Validated Group Health and Wellness Coaching Competencies
The prevalence of chronic diseases is increasing worldwide. To address this issue, Health and Wellness Coaching (HWC) has emerged as an effective way to help patients and clients make positive behavior changes that relate to their health & wellbeing.
As HWC gains popularity, there is a growing interest in group coaching. However, up until now, there have not been any published competencies specifically focused on Group Health and Wellness Coaching (GHWC).
To fill this gap, NBHWC, in collaboration with 7 highly qualified Subject Matter Experts, has identified and proposed 72 GHWC competencies. These competencies have been validated by 78 National Board Certified Health and Wellness Coaches (NBC-HWCs) who are actively practicing GHWC. These competencies will serve as a valuable resource for individuals and organizations involved in group health and wellness coaching.
| Domain 1: Coaching structure competencies, frequency and importance validation ratings (N=78; Domain weight = 36.3%) | |||||
|---|---|---|---|---|---|
| 1.1 | Before First Session | IMP | FREQ | WT | |
| 1.1.1 | Clearly identify initial theme/focus for the offered group and communicate that appropriately in marketing materials | 3.65 | 4.41 | 0.49 | |
| 1.1.2 | Pre-screen/interview interested group participants individually to: Explore the opportunities and responsibilities Confirm commitment of joining a group Listen for common requests and themes Answer any individual questions Note group fit (or not) and identify any need for another type of support Discuss and administer any assessment tools used | 3.37 | 3.95 | 0.41 | |
| 1.1.3 | Identify any accommodations needed | 3.21 | 3.77 | 0.38 | |
| 1.1.4 | Establish all aspects of the Coaching Agreement and send to group members | 3.41 | 4.06 | 0.43 | |
| 1.1.5 | Create a customized structure for sessions that aligns with group needs | 3.56 | 4.38 | 0.48 | |
| 1.1.6 | Meet different participant preferences for technology, interactive activities, content sharing, etc. | 3.05 | 3.92 | 0.38 | |
| 1.1.7 | Balance structured activities with space for group processing | 3.6 | 4.51 | 0.49 | |
| 1.1.8 | Confirm size and make-up of the group to optimize participant experience, for both individual sharing and group connection (recommendation 6-8 optimal, 12 max.) | 3.46 | 4.32 | 0.46 | |
| 1.1.9 | Manage the room and setup (virtual or in-person) to create an optimal learning environment | 3.58 | 4.47 | 0.49 | |
| 1.1.10 | If meeting virtually, test the technology, ensure the facilitator(s) have proper equipment and support, and provide participants with instructions for using the technology | 3.6 | 4.28 | 0.48 | |
| 1.1.11 | Review completed assessments and other data sources | 3.42 | 4.21 | 0.44 | |
| 1.2 | First Session | IMP | FREQ | WT | |
| 1.2.1 | Set the climate/stage by establishing and maintaining a safe and inclusive group container | 3.92 | 4.63 | 0.54 | |
| 1.2.2 | Ask for identification preferences such as name, pronoun, etc. | 3.29 | 3.77 | 0.39 | |
| 1.2.3 | Review basic group coaching process | 3.44 | 4.19 | 0.46 | |
| 1.2.4 | Establish, demonstrate, and maintain agreed upon group guidelines for safety and productivity | 3.74 | 4.42 | 0.5 | |
| 1.2.5 | Create supportive physical or virtual space | 3.65 | 4.53 | 0.5 | |
| 1.2.6 | Encourage each participant to take ownership of the process | 3.71 | 4.41 | 0.49 | |
| 1.3 | Structure in All Sessions | IMP | FREQ | WT | |
| 1.3.1 | Review larger intention for this group, and (Session 2 and forward) consider themes or needs that arose from the previous session, to set an initial plan for this session | 3.45 | 4.29 | 0.46 | |
| 1.3.2 | Confirm logistics (meeting location, conference call arrangements, etc.) ensuring all group members are aware and able to access | 3.71 | 4.47 | 0.51 | |
| 1.3.3 | Provide a flexible agenda or outline in order to best manage time, flow, and focus of session | 3.41 | 4.38 | 0.46 | |
| 1.3.4 | Invite participants to check-in on state of being, prior session action steps, and needs for the session | 3.58 | 4.4 | 0.48 | |
| 1.3.5 | Create opportunities for participant interactions with clearly established logistics, guidelines, instructions, and boundaries | 3.59 | 4.45 | 0.48 | |
| 1.3.6 | End each session with an appropriate closing and check-out | 3.68 | 4.6 | 0.51 | |
| 1.4 | Final Session | IMP | FREQ | WT | |
| 1.4.1 | Create a closing outline that includes: Inviting the clients to reflect on, assess, and to articulate progress made, challenges experienced, lessons learned, and growth attained Finalizing maintenance plans and sustainable pathways forward Facilitating members in identifying and accessing social supports, services, and other resources | 3.88 | 4.64 | 0.54 | |
| 1.4.2 | Formally acknowledge, facilitate celebration of their accomplishments, and close the ‘container’ of the group | 3.74 | 4.6 | 0.52 | |
| 1.4.3 | When applicable, collect feedback about participant’s group experience | 3.65 | 4.46 | 0.49 | |
| Scores for Importance (IMP) based on 1–4 Likert scale, where: 1 = Not Important; 2 = Somewhat Important; 3 = Important; 4 = Very Important. Scores for Frequency (FREQ) based on 1–5 Likert scale, where: 1 = Never; 2 = Infrequently; 3 = Occasionally; 4 = Frequently; and 5=Very Frequently. | |||||
| Domain 2: Coaching process competencies, frequency and importance validation ratings (N=78; Domain weight = 63.7%) | |||||
| 2.1 | Client-Centered Relationship | IMP | FREQ | WT | |
| 2.1.1 | Continuously recognize the group’s individual and collective needs and design content and activities to meet them | 3.59 | 4.47 | 0.86 | |
| 2.1.2 | Adjust approach according to the group’s evolving health literacy | 3.54 | 4.28 | 0.81 | |
| 2.1.3 | Intentionally create a climate that respects social and cultural differences, and fosters inclusivity | 3.88 | 4.56 | 0.93 | |
| 2.1.4 | Respect and explore the larger meaning of health and wellbeing across diverse group members | 3.55 | 4.22 | 0.8 | |
| 2.2 | Managing Group Dynamics and Challenges | ||||
| 2.2.1 | Establish and maintain trust and rapport | ||||
| 2.2.2.1 | Model unconditional positive regard, benevolence, honesty, sincerity, and authenticity | 3.96 | 4.79 | 0.99 | |
| 2.2.1.2 | Provide strong leadership and facilitation when the group is forming; respond to the evolving culture and needs of the group | 3.82 | 4.73 | 0.95 | |
| 2.2.1.3 | Foster shared meaning and honor diversity (e.g. cultural, racial) | 3.82 | 4.44 | 0.9 | |
| 2.2.1.4 | Monitor appropriate boundaries that meet the needs of individual participants and the group | 3.62 | 4.41 | 0.86 | |
| 2.2.1.5 | Elicit commitment from participants to attend and to focus their participation by their elimination of all distractions around them | 3.53 | 4.23 | 0.79 | |
| 2.2.1.6 | Create a comfortable setting, through expressing empathy and friendliness, holding a positive attitude, encouraging participants to share ideas, and building on each participant’s knowledge, as opposed to lecturing | 3.95 | 4.83 | 1 | |
| 2.2.1.7 | Actively care about and equally value each participant with their unique contributions and needs | 3.9 | 4.73 | 0.97 | |
| 2.2.1.8 | Follow through on commitments made to the group and co facilitators as appropriate | 3.9 | 4.78 | 0.98 | |
| 2.2.1.9 | Honor participants privacy, confidentiality, choices, expertise and contributions (verbal, written and A/V recordings) | 3.95 | 4.83 | 1 | |
| 2.2.2 | Apply communication skills | ||||
| 2.2.2.1 | Facilitate development of effective communication skills within the group (e.g. focus on ‘I’ statements, bottom lining/laser speech, and disallowing advice-giving) | 3.55 | 4.23 | 0.8 | |
| 2.2.2.2 | Elevate the group’s shared wisdom by modeling coaching techniques (e.g. open-ended questions, reflections, affirmations, and intentional silence) | 3.77 | 4.68 | 0.93 | |
| 2.2.3 | Provide context and manage participant expectations | ||||
| 2.2.3.1 | Summarize topics and segue to next topic intentionally | 3.41 | 4.36 | 0.79 | |
| 2.2.3.2 | Provide instructions for activities, eliciting participant understanding, and clarifying as needed | 3.62 | 4.51 | 0.86 | |
| 2.2.4 | Encourage participation and group cohesion | ||||
| 2.2.4.1 | Identify common themes and link participants into the topic being discussed | 3.58 | 4.47 | 0.85 | |
| 2.2.4.2 | Harvest group wisdom and resources by identifying themes and new awareness | 3.62 | 4.46 | 0.86 | |
| 2.2.4.3 | Balance coach guidance with participant and group autonomy | 3.67 | 4.51 | 0.88 | |
| 2.2.4.4 | Incorporate a range of appropriate group activities, such as open group discussion, round robin, brainstorming, and breakout groups | 3.37 | 4.08 | 0.74 | |
| 2.2.4.5 | Facilitate a sense of belonging and cultivate interdependence among all group participants | 3.63 | 4.54 | 0.87 | |
| 2.2.4.6 | Ensure adequate and appropriate attention for each group participant | 3.72 | 4.56 | 0.9 | |
| 2.2.4.7 | Recognize and create experiences that facilitate discovery while accommodating different learning styles and preferences | 3.47 | 4.22 | 0.78 | |
| 2.2.4.8 | Promote collaborative discussions by encouraging the acknowledgment of other’s contributions | 3.6 | 4.54 | 0.87 | |
| 2.2.5 | Group development and evolution | ||||
| 2.2.5.1 | Recognize that bonding and investment of members builds engagement through the practice of altruism | 3.27 | 3.9 | 0.69 | |
| 2.2.5.2 | Champion the group by regularly and consistently giving supportive feedback that is specific and timely | 3.64 | 4.55 | 0.88 | |
| 2.2.5.3 | Understand and facilitate the phases of the group development process | 3.32 | 4.05 | 0.73 | |
| 2.2.6 | Manage energy, emotions, and flow of the session | IMP | FREQ | WT | |
| 2.2.6.1 | Attend to shifts in both individual and group energy (e.g. nonverbal communication signals) | 3.6 | 4.36 | 0.83 | |
| 2.2.6.2 | Apply nonverbal communication appropriately to the group | 3.45 | 4.24 | 0.79 | |
| 2.2.6.3 | Demonstrate empathy and honor emotions, recognizing the importance of respecting both individual and group boundaries | 3.86 | 4.71 | 0.95 | |
| 2.2.6.4 | Manage emotions to create a safe container for the group, by naming and reflecting the emotion | 3.69 | 4.38 | 0.86 | |
| 2.2.6.5 | Celebrate the forward progress of some, while remaining sensitive to others who may be ‘stuck’ | 3.74 | 4.46 | 0.88 | |
| 2.2.6.6 | Use humor to raise or lighten group energy when it best serves the group process | 3.55 | 4.33 | 0.81 | |
| 2.2.6.7 | Foster group and individual self-compassion | 3.79 | 4.62 | 0.92 | |
| 2.2.7 | Manage challenging group participant behaviors (i.e. under or over-talking, interrupting, fixing, arguing, using inappropriate language, being culturally insensitive, veering off topic, etc.) escalating as necessary from general to specific, for example: Reinforce group honoring of ground rules Redirect and reframe communication Openly name and address discord appropriately within the group as it occurs Have a private discussion with participant(s) outside of group Attend to patterns of group conflict and resistance Model skills for conflict management and navigation of difficult conversations | 3.78 | 3.79 | 0.76 | |
| 2.3 | Model Active, Mindful Listening and Nonjudgmental Presence | ||||
| 2.3.1 | Take into account differing processing styles and pace | 3.76 | 4.45 | 0.89 | |
| 2.3.2 | Demonstrate cultural sensitivity and accommodate different world views | 3.78 | 4.18 | 0.84 | |
| 2.4 | Set Goals, Implement Action Commitments, and Review Progress | ||||
| 2.4.1 | Consistently integrate goal setting and progress reviews into sessions | 3.55 | 4.41 | 0.84 | |
| 2.4.2 | Support accountability among group participants | 3.47 | 4.31 | 0.8 | |
| 2.4.3 | Apply learning to real life goals and action, which may include debriefing of activities | 3.67 | 4.45 | 0.87 | |
| 2.4.4 | Invite group members to normalize and reframe setbacks, obstacles, and challenges | 3.73 | 4.45 | 0.87 | |
| 2.4.5 | Honor individual preferences for self-monitoring | 3.56 | 4.23 | 0.81 | |
| 2.4.6 | Elicit commitment for actions to be taken before the next session | 3.51 | 4.37 | 0.83 | |
| 2.5 | Enhance Social Support | ||||
| 2.5.1 | Facilitate participants in developing and accessing social support inside and outside of the group | 3.42 | 4.12 | 0.76 | |
| 2.5.2 | Facilitate participants envisioning how to create needed support outside of the group, transferring the skills they’ve learned in the group | 3.42 | 4.08 | 0.75 | |
| Scores for Importance (IMP) based on 1–4 Likert scale, where: 1 = Not Important; 2 = Somewhat Important; 3 = Important; 4 = Very Important. Scores for Frequency (FREQ) based on 1–5 Likert scale, where: 1 = Never; 2 = Infrequently; 3 = Occasionally; 4 = Frequently; and 5=Very Frequently. | |||||
| From Wolever, RQ, Cline, TR, Weiss, JM, Carmack, S, Schultz, C, Arloski, M & Lawson, K (2024). Group Health & Wellness Coaching: Development and Validation of the Required Competencies. BMC Health Services Research. https://doi.org/10.1186/s12913-024-10704-x | |||||