Coaching for health and lifestyle change: Theory and guidelines for interacting and reflecting with women about their challenges and aspirations

Abstract

Coaching is increasingly applied throughout life and work domains as a relatively new way to support the learning and development of individuals and groups. In a research project group coaching was applied and explored with menopausal women (45 to 55 years of age). The goal of the research project was to support women in their attempts to remain physically active and to develop and maintain a healthy lifestyle. The main objective of this article is to take a close look at the best way to achieve this-not by telling the women what to do or by pushing them towards specific goals, but by inviting them into a space of common reflection and joint action. In that sense, the interaction (not intervention) will take its point of departure in a broad, collaboratively inspired approach that is broader in focus than widespread interventions, which are often exclusively based on motivational interviewing. The goal of this article is to present a theoretical basis and practice guidelines for a series of group coaching dialogues and to serve as an inspiration for the further development of the reader's own practice.

Full text

International Coaching Psychology Review l Vol. 13 No. 1 Spring 2018 61
Coaching for health and lifestyle change:
Theory and guidelines for interacting
and reflecting with women about their
challenges and aspirations
Reinhard Stelter & Vinnie Andersen
Coaching is increasingly applied throughout life and work domains as a relatively new way to support the
learning and development of individuals and groups. In a research project group coaching was applied and
explored with menopausal women (45 to 55 years of age). The goal of the research project was to support
women in their attempts to remain physically active and to develop and maintain a healthy lifestyle. The
main objective of this article is to take a close look at the best way to achieve this – not by telling the women
what to do or by pushing them towards specic goals, but by inviting them into a space of common reection
and joint action. In that sense, the interaction (not intervention) will take its point of departure in a broad,
collaboratively inspired approach that is broader in focus than widespread interventions, which are often
exclusively based on motivational interviewing. The goal of this article is to present a theoretical basis and
practice guidelines for a series of group coaching dialogues and to serve as an inspiration for the further
development of the reader’s own practice.
Keywords: Motivational interviewing; health coaching; group coaching; lifestyle change; collaborative
practice; lifeworld; self-determination theory; wellbeing; positive psychology; stages of change.
FOR SEVERAL YEARS, professionals within
sports, health and clinical psychology have
been searching for intervention methods
that are more effective than expert advice. The
health benets of, for example, physical activ-
ity, healthy eating habits and non-smoking has
become common knowledge – highly inu-
enced by mass media coverage, without, how-
ever, resulting in a healthier population where
virtually everyone is physically active, controls
their body weight and thrives at work and
in their personal life. Hence, psychologists
have developed new forms of developmental
dialogues as a way to help people help them-
selves. As part of this effort, motivational inter-
viewing has been applied as a conversational
tool, especially in relation to clients’ develop-
ment of a healthier lifestyle. The present study
explores new ways to improve the participants’
motivation and maintenance of a physically
active and healthy lifestyle in accordance with
ofcial public health guidelines. The success
of the intervention depends on the willingness
and determination of the participants and
focuses in particular on the positive impact of
the group setting on motivation and readiness
to change.
The article argues for a new type of col-
laborative, group-based dialogue with people
who are interested and engaged in striving
for a healthy lifestyle with a focus on build-
ing new habits in regard to physical activity,
nutrition and general wellbeing.
Moving beyond motivational
interviewing
Health research generally has a strong focus
on types of intervention with a narrow path
to behavioural change. One of the frequently
applied approaches is Motivational Inter-
viewing (MI) (Britt et al., 2004; Dimarco et
al. 2009; Hardcastle & Hagger, 2011; Martins
& McNeil, 2009; Miller & Rollnick, 2012;
Rollnick, Miller & Butler, 2007). In a review

62 International Coaching Psychology Review l Vol. 13 No. 1 Spring 2018
Reinhard Stelter & Vinnie Andersen
article on MI, Britt and colleagues (2004)
highlighted MI as an improvement com-
pared to advice-giving and as a more moti-
vating and involving way to make patients
ready for health-related behaviour changes
(see also Barnes & Ivezaj, 2015; Dilillo &
West, 2011; Ekong & Kavookjian, 2016; Sim-
mons & Wolever, 2013). Britt and colleagues
(2004) emphasised that MI is not based on
any specic theory but includes a number
of theoretical concepts, such as Locus of
Control, Theory of Reasoned Action, Social
Cognitive Theory, Decisional Balance,
Health Belief Model, Health Action Pro-
cess Model, Self-Determination Theory and
Self-Regulatory Model. As a key perspective
in regard to building a relationship with the
client, Britt and colleagues mentioned the
importance of empathic processes based
on Carl Rogers’s client-centred approach.
In their opinion, MI also provides health
practitioners with a means of tailoring
their interventions in a way that suits the
patient’s degree of readiness for change. The
steps of the MI procedure are straightfor-
ward and are described by Miller and Roll-
nick (2012) as:
1. Engaging: The main aim of engaging is
to form a relationship with the client in
a non-directive way, which is based on
empathy and the desire to understand
clients from their own perspective, with-
out a specic agenda.
2. Focusing: In this process, the coach
supports and guides the client towards
a target behaviour that is important to
them. It is important to identify a target
area that the client is ambivalent about,
or where the client is struggling to make
a change. At this stage it is vital to iden-
tify the real challenges related to the tar-
get area.
3. Evoking: This process aims to draw out
the client’s motivation by highlighting
their personal reasons for and interests
in behaviour change. The task of the
coach is to support the client’s ideas
by reinforcing and summarizing their
change talk and by not appearing as
an expert. The goal is to support the
client’s motivation for change.
4. Planning: The goal of this process is to
ensure that the client commits to the
change agenda by asking questions that
activate the client’s readiness for action
planning, by helping the client plan for
change, by revising doubtful or unsta-
ble plans and by developing additional
change plans.
The authors of the present article support
Rubak and colleagues’ (2005) conclusion
that MI is typically more effective than no
treatment and than traditional advice-giving.
However, two central aspects can be high-
lighted as the basis for further improvement
of a dialogue towards lifestyle change in an
adult population:
■MI and other cognitive-behaviour-based
intervention methods focus too little on
the subjects’ lifeworld (Merleau-Ponty,
2012) and habitus (Bourdieu, 1992;
Mukerji, 2014) and on their specic chal-
lenges, living conditions, experiences,
social habits, practices, etc. Consequently,
these aspects are not the main focus of
attention for the health professional, for
example, a health coach, counsellor or
nurse. In a general practitioner setting MI
might offer a helpful compromise, con-
sidering the time constrains. Although MI
can be understood as non-judgemental,
non-confrontational and non-adversarial,
its dialogical orientation may be seen as
more or less focused and goal-directed.
The aim is to develop new and healthier
behaviours. From a developmental coach-
ing and counselling perspective, however,
it seems necessary to provide a richer and
longer-lasting opportunity for clients by
working in depth with their life situation
and its meaningfulness as regards specic
possibilities and aspirations for lifestyle
change. By focusing on meaning-making
and collaborative dialogue and by viewing
the life of the client in a broader perspec-
tive we assume it is possible to achieve
more lasting and sustainable change with

International Coaching Psychology Review l Vol. 13 No. 1 Spring 2018 63
Coaching for health and lifestyle change
the client group in focus. From this point
of view, the present article addresses life-
style change in a broader perspective that
embraces the client’s life in full.
■A number of comparable studies in areas
such as leadership and education (Alrø &
Dahl, 2015; Merriman et al., 2015; Som-
mers & Lawson, 2013; Stelter et al., 2011)
have shown that group coaching may be
a viable path for developing individuals in
a more meaningful, in-depth and efca-
cious way. Considering the explosive rise
of costs in the healthcare sector, it seems
benecial to search for cost-effective ways
of promoting a healthy lifestyle. Some
attempts are being made in this eld.
Armstrong and colleagues (2013, p.96)
argued as follows:
The importance of improved patient engage-
ment has become increasing apparent, as life-
style behaviours are a major factor in at least
80 per cent of chronic disease. Health and
wellness coaching has been proposed as one
approach to empower individuals to make
choices that will improve their health and well-
being. Group models would likely increase the
availability, access, and potential population
impact of coaching.
Based on the understanding of the pos-
sible limitations of MI outlined above and
inspired by the potential for enriching the
developmental dialogue by taking a broader
lifeworld perspective and utilising the cata-
lysing impact of a peer group, this article
describes the theoretical basis and specic
guidelines for an interaction that draws on
the existing knowledge in health research in
an approach that includes clients as active
and collaborative partners in the develop-
mental dialogue.
Group coaching for health and lifestyle
change
Group coaching for health and lifestyle
change has been part of a large research
initiative under ‘The University of Copen-
hagen Excellence Programme for Inter-
disciplinary Research (2016)’ with the title
‘Physical Activity and Nutrition for Health’.
The research team, entitled the Copenhagen
Women Study, decided to bundle its efforts
on different health issues with a special focus
on women (http://cws.ku.dk) and received
grants totalling 3.4 million euros. The work
package that this project has been a part
of focused on women before, during and
after the menopausal transition (http://
cws.ku.dk/workpackages/wp2). During the
rst part of the intervention, the women
were enrolled in a physical activity training
programme (e.g. spinning) with the aim of
including this intervention in a number of
physiological studies. After the end of such
a training programme, the participants would
normally leave the research project. This is
where the group coaching project came in.
The intention aimed to help women reect
on their experiences and to support them in
continuing or reactivating their engagement
in physical activity and healthy living. The
project was divided into two research parts:
a quantitative, quasi-experimental study and
a qualitative interview study:
1. The project examined the effects
of group coaching compared with
a control group during an intervention
period of three months.
2. It furthermore examined the par-
ticipants’ subjective experience with
participating in group coaching and
maintaining a physically active lifestyle
compared with a control group.
The focus of this article is to describe the
theoretical and practical framework of group
coaching for health and lifestyle change:
six group sessions of 90 minutes each with
about ve participants over a period of three
months.
Theoretical framework and implications
for practice
The critique of MI will form the basis for
developing a theoretical model and practi-
cal guidelines to inspire health and lifestyle
change practitioners to implement an effec-

64 International Coaching Psychology Review l Vol. 13 No. 1 Spring 2018
Reinhard Stelter & Vinnie Andersen
tive dialogue with their clients. As mentioned
earlier, a group intervention might enable
a new dimension in the change effort com-
pared to individual dialogues. The main the-
oretical argument for a group intervention
lies in the development of social capital, an
‘enzyme’ that can boost the change effort, as
the individual group member realise that oth-
ers face similar challenges. The group mem-
bers collaboratively develop new perspectives
on their situation. In that sense, the group
setting may enable the participants to mutu-
ally strengthen each other in the pursuit of
an ambition that may be too difcult for any
of them to reach on their own. Social capital
is a theoretical concept that highlights the
importance of social relationships as a kind
of ‘glue’ in social networks and organisations
on any level – from a small group to society
at large. This perspective is gaining growing
attention in regard to health promotion, on
both a social network and a community level
(Moore et al., 2013). The French sociologist
P. Bourdieu (1983) dened social capital as:
The aggregate of the actual or potential
resources which are linked to possession of
a durable network of more or less institutional-
ized relationships of mutual acquaintance or
recognition (p.248).
In the following, some foundational theo-
retical dimensions of the author’s concept of
third-generation coaching (Stelter, 2014) will be
unfolded. These factors are relevant both for
the individual participant and for the group
as an interactive and co-created social body:
1. Meaning-making in dialogue: Meaning-
making is an existential premise
for individuals’ self-understanding
and for social interactions. Finding
what is meaningful in specic situa-
tions, through our actions and in life
in general, is a fundamental basis of
human viability. Meaning-making is
a key concept that serves as the basis
for co-creating in dialogue and thus as
a prerequisite for understanding one-
self, one’s lifeworld and the specic
contexts and conditions of one’s life.
Meaning emerges through two separate
and, in practice, intertwined processes:
through bodily-sensory experiencing
in and of the situation and through
interactions in relationships and dia-
logue. Building on the link between
existential-phenomenological (Depraz
et al., 2003; Merleau-Ponty, 2012) and
social-constructionist, co-creative theory
(Gergen, 2009) the approach enables
a fruitful and transformative dialogue
for all participants with meaning as
a key pillar of the group dialogue.
2. Values – a basis for action: Our cur-
rent times promote a sense of restless-
ness where life is not always perceived
as meaningful but instead often renders
us slaves to self-control, self-surveillance
and our own performance drive (Han,
2015). We fail to make time for reec-
tion – an activity that needs to be rein-
troduced and vitalised. Reecting on
values provides a strong basis for indi-
vidual agency. Values emerge when we
immerse ourselves in what is meaningful
and most important in our lives. Values
also come to the forefront in conict
situations and acknowledged dilemmas.
Examining values or central concepts
and themes in life helps prepare the
individual to act with condence, con-
sistence, and commitment (Kirkeby,
2009; Stelter, 2016b). Values are a key
anchor point for our identity and form
a link between our ethical convictions
and our actions. Values can be dened
as one specic foundation of personal
identity and have an explicit impact
on promoting an in-depth dialogue.
Reecting on values – for example,
what does health mean to me? – leads to
symmetrical and shared moments in the
group dialogue.
3. The narrative perspective – transfor-
mation through sharing: Throughout
history, people have told each other
stories as a way to share important
events, sorrows and joys. Narratives or

International Coaching Psychology Review l Vol. 13 No. 1 Spring 2018 65
Coaching for health and lifestyle change
stories help to shape our understand-
ing of how we live, what we value, how
we have changed and survived and how
we manage to develop in the future
(Bruner, 2002; Frank, 1995; Kraus,
2006). For the individual, narratives lay
the foundation for creating and shap-
ing oneself and for developing a sense
of identity and self-understanding. In
our hypercomplex world, where grand
narratives have lost their power of iden-
tication or legitimation, narratives can
take on new meaning. Personal experi-
ences and reections enable the indi-
vidual and the group to become active
co-narrators in the dialogue, thus con-
tributing and acting as mutually sup-
portive partners, enabling each other to
handle life and its particular challenges
in a new and more adaptive way. The
role of the narrative can be described
as a way we speak to each other. Nar-
ratives help make meaning for an indi-
vidual, while for a community they help
establish a collective understanding. We
develop through dialogue – individu-
ally and on a group level. Narratives are
bearers of inherent values. Through the
narrative we can express things that are
important to us. As part of our dialogue
practice, narratives and the narrative-co-
creative approach lay a foundation that
integrates meaning-making and values
into a coherent process.
Third-generation group coaching practice
This approach, which was developed by the
rst author (Stelter, 2014) is not a closed
system or manual, but an integration of exis-
tential aspects with social-constructionist
and narrative-collaborative approaches. The
actual dialogue builds on the idea that the
coaching participants construct their social
reality in a collaborative process by listen-
ing to each other’s stories, by sharing reec-
tions and by supporting each other by acting
as outsider witnesses (White, 2000, 2007).
Through these interactions, the group
members form shared meaning in regard
to specic challenges and aspirations based
on their earlier involvement in the physical
activity programme. Some central guidelines
and procedures for the coach are listed in
Table 1(see also Stelter et al., 2011):
Third-generation coaching is a further
development of approaches from second-
generation models and theories based on
different systemic and solution-focused
approaches. It involves a shift, however, in
the coach’s basic orientation and relation to
the coachee. First-generation coaching (e.g.
MI) and second-generation coaching are
characterised by a clear asymmetry between
coach and coachee. The coach’s basic posi-
tion is to be neutral and not-knowing and to
avoid being directly engaged or involved in
the coachee’s challenges. A third-generation
coach will place a higher emphasis on being
a fellow human being and a collaborative
partner like all the other participants in
a group coaching session (Stelter, 2016a).
In certain stages and situations, the coach-
ing conversation becomes a genuine dia-
logue between two or more human beings
(cf. Buber, 1999), where the coach or one of
the participants shares his or her considera-
tions and reections with a group member
in order to serve as a witness and a co-creator
of the dialogue. The coaching conversa-
tion can be described as a collaborative
process, where all participants are experts
within their respective domains and, at the
same time, not-knowing at the outset of the
conversation. The generated knowledge
emerges between them in a dialogue pro-
cess that gives rise to something new, possi-
bly for all participants. As a prominent fea-
ture, the coaching dialogue revolves around
values and the meaning-making aspects of
life – aspects that are particularly central in
people’s lives – thus inviting all group mem-
bers into a reective space that transcends
everyone’s life and its challenges. The coach
includes herself as a co-reecting partner
and a withness-thinker. Withness-thinking
was described by Shotter (2006) as follows:

66 International Coaching Psychology Review l Vol. 13 No. 1 Spring 2018
Reinhard Stelter & Vinnie Andersen
Table 1: [insert title]
Both coach and coachee(s) are conversation partners. Each participant contributes to the joint
process of meaning-making and the production of knowledge.
All participants strive to be flexible and willing to change; this makes mutual development possible
and allows the participants to redefine their perspective and position.
Being attentive to others and to differences can be very fruitful for one’s own development and learning.
All participants value the contribution of others to the dialogue and the knowledge that unfolds
co-creatively, but also value potential and enduring differences.
Generous listening is central for mutual inquiry, where interested and sometimes naïve wondering
helps to develop generative conversations.
The coach can support the process by paraphrasing the coachee’s remarks or reflections and
interpreting or shaping these reflections on one’s own terms, including associative comments on
specific reflections (‘When you say that, it makes me think of …’).
Flexible attitudes make it possible to redefine one’s own and others’ positions, leaving one open to
developing and to learning from others.
Through the use of questions, the coach can invite the participant(s) to consider a new perspective.
The emphasis in this approach is on various types of circular questions, similar to those used in
systemic coaching.
Through the use of metaphors the coach can invite the coachee to unfold sensuous reflections and
expand the dimensions of actions, perceptions and thoughts.
By coupling landscapes of action (focus on purpose, goals and action) with landscapes of
consciousness (focus on values, identity, aspiration, dreams and wishes) the interconnection
between action and identity can be unfolded.
By linking specific values to individuals who are or may have been important to the coachee(s),
the stories of the coachee(s) grow richer and more complex and may develop in a new direction
(alternative storyline). This lets the coach strengthen the coachee’s sense of identity in a
scaffolding process that bridges the coachee’s learning gap by recruiting lived experiences.
The use of narrative documents – a poem, short essay, specific reflection or retelling of a story, either
by the coach or the coachee(s), the coach encourages new ways of reflecting on challenging issues.
■Identifying/highlighting a specific expression or phrase used by the coachee: ‘What expression
or phrase caught your attention as you listened to the story?’
■Asking others to imagine being the coachee: What kind of picture do you get of the coachee’s
life, identity or way of relating to things in general? What does this expression or phrase reveal
about the coachee’s intentions, values, attitudes, aspirations, hopes, dreams or commitments?
■Relating an expression or phrase to one’s own life: How does that expression/phrase resonate
with aspects of your own life? What kinds of ideas about your own intention, values, attitudes
etc., struck you while listening to the story? How might elements of this story be important to
your life, career, etc. – and why?
■Description of one’s own response to the story: How were you touched by an expression,
a phrase or the story as a whole? Where do your own experiences with the story lead you?
What kinds of changes do you notice in yourself?

International Coaching Psychology Review l Vol. 13 No. 1 Spring 2018 67
Coaching for health and lifestyle change
Withness (dialogic)-talk/thinking occurs in
those reective interactions that involve our
coming into living, interactive contact with an
other’s living being, with their utterance, with
their bodily expressions, with their words, their
‘works’. It is a meeting of outsides, of surfaces,
of two kinds of ‘esh’ (Merleau-Ponty, 1968),
such that they come into ‘touch’ or ‘contact’
with each other. […]
In the interplay of living moments intertwin-
ing with each other, new possibilities of rela-
tion are engendered, new interconnections are
made, new ‘shapes’ of experience can emerge
(p.600).
It is important to underline that it is not only
the coach who strives to be a withness-thinker;
in fact, all the group members benet from
doing so, as it helps to intensify the dialogue
and one’s understanding of oneself and the
other.
Supporting theoretical approaches
Several approaches were included as supple-
ments to the described theoretical frame-
work of third-generation coaching and its
practice: (1) Self-determination theory; (2)
Stages of Change model; (3) A broad under-
standing of mental and physical health; and
(4) Features from positive psychology. The
following section offers a brief presenta-
tion and discussion of these four theoretical
aspects and their implications for the prac-
tice of the health coach or consultant.
Self-Determination Theory (SDT)
SDT (Ryan & Deci, 2017) is widely used to
describe and explain motivational processes
across a variety of areas (e.g. work, health-
care, education, psychotherapy, sport and
physical activity). According to SDT, motiva-
tional processes are formed on a continuum
from intrinsic (inherently driven) to extrin-
sic (stimulated by external sources) moti-
vation. Ryan and Deci (2000) highlighted
three psychological needs as fundamental to
intrinsic motivation: (1) autonomy; (2) com-
petence; and (3) relatedness.
In the group coaching process we high-
lighted these aspects in the following way.
In regard to autonomy we helped to explore
the personal values and meaningfulness of
the individual coaching participant: how do
I want to engage in physical activity and other
lifestyle changes on the basis of my needs,
attitudes and values? In regard to competence
we supported the coaching participants in
becoming aware of what they actually enjoy
to do when they are physical active or to focus
on other activities in regard to their health
and wellbeing. And in regard to relatedness
we included the group in an effort to help
all participants restore their memory, expe-
riences and expectations, share their stories
and develop new perspectives and views on
their life and which possible changes they
wish to make and have the energy to do.
Transtheoretical model – stages of
change model
As a guiding theoretical framework, the
Stages of Change Model (Prochaska, Nor-
cross & DiClemente, 1994; Prochaska &
Prochaska, 2016) has often been used to
help shed light on the challenges faced by
a person who is moving towards a healthier
lifestyle. The stages in the model are dened
as precontemplation, contemplation, prepa-
ration, action, maintenance and relapse.
The model has been criticised by several
authors (Littell & Girvin, 2002; Whitelaw et
al., 2000) for its limited practical utility in
regard to the validity of stage assessments. As
with other stage models, the critique focused
on the oversimplication in regard to the
complexities of behavioural change, which
might be better approached as a process
with all the ups and downs that the individ-
ual goes through. West (2005) suggested an
alternative model:
The model needs to consider the difference
between desire and value attaching to a specic
behaviour (smoking a cigarette) vs. a label
(being a smoker). Lasting behaviour change
relies on the balance of motivational forces
regarding the specic behaviour consistently

68 International Coaching Psychology Review l Vol. 13 No. 1 Spring 2018
Reinhard Stelter & Vinnie Andersen
favouring the alternative whenever the oppor-
tunity to engage in it arises. The model of
change needs to describe and explain how this
occurs (p.1038).
The Stages of Change model was only used as
an explanatory tool in the dialogue with the
coaching group participants. We appreciated
the heuristic value of the model, because
it helped to portray change as an individu-
ally challenging process and because it pro-
moted a less pejorative view of people who
relapse or who struggle to achieve a lifestyle
change. We used the model to help the par-
ticipants understand what they might go
through, what kinds of barriers they might
encounter, and that relapse can be part of
the change process. It may also be helpful
for the coach to understand which phase
the individual participants were in, and what
might be the necessary subsequent step on
their way forward.
Understanding of mental and physical
health
Health is much more than absence of ill-
ness, pain or minor malfunction. We were
inspired by the Antonovsky’s (1987) salu-
togenetic concept, where the focus in not
on disease, on pathogenesis, but on two
fundamental aspects that form the basis for
a broader understanding of health: rst, he
draws attention to the concept of generalised
resistance resources, which refers to biological,
material and psychosocial factors, such as
ego-strength, money and social support, that
help people perceive their lives as consistent,
structured and understandable. We saw the
coaching group as a resistance resource that
might help the participants see themselves
as part of a peer group. For us, the most
important factor in Antonovsky’s approach
was his emphasis on a sense of coherence,
which includes comprehensibility, manage-
ability and meaningfulness. These compo-
nents refer to the participants’ ability to see
their lives in a broader perspective, where
even inclemencies and detours might make
sense. This approach is further supported
by research on resilience, a research area of
growing interest, where the interrelatedness
between physical health and mental wellbe-
ing becomes obvious (Zautra, Hall & Murray,
2008). Reivich and Shatté (2002) dened
resilience:
as the basic strength underpinning all the posi-
tive characteristics in a person’s emotional and
psychological makeup. A lack of resilience is the
major cause of negative functioning. Without
resilience there is no courage, no rationality, no
insight. It is the bedrock on which all else is
built (p.59).
Reivich and Shatté underlined peo-
ple’s ability to see the interconnectedness
between thoughts and feelings, to gain
insight into one’s own convictions and to
look for alternative explanations when the
going gets tough. Some of these ideas were
integrated into our health coaching effort
with a special focus on relationships, mean-
ing and personal strength.
Features from positive psychology
In regard to our nal theoretical source, we
used features from positive psychology to
support the participants in taking a closer
look at their character or signature strength and
virtues (Peterson & Seligman, 2004) with the
intention of nding their personal anchor
in terms of what they appreciate most and
how they intend to move forward on their
health and lifestyle agenda. According to
this positive psychology theory, people have
ve signature strengths, which Linley (2008)
dened – similar to our understanding – as
learned behaviour that helps individuals
identify what provides or blocks their energy.
In that sense, a focus on strength and virtues
relates to the emphasis in third-generation
coaching on values and meaning-making as
an important means for the participants to
nd personal engagement and the readi-
ness to act. Other elements from positive
psychology have also served as an inspira-
tion, including mindfulness, which can be
seen as a resilience and self-regulating fac-

International Coaching Psychology Review l Vol. 13 No. 1 Spring 2018 69
Coaching for health and lifestyle change
tor that improves one’s ability to be pre-
sent in the here-and-now (Childs, 2007).
The nal elements associated with positive
psychology were hope, optimism and attribu-
tion pattern. Even someone with a tendency
towards a negative attribution style can actu-
ally learn to be more optimistic and hopeful
(Kobau et al., 2011; Seligman, 1998). In the
third-generation coaching, the coach sup-
ports such a change in attribution style by
drawing attention to situations where the
participant actually was successful, satised
and happy about specic events and new
action patterns.
Individual sessions
The main challenge in a research project
such as this was that due to randomisation,
the participants have not actively chosen to
participate in a coaching group. They gave
their consent to be part of the project, and
they were selected to join a coaching group
while others (initially) wound up in the con-
trol group (this latter group was later offered
to take part in a workshop on health and
lifestyle change). From that perspective, all
sessions were organised around two compo-
nents: (1) Psychoeducation in the form of
a brief lecture presented by the coach; and
(2) the actual coaching session. In the intro-
duction to the rst session, the participants
were informed about ethical issues (con-
dentiality, respect for others) and some
specic ideas and rules in regard to the cho-
sen form of group coaching (active listen-
ing, outsider witnessing, sharing with each
other). Some further details concerning the
composition of the individual session:
1. To form common ground for all par-
ticipants, each session was introduced
by about 15 minutes of psychoeducation.
Here, the coach presented basic theo-
retical ideas from the Stages of Change
model (rst session), self-determination
theory (second session), mental and
physical health and resilience (third ses-
sion), strength and virtues (fourth ses-
sion), mindfulness (fth session) and,
nally, hope and optimism (sixth and
nal session). These short introductions
to a specic topic helped to organise
the subsequent coaching dialogue on
a provided a topic and helped the group
participants develop a joint theme for
dialogue going forward. Furthermore,
each topic was also addressed in a small
homework assignment to serve further
promote individual reections. For
example, the homework in relation to
the topic of strength in session four was,
‘How can you use your strength more
consciously in your life and in relation
to the changes you wish to make? Keep
both your mental and physical health in
mind!’
2. The coaching sessions had the follow-
ing structure: each session began with
the group participants’ reections since
the previous meeting, followed by the
psychoeducation segment. The theme
of the specic session led to a number
of reections and issues for group work,
where the women learned to share their
thoughts, specic challenges and ideas
for possible future actions. During this
part of the session, third-generation
coaching, with its focus on collabora-
tive practices, was used as the main
approach supported by the specic the-
oretical orientation of the given session.
The session concluded with a segment
where the participants were asked what
each of them would be taking home
as their key focus point, learning or
issue for further reection and action.
Finally, the homework assessment for
the next session – based on the topic of
the current session – was handed out.
Conclusion
A group coaching setting clearly has both
benets and challenges. The immediate ben-
et was that the participants became aware
that they were not alone with their challenge.
A challenge in group work was the dynamics
at play between the participants and within
the group as a whole. In practice, it may be
benecial to select participants based on

70 International Coaching Psychology Review l Vol. 13 No. 1 Spring 2018
Reinhard Stelter & Vinnie Andersen
their earlier engagement in physical activity,
socialisation in regard to physical activity and
their stage in the menopausal transition. The
results of this research will be published in
a subsequent article (Elsborg, Andersen &
Stelter, submitted).
Authors
[info]
Correspondence
[info]
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