How a Health Coach Helped Me Finally Get a Good Night's Sleep
Scott and I connected through the deeply unsexy-sounding Telephonic Wellness Coaching program, an incentive offered by my family’s insurance provider to motivate covered employees and their spouses to get healthier. I admit I was initially drawn to the $200 that would be plunked into our health savings account just for participating in four phone calls; I'd choose a medical or personal care issue I wanted to improve and then work with a wellness coach to make it happen. Why not? I figured. I'll listen to Scott whisper sweet nothings about healthy living, then collect my cash.
As it turned out, though, Scott had something to teach me. I pride myself on being a fit, healthy person—I should be; I report on these topics for a living. But for years, I've had one very unhealthy vice: I'm a chronic night owl. Though I know about sleep’s link to brain health, stress reduction, and even lowered risk of cancer and heart disease, I routinely stay awake too late, catching up on work or social media when I should be catching some zzz's.
Previously, I'd thought good sleep habits were all-or-nothing—if I wasn't prepared to turn in early every night, why try at all? Scott was the first person to suggest that baby steps could work. He asked what I considered a doable goal; I said I could make an effort to hit the sack at a reasonable time one night per week. Then he challenged me to plan that evening in reverse: What did I have to do in the hours leading up to 10 p.m. in order to hit my target bedtime? I told him I’d need to physically put myself to bed by 9:45, power off electronics by 9:30, eat by 8, and get the kids down by 7:30. It wasn’t easy, but I found that kissing the kids goodnight set off a domino effect that helped me tumble into slumber. When Scott checked in three weeks later, I felt giddy to report that I was on track.
Health coaching is a budding field built around the latest science on motivation and behavioral change. "Coaches give you a key role in determining your action plan, help you lay it out in a step-by-step format, and support you along the way," explains clinical health psychologist Ruth Q. Wolever, PhD, director of health coaching for the Vanderbilt University School of Nursing in Nashville.
In some ways, health coaches are like therapists: They want to help you change your mindset and behavior—and by extension, improve your life. However, they likely won't ask you to explore your feelings, and it's not the coaches’ role to make a diagnosis or prescribe medication. (If they think psychological issues are getting in your way, they may refer you to a mental health expert.)
Many people turn to health coaches for help losing weight—that's how Karen Bennett, 62, from Bloomington, Illinois, dropped 35 pounds during the past year. "I'd tried counting calories, low-carb diets, exercise, but I always struggled with consistency," says Bennett, also a caretaker for her 23-year-old son, who has special needs. Then she signed up for Healthe You, a free program offered by her employer. "My coach asked what my number one priority was. I said, 'My son. And I can no longer lift him.' So we decided I'd start by gaining strength." Instead of again striving—and failing—to meet a Fitbit goal of 10,000 daily steps, she aimed for a more realistic 2,000 combined with lifting weights. One month, two calls, and four online seminars later, Bennett was ten pounds lighter, had more energy, and was eating healthier. The convenience was key: "I'd Skype with my coach from my home office while my son played video games in the next room."
Bennett and I are just two of many success stories: Studies show that health coaches can help people manage chronic conditions (like diabetes), lose weight and keep it off, increase movement and activity, and generally improve their physical and mental health. Employers and insurance companies appreciate that coaches can help bring down patient coverage costs and reduce claims. Don’t worry that using a coach will compromise your privacy: The services are covered under the Health Insurance Portability and Accountability Act, which prohibits employers from accessing worker medical records or insurance claims. (If you have specific questions about what a coach can share with your insurance company, ask your provider.)
One reason the coach approach is so effective? "When we tell another person we're going to do something, and we know we have to report back to them, we'll exert additional effort to make sure we follow through," Wolever says. Indeed, research shows social support makes people more likely to stick with behavioral changes like exercising and quitting smoking, as well as going for breast cancer screenings.
Case in point: When the clock struck 9 and I was still enjoying a predinner glass of Riesling, I'd find myself wondering, What would Scott think? During our second session, he asked whether anyone close to me might be able to help me reach my sleep goals; that led me to text my husband midday and ask for encouragement to get to bed early—just the push I needed.
Wolever points out that health coaching also helped build my self-efficacy—my belief in my ability to get stuff done. In other words: Tuck a woman into bed, help her sleep for a night; teach her to tuck herself in, help her sleep for a lifetime.
My initial coaching program has concluded, and I'm pleased to report that not only am I in bed by 10 p.m. at least twice a week, but I'm feeling more rested and alert. The bonus: "Now that you've mastered one problem," Wolever says, "you're more likely to be able to problem solve in a similar way in another context."
Ready to get in the game? Many insurance companies—including UnitedHealthcare, Humana, Cigna, and Aetna—offer coaching programs, sometimes with perks like reduced premiums or gift cards. Insurance plan coaches are usually vetted; for instance, UnitedHealthcare says all its coaches have at least a bachelor’s degree, typically in a health-related discipline, and receive additional education. You can also pay for a hospital- or private practice–based coach. In total, there are at least 15,000 to 20,000 self-identified coaches in the U.S. Just be sure to check their background; as Wolever warns, "Anyone could hang out their shingle." (She's on the board of a consortium planning to offer a national certification program this year.) For me, health coaching was a win-win. Best money I never spent.
Photographs by Jeff Harris.
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