In this Expert Interview, AdvancingWellness CEO Mari Ryan and Ed Framer, Ph.D. discuss health coaching and the role it can play in supporting behavior change. Ed is Senior Director of Health and Behavioral Sciences at Health Fitness Corporation.
Ed Framer Interview
Mari Ryan: Welcome to the Workplace Wellbeing Essentials Series. I'm Mari Ryan, I'm the CEO and founder of Advancing Wellness. It's my pleasure to welcome you to this expert interview, where we explore topics that relate to employee wellbeing. My guest today is Ed Framer.
For the past fourteen years, Ed has been in the role of Senior Director of Health and Behavioral Sciences at Health Fitness Corporation. In this role, Ed is responsible for health and behavioral sciences information acquisition and dissemination, as well as a generation of science-based health recommendations. Ed has both clinical and administrative experience across a wide spectrum of physical and behavioral health issues, including clinical psychology, health psychology, organizational psychology, behavioral analysis, behavioral medicine, and behavioral incentives.
Ed earned his PhD in clinical psychology from North Texas State University in Denton, Texas. When not understanding and motivating behavior change, Ed can be found working on a long-term home renovation project. Ed, welcome, I’m so excited to have you here today.
Ed Framer: Thank you, Mari, it’s a pleasure to be here with you.
Mari Ryan: Thanks. Today we are going to explore some elements around behavior change, and in particular the topic around health coaching. We all know that behavior change is hard; think about your new year’s resolutions, those are probably long gone by now. For that reason, many employers, insurance companies, and EAPs are offering support to their employees in the form of health coaching. Unfortunately, this is a service that is underutilized by many employees. Today we are going to explore what it means to do great health coaching and the benefits it provides to both employee and the organization in which they work.
Ed, let’s start by talking a little bit about what is health coaching exactly? Perhaps not everybody in our audience knows exactly what health coaching is.
Ed Framer: Okay, happy to, Mari. Health coaching is very similar to coaching in athletics. The difference being is you are working with people’s health-oriented behaviors and not with a lot of the physical things, like doing a flip. When we work on these, it’s very important to remember this is not therapy. This is coaching. Coaches listen carefully to what the client is saying in terms of what do I want. What am I trying to accomplish. It’s not going into the deepest aspects of somebody’s psyche.
Mari Ryan: Okay, what would you say then is the difference between coaching – so it’s not about the psychological aspect of who I am as a being, can you say a little bit more about that difference between that health coaching and the therapy piece?
Ed Framer: Sure. Therapy is frequently trying to get to a lot about your history, and knowing what kinds of things have traumatized you in your life, what you’re concerned about, a lot about what upsets you, and how you can generate new and different behavior that helps you be more satisfied with your life. When you are coaching for health, you’re frequently looking at what does the client want to accomplish; they will come in and say “I want to lose weight. I’d like to be more physically active. I don’t think I eat very well.” They will be bringing in more issues around health and living to you, as opposed to issues about what’s wrong with my life in a more general way, and that is really a lot of the big differences.
Mari Ryan: Great clarification, thank you. What are the benefits to the individual who’s receiving the coaching?
Ed Framer: When people join a health coaching situation, what they get in terms of benefits are often new and better behavioral skills for problem solving around health. They find themselves, hopefully, generating better health over time, because that’s an important issue for many of us in the culture today.
People become more mindful as a result of health coaching, and more in the present. I hope I’m not using a term that most people aren’t familiar with, but people start to avoid less. They start to confront things more, and to deal more effectively with the issues that have blocked them from good health behaviors.
Mari Ryan: Excellent, that’s a good way to think about some of the benefits that individuals receive. What might be the benefits to the organization in which this person works when an employee receives coaching?
Ed Framer: The organization, first and foremost, will find that employees who have undergone health coaching tend to be more productive. If you are avoiding a lot of concerns in many areas of your life, including health, you tend to be more distracted, less present, less available to what you are trying to accomplish. When people are working hard in health coaching and getting personal benefits, I find the organization almost always gets a more productive employee, and I’m certainly not the only person who is saying this.
Other things that the organization gets is, if they have a lot of employees who are actually engaged in health coaching. Over time, they should see changes in health behavior, in the culture of health that many companies are currently hoping to generate in their organizations, and I find that one of the things that … or another thing that they will also be at is they will get a happier organization out of people if they’ve had a lot of people undergoing the health coaching process.
Mari Ryan: That sounds like it’s going to make for a more wonderful workplace for everyone then.
Ed Framer: Yes, exactly. It may take a while. This is not something that you can do immediately or instantly, but yes, a happier workplace in which everyone seems to be working more effectively together.
Mari Ryan: Let’s talk for a minute about this from the perspective of the coach. What are the skills that a coach needs to provide great coaching? This isn’t just something anybody can do, right?
Ed Framer: It’s not something that just anybody can do. There are a couple of things that coaches have to commit themselves to and learn to do over time, I think, in order to do great coaching. It’s not just a matter of learning to follow a particular script. One must bring oneself to the coaching situation with tremendous vulnerability, openness, the desire to serve. This is not about telling people what to do. It’s about helping people figure out what will work best for them in order to accomplish the goals that they bring to the coach. If you are doing good coaching, it’s probably a little scary for the coach because you are going to be very present, you are going to be what people refer to as being out there on the edge, you’re going to be listening very actively, and sometimes you are going to have to say to a client, whoops, I think I pushed that a little too hard. Can we back up and try that again? People don’t naturally do that. It’s a very different … you have to bring presence, vulnerability, openness and listening, all in a very active way. I have found that many clients, well, many coaches have a hard time bringing that to the situation. It often takes a tremendous amount of training, and I’m probably going to insult some people, but it’s different than the training I often see talked about for health coaches.
Mari Ryan: Very interesting, so that’s a very interesting combination of skills and talents to a certain extent.
Ed Framer: Yes, and you have to know the information in the areas in which you are coaching as well, which often takes a while to learn and become proficient at because most of us come to it with, oh, I had a psychology background, oh, I had a nutrition background. Perhaps I have a physical activity background. When you try to coach, that’s not the only areas or concerns that a participant may bring to you. So, you end up having to work with coaches in order to acquire a whole broader range of skills than they currently have. It also helps to teach people to be empirical, and to be willing to develop and look at data points that say whether or not they are doing what they meant to do with a client and producing the results that they and the client agreed on and often that the employer would like to see.
Mari Ryan: Interesting, very interesting.
Ed Framer: If you don’t look at what you’re doing, if you’re having a hard time looking at what you’re doing, it’s very difficult to know if you are on the right path, and what you would like to retain and what you would like to change.
Mari Ryan: Like anything else, I guess, we have to be able to measure it.
Ed Framer: Yes, this is exactly right. You have to be able to measure it, and a lot of times what people measure is are we doing what we meant to do, as opposed to measuring are we bringing the outcomes that everybody is looking for. That’s a very different way of going at it.
Mari Ryan: It is very different. I’m curious, Ed, why do you think that these health coaching services are so underutilized?
Ed Framer: There are probably two or three main reasons. The first one is a lot of organizations which are our there today originally talked down live coaching over probably the last decade because everybody was getting enamored of automation. We can have a story about the person and we can plug the person into the story, and everything will go fine. Our computers will get the job done. What people have been finding is not so. Computers can help with scalability, and they can help do certain jobs for the coach and for the client, but you still need good people in the loop. We’re not so practiced at turning all of those things into expert systems or neural networks that you can just count on the computer to get things done. That was something that was said a lot over the last five to ten years. I think it kind of puts coaching down in a lot of people’s eyes.
The second thing that I think is going on is people haven’t learned, as we were talking earlier, databased. They don’t really look at what they are doing. They look at what we’re doing that we hope … are we doing the right skills, as opposed to are we getting the right outcomes. That’s probably the best way to say it – sorry, it took a second to get that organized. When one does that, it means that people over time aren’t getting the results that they hope to get and they were paying for. Now, suddenly, people start to push back and say this is not good enough. You’re nice people, but you aren’t doing a good enough job. I think that’s hurt us over the last ten or fifteen years. Before that, people didn’t expect the kinds of outcomes that are being expected today, so I think it’s harder to do today. You have to be more empirical and have better coaching programs, and better training for your coaches than was necessary fifteen, twenty years ago.
Mari Ryan: I’m curious whether there’s much research that is emerging. Health coaching has been around for a while now. Is there much research that shows the efficacy of health coaching?
Ed Framer: It’s a mixed bag, Mari. There’s research out there that almost every company that does health coaching is taking some kinds of data to try and look at what they are doing, but I think, and this is just my opinion, I think we rarely ask the right questions about what’s going on. Everything gets turned into percentages. We have 40% of the people who did this, and 20% of the people who did that, and we held on to 60% of your people for at least six months, those sorts of things. You can’t improve a program from that kind of data. It doesn’t tell you anything. You are kind of looking at averages or summary scores, and you have no way of understanding what I as a coach need to do in order to get better. How many of my people are actually learning to do what they came to me for.
Most of what’s out there, I think, we are not looking the right way at what we need to be doing in order to get the outcomes that are generally desired. I don’t know that the literature in general has caught up to that yet. There are other problems like a lot of failure to be able to keep people in your programs long enough to see long-term changes, but we could start nit-picking in those areas, and I don’t think that would be productive on this call.
Mari Ryan: I think that’s an opportunity that, hopefully, we will see some continuing results because I know many close friends who are health coaches, and I’ve seen the results and I know that it is an important thing. To me, it’s a shame that it’s such a underutilized resource in so many ways because for some individuals it can have huge life-changing benefits.
Ed Framer: It can, and I think, really, it can have life-changing benefits for the vast majority of people who come to us. We as health coaches and as providers of health-coaching services simply need to do a better job than has often been done in the past. Again, that means we have to be more empirical, be able and willing to look at ourselves, confront what we’re doing well, and what we’re not doing well, and learn to change. That’s hard – I’m telling you, that’s really hard. That’s not what we often get paid to do. People want to be right too much of the time, and are afraid to make mistakes and learn from them. I worry that’s part of what is holding up what I would call really, dramatically, good health coaching.
Mari Ryan: Thank you for sharing that perspective. If our audience wants to learn more about you and the work you are doing, where can they find you?
Ed Framer: They can find me at ed.framer at hfit.com or I’m on LinkedIn. Just put in my name and I’ll come up and I would be happy to respond to people.
Mari Ryan: Wonderful. Thanks so much for being here today and sharing your perspectives on this important topic that’s related to employee wellbeing. Thanks.
Ed Framer: Thank you for inviting me, Mari, it’s been a pleasure.
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