Since at the moment I am not tied to a coaching contract, I wanted to take an opportunity to share my experiences, observations and outcomes as an onsite corporate wellness coach. An opportunity to be authentic and detached from the functions and processes of the industry and speak from the reality I see. I am not, by any means, a wellness expert, but maybe I have something of value to say. Or maybe unconsciously forcing myself into early retirement.
Over the last 12 years, I have been working onsite “in the trenches” endlessly supporting change in employees –to be healthier, more balanced and have a better quality of life. I have personally coached, face-to-face, over 1,000 of the most amazing people I’ve ever met who have given me the honor of sharing their personal stories with me. I have mingled within their work environment and have observed what creates a positive, motivating and productive work culture and what elements make one toxic and debilitating. I’ve co-existed in hospitals, manufacturing companies, customer service locations and law firms. I have coached CEO’s, janitors and everyone in between.
I’ve had an upfront and personal vantage point, but I don’t get an opportunity to share much of what I have learned from the people that I have served. In the wellness industry, the goal is to be able to show a CFO hard dollar proof that the employer’s investment is working, mostly in the form of impersonalized analytical data. The intrinsic value of the work I do with the employees gets watered down to a tick in biometric screening improvements (which doesn’t always translate into an improvement in a population's overall health) and a summary of what I did last year for their people in two paragraphs or less.
I keep up with the trends in the wellness world, but I often don’t relate to the conversation. Sometimes I chuckle -sometimes I just scratch my head. Whether you call it wellness, wellbeing, engagement or whatever, not much of it touches on what I see as the reason people aren’t responding to change and what needs to happen to change it. I find that the strategies for change do not focus on what people need – in the real world. Human connection.
Wellness strategies mostly focus on external factors to change behaviors. Of importance is the ability to capture tangible evidence and to automate the process so it is cost efficient and can be sold to large employers. The thing is, the external factors, the “hows and whats,” are the easy part. The reality is, for a large part of the population, the challenges in changing lifestyle behaviors stem mostly from internal factors. It’s the age-old problem of knowing what to do, but not being able to get yourself to do it. But it is so much more complicated than that.
Here’s the Reality
In my experiences as an onsite coach, I’d say maybe 15-20% were actually “ready to change." Effectively coaching people in the workplace isn’t as simple as an employee knowing what they want, helping them set goals, supporting them and holding them accountable. Oh, how I wish it were that easy! We’d all be happy and healthy!
Here’s the thing. For most people, it’s HARD to change lifestyle habits, environments and mindsets and it takes time and practice. Now, add to that the reality that many of your employees are dealing with a lot of life issues as well. Serious life issues. Children with addiction, raising grandbabies, nasty divorces, caring for an invalid parent or caring for a spouse with terminal cancer as mounting medical bills suck their 401(k) dry. In spite of the "MeToo" movement, physical, verbal and sexual abuse is common. Grief, depression, financial worries, anxiety…. It’s rampant in today’s world.
Day-to-day demands of life, technology and environmental influencers are constantly attacking even in absence of a major event going on in an employee’s life. The reality is, too many Americans are exhausted, distracted and their needs and wants for themselves come last. If, on top of everything else their work environment is stressful, unsupportive or they don’t feel important, it exacerbates their situations. There is no escape.
Yes, there is a resource for the messy stuff. EAP. But accessing EAP is not that simple no matter how accessible and beneficial they are. Being in the trenches, I see disconnects between someone needing help and someone proactively calling EAP as a resource. When I ask an employee about EAP, they may know it’s there but don’t think about it in their time of crisis. Or sometimes they don’t view their “crisis” as being serious enough to warrant such a step ("everybody’s mother dies "). And, there is a difference between knowing the resource is there and actually taking the initiative to use it. They often have a lot of questions and concerns: Stigma, privacy, I don’t have time, etc.– it can be a scary thing. Sometimes, we pick up the phone together when fear and anxiety won’t let them. The point is that a conduit to connect the person in need with the EAP resource is extremely helpful.
With all of these “realities” in people’s lives, it is no wonder a good portion of employees roll their eyes when the wellness "lunch and learn" discusses the benefits of quinoa and suggests taking a yoga class for their stress. Yeah, right. Wellness Programs are not providing (or maybe cannot provide) relative information - something raw, relatable, and doable that this segment of the population feels they can actually fit into their crazy life. By the way, employees hate portals. When it comes to wellbeing, technology cannot come close to replacing the value of human connection.
There is a wellness world stigma that the population who sits on the sidelines of engagement programs and don’t participate aren’t team players - don’t want to change or can’t change. Yes they do and they can! It’s amazing to see how strong and resilient people are and how much they can change when they have interventions that are meaningful and that relate to them. The people who are in this segment of population are typically at highest risk physically, mentally and even more so for unproductivity and absenteeism.
Many Wellness Programs provide coaching but their outreach is usually limited. If the coaching process starts with intake forms, 15-minute scheduled time frames and a limited number of sessions, it’s unlikely to develop a connection with people who aren’t proactively seeking the help. There isn’t enough focus or investment in this incredible benefit to utilize the impact of it’s potential. There is a need to re-define the coaching process to capture the people who aren't even thinking about themselves let alone having the mental space to change.
The enhanced coach role wouldn’t cross the line into therapy, but by expanding the parameters and interactions with the population, the enhanced title would include an outreach to the large part of the population who are not ready to change (or think they aren’t ready) but may want or need assistance. The coach’s initial role is just being there for them. Over time, as trust develops, a coach’s office can become a safe haven for an employee to have a private conversation, giving them time to decompress and breathe. Contrary to the industry belief that most people are resistant to coaching, I find that once trust is established, most people are an open book. They are so relieved and grateful to be able to confidentially talk to someone without judgment and to be validated! For once it can be about them. And access to this incredible benefit can sometimes be as simple as catching the coach in the hallway – hey, you got a minute today? It’s not unusual for the seemingly unwilling individuals to benefit most and have the greatest outcomes. At one worksite, 80% of at-risk employees who agreed to an incentivized one-time face-to-face coaching session continued coaching without incentive.
Once the employee is able to see that their needs matter regardless of the demands around them, the coach can effectively lead them to available outside resources and the coach relationship can focus on what other things may be getting in the way of their personal needs. For many, unmanaged stress/anxiety and not valuing “self” is at the forefront. Other common mindset barriers like bad habits, "on and off" thinking, dieting mindsets, sabotage (the list goes on) are the core causes of unhealthy lifestyles – not lack of knowledge - but not fully understanding the underlying cause of their actions. Coaching can help them realize that they are capable of change even when life is hard. And then, they can start working on small goals that will improve their health and life that works for them.
Observing Medical Care (from the Trenches)
Coach conversations often turn to discussions of medical care. I’m certainly not in a position to question treatment, but I do feel it is important to empower employees to be stewards of their own health care. It’s proven that lifestyle factors play an important role in our overall health, but doctors don’t seem to provide this low cost prescription very well. For example:
ER and doctor visits often lead to expensive testing for chest pains, stomach issues, breathing problems or generalized aches and pains when the underlying cause is extreme stress/anxiety. I know their story. I know their stress. Many doctors don’t even ask the question.
Newly diagnosed diabetics (or pre-diabetics) are not sent to nutritional counseling, but instead the doctor prescribes metformin and merely instructs them to stop eating carbs.
Some doctors, whether intentionally or unintentionally “fat shame” their patients. I have heard the employee's stories often, which delays care and certainly doesn’t empower a patient to make changes in self care
It seems many primary care doctors specialize in sending patients to specialists. And specialists don’t talk to each other. The focus seems to be to figure out what is wrong within the scope of their practice. There is little “connecting of the dots” to see if one problem could be connected to another. Patients are passed from one specialist to another and the employer and employee are paying the bill – not to mention the loss in productivity.
There are other reocurring themes from stories employees tell about utlizing the health care system ranging from lack of care to over-care. I'll stop here as I have no expertise, only observation. And this blog is already way too long, but boy does it feel good to write it.
Given that many “evidence-based” wellness program analytics have now been challenged as misleading, maybe the industry could consider a less sophisticated, more holistic approach to presenting wellness value. An onsite coach is in a great position to report on what actually happened as a result of the investment in wellness - in real time. You don’t have to wait three years to see a change, it can be reported in as little as six months or even month-to-month.
Focusing on the internal factors that keep people from change will greatly improve outcomes in productivity, morale, retention, and dare I say, at some point, health care costs. If I were to put my benefits broker hat on (which I used to be for 15 years), I’d restructure my client’s wellness dollars and invest them in their people. Pull the money spent on the automation and technology to prove ROI and invest in putting experts in the trenches to work directly with the people and provide not only coaching services, but programming and culture change that is designed and delivered to meet their needs.
Let the coaches show the value by reporting on individualized improvements and observations, plus evaluations, testimonials and feedback by the employees themselves, those who the wellness program is supposed to serve. Your people will tell you if your investment is making a difference. Let them “show you the money”.