Lifestyle coaching for mental health difficulties: scoping review
| DOI | https://doi.org/10.1108/JPMH-04-2017-0018 |
| Date | 19 March 2018 |
| Published date | 19 March 2018 |
| Pages | 29-44 |
| Author | Lauren Bishop,Ann Hemingway,Sara Ashencaen Crabtree |
| Subject Matter | Health & social care,Mental health,Public mental health |
Lifestyle coaching for mental health
difficulties: scoping review
Lauren Bishop, Ann Hemingway and Sara Ashencaen Crabtree
Abstract
Purpose –UK mental health strategy calls for interventions that empower people to self-manage their
condition. In lifestyle coaching, coach and client work collaboratively on positive behaviour change to improve
client health. There is debate about the appropriateness of coaching for mental health, yet claims have not
been supported with evidence. Therefore, the purpose of this paper is to explore the nature and scope of the
existing research literature in this field.
Design/methodology/approach –Scoping review.
Findings –The growing evidence base shows positive outcomes of coaching; for instance, symptom
reduction, enhanced self-management and achievement of personal goals.
Research limitations/implications –The evidence base is small and of variable quality, offering insights
that warrant further exploration.
Practical implications –Coaching not only supports better self-management but also addresses further
mental health strategy priorities (such as improved physical health and social functioning). Coaches need not
be mental health experts; therefore coaching may be a cost-effective intervention.
Social implications –As mental ill-health prevalence continues to rise despite widespread use of Improving
Access to Psychological Therapies and medication, there is a need to explore how novel approaches such as
coaching might be integrated into mental healthcare.
Originality/value –This is the first study to collate the evidence on mental health coaching, highlighting its
extensive potential, which should be further explored in research and practice.
Keywords Strategy, Lifestyle, Intervention, Scoping review, Mental health, Coaching
Paper type Literature review
1. Introduction
Increasing prevalence of mental ill-health is a key public health concern in the UK, as highlighted
in the “Five Year Forward View for Mental Health”(Mental Health Taskforce (MHT), 2016), a
strategic document outlining a vision for mental healthcare in the coming years. The document
calls for empowerment-based interventions, with empowerment in public health being defined as
a process whereby individuals take control of decisions that affect their wellbeing (Laverack,
2009). One such intervention is health/wellness coaching, which can be defined in basic terms as
the application of life-coaching principles to health and wellbeing (Olsen, 2014).
A fuller definition for health coaching is more complex, a useful starting point being to distinguish it
from othertypes of coaching. Coaching is often directed at improvingperformance in an areasuch
as sport( Merianand Snyder, 2015)or employment (Ladyshewsky, 2017),whereas healthcoaching
seeksto support the clientwith lifestyle changesthat enhance theirwellbeing. Thismight be through
health coaching programmes(whereby health is the focus of the intervention at the outset; Michie
et al., 2008), or through life coaching (whereby any issue may be the focus and the client selects
health-related goals; Ammentorp et al., 2013). Collectively, these approaches might be labelled
“lifestyle coaching”, in order to distinguish them from performance coaching. For the remainder of
this paper, “coaching”can be taken to mean lifestyle coaching unless stated otherwise.
Coaching has been critiqued for being an “undefinable”concept due to variability in features
such as coach credentials, intervention duration/frequency and mode of delivery (Olsen, 2014).
Received 25 April 2017
Revised 14 January 2018
Accepted 16 January 2018
The authors would like to thank
Jan Hutt for casting an expert eye
over the search strategy for
this review.
Lauren Bishop is an MSc
Student and Ann Hemingway is
a Professor of Public Health,
both at the Department of
Human Sciences & Public
Health, Bournemouth
University, Bournemouth, UK.
Sara Ashencaen Crabtree is
based at the Department of
Human Sciences & Public
Health, Bournemouth
University, Bournemouth, UK.
DOI 10.1108/JPMH-04-2017-0018 VOL. 17 NO. 1 2018, pp. 29-44, © Emerald Publishing Limited, ISSN 1746-5729
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However, operational details aside, coaching is grounded in some clear-cut principles that form
the basis of the concept: coaching is about enabling someone to make life changes through
working towards individual goals; a process which may include supporting them to develop
confidence, skills, knowledge and self-awareness (Bora et al., 2010; Starr, 2013). Coach-client
collaboration is the key, with the coach’s use of communication skills and coaching techniques
being paramount (see Bora et al., 2010 for an overview of the skills and techniques of coaching).
Coaching has been shown to be beneficial in a range of health contexts. This includes supporting
people to self-manage chronic illnesses, where outcomes include improved self-rated health,
enhanced mood, increased self-efficacy and positive changes to health-related behaviours
(Galantino et al., 2009; Wolever et al., 2010; Park and Chang, 2014). Coaching has also been
utilised outside of the realm of chronic illness, and has been effective in health-improvement
programmes such as weight loss and smoking cessation (Tao et al., 2014; Boccio et al., 2017).
Furthermore, positive health-improvement outcomes from coaching are seen in demographic
groups that traditionally have poorer health outcomes and lower health service engagement,
such as offenders, war veterans, people with mental health problems and those with low income
( Jennings et al., 2013; Shahnazari et al., 2013; Bailey and Kerlin, 2015; Willard-Grace et al.,
2015). Ammentorp et al. (2013) suggest that the success of coaching in supporting such groups
could be down to its empowering nature, a notion corroborated by studies that have pinpointed
mechanisms such as autonomy-building, collaborative problem-solving and enhanced self-
efficacy as being a key to success in health coaching (Cinar and Schou, 2014; Dufour et al., 2015;
McGloin et al., 2015).
Given the accessibility and empowering nature of coaching, it appears to meet the current
demand for interventions that support people to better manage their own mental health, an
approach that might be termed “mental health coaching”. This possibility has been explored
previously by Bora et al. (2010), who recognised an overlap between coaching and recovery-
based approaches, offering a theoretical argument for the potential value of coaching in mental
health. However, there is a discrepancy of opinion as to whether coaching is an appropriate
mental health intervention: a variety of organisations endorse the approach (Foundation for
Recovery Coaching UK, 2016); Soul Self-Help (Mahari, 2016); Rethink Mental Illness (Bora,
2012), whilst multiple authors claim that it is inappropriate, even dangerous, for mental health
patients ( Jenner, 2014; Olsen, 2014). Others suggest that coaching has a place in mental health,
but caution should be exercised in implementing such interventions (Ley, 2014). None of these
authors have provided evidence to support their assertions, raising the question of whether any
research has been conducted in the field. Therefore, this literature review sought to establish the
state of the research literature on mental health coaching.
1.1 Research question
RQ1. What is the current state of the research literature on mental health coaching?
1.2 Aims
The paper aims to explore:
1. the nature and scope of existing research on mental health coaching;
2. research findings; and
3. implications and directions for future research.
2. Methodology
The method chosen was scoping review, a method designed for exploring the state of a research
field and highlighting directions for further research (Arksey and O’Malley, 2005), both of which
were aims of this study. The review was conducted using Arksey and O’Malley’s (2005) six-stage
framework, with adaptations based on study-specific requiremen ts and on framework
enhancements proposed by later scoping review methodologists. As recommended by
Joanna Briggs Institute ( JBI) (2015), a protocol was developed ahead of study commencement,
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