuing education, mentoring and community engagement
after graduation?
• Would you like to attend a school where employers seek to hire their graduates?
SECTION III:
THE RAPID GROWTH

AND RECOGNITION OF
HEALTH COACHING
CHAPTER 9:
Is Health Coaching a Legitimate Profession?
The answer is a resounding YES! There are several reasons why we can make this claim.
yes!
• Health coaches who graduate from approved schools can be granted national
board certification.
• Health coaching is on track for insurance reimbursement.
• More and more esteemed medical institutions or organizations recognize

the value of health coaching.
Board-certification is the knowledge and skills essential to the

practice of health coaching. Increasingly, it’s
the gold standard that becoming the gold standard. A growing
elevates the profession number of organizations, including medical
practices and corporations, list board-
When asked about which health coach certification as a qualification in their job
training program to choose, I always descriptions and come to NBHWC seeking
recommend enrolling in a school that is out candidates.
fully-approved by the National Board for
Health and Wellness Coaching (NBHWC). Let’s discuss health coaching and insurance
Graduates of these schools, which includes reimbursement.
FMCA™️, are eligible to apply for board-
certification through NBHWC. Health coaching is on
I advise graduates of FMCA™️and other track for insurance
schools to become nationally board-certified. reimbursement
The process involves logging coaching hours
and sitting for an exam. It’s worth it and Would you like to submit claims so that your
here’s why: services can be reimbursable through
insurance? That’s another compelling reason
NBHWC partners with the National Board of to go the extra mile and become a nationally
Medical Examiners to provide minimum board-certified health and wellness coach.
competency standards and assess mastery of
Thanks to the efforts of NBHWC, two The Category III

significant milestones were recently achieved:
Health and Well-Being
the introduction of Category III CPT codes and
a taxonomy code for health and wellness
Coaching Codes:
coaching. Additionally, coding changes in • 0591T Health and Well-Being Coaching
2020 created a landscape that offers face-to-face; individual, initial
pathways for medical practices to receive assessment
reimbursement through the payer system for
services that incorporate health coaches. • 0592T individual, follow-up session, at
least 30 minutes
CPT codes for health • 0593T group (two or more individuals),
and wellness coaching at least 30 minutes
As of January 1, 2020, the American Medical

Association (AMA) approved Category III Taxonomy Code
Current Procedural Terminology (CPT®) Effective April 1, 2021, health and wellness
codes for health and wellness coaching. coaching was granted the taxonomy code
71400000X. This unique 10-character code
NBHWC worked diligently for the creation of
designates the specific classification and
these tracking codes. Utilization figures and
specialization. Coaches can use this code
data collection will support eventual AMA
when applying for a National Provider
approval of Category I codes. Achieving this
Identifier (NPI), a unique identification
higher status will open the door for health
number for covered health care providers,
and wellness coaching to be reimbursed
that improves the efficiency and effectiveness
through the payer system.
of electronic transmission of health
The Category III codes can be used by information.
coaches who are nationally board-certified by
NBHWC considers this another significant
NBHWC. The establishment of these codes is
step forward for the profession as it further
considered a “home run” for the profession,
demonstrates the importance of the role of
as their adoption increases recognition of
the health and wellness coach.
health and wellness coaching as a valuable
service. Any healthcare provider, healthcare
clearinghouse or healthcare organization that
Utilization of the new codes by board-
conducts transactions or uses health records
certified health and wellness coaches will
that fall under HIPAA regulations is required
support reimbursement in the near future.
to obtain an NPI. This includes organizations have an NPI number.

and providers that use a medical billing
company to process their claims. HIPAA National Board-Certified Health & Wellness
requires that any individual, business or Coaches need an NPI number if they work for
health care agency who transmits any patient a healthcare organization or in partnership
health information in electronic form in with a physician.
connection with a transaction is required to
Health coaching is on track to “go mainstream”

“I think that within the next 10 years there’s going to be a health coach in every primary
care practice.” Cheng Ruan, MD Founder, Texas Center for Lifestyle Medicine
“Health coaching is such an important and blossoming new profession.”

Tom Blue, Strategic Advisor, Institute for Functional Medicine
Co-Founder, Virtual Practices
An increasing number of physician practices, Dr. Cheng Ruan is one of the key physicians
major medical institutions, and corporations leading the charge for health coaching
recognize the value of health coaching, advocacy. He believes that every primary care
including prestigious institutions such as the doctor should have four health coaches
Cleveland Clinic and Harvard University. working on their collaborative care team. Dr.
Ruan refers to his own clinic as a “clinical
Thanks to the CPT coding changes described coaching practice,” meaning that the coaches
above, medical practices will be able to are the first point of contact with patients, as
receive reimbursement for services well as providing the crucial coaching
performed by a health coach. Increasingly, sessions that follow the clinical consultations.
health coaching will no longer be “cash only.” The doctors in Dr. Ruan’s clinic provide the
As a result, doors will open for thousands of diagnosis, lab test recommendations, and
people to work with a health coach. Get ready treatment plan. The health coaches ensure
for health coaching to “go mainstream.” that the patients are engaged with the plan
and making progress.
Pause to Reflect
• Imagine yourself as a nationally board-certified health and wellness coach.
• Imagine yourself as a well-respected member of a clinical care team, working either within
a medical practice, or receiving referrals from one.
CHAPTER 10:
What’s on the Horizon for Health Coaching?
The health coaching profession is expected to grow rapidly due to a number of factors:
• The after-effects of COVID-19 and all of the variants continue to emerge. We’re facing a
significant rise in both physical and emotional health problems brought on by the
pandemic.
• The incidence of chronic diseases continues to climb and the current healthcare system
cannot adequately address the underlying factors, such as poor diet and lack of exercise.
• As healthcare costs spiral out of control, an increasing number of companies will

positively appraise the value of health coaching.
• We’re moving rapidly into the era of patient-empowered healthcare. More and more tests,
including lab work, are becoming direct-to-consumer, thus bypassing the need to see a
doctor to get a medical order. At the same time, there’s an explosion of remote tracking
devices hitting the marketplace. These include continuous glucose monitors, sleep
trackers, and stress reduction tools. Many of the companies creating these devices and
apps are offering health coaching as an additional option for the consumer.
• As a result of the COVID-19 public health emergency, rules and regulations were relaxed
around telehealth. This model is ideal for health coaching and we’re seeing a large
increase in the number of medical practices hiring coaches to work remotely.
• Changes to the payer system in 2020 paved the way for increased use of health coaches
by insurance-based medical practices. Due to favorable reimbursement rates, there’s a
compelling financial reason to hire coaches
Payer System Changes

For physicians operating in the United States as well as covering the cost of paying for a
within the payer system (i.e., they accept health coach: group medical visits and remote
insurance), two new changes in 2020 offer patient monitoring.
the potential for earning additional revenue
Group Medical Visits Remote Patient Monitoring

Facilitating group medical visits is one of the
(RPM)
best ways that coaches can Tom Blue, Co-founder of Virtual Practices,
bring value to a medical describes the coach as the member of the
practice. collaborative care team who helps the
practice transition into health surveillance
For example, create
through monitoring of the data from remote
a sixty minute group
wearable devices.
for patients with type 2
diabetes, While the coach Suppose the physician prescribes a
leads the discussion, the continuous glucose monitor. The health coach
physician or nurse practitioner educates clients about how to use the device,
takes participants out one at a supports them to intelligently use it, and
time for an individual evaluation and most importantly, uses the data as a
management session, typically up to ten springboard for discussions about setting
minutes. If the group is on Zoom, the goals for diet and lifestyle changes.
breakout room will be the ideal place for the
private consultation. Group medical visits set Although the above scenario did not involve a
up with this structure can be billed as direct patient encounter, it’s now a billable
individual appointments for all attendees. service through Medicare and the private
The coach could be paid at a flat rate, such as payers.
$150-$200, or a percentage of the total
amount collected by the practice for the Thanks to the favorable reimbursement rates
session. for both group medical visits and remote
patient monitoring, the cost of hiring a health
For cash-based or hybrid practices, where coach will be covered and the practice will
some services are billable through insurance still yield a profit from these services.
and others are non-covered services, the Therefore, the dispute, “I can’t afford to pay
coach could facilitate specialty groups. for a health coach” no longer applies.
Perhaps clients have an interest in
participating in a group devoted to learning Pause to Reflect
meditation or breathing techniques. If these
sessions are purely educational and don’t • Imagine being a valued member of a
include the individual evaluation and medical care team or running
management breakout sessions, they would employee wellness programs.
not qualify as billable services. Participants
• Imagine working for a company that’s
would pay for the training in advance,
creating innovative AI-driven
possibly six or eight online weekly sessions.
wearables for monitoring health
The practice compensates the coach with a
information.
flat rate or a percentage of the total revenue
collected for the group. • Visualize how you want to make a
difference by becoming a health coach.
CONCLUSION
“Imagine those who are stuck in a maze, walking in circles and are having trouble finding
the way out. If you knew you could guide them out, wouldn’t you want to grab their hand
and help them? As a coach you can support your clients to reduce confusion, educate them,
share resources and partner with your clients to find their own answers and guide them to
reach their finish line.”
Carla Alpert
Picture the ideal medical office of the future:

• The patient plays a central role in directing their care
• The practice calls themselves a “medical coaching practice”
• In addition to at least one health coach, the collaborative care team consists of doctors,
nurses, nutritionists, and also includes mental health professionals, occupational, and
physical therapists, based on the needs of the patient.
• Visits take place either remotely or in-person.
• Group visits facilitated by the health coach, and including

individual sessions with the doctor in breakout rooms, are
routine.
FUNCTIONAL
• Health coaching services are reimbursable through insurance. MEDICINE
• Remote patient monitoring with the health coach as manager is
the standard of care.
• Many at-home diagnostic tests are available

on a direct to consumer basis and
readily available. POSITIVE PSYCHOLOGY MIND-BODY
• All medicine is Functional Medicine!
NUTRITION
The above scenario is not far-fetched. Many Let’s not forget another group that will
of these possibilities are already taking place benefit from the work you do if you choose to
or in development. pursue a career as a health coach. The doctors
and allied staff that you interact with will be
It’s my personal mission to work towards a touched by your presence as the behavior
healthcare ecosystem where it’s customary to change specialist on the team. Their jobs will
find health coaches serving as important become easier and burnout will decrease.
members of collaborative care teams, playing
a crucial role as the behavior change I invite you to join the movement that’s
specialist in every medical office. Each day, transforming healthcare. You don’t need prior
this vision becomes more of a reality, as the formal training in healthcare. You don’t need
demand for health coaches is exploding to enroll in a degree program to become a
around the globe. health coach. All you need is a deep desire to
serve others. You already possess that, as it’s
Imagine waking up every morning happy to what brought you to pick up this book in the
go to work and knowing that you’re making a first place.
huge difference in people’s lives. The clients
that engage with you attain better physical I hear from many burned-out physicians that
and emotional health as a result of their they would not advise their children to enter
partnership with you. The changes they make the medical profession. I’ve heard similar
have a ripple effect, positively impacting their stories from exhausted nurses, mental health
loved ones and even their community-at- professionals and teachers, as well as from
large. The process of creating and nurturing a those working in corporate positions. In
strong alliance with clients results in an stunning contrast, Functional Medicine
additional, important benefit: you as the certified health coaches responded differently
coach will be personally transformed as well. when asked if they would recommend the
I can’t overstate the value that coaches derive health coaching profession to others.
from engaging in client-centered work.
Would you
recommend
this profession
to others?
Coach Reflections
“I am filled with joy every time I work “I believe life is about helping and
with a client and they are able to feel serving others. And as a health coach we
success with their goals. If helping others are providing both health and service,
find their goals and teach them is which is an excellent combination for
something that you are passionate about, humanity.”
this is the job for you! Helping others reach Deepa Rajani
their potential is amazing!”
Melissa Champine
“Health coaching is not for everyone. It
requires empathy, creativity, patience,
“I recommend this profession as it’s so dissolution of ego, and exceptional
valuable in this period of our lives. With the communication skills. I would recommend
aging of America, increased obesity in it to anyone with that unique cluster of traits.”
young people, and sedentary lifestyles, Kimberly Kaye
health coaches hold the key to empowering
clients to understand and implement
changes that result in a higher quality of “This is the very best profession for the
living.” Antoinette Alaimo person who is willing to allow their client to
be the expert of their own life and destiny.
As a health coach, getting to observe the
“It’s a relatively new field and there is a
client perform their own magic and
lot of scope for growth.
alchemy and transform into the Divine
If you are passionate about health and Being they are meant to be is breathtaking!’
wellness, and if you want to help others Tiffany Zwieg
genuinely, this is the way to go. It gives you
the opportunity to be yourself, to grow as a
“Health coaching offers one of the most
person and a professional, and have the
exciting opportunities to fuel systemic
freedom to do the work you most love.”
healthcare change at the most fundamental
Zara Faisal
level. To heal, people need time, while time
is the one, critical factor missing in our
“If you have a passion for growth and healthcare system. As a health coach, you
self development, to empower others and a get to dedicate your time to meet people
mission to make a difference, I would highly where they are and help them go where
recommend considering a career in health only they can.”
coaching. The health status of the world is Allison Kelly
in dire need of professionals with tools and
strategies to facilitate change and there are
many people out there eager for guidance
on how to live a well life.”
Claudette Jordan
“I think health coaching has the potential “Functional Medicine health coaching
to literally transform lives. And while many simply transforms lives. You empower
diseases may not be “curable” in the people to look actively after themselves,
traditional sense, health coaches can transform their lives and lives of others as a
empower, inspire and motivate their clients ripple effect! You change the world one
to heal themselves from the inside out and person at a time!”
make the changes required to sustain good Benedicta Sivarajasingham
health.”
Anindita Guha Maulik
I hope you’re inspired by the above reflections,
and after reading this book, choose to enter
“The coach approach promotes change the personally enriching field of health and
and wellness not only for the person being wellness coaching. If you decide to become a
coached but also flows to those around Functional Medicine health coach, you’ll
them unleashing a powerful and beautiful belong to a growing community with a mission
ripple effect of positivity and meaningful to help people address the root causes of
familial, community and even global disease through lifestyle change. Not only will
impact. In a world that is increasingly you be of utmost service to potentially
demanding positive change in their state of thousands of other people, you will experience
wellbeing, the art and science of the coach abundance and joy from your work.
profession is most effective in moving
people from here to there. I wholeheartedly Join me in becoming part
recommend this profession to the person of the movement that’s
who feels passion and purpose in helping transforming healthcare.
to create a better world for everyone.”
Debbie VanderWeyden Humanity needs you, now
more than ever!
Acknowledgments
With gratitude for the following members of the FMCA alumni community who so eloquently
expressed their thoughts about the joy of being a Functional Medicine health coach. I could not
have written this book without your contributions.
Margot Akeroyd Courtney Contos Cofino Jen Lendaris Jennifer Shorts
Antoinette Alaimo Daniela Cook Kirin Loomis Benedicte

Sivarajasingham
Carly Alpert Paula DeFreitas Rupali Lubchansky
Stephanie Staples
Anne Altizer Zara Faisal Linda Lynch
Robyn Steele
Tita Arroyo Marilyn Ocasio Forward Herb Massin
Beatrice A Strayer
Rebecca Arsena Erien W. Fryer Jennifer Mccann
Ann Swietnicki
Yvette Aungamuthu Jackie Ganz Kate McMorrow (Mesinger)
Nicole Batiste Shelby Garay Jennifer Newton

Keri Sitrick
Dawn Bernard Polly Geng Juliana Nikolova

Angela H Small
Elisabetta Bernardini Nicole Gleason Beth O’Leary

Juliet Tabbara
Jill Booth-Clibborn Laura Gonzalez, Ph.D. Lindsey Pastorova

Monica Tarr
Sudha Gopal Erendira Preciado

Kathy Borthwick Debbie
Lyndakaye Prior VanderWeyden
Sophie Boyle Kim Hochman
Deepa Rajani Jane Webster
Honey Bronson Claudette Jordan
Lura Kay Robison Andrea White
Leslie Case Marisa Pizzuto Jutras
Anindita Guha Maulik Lis Wiesen
Kerry Chamberlain Kimberly Kaye
Rungta
Laura Wild
Melissa Champine Allison Kelly Leeann Rybakov
Sandy Zielinski
Colette Chandler Tracy Klein Deborah Schapiro
Tiffany Zweig
Ishita Chelliah Sandy Kleiman Linda Schillinger
Mary Clevidence Alexandria Larsen Erica Zygelman
Crystal Sgro

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FUNCTIONAL

POSITIVE PSYCHOLOGY MIND-BODY

How to Become a Health Coach:

The Career That

Foreword by Cheng Ruan, MD

SECTION I: THE HEALTH COACHING PROCESS

SECTION II: ENTERING THE HEALTH COACHING

SECTION III: THE RAPID GROWTH AND RECOGNITION OF

crucial to the current medical ecosystem. Encouraged by data showing significant

• Which career has the biggest potential In order to become an

Does pursuing a career that consists of support-

To help you gain insights about the health

2. What brings you the most joy as a health coach?

3. Would you recommend that others pursue a career as

These reflections are sprinkled throughout the book.

“I wanted to help people overcome

Why are health coaches in demand?

Who’s hiring health coaches?

• Medical practices, including those that • Companies developing artificial

What Makes Health Coaching So Extraordinary?

The World Needs Health Coaches Now!

As we enter the third year of the pandemic,

Join the movement that’s

• If you want to be a key member of a • Who do health coaches serve and

National Board for Health & Wellness Coaching (NBHWC)

Health coaching evolved from life coaching

The Coaching Structure

The Coaching Process

Four key features result

“My greatest joy is actually

• Consider times in your life when you had a trusted guide.

Here’s seven of the crucial ways that coaches support clients:

2. Provides education and clears up confusion

3. Facilitates problem-solving and resolve ambivalence

4. Helps set realistic goals and celebrates tiny wins

5. Provides crucial emotional support

7. The coaching process is equally powerful for the coach

1 Takes the time to truly listen

2 Provides education and not confused, and are fully-committed to

“My favorite phrase to hear from a “I am overjoyed when I see the

The “secret sauce” lies What’s outside the

The following areas are considered to be outside the

Developing treatment plans

Ordering and interpreting lab testing

Recommending medications and supplements

Recommending specialized diets

Read how health coaches describe the power of the

“I wanted to be able to empower

The coach as educator

Receiving advice from experts often fails.

The coach as behavior change agent

“I am happy to see my clients thrive as “I became a health coach because I

The Functional Medicine Approach

“I was inspired by my own incredible

The Positive Psychology Approach

Functional Medicine Health Coaching

Coach Reflections “Facilitating the process for my clients

• Imagine helping people experience an “aha” moment

ENTERING THE HEALTH